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Sample records for monofilament suture materials

  1. Bacterial adhesion to suture material in a contaminated wound model: Comparison of monofilament, braided, and barbed sutures.

    Science.gov (United States)

    Dhom, Jonas; Bloes, Dominik A; Peschel, Andreas; Hofmann, Ulf Krister

    2016-05-21

    Contaminated suture material plays an important role in the physiopathology of surgical site infections. Recently, suture material has been developed characterized by barbs projecting from a monofilament base. Claimed advantages for barbed sutures are a shortened wound closure time and reduced maximum wound tension. It has also been suggested that these sutures would be advantageous microbiologically. The aim of this study was to test the microbiological characteristics of the barbed Quill in comparison to the monofilament Ethilon II and the braided sutures Vicryl and triclosan-coated Vicryl Plus. In our study, sutures were cultivated on color-change agar with Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecium, Escherichia coli, and Pseudomonas aeruginosa and the halo size was measured. In a second study arm with longer cultivation bacterial growth was followed by antibiotic treatment. Ethilon II and Quill showed good comparable results, whereas large halos were found around Vicryl. Vicryl Plus results depended on triclosan sensitivity. After longer bacterial cultivation and antibiotic treatment, halos were up to 3.6 times smaller on Quill than on Vicryl (P <.001), but 1.4 times larger than on Ethilon II (P <.001) regarding S. aureus. Confocal microscopy analysis showed bacterial colonization between the braided filaments on Vicryl and beneath the barbs on Quill. From a microbiological perspective, barbed sutures can be recommended in aseptic surgery, but should only be used carefully in septic surgery. This article is protected by copyright. All rights reserved.

  2. Experimental evaluation of horse hair as a nonabsorbable monofilament suture

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    Swati R Yedke

    2013-01-01

    Full Text Available Background: Success of surgery depends on wound closure and healing. Ancients had coated many suture materials from plant and animal origin. As the quest for natural nonabsorbable, monofilament surgical suture continues, horsehair has been taken for study, which is mentioned in ancient literature. Objectives: Aim of the study was to evaluate detail mechanical and biophysical properties of horsehair. Materials and Methods: Physical properties, that are diameter, straight pull and knot pull tensile strength, bioburden, sterility tests were performed. Visual and histological wound healing parameters were studied in experimental Wistar rat incision wound model. Two experimental wounds about 5 cm long were created on each side of dorsal midline. Each animal received two sutures-Horsehair 4-0 and Ethilon 4-0. The sutured areas were grossly examined on 3 rd and 7 th days for visual observations like congestion, edema, infection, wound disruption, and impression of suture material on healed wound and then subjected for histological study. Results: Revealed that horsehair has got diameter of 0.19 mm which complies with the 4-0 size USP standard. Straight pull tensile strength was found 0.5851 ± 0.122 kg and knot pull tensile strength was 0.3998 ± 0.078 kg, which complies with the standards of United State Pharmacopia for class II nonabsorbable suture materials. In vivo study revealed that there was no evidence of edema, congestion, and discharge in both the groups. Wounds healed with minimum impressions of suture material with minimum scar mark. Mean histological scoring shows very mild tissue reaction. Conclusion: Horsehair has got properties of standard suture material except low tensile strength and hence can be used in reconstructive, plastic surgeries, and ophthalmic surgeries.

  3. MonoMax Suture: A New Long-Term Absorbable Monofilament Suture Made from Poly-4-Hydroxybutyrate

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    Erich K. Odermatt

    2012-01-01

    Full Text Available A long-term absorbable monofilament suture was developed using poly-4-hydroxybutyrate (P4HB made from a biosynthetically produced homopolymer of the natural metabolite 4-hydroxybutyrate. The suture, called MonoMax, has prolonged strength retention. At 12 weeks, a size 3-0 MonoMax suture retains approximately 50% of its initial tensile strength in vivo and is substantially degraded in one year with minimal tissue reaction. In contrast, PDS II monofilament suture (Ethicon, Inc., Somerville, NJ has no residual strength in vivo after 12 weeks. In vivo, the MonoMax suture is hydrolyzed primarily by bulk hydrolysis, and is then degraded via the Krebs cycle. MonoMax is substantially more compliant than other monofilament sutures, and incorporates an element of elasticity. Its tensile modulus of 0.48 GPa is approximately one-third of the value of the PDS II fiber providing an exceptionally flexible and pliable fiber with excellent knot strength and security. These features are further enhanced by the fiber's elasticity, which also improves knot security and may help prevent wound dehiscence. Because of its performance advantages, this suture may find clinical utility in applications where prolonged strength retention, and greater flexibility are required, particularly in procedures like abdominal wall closure where wound dehiscence is still a significant post-surgical complication.

  4. Unidirectional barbed suture versus standard monofilament for urethrovesical anastomosis during robotic assisted laparoscopic radical prostatectomy

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    Marc Manganiello

    2012-02-01

    Full Text Available PURPOSE: V-LocTM180 (Covidien Healthcare, Mansfield, MA is a new unidirectional barbed suture that may reduce loss of tension during a running closure. We evaluated the use of the barbed suture for urethrovesical anastomosis (UVA during robotic assisted laparoscopic prostatectomy (RALP. Time to completion of UVA, post-operative anastomotic leak rate, and urinary incontinence were compared in patients undergoing UVA with 3-0 unidirectional-barbed suture vs. 3-0 MonocrylTM (Ethicon, Somerville, NJ. MATERIALS AND METHODS: Data were prospectively collected for 70 consecutive patients undergoing RALP for prostate cancer between November 2009 and October 2010. In the first 35 patients, the UVA was performed using a modified running van Velthoven anastomosis technique using two separate 3-0 monofilament sutures. In the subsequent 35 patients, the UVA was performed using two running novel unidirectional barbed sutures. At 7-12 days postoperatively, all patients were evaluated with a cystogram to determine anastomotic integrity. Urinary incontinence was assessed at two months and five months by total daily pad usage. Clinical symptoms suggestive of bladder neck contracture were elicited. RESULTS: Age, PSA, Gleason score, prostate size, estimated blood loss, body mass index, and clinical and pathologic stage between the 2 groups were similar. Comparing the monofilament group and V-LocTM180 cohorts, average time to complete the anastomosis was similar (27.4 vs. 26.4 minutes, p = 0.73 as was the rate of urinary extravasation on cystogram (5.7 % vs. 8.6%, p = 0.65. There were no symptomatic bladder neck contractures noted at 5 months of follow-up. At 2 months, the percentage of patients using 2 or more pads per day was lower in the V-LocTM180 cohort (24% vs. 44%, p < 0.02. At 5 months, this difference was no longer evident. CONCLUSIONS: Time to complete the UVA was similar in the intervention and control groups. Rates of urine leak were also comparable

  5. Torsion of monofilament and polyfilament sutures under tension decreases suture strength and increases risk of suture fracture.

    LENUS (Irish Health Repository)

    Hennessey, D B

    2012-08-01

    A continuous running suture is the preferential method for abdominal closure. In this technique the suture is secured with an initial knot and successive tissue bites are taken. At each tissue bite, the needle is rotated through the tissue; in doing so, the suture can twist around the knot which acts as an anchor.

  6. Suture Materials in Ophthalmic Surgery

    OpenAIRE

    KÖHLE, Ülkü; Demir, Canser Yılmaz

    2003-01-01

    Suture materials is one of the basic subjects which every surgeon should know. The operation of suturing, sewing together two sides of a wound, is probably one of the oldest in the history of medicine. Its purpose is to aid healing as atraumatically as possible and it has mainly the mechanical effect of holding the wound edges together. Different suture materials have been manufactured. Each material is suited to different types of tissue, but all must posses certain character...

  7. Influence of different types of surgical suture material on the intensity of tissue reaction in oral cavity

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    Mirković Siniša M.

    2008-01-01

    Full Text Available Throughout the history the most diverse suture material have been used for closing and suturing surgical wounds. The four basic features of suture material are described: knot safety, stretch capacity, tissue reactivity and wound safety. Tissue reaction, even the minimum one, which develops during the first to seven days after applying the suture in the tissue. The aim of this study was to investigate influence of a monofilament suture material (nylon on the intensity of local tissue reaction in experimental conditions, and to compare it with the multifilament suture used in the routine practice of oral surgery (silk. This investigation is a prospective experimental study carried out on Wistar rats. The experiment included 30 animals, in which Black Silk (thickness 4-1 and Nylon (thickness 4-0 were applied in the upper and lower jaw, respectively. To monitor tissue reaction on different suture materials the following parameters were used: coagulum formation, presence of polymorphonuclear leukocytes, presence of macrophages and granuloma, formation of epithelial bridge and connective tissue, collagen synthesis, granulomatous tissue formation and presence of fibrous tissue. After comparing parameters for the intensity of tissue reaction to the investigate suture materials by suturing the oral mucosa, certain advantage could be given to the monofilament suture materials.

  8. Influence of different types of surgical suture materials on mehanical damage of oral mucosa

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    Mirković Siniša

    2011-01-01

    Full Text Available Introduction. Throughout history many kinds of different suture materials have been used for closing and suturing surgical wounds. Medical literature describes four basic characteristics of suture material: knot safety, tensile strength, tissue reaction and wound safety. The tissue reaction is reflected in an inflammatory response, which, though minimal, occurs during first two to seven days after implanting suture into the tissue. The aim of this research was to investigate whether different suture materials affect the development of decubital damage of oral mucosa, which to a great extent can compromise the process of wound healing. Material and methods. The investigation was designed as a prospective clinical study including 150 patients of both genders, aged between 25 and 60. The patients were distributed into three groups of 50 persons. The suture Black Silk was used in the first group, designated as a control group. Nylon and Vicril were used in the second and third group, i.e. experimental groups, respectively. Decubital damage of the surrounding soft tissues was the main parameter for monitoring the effects of selected suture materials on the oral mucosa. Conclusion. The comparison of results obtained for the investigated suture materials after suturing oral mucosa revealed that certain advan­tage could be given to synthetic monofilament suture materials

  9. Evaluation of four suture materials for surgical incision closure in Siberian sturgeon

    Science.gov (United States)

    Boone, S. Shaun; Hernandez, Sonia M.; Camus, Alvin C.; Peterson, Douglas C.; Jennings, Cecil A.; Shelton, James L.; Divers, Stephen J.

    2015-01-01

    The visual and microscopic tissue reactions to the absorbable monofilament Monocryl, absorbable monofilament triclosan-coated Monocryl-Plus, absorbable multifilament Vicryl, and nonabsorbable monofilament Prolene were evaluated for their use of surgical closure in Siberian Sturgeon Acipenser baerii. Postoperative assessments were conducted at 1, 2, 8, 12, and 26 and 55 weeks to visually evaluate the surgical incision for suture retention, incision healing, erythema, and swelling. Incisions were also assessed microscopically at 1, 2, and 8 weeks for necrosis, inflammation, hemorrhage, and fibroplasia. The results indicated that incisions closed with either Vicryl or Prolene suture materials were more likely to exhibit more erythema or incomplete healing compared with those closed with Monocryl or Monocryl-Plus. The surgical implantation of a transmitter in the coelomic cavity did not significantly affect the response variables among the four suture materials. Monocryl or Monocryl-Plus were equally effective and superior to other suture materials used for closing surgical incisions in Siberian Sturgeon or closely related species of sturgeon. Furthermore, Monocryl or Monocryl-Plus may decrease the risk of transmitter expulsion through the incision, as surgical wounds appear to heal faster and exhibit less erythema compared with those closed with Vicryl.

  10. Flow resistance of textile materials, Part I: Monofilament fabrics

    NARCIS (Netherlands)

    Gooijer, H.; Warmoeskerken, M.M.C.G.; Groot Wassink, J.

    2003-01-01

    This paper describes the relation between the flow resistance of a textile material and its geometry. A literature survey reveals that the orifice model is most suited to modeling the flow resistance of woven fabrics, but applications of this model were, until now, restricted to relatively open fabr

  11. Choice of surgical suture material used in oral cavity: Clinical study

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    Mirković Siniša

    2010-01-01

    Full Text Available Introduction. Historical data on closing and suturing of surgical wounds describe a wide range of various suture materials. The choice of the surgical catgut, i.e. type and diameter, depends on the localization, characteristics and condition of the tissue to be treated. From the stand-point of oral-surgical practice the following clinical parameters are of the outstanding importance regarding the choice of suture material: accumulation of soft deposits on the sutures, decubitus of the adjacent soft tissues and dehiscence of the operative wound. Aim. The aim of this research was to determine the correlation between different types of suture materials and accumulation of soft deposits on the sutures, decubitus of the adjacent soft tissues and dehiscence of the operative wound. Material and methods. Our prospective clinical study included 150 patients distributed into three groups of 50 subjects. The surgical procedure performed on each patient involved resection (apicoectomy of the tooth root end in the intercanine sector of the upper jaw. The following suture materials were applied: BLACK SILK 5-0, NYLON 5-0 and VICRYL 5-0. The effects of the selected sutures were evaluated by using several parameters: accumulation of soft deposits, wound dehiscence and decubitus of the adjacent soft tissues. The effects of the applied sutures were recorded on days 2, 5 and 7 after the surgery. Conclusion. The comparison of cited parameters of the investigated materials after suture of oral cavity mucosa revealed that none of the used material was ideal; however, a certain preference might be given to the synthetic monofilament suture materials.

  12. Flexor tendon repair: a comparative study between a knotless barbed suture repair and a traditional four-strand monofilament suture repair.

    LENUS (Irish Health Repository)

    Joyce, C W

    2014-01-01

    We compared the tensile strength of a novel knotless barbed suture method with a traditional four-strand Adelaide technique for flexor tendon repairs. Forty fresh porcine flexor tendons were transected and randomly assigned to one of the repair groups before repair. Biomechanical testing demonstrated that the tensile strengths between both tendon groups were very similar. However, less force was required to create a 2 mm gap in the four-strand repair method compared with the knotless barbed technique. There was a significant reduction in the cross-sectional area in the barbed suture group after repair compared with the Adelaide group. This would create better gliding within the pulley system in vivo and could decrease gapping and tendon rupture.

  13. Evaluation of surgical implantation of electronic tags in European eel and effects of different suture materials

    DEFF Research Database (Denmark)

    Thorstad, Eva B.; Økland, Finn; Westerberg, Håkan

    2013-01-01

    Effects of implanting data-storage tags in European eel, Anguilla anguilla, and the suitability of different suture materials (braided permanent silk, permanent monofilament, absorbable and absorbable antibacterial) were examined. The tags consisted of an electronic unit and three floats on a wire....... Antibacterial treatment had no effect on inflammation or healing rates. After 6 months, the tag started to become expelled through the incision in five fish (12%). The internal reaction appeared stronger around the floats, suggesting that the coating material of the floats created a tissue reaction, which...

  14. Comparison of Piezoresistive Monofilament Polymer Sensors

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    Mark Melnykowycz

    2014-01-01

    Full Text Available The development of flexible polymer monofilament fiber strain sensors have many applications in both wearable computing (clothing, gloves, etc. and robotics design (large deformation control. For example, a high-stretch monofilament sensor could be integrated into robotic arm design, easily stretching over joints or along curved surfaces. As a monofilament, the sensor can be woven into or integrated with textiles for position or physiological monitoring, computer interface control, etc. Commercially available conductive polymer monofilament sensors were tested alongside monofilaments produced from carbon black (CB mixed with a thermo-plastic elastomer (TPE and extruded in different diameters. It was found that signal strength, drift, and precision characteristics were better with a 0.3 mm diameter CB/TPE monofilament than thick (~2 mm diameter based on the same material or commercial monofilaments based on natural rubber or silicone elastomer (SE matrices.

  15. Comparison of suture materials for subcuticular skin closure at cesarean delivery.

    Science.gov (United States)

    Tuuli, Methodius G; Stout, Molly J; Martin, Shannon; Rampersad, Roxane M; Cahill, Alison G; Macones, George A

    2016-10-01

    Subcuticular skin closure with suture after cesarean has been shown to result in lower rates of wound complications than with staple closure. However, the optimal choice of suture material for subcuticular skin closure is unclear. Vicryl (a braided multifilament synthetic suture; Ethicon, Somerville, NJ) and Monocryl (a monofilament synthetic suture; Ethicon) are the commonly used suture materials for subcuticular closure of transverse skin incisions after cesarean in the United States. Whereas in vitro and animal studies suggest multifilament suture materials may be associated with a higher risk of wound infection than monofilament sutures, clinical data on their relative effectiveness are limited. We sought to test the hypothesis that Vicryl is associated with a higher rate of wound complications than Monocryl. This is a secondary analysis of data from a randomized trial in which pregnant women undergoing scheduled or unscheduled cesareans were randomly assigned to preoperative skin preparation with either chlorhexidine-alcohol or iodine-alcohol. Women with low transverse skin incisions who were closed with either 4-0 Monocryl or 4-0 Vicryl were included in this analysis. Choice of suture material was at the discretion of the operating physician. The primary outcome was superficial or deep surgical site infection within 30 days after cesarean. Secondary outcomes were other wound complications. Outcomes were compared between the 2 groups using univariable and multivariable statistics. Of 1082 patients who had follow-up after discharge in the primary trial, 871 had subcuticular suture: 180 with 4-0 Vicryl and 691 with 4-0 Monocryl. Skin closure with Vicryl or Monocryl did not significantly differ between women allocated to chlorhexidine-alcohol or iodine-alcohol (51.1% vs 49.4%, P = .67). There was no significant difference in the risk of surgical site infection in women closed with Vicryl compared with Monocryl (11 [6.1%] vs 35 [5.1%]; P = .58; adjusted odds

  16. Flexor Tenorrhaphy Using Absorbable Suture Materials

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    Hyung Joo Kang

    2012-07-01

    Full Text Available Background Nonabsorbable sutures are favorable for repairing flexor tendons. However,absorbable sutures have performed favorably in an animal model.Methods Two-strand sutures using the interlocking modified Kessler method with polydioxanoneabsorbable sutures 4-0 were used to repair completely ruptured flexor tendons in 55 fingersfrom 41 consecutive patients. The medical records of average 42 follow up weeks were analyzedretrospectively. The data analyzed using the chi-squared test, and Fisher’s exact test was used forpostoperative complications. The results were compared with those of other studies.Results Among the index, middle, ring, and little fingers were injured in 9, 17, 16, and13 fingers, respectively. The injury levels varied from zone 1 to 5. Of the 55 digits in ourstudy, there were 26 (47% isolated flexor digitorum profundus (FDP injuries and 29 (53%combined FDP and with flexor digitorum superficialis injuries. Pulley repair was also conducted.Concomitant injuries of blood vessels and nerves were found in 17 patients (23 fingers; nerveinjuries occurred in 5 patients (10 fingers. Two patients had ruptures (3.6%, and one patienthad two adhesions (3.6%. Using the original Strickland criteria, all the patients were assessedto be excellent or good. Also, fibrosis and long-term foreign body tissue reactions such as stitchgranuloma were less likely occurred in our study. Compared to the Cullen’s report that usednonabsorbable sutures, there was no significant difference in the rupture or adhesion rates.Conclusions Therefore, this study suggests that appropriate absorbable core sutures can beused safely for flexor tendon repairs.

  17. EFFECTS OF DIFFERENT SUTURE MATERIALS ON TISSUE HEALING

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    Fırat SELVİ

    2016-01-01

    Full Text Available Purpose: The purpose of this study was to investigate the healing differences in between four different widely used suture materials in the oral surgery practice, including silk (Perma- Hand; Ethicon, INC., Somerville, NJ, USA, polypropylene (Prolene; Ethicon, INC., Somerville, NJ, USA, coated polyglactin 910 (Ethicon, INC., Somerville, NJ, USA. and polyglecaprone 25 (Ethicon, INC., Somerville, NJ, USA . Materials and Methods: 20 male rats were randomly allocated into two groups depending on their sacrification days (post-operative 1st and the 7th days. Four longitudinal incision wounds, each 1cm in size, were created on the dorsum of each animal which were then primarily closed with four different types of sutures. Results: The effects of these suture materials on soft tissue healing were compared histopathologically, by means of density of the cells, necrosis, fibrosis, foreign body reaction, the presence of cells of acute and chronic infection. No statistically significant difference was observed between the groups regarding the density of the cells, necrosis, fibrosis, foreign body reaction, and the presence of the cells of acute & chronic infections. Of note, propylene showed slightly less tissue reaction among the other materials. Conclusion: The results of our study showed that there is no only one ideal suture material for surgical practice. The factors related to the patient, the type of the surgery and the quality of the tissue are important to decide an appropriate suture material.

  18. Stress-Softening and Residual Strain Effects in Suture Materials

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    Alex Elías-Zúñiga

    2013-01-01

    Full Text Available This work focuses on the experimental characterization of suture material samples of MonoPlus, Monosyn, polyglycolic acid, polydioxanone 2–0, polydioxanone 4–0, poly(glycolide-co-epsilon-caprolactone, nylon, and polypropylene when subjected to cyclic loading and unloading conditions. It is found that all tested suture materials exhibit stress-softening and residual strain effects related to the microstructural material damage upon deformation from the natural, undistorted state of the virgin suture material. To predict experimental observations, a new constitutive material model that takes into account stress-softening and residual strain effects is developed. The basis of this model is the inclusion of a phenomenological nonmonotonous softening function that depends on the strain intensity between loading and unloading cycles. The theory is illustrated by modifying the non-Gaussian average-stretch, full-network model to capture stress-softening and residual strains by using pseudoelasticity concepts. It is shown that results obtained from theoretical simulations compare well with suture material experimental data.

  19. Comparison of Subcuticular Suture Materials in Cesarean Skin Closure

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    Pınar Solmaz Hasdemir

    2015-01-01

    Full Text Available Aim. Comparison of the rate of wound complications, pain, and patient satisfaction based on used subcuticular suture material. Methods. A total of 250 consecutive women undergoing primary and repeat cesarean section with low transverse incision were prospectively included. The primary outcome was wound complication rate including infection, dehiscence, hematoma, and hypertrophic scar formation within a 6-week period after operation. Secondary outcomes were skin closure time, the need for use of additional analgesic agent, pain score on numeric rating scale, cosmetic score, and patient scar satisfaction scale. Results. Absorbable polyglactin was used in 108 patients and nonabsorbable polypropylene was used in 142 patients. Wound complication rates were similar in primary and repeat cesarean groups based on the type of suture material. Skin closure time is longer in nonabsorbable suture material group in both primary and repeat cesarean groups. There was no difference between groups in terms of postoperative pain, need for additional analgesic use, late phase pain, and itching at the scar. Although the cosmetic results tended to be better in the nonabsorbable group in primary surgery patients, there was no significant difference in the visual satisfaction of the patients. Conclusions. Absorbable and nonabsorbable suture materials are comparable in cesarean section operation skin closure.

  20. Influence of surgical sutures on wound healing

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    Mirković Siniša

    2010-01-01

    Full Text Available Historical data on closing and suturing of surgical wounds describe a wide range of various suture materials. The choice of the surgical catgut, i.e. the type and diameter, depends on the locality, characteristics and condition of the tissue to be treated. From the standpoint of oral-surgical practice the following clinical parameters are of outstanding importance with respect to the selection of suture material: accumulation of soft deposits on the sutures, score of the adjacent soft tissues and dehiscence of the operative wound. Our prospective clinical study included 150 patients distributed into three groups of 50 subjects. The surgical procedure performed on each patient involved resection (apicotomy of the tooth root end in the intercanine sector of the upper jaw. The following suture materials were applied: Black Silc 5-0, Nylon 5-0 and Vicryl 5-0. The effects of the selected sutures were evaluated according to the wound dehiscence. The effects of the applied sutures were recorded on Days 2, 5 and 7 after the surgery. The comparison of cited parameters of the investigated materials after suturing the oral mucosa revealed that none of the used material was ideal; however, a certain advantage might be given to the synthetic monofilament suture materials.

  1. Does UV disinfection compromise sutures? An evaluation of tissue response and suture retention in salmon surgically implanted with transmitters

    Energy Technology Data Exchange (ETDEWEB)

    Walker, Ricardo W.; Brown, Richard S.; Deters, Katherine A.; Eppard, M. B.; Cooke, Steven J.

    2013-10-01

    Ultraviolet radiation (UVR) can be used as a tool to disinfect surgery tools used for implanting transmitters into fish. However, the use of UVR could possibly degrade monofilament suture material used to close surgical incisions. This research examined the effect of UVR on monofilament sutures to determine if they were compromised and negatively influenced tag and suture retention, incision openness, or tissue reaction. Eighty juvenile Chinook salmon Oncorhynchus tshawytscha were surgically implanted with an acoustic transmitter and a passive integrated transponder. The incision was closed with a single stitch of either a suture exposed to 20 doses of UV radiation (5 minute duration per dose) or a new, sterile suture. Fish were then held for 28 d and examined under a microscope at day 7, 14, 21 and 28 for incision openness, ulceration, redness, and the presence of water mold. There was no significant difference between treatments for incision openness, redness, ulceration or the presence of water mold on any examination day. On day 28 post-surgery, there were no lost sutures; however, 2 fish lost their transmitters (one from each treatment). The results of this study do not show any differences in negative influences such as tissue response, suture retention or tag retention between a new sterile suture and a suture disinfected with UVR.

