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West Visayas State University

COLLEGE OF ARTS AND SCIENCES


Iloilo City
1

Chapter 1

Introduction to the Study

Chapter One consists of six parts: (1) Background of

the Study; (2) Statement of the Problem and Hypothesis; (3)

Research Paradigm; (4) Significance of the Study; (5) Scope

and Delimitation of the Study; (6) Definition of Terms.

Part One, Background of the Study, gives the

background and the importance of the choice of the problem

including the variables.

Part Two, Statement of the Problem and Hypothesis,

describes the purpose for conducting the study and

enumerates the problems and the hypothesis tested.

Part Three, Research Paradigm, identifies the

independent and dependent variables.

Part Four, Significance of the Study, discusses the

benefits that may be derived from the study.

Part Five, Scope and Delimitation of the Study sets

the limit and scope of the study and the procedures used in

gathering of data.

Part Six, Definition of terms, defines the conceptual

and operational definitions of the important terms used.


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Background of the Study

Surgical thread or suture is the material used to hold

wound or cut together until it heals. The area that

requires a suture may be the result of injuries or surgery,

and the type of suture used depends on where in the body,

the surgical suture is needed. There are two types of

surgical thread; these are the absorbable and non-

absorbable surgical threads.

Musa textilis is a tree-like herb resembling the

banana in appearance, except for the distinguishing marks

in its leaves, trunk, color, formation, and the shape of

its fruit is heart. The leaves of banana are upright,

pointed, tapering and narrower. Its trunk is noted to be

smaller than that of banana's (Aznar, 2012).

Each sheath is composed of three layers: an outer

layer from which most of the fiber is obtained; the middle

layer which contains some fine white fiber, tensile

strength than that obtained from the outer layer; and the

inner layer which contains no fiber.

This study aimed to compare the selected fiber

characteristics: tensile strength and wound holding


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capacity of the banana thread and the two commercial

surgical threads.

Statement of the Problem

This study aimed to find out the potential of banana

(Musa textilis) fibers as a possible substitute for

surgical thread. Specifically, this study aimed to find

answers to the following questions:

1. What are the properties of surgical thread produced from

Banana (Musa textilis fibers in terms of the following:

a. Tensile strength

b. Wound holding capacity

2. Are there significant differences among the following

properties of banana fibers and the two commercial surgical

threads?

a. Tensile strength

b. Wound holding capacity


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Hypothesis

There are no significant differences in the tensile

strength and wound holding capacities produced by banana

thread and the two commercial surgical threads.

Research Paradigm

Independent Variables Dependent Variables

Banana thread Diameter

Absorbable
Commercial Tensile Strength
Surgical thread

Non-absorbable Wound Holding


Commercial
Surgical thread Capacity
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Significance of the Study

This study assessed the feasibility of banana fibers as

a possible source of cheap and locally manufactured surgical

fibers. Besides helping heal physical wounds, it may also

lighten the burden of people from having to pay expensive

commercial surgical thread.

Also, this study aimed to make alternative threads of

the plant sample commonly found in our locality.

Scope and Delimitation of the Study

This study was only limited to using banana fibers in

producing surgical thread. The researchers aimed to compare

the potential banana thread with commercially available

surgical thread in terms of tensile strength and elasticity

coefficient, adhesive property and capacity to hold the

wound close.

The banana plant was gathered from Brgy. Garangan,

Tapaz, Capiz around 7:00 in the morning. This was brought

to the strip maker to extract the fibers from the plant

sample. After extraction of banana fibers, evaluation was

done at Tuburan, Janiuay, Iloilo.


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Definition of Terms

The following were defined conceptually and

operationally for thorough understanding of the study terms

used:

Banana fibers – is made up of non-starch polysaccharides,

such as cellulose, dextrins, inulin, lignin, chitins, pectins,

beta-glucans, waxes and oligosaccharides (Ehrlich, 2013).

In this study, banana fibers are the materials used to

produce banana thread and the materials to be tested in the

study.

Surgical thread – it is a strand of material used for

closing wounds which is subsequently dissolved by the

tissue fluids (Farlex Incorporation, 2012).

In this study, banana fibers were made to match the

characteristics of surgical thread and were assessed for

comparability to commercial surgical thread.