  2. Biocompatibility and biomechanical analysis of elastic TPU threads as new suture material.

    Science.gov (United States)

    Vogels, Ruben R M; Lambertz, Andreas; Schuster, Philipp; Jockenhoevel, Stefan; Bouvy, Nicole D; Disselhorst-Klug, Catherine; Neumann, Ulf P; Klinge, Uwe; Klink, Christian D

    2017-01-01

    High suture tension is one of the causes for many wound-healing problems. Constriction of tissue within the suture loops of nonelastic sutures can lead to cutting of the suture through tissues and necrosis of the tissue within these loops. The use of elastic materials in new suture types could give the material the ability to adapt tension to the tissue requirements and subsequently lead to more vital tissue within its loops. We evaluated the foreign body host response, as indicator of biocompatibility, to a new thermoplastic poly(carbonate) urethane (TPU) synthetic suture material in a rat model compared with standard nonelastic polypropylene (PP) sutures. Tissue samples were collected at 7 and 21 days, and host response was evaluated. Subsequently, suture tension curves of the new elastic sutures for the first 30 min after knotting were recorded in a pig model. The new TPU sutures showed an improved foreign body response when compared with that of PP, with a reduction in the amount of macrophages surrounding the material. Tension experiments showed a superior tension curve for TPU sutures, with a major reduction in peak suture tension when compared with that of standard PP sutures, while still retaining adequate tension after 30 min. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 99-106, 2017.

  3. Interrupted or continuous-intradermal suturing? Statistical analysis of postoperative scars

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    Elif Sarı

    2014-12-01

    Full Text Available Background and Design: Postoperative scar development is an important problem for patients treated in plastic surgery clinics. Most patients think that continuous intradermal suturing is superior to interrupted suturing because they assume that it creates less scarring. We evaluated scars that form following intradermal and interrupted suturing. This article presents our controlled study that objectively compared the scars on patients' faces using a wound evaluation scale. Materials and Methods: Thirty-five patients, who had undergone operations on the bilateral cheeks, were included in this study. Thirty patients were female; five patients were male. Their mean age was 40.05 years. The average scar evaluation time after surgery was 9.05 months. Elliptical excisions were made on the lesions under local anesthesia. The incisions on the right cheeks were sutured with 6/0 monofilament nonabsorbable sutures using the continuous intradermal suturing technique. The left cheek incisions were sutured with same sutures using the interrupted suturing method. Results: The patients were evaluated 7–11 months after operation (mean: 9.05 months using the Stony Brook Scar Evaluation Scale. A Related Samples T-test was used for statistical evaluation of the differences between the suturing techniques. No significant differences were noted in scar formation between the two suturing methods (p>0.05. Conclusion: We found no differences in scar formation between the two frequently used suturing techniques studied here. We believe that the suturing technique is a less important determinant of scar formation than are other factors.

  4. Effects of myrrh on the strength of suture materials: an in vitro study.

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    Alshehri, Mohammed A; Baskaradoss, Jagan Kumar; Geevarghese, Amrita; Ramakrishnaiah, Ravikumar; Tatakis, Dimitris N

    2015-01-01

    The present in vitro study sought to determine the effects of myrrh-containing solutions on common suture materials used in periodontal surgery. Three commonly used suture materials (silk, polyglactin 910, polytetrafluoroethylene) were immersed in four thermostatically controlled experimental media to simulate daily oral rinsing activity, namely -artificial saliva, normal saline solution with 0.2% Commiphora myrrh, full-concentration (100%) Commiphora myrrh oil, and a myrrh-containing commercial mouthwash. Tensile strength was measured at the end of each day using an Instron tensile testing machine. Silk sutures were susceptible to tensile strength loss when exposed to 0.2% myrrh solution once daily for 5 days. Myrrh-containing commercial mouthwash had no effect on tensile strength, but all three suture materials lost tensile strength when exposed to 100% myrrh oil. For patients that routinely use myrrh mouthwashes postoperatively, findings of this study suggested that silk sutures might not be the optimal material choice.

  5. Comparison of antibacterial-coated and non-coated suture material in intraoral surgery by isolation of adherent bacteria

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    Klaus Pelz

    2015-09-01

    In terms of the total number of oral bacteria, and especially oral pathogens, that adhered to suture material, no reduction was demonstrated for Vicryl Plus. The use of triclosan-coated suture material offers no advantage in intraoral surgery.

  6. A clinical study on the influence of suturing material on oral wound healing

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    Gazivoda Dragan

    2015-01-01

    Full Text Available Background/Aim. Suture materials play an important role in healing, enabling reconstruction and reassembly of tissue separated by the surgical procedure or trauma, and at the same time facilitating and promoting healing and hemostasis. Suture materials are used daily in oral surgery, and are considered to be substances most commonly implanted in human body. The aim of this clinical study was to examine the speed of wound healing and complications incidence, after the use of three different absorbable synthetic suture materials in oral surgery (catgut, Dexon and Vicryl rapide, and to ascertain which one is the most suitable for oral surgery. Methods. The study was conducted on 96 patients undergoing root resection or surgical extraction of third molars. Each of the suture materials (catgut, Dexon and Vicryl rapide was used for 8 root resections and 8 surgical third molar extractions in the maxilla, as well as in the mandible (a total of 32 surgical interventions for each suture material. Results. The faster wound healing was obtained with Vicryl rapide compared to other two suturing material tested. There was no significant difference regarding the presence of local reaction in all the three groups of patients on the 21st postoperative day. Conclusion. The results of our clinical study point out that Vycrilrapid contributes more than catgut or Dexon to faster healing of human wounds, with fewer incidences of wound dehiscence and milder local reactions.

  7. Comparison of seven different suture materials in the feline oral cavity.

    Science.gov (United States)

    DeNardo, G A; Brown, N O; Trenka-Benthin, S; Marretta, S M

    1996-01-01

    Seven different suture materials were implanted into the oral tissues of 12 cats. The sutures and surrounding tissues were retrieved en bloc from each of two cats on days one, three, seven, 14, 21, and 28 postimplantation. Tissue reaction and suture duration were evaluated by gross visual observation and histological examination. Chromic gut disappeared between days three and seven; polyglactin 910 disappeared between days 14 and 21; and polyglycolic acid disappeared as early as seven to 14 days. Polydioxanone still was intact at day 28 and is recommended as an absorbable material for procedures in which longer healing time is anticipated. All the nonabsorbable suture materials (i.e., polypropylene, stainless steel, and nylon) were intact at day 28 postimplantation. Visual inspection showed polypropylene to have the least tissue reaction.

  8. Influence of suturing material on wound healing: Experimental study in dogs

    Directory of Open Access Journals (Sweden)

    Gazivoda Dragan

    2015-01-01

    Full Text Available Background/Aim. The most common materials implanted in the human organism are suture materials that are classified on the basis of several criteria, usually the origin, structure, and properties. The properties of suture materials are related to its absorbability and non-absorbability. When using resorbable materials it is of great importance to determine whether its absorbability and tensile strength help wound healing in function of time. Sutures themselves can become a source of inflammation, that may reduce or compromise the potential of reparation and regeneration. The aim of this experimental study on dogs was to ascertain whether the absorption rate and the degree of local tissue reactions differ from information provided by the manufacturers, whether there are differences between the applied suture materials and which of the used suture materials have better effect on wound healing. Methods. Experimental testing of the selected suture materials basic characteristics was performed on 6 German Shepherd dogs, which, after induction of general anesthesia, were made 3 identical incisions each in all 4 quadrants (left and right side of the upper and lower jaws, so that 12 horizontal incisions were formed, 10 mm long, 20-25 mm distant from one another, on each animal. Randomly, incisions were stitched up in the following order, starting from back to front: catgut, Dexon®, Vicryl-Rapid®. The experiment was terminated by histopathological examination of tissue samples, taken on postoperative day 3, 7, 14 and 21 in order to identify the effect of healing and the degree of local reaction. Results. The obtained results suggest that catgut has the highest absorption rate, while Dexon® the lowest. Vicryl-Rapid® causes the lowest level of local reactions, while Dexon® the highest. Conclusion. There is no ideal suture material because various patient factors also influence the wound healing process.

  9. VEGF-releasing suture material for enhancement of vascularization: development, in vitro and in vivo study.

    Science.gov (United States)

    Bigalke, Christian; Luderer, Frank; Wulf, Katharina; Storm, Thilo; Löbler, Marian; Arbeiter, Daniela; Rau, Bettina M; Nizze, Horst; Vollmar, Brigitte; Schmitz, Klaus-Peter; Klar, Ernst; Sternberg, Katrin

    2014-12-01

    As it has been demonstrated that bioactive substances can be delivered locally using coated surgical suture materials, the authors developed a vascular endothelial growth factor (VEGF)-releasing suture material that should promote vascularization and potentially wound healing. In this context, the study focused on the characterization of the developed suture material and the verification of its biological activity, as well as establishing a coating process that allows reproducible and stable coating of a commercially available polydioxanone suture material with poly(l-lactide) (PLLA) and 0.1μg and 1.0μg VEGF. The in vitro VEGF release kinetics was studied using a Sandwich ELISA. The biological activity of the released VEGF was investigated in vitro using human umbilical vein endothelial cells. The potential of the VEGF-releasing suture material was also studied in vivo 5days after implantation in the hind limb of Wistar rats, when the histological findings were analyzed. The essential results, enhanced cell viability in vitro as well as significantly increased vascularization in vivo, were achieved using PLLA/1.0μg VEGF-coated suture material. Furthermore, ELISA measurements revealed a high reproducibility of the VEGF release behavior. Based on the results achieved regarding the dose-effect relationship of VEGF, the stability during its processing and the release behavior, it can be predicted that a bioactive suture material would be successful in later in vivo studies. Therefore, this knowledge could be the basis for future studies, where bioactive substances with different modes of action are combined for targeted, overall enhancement of wound healing. Copyright © 2014 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  10. Pancreaticojejunostomy after pancreaticoduodenectomy: Suture material and incidence of post-operative pancreatic fistula.

    Science.gov (United States)

    Andrianello, Stefano; Pea, Antonio; Pulvirenti, Alessandra; Allegrini, Valentina; Marchegiani, Giovanni; Malleo, Giuseppe; Butturini, Giovanni; Salvia, Roberto; Bassi, Claudio

    2016-01-01

    Pancreatic fistula represents the most important complication in terms of clinical management and costs after pancreaticoduodenectomy. A lot of studies have investigated several techniques in order to reduce pancreatic fistula, but data on the effect of sutures material on pancreatic fistula are not available. The analysis investigated the role of suture material in influencing pancreatic fistula rate and severity. Results from 130 consecutive pancreaticoduodenectomy with pancreaticojejunostomy performed between March 2013 and September 2014 were prospectively collected and analyzed. In 65 cases pancreaticojejunostomy was performed with absorbable sutures, in the other 65 cases using non-absorbable sutures (polyester, silk and polybutester). Pancreaticojejunostomy with non-absorbable sutures had the same incidence of pancreatic fistula, but less severe and with less episodes of post-operative bleeding if compared with absorbable sutures. A sub-analysis was carried out comparing polydioxanone with polyester: the latter was associated with a lower pancreatic fistula rate (11.9% vs. 31.7%; p = 0,01) and less severe pancreatic anastomosis dehiscence (grade C - 0% vs. 30%; p = 0.05). Univariate and multivariate analysis confirmed that hard pancreatic texture, pancreatic ductal adenocarcinoma at final histology and the use of polyester for pancreaticojejunostomy were associated with a lower pancreatic fistula rate (p fistula with less severe clinical impact. Copyright © 2015 IAP and EPC. Published by Elsevier India Pvt Ltd. All rights reserved.

  11. Post operation recurrence of inguinal hernia in children and its relation with suture material

    Directory of Open Access Journals (Sweden)

    Omid Amanollahi

    2011-09-01

    Full Text Available Background: Using non-absorbable suture in children hernia repair to decrease of recurrence is recommended in the most pediatric surgery centers. The aim of this study was to determine relationship between kind of suture material and rate of hernia recurrence. Methods: In this clinical trial 200 children (age 1-5 years with inguinal hernia who operated in Imam-Reza Hospital (kermanshah –Iran Between April 2007 until April 2008 enrolled into the study. Cases were selected by convenience sampling method and then randomly divided into two groups (100 cases per group and operated with absorbable (silk 3-0 and non-absorbable (vicryli 3-0 suture material. Following period was 12 months after operation and collected data analyzed by statistical software. Emergency operations were excluded from the study.Results: 83% of patients were boy and 17% were girl. %53 showed right side inguinal, 29% left side and %18 were bilateral hernia. After one year follow up only one case of recurrence was observed in each group.Conclusion: Our study confirmed that recurrence of inguinal hernia in children after surgery, is not related to kind of suture material (absorbability and we didn’t find any significant difference. Other factors than suture material may influence recurrence rate of hernia operation in children.

  12. Clinical Outcome and Wound Healing following Carpal Tunnel Decompression: A Comparison of Two Common Suture Materials

    Directory of Open Access Journals (Sweden)

    Robert J. MacFarlane

    2014-01-01

    Full Text Available Introduction. Debate exists amongst surgeons regarding the ideal suture material for skin closure in carpal tunnel decompression (CTD. This study compares wound related complications, patient satisfaction, and functional outcome following open carpal tunnel decompression in patients undergoing wound closure with either of two common absorbable and nonabsorbable suture types. Materials and Methods. 53 patients underwent CTD with either 4/0 polypropylene (ProleneTM, n = 28 or 4/0 polyglactin (Vicryl RapideTM, n = 25 for skin closure. QuickDASH, VAS satisfaction scores, and Southampton wound scores were assessed preoperatively and at 2 and 6 weeks postoperatively. Results. At 6 weeks the mean QuickDASH scores postoperatively were 18.54 and 17.70 for absorbable and nonabsorbable sutures, respectively, (P = 0.86. The mean VAS scores were 0.61 and 0.42 (P = 0.91, respectively. All patients achieved a Southampton wound score of 0 by 6 weeks except one, who achieved 1C in the nonabsorbable group, equivalent to mild erythema. There were no complications in either group. Conclusion. Both suture types are safe and effective materials for CTD, and we recommend surgeons to choose according to personal preference, handling properties, and resources available for suture removal.

  13. Evaluation of the histologic reactions to commonly used suture materials in the skin and musculature of ball pythons (Python regius).

    Science.gov (United States)

    McFadden, Michael S; Bennett, R Avery; Kinsel, Michael J; Mitchell, Mark A

    2011-10-01

    To evaluate histologic reactions to 8 suture materials and cyanoacrylate tissue adhesive (CTA) in the musculature and skin of ball pythons. 30 hatchling ball pythons. In each snake, ten 1-cm skin incisions were made (day 0). At 8 sites, a suture of 1 of 8 materials was placed in the epaxial musculature, and the incision was closed with the same material. One incision was closed by use of CTA. No suture material was placed in the tenth incision, which was allowed to heal by second intention (negative control). Snakes (n = 5/group) were euthanized for harvest of treatment-site tissues at days 3, 7, 14, 30, 60, and 90. Skin and muscle sections were examined microscopically and assigned a subjective score (0 to 4) for each of the following: overall severity of inflammation, fibrosis, number of macrophages, number of granulocytes, number of perivascular lymphocytes, and degree of suture fragmentation. Subjective score analysis revealed that CTA did not cause a significant inflammatory response, compared with the negative control. All suture materials caused significantly more inflammation over all time points; for all suture materials, inflammatory response scores were significantly higher than values for the negative control 90 days after implantation. No sutures were completely absorbed by the end of the study period, and several sutures appeared to be in the process of extrusion. In snakes, CTA can be used to close small superficial incisions or lacerations with minimal inflammatory response, and sutures may undergo extrusion from tissues prior to complete absorption.

  14. An investigation of the fixation materials for cartilage frames in microtia.

    Science.gov (United States)

    Sakamoto, Aritaka; Kiyokawa, Kensuke; Rikimaru, Hideaki; Watanabe, Koichi; Nishi, Yukiko

    2012-05-01

    When performing auriculoplasty for microtia surgery, wires are typically used to fix the costal cartilage frames. However, cases in which such wires become exposed during a long-term follow-up were frequently observed at our facility. Hence, using various materials, we conducted an investigation of the materials most suitable for fixation. The subjects consisted of 122 cases in which auriculoplasty by costal cartilage graft surgery was performed and the postoperative course was traceable, within approximately 24 years from January 1984 to March 2007. Regarding the fixation materials used in the 84 cases in which wire was used, 5 cases used monofilament non-absorbable sutures (Nylon(®)), 5 cases used monofilament absorbable sutures (PDS(®)), and 28 cases used braided absorbable sutures(VICRYL(®)).Their postoperative course was investigated, and the presence of auricular deformities caused by a loosening of the fixation materials and the exposure of the fixation materials was examined. An exposure of the wire was observed in 19 cases (22.6%) of the 84 cases that used wires. An exposure of nylon was observed in 2 (40%) of 5 the cases that used nylon, and of those, a mild deformation was observed in the lower helix in one case that was suspected to have been caused by a loosening of the surgical suture. Regarding the 33 cases in which absorbable sutures were used (5 cases used monofilament absorbable sutures and 28 cases used braided absorbable sutures), neither any auricular deformities nor exposure of the fixation materials was observed in any of the cases. Whether using monofilament or braided sutures, absorbable sutures are therefore believed to be the most suitable material for the fixation of cartilage. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. Comparison of two different suture-passing techniques with different suture materials and thicknesses: Biomechanical study of flexor tendons for yield points, gap formation and early post-operative status

    Directory of Open Access Journals (Sweden)

    Volkan Ergan

    2016-12-01

    Conclusion: The yield points with higher forces is expected to be preferred, but their thicknesses can be 3-0 or 4-0. Oblique suture passing should be preferred rather than longitudinal passing. Obviously, suture strengthening methods, like epitendineous running sutures and core sutures, should be used. Without these measures, even passive wrist motion can result in gap formation at the repair site. The results of this study showed that tensile properties of the repaired vary considerably with differences in suture material and design. [Hand Microsurg 2016; 5(3.000: 130-136

  16. Suturing property of tough double network hydrogels for bio-repair materials

    Science.gov (United States)

    Na, Yang Ho; Oh, Hwa Yeon; Ahn, Young Ju; Han, Youngbae

    2015-02-01

    Cartilage and meniscal lesions have limited potential for spontaneous repair. Consequently, much effort has been made to develop methods for repairing such lesions. Double-network (DN) gels are new candidate-materials for repairing such lesions. They exhibit exceptional mechanical strength and toughness in spite of their high water content. In this study, we prepared highly tough DN hydrogels and investigated the mechanical properties related to clinical implant use. The mechanical properties such as Young's modulus and suture tear-out strength were measured for the artificial replacement. The results suggest that the suture property of DN hydrogels can be adjusted by controlling the crosslinking density and monomer concentration. Finite element method was also applied to these DN hydrogels in order to check whether the fracture strength of the material is enough to meet a medical purpose.

  17. Comparison of antibacterial-coated and non-coated suture material in intraoral surgery by isolation of adherent bacteria

    Directory of Open Access Journals (Sweden)

    Klaus Pelz

    2015-09-01

    Full Text Available Objectives. In general surgery the incidence of postoperative wound infections is reported to be lower using triclosan-coated sutures. In intraoral surgery, sutures are faced with different bacterial species and the question arises whether the antibacterial-coated suture material has the same positive effects. Materials and Methods. Triclosan-coated and uncoated suture materials were applied in 17 patients undergoing wisdom tooth extraction. Postoperatively, sutures were removed and adherent bacteria were isolated, colony-forming units (cfu were counted, and species identified. Results. Oral bacteria were found in high numbers (cfu>10[sup]7[/sup] on both Vicryl and the triclosan-coated Vicryl Plus. The total number of bacteria isolated from Vicryl Plus was 37% higher than for Vicryl, mainly due to increased numbers of anaerobes. The number of bacterial strains identified was higher for Vicryl ( n=203 than for Vicryl Plus (n=198, but the number of pathogens was higher on Vicryl Plus (n=100 than on Vicryl (n=97. Fewer Gram-positive strains were found on Vicryl Plus (n=95 than on Vicryl (n=107 and, conversely, more Gram-negative strains on Vicryl Plus (103vs.96. Conclusions. In terms of the total number of oral bacteria, and especially oral pathogens, that adhered to suture material, no reduction was demonstrated for Vicryl Plus. The use of triclosan-coated suture material offers no advantage in intraoral surgery.

  18. Continuous Sputter Deposition Coating of Long Monofilaments

    Science.gov (United States)

    2014-04-01

    of the monofilament, a narrow channel with a thin outer wall of copper would remain. That channel would be open for fluid flow, and also have a...Hart, S. D.; Benoit, G.; Kuriki, Y.; Viens, J. F.; Bayindir, M.; Joannopoulos, J. D.; Fink, Y. Hollow Multilayer Photonic Bandgap Fibers for NIR...strips of silicon were placed 0.4 in (1 cm) below the monofilament and later tested with Rutherford Backscattering Spectroscopy to measure the thickness

  19. [Production of superoxide anion radical and nitric oxide in renal tissues sutured with different surgical suture material].

    Science.gov (United States)

    Kostenko, V O; Tsebrzhins'kii, O I

    2000-01-01

    The generation of superoxide anion radicals (in mitochondria, microsomes and under respiratory burst of leucocytes) and nitric oxide (NO) in renal tissue has been studied in the experiment with white rats, which had been carried out nephrotomy with following usage for suture such absorbable surgical threads as plain and chromic catgut, biofil (of dura mater spinalis of the cattle), Dexon II (polyglycolic acid) and biofil modified with aethonium, succinate and mexidol. The research proves the use of plai and chromic catgut leads to the development longer oxidative stress with increasing of cytotoxic agents production (superoxide anion and NO). The risk of longitudinal oxidative stress decreases under the use of biofil suture modified with biological active compounds (aethonium, succinate and mexidol). In this case, the generation of superoxide anion radicals in mitochondria and microsomes is normalised earlier. The superoxide generation with respiratory burst of leucocytes and NO production decreases in 14 day of postoperative period under the use of biofil suture modified with succinate and mexidol.

  20. Induction of immune gene expression and inflammatory mediator release by commonly used surgical suture materials: an experimental in vitro study.

    Science.gov (United States)

    Lock, Alistair M; Gao, Ryan; Naot, Dorit; Coleman, Brendan; Cornish, Jillian; Musson, David S

    2017-01-01

    Surgeons have a range of materials to choose from to complete wound closure, yet surprisingly very little is still known about the body's immune response to the suture materials in current use. The growing literature of adverse suture material reactions provided the objective of this study, to use in vitro assays to quantify levels of inflammation produced by seven commonly used suture materials in surgical procedures. Human monocyte/macrophage THP-1 cells were exposed to suture materials for 1, 3 and 5 days. Gene expression and protein secretion of six inflammatory cytokines and two cell surface markers were assessed using qPCR and ELISA respectively, with LPS exposure providing a positive control. Furthermore, a IL-1β/IL-1RA marker ratio was assessed to determine the balance between pro-/anti-inflammatory expression. The findings from our in vitro study suggest that four commonly used suture materials cause upregulation of pro-inflammatory markers indicative of an early foreign body reaction, with no balance from anti-inflammatory markers. As prolonged early pro-inflammation is known to produce delayed wound healing responses, the knowledge produced from this study has potential to improve informed surgical decision making and patient safety. This work has the capability to reduce suture-related adverse immune reactions, and therefore positively affect patient outcomes.

  1. Identification and quantification of the crystalline structures of poly(vinylidene fluoride) sutures by wide-angle X-ray scattering and differential scanning calorimetry.

    Science.gov (United States)

    Laroche, G; Lafrance, C P; Prud'homme, R E; Guidoin, R

    1998-02-01

    The outstanding biocompatibility of the polyvinylidene fluoride (PVDF) monofilament suture together with other desirable characteristics, such as ease of handling and resistance to biodegradation, makes it an attractive alternative monofilament suture material for cardiovascular surgery. However, to achieve a high performance suture, the polymeric raw material must be exposed to different treatments, which lead to different degrees and types of crystallization. Since these crystalline modifications deeply influence the mechanical characteristics and the biostability of the sutures, the authors hereby propose a method of quantifying the different structures of PVDF using wide angle X-ray diffraction (WAXD) and differential scanning calorimetry (DSC). The commercial devices are achieved by coloring and processing the polymeric raw material. The white and unprocessed 4-0 unswaged suture presents 19% of the alpha phase, 38% of the beta structure, and no gamma form. Coloration increases the amount of the beta phase by 5-9% at the expense of the alpha phase. On the other hand, processing the fibers lead to the conversion of some of the amorphous phase to the gamma structure, the importance of which is 6-7%. Finally, tensile measurements performed on the different PVDF fibers clearly proves that their mechanical characteristics depend on the presence of these crystalline forms in the polymeric structure of PVDF.

  2. Nonspecific iodine accumulation in surgical suture material mimicking follicular thyroid cancer bone metastasis in (131)I scintigraphy.

    Science.gov (United States)

    Winkens, Thomas; Nietzsche, Sandor; Gottschaldt, Michael; Freesmeyer, Martin

    2014-02-01

    A 23-year-old man with follicular thyroid carcinoma and cervical lymph node metastases showed a clear I focus on the skull after radioiodine therapy; therefore, an osseous metastasis was suspected. I and MRI fusion suggested the I focus to be adjacent to an epicranial suture from an early childhood trepanation for epidural hematoma. Radio-guided surgery found dark brown material to be the source of the radiation and successfully removed the material. Subsequent electron microscopy revealed a thread within the dark brown material, suggesting suture material as the cause of I accumulation.

  3. Effects of suture material and ultrasonic transmitter size on survival, growth, wound healing, and tag expulsion in rainbow trout

    Science.gov (United States)

    Ivasauskas, Tomas J.; Bettoli, P.W.; Holt, T.

    2012-01-01

    We examined the effects of suture material (braided silk versus Monocryl) and relative ultrasonic transmitter size on healing, growth, mortality, and tag retention in rainbow trout Oncorhynchus mykiss. In experiment 1, 40 fish (205-281mmtotal length [TL], 106-264 g) were implanted with Sonotronics IBT-96-2 (23??7 mm; weight in air, 4.4 g; weight in water, 2.4 g) or IBT 96-2E (30 ?? 7 mm; weight in air, 4.9 g; weight in water, 2.4 g) ultrasonic telemetry tags. In experiment 2, 20 larger fish (342-405 mm TL; 520-844 g) were implanted with Sonotronics IBT-96-5 ultrasonic tags (36 ?? 11 mm; weight in air, 9.1 g; weight in water, 4.1 g). The tag burdens for all implanted fish ranged from 1.1% to 3.4%, and fish in both studies were held at 10-15??C. At the conclusion of both experiments (65 d after surgery), no mortalities were observed in any of the 60 tagged fish, most incisions were completely healed, and all fish in both experiments grew in length, although tagged fish grew more slowly than control fish in experiment 1. In both experiments, fish sutured with silk expelled tags more frequently than those sutured with Monocryl. Expulsion was observed in 45-50% of the fish sutured with silk and 0-25% of the fish sutured withMonocryl. Tag expulsion was not observed until 25-35 d after surgery. Fish sutured with silk exhibited a more severe inflammatory response 3 weeks after surgery than those sutured with Monocryl. In experiment 1, the rate of expulsion was linked to the severity of inflammation. Although braided silk sutures were applied faster than Moncryl sutures in both experiments, knots tied with either material were equally reliable and fish sutured with Monocryl experienced less inflammation and lower rates of tag expulsion. American Fisheries Society 2012.

  4. Evaluation of the effect of 4 types of knots on the mechanical properties of 4 types of suture material used in small animal practice.

    Science.gov (United States)

    Avoine, Xytilis; Lussier, Bertrand; Brailovski, Vladimir; Inaekyan, Karine; Beauchamp, Guy

    2016-04-01

    The influence of the type of material used, knot configuration, and use of an additional throw on the tensile force at failure, the elongation, and the mode of failure of different configurations of linear sutures and knotted suture loops was evaluated in this in-vitro mechanical study. We hypothesized that all types of knots would significantly influence the initial force and elongation of suture materials and would influence the force and elongation at which the knotted loops break, but not their mode of failure. A total of 432 samples of 4 types of size 3-0 suture material (polydioxanone, polyglecaprone 25, polyglactin 910, and nylon), representing 9 configurations, were tested in a tensiometer. The configurations were 1 linear suture without a knot and the following loops: square (SQ) knot; surgeon's (SU) knot; granny (GR) knot; and sliding half-hitch (SHH) knot using either 4 and 5 or 3 and 4 throws, depending on the material. For polydioxanone, SQ and SU knots did not decrease the initial force at failure of the suture. Granny (GR) and SHH knots decreased the tensile force at failure and elongation by premature failure of the loop. For polyglecaprone 25, all knots decreased the initial force at failure of the suture, with SHH being weaker than the other knots. For coated polyglactin 910, all knots decreased the initial force at failure of the suture and slippage increased significantly compared with the other 3 sutures. The use of SQ knots with 3 throws did not result in a safe knot. For nylon, knots did not alter the original mechanics of the suture. In conclusion, all knots and types of suture material do not necessarily have the same effect on the initial tensile force at failure of suture materials.

  5. Mechanical comparison of monofilament nylon leader and orthopaedic wire for median sternotomy closure.

    Science.gov (United States)

    McCready, D J; Bell, J C; Ness, M G; Tarlton, J F

    2015-08-01

    To compare the mechanical properties of monofilament nylon leader and orthopaedic wire for median sternotomy closure in the dog. Median sternotomy was performed in 14 canine cadaver sternums with the manubrium intact. The sternotomy was closed with either 80 lb monofilament nylon leader or 20G orthopaedic stainless steel wire in a peristernal figure of 8 pattern. Constructs were loaded in a servohydraulic material testing machine. Load at yield, maximum load, stiffness, displacement and mode of failure were compared between constructs subjected to a single cycle load to failure. No significant differences were found in load at yield, maximum load, stiffness or displacement between the monofilament nylon leader and the stainless steel wire constructs. No implant failure was evident in the stainless steel wire constructs. Four of the monofilament nylon leader constructs failed by pulling of the nylon through the crimp. Monofilament nylon leader is mechanically comparable to stainless steel wire and potentially a suitable alternative for closure of median sternotomy in the dog. © 2015 British Small Animal Veterinary Association.

  6. MERSILENE (POLYESTER), A NEW SUTURE FOR PENETRATING KERATOPLASTY

    NARCIS (Netherlands)

    RAMSELAAR, JAM; BEEKHUIS, WH; RIJNEVELD, WJ; VANANDEL, MV; DIJK, F; JONGEBLOED, WL

    1992-01-01

    Mersilene (polyester monofilament) seems to be suitable for penetrating keratoplasty because it is strong, shows no degradation by ultraviolet light, is insoluble, so that it can be left in situ, and offers the possibility of regulating postoperative astigmatism by suture adjustment. In 12 patients

  7. Efficacy of Murva (Sansevieria roxburghiana Schult. and Schult.f.) as a suture material in closure of incisions in third molar surgeries: A prospective study.

    Science.gov (United States)

    Lambade, Pravin; Thorat, Ashutosh

    2017-01-01

    Adequate closure of the surgical wound is one of the most important aspects of surgery; improper suturing techniques or improper suturing materials sometimes compromise the success of surgery. Many synthetic materials have replaced the natural materials, which were once used for suturing in the ancient era, and Murva is one of them. There are references of Murva (Sansevieria roxburghiana Schult. and Schult.f.) at various contexts of "Sushruta Samhita" where it has been used as a suture material. It is a xerophytic herbaceous plant occurring abundantly in the eastern coastal region of India. The aim of this study is to evaluate the efficacy of Murva fibers as a suturing material in closure of intraoral incision in third molar surgeries. Fifty incisions (Wards incision) placed for the surgical removal of mandibular third molar were sutured with Murva, and follow-up was carried out postoperatively on 1(st), 2(nd), 3(rd), and 7(th) day. Patients were evaluated for pain, swelling, bleeding, infection, wound dehiscence, local tissue irritation, and bacterial colonization. On various follow-ups, progressively significant and predictable healing was observed without any uneventful evidence. The use of Murva as a suture material proved to be effective in closure of intraoral incisions.

  8. Multifunctional resistive-heating and color-changing monofilaments produced by a single-step coaxial melt-spinning process.

    Science.gov (United States)

    Laforgue, Alexis; Rouget, Geoffroy; Dubost, Sylvain; Champagne, Michel F; Robitaille, Lucie

    2012-06-27

    Multifunctional coaxial monofilaments were successfully produced by melt-spinning several polymer composites in a single-step. The external layer of the monofilaments was a thermochromic composite having a color-transition at 40 °C (above the ambient temperature) in order to avoid control interferences by the external temperature. The core layer of the monofilaments was a conductive polymer nanocomposite whose resistive heating properties were used to control the monofilament's temperature and therefore its color using electrical current. The careful selection of the materials and adequate formulation allowed to obtain a trilayer structure with enhanced compatibility between the layers. The mechanical properties of the monofilaments were improved by a solid-state stretching step while also decreasing their diameter. A 64 cm(2) prototype fabric was woven to characterize the resistive-heating and color-changing properties of the monofilaments. Exceptional thermal output levels were reached, with a temperature rising up to over 100 °C at voltages above 110 V. The reversible color change properties were also successfully demonstrated.

  9. Humidity affects the performance of von Frey monofilaments

    DEFF Research Database (Denmark)

    Werner, M U; Nielsen, Per Rotbøll; Ellehuus-Hilmersson, C

    2011-01-01

    Assessment of tactile and nociceptive thresholds of the skin with calibrated polyamide monofilaments is an established testing method both in animal and in human research. It is known that changes in relative humidity may affect the physical properties of the monofilaments. As this effect has only...

  10. No-mesh inguinal hernia repair with continuous absorbable sutures: A dream or reality? (a study of 229 patients

    Directory of Open Access Journals (Sweden)

    Desarda Mohan

    2008-01-01

    Full Text Available Background/Aim: The author has published results from two series based on his new technique of inguinal hernia repair. Interrupted sutures with a nonabsorbable material were used for repairs in both theses series. The author now describes the results of repairs done with continuous absorbable sutures. Materials and Methods: This is a prospective study of 229 patients having 256 hernias operated from December 2003 to December 2006. An undetached strip of the external oblique aponeurosis was sutured between the inguinal ligament and the muscle arch to form the new posterior wall. Continuous sutures were taken with absorbable suture material (Monofilament Polydioxanone Violet. Data of hospital stay, complications, ambulation, recurrences, and pain were recorded. Follow-up was done until June 2007. Results: A total of 224 (97.8% patients were ambulatory within 6-8 h (mean: 6.42 h and they attained free ambulation within 18-24 h (mean: 19.26 h. A total of 222 (96.4% patients returned to work within 6-14 days (mean: 8.62 days and 209 (91.26% patients had one-night stays in the hospital. A total of 216 (94.3% patients had mild pain for 2 days. There were four minor complications, but no recurrence or incidence of chronic groin pain. Patients were followed up for a mean period of 24.28 months (range: 6-42 months. Conclusions: The results of this study correlate well with the author′s previous publications. Continuous suturing saves operative time and one packet of suture material. The dream of every surgeon to give recurrence-free inguinal hernia repair without leaving any foreign body inside the patient may well become a reality in future.

  11. [5.07 Monofilament: the use of this monofilament in outpatient offices by nurses in primary health care units].

    Science.gov (United States)

    Orihuela Casarra, Roser; Heras Tebar, Antonio; Pozo Gil, Maria

    2005-12-01

    A diabetic foot is the most important cause of disability and loss of life quality among diabetics. To inspect a diabetic's feet and to explore his/her protective sensibility capability with a 5.07 monofilament are efficient methods to detect the risk of lesions. The authors' objective was to discover if our Primary Health Care Unit utilizes this instrument; therefore, we carried out a poll among all the nurses in our unit. 79% of these nurses are aware of the 5.07 monofilament; 62% have this monofilament available for their use; 55% stated they utilize it. The primary reasons to not use this monofilament are its unavailability and a lack of knowledge regarding it. Priority must be given to facilitate the availability of this instrument and to promote among nurses an understanding how to correctly utilize a 5.07 monofilament.

  12. The impact of bone and suture material properties on mandibular function in Alligator mississippiensis: testing theoretical phenotypes with finite element analysis

    Science.gov (United States)

    Reed, David A; Porro, Laura B; Iriarte-Diaz, Jose; Lemberg, Justin B; Holliday, Casey M; Anapol, Fred; Ross, Callum F

    2011-01-01

    Abstract The functional effects of bone and suture stiffness were considered here using finite element models representing three different theoretical phenotypes of an Alligator mississippiensis mandible. The models were loaded using force estimates derived from muscle architecture in dissected specimens, constrained at the 18th and 19th teeth in the upper jaw and 19th tooth of the lower jaw, as well as at the quadrate-articular joint. Stiffness was varied systematically in each theoretical phenotype. The three theoretical phenotypes included: (i) linear elastic isotropic bone of varying stiffness and no sutures; (ii) linear elastic orthotropic bone of varying stiffness with no sutures; and (iii) linear elastic isotropic bone of a constant stiffness with varying suture stiffness. Variation in the isotropic material properties of bone primarily resulted in changes in the magnitude of principal strain. By comparison, variation in the orthotropic material properties of bone and isotropic material properties of sutures resulted in: a greater number of bricks becoming either more compressive or more tensile, changing between being either dominantly compressive or tensile, and having larger changes in the orientation of maximum principal strain. These data indicate that variation in these model properties resulted in changes to the strain regime of the model, highlighting the importance of using biologically verified material properties when modeling vertebrate bones. When bones were compared within each set, the response of each to changing material properties varied. In two of the 12 bones in the mandible, varied material properties within sutures resulted in a decrease in the magnitude of principal strain in bricks adjacent to the bone/suture interface and decreases in stored elastic energy. The varied response of the mandibular bones to changes in suture stiffness highlights the importance of defining the appropriate functional unit when addressing relationships of

  13. Comparação entre dois fios de sutura não absorvíveis na anastomose traqueal término-terminal em cães Comparison of two nonabsorbable suture materials in the end-to-end tracheal anastomosis in dogs

    Directory of Open Access Journals (Sweden)

    Sheila Canevese Rahal

    1995-01-01

    Full Text Available Doze cães sem raça definida, com idade variando entre 1 e 6 anos e peso de 6 a 20kg, foram submetidos a ressecção traqueal e anastomose término-terminal, na qual foram testados os fios poliéster trançado não capilar e náilon monofilamento. Seis animais, cada três com um mesmo tipo de fio de sutura, sofreram a excisão equivalente a três anéis traqueais. Com 15 dias foi executada uma nova intervenção onde se ressecou o equivalente a mais seis anéis, perfazendo um total de nove. Ao final de outros 15 dias foram sacrificados. Os outros seis animais, cada três com um mesmo tipo de fio, foram submetidos à excisão equivalente a três anéis traqueais e mantidos por 43 dias. As traquéias foram avaliadas por exames clínicos, radiográficos, macroscópicos e histopatológicos. O fio de náilon monofilamento apresentou menos reação tecidual do que o poliéster trançado não capilar, promoveu uma anastomose segura e com menor chance de formação de granuloma.Twelve mongrel dogs, with age between 1 and 6 years old and weight between 12 and 40 pounds, were submitted to tracheal resection and end-to-end anastomosis in which were tested braided polyester no capillary and monofilament nylon materiais. Six animais, every threeones with a same type of suture material, suffered the excision equivalent to three tracheal rings. A new intervention was performed with fifteen days, in which the equivalent of more six tracheal rings were removed, completing the total of nine. At the end of more fifteen days they were sacrificed. The other six animals, every three with a same type of suture material, were submitted to the excision equivalent to three tracheal rings and maintained for 43 days. The tracheal anastomosis were evaluated to clinic, radiographic, macroscopic and histopathologic studies. The monofilament nylon material exhibited less reaction than polyester and promoted a secure anastomosis with less risk of granuloma formation.

  14. Selective suture cutting for control of astigmatism following cataract surgery

    Directory of Open Access Journals (Sweden)

    Bansal R

    1992-01-01

    Full Text Available Use of 10-0 monofilament nylon in ECCE cataract surgery leads to high with the rule astigmatism. Many intraoperative and post operative methods have been used to minimise post operative astigmatism. We did selective suture cutting in 38 consecutive patients. Mean keratometric astigmatism at three and six weeks post operative was 5.76 and 5.42 dioptres (D respectively. 77.5% of eyes had astigmatism above 2 D. Selective suture cutting along the axis of the plus high cylinder was done after six weeks of surgery. Mean post suture cutting keratometric astigmatism was 3.3 D and 70% of the eyes had astigmatism below 2 D. After 3 months of surgery mean keratometric astigmatism was reduced to 1.84 D. Axis of the astigmatism also changed following suture cutting. 40% of the eyes showed improvement in their Snellen acuity following reduction in the cylindrical power.

  15. Porous monofilaments by continuous solid-state foaming

    NARCIS (Netherlands)

    Krause, B.; Kloth, M.; van der Vegt, N.F.A.; Wessling, Matthias

    2002-01-01

    We report a new semicontinuous process for the production of porous polyetherimide monofilaments. Dense, carbon-dioxide-saturated fibers are spun at rates up to 1 m/s, and porosity is introduced at the spinning head, which establishes the transition from the pressure cell to the heating bath. The pr

  16. Randomized comparison of polyglycolic acid and polyglyconate sutures for abdominal fascial closure after laparotomy in patients with suspected impaired wound healing

    DEFF Research Database (Denmark)

    Osther, P J; Gjøde, P; Mortensen, Sophie Berit Bondegaard

    1995-01-01

    A randomized study of abdominal fascial closure using interrupted polyglyconate and polyglycolic acid sutures after laparotomy was carried out in 204 consecutive patients with suspected impaired wound healing. There were no statistically significant differences between the two sutures with regard...... to the development of fascial disruption and incisional hernia. Wound infection demanding surgical intervention was found in 7 per cent of patients with polyglyconate sutures and in 16 per cent of those with polyglycolic acid sutures (P = 0.04). Monofilament polyglyconate suture does not reduce the incidence...

  17. ABDOMINAL CLOSURE WITH ANTI BACTERIAL COATED SUTURE MATERIALS AND ITS RELATION TO THE INCIDENCE OF POST OPERATIVE SUPERFICIAL SURGICAL SITE INFECTION RATES

    Directory of Open Access Journals (Sweden)

    Josephine Pudumai Selvi

    2017-07-01

    Full Text Available BACKGROUND Surgical site infection (SSI is an immense burden on healthcare resources even in the modern era of immaculate sterilization approaches and highly effective antibiotics. An estimated 234 million various surgical procedures, involving skin incisions requiring various types of wound closure techniques, are performed in the world, with the majority resulting in a wound healing by primary intention. Triclosan (5-chloro-2-(2, 4-dichlorophenoxy phenol is a broad-spectrum bactericidal agent that has been used for more than 40 years in various products, such as toothpaste and soaps. Higher concentrations of Triclosan work as a bactericide by attacking different structures in the bacterial cytoplasm and cell membrane. Use of Triclosan-coated sutures should theoretically result in the reduction of SSI. The aim of the study is to assess the abdominal closure with antibacterial coated suture materials and its relation to the incidence of post-operative superficial surgical site infection rates. MATERIALS AND METHODS The data will be collected from hospital records of surgery performed, post-operative daily progress notes and outpatient folders and telephonic conversations with patients after discharge. All patients undergoing laparotomy procedure for any cause. 100 patients divided as 50 in each group. RESULTS The positive outcome of infection (21.5% in patients using ordinary sutures was significantly differed with the positive outcome of infection (11.4% of Triclosan coated sutures. CONCLUSION In conclusion since there was a definite advantage inferred to the patients by using Triclosan coated polyglactin 910, it is the opinion of the researcher that Triclosan coated sutures has a role to play in reducing SSI in clean wounds and its use should be confined to areas where its application has proven benefits. However more studies should be done to clearly define its role and indications in surgery.

  18. Assessment of mechanical properties and dimensions of suture threads utilized in orthopedic surgeries

    Directory of Open Access Journals (Sweden)

    Sardenberg Trajano

    2003-01-01

    Full Text Available Surgical materials of monofilament nylon (0, 3-0 and 4-0, braided polyester (0, 3-0 and 4-0 and monofilament polypropylene (0, 3-0 and 4-0 of 7 trademarks commercialized in Brazil, was submitted to analysis of diameter, length, enchasement resistance, tensile strength of surgery materials knotted and unknotted, according to ABNT. The results show that most of surgical materials was inside of preconizing patterns of ABNT.

  19. A microsurgical procedure for middle cerebral artery occlusion by intraluminal monofilament insertion technique in the rat: a special emphasis on the methodology.

    Science.gov (United States)

    Güzel, Aslan; Rölz, Roland; Nikkhah, Guido; Kahlert, Ulf D; Maciaczyk, Jaroslaw

    2014-01-01

    Although there are many experimental studies describing the methodology of the middle cerebral artery occlusion (MCAO) in the literature, only limited data on these distinct anatomical structures and the details of the surgical procedure in a step by step manner. The aim of the present study simply is to examine the surgical anatomy of MCAO model and its modifications in the rat. Forty Sprague-Dawley rats were used; 20 during the training phase and 20 for the main study. The monofilament sutures were prepared as described in the literature. All surgical steps of the study were performed under the operating microscope, including insertion of monofilament into middle cerebral artery through the internal carotid artery. After an extensive training period, we lost two rats in four weeks. The effects of MCAO were confirmed by the evidence of severe motor deficit during the recovery period, and histopathological findings of infarction were proved in all 18 surviving rats. In this study, a microsurgical guideline of the MCAO model in the rat is provided with the detailed description of all steps of the intraluminal monofilament insertion method with related figures.

  20. Tension free monofilament macropore polypropylene mesh (Gynemesh PS in female genital prolapse repair

    Directory of Open Access Journals (Sweden)

    Vicente Sola

    2006-08-01

    Full Text Available OBJECTIVES: To review intraoperative and postoperative complications associated to the correction of cystocele and rectocele with polypropylene mesh macropore monofilament (Gynemesh PS using transvaginal free tension technique. MATERIALS AND METHODS: Prospective study of patients that have been submitted to correction of cystocele and/or rectocele between November 2004 and August 2005 in the Urogynecology and Vaginal Surgery Unit of Gynecology and Obstetrics Department, Las Condes Clinic. Mesh was used in 31 patients: 9 for cystocele, 11 for rectocele, and 11 for concomitant meshes. Total mesh used 42. Media age 55 years old, weight 64 kilograms. In 7 patients we used a third mesh for correction of urinary incontinence by TVT-O technique. RESULTS: They did not present intraoperative complications, neither in immediate or delayed postoperative time. We did not observe hematoma, infection, erosion or exposition mesh. Healing of cystocele and rectocele was obtained in 100% of patients, with a pursuit between 1 and 8 months. DISCUSSION: The use of prosthetic polypropylene monofilament macropore mesh in the correction of cystocele and/or rectocele, by transvaginal route with tension free technique seems to be a safe and effective surgery procedure.

  1. Mechanical analysis of twelve toggle suture constructs for stabilization of coxofemoral luxations.

    Science.gov (United States)

    Jha, Shantibhushan; Kowaleski, Michael P

    2012-11-01

    To compare the mechanical performance of 12 commonly used toggle suture constructs (TSCs). In vitro biomechanical study. Toggle suture constructs (n = 136). TSC evaluated included #5 OrthoFiber, double strand of 5 Ethibond sutures (polyethylene terephthalate suture), 80 lb monofilament nylon, or #5 FiberWire, combined with Piermattei toggle (3/32" Steinmann pin), modified Piermattei toggle (0.045" Kirschner wire), and 1/8" Securos toggle rod for a total of 12 test groups. Acute and cyclic testing were performed using a servohydraulic testing machine and load at failure and cycles to failure were determined. In acute testing, modified Piermattei TSCs failed by toggle deformation and Piermattei and Securos TSCs failed by suture breakage at the eyelet. Mean failure load of Piermattei-#5 OrthoFiber TSC (1416 ± 74 N) was significantly greater than that of Piermattei-#5 Ethibond (883 ± 38 N); both were significantly greater than all other TSCs. Only the Piermattei TSC with #5 OrthoFiber, #5 Ethibond, and 80 lb monofilament nylon did not fail during cyclic testing. A combination of the Piermattei toggle and #5 OrthoFiber or #5 Ethibond achieved a higher load at failure than all other groups, and resisted the greatest number of cycles to failure. Long-term mechanical testing of these TSCs are warranted to further define their durability. © Copyright 2012 by The American College of Veterinary Surgeons.

  2. Reacción tisular a materiales de sutura no absorbibles en piel de equinos Tissue reaction to nonabsorbable suture materials in horse skin

    Directory of Open Access Journals (Sweden)

    F Maldonado

    2006-01-01

    Full Text Available Se evaluó clínica e histológicamente el grado de reacción tisular frente a cuatro materiales de sutura no absorbibles (lino, nylon, caprolactam polimerizado y polipropileno, implantados en la piel de 8 equinos. Se determinó clínicamente el edema provocado y la ausencia o presencia de exudado a los 5 y 10 días de haber sido implantados los materiales de sutura, además al 10º día se realizó una biopsia para determinar histológicamente el grado de reacción tisular. Los resultados obtenidos mostraron que el lino causó un mayor edema al día 5, mientras que al día 10 el nylon y caprolactam provocaron un menor de edema. Con respecto a la presencia o ausencia de exudado, al día 5 la sutura de nylon fue la única que no presentó exudado en ninguno de los 8 ejemplares, sin embargo, al día 10, salvo un ejemplar que presentó exudado en todos los materiales, el nylon, caprolactam y polipropileno no presentaron exudado. En cuanto a la evaluación histológica tanto el nylon como el caprolactam mostraron menor grado de reacción tisular. En conclusión, el lino resultó tener el mayor grado de reacción tisular durante el presente estudio, y el nylon si bien es similar al caprolactam y polipropileno respecto a la reacción tisular, causó una menor cantidad de equinos con presencia de exudado que los otros materiales utilizados.The degree of tissue reaction of 4 nonabsorbable suture materials (linen, nylon, polymerized caprolactum and polypropylene implanted into health skin of 8 horses was clinically and histologically evaluated. Cutaneous oedema and absence or presence of the exudation were clinically evaluated 5 and 10 days following suture material implantation. Biopsies were taken to histologically evaluate tissue reaction at 10 days. The results obtained showed that linen caused more oedema by the 5th day, whereas the nylon and caprolactum had less oedema on the 10th day. With respect to the presence or absence of exudation, nylon was

  3. Comparison between absorbable and nonabsorbable sutures in arterial anastomoses in growing dogs.

    Science.gov (United States)

    Gersak, B

    1991-01-01

    Five dogs, 10 weeks old, underwent operation using ketamin-HCl anesthesia and end-to-end anastomoses of the femoral and brachial arteries were made using polyfilament nonabsorbable material (Ethibond), monofilament nonabsorbable material (Prolene), polyfilament absorbable material (Vicryl) and monofilament absorbable material (PDS). The arterial diameter using a micrometer and blood flow using an electromagnetic flow meter were determined. After six months another operation was performed and diameter and blood flow were measured again. No statistically significant differences were found between the different materials used with respect to growth related increases either in arterial diameter or blood flow.