Absorbable surgical thread – this surgical thread is

prepared either from the collagen of healthy mammals. Some

are absorbed rapidly, while others are treated or

chemically structured to lengthen absorption time (Shah,

2012).
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In this study, absorbable surgical thread was used as

one of the controls.

Non-absorbable surgical thread – it is a surgical

thread which are not digested by body enzymes or hydrolyzed

in body tissue (Shah, 2012).

In this study, non-absorbable surgical thread was used

as one of the controls.

Tensile strength test – it measures the force required

to pull something such as rope, wire, or a structural beam

to the point where it breaks (Hogan and Hogan, 2012).

In this study, tensile strength refers to one of the

tests used to evaluate the property of banana thread.

Wound holding capacity – it is an ability or power of

the “pig skin” to hold the wound closed using the spring

balance and surgical scissors (Hogan and Hogan, 2012).

In this study, wound holding capacity refers to one of

the tests used to evaluate the property of banana thread.


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Chapter 2

Review of Related Literature

This chapter presents review of related literature

involving the two commercial surgical threads and one of

the species banana plant.

Musa textilis

Musa textilis is a tree-like herb resembling the

banana in appearance, except for the distinguishing marks

in its leaves, trunk, color, formation, and the shape of

its fruit is heart. It is claimed to be stronger than the

real hemp and is three times stronger than cotton (Cebu

Furniture Industries Foundation, Inc.,2014).

Furthermore, it grows to a height of about 4.6-7.7 m.

The true stem of the plant is that part which has a

diameter of about 5 cm and bears the fruit. The trunk is

formed by this true stem and thickened leafstalks of the

leaves. It bears open leaves composed of fleshy, fiber less

core surrounded by overlapping leaf sheaths starting from

the base and extending nearly to the top.


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Each sheath is composed of three layers: an outer

layer from which most of the fiber is obtained; the middle

layer which contains some fine white fiber of flower

tensile strength than that obtained from the outer layer;

and the inner layer which contains no fiber. The fruit is a

small, inedible and full of seeds. The stalks turn reddish

brown at maturity (Cebu Furniture Industries Foundation,

Inc.,2014).

Florian, Kronkright and Norton (2012) noted that plant

fibers that have been fabricated by crude retting or simply

by striping the fibers from the plant usually include

remnants of other associated plant tissue with

characteristic cells or cell contents, such as crystals,

which aid in identification. Commercial fibers generally

are free of extraneous material; thus identification is

completely dependent on the fiber characteristics.

Direction of the twist in the thread and composition of the

thread are additional aids in determining whether the fiber

is of native or commercial origin.


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Surgical thread

Surgical threads or sutures are materials used to

close a wound. They are used in an attempt to improve and

speed healing. Pulling the edges of a wound together and

stitching help in healing process. Sutures are used to

close cuts from injuries or surgery. Moreover, they are

commonly used on the skin, internal tissues, organs, and

blood vessels (Agarwal, 2012).

Different types of materials can be used to close a

wound depending upon the style of wound, location and depth

in the body. The material can be special glue, staples,

animal protein or thread like materials. Furthermore, the

suture material comprises polyester, silk, nylon and

stainless steel wire (Agarwal, 2012).

According to the same author, these sutures can

further be absorbable or non-absorbable. The absorbable

ones get dissolved in the body on their own and do not

require removal while non-absorbable ones have to be

removed after specified time. The type of suture is decided

again by the location of the wound. The internal layers are

stitched by absorbable sutures and the upper or the skin

may be stitched by the non-absorbable sutures. Local or


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general anesthesia has to be given to the patient as per

the requirement before suturing.

Absorbable surgical thread

According to Zhan (2012), absorbable surgical thread

is made of materials which are broken down in tissue after

a given period of time, which depending on the material can

be from ten days to eight weeks. They are used therefore in

many of the internal tissues of the body. In most cases,

three weeks is sufficient for the wound to close firmly

(Zhan, 2012). The suture is not needed any more, and the

fact that it disappears is an advantage, as there is no

foreign material left inside the body and no need for the

patient to have the sutures removed.