  4. Nano-Mechanical Studies on Polyglactin Sutures Subjected to In Vitro Hydrolytic and Enzymatic Degradation.

    Science.gov (United States)

    Sun, Leming; Wanasekara, Nandula; Chalivendra, Vijaya; Calvert, Paul

    2015-01-01

    An experimental investigation on the effects of in vitro hydrolytic and enzymatic degradation on mechanical properties of polyglactin 910 monofilament sutures was performed by conducting nanoindentation studies using an atomic force microscope (AFM). For hydrolytic degradation, the sutures were incubated in phosphate buffered saline (PBS) solution at three different pH conditions, 5, 7.4, and 10. For enzymatic degradation, esterase was employed at pH condition of 7.4. The property of the sutures changed with time at different conditions were investigated by nanoindentation, tensile test experiments, image analysis using both of scanning electron microscopy (SEM) and AFM, and also Fourier transform infrared spectroscopy (FTIR). The effects of degradation on gradation of Young's modulus values across the cross section of the sutures were studied by doing progressive nanoindentation from center to surface. FTIR studies revealed the formation of new hydroxyl bonds due to both hydrolytic and enzymatic degradations. Nanoindentation results indicated that the degradation does not cause a gradient of Young's modulus of the polyglactin 910 monofilament sutures across the cross section from center to surface at different degradation times for both hydrolytic and enzymatic degradations. However, in general, the Young's modulus of all samples was decreased over 4 weeks of degradation. The microscopic evaluation of the samples also showed both qualitative changes in surface morphology and quantitative changes in surface roughness on the surface of degraded sutures. This study provided a deep understanding of the polyglactin sutures subjected to in vitro hydrolytic and enzymatic degradation, and also opened a new avenue to study the biomaterials at nano-scale.

  5. Reliability of the electrical perceptual threshold and Semmes-Weinstein monofilament tests of cutaneous sensibility

    National Research Council Canada - National Science Library

    Ellaway, P H; Catley, M

    2013-01-01

    ...) and Semmes-Weinstein monofilament (SWM) tests for cutaneous sensibility. EPT and SWM tests have potential as quantitative and sensitive adjuncts to the American Spinal Injuries Association (ASIA) Impairment Scale (AIS...

  6. An in vitro study assessing the effect of mesh morphology and suture fixation on bacterial adherence.

    Science.gov (United States)

    Sanders, D; Lambie, J; Bond, P; Moate, R; Steer, J A

    2013-12-01

    Prosthetic infections, although relatively uncommon in hernia surgery, are a source of considerable morbidity and cost. The aims of this experimental study were to assess the influence of the morphological properties of the mesh on bacterial adherence in vitro. The morphological properties assessed were the polymer type, filament type, filament diameter, mesh weight, mean pore size, and the addition of silver chlorhexidine and titanium coatings. In addition, the study assessed the effect on bacterial adherence of adding a commonly used suture to the mesh and compared adherence rates to self-gripping mesh that does not require suture fixation. Eight commercially sourced flat hernia meshes with different material characteristics were included in the study. These were Prolene(®) (Ethicon(®)), DualMesh(®) (Gore(®)), DualMesh(®) Plus (Gore(®)), Parietex™ ProGrip (Covidien™), TiMesh(®) Light (GfE Medical), Bard(®) Soft Mesh (Bard(®)), Vypro(®) (Ethicon(®)), and Omyra(®) (Braun(®)). Individual meshes were inoculated with Staphylococcus epidermidis and Staphylococcus aureus with a bacterial inoculum of 10(2) bacteria. To assess the effect of suture material on bacterial adhesion, a sterile piece of commonly used monofilament suture material (2.0 Prolene(®), ZB370 Ethicon(®)) was sutured to selected meshes (chosen to represent different commonly used polymers and/or the presence of an antibacterial coating). Inoculated meshes were incubated for 18 h in tryptone soy broth and then analysed using scanning electron microscopy. A previously validated method for enumeration of bacteria using automated stage movement electron microscopy was used for direct bacterial counting. The final fraction of the bacteria adherent to the mesh was compared between the meshes and for each morphological variable. One-way analysis of variance (ANOVA) was performed on the bacterial counts. Tukey's test was used to determine the difference between the different biomaterials in

  7. Shear lag sutures: Improved suture repair through the use of adhesives.

    Science.gov (United States)

    Linderman, Stephen W; Kormpakis, Ioannis; Gelberman, Richard H; Birman, Victor; Wegst, Ulrike G K; Genin, Guy M; Thomopoulos, Stavros

    2015-09-01

    Suture materials and surgical knot tying techniques have improved dramatically since their first use over five millennia ago. However, the approach remains limited by the ability of the suture to transfer load to tissue at suture anchor points. Here, we predict that adhesive-coated sutures can improve mechanical load transfer beyond the range of performance of existing suture methods, thereby strengthening repairs and decreasing the risk of failure. The mechanical properties of suitable adhesives were identified using a shear lag model. Examination of the design space for an optimal adhesive demonstrated requirements for strong adhesion and low stiffness to maximize the strength of the adhesive-coated suture repair construct. To experimentally assess the model, we evaluated single strands of sutures coated with highly flexible cyanoacrylates (Loctite 4903 and 4902), cyanoacrylate (Loctite QuickTite Instant Adhesive Gel), rubber cement, rubber/gasket adhesive (1300 Scotch-Weld Neoprene High Performance Rubber & Gasket Adhesive), an albumin-glutaraldehyde adhesive (BioGlue), or poly(dopamine). As a clinically relevant proof-of-concept, cyanoacrylate-coated sutures were then used to perform a clinically relevant flexor digitorum tendon repair in cadaver tissue. The repair performed with adhesive-coated suture had significantly higher strength compared to the standard repair without adhesive. Notably, cyanoacrylate provides strong adhesion with high stiffness and brittle behavior, and is therefore not an ideal adhesive for enhancing suture repair. Nevertheless, the improvement in repair properties in a clinically relevant setting, even using a non-ideal adhesive, demonstrates the potential for the proposed approach to improve outcomes for treatments requiring suture fixation. Further study is necessary to develop a strongly adherent, compliant adhesive within the optimal design space described by the model.

  8. A comparative study of outcome of the absorbable suture polydioxanone and nonabsorbable suture polypropylene in laparotomy wound closure

    Directory of Open Access Journals (Sweden)

    Kiran Shankar H.

    2016-06-01

    Full Text Available Background: Abdominal wound closure is one of the common operations for a general surgeon. Prevention of complications is important to reduce post-operative morbidity and mortality. Post-operative wound pain, wound infection, wound dehiscence, suture sinus formation; palpable knots and incisional hernia are the parameters are to be studied. Therefore, the present study was undertaken to compare polydioxanone and polypropylene suture material for abdominal fascial closure regarding morbidity in terms of post-operative wound complications. Methods: Patients admitted in the department of surgery, who undergo laparotomy operations, with midline abdominal incisions were included in the study. The recruited subjects were divided into Group-A, whom abdominal incisions are closed with non-absorbable suture material polypropylene and Group-B whom abdominal incisions are closed with absorbable suture material polydioxanone. Data was expressed as percentages. Results: The incidence of wound pain was observed in all the patients in both immediate and delayed post-operative period in the polypropylene suture material compared to polydioxanone. The incidence of wound infection was higher in polypropylene (24% compared to PDS (2%. There were 4% cases of wound dehiscence in the present study. The incidence of suture sinus formation was higher in the polypropylene suture material (9% compared to the polydioxanone suture material (2% in the delayed postoperative period. The incidence of palpable knots was higher in the polypropylene suture material (23% compared to the polydioxanone suture material. No cases of incisional hernia were reported with polydioxanone suture material. Conclusions: The overall morbidity from abdominal closure was considerably reduced in the Polydioxanone group. We encountered reduction in wound complications like burst abdomen, wound infection, wound pain, suture sinus formation, palpable knots and incisional hernia. Therefore

  9. Security and biomechanical strength of three end-pass configurations for the terminal end of intradermal closures performed with unidirectional barbed suture material in dogs.

    Science.gov (United States)

    Regier, Penny J; Smeak, Daniel D; McGilvray, Kirk C

    2016-12-01

    OBJECTIVE To compare security of continuous intradermal suture lines closed by use of barbed suture with 3 end-pass configurations or without an end-pass configuration. SAMPLE 40 full-thickness, 4-cm-long, parasagittal wounds in canine cadavers. PROCEDURES Each continuous intradermal closure was terminated with 1 of 3 end-pass techniques or without an end-pass configuration (control group). A servohydraulic machine applied tensile load perpendicular to the long axis of the suture line. A load-displacement curve was generated for each sample; maximum load, displacement, stiffness, mode of construct failure, and load at first suture slippage at termination (ie, terminal end of the suture line) were recorded. RESULTS Values for maximum load, displacement, and stiffness did not differ significantly among the 3 end-pass techniques, and load at first suture slippage at termination was not significantly different among the 4 groups. A 1-pass technique slipped in 5 of 9 samples; 3 of these 5 slips caused failure of wound closure. A 2-pass technique slipped in 3 of 9 samples, none of which caused failure of wound closure. Another 2-pass technique slipped in 4 of 10 samples; 2 of these 4 slips caused failure of wound closure. The control group had slippage in 10 of 10 samples; 9 of 10 slips caused failure of wound closure CONCLUSIONS AND CLINICAL RELEVANCE An end-pass anchor was necessary to terminate a continuous intradermal suture line, and all 3 end-pass anchor techniques were suitable to prevent wound disruption. The 2-pass technique for which none of the suture slippages caused wound closure failure provided the most reliable configuration.

  10. Biomechanical Dynamics of Cranial Sutures during Simulated Impulsive Loading

    Directory of Open Access Journals (Sweden)

    Z. Q. Zhang

    2015-01-01

    Full Text Available Background. Cranial sutures are deformable joints between the bones of the skull, bridged by collagen fibres. They function to hold the bones of the skull together while allowing for mechanical stress transmission and deformation. Objective. The aim of this study is to investigate how cranial suture morphology, suture material property, and the arrangement of sutural collagen fibres influence the dynamic responses of the suture and surrounding bone under impulsive loads. Methods. An idealized bone-suture-bone complex was analyzed using a two-dimensional finite element model. A uniform impulsive loading was applied to the complex. Outcome variables of von Mises stress and strain energy were evaluated to characterize the sutures’ biomechanical behavior. Results. Parametric studies revealed that the suture strain energy and the patterns of Mises stress in both the suture and surrounding bone were strongly dependent on the suture morphologies. Conclusions. It was concluded that the higher order hierarchical suture morphology, lower suture elastic modulus, and the better collagen fiber orientation must benefit the stress attenuation and energy absorption.

  11. Current manufacturing processes of drug-eluting sutures.

    Science.gov (United States)

    Champeau, Mathilde; Thomassin, Jean-Michel; Tassaing, Thierry; Jérôme, Christine

    2017-02-24

    Drug-eluting sutures represent the next generation of surgical sutures since they fulfill their mechanical functions but also deliver the drug in their vicinity after implantation. These implants are produced by a variety of manufacturing processes. Drug-eluting sutures represent the next generation of surgical sutures since they fulfill their mechanical functions but also deliver the drug in their vicinity after implantation. These implants are produced by a variety of manufacturing processes. Two general approaches can be followed: (i) the ones that add the API into the material during the manufacturing process of the suture and (ii) the ones that load the API to an already manufactured suture. Areas covered: This review provides an overview of the current manufacturing processes for drug-eluting suture production and discusses their benefits and drawbacks depending on the type of drugs. The mechanical properties and the drug delivery profile of drug-eluting sutures are highlighted since these implants must fulfill both criteria. Expert opinion: For limited drug contents, melt extrusion and electrospinning are the emerging processes since the drug is added during the suture manufacture process. Advantageously, the drug release profile can be tuned by controlling the processing parameters specific to each process and the composition of the drug-containing polymer. If high drug content is targeted, the coating or grafting of a drug layer on a pre-manufactured suture allows for preservation of the tensile strength requirements of the suture.

  12. Fiber from ramie plant (Boehmeria nivea): A novel suture biomaterial

    Energy Technology Data Exchange (ETDEWEB)

    Kandimalla, Raghuram; Kalita, Sanjeeb; Choudhury, Bhaswati [Drug discovery laboratory, Institute of Advanced Study in Science and Technology, Guwahati, Assam 781035 (India); Devi, Dipali [Seri biotech laboratory, Institute of Advanced Study in Science and Technology, Guwahati, Assam 781035 (India); Kalita, Dhaneswar [Government Ayurvedic College and Hospital, Jalukbari, Guwahati, Assam 781014 (India); Kalita, Kasturi [Department of Pathology, Hayat Hospital, Guwahati, Assam 781034 (India); Dash, Suvakanta [Girijananda Chowdhury Institute of pharmaceutical science, Azara, Guwahati, Assam 781017 (India); Kotoky, Jibon, E-mail: jkotoky@gmail.com [Drug discovery laboratory, Institute of Advanced Study in Science and Technology, Guwahati, Assam 781035 (India)

    2016-05-01

    The quest for developing an ideal suture material prompted our interest to develop a novel suture with advantageous characters to market available ones. From natural origin only silk, cotton and linen fibers are presently available in market as non-absorbable suture biomaterials. In this study, we have developed a novel, cost-effective, and biocompatible suture biomaterial from ramie plant, Boehmeria nivea fiber. Field emission scanning electron microscopy (FE-SEM), energy-dispersive X-ray spectroscopy (EDX), attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR) and thermo gravimetric analysis (TGA) results revealed the physicochemical properties of raw and degummed ramie fiber, where the former one showed desirable characteristics for suture preparation. The braided multifilament ramie suture prepared from degummed fiber exhibited excellent tensile strength. The suture found to be biocompatible towards human erythrocytes and nontoxic to mammalian cells. The fabricated ramie suture exhibited significant antibacterial activity against Escherichia coli, Bacillus subtilis and Staphylococcus aureus; which can be attributed to the inherent bacteriostatic ability of ramie plant fiber. In vivo wound closure efficacy was evaluated in adult male wister rats by suturing the superficial wound incisions. Within seven days of surgery the wound got completely healed leaving no rash and scar. The role of the ramie suture in complete wound healing was supported by the reduced levels of serum inflammatory mediators. Histopathology studies confirmed the wound healing ability of ramie suture, as rapid synthesis of collagen, connective tissue and other skin adnexal structures were observed within seven days of surgery. Tensile properties, biocompatibility and wound closure efficacy of the ramie suture were comparable with market available BMSF suture. The outcome of this study can drive tremendous possibility for the utilization of ramie plant fiber for

  13. Hypersensitivity to Suture Anchors

    Directory of Open Access Journals (Sweden)

    Masafumi Goto

    2013-01-01

    Full Text Available Hypersensitivity to suture anchor is extremely rare. Herein, we present a case in which hypersensitivity to suture anchor was strongly suspected. The right rotator cuff of a 50-year-old woman was repaired with a metal suture anchor. Three weeks after the surgery, she developed erythema around her face, trunk, and hands, accompanied by itching. Infection was unlikely because no abnormalities were detected by blood testing or by medical examination. Suspicious of a metallic allergy, a dermatologist performed a patch testing 6 months after the first surgery. The patient had negative reactions to tests for titanium, aluminum, and vanadium, which were the principal components of the suture anchor. The anchor was removed 7 months after the first surgery, and the erythema disappeared immediately. When allergic symptoms occur and persist after the use of a metal anchor, removal should be considered as a treatment option even if the patch test result is negative.

  14. 3D characterization of thermal fatigue damage in monofilament reinforced copper for heat sink applications in fusion reactor systems; 3D-Charakterisierung von thermischer Ermuedungsschaedigung in Monofilament verstaerktem Kupfer zur Anwendung als Waermeleiter in Kernfusionsreaktorsystemen

    Energy Technology Data Exchange (ETDEWEB)

    Schoebel, Michael; Degischer, H. Peter [Vienna Univ. of Technology (Austria). Inst. of Materials Science and Technology; Brendel, Annegret [Max-Planck-Institut fuer Plasmaphysik, Garching (Germany); Harrer, Bernhard [Upper Austria Univ. of Applied Sciences, Wels (Austria); Di Michiel, Marco [European Synchrotron Radiation Facility (ESRF), 38 - Grenoble (France)

    2012-07-01

    Monofilament reinforced metals (MFRM) are developed as high temperature heat sink materials for fusion reactor applications. These composites combine the high thermal conductivity (TC) of a Cu matrix with low thermal expansion (CTE) of SiC or W filaments. The CTE mismatch between matrix and reinforcement lead to high micro stresses under operation conditions. Stress induced thermal fatigue damage such as interface delamination and fiber/matrix damage degrades the thermal properties of these composites. Different interface designs are developed for SiC as well as W filaments to improve bonding strength and increase the long term stability. Conventional as well as synchrotron tomography was applied on different MFRMs to characterize thermal fatigue damage and its propagation before, during and after thermal cycling. (orig.)

  15. A technique for introducing looped sutures in flexor tendon repair

    Directory of Open Access Journals (Sweden)

    Kamath B

    2006-01-01

    Full Text Available Stronger flexor tendon repairs facilitate early active motion therapy protocols. Core sutures using looped suture material provide 1 ½ to twice the strength of Kessler′s technique (with four strand and six strand Tsuge technique respectively. The technique is well-described and uses preformed looped sutures (supramid. This is not available in many countries and we describe a technique whereby looped sutures can be introduced in flexor tendon repair by the use of 23 G hypodermic needle and conventional 4.0 or 5.0 sutures. This is an alternative when the custom made preformed sutures are not available. This can be practiced in zone 3 to zone 5 repairs. Technical difficulties limit its use in zone 2 repairs.

  16. Quantifying allodynia in patients suffering from unilateral neuropathic pain using Von Frey monofilaments

    NARCIS (Netherlands)

    Keizer, D.; van Wijhe, M.; Post, W.J.; Wierda, J.M.K.H.

    Objectives: The aim of this study is to investigate whether quantitative sensory testing with Von Frey monofilaments (VFMs) can be used for the quantification of allodynia in patients with chronic neuropathic pain, and how the pain threshold of affected skin differs from healthy skin. Methods: Using

  17. Quantifying allodynia in patients suffering from unilateral neuropathic pain using Von Frey monofilaments

    NARCIS (Netherlands)

    Keizer, D.; van Wijhe, M.; Post, W.J.; Wierda, J.M.K.H.

    2007-01-01

    Objectives: The aim of this study is to investigate whether quantitative sensory testing with Von Frey monofilaments (VFMs) can be used for the quantification of allodynia in patients with chronic neuropathic pain, and how the pain threshold of affected skin differs from healthy skin. Methods: Using

  18. Mechanical performance of gamma irradiated surgical sutures

    Energy Technology Data Exchange (ETDEWEB)

    Pino, Eddy S.; Rela, Paulo P. [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil)

    2000-07-01

    Surgical sutures are medical devices made of natural or synthetic polymeric materials that, due to its end-use, have to be sterilized. Historically, the sterilization by heat or using ethylene oxide had presented so numerous drawbacks that today the non-pollutant radiation sterilization has become a well established sterilization process, that brings, environmental, technical, and economical advantages. The amount of irradiation doses required for sterilization of health care products is 25 kGy in most instances to achieve the necessary sterility assurance level. As high energy radiation produces modifications in the molecular structure of organic materials with changes in its mechanical properties, the aim of this work was to evaluate the mechanical behavior of surgical sutures under irradiation. Silk, polyamide and catgut sutures were gamma irradiated up to doses of 50 kGy in an industrial irradiation sterilization plant. Afterwards, these sutures were mechanical tested for tensile strength under knot following the specifications of the NBR13904 draft standard, using the CTRD-INSTRON at IPEN. The mechanical lab results show that sutures made of Silk and Polyamide do not present any change in their mechanical performance up to the dose of 50 kGy. On the other hand, Catgut present mechanical stability up to 30 kGy and afterwards, a slight decrease in its tensile strength was detected. (author)

  19. Low pacemaker incidence with continuous-sutured valves: a retrospective analysis.

    Science.gov (United States)

    Niclauss, Lars; Delay, Dominique; Pfister, Raymond; Colombier, Sebastien; Kirsch, Matthias; Prêtre, René

    2017-06-01

    Background Permanent pacemaker implantation after surgical aortic valve replacement depends on patient selection and risk factors for conduction disorders. We aimed to identify risk criteria and obtain a selected group comparable to patients assigned to transcatheter aortic valve implantation. Methods Isolated sutured aortic valve replacements in 994 patients treated from 2007 to 2015 were reviewed. Demographics, hospital stay, preexisting conduction disorders, surgical technique, and etiology in patients with and without permanent pacemaker implantation were compared. Reported outcomes after transcatheter aortic valve implantation were compared with those of a subgroup including only degenerative valve disease and first redo. Results The incidence of permanent pacemaker implantation was 2.9%. Longer hospital stay ( p = 0.01), preexisting rhythm disorders ( p pacemaker implantation. Although prostheses were sutured with continuous monofilament in the majority of cases (86%), interrupted pledgetted sutures were used more often in the pacemaker group ( p = 0.002). In the subgroup analysis, the incidence of permanent pacemaker implantation was 2%; preexisting rhythm disorders and the suture technique were still major risk factors. Conclusion Permanent pacemaker implantation depends on etiology, preexisting rhythm disorders, and suture technique, and the 2% incidence compares favorably with the reported 5- to 10-fold higher incidence after transcatheter aortic valve implantation. Cost analysis should take this into account. Often dismissed as minor complication, permanent pacemaker implantation increases the risks of endocarditis, impaired myocardial recovery, and higher mortality if associated with prosthesis regurgitation.

  20. [Assessing the effect of subcuticular buried sutures with subcutaneous closed suction drain to prevent surgical site infection in patients undergoing total cystectomy with urinary diversion using intestine].

    Science.gov (United States)

    Kanamaru, Sojun; Tsuchihashi, Kazunari; Makino, Yuki; Shimizu, Yosuke; Ito, Noriyuki

    2014-11-01

    We assessed the effect of subcuticular buried sutures with subcutaneous closed suction drain to prevent surgical site infection (SSI) in patients undergoing total cystectomy with urinary diversion using the intestine. We reviewed the clinical charts of 43 consecutive patients who underwent total cystectomy with urinary diversion using the intestine from February 2006 to March 2011 at Nishi-Kobe Medical Center. All patients received intravenous prophylactic antibiotics before and throughout surgery as well as for three days after surgery. Skin closure was performed with interrupted vertical mattress sutures with 2-0 nylon on the first 22 patients (mattress group), and with interrupted subcuticular buried sutures with 4-0 absorbable monofilament with subcutaneous closed suction drain on the remaining 21 patients (subcuticular buried suture with subcutaneous drain; SBD group). SSI occurred in 7 (31.8%) patients in the mattress group, but did not affect any patient in the SBD group. We compared risk factors for SSI between the groups, and found that the method of skin closure was significant risk factor for SSI (P = 0.005). We concluded that interrupted subcuticular buried sutures with 4-0 absorbable monofilament with subcutaneous suction drain is effective for prevention of SSI in total cystectomy with urinary diversion using the intestine.

  1. Bundles of spider silk, braided into sutures, resist basic cyclic tests: potential use for flexor tendon repair.

    Directory of Open Access Journals (Sweden)

    Kathleen Hennecke

    Full Text Available Repair success for injuries to the flexor tendon in the hand is often limited by the in vivo behaviour of the suture used for repair. Common problems associated with the choice of suture material include increased risk of infection, foreign body reactions, and inappropriate mechanical responses, particularly decreases in mechanical properties over time. Improved suture materials are therefore needed. As high-performance materials with excellent tensile strength, spider silk fibres are an extremely promising candidate for use in surgical sutures. However, the mechanical behaviour of sutures comprised of individual silk fibres braided together has not been thoroughly investigated. In the present study, we characterise the maximum tensile strength, stress, strain, elastic modulus, and fatigue response of silk sutures produced using different braiding methods to investigate the influence of braiding on the tensile properties of the sutures. The mechanical properties of conventional surgical sutures are also characterised to assess whether silk offers any advantages over conventional suture materials. The results demonstrate that braiding single spider silk fibres together produces strong sutures with excellent fatigue behaviour; the braided silk sutures exhibited tensile strengths comparable to those of conventional sutures and no loss of strength over 1000 fatigue cycles. In addition, the braiding technique had a significant influence on the tensile properties of the braided silk sutures. These results suggest that braided spider silk could be suitable for use as sutures in flexor tendon repair, providing similar tensile behaviour and improved fatigue properties compared with conventional suture materials.