According to the same author, absorbable surgical

threads were originally made of the intestines of sheep,

the so called catgut. The manufacturing process was similar

to that of natural musical strings for violins and guitars,

and also of natural strings for tennis racquets. Today, gut

sutures are made of specially prepared beef and sheep

intestine, and may be untreated (plain gut), tanned with

chromium salts to increase their persistence in the body


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(chromic gut), or heat-treated to give more rapid

absorption (fast gut).

Zhan (2012) further states that the major part of the

absorbable sutures used are now made of synthetic polymer

fibers, which may be braided or monofilament; these offer

numerous advantages over gut sutures, notably ease of

handling, low cost, low tissue reaction, consistent

performance and guaranteed non-toxicity. Furthermore, each

major suture manufacturer has its own proprietary

formulations for its brands of synthetic absorbable

sutures; various blends of polyglycolic acid (Vicryl for

example), lactic acid or caprolactone are common. In rare

cases, absorbable sutures can cause inflammation and be

rejected by the body rather than absorbed.

Non-absorbable surgical thread

Garcia describes a non-absorbable surgical thread as a

material used to hold a wound closed until it heals and the

suture can be removed. Surgeons typically use a non-

absorbable suture material outside the body, where it can

be easily accessed for removal. Moreover, a non-absorbable


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suture might be made of silk, cotton, steel, or a synthetic

material.

According to the same author, several synthetic non-

absorbable sutures provide different advantages based on

their use. A nylon material offers pliability and more

strength than silk. It typically remains stable for two

years and causes minimal reaction with tissue. Silk sutures

also last two years and are coated with silicone or

beeswax. Cotton loses half its strength within six months,

making it unsuitable as an internal suturing material. This

type of suture commonly contains a coating of fibers to

improve its strength. This non-absorbable suture material

might be useful for wounds on the face from plastic

surgery.

Moreover, the stainless steel represents one of the

most stable forms of a non-absorbable suture that lasts

indefinitely. Heart surgeons commonly use the material to

close the thoracic cavity after open-heart surgery. It is

also used by neurosurgeons and orthopedic surgeons to

permanently repair damage. Most people tolerate these

sutures without inflammation, but they tend to kink and are

considered hard to handle.


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Furthermore, a non-absorbable suture made from

polyester, for example, constitutes a long-lasting product

that produces few reactions with tissue. Other manmade

suture materials might offer superior elasticity or hold

knots wells. Doctors commonly choose the type they believe

will close an opening or wound without causing adverse

reactions.
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Chapter 3

Methodology

This chapter describes the methods that were used by

the researchers, (1) the Materials, (2) the Collection of

Plant Sample, (3) the Fiber Extraction (4) the Evaluation

processes, and (6) the Data analysis.

This research involved the treatment process of banana

(Musa textilis) fibers; spinning of degummed fibers, which

produces the thread and the quality evaluation of the

thread.

Preliminary Activities

Collection of Plant Sample. The banana pseudo stems

were collected from Brgy. Garangan, Tapaz, Capiz at seven

o’clock in the morning. A sample of the banana plant was

brought to Department of Agriculture for identification.

Two banana pseudo stems were used for the fiber extraction.

The banana fibers were extracted from banana pseudo

stems. The pseudo stems were peeled. The brown-green skin


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was thrown away retaining the cleaner or white portion

which was processed into knotted fibers.

Fiber Extraction. The fibers were extracted through

hand extraction machine containing either serrated or non-

serrated knives. The peel was clamped between the wood

plank and knife and hand-pulled through it, removing the

resinous material. The extracted fibers were sun-dried

which whitens the fiber.

After drying, the fibers were prepared for knotting. A

bunch of fibers was mounted or clamped on a stick to

facilitate segregation. Each fiber was separated according

to fiber sizes and grouped accordingly. In knotting the

fiber, each fiber was separated and knotted to the end of

another fiber manually. The separation and knotting was

repeated until bunches of unknotted fibers was finished to

form a long continuous strand.

The raw fibers underwent different processes. First,

the banana threads were soaked into distilled water for

cleansing. Then, the banana threads were washed thoroughly

and boiled again with tap water. Lastly, the threads went

through spinning.
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Spinning. The degummed fibers were manually spun using

10 strands per thread. The number of fibers depends on the

size of the fibers to approximate the size of the

commercially available surgical thread. The banana threads

were cut to a length of 10 inches.

Actual Conduct

Banana Fiber Evaluation

Tensile Strength Test. Forty threads were used for

this test, three for each trial for the banana thread and

three for commercially available surgical thread. The

thread was cut into a length of ten inches. Each thread was

suspended in a spring balance. Careful observations were

made as the threads were stretched until they break. The

mass measured with the aid of spring balance.

Adhesive Property. It is a test that measured the

capacity of the banana thread to absorb the bromoethylene

stain. This was tested on a “pig skin”. The “pig skin” was

cut by a gauge 16 blade with three parallel incisions 4 cm

long and 1 cm apart. The banana threads and the two

commercial surgical threads were used to close the wound


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using the square knot technique. A 0.2 ml of bromoethylene

blue was dropped over each stitched wound in a horizontal

plane (one drop over one centimeter of the incision line

released from a height of 0.5 cm). This was used to

evaluate the permeability of each banana thread on the

basis of the uptake of the stain by the wound bed. The

diffusion of the stain was followed up every 5 minutes,

with digital photos (3 per suture) taken from the banana

threads until the remaining stain, if any dried. The

permeability of the banana thread was determined by the

percentage of the thread that was colored by the stain.

Wound Holding Capacity. Nine “pig skins” measuring 3x2

inches were used for this test. To simulate a wound three

parallel, stitches were made on each skin using a gauge 16

surgical blade. Each cut is 4 cm long and are 1 cm apart.

The banana threads and commercial surgical threads were

used to close the wound using the square knot technique.

After closing the wound, the upper portion of the “pig

skin” was clipped by a surgical scissors that was attached

on the spring balance and the lower portion was clipped by

another surgical scissors. The “pig skin” was then


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stretched until one of the stitch give way the force is

then recorded. The measured force from the spring balance

was recorded, analyzed and composed.

Data Analysis

Descriptive Statistics. Mean was used to compare the

fiber characteristics of the banana thread and those two

commercial surgical threads.

Inferential Statistics. One-Way Analysis of Variance

was used to compare the fiber characteristics banana of the

banana thread and the two commercial surgical threads.


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Chapter 4

Results and Discussion

Chapter Four consists of Descriptive Data Analysis,

deals with the presentation, analysis and interpretation of

the diameter, tensile strength, and wound holding capacity

of banana surgical thread and the two commercial surgical

threads.

Descriptive Data Analysis

This experimental study was conducted in order to

determine the potential of banana (Musa textilis) fibers on

producing surgical thread.


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Diameter

Figure 1 shows the different diameter of produced

banana thread and the two commercial surgical threads. The

diameter of fine banana thread was 0.1 cm, medium banana

thread was 0.20 cm, absorbable commercial thread was 0.35

cm, and non-absorbable commercial thread was 0.30 cm.

0.4

0.35

0.3

0.25
centimeter

0.2

0.15

0.1

0.05

0
Banana thread Commercial thread Commercial thread
(medium) (absorbable) (non-absorbable)

Figure 1. Average diameter of banana surgical threads

and the two commercial surgical threads.


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Tensile Strength

Figure 2 shows the average tensile strengths of the

three threads that were tested. The average tensile

strength of banana thread was T=13.33N, absorbable thread

was T=23.33N; and non-absorbable was T=30.67N.

30

25

20
Newton

15

10

0
Banana thread Commercial thread Commercial thread
(medium) (absorbable) (non-absorbable)

Figure 2. Average tensile strength of banana surgical

threads and commercial surgical threads.


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Wound Holding Capacity

Figure 3 shows the different average of wound holding

capacity of banana thread and the two commercial available

surgical threads. The banana thread results was T=13.33N;

absorbable commercial surgical thread was T=24N; and non-

absorbable commercial surgical thread was T=26.67N.

30

25

20
Newton

15

10

0
Banana thread Commercial thread Commercial thread
(medium) (absorbable) (non-absorbable)

Figure 3. Average capacity of banana surgical threads

and commercial surgical threads to hold a wound.


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For the capacity of the surgical threads, the non-

absorbable commercial surgical thread has the highest

capacity to hold a wound compared to other surgical

threads. Thus, it is better than the absorbable commercial

surgical thread and banana thread. In this test, the banana

thread (fine) was disregarded since the thread can no

longer hold a wound.