  2. Bundles of Spider Silk, Braided into Sutures, Resist Basic Cyclic Tests: Potential Use for Flexor Tendon Repair

    Science.gov (United States)

    Hennecke, Kathleen; Redeker, Joern; Kuhbier, Joern W.; Strauss, Sarah; Allmeling, Christina; Kasper, Cornelia; Reimers, Kerstin; Vogt, Peter M.

    2013-01-01

    Repair success for injuries to the flexor tendon in the hand is often limited by the in vivo behaviour of the suture used for repair. Common problems associated with the choice of suture material include increased risk of infection, foreign body reactions, and inappropriate mechanical responses, particularly decreases in mechanical properties over time. Improved suture materials are therefore needed. As high-performance materials with excellent tensile strength, spider silk fibres are an extremely promising candidate for use in surgical sutures. However, the mechanical behaviour of sutures comprised of individual silk fibres braided together has not been thoroughly investigated. In the present study, we characterise the maximum tensile strength, stress, strain, elastic modulus, and fatigue response of silk sutures produced using different braiding methods to investigate the influence of braiding on the tensile properties of the sutures. The mechanical properties of conventional surgical sutures are also characterised to assess whether silk offers any advantages over conventional suture materials. The results demonstrate that braiding single spider silk fibres together produces strong sutures with excellent fatigue behaviour; the braided silk sutures exhibited tensile strengths comparable to those of conventional sutures and no loss of strength over 1000 fatigue cycles. In addition, the braiding technique had a significant influence on the tensile properties of the braided silk sutures. These results suggest that braided spider silk could be suitable for use as sutures in flexor tendon repair, providing similar tensile behaviour and improved fatigue properties compared with conventional suture materials. PMID:23613793

  3. Posterior C1-C2 Fixation Using Absorbable Suture for Type II Odontoid Fracture in 2-Year-Old Child: Description of a New Technique and Literature Review.

    Science.gov (United States)

    Labbe, Jean L; Peres, Olivier; Leclair, Olivier; Goulon, Renaud; Scemama, Patrice; Jourdel, François; Bertrou, Véronique; Murgier, Jerome

    2016-12-01

    Odontoid synchondrosis fractures are rare in children, even though they are the more common cervical fracture in children less than 7 years old. Nonoperative treatment with external orthosis immobilization is the treatment of choice for stable undisplaced or minimally displaced injuries. In unstable fractures, when reduction cannot be achieved or maintained, surgical fixation is recommended. We report a 2-year-old boy with an unstable fracture of the odontoid treated surgically using an absorbable monofilament suture for C1-C2 interlaminar fixation without bone grafting. This suture was strong enough to provide the stability necessary to allow healing of the synchondrosis and the delayed resorption of the suture was followed by complete restoration of the mobility between C1 and C2. This case illustrates that surgical stabilization using an absorbable suture in young children with an unstable odontoid fracture is a safe and effective alternative to other surgical techniques.

  4. Craniofacial clefting and sutural dystopia.

    Science.gov (United States)

    Moore, M H; Edwards, T J; David, D J

    1991-07-01

    Sutural anomalies in conjunction with craniofacial clefting are unusual. A case of median frontal clefting is presented in which there was an absence of a normal metopic suture and replacement by paramedian frontal sutures. The association of an underlying brain anomaly, with attendant surgical difficulties, is noted, as are the radiological techniques of preoperative diagnosis.

  5. Tension of knotted surgical sutures shows tissue specific rapid loss in a rodent model

    Directory of Open Access Journals (Sweden)

    Klink Christian D

    2011-12-01

    Full Text Available Abstract Background Every surgical suture compresses the enclosed tissue with a tension that depends from the knotting force and the resistance of the tissue. The aim of this study was to identify the dynamic change of applied suture tension with regard to the tissue specific cutting reaction. Methods In rabbits we placed single polypropylene sutures (3/0 in skin, muscle, liver, stomach and small intestine. Six measurements for each single organ were determined by tension sensors for 60 minutes. We collected tissue specimens to analyse the connective tissue stability by measuring the collagen/protein content. Results We identified three phases in the process of suture loosening. The initial rapid loss of the first phase lasts only one minute. It can be regarded as cutting through damage of the tissue. The percentage of lost tension is closely related to the collagen content of the tissue (r = -0.424; p = 0.016. The second phase is characterized by a slower decrease of suture tension, reflecting a tissue specific plastic deformation. Phase 3 is characterized by a plateau representing the remaining structural stability of the tissue. The ratio of remaining tension to initial tension of phase 1 is closely related to the collagen content of the tissue (r = 0.392; p = 0.026. Conclusions Knotted non-elastic monofilament sutures rapidly loose tension. The initial phase of high tension may be narrowed by reduction of the surgeons' initial force of the sutures' elasticity to those of the tissue. Further studies have to confirm, whether reduced tissue compression and less local damage permits improved wound healing.

  6. Effect of Sizing on the Interfacial Shear Strength of Carbon Fiber/Epoxy Resin Monofilament Composite

    Institute of Scientific and Technical Information of China (English)

    YANG Yusong; ZHAO Yan; LI Ye; DONG Qi; CHEN Da

    2014-01-01

    The single fiber fragmentation test (SFFT) was used to measure the interfacial shear strength (IFSS) of sized and unsized CF800/epoxy resin monofilament composite in order to evaluate the effect of sizing respectively. Besides, the interfacial reinforcing mechanism was explored by analyzing the surface morphology of the carbon fibers, the wettability between the carbon fibers and the epoxy resin, and the chemical characteristics of the fiber surface. Moreover, the effect of sizing on heat and humidity resistance of interface was investigated by aging test. The results show that sizing improves IFSS of CF800/epoxy resin monofilament composite by 59% through increasing the functional groups containing oxygen and through enhancing wettability, while after sizing the heat and humidity resistance of interface is decreased.

  7. Contingency Airfield Construction: Mechanical Stabilization Using Monofilament and Fibrillated Fibers

    Science.gov (United States)

    1994-01-01

    geosynthetics in pavement design. Articles that provided "state-of-the-art" or otherwise noteworthy information were acqured by the WES library. The...Waterways Experiment Station, Vicksburg, MS. Dass, W. G. (1992). " Geosynthetics and fiber-reinforced materials for airfield pavements: a literature

  8. Cranial suture morphology and its relationship to diet in Cebus.

    Science.gov (United States)

    Byron, Craig D

    2009-12-01

    Cranial sutures are complex morphological structures. Four Cebus species (C. albifrons, C. apella, C. capucinus, C. olivaceus) are used here to test the hypothesis that sagittal suture complexity is enhanced in animals that eat materially challenging foods. These primates are ideal for such comparative studies because they are closely related and some are known to exhibit differences in the material properties of the foods they ingest and masticate. Specifically, Cebus apella is notable among members of this genus for ingesting food items of high toughness as well as consistently demonstrating a relatively robust cranial morphology. Consistent with previous studies, C. apella demonstrates significantly more robust mandibular and temporal fossa morphology. Also, C. apella possesses sagittal sutures that are more complex than congenerics. These data are used to support the hypothesis that cranial suture complexity is increased in response to consuming diets with more obdurate material properties. One interpretation of this hypothesis is that, compared to non-apelloids, total strain in the apelloid cranial suture connective tissue environment is elevated due to increased jaw muscle activity by increases in either force magnitudes or the number of chewing events. It is argued that greater masticatory function enhances the growth and modeling of cranial suture interdigitation. These data show that cranial suture complexity is one more hard tissue feature from the skull that might be used to inform hypotheses of dietary functional morphology.

  9. Thermal cycling stresses in W-monofilament reinforced copper

    Energy Technology Data Exchange (ETDEWEB)

    Schoebel, Michael; Jonke, Johannes; Degischer, H. Peter [Institute of Materials Science and Technology, Vienna University of Technology (Austria); Herrmann, Aurelia; Brendel, Annegret [Max-Planck-Institut fuer Plasmaphysik, Garching (Germany); Wimpory, Robert [Helmholtz Zentrum Berlin, Wannsee (Germany); Buslaps, Thomas [European Synchrotron Radiation Facility, Grenoble (France)

    2011-08-15

    New materials have to be developed for fusion reactor systems to withstand the high thermal load and heavy irradiation under service conditions. The divertor element collects the residuals of the nuclear reaction and withdraws heat from the reaction chamber into a heat sink. A thermal flux of {approx}20 W mK{sup -1} can be expected in such components. A plasma facing W plate is attached to a CuCrZr heat sink suffering CTE mismatch stresses at the interface due to pulsed operation required for the Tokamak reactor design. Fiber reinforced metal matrix composites are applied as an interlayer to reduce macroscopic interfacial stresses in these components. W-wire reinforced copper is a promising material for this application due to a good fiber-matrix bonding strength which is further increased by surface etching or graded interface designs. Thermal stresses in between the matrix and the wires are responsible for thermal fatigue damage within the constituents and at their interface. Neutron and synchrotron diffraction was performed in situ during thermal cycling to determine the micro stress amplitudes and their changes under simulated service conditions. (Copyright copyright 2011 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  10. Performance of antegrade suture passers according to tendon thickness

    Directory of Open Access Journals (Sweden)

    Myung-Sun Kim

    2015-01-01

    Full Text Available Purpose: To determine the effect of tendon thickness on the needle penetration ability of four different designs of antegrade suture passers. Materials and Methods: Four antegrade suture passers were tested: (a ExpresSew II (Depuy Mitek Inc., Raynham, MA, (b Arthrex Scorpion (Arthrex, Naples, FL, (c Concept (Linvatec Corp, Largo, FL, and (d ElitePass (Smith and Nephew Endoscopy, Andover, MA. Bovine tendons were divided into five thickness groups: 3, 5, 7, 9 and 11 mm. At each tendon thickness, we performed 15 trials with the suture loaded and 15 unloaded per device. Successful needle penetration was recorded, and in case of success, the exit point of the needle was noted in relation to the superior arm of the grasping component. Results: All tested suture passing devices successfully penetrated tendon thicknesses of 3 and 5 mm. With the suture loaded, one device (Concept only successfully penetrated 7 mm group tendons in 3/15 (20% trials. Success rates at 9 mm with the suture loaded were 40% in ExpresSew II, 53% in Arthrex Scorpion, 0% in Concept and 53% in ElitePass. Among successful passages with a loaded suture in the 7 and 9 mm-groups, about 20-50% of passages were oblique, and the needle came out distal to the superior arm of grasping the component. No trial with any device succeeded with 11 mm tendons in the suture loading condition. Conclusion: Using an antegrade suture passer during arthroscopic rotator cuff repair should be carefully considered when the torn end of the tendon is thicker than about 7-9 mm due to potential failure of needle penetration and/or too oblique a suture passage. Level of Evidence: Controlled laboratory study.

  11. Performance of antegrade suture passers according to tendon thickness

    Science.gov (United States)

    Kim, Myung-Sun; Kim, Dong Whan; Choi, Young Eun; Bachman, Larry; Kim, Sae Hoon

    2015-01-01

    Purpose: To determine the effect of tendon thickness on the needle penetration ability of four different designs of antegrade suture passers. Materials and Methods: Four antegrade suture passers were tested: (a) ExpresSew II (Depuy Mitek Inc., Raynham, MA), (b) Arthrex Scorpion (Arthrex, Naples, FL), (c) Concept (Linvatec Corp, Largo, FL), and (d) ElitePass (Smith and Nephew Endoscopy, Andover, MA). Bovine tendons were divided into five thickness groups: 3, 5, 7, 9 and 11 mm. At each tendon thickness, we performed 15 trials with the suture loaded and 15 unloaded per device. Successful needle penetration was recorded, and in case of success, the exit point of the needle was noted in relation to the superior arm of the grasping component. Results: All tested suture passing devices successfully penetrated tendon thicknesses of 3 and 5 mm. With the suture loaded, one device (Concept) only successfully penetrated 7 mm group tendons in 3/15 (20%) trials. Success rates at 9 mm with the suture loaded were 40% in ExpresSew II, 53% in Arthrex Scorpion, 0% in Concept and 53% in ElitePass. Among successful passages with a loaded suture in the 7 and 9 mm-groups, about 20-50% of passages were oblique, and the needle came out distal to the superior arm of grasping the component. No trial with any device succeeded with 11 mm tendons in the suture loading condition. Conclusion: Using an antegrade suture passer during arthroscopic rotator cuff repair should be carefully considered when the torn end of the tendon is thicker than about 7-9 mm due to potential failure of needle penetration and/or too oblique a suture passage. Level of Evidence: Controlled laboratory study. PMID:25937714

  12. Development and characterization of antibacterial braided polyamide suture coated with chitosan-citric acid biopolymer.

    Science.gov (United States)

    Debbabi, Faten; Gargoubi, Sondes; Hadj Ayed, Mohamed Adnene; Abdessalem, Saber Ben

    2017-09-01

    Braided polyamide sutures are frequently used in dermatologic surgery for wound closure. However, braided sutures promote bacteria proliferation. In order to prevent wound complications due to this effect, antibacterial sutures should be used. The main objective of this study is the development of new non-absorbable antibacterial polyamide braided suture. This paper suggests new coating process that leads to obtain suture uniformly covered by antibacterial film enclosing chitosan, which is known for its antibacterial benefit. Mechanical properties and surface morphology of developed sutures were investigated by using mechanical tests. Sutures surfaces were also examined by scanning electron microscope, to perceive spreading of coating product on suture surface. In order to identify potential reactions between chemical compounds present in coating solution and suture material, sutures were analyzed by ATR-IF spectroscopy. It has been demonstrated that many eventual bonds between compounds present in coating solutions and polyamide macromolecular chain may occur. The existence of these bonds implies the fixation of biopolymer coating on suture surface. It has been demonstrated that uniform surface may be obtained by progressively applying coating solution containing little amount of chitosan on suture surface. We have also found that developed coating process has not affected mechanical properties of suture, which still meet United States Pharmacopeia requirement. Finally, antibacterial effects against four colonies, very widespread in hospitals, were studied. Prominent antibacterial effects of braided polyamide suture against two gram-positive ( S Aureus, S epidermidis) and two gram-negative ( E coli and P aeruginosa) colonies are presented. Optimal result of best properties is obtained by applying three layers of biopolymer coating comprising 1% chitosan and 10% citric acid. The new developed suture coating process appears as a promising method for obtaining

  13. Midwives conducting perineal repair: The Danish Suture Trial

    DEFF Research Database (Denmark)

    Kindberg, Sara

    2007-01-01

    Midwives conducting perineal repair: The Danish Suture Trial.     Background Suture techniques and materials for repair of 2nd degree perineal lacerations and episiotomies have been tested in several clinical trials. Danish midwives and obstetricians have developed a new, simple and time-efficien......Midwives conducting perineal repair: The Danish Suture Trial.     Background Suture techniques and materials for repair of 2nd degree perineal lacerations and episiotomies have been tested in several clinical trials. Danish midwives and obstetricians have developed a new, simple and time...... assessed day 1-2 and 10 post partum. Secondary outcomes: patient satisfaction with wound healing, need for secondary repair, superficial pain during intercourse.   Data management: Double entry of all data and intention-to-treat analysis.   Results The follow up rate was 97%. Baseline data were evenly...

  14. Suture-induced right coronary artery stenosis.

    Science.gov (United States)

    Seltmann, Martin; Achenbach, Stephan; Muschiol, Gerd; Feyrer, Richard

    2010-01-01

    An 82-year-old patient developed right heart failure in the days after surgical aortic valve replacement. Coronary CT angiography showed a high-grade stenosis of the mid-right coronary artery. Adjacent suture material seen on noncontrast CT suggested that the lesion was related to surgical closure of the right atrial cannulation site. Invasive angiography confirmed the stenosis, and percutaneous intervention was successfully performed.

  15. Fibre-matrix interfaces in titanium matrix composites made with sigma monofilament

    Energy Technology Data Exchange (ETDEWEB)

    Shatwell, R.A. [DERA, Farnborough (United Kingdom). Struct. Mater. Centre

    1999-01-31

    A review of the development of coatings for sigma monofilament is given. The coating must protect the underlying silicon carbide before, during and after consolidation. This requires the coating outer surface to be under negative or zero residual stress at room temperature. The coating should also be well bonded to the SiC. It is shown that stoichiometric TiB{sub 2} is under a tensile stress of around 3 GPa under these conditions and hence is unsuitable. The boron-rich outer surface of SM1240 is essentially unstressed and the carbon surface of SM1140+ is under {approx}300 MPa axial compressive stress. Failure of monofilament in the composite initiates at the W-SiC interface, rather than at the metal-fibre interface characteristic of SCS-6. In order to ensure this behaviour, the coating in the composite must be thick enough to ensure that the stress concentration field arising from irregularities at the TiC-C boundary do not initiate fracture of the SiC. This requires a minimum thickness of around 1 {mu}m of carbon. (orig.) 10 refs.

  16. Using sutures to attach miniature tracking tags to small bats for multimonth movement and behavioral studies

    Science.gov (United States)

    Castle, Kevin T.; Weller, Theodore J.; Cryan, Paul M.; Hein, Cris D.; Schirmacher, Michael R.

    2015-01-01

    1. Determining the detailed movements of individual animals often requires them to carry tracking devices, but tracking broad-scale movement of small bats (bat dispersal and migration, particularly in the context of emerging conservation issues like fatalities at wind turbines and diseases. 2. We tested a novel method of attaching lightweight global positioning system (GPS) tags and geolocating data loggers to small bats. We used monofilament, synthetic, absorbable sutures to secure GPS tags and data loggers to the skin of anesthetized big brown bats (Eptesicus fuscus) in Colorado and hoary bats (Lasiurus cinereus) in California. 3. GPS tags and data loggers were sutured to 17 bats in this study. Three tagged bats were recaptured seven months after initial deployment, with tags still attached; none of these bats showed ill effects from the tag. No severe injuries were apparent upon recapture of 6 additional bats that carried tags up to 26 days after attachment, however one of the bats exhibited skin chafing. 4. Use of absorbable sutures to affix small tracking devices seems to be a safe, effective method for studying movements of bats over multiple months, although additional testing is warranted. This new attachment method has the potential to quickly advance our understanding of small bats, particularly as more-sophisticated miniature tracking devices (e.g., satellite tags) become available.

  17. Biomechanical study on the suture strength of ligament in cruciate ligament reconstruction

    Institute of Scientific and Technical Information of China (English)

    张春礼; 李起鸿; 杨柳

    2003-01-01

    Objective: To test the suture strength on the tendon or ligament end and evaluate the stitch in the reconstruction of cruciate ligament and its clinical application. Methods: Twenty-four specimens of patellar tendon with free ends were divided into 3 groups: Group I (3 Krackow stitches), Group II (2 Krackow stitches) and Group III (2 Krackow stitches with the first stitch passing through the tendon tissue as a modified Krackow stitch). These 3 groups were further divided into 6 subgroups according to different suture materials, No 1 Ethilon or stainless steel wire (φ= 0.4 mm). Tensile test was undertaken to find out the least stitches with efficient suture pattern. Results: Two Krackow locking stitches had stronger strength than 0.4 mm-diameter stainless steel wire. The fixation strength of 2 stitches with No 1 Ethilon was more than 80 N, superior to the failure strength of the material itself. The same strength was maintained if the first stitch was across the tendon tissue transversely. There was no statistically significant difference in the suture strength between 2 and 3 Krackow locking stitches. Conclusions: The suture strength is greater than the failure strength of the suture material. Less suture exposure can be achieved when the first stitch is across the tendon tissue while maintaining a comparable strength to other sutures. To attain higher suture strength, stronger materials or multiple strands rather than more stitches are preferred. Therefore, a rapid early rehabilitation of range of motion (ROM) is possible and reliable in practice.

  18. Recent advances in biodegradable metals for medical sutures: a critical review.

    Science.gov (United States)

    Seitz, Jan-Marten; Durisin, Martin; Goldman, Jeremy; Drelich, Jaroslaw W

    2015-09-16

    Sutures that biodegrade and dissolve over a period of several weeks are in great demand to stitch wounds and surgical incisions. These new materials are receiving increased acceptance across surgical procedures whenever permanent sutures and long-term care are not needed. Unfortunately, both inflammatory responses and adverse local tissue reactions in the close-to-stitching environment are often reported for biodegradable polymeric sutures currently used by the medical community. While bioabsorbable metals are predominantly investigated and tested for vascular stent or osteosynthesis applications, they also appear to possess adequate bio-compatibility, mechanical properties, and corrosion stability to replace biodegradable polymeric sutures. In this Review, biodegradable alloys made of iron, magnesium, and zinc are critically evaluated as potential materials for the manufacturing of soft and hard tissue sutures. In the case of soft tissue closing and stitching, these metals have to compete against currently available degradable polymers. In the case of hard tissue closing and stitching, biodegradable sternal wires could replace the permanent sutures made of stainless steel or titanium alloys. This Review discusses the specific materials and degradation properties required by all suture materials, summarizes current suture testing protocols and provides a well-grounded direction for the potential future development of biodegradable metal based sutures.

  19. First investigation of spider silk as a braided microsurgical suture.

    Science.gov (United States)

    Kuhbier, Joern W; Reimers, Kerstin; Kasper, Cornelia; Allmeling, Christina; Hillmer, Anja; Menger, Björn; Vogt, Peter M; Radtke, Christine

    2011-05-01

    Inhibition of axonal outgrowth accompanied by neuroma formation appears in microsurgical nerve repair as reaction to common microsuture materials like silk, nylon, or polyglycolic acid. In contrast, recent findings revealed advantages of spider silk fibers in guiding Schwann cells in nerve regeneration. Here, we asked if we could braid microsutures from native spider silk fibers. Microsutures braided of native spider dragline silk were manufactured, containing either 2 × 15 or 3 × 10 single fibres strands. Morphologic appearance was studied and tensile strength and stress-strain ratio (SSR) were calculated. The constructed spider silk sutures showed a median thickness of 25 μm, matching the USP definition of 10-0. Maximum load and tensile strength for both spider silk microsutures were significantly more than 2-fold higher than for nylon suture; SSR was 1.5-fold higher. All values except elasticity were higher in 3 × 10 strand sutures compared to 2 × 15 strand sutures, but not significantly. In this pilot study, we demonstrate the successful manufacture of microsutures from spider silk. With regards to the mechanical properties, these sutures were superior to nylon sutures. As spider silk displays high biocompatibility in nerve regeneration, its usage in microsurgical nerve repair should be considered. Copyright © 2011 Wiley Periodicals, Inc.

  20. Development of braided drug-loaded nanofiber sutures

    Energy Technology Data Exchange (ETDEWEB)

    Hu Wen [School of Materials Science and Engineering, Tongji University, 1239 Siping Road, Shanghai 200092 (China); Huang Zhengming [School of Aerospace Engineering and Applied Mechanics, Tongji University, 1239 Siping Road, Shanghai 200092 (China); Liu Xiangyang, E-mail: huangzm@tongji.edu.cn [Department of Physics, National University of Singapore, 2 Science Drive 3, 117542 (Singapore)

    2010-08-06

    The objectives of this work are twofold. Firstly, while most work on electrospinning is limited to the development of only functional materials, a structural application of electrospun nanofibers is explored. Secondly, a drug-loaded tissue suture is fabricated and its various properties are characterized. Braided drug-loaded nanofiber sutures are obtained by combining an electrospinning process with a braiding technique followed by a coating procedure. Two different electrospinning techniques, i.e. blend and coaxial electrospinning, to incorporate a model drug cefotaxime sodium (CFX-Na) into poly(L-lactic acid) (PLLA) nanofibers have been applied and compared with each other. Properties of the braided drug-loaded sutures are characterized through a variety of methods including SEM, TEM and tensile testing. The results show that the nanofibers had a preferable micromorphology. The drug was incorporated into the polymer nanofibers homogeneously, with no cross-linking. The nanofibers maintained their fibrous structures. An in vitro release study indicates that the drug-loaded nanofibers fabricated by blend electrospinning and coaxial electrospinning had a different drug release behavior. An inhibition zone experiment shows that both sutures obtained from the nanofibers of the different electrospinning techniques had favorable antibacterial properties. The drug-loaded sutures had preferable histological compatibility performance compared with commercial silk sutures in an in vivo comparative study.

  1. Sutured Floer homology and hypergraphs

    CERN Document Server

    Juhász, András; Rasmussen, Jacob

    2011-01-01

    By applying Seifert's algorithm to a special alternating diagram of a link L, one obtains a Seifert surface F of L. We show that the support of the sutured Floer homology of the sutured manifold complementary to F is affine isomorphic to the set of lattice points given as hypertrees in a certain hypergraph that is naturally associated to the diagram. This implies that the Floer groups in question are supported in a set of Spin^c structures that are the integer lattice points of a convex polytope. This property has an immediate extension to Seifert surfaces arising from homogeneous link diagrams (including all alternating and positive diagrams). In another direction, together with work in progress of the second author and others, our correspondence suggests a method for computing the "top" coefficients of the HOMFLY polynomial of a special alternating link from the sutured Floer homology of a Seifert surface complement for a certain dual link.