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Inferential Data Analysis

Comparison of Wound Holding Capacity

Table 1 shows the One-Way Analysis of Variance table

for the comparison of the wound holding capacity of the

different threads that were tested. The result is

F(2.6)=6.962* and P=0.027 < α0.05. Since the P value is

less than the set alpha value of 0.05, the null hypothesis

is therefore rejected. Furthermore, the table of multiple

comparisons shows that the wound holding capacity of the

two commercial surgical threads are not significant from

each other, and are both significantly higher than that of

the banana threads.

Table 1. Comparison of the wound holding capacity of the

banana thread and the two commercial surgical threads.

Sum of Df Mean F Sig.


Squares Square

Wound holding Between 160.889 2 80.444 6.962* .027


capacity Groups
Within 69.333 6 11.556
Groups

Legend* significant at 0.05


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Table 1 shows that in terms of wound holding capacity,

there is a significant difference among the three surgical

threads used, F(2,6)=6.962<0.05. This may imply that the

non-absorbable commercial surgical thread has the most

effective in wound holding capacity as compared to the two

other surgical threads used.


In the post hoc table (Appendix D), the wound holding

capacity of banana thread shows lower significant

difference among the banana surgical thread and the two

commercial surgical threads.

Table 2. Comparison of the tensile strength of the banana

thread and the two commercial surgical threads.

Sum of Df Mean F Sig.


Squares Square

Total 230.222 8
Tensile Between 312.000 2 156.000 24.719* .001
strength Groups
Within 37.875 6 6.313
Groups
Total 349.875 8
Legend* significant at 0.05
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Table 2 shows in terms of tensile strength test, there is a

significant difference among the three surgical threads

used, F(2,6)=24.713<0.05. This may imply that the non-

absorbable commercial surgical thread has the highest

tensile strength as compared to the two other surgical

threads used.

In the post hoc table (Appendix E), the tensile

strength of banana thread shows lower significant

difference among the banana surgical thread and the two

commercial surgical threads.


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Discussion

According to Mukherjee (2014), there are many kinds of

sutures, with different properties suitable for various

uses. Sutures can be divided into two main groups:

absorbable and non-absorbable. An absorbable suture

decomposes in the body. It degrades as a wound or incision

heals. A non-absorbable suture resists the body's attempt

to dissolve it. Non-absorbable sutures may be removed by a

surgeon after a surface incision has healed.

Moreover, sutures are made from both man-made and

natural materials. Natural suture materials include silk,

linen, and catgut, which is actually the dried and treated

intestine of a cow or sheep. Synthetic sutures are made

from a variety of textiles such as nylon or polyester,

formulated specifically for surgical use.

Furthermore, synthetic absorbable sutures may be made

of polyglycolic acid, a glycolide-lactide copolymer or

polydioxanone, a copolymer of glycolide and trimethylene

carbonate while synthetic non-absorbable sutures may be

made of polypropylene, polyester, polyethylene

terephthalate, polybutylene terephthalate, polyamide,

different proprietary nylons, or Goretex.


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According to Mukhopadhyay, Fangueiro, Arpac and

Senturk (2008) bast fibers, like banana, are complex in

structure. They are generally lignocellulosic, consisting

of helically wound cellulose microfibrils in amorphous

matrix of lignin and hemicellulose. The cellulose content

serves as a deciding factor for mechanical properties along

with microfibril angle. A high cellulose content and low

microfibril angle impart desirable mechanical properties

for bast fibers.

The banana thread has low tensile strength and wound

holding capacity because it was made out of manual

processes without using any high machines nor aid of any

chemicals involved.
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Chapter 5

Summary, Conclusions, Implications and Recommendations

This Chapter contains three parts: (1) Summary of the

Findings, (2) Conclusions, (3) Implications and (4)

Recommendations.

Part One, Summary, reflects the vital points of the

study and presents the findings after analyzing the data

gathered.

Part Two, Conclusions, presents the decision drawn the

result of the study.

Part Three, Implications, clarifies the relationships

between the results in the study and the facts presented in

relation to the study.

Part Four, Recommendations, offers certain advice in

view of the conclusion given.


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Summary of the Findings

This study was conducted to determine the potential of

banana (Musa textilis) trunk fibers on producing surgical

thread.

This study sought answer to the following questions:

1. What are the properties of surgical thread produced

from banana (Musa textilis) fibers in terms of the

following:

a. Tensile strength

b. Wound Holding Capacity

2. Are there significant differences among the

properties of banana fibers and the two commercial surgical

threads?

a. Tensile strength

b. Wound Holding Capacity

Analysis of the gathered data revealed the following

findings.

1. a. Average tensile strength of the three threads

Banana-13.33N

Absorbable-23.33N

Non-absorbable-27.33N
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1. b. Average wound holding capacity of the three

threads

Banana-13.33N

Absorbable-24N

Non-absorbable-26.67N

2. a. Average tensile strength of the three threads

There is a significant difference on the tensile

strength produced by banana threads and the two

commercial surgical threads.

2. b. Average wound holding capacity of the three

threads

There is a significant difference on the wound

holding capacity produced by banana threads and the two

commercial surgical threads.


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Conclusions

Based on the results, the following conclusions were

formulated:

There are significant differences between the tensile

strength and wound holding capacities of by banana thread

and the two commercial surgical threads. However, in terms

of tensile strength and would holding capacity, the banana

surgical threads were not comparable to the two commercial

surgical threads.

Implications

The findings of this study showed that the banana

threads were not as good as to the absorbable and non-

absorbable surgical threads in terms of tensile strength

test and wound holding capacity.

This implies it is not practical to use banana threads

as surgical thread substitute.


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Recommendations

1. Perform the same test using other fibers of the plant

or family of banana.

2. Test the effects of the surgical threads to advance

procedures or processes.

3. Process the banana fiber and compare with other

commercially available fibers.


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References

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Cebu Furniture Industries Foundation, Inc. (2014). Abaca.

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Conjecture Corporation. (2012). What is Biodegradability.

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www.medical-dictionary.thefreedictionary.com.
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Florian M., Kronkright, D., and Norton, R. (2012). The

Conservation of Artifacts Made from Plant Materials.

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Garcia, M. (2013). What is a Non-Absorbable Sutures.

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www.madehow.com

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(2008). Banana Fibers–Variability and Fracture

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An innovative method to evaluate the suture compliance

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West Visayas State University
COLLEGE OF ARTS AND SCIENCES
Iloilo City
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Textile Exchange. (2009). Banana Fiber. Retrieved from

www.teonline.com

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Appendices

Appendix A

Diameter of Surgical Thread

Medium Absorbable Non-absorbable


(banana thread) (commercial (commercial thread)
thread)
0.20 cm 0.35 cm 0.30 cm

0.20 cm 0.35 cm 0.30 cm

0.20 cm 0.35 cm 0.30 cm


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Appendix B

Tensile Strength of Surgical Thread

Medium Absorbable Non-absorbable


(banana thread) (commercial (commercial thread)
thread)
13.5 N 22 N 32 N

13.75 N 24 N 24 N

12.75 N 24 N 26 N
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Appendix C

Wound Holding Capacity

Banana thread Absorbable Non-absorbable


(medium) (commercial thread) (commercial thread)

12 N 20 N 26 N

20 N 24 N 28 N

18 N 28 N 26 N
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Appendix D

Wound Holding Capacity


Thread type N Subset for
alpha = 0.05
1 2
16.666
Banana thread 3
67
Absorbable 24.000
Duncan surgical thread 3
00
a
Non-absorbable 26.666
3
surgical thread 67
Sig. 1.000 .374
Means for groups in homogeneous subsets are
displayed.

a. Uses Harmonic Mean Sample Size = 3.000.


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COLLEGE OF ARTS AND SCIENCES
Iloilo City
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Appendix E

Tensile Strength
Thread type N Subset for
alpha = 0.05
1 2
13.333
Banana thread 3
33
Absorbable 23.333
Duncan 3
a surgical thread 33
Non-absorbable 27.333
3
surgical thread 33
Sig. 1.000 .099
Means for groups in homogeneous subsets are
displayed.

a. Uses Harmonic Mean Sample Size = 3.000.

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