  2. Unusual sutural bones at pterion

    Directory of Open Access Journals (Sweden)

    Nayak SB

    2008-08-01

    Full Text Available The existence of Wormian (sutural bones in the skull is well known. We found three unusual Wormian bones at the right pterion in an adult Indian skull. The variation noted was unilateral. This type of variation has not been reported yet.

  3. Braiding Parameters of Medical Silk Braided Suture

    Institute of Scientific and Technical Information of China (English)

    张佩华; 吴建华

    2001-01-01

    The relationships between braiding parameters and properties of medical silk braided suture are investigated. Experimental results indicate that the main factors affecting the suture properties include the proportion of core silk and shell silk, braiding density and braiding tension. The results show that the braiding technology significantly influences the suture properties and the optimal braiding parameters were obtained by using the regression method.

  4. Surgical sutures filled with adipose-derived stem cells promote wound healing.

    Directory of Open Access Journals (Sweden)

    Ann Katharin Reckhenrich

    Full Text Available Delayed wound healing and scar formation are among the most frequent complications after surgical interventions. Although biodegradable surgical sutures present an excellent drug delivery opportunity, their primary function is tissue fixation. Mesenchymal stem cells (MSC act as trophic mediators and are successful in activating biomaterials. Here biodegradable sutures were filled with adipose-derived mesenchymal stem cells (ASC to provide a pro-regenerative environment at the injured site. Results showed that after filling, ASCs attach to the suture material, distribute equally throughout the filaments, and remain viable in the suture. Among a broad panel of cytokines, cell-filled sutures constantly release vascular endothelial growth factor to supernatants. Such conditioned media was evaluated in an in vitro wound healing assay and showed a significant decrease in the open wound area compared to controls. After suturing in an ex vivo wound model, cells remained in the suture and maintained their metabolic activity. Furthermore, cell-filled sutures can be cryopreserved without losing their viability. This study presents an innovative approach to equip surgical sutures with pro-regenerative features and allows the treatment and fixation of wounds in one step, therefore representing a promising tool to promote wound healing after injury.

  5. Complexity of serrated sutures of a human skull

    Directory of Open Access Journals (Sweden)

    Kochenkova О.V.

    2011-09-01

    Full Text Available Objective: to reveal the variability mechanism of complexity of serrated sutures of a human skull in the correlation with cranial form. Materials and methods. Researches of 253 arches of male and female skulls of patients at the age of 1 day-105 years without signs of cranial trauma or skeletal systemic diseases with absence of morphological signs of increase of intracranial pressure. Minimal (Min and maximal (Max values, average arithmetic (M, a mistake of average arithmetic (m have been studied. For definition of reliability of average size difference parametrical and non-parametric statistical criteria were used: parametrical criterion (t-criterion of Student applied for parameters submitting to the law of normal distribution (Lakin G. R, 1990. Distinctions of average arithmetic size were considered statistically authentic from 95% (p<0,05 a level of correct judgement (Plokhinskiy N.A., 1970. Results. On the surface of the arch lambdoid and coronal sutures in male skulls and lambdoid and sagittal sutures in female were found out to be of the greatest degree of complexity. Conclusion. The increase of complexity of sutures has been observed in children and adolescents; the directed asymmetry of sutures form is absent

  6. Normal threshold values for a monofilament sensory test in sural and radial cutaneous nerves in Indian and Nepali volunteers.

    Science.gov (United States)

    Wagenaar, Inge; Brandsma, Wim; Post, Erik; Richardus, Jan Hendrik

    2014-12-01

    The monofilament test (MFT) is a reliable method to assess sensory nerve function in leprosy and other neuropathies. Assessment of the radial cutaneous and sural nerves, in addition to nerves usually tested, can help improve diagnosis and monitoring of nerve function impairment (NFI). To enable the detection of impairments in leprosy patients, it is essential to know the monofilament threshold of these two nerves in normal subjects. The radial cutaneous, sural, ulnar, median and posterior tibial nerves of 245 volunteers were tested. All nerves were tested at three sites on both left and right sides. Normal monofilament thresholds were calculated per test-site and per nerve. We assessed 490 radial cutaneous and 482 sural nerves. The normal monofilament was 2 g (Filament Index Number (FIN) 4.31) for the radial cutaneous and 4 g (FIN 4.56) for the sural nerve, although heavy manual laborers demonstrated a threshold of 10 g (FIN 5.07) for the sural nerve. For median and ulnar nerves, the 200 mg (FIN 3.61) filament was confirmed as normal while the 4 g (FIN 4.56) filament was normal for the posterior tibial. Age and occupation have an effect on the mean touch sensitivity but do not affect the normal threshold for the radial cutaneous and sural nerves. The normal thresholds for the radial cutaneous and sural nerves are determined as the 2 g (FIN 4.31) and the 4 g (FIN 4.56) filaments, respectively. The addition of the radial cutaneous and sural nerve to sensory nerve assessment may improve the diagnosis of patients with impaired sensory nerve function.

  7. Study of tactile sensitivity by Semmes–Weinstein monofilaments in patients with carpal tunnel syndrome and healthy individuals

    Directory of Open Access Journals (Sweden)

    I. G. Mikhailyuk

    2014-01-01

    Full Text Available Surface sensitivity disorders are observed in many diseases of the central and peripheral nervous system. Surface sensitivity thresholds were estimated in healthy individuals and patients with carpal tunnel syndrome. There was a statistically significant (p < 0.001 increase in the sensitivity threshold in the distal phalanx of the index finger in patients with carpal tunnel syndrome as compared to healthy individuals, by evaluating the surface sensitivity by Semmes–Weinstein monofilaments.

  8. The effect of a weak W/SiC interface on the strength of sigma silicon carbide monofilament

    Science.gov (United States)

    Dyos; Shatwell

    1999-11-01

    Fractography studies have shown that the strength-determining flaws in silicon carbide monofilaments are generally at the core/silicon carbide interface or in the vicinity of the outside, carbon-based coating. In tungsten-cored monofilaments like DERA Sigma, the W/SiC flaws primarily determine the strength. Fracture is accompanied by brittle failure of the tungsten. The crack propagates simultaneously outwards through the silicon carbide, inwards through the tungsten and also around the W/SiC interface before being deflected into the tungsten or out through the silicon carbide. Experiments depositing boundary layers between the tungsten and silicon carbide have resulted in significantly different fracture behaviour. The tungsten fails in a ductile manner and the strength-determining flaws are located predominantly at the outside surface of the silicon carbide. This behaviour is discussed in terms of models proposed by E. Martin and W. Curtin. It is thought that the work will ultimately lead to a significantly stronger, tungsten-based monofilament.

  9. Fabrication of thermally evaporated Al thin film on cylindrical PET monofilament for wearable computing devices

    Science.gov (United States)

    Liu, Yang; Kim, Eunju; Han, Jeong In

    2016-01-01

    During the initial development of wearable computing devices, the conductive fibers of Al thin film on cylindrical PET monofilament were fabricated by thermal evaporation. Their electrical current-voltage characteristics curves were excellent for incorporation into wearable devices such as fiber-based cylindrical capacitors or thin film transistors. Their surfaces were modified by UV exposure and dip coating of acryl or PVP to investigate the surface effect. The conductive fiber with PVP coating showed the best conductivities because the rough surface of the PET substrate transformed into a smooth surface. The conductivities of PET fiber with and without PVP were 6.81 × 103 Ω-1cm-1 and 5.62 × 103 Ω-1cm-1, respectively. In order to understand the deposition process of Al thin film on cylindrical PET, Al thin film on PET fiber was studied using SEM (Scanning Electron Microscope), conductivities and thickness measurements. Hillocks on the surface of conductive PET fibers were observed and investigated by AFM on the surface. Hillocks were formed and grown during Al thermal evaporation because of severe compressive strain and plastic deformation induced by large differences in thermal expansion between PET substrate and Al thin film. From the analysis of hillock size distribution, it turns out that hillocks grew not transversely but longitudinally. [Figure not available: see fulltext.

  10. Absorbable Polydioxanone (PDS) suture provides fewer wound complications than polyester (ethibond) suture in acute Tendo-Achilles rupture repair

    LENUS (Irish Health Repository)

    Baig, M N

    2017-05-01

    We prospectively studied acute Achilles tendon rupture in patients over a two 2-year period and reviewed the causes, outcome and complications. There were 53 patients included with acute Achilles rupture with minimum follow up period of 6 months. We compared the outcomes including infection rate and Boyden score between the two groups repaired by Polydioxanone and Polyester respectively. All infected cases had a suture repair using the polyester suture. The difference in the infection rate was highly significant between the 2 groups (p=0.001). All 34 patients (100%) in the PDS group had good \\/ excellent results based on the Boyden clinical assessment. Conversely, only 16 patients 9(68.4%) had good or excellent results IN Polyester repair group. Patients treated with a non- absorbable suture (ethibond) material for repair had a higher incidence infection and worse Boyden scores than the absorbable PDS group.

  11. Antibacterial-Coated Suture in Reducing Surgical Site Infection in Breast Surgery: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Enora Laas

    2012-01-01

    Full Text Available Background. To reduce the incidence of microbial colonization of suture material, Triclosan- (TC-coated suture materials have been developed. The aim of this study was to assess the incidence of suture-related complications (SRC in breast surgery with and without the use of TC-coated sutures. Methods. We performed a study on two consecutive periods: 92 patients underwent breast surgery with conventional sutures (Group 1 and 98 with TC-coated sutures (Group 2. We performed subgroups analyses and developed a model to predict SRC in Group 1 and tested its clinical efficacy in Group 2 using a nomogram-based approach. Results. The SRC rates were 13% in Group 1 and 8% in Group 2. We found that some subgroups may benefit from TC-coated sutures. The discrimination obtained from a logistic regression model developed in Group 1 and based on multifocality, age and axillary lymphadenectomy was 0.88 (95% CI 0.77–0.95 (. There was a significant difference in Group 2 between predicted probabilities and observed percentages (. The predicted and observed proportions of complications in the high-risk group were 38% and 13%, respectively. Conclusion. This study used individual predictions of SRC and showed that using TC-coated suture may prevent SRC. This was particularly significant in high-risk patients.

  12. An Alternative Alar Cinch Suture

    Science.gov (United States)

    Rauso, Raffaele; Freda, Nicola; Curinga, Giuseppe; Del Pero, Claudio; Tartaro, Gianpaolo

    2010-01-01

    Nasal widening is commonly associated to maxillary osteotomies, but it is only partially dependent on the amount of skeletal movement. Techniques for controlling lateralization of the ala, including the alar base cinch technique, originally described by Millard, have been well reported by Collins and Epker and later modified by others. In this article, authors report the effect of a new alar cinch suture technique on a sample of 32 patients. PMID:21187940

  13. An innovative method to evaluate the suture compliance in sealing the surgical wound lips

    Directory of Open Access Journals (Sweden)

    Farid Saleh, Beniamino Palmieri, Danielle Lodi, Khalid Al-Sebeih

    2008-01-01

    Full Text Available Background and aim: The increasing number of surgical procedures performed with local anesthesia, followed by immediate patient discharge from the hospital, emphasizes the need for a tight waterproof suture that is capable of maintaining its tensile strength in the postoperative phase when the wound tumescence, edema due to the anesthetic drug, and surgical trauma disappear. Moreover, the issue of having an accurate surgical wound closure is very relevant in vivo in order to prevent hemorrhage and exogenous microbial infections. This study aimed at designing a new a lab technique that could be used for evaluating the best surgical material. Using such a technique, we compared the wound-lip-sealing properties of three commonly-used suture threads, namely polyurethane, polypropylene, and polyamide. Materials and methods: The mechanical properties of same-size suture threads made from polyurethane, polypropylene, and polyamide, were compared in order to define the one that possess the best elastic properties by being able to counteract the tension-relaxation process in the first 12 hours following surgery. The tension holding capacity of the suture materials was measured in both in vivo and in vitro experiments. The surface area of the scar associated with the three different suture threads was measured and compared, and the permeability of the three different suture threads was assessed at 0 minute, 2 minute, 4 minute, 6 minute, and 8 minute- interval. Results: Results showed that polyurethane suture threads had significantly (P < 0.05 better tensile strength, elongation endurance before breakage, and better elasticity coefficient as compared to polypropylene and polyamide suture threads. Moreover, polyurethane suture threads were significantly (P < 0.05 more impermeable as compared to the other two suture thread types (polypropylene and polyamide. This impermeability was also associated with a tighter wound-lip-sealing ability, and with

  14. Suture anchor versus suture through tunnel fixation for quadriceps tendon rupture: a biomechanical study.

    Science.gov (United States)

    Lighthart, William A; Cohen, David A; Levine, Richard G; Parks, Brent G; Boucher, Henry R

    2008-05-01

    This biomechanical study compared suture anchors versus transosseous sutures for repair of quadriceps tendon ruptures using a force of 150 N at a frequency of 0.5 Hz. No significant difference in displacement was found between the 2 techniques with initial loading or with load or no load after 1000 cycles. Displacement after 1000 cycles for suture anchors and bone tunnels was 4.65 and 4.50 mm, respectively. These findings suggest a possible role for suture anchors in repairing quadriceps tendon ruptures. Suture anchors are relatively expensive but require less dissection over the patella and do not involve suture placement about the patella tendon.

  15. Age changes in the human frontozygomatic suture from 20 to 95 years.

    Science.gov (United States)

    Kokich, V G

    1976-04-01

    The frontozygomatic suture of human cadaver material was examined by a combination of histologic, radiographic, and gross tecniques to determine the aging changes in the suture and the approximate age at which sutural fusion occurs. The sample consisted of sixty-One specimens of human beings ranging in age from 20 to 95 years. Observations were made on specimens at age intervals of 5 years. Since the frontozygomatic suture is bilateral, one suture from each specimens was used for radiographic and gross examination for synostosis, and the opposite side was subjected to histologic analysis. The findings of this study have lead to the following conclusions: 1. The human frontozygomatic suture undergoes synostosis during the eigth decade of life, but does not completely fuse by the age of 95 years. 2. Synostosis is a progressive process which commences as small areas of bony union that occur initially within the internal portion of the suture and then progresses to the orbital perisosteal surface. Bony union is not found at or near the facial periosteal surface. 3. The bony surfaces of the frontozygomatic suture become increasingly irregular with advancing age as a result of the formation of projections or interifitations=

  16. Medial grasping sutures significantly improve load to failure of the rotator cuff suture bridge repair.

    Science.gov (United States)

    Awwad, George E; Eng, Kevin; Bain, Gregory I; McGuire, Duncan; Jones, Claire F

    2014-05-01

    The suture bridge (SB) transosseous-equivalent rotator cuff repair reduces re-tear rates compared with single-row or other double-row constructs. However, failure rates continue to be high, especially in large and massive tears. The aim of this study was to assess the biomechanical performance of a new SB repair with use of a medial grasping suture compared with the traditional SB repair. Seven matched pairs of sheep infraspinatus tendons were randomly assigned to either SB or suture bridge with grasping suture (SBGS) repair. Each construct was subjected to cyclic loading and then loaded until failure under displacement control in a materials testing machine. Footprint displacement, ultimate load to failure, and mode of failure were assessed. The rotator cuff footprint displacement was less during tensile loading with the addition of the medial grasping suture. The ultimate load to failure was significantly greater for the SBGS repair group than for the SB repair group (334.0 N vs 79.8 N). The mode of failure was the tendon pulling off the footprint in all cases (type 1 tear). There were no failures in which the tendon tore at the medial row of anchors, leaving part of the tendon still on the footprint (type 2 tear). The addition of a medial grasping suture significantly improved the ultimate load to failure and reduced the footprint displacement of the SB rotator cuff repair in a biomechanical model. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  17. CORNEAL ASTIGMATISM AFTER ECCE: A COMPARATIVE STUDY BETWEEN SILK VERSUS NYLON SUTURE

    Directory of Open Access Journals (Sweden)

    Sunita

    2013-11-01

    Full Text Available ABSTRAC T: INTRODUCTION: Cataract as a potent cause of loss of vision in old age persons is probably known since the dawn of human civilization. Post operative astigmatism after cataract extraction remains a big problem for cataract surgeons since Jacques Daviel e ra. Astigmatism is that type of refractive anomaly in which no point focus is formed owing to the unequal refraction of the incident light by the diopteric system of the eye in different meridians. The goal of modern cataract surgery is to produce a pseudo phakic with the quality of vision of a normal phakic eye. Various studies to find out any effect of IOL on post operative astigmatism were carried out but results are controversial. MATERIAL AND METHODS: 60 patients suffering from cataract and fit for extr action were enlisted during the month of August 2008 to February 2009. The general, physical and local examination including preoperative Keratometry, vision and tension were recorded. RESULTS: In the present study, male patients were 38 (63% and female p atients were 22 (37%. Out of the total 60 cases studied, corneo - scleral section of 28 cases (47% were sutured with 10 - 0 nylon suture (Group A while sections of 32 cases were sutured with 8 - 0 black virgin silk suture (Group B.Out of 28 cases of Group A, interrupted sutures were applied in 14 cases (50% (Group A 1 . Cross interrupted sutures were applied in 9 cases (32% Group A 2 , while bootlace continuous sutures were applied in 5 cases (18% (Group A 3 . Out of 32 cases of Group B, interrupted sutures we re applied in 26 cases (80% (Group B 1 , cross interrupted were applied in 3 cases (10% (Group B 2 , while bootlace continuous suture were applied in 3 cases (Group B 3 . In the present series, 19 cases (31% showed with the rule astigmatism, 21 cases (36% showed astigmatism against the rule and 20 cases (33% showed no astigmatism preoperatively, 16 cases were in the range of 0.50D to 1.0D and 12 cases were in the range of 1

  18. Threshold for detection of diabetic peripheral sensory neuropathy using a range of research grade monofilaments in persons with Type 2 diabetes mellitus.

    Science.gov (United States)

    Thomson, Mary P; Potter, Julia; Finch, Paul M; Paisey, Richard B

    2008-09-11

    To identify the threshold of reduced sensory perception in Type 2 diabetes mellitus (Type 2 DM) using a range of research grade monofilaments. Three groups of participants were recruited into a between subject, cross-sectional study. Group 1(NEW), persons with Type 2 DM diagnosed for less than 2 years (n = 80); Group 2 (EST) persons with Type 2 DM diagnosed for more than 2 years (n = 91), and Group 3, a Comparison group without Type 2 DM (n = 73), resulted in a total study population, n = 244. Research grade monofilaments (2, 4, 6, 8 and 10-gram) were employed using standardised protocol, at 6 sites on the plantar aspect of both feet. The demographic and anthropometric measures of gender, age, height, weight, body mass index (BMI), blood pressure and duration of Type 2 DM since diagnosis (if applicable) of the participants were analysed. Perception of the research grade monofilaments differed significantly between the 3 groups (p threshold of normal perception, based on 90% of the Comparison group perceiving the 6-gram monofilament at all sites in contrast to 64% of NEW and 48% of EST groups. The 6-gram monofilament was identified as the threshold of normal sensory perception. Inability to perceive the 6-gram monofilament indicates, when using the method described in this study, that diminution of sensory perception is evident. Employing a range of monofilaments, 6, 8 and 10-grams in Type 2 DM foot screening would allow the clinical detection of deteriorating sensory perception and enable implementation of foot protection strategies at an earlier stage than is currently practised.

  19. Is the pterygopalatomaxillary suture (sutura sphenomaxillaris) a growing suture in the fetus?

    Science.gov (United States)

    Vacher, C; Onolfo, J P; Barbet, J P

    2010-08-01

    The pterygopalatomaxillary suture is considered as having an important role in the posteroanterior growing of the maxilla. To determine whether this suture is a growing suture in the fetus, we performed a histological study of this suture in a fetus aged of 16 weeks of amenorrhea. Serial sections (5 microm) of the pterygopalatomaxillary suture area have been performed. Fibrous sutures are separating four pieces of ossification (maxilla, palatine bone, lateral and medial plates of the pterygoid process). A fibroblastic growing site has been observed on the dorsal aspect of the pterygopalatomaxillary suture, in contact to the anterior border of the lateral plate of the pterygoid process. The posteroanterior growing of maxilla is dependent on a growing suture located on the anterior border of the pterygoid process. The pterygoid process (via its lateral plate) makes the junction between the maxilla and both the cranial base and the condylar mandibular site of growth.

  20. Bio-inspired ``jigsaw''-like interlocking sutures: Modeling, optimization, 3D printing and testing

    Science.gov (United States)

    Malik, I. A.; Mirkhalaf, M.; Barthelat, F.

    2017-05-01

    Structural biological materials such as bone, teeth or mollusk shells draw their remarkable performance from a sophisticated interplay of architectures and weak interfaces. Pushed to the extreme, this concept leads to sutured materials, which contain thin lines with complex geometries. Sutured materials are prominent in nature, and have recently served as bioinspiration for toughened ceramics and glasses. Sutures can generate large deformations, toughness and damping in otherwise all brittle systems and materials. In this study we examine the design and optimization of sutures with a jigsaw puzzle-like geometry, focusing on the non-linear traction behavior generated by the frictional pullout of the jigsaw tabs. We present analytical models which accurately predict the entire pullout response. Pullout strength and energy absorption increase with higher interlocking angles and for higher coefficients of friction, but the associated high stresses in the solid may fracture the tabs. Systematic optimization reveals a counter-intuitive result: the best pullout performance is achieved with interfaces with low coefficient of friction and high interlocking angle. We finally use 3D printing and mechanical testing to verify the accuracy of the models and of the optimization. The models and guidelines we present here can be extended to other types of geometries and sutured materials subjected to other loading/boundary conditions. The nonlinear responses of sutures are particularly attractive to augment the properties and functionalities of inherently brittle materials such as ceramics and glasses.

  1. Comparação dos gastos com material para reparação de perfurações de córnea com cola de cianoacrilato e sutura de córnea Comparative cost evaluation in corneal perforation repair with cyanoacrylate adhesive versus corneal suture

    Directory of Open Access Journals (Sweden)

    Emerson Lioji Ueda

    2004-02-01

    Full Text Available OBJETIVO: Avaliação comparativa de custos de reparação de pequenas perfurações oculares utilizando a técnica da cola de cianoacrilato Super Bonder® (2-metil-cianoacrilato comparada à técnica de sutura de córnea. MÉTODOS: A fim de avaliar comparativamente os custos do uso da técnica de cola de cianoacrilato com a técnica de sutura de córnea, realizou-se análise dos materiais usados em ambas técnicas. RESULTADOS: A análise de custos comparativos entre o uso da técnica de cola de cianoacrilato em pequenas perfurações, versus a técnica de sutura de córnea demonstrou menor gasto com uso do adesivo. CONCLUSÃO: A utilização da técnica de cola de cianoacrilato, para reparação de perfuração de córnea, apresentou custos menores quando comparada com a técnica de sutura de córnea.PURPOSE: The aim of this study was performing a comparative evaluation of cost in small ocular perforation repair using cyanoacrylate adhesive technique Super BonderTM (methyl-2-cyanoacrylate as compared with corneal suture technique. METHODS: In order to compare evaluations of cost a cost analysis in "reais" (R$ was conducted for both techniques according to the materials used in cyanoacrylate glue technique and the corneal suture. RESULTS: The analysis of comparative cost of the cyanoacrylate adhesive technique in small perforations versus corneal suture showed a lower cost of the former. CONCLUSION: Lower cost was found for the cyanoacrylate glue technique for corneal perforation repair when compared to the corneal suture technique.

  2. Use of Absorbable Sutures in Canine Carotid Arteries

    Science.gov (United States)

    Rey, Alejandro R.; Carrillo-Farga, Joaquin; Velasco, Carlos O.; Valencia, Martin O.V.

    1990-01-01

    To study the functional and microstructural characteristics of polydioxanone sutures in vascular surgery, we created 48 vascular anastomoses in the right and left common carotid arteries of 24 mongrel dogs. In each animal, polydioxanone sutures were used in 1 carotid artery, and polypropylene sutures were used in the contralateral carotid artery. Twelve groups of 2 animals each were then formed. The 1st group was observed for 1 month, the 2nd for 2 months, the 3rd for 3 months, and so on until the 12th group, which was observed for 12 months. At the end of each observation period, reoperation was undertaken to evaluate the vascular anastomoses by means of angiography and microscopy. The polypropylene anastomoses showed a marked deformity, with tissue retraction and a foreign body reaction. In contrast, the polydioxanone anastomoses exhibited satisfactory healing, without deformity, and were well tolerated histologically. We believe that polydioxanone may be a useful, alternative vascular suture material. (Texas Heart Institute Journal 1990;17:99-102) Images PMID:15227391

  3. Introduction of a New Suture Method in Repair of Peripheral Nerves Injured with a Sharp Mechanism

    Directory of Open Access Journals (Sweden)

    Alireza Saied

    2015-09-01

    Full Text Available Background: The standard method for repair of an injured peripheal nerve is epineural repair with separate sutures. Herein we describe a method in which the nerve is sutured with continous sutures. In fact this method has not been utilized for nerve repair previously and our purpose was to compare it to the standard method. If it proved to be successful it would replace the standard method in certain circumstances. Methods: The proposal of the clinical trial was given a reference number form the ethics comitee. 25 dogs in which the scaitic nerve was cut by a sharp blade under genaeral anesthesia were divided randomly into three groups: control (5 dogs, repair of sciatic nerve with simple sutures (10 and repair with continous sutures (10. In the control group the nerve was not repaired at all. After 6 weeks the dogs were killed and the nerve was studied by light and electronic microscopes. The amount of consumed suture material, time of repair, myelin thickness and axon diiameter were examined. Ultrastructural studies were performed to assess degeneration and regeneration findings. Results: Time of repair and the amount of consumed suture material were significantly lower in the continous group (P

  4. Nonabsorbable versus absorbable sutures in large, hang-back medial rectus muscle recessions.

    Science.gov (United States)

    Awadein, Ahmed; Marsh, Justin D; Guyton, David L

    2016-06-01

    To investigate the value of nonabsorbable sutures in reducing the incidence of consecutive exotropia after large, "hang-back" medial rectus recessions. The medical records of patients who underwent medial rectus recession of ≥6.5 mm in individuals ≤2 years of age, or ≥7.0 mm in those >2 years were retrospectively reviewed. Patients were divided into two groups based on suture material used: absorbable, polyglactin 910 sutures (44 patients); nonabsorbable, polyester sutures (50 patients). Preoperative measurements, ductions, strabismus surgery, and postoperative results were analyzed. Inadequate anchoring of the medial rectus muscle was suspected when consecutive exotropia developed 4-7 weeks after surgery after initial satisfactory alignment and was confirmed if during reoperation the medial rectus muscle appeared recessed >2 mm beyond the originally intended recession. Consecutive exotropia due to inadequate anchoring of the medial rectus muscle occurred in 11 of 66 muscles (17%) in the absorbable suture group. The muscle was found 6-10 mm posterior to the intended recession. Limited duction in the field of action of the involved medial rectus muscle occurred in 9 of the 11 muscles (82%). None of the eyes with nonabsorbable sutures showed inadequate anchoring. The incidence of consecutive exotropia was higher in the absorbable suture group (30%) than in the nonabsorbable suture group (6%) (P < 0.005). Using nonabsorbable suture for large, hang-back medial rectus recessions greatly reduces the incidence of consecutive exotropia that can occur when absorbable suture dissolves. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  5. A new, removable, sliding noose for adjustable-suture strabismus surgery.

    Science.gov (United States)

    Deschler, Emily K; Irsch, Kristina; Guyton, Kristina L; Guyton, David L

    2013-10-01

    We describe a new removable sliding polyglactin 910 suture noose for postoperative suture adjustment following extraocular muscle surgery. No excess suture material remains after adjustment has been completed, helping to reduce discomfort, inflammation, and scarring. We have used this noose with the cul-de-sac conjunctival incision in approximately 360 patients over a period of 18 months. This report details how to fashion, use, and remove the noose. Copyright © 2013 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  6. In Vitro Oral Biofilm Formation on Triclosan-Coated Sutures in the Absence and Presence of Additional Antiplaque Treatment

    NARCIS (Netherlands)

    Venema, Sebastiaan; Abbas, Frank; van de Belt-Gritter, Betsy; van der Mei, Henny C.; Busscher, Henk J.; van Hoogmoed, Chris G.

    Purpose: This study evaluated the in vitro plaque inhibitory effect of triclosan-coated polyglactin 910 sutures in the absence and presence of an additional antiplaque agent commonly used after oral surgery. Materials and Methods: Triclosan-coated sutures were incubated for 4 hours in freshly

  7. In Vitro Oral Biofilm Formation on Triclosan-Coated Sutures in the Absence and Presence of Additional Antiplaque Treatment

    NARCIS (Netherlands)

    Venema, Sebastiaan; Abbas, Frank; van de Belt-Gritter, Betsy; van der Mei, Henny C.; Busscher, Henk J.; van Hoogmoed, Chris G.

    2011-01-01

    Purpose: This study evaluated the in vitro plaque inhibitory effect of triclosan-coated polyglactin 910 sutures in the absence and presence of an additional antiplaque agent commonly used after oral surgery. Materials and Methods: Triclosan-coated sutures were incubated for 4 hours in freshly collec

  8. Mesenchymal stem cell-coated sutures enhance collagen depositions in sutured tissues.

    Science.gov (United States)

    Casado, Javier G; Blazquez, Rebeca; Jorge, Inmaculada; Alvarez, Veronica; Gomez-Mauricio, Guadalupe; Ortega-Muñoz, Mariano; Vazquez, Jesus; Sanchez-Margallo, Francisco M

    2014-01-01

    Sutures are commonly used for surgical procedures and new sutures are being developed to improve wound healing. In the past decade, it has been extensively shown that mesenchymal stem cells (MSCs) have a wound healing potential. To benefit the overall wound healing process, we aimed to analyze the usage of pretreated sutures for improving the implantation of MSCs in the tissues. Our results firstly showed that suture pretreatments with gelatin, poly-L-lysine, and NaOH improved the adhesive strength of MSCs to sutures. These cells remained surrounding the sutured tissue and no significant phenotypic changes were found in those cells cultured onto pretreated sutures. In vivo experiments showed that the implantation of MSCs by suturing increases the collagen content in the sutured tissue. Moreover, proteomics analysis of secreted proteins showed that collagen alpha-1(I) chain was the most abundant collagen found. To our knowledge, this is the first report that aimed to improve the implantation of MSCs in tissue by suture pretreatments. Moreover, in vivo experiments suggest that MSC-coated sutures may enhance wound healing and tissue remodeling through the release of different collagen types being applicable for those patients that tend to have difficulty healing.

  9. Comparison between tenocutaneous suture and Kessler suture techniques in treating acute closed Achilles tendon rupture.

    Science.gov (United States)

    Ding, Wen-Ge; Li, Huan; Zhu, Ya-Ping; Liu, Zhi-wei

    2014-06-01

    To compare the effectiveness of tenocutaneous suture and conventional Kessler suture techniques in treating acute closed Achilles tendon rupture. A total of 33 patients with acute closed Achilles tendon rupture who were admitted to our hospital from February 1998 to December 2008 underwent repair with either a tenocutaneous suture or Kessler suture technique. All patients were followed up for 1-5 years (mean, 3 years). According to the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale, the excellence rate was 91% in the Kessler suture group and 98% in the tenocutaneous suture group, with a significant difference between groups. Our tenocutaneous suture technique is an effective method for treating Achilles tendon rupture. It has certain advantages compared with the conventional incision method and is worthy of wide clinical application. Copyright © 2014 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  10. New adjustable suture technique for trabeculectomy

    Directory of Open Access Journals (Sweden)

    Vespasiano Rebouças-Santos

    2013-06-01

    Full Text Available PURPOSE: To describe an adjustable suture (AS experimental model that allows for tightening, loosening and retightening of the suture tension in trabeculectomy. METHODS: Standard trabeculectomy was performed in fifteen pig eyeballs. All pig eyes were tested twice: one test with conventional suture in both flap's corners (conventional suture group and another test with a conventional suture at one corner and an adjustable suture in the other corner (AS group. The order in which each test was performed was defined by randomization. Intraocular pressure was measured at three time points: T1 when the knots were tightened; T2 when the AS was loosened or the conventional knot was removed; and T3 when the AS was retightened in the AS group or five minutes after the knot removal in the conventional suture group. RESULTS: The mean Intraocular pressure was similar between the two groups at time point 1 (p=0.97. However, significant Intraocular pressure differences were found between eyes in the conventional and adjustable suture groups at time points 2 (12.6 ± 4.2 vs 16.3 ± 2.3 cmH2O, respectively, p=0.006 and 3 (12.2 ± 4.0 vs 26.4 ± 1.7cmH2O, respectively; p=0.001. While the conventional technique allowed only Intraocular pressure reduction (following the knot removal; T2 and T3, the AS technique allowed both Intraocular pressure reduction (T2 and elevation (T3 through the management (loosening and retightening of the suture. CONCLUSION: This experimental model provides an effective noninvasive postoperative mechanism of suture tension adjustment.

  11. Visibility of Sutures of the Orbit and Periorbital Region Using Multidetector Computed Tomography

    OpenAIRE

    2014-01-01

    Objective Knowledge of cranial suture morphology is crucial in emergency medicine, forensic medicine, and maxillofacial reconstructive surgery. This study assessed the visibility of sutures of the orbit and periorbital region on multidetector computed tomography. Materials and Methods Multidetector computed tomography scans of 200 patients (127 males, 73 females; mean age 51.3 years; range, 6-92 years) were evaluated retrospectively. The slice thicknesses varied from 0.5 to 1 mm, and the tube...

  12. Postoperative washing of sutured wounds

    Directory of Open Access Journals (Sweden)

    Conrad Harrison

    2016-11-01

    Full Text Available A best evidence topic was written according to the structured protocol. The three part question addressed was: [In patients undergoing closure of surgical wounds with sutures] does [keeping the wound dry for the first 48 h after closure] [reduce the incidence of surgical site infections (SSIs]? 4 relevant papers were culled from the literature and appraised. The authors, date, country, population, study type, main outcomes, key results and study weaknesses were tabulated. Current NICE guidelines recommend cleaning surgical wounds with sterile saline only for the first 48 h following skin closure. We found no evidence that washing wounds with tap water during this period increases the incidence of SSIs compared to keeping them dry. Further randomised controlled trials will enable the construction of conclusive systematic reviews and meta-analyses.

  13. Skin closure in vascular neurosurgery: A prospective study on absorbable intradermal suture versus nonabsorbable suture.

    Science.gov (United States)

    Pereira, Julio Leonardo Barbosa; Vieira, Gerival; de Albuquerque, Lucas Alverne Freitas; Mendes, George de Albuquerque Cavalcanti; Salles, Ludmila Rezende; de Souza, André Felipe Ferreira; Dellaretti, Marcos; de Sousa, Atos Alves

    2012-01-01

    The craniotomy performed with minimal hair removal and closure with intradermal suture alone is an option in neurosurgical procedures, which can help faster psychological recovery of the patient, as it allows a better cosmetic result. This study is aimed at evaluating if such method is safe and effective, compared with continuous skin sutures with 2-0 nylon. We analyzed the sutures in 117 patients undergoing craniotomies for cerebral aneurysm clipping. In the case group (n = 49), closure of the scalp was performed only with intradermal absorbable sutures using wire Monocryl(®) 2-0. In the control group (n = 68), closure was performed with continuous suture using 2-0 nylon. The case group was composed of 49 patients in whom just intradermal suture was performed. One (2.2%) patient developed wound infection and was given proper medical treatment. No cases of dehiscence or cerebrospinal fluid leaks were observed. The control group was composed of 68 patients in whom the skin was closed with 2-0 nylon continuous suture. Three (5.3%) patients developed wound infection and were given proper medical treatment. There were no cases of wound dehiscence. The overall infection rate in the control group was 4%. There was no statistically significant difference in the number of wound infections between the two groups (P = 0.73). The closure with intradermal suture alone in craniotomies is as safe as the traditional skin closure with nylon sutures, besides eliminating the need for suture removal and providing a cosmetic advantage.

  14. Eğirdir Gölü' nde Monofilament ve Multifilament Sade Uzatma Ağlarının Av ve Ekonomik Verimliliklerinin Karşılaştırılması

    Directory of Open Access Journals (Sweden)

    Mustafa İlker SÜRER

    2014-07-01

    Full Text Available The use of monofilament gill nets were prohibited from 2011 fishing period. Fishing efficiency of monofilament gill nets with multifilament gill nets were investigated effect on region fishing. In this study, catch efficiencies of the same features monofilament and multifilament 80, 90, 100, 110 and 120 mm mesh size gill nets compared within including from November 2009 to November 2010 in Egirdir Lake. As a result of this study, according to the fishing, productivity was found more plentiful in monofilament gill nets than multifilament gill nets. The highest fishing productivity of 90 mm monofilament gill net 15925 g (23.66% and the lowest 80 mm multifilament gill net 997 g (4.12% for caught most (%92,50 in total fishing of Prussian carp, Carassius gibelio, (Bloch, 1782 were found

  15. Pectoralis major tendon repair: a biomechanical study of suture button versus transosseous suture techniques.

    Science.gov (United States)

    Thomas, William; Gheduzzi, Sabina; Packham, Iain

    2015-09-01

    Pectoralis major tendon avulsion injury benefits from surgical repair. The technique used and speed of rehabilitation in this demanding population remains subject to debate. We performed a biomechanical study comparing suture button (Pec Button™, Arthrex, Naples, FL) with a transosseous suture technique (FibreWire, Arthrex, Naples, FL). Freshly slaughtered porcine humeri were prepared to model a single transosseous suture or suture button repair. A static, tensile load to failure experiment and a cyclic, tensile load experiment to model standard (10,000 cycles) and accelerated rehabilitation (20,000 cycles) philosophies were tested. The mode of failure, yield and ultimate failure load, extension (clinical failure >10 mm) and the resistance to cyclic loading was measured. The mode of failure was suture fracture in all the static load experiments with 10/11 occurring as the suture passed through the button and 7/11 as the suture passed through the bone tunnels. There was a significant difference in yield load, favouring transosseous suture [p = 0.009, suture button (SB) 673.0 N (647.2-691.7 N), transosseous suture (TOS) 855.0 N (750.0-891.4 N)] and median extension, favouring suture button [p = 0.009, SB 8.8 mm (5.0-12.4 mm), TOS 15.2 mm (13.2-17.1 mm)]. 2/3 transosseous suture and 0/3 suture buttons failed before completing 20,000 cycles. The difference in mean number of cycles completed was non-significant. The difference in mean extension was 5.1 mm (SB 6.7 mm, TOS 11.7 mm). Both techniques show advantages. The difference in extension is likely to be more clinically relevant than load tolerated at failure, which is well above physiological levels. The findings do not support an accelerated rehabilitation model.

  16. Influence of different length of core suture purchase among suture row on the strength of 6-strand tendon repairs.

    Science.gov (United States)

    Okubo, Hirotaka; Kusano, Nozomu; Kinjo, Masaki; Kanaya, Fuminori

    2015-01-01

    In multi-strand suture methods consisting of several suture rows, the different length of core suture purchase between each suture row may affect the strength of repairs. We evaluated the influence of the different length of core suture purchase between each suture row on the strength of 6-strand tendon repairs. Rabbit flexor tendons were repaired by using a triple-looped suture technique in which the suture purchase length in each suture row was modified. Group 1, all lengths are 8-mm. Group 2, all lengths are 10-mm. Group 3, two are 10-mm and one is 8-mm. Group 4, one is 10-mm and two are 8-mm. The repaired tendons were subjected to load-to-failure test. The gap strength was significantly greater in Group 1 and Group 2 than in Group 3 and Group 4. This study demonstrates that maintaining equal core suture purchase lengths of each suture row increases the gap resistance.

  17. Transeptal suturing - a cost-efficient alternative for nasal packing in septal surgery.

    Science.gov (United States)

    Plasencia, Daniel Pérez; Falcón, Juan Carlos; Barreiro, Silvia Borkoski; Bocanegra-Pérez, María Sacramento; Barrero, Mario Vicente; Macías, Ángel Ramos

    2016-01-01

    Nasal packing is routinely used in septal surgery to prevent postoperative bleeding. To demonstrate the possibility of transeptal suture as a safe and effective way to avoid nasal packing and to improve efficiency. This is a prospective, descriptive, inferential cost study comprising 92 patients. Two randomized groups of patients were analyzed, one with nasal packing and the other with transeptal suture. In the group of transeptal suture no patient experienced postoperative bleeding, and a statistically significant reduction of pain and headache was demonstrated. At the same time, we improved efficiency by saving on material costs. Transeptal suture is an effective and safe alternative to classic nasal packing in septal surgery. Moreover, it improves the efficiency of the intervention by saving costs. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  18. Transeptal suturing - a cost-efficient alternative for nasal packing in septal surgery

    Directory of Open Access Journals (Sweden)

    Daniel Pérez Plasencia

    Full Text Available ABSTRACT INTRODUCTION: Nasal packing is routinely used in septal surgery to prevent postoperative bleeding. OBJECTIVE: To demonstrate the possibility of transeptal suture as a safe and effective way to avoid nasal packing and to improve efficiency. METHODS: This is a prospective, descriptive, inferential cost study comprising 92 patients. Two randomized groups of patients were analyzed, one with nasal packing and the other with transeptal suture. RESULTS: In the group of transeptal suture no patient experienced postoperative bleeding, and a statistically significant reduction of pain and headache was demonstrated. At the same time, we improved efficiency by saving on material costs. CONCLUSIONS: Transeptal suture is an effective and safe alternative to classic nasal packing in septal surgery. Moreover, it improves the efficiency of the intervention by saving costs.

  19. Suture slippage in knotless suture anchors resulting in subacromial-subdeltoid bursitis.

    Science.gov (United States)

    Hayeri, Mohammad Reza; Keefe, Daniel T; Chang, Eric Y

    2016-05-01

    Rotator cuff repair using a suture bridge and knotless suture anchors is a relatively new, but increasingly used technique. The suture bridge technique creates an anatomically similar and more secure rotator cuff repair compared with conventional arthroscopic techniques and the use of knotless anchors eliminates the challenges associated with knot tying during arthroscopic surgery. However, previous in vitro biomechanical tests have shown that the hold of the suture in a knotless suture anchor is far lower than the pullout strength of the anchor from bone. Up until now slippage has been a theoretical concern. We present a prospectively diagnosed case of in vivo suture loosening after rotator cuff repair using a knotless bridge technique resulting in subacromial-subdeltoid bursitis.

  20. Skin closure in vascular neurosurgery: A prospective study on absorbable intradermal suture versus nonabsorbable suture

    OpenAIRE

    Pereira, Julio Leonardo Barbosa; Vieira,Gerival; de Albuquerque, Lucas Alverne Freitas; Mendes, George de Albuquerque Cavalcanti; Salles, Ludmila Rezende; de Souza, André Felipe Ferreira; Dellaretti, Marcos; Sousa,Atos Alves de

    2012-01-01

    Background: The craniotomy performed with minimal hair removal and closure with intradermal suture alone is an option in neurosurgical procedures, which can help faster psychological recovery of the patient, as it allows a better cosmetic result. This study is aimed at evaluating if such method is safe and effective, compared with continuous skin sutures with 2-0 nylon. Methods: We analyzed the sutures in 117 patients undergoing craniotomies for cerebral aneurysm clipping. In the case group (...

  1. 21 CFR 878.5030 - Natural nonabsorbable silk surgical suture.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Natural nonabsorbable silk surgical suture. 878... Natural nonabsorbable silk surgical suture. (a) Identification. Natural nonabsorbable silk surgical suture... Bombycidae. Natural nonabsorbable silk surgical suture is indicated for use in soft tissue...

  2. 21 CFR 878.4495 - Stainless steel suture.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Stainless steel suture. 878.4495 Section 878.4495...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4495 Stainless steel suture. (a) Identification. A stainless steel suture is a needled or unneedled nonabsorbable surgical suture composed of...

  3. Strength of different meniscus suturing techniques.

    Science.gov (United States)

    Aşik, M; Sener, N; Akpinar, S; Durmaz, H; Göksan, A

    1997-01-01

    We measured and compared the primary stabilities of five different meniscal suturing techniques. The techniques tested were horizontal mattress, vertical mattress, knot-end, vertical, and vertical loop. Twenty bovine medial menisci were cut to simulate peripheral longitudinal tears and repaired with one of the five suture techniques. Then the two parts of the meniscus were pulled using the Instron Tensometer until failure occurred. Knot-end techniques gave inferior results (mean ultimate failure strength 64 +/- 5 N) compared with the other techniques. Vertical mattress failed at 130 +/- 3 N, vertical loop at 128 +/- 4.5 N, horizontal mattress at 98 +/- 5 N and vertical suturing at 136 +/- 2.7 N. This study shows the superior mechanical characteristic of the vertical suturing technique.

  4. Development of manufacturing process for large-diameter composite monofilaments by pyrolysis of resin-impregnated carbon-fiber bundles

    Science.gov (United States)

    Bradshaw, W. G.; Pinoli, P. C.; Vidoz, A. E.

    1972-01-01

    Large diameter, carbon-carbon composite, monofilaments were produced from the pyrolysis of organic precursor resins reinforced with high-strenght carbon fibers. The mechanical properties were measured before and after pyrolysis and the results were correlated with the properties of the constituents. The composite resulting from the combination of Thornel 75 and GW-173 resin precursor produced the highest tensile strength. The importance of matching strain-to-failure of fibers and matrix to obtain all the potential reinforcement of fibers is discussed. Methods are described to reduce, within the carbonaceous matrix, pyrolysis flaws which tend to reduce the composite strength. Preliminary studies are described which demonstrated the feasibility of fiber-matrix copyrolysis to alleviate matrix cracking and provide an improved matrix-fiber interfacial bonding.

  5. Frimand Needle Holder Reduces Suturing Time and Surgical Stress When Suturing in Palm Grip.

    Science.gov (United States)

    Frimand Rönnow, Carl-Fredrik; Jeppsson, Bengt; Thorlacius, Henrik

    2016-06-01

    Purpose The Frimand needle holder (FNH) was developed to facilitate palm grip suturing. In the present study, we wanted to examine the impact of the FNH compared with a conventional Hegar-styled needle holder (HSNH) on suture time and surgical stress. Methods Thirty-two surgeons were enrolled and they performed sets of 3 continuous sutures on a polyurethane pad with premarked insert and exit points and the time for suturing was measured. Surgical stress was quantified by having the surgeons to perform 10 release maneuvers with the FNH and the HSNH on a needle attached to a scale. The scale sent 5 values per second to a computer. The first measurement of each series was regarded as the starting weight and all subsequent measurements were either regarded as neutral, pressure or traction. The sum of these measurements represented total surgical stress. Results We found that all surgeons reduced their median suturing time by 16% when using FNH for palm grip suturing with no difference between junior and senior surgeons. Moreover, it was observed that FNH decreased median surgical stress by 62% for all surgeons performing palm grip suturing compared with a conventional HSNH. Conclusion We conclude that the FNH reduces suture time and surgical stress compared with HSNH when performing palm grip suturing. These findings warrant studies in surgical patients in order to evaluate the potential clinical impact of FNH.

  6. Comparative evaluation of sutures coated with triclosan and chlorhexidine for oral biofilm inhibition potential and antimicrobial activity against periodontal pathogens: An in vitro study

    Directory of Open Access Journals (Sweden)

    Kunal Sunder Sethi

    2016-01-01

    Full Text Available Background: Surgical site plaque accumulation is one of the challenging problems leading to unfavorable healing. The antibacterial sutures can be used to reduce or inhibit plaque formation. Presently there is no study comparing efficacy of sutures coated with triclosan and chlorhexidine in terms of oral biofilm inhibition and antimicrobial property against periodontal pathogens. Aim: The aim of present study was to evaluate the antibacterial efficacy and oral biofilm inhibition around chlorhexidine and triclosan coated polyglactin sutures in comparison to uncoated sutures. Materials and Method: Equal segments of chlorhexidine and triclosan coated polyglactin sutures (3-0 were incubated at 370°C in saliva collected from 10 chronic periodontitis patients for 7 days. Plain uncoated suture served as control. Biofilm formation was analyzed with Confocal Laser-Scanning Microscopy (CLSM and Scanning Electron Microscopy (SEM. Quantitative assessment was done using Colony Forming Units (CFU/mL.The antibacterial efficacy of the sutures was tested against specific periodontal pathogens (S.mutans, F.nucleatum, A.actinomycetomcomitans, P.intermedia, P.gingivalis using agar diffusion method. CLSM and SEM were not subjected to statistical analysis. ANOVA test was used for colony forming units and agar diffusion test. (P < 0.05 Results: CLSM and SEM showed substantial biofilm inhibition around chlorhexidine-coated sutures followed by triclosan-coated when compared to plain uncoated suture. The antibacterial coated sutures showed statistically significant difference in CFUs/ml and zone of inhibition compared to plain uncoated sutures. Among coated sutures, chlorhexidine-coated sutures showed better results. Conclusion: The antibacterial coated sutures have a promising potential in preventing the colonization of periodontal pathogens around it thereby inhibiting biofilm formation.

  7. The hidden X suture: a technical note on a novel suture technique for alveolar ridge preservation

    Science.gov (United States)

    2016-01-01

    Purpose The present study investigated the impact of 2 different suture techniques, the conventional crossed mattress suture (X suture) and the novel hidden X suture, for alveolar ridge preservation (ARP) with an open healing approach. Methods This study was a prospective randomized controlled clinical trial. Fourteen patients requiring extraction of the maxillary or mandibular posterior teeth were enrolled and allocated into 2 groups. After extraction, demineralized bovine bone matrix mixed with 10% collagen (DBBM-C) was grafted and the socket was covered by porcine collagen membrane in a double-layer fashion. No attempt to obtain primary closure was made. The hidden X suture and conventional X suture techniques were performed in the test and control groups, respectively. Cone-beam computed tomographic (CBCT) images were taken immediately after the graft procedure and before implant surgery 4 months later. Additionally, the change in the mucogingival junction (MGJ) position was measured and was compared after extraction, after suturing, and 4 months after the operation. Results All sites healed without any complications. Clinical evaluations showed that the MGJ line shifted to the lingual side immediately after the application of the X suture by 1.56±0.90 mm in the control group, while the application of the hidden X suture rather pushed the MGJ line slightly to the buccal side by 0.25±0.66 mm. It was demonstrated that the amount of keratinized tissue (KT) preserved on the buccal side was significantly greater in the hidden X suture group 4 months after the procedure (Pclinical and radiographic verification of the efficacy of the hidden X suture in preserving the width of KT and the dimensions of the alveolar ridge after ARP. PMID:28050319

  8. Functional implications of squamosal suture size in paranthropus boisei.

    Science.gov (United States)

    Dzialo, Christine; Wood, Sarah A; Berthaume, Michael; Smith, Amanda; Dumont, Elizabeth R; Benazzi, Stefano; Weber, Gerhard W; Strait, David S; Grosse, Ian R

    2014-02-01

    It has been hypothesized that the extensively overlapping temporal and parietal bones of the squamosal sutures in Paranthropus boisei are adaptations for withstanding loads associated with feeding. Finite element analysis (FEA) was used to investigate the biomechanical effects of suture size (i.e., the area of overlap between the temporal and parietal bones) on stress, strain energy, and strain ratio in the squamosal sutures of Pan troglodytes and P. boisei (specimen OH 5) during biting. Finite element models (FEMs) of OH 5 and a P. troglodytes cranium were constructed from CT scans. These models contain sutures that approximate the actual suture sizes preserved in both crania. The FEM of Pan was then modified to create two additional FEMs with squamosal sutures that are 50% smaller and 25% larger than those in the original model. Comparisons among the models test the effect of suture size on the structural integrity of the squamosal suture as the temporal squama and parietal bone move relative to each other during simulated premolar biting. Results indicate that with increasing suture size there is a decreased risk of suture failure, and that maximum stress values in the OH 5 suture were favorable compared to values in the Pan model with the normal suture size. Strain ratios suggest that shear is an important strain regime in the squamosal suture. This study is consistent with the hypothesis that larger sutures help reduce the likelihood of suture failure under high biting loads. Copyright © 2013 Wiley Periodicals, Inc.

  9. [Influence of tendon surgery training on the quality of the suture].

    Science.gov (United States)

    Poniński, Michał; Tokarski, Maciej; Andrzejewski, Tomasz; Czarnecki, Piotr; Spławski, Robert

    2010-01-01

    Injuries of flexor tendons are one of the most common injuries that need surgical treatment at emergency room. Technique and quality of the surgery was performed are two factors of the utmost importance. The aim of the study was to determine influence of basic surgical training on the quality of suture. Research was divided into four surgical sessions which were held each once a week. Sutures were put by three medical students. Material that was used were deep flexor tendons dissected from fresh pig's legs. Sessions 1st, 2nd and 4th were preceded by training done by experienced surgeon. During study 90 modified-Kessler sutures without additional running suture were made. Breaking strength was assesed by tensile machine (INSTRON 4481). Time of each suture was also recorded. Outcomes were analyzed by tests: ANOVA and post-hoc LSD tests. Time significantly dropped by 64% after the first session and was held on the same level. Strength of sutures rises in each session preceded by training. There was statistically significant difference between session 1 (mean 13.58; SD 9.86N) and 2nd (mean 42.69; SD 9.27N) and 3rd (mean 38.42; SD 12.28N) and 4th (mean 57.12; SD 12.78N). Conclusions. Time of procedure significantly dropped after first teaching course and was held on the same level despite further training. Breaking strength rise in every session that was preceded by teaching course.

  10. A single centre comparative study of laparoscopic mesh rectopexy versus suture rectopexy

    Directory of Open Access Journals (Sweden)

    Manash Ranjan Sahoo

    2014-01-01

    Full Text Available Aim: The aim of our study is to compare the results of laparoscopic mesh vs. suture rectopexy. Materials and Methods: In this retrospective study, 70 patients including both male and female of age ranging between 20 years and 65 years (mean 42.5 yrs were subjected to laparoscopic rectopexy during the period between March 2007 and June 2012, of which 38 patients underwent laparoscopic mesh rectopexy and 32 patients laparoscopic suture rectopexy. These patients were followed up for a mean period of 12 months assessing first bowel movement, hospital stay, duration of surgery, faecal incontinence, constipation, recurrence and morbidity. Results: Duration of surgery was 100.8 ± 12.4 minutes in laparoscopic suture rectopexy and 120 ± 10.8 min in laparoscopic mesh rectopexy. Postoperatively, the mean time for the first bowel movement was 38 hrs and 40 hrs, respectively, for suture and mesh rectopexy. Mean hospital stay was five (range: 4-7 days. There was no significant postoperative complication except for one port site infection in mesh rectopexy group. Patients who had varying degree of incontinence preoperatively showed improvement after surgery. Eleven out of 18 (61.1% patients who underwent laparoscopic suture rectopexy as compared to nine of 19 (47.3% patients who underwent laparoscopic mesh rectopexy improved as regards constipation after surgery. Conclusion: There were no significant difference in both groups who underwent surgery except for patients undergoing suture rectopexy had better symptomatic improvement of continence and constipation. Also, cost of mesh used in laparoscopic mesh rectopexy is absent in lap suture rectopexy group. To conclude that laparoscopic suture rectopexy is a safe and feasible procedure and have comparable results as regards operative time, morbidity, bowel function, cost and recurrence or even slightly better results than mesh rectopexy.

  11. Evaluation of absorbable and nonabsorbable sutures for repair of achilles tendon rupture with a suture-guiding device.

    Science.gov (United States)

    Kocaoglu, Baris; Ulku, Tekin Kerem; Gereli, Arel; Karahan, Mustafa; Turkmen, Metin

    2015-06-01

    The purpose of this study was to compare the functional and clinical results of Achilles tendon repairs with an Achilles tendon suture-guiding device using nonabsorbable versus absorbable sutures. We hypothesized that the absorbable suture would have clinical results comparable to those of the nonabsorbable suture for Achilles tendon repair with an Achilles tendon suture-guiding system. From January 2010 to September 2013, 48 consecutive patients who had sustained a spontaneous rupture of the Achilles tendon underwent operative repair with an Achilles tendon suture-guiding device using 2 different suture types. All ruptures were acute. The patients were divided equally into 2 groups according to suture type. In the nonabsorbable suture group, No. 2 braided nonabsorbable polyethylene terephthalate sutures were used, and in the absorbable suture group, braided absorbable polyglactin sutures were used. The average age of the patients was 38 years (range, 28-50 years). Functional outcome scores and complications were evaluated. All patients had an intact Achilles repair after surgery. The American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot clinical outcome scores were 98 (range, 90-100) in the nonabsorbable suture group and 96.8 (range, 87-100) in the absorbable suture group. All patients returned to their previous work. The absorbable suture group had fewer postoperative complications (0%) than the nonabsorbable suture group (12.5%) (P Achilles tendon repair by an Achilles tendon suture-guiding system was associated with a lower incidence of suture reaction; however, functionally the results were not notably different from those using a traditional nonabsorbable suture. We conclude that repair with absorbable sutures is appropriate for Achilles tendon ruptures. Level II, prospective comparative study. © The Author(s) 2015.

  12. Modified method for bronchial suture by Ramirez Gama compared to separate stitches suture: experimental study

    Directory of Open Access Journals (Sweden)

    Vitor Mayer de Moura

    Full Text Available OBJECTIVE: To experimentally compare two classic techniques described for manual suture of the bronchial stump. METHODS: We used organs of pigs, with isolated trachea and lungs, preserved by refrigeration. We dissected 30 bronchi, which were divided into three groups of ten bronchi each, of 3mm, 5mm, and 7mm, respectively. In each, we performed the suture with simple, separated, extramucosal stitches in five other bronchi, and the technique proposed by Ramirez and modified by Santos et al in the other five. Once the sutures were finished, the anastomoses were tested using compressed air ventilation, applying an endotracheal pressure of 20mmHg. RESULTS: the Ramirez Gama suture was more effective in the bronchi of 3, 5 and 7 mm, and there was no air leak even after subjecting them to a tracheal pressure of 20mmHg. The simple interrupted sutures were less effective, with extravasation in six of the 15 tested bronchi, especially in the angles of the sutures. These figures were not significant (p = 0.08. CONCLUSION: manual sutures of the bronchial stumps were more effective when the modified Ramirez Gama suture was used in the caliber bronchi arms when tested with increased endotracheal pressure.

  13. Facial thread lifting with suture suspension.

    Science.gov (United States)

    Tavares, Joana de Pinho; Oliveira, Carlos Augusto Costa Pires; Torres, Rodolfo Prado; Bahmad, Fayez

    2017-05-09

    The increased interest in minimally-invasive treatments, such as the thread lifting, with lower risk of complications, minimum length of time away from work and effectiveness in correcting ptosis and aging characteristics has led many specialists to adopt this technique, but many doubts about its safety and effectiveness still limit its overall use. To analyze data published in the literature on the durability of results, their effectiveness, safety, and risk of serious adverse events associated with procedures using several types of threading sutures. Literature review using the key words "thread lift", "barbed suture", "suture suspension" and "APTOS". Due to the scarcity of literature, recent reports of facial lifting using threads were also selected, complemented with bibliographical references. The first outcomes of facial lifting with barbed sutures remain inconclusive. Adverse events may occur, although they are mostly minor, self-limiting, and short-lived. The data on the maximum effect of the correction, the durability of results, and the consequences of the long-term suture stay are yet to be clarified. Interest in thread lifting is currently high, but this review suggests that it should not yet be adopted as an alternative to rhytidectomy. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  14. Suture placement near the musculotendinous junction in the supraspinatus: implications for rotator cuff repair.

    Science.gov (United States)

    Kullar, Raj S; Reagan, Jeffrey M; Kolz, Christopher W; Burks, Robert T; Henninger, Heath B

    2015-01-01

    Transosseous-equivalent rotator cuff repair has an increased incidence of medial rotator cuff failure compared with single-row repair. No studies have evaluated the influence of the proximity of the suture row to the musculotendinous junction (MTJ) on cyclic gapping and failure properties. A single row of horizontal mattress sutures placed within the supraspinatus tendon lateral to the MTJ will experience less gap formation and higher failure loads than a similar suture row placed at the MTJ. Controlled laboratory study. Paired supraspinatus tendons were isolated from human cadaveric specimens and resected at the tendon insertion to the humerus. Randomized within a pair, a single row of 4 horizontal mattress sutures was placed either in the tendon 5 mm lateral to the MTJ or at the MTJ. The tied sutures secured the tendon to a fixture that ensured consistent placement of the suture row in the tendon and static fixation of the row. The muscle belly was gripped in a cryoclamp, and a servohydraulic materials testing machine was used to provide uniaxial tensile deformation for 500 cycles at 1 Hz, followed by load to failure at 1 mm/s. Fiducial markers with video tracking were used to quantify gap formation at the suture line, while the materials testing machine recorded loading for the cyclic and failure tests. During cyclic loading, both constructs experienced gross initial gap formation, followed by progressive gap formation that plateaued after cycle 200. The MTJ specimens had significantly higher mean cumulative gapping than the tendon specimens: 3.6±1.0 mm versus 2.4±0.6 mm, respectively (P=.012). The tendon specimens had significantly higher mean loads to failure than did the MTJ specimens: 567.1±121.8 N versus 434.2±148.1 N, respectively (P=.013). The mean failure displacement did not differ between groups for the tendon and MTJ: 5.7±2.5 mm versus 4.5±2.0 mm, respectively (P=.144). A horizontal suture row placed at the MTJ has inferior mechanical properties

  15. Polydioxanone-based bio-materials for tissue engineering and drug/gene delivery applications.

    Science.gov (United States)

    Goonoo, Nowsheen; Jeetah, Roubeena; Bhaw-Luximon, Archana; Jhurry, Dhanjay

    2015-11-01

    Since the commercialization of polydioxanone (PDX) as a biodegradable monofilament suture by Ethicon in 1981, the polymer has received only limited interest until recently. The limitations of polylactide-co-glycolide (PLGA) coupled with the growing need for materials with enhanced features and the advent of new fabrication techniques such as electrospinning have revived interest for PDX in medical devices, tissue engineering and drug delivery applications. Electrospun PDX mats show comparable mechanical properties as the major structural components of native vascular extracellular matrix (ECM) i.e. collagen and elastin. In addition, PDX's unique shape memory property provides rebound and kink resistance when fabricated into vascular conduits. The synthesis of methyl dioxanone (MeDX) monomer and copolymers of dioxanone (DX) and MeDX have opened up new perspectives for poly(ester-ether)s, enabling the design of the next generation of tissue engineering scaffolds for application in regenerating such tissues as arteries, peripheral nerve and bone. Tailoring of polymer properties and their formulation as nanoparticles, nanomicelles or nanofibers have brought along important developments in the area of controlled drug or gene delivery. This paper reviews the synthesis of PDX and its copolymers and provides for the first time an exhaustive account of its applications in the (bio)medical field with focus on tissue engineering and drug/gene delivery.

  16. Cauterization technique for suture erosion in transscleralfixation of intraocular lenses

    Directory of Open Access Journals (Sweden)

    Xu-Ting Hu

    2013-12-01

    Full Text Available Transscleral suturing is a commonly applied technique to fix intraocular implants in the sulcus. A major problem after transscleral implantation is suture erosion that normally happens in the late post-surgery period and may result in an increased incidence of endophthalmitis. Here we describe an original cauterization method by using a glass rod to melt the exposed suture end without damaging the suture knot in the sclera to avoid suture exposure in sclera-fixed IOL implantation. This is a simple, quick and effective technique that can be performed without conjunctiva incisions and will help to reduce suture erosion related complications.

  17. Polypropylene suture--is it safe?

    Science.gov (United States)

    Calhoun, T R; Kitten, C M

    1986-07-01

    Polypropylene suture has steadily gained popularity for use in vascular and cardiac surgical procedures because of its long-term tensile strength and minimal tissue trauma. However, recently some questions have arisen concerning its safety. We recently had two cases of polypropylene fracture, one occurring early and the other late after operation. Comparison and collation of these two cases with other reports leads to the conclusion that polypropylene suture is safe in most situations, but care must be taken to avoid instrumentation trauma and kinking stresses at knots, which probably explain most of the reported cases of polypropylene failure. In addition, polypropylene probably should not be used in graft-to-graft anastomoses in which the continual sawing stresses of two rigid structures appears to lead to an excessive incidence of late suture fracture with resultant false aneurysm formation.

  18. Allergy to Prolene Sutures in a Dural Graft for Chiari Decompression

    Directory of Open Access Journals (Sweden)

    Iahn Cajigas

    2015-01-01

    Full Text Available Allergy to Prolene suture is exceedingly rare with only 5 cases reported in the literature. There have been no such cases associated with neurosurgical procedures. Diagnosis is nearly always delayed in spite of persistent symptomatology. A 27-year-old girl with suspected Ehlers-Danlos, connective tissue disorder, underwent posterior fossa decompression for Chiari Type 1 malformation. One year later, the patient presented with urticarial rash from the neck to chest. Cerebrospinal fluid and blood testing, magnetic resonance imaging, and intraoperative exploration did not suggest allergic reaction. Eventually skin testing proved specific Prolene allergy. After suture material was removed, the patient no longer complained of pruritus or rash. This single case highlights the important entity of allergic reaction to suture material, namely, Prolene, which can present in a delayed basis. Symptomatology can be vague but has typical allergic characteristics. Multidisciplinary approach is helpful with confirmatory skin testing as a vital part of the workup.

  19. Performance Assessment of Suture Type in Juvenile Chinook Salmon Surgically Implanted with Acoustic Transmitters

    Energy Technology Data Exchange (ETDEWEB)

    Deters, Katherine A.; Brown, Richard S.; Carter, Kathleen M.; Boyd, James W.

    2009-02-27

    The objective of this study was to determine the best overall suture material to close incisions from the surgical implantation of Juvenile Salmon Acoustic Telemetry System (JSATS) acoustic microtransmitters in subyearling Chinook salmon Oncorhynchus tshawytscha. The effects of seven suture materials, four surgeons, and two water temperatures on suture retention, incision openness, tag retention, tissue inflammation, and tissue ulceration were quantified. The laboratory study, conducted by researchers at the Pacific Northwest National Laboratory, supports a larger effort under way for the U.S. Army Corps of Engineers, Portland District, aimed at determining the suitability of acoustic telemetry for estimating short- and longer-term (30-60 days) juvenile-salmonid survival at Columbia and Snake River dams and through the lower Columbia River.

  20. The Gore-Tex Suture in Periareolar Closure: A Modified Closure Technique.

    Science.gov (United States)

    Chapman, Jade; Ingram, Scott

    2016-12-01

    In breast reduction and mastopexy procedures, the periareolar closure forms a vital component of the surgery. Periareolar closures completed with an absorbable suture may be prone to significant widening, hypertrophy and/or areolar distortion. In an effort to avoid this, some surgeons use a non-absorbable/permanent suture material [Franco (Arch Plast Surg 41 (6): 728-733, 2014)]. Hammond (Plast Reconstr Surg 119 (3):804-809, 2007) recommends the use of a Gore-Tex® suture for this purpose in view of the supple, pliable nature of the material; however, there remain at least occasional instances of infection and extrusion of the knot used to tie off the Gore-Tex "purse-string" [Franco (Arch Plast Surg 41 (6): 728-733, 2014); Salgarello (Aesthet Plast Surg 37 (5):1061-1062, 2013)]. We describe a method of securing the suture ends, which avoids the creation of a bulky knot, thus minimising the risk of infection and suture extrusion. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  1. The Effect of Sintering Temperature on The Rolled Silver-Sheathed Monofilament Bi,Pb-Sr-Ca-Cu-O Superconducting Wire

    Science.gov (United States)

    Hendrik; Sebleku, P.; Siswayanti, B.; Pramono, A. W.

    2017-05-01

    The manufacture of high critical temperature (Tc) Bi, Pb-Sr-Ca-Cu-O (HTS BPSCCO) superconductor wire fabricated by power-in-tube (PIT) is a multi-step process. The main difficulty is that the value of Tc superconductor wire determined by various factors for each step. The objective of this research is to investigate the effect of sintering parameters on the properties of final rolled material. The fabrication process of 1 m rolled-silver sheath monofilament superconductor BPSCCO wire using mechanical deformation process including rolling and drawing has been carried out. The pure silver powders were melted and formed into pure silver (Ag) tube. The tube was 10 mm in diameter with a sheath material: superconductor powders ratio of about 6 : 1. Starting powders, containing the nominal composition of Bi2-Sr2-Cam-1-Cum-Oy, were inserted into the pure silver tube and rolled until it reached a diameter of 4 mm. A typical area reduction ratio of about 5% per step has been proposed to prevent microcracking during the cold-drawing process. The process of rolling of the silver tube was subsequently repeated to obtain three samples and then followed by heat-treated at 820 °C, 840 °C, and 860 °C, respectively. The surface morphology was analyzed by using SEM; the crystal structure was studied by using X-RD, whereas the superconductivity was investigated by using temperature dependence resistivity measurement by using four-point probe technique. SEM images showed the porosity of the cross-sectional surface of the samples. The sample with low heating temperature showed porosity more than the one with high temperature. The value of critical temperature (Tc) of the sample with a dwelling time of heating of 8 hours is 70 K. At above 70 K, it shows the behavior of conductor properties. However, the porosity increased as the heating time increased up to 24 hours. The critical temperature was difficult to be identified due to its porosity. According to XRD results, the Bi-2212

  2. Usefulness of biodegradable stents constructed of poly-/-lactic acid monofilaments in patients with benign esophageal stenosis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To report 13 patients with benign esophageal stenosis treated with the biodegradable stent.METHODS: We developed a Ultraflex-type stent by knitting poly-l-lactic acid monofilaments.RESULTS: Two cases were esophageal stenosis caused by drinking of caustic liquid, 4 cases were due to surgical resection of esophageal cancers, and 7 cases were patients with esophageal cancer who received the preventive placement of biodegradable stents for postendoscopic mucosal dissection (ESD) stenosis. The preventive placement was performed within 2 to 3 d after ESD. In 10 of the 13 cases, spontaneous migration of the stents occurred between 10 to 21 d after placement. In these cases, the migrated stents were excreted with the feces, and no obstructive complications were experienced. In 3 cases, the stents remained at the proper location on d 21 after placement. No symptoms of re-stenosis were observed within the follow-up period of 7 mo to 2 years. Further treatment with balloon dilatation or replacement of the biodegradable stent was not required.CONCLUSION: Biodegradable stents were useful for the treatment of benign esophageal stenosis, particularly for the prevention of post-ESD stenosis.

  3. Comparison of suture types in the closure of scalp wounds.

    LENUS (Irish Health Repository)

    Bonham, Joseph

    2011-06-01

    Innovation in practice can benefit patients and healthcare providers but must be evidence based. This article describes a quantitative study of whether absorbable sutures are as beneficial as non-absorbable sutures in the management of simple scalp lacerations in adults. The results suggest that absorbable sutures can provide the same cosmetic and functional results as non-absorbable sutures. Their use can also reduce patient returns and save money and resources.

  4. Barbed sutures in general and digestive surgery. Review.

    Science.gov (United States)

    Ferrer-Márquez, Manuel; Belda-Lozano, Ricardo

    2016-02-01

    The appearance of new barbed sutures is an advance in making knots and anastomosis, mainly in laparoscopic surgery, where the majority of the surgeons find themselves limited dealing with these sutures. Through this review we aim to evaluate both the use and the safety of the sutures in General and Laparoscopic Surgery. Barbed sutures seem to ease the procedures improving key aspects such as reproducibility and operative time.

  5. The red-eared slider turtle carapace under fatigue loading: The effect of rib-suture arrangement.

    Science.gov (United States)

    Achrai, Ben; Daniel Wagner, H

    2015-08-01

    Biological structures consisting of strong boney elements interconnected by compliant but tough collagenous sutures are abundantly found in skulls and shells of, among others, armadillos, alligators, turtles and more. In the turtle shell, a unique arrangement of alternating rigid (rib) and flexible (suture) elements gives rise to superior mechanical performance when subjected to low and high strain-rate loadings. However, the resistance to repeated load cycling - fatigue - of the turtle shell has yet to be examined. Such repeated loading could approximately simulate the consecutive high-stress bending loads exerted during (a predator) biting or clawing. In the present study flexural high-stress cyclic loads were applied to rib and suture specimens, taken from the top dorsal part of the red-eared slider turtle shell, termed carapace. Subsequently, to obtain a more complete and integrated fatigue behavior of the carapace, specimens containing a complex alternating rib-suture-rib-suture-rib configuration were tested as well. Although the sutures were found to be the least resistant to repeated loads, a synergistic effect was observed for the complex specimens, displaying improved fatigue durability compared to the individual (suture or even rib) constituents. This study may assist in the design of future high-stress fatigue-resistant materials incorporating complex assemblies of rigid and flexible elements. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Non-suture methods of vascular anastomosis

    NARCIS (Netherlands)

    Zeebregts, CJ; Heijmen, RH; van den Dungen, JJ; van Schilfgaarde, R

    2003-01-01

    Background: The main aim of performing a vascular anastomosis is to achieve maximal patency rates. An important factor to achieve that goal is to minimize damage to the vessel walls. Sutures inevitably induce vascular wall damage, which influences the healing of the anastomosis. Over time, several a

  7. Laparoscopic sacral suture hysteropexy for uterine prolapse.

    Science.gov (United States)

    Krause, Hannah G; Goh, Judith T W; Sloane, Kate; Higgs, Peta; Carey, Marcus P

    2006-06-01

    This study aims to describe and review a new method of uterine conservation in pelvic reconstruction for women with uterine prolapse. This is a prospective study of women who have undergone laparoscopic sacral suture hysteropexy. Structured questions, visual analogue patient satisfaction score (VAS), and vaginal examination were undertaken. Follow-up was performed by non-surgical reviewers. From July 2001 until August 2003, a total of 81 women underwent laparoscopic sacral suture hysteropexy for uterine prolapse. At a mean of 20.3 months follow-up, 76 women (93.8%) were available for questioning and 57 (70.3%) attended for examination. Sixty-five women (87.8%) had no symptoms of pelvic floor prolapse, 54 women (94.7%) had no objective evidence of uterine prolapse, and 61 women (82.4%) were satisfied with their surgery (VAS > or = 80%). Laparoscopic sacral suture hysteropexy attaches the posterior cervix to the sacral promontory via the right uterosacral ligament. Follow-up data of laparoscopic sacral suture hysteropexy indicate it to be an effective method in the management of uterine prolapse.

  8. Experimental study on tissue phantoms to understand the effect of injury and suturing on human skin mechanical properties.

    Science.gov (United States)

    Chanda, Arnab; Unnikrishnan, Vinu; Flynn, Zachary; Lackey, Kim

    2017-01-01

    Skin injuries are the most common type of injuries occurring in day-to-day life. A skin injury usually manifests itself in the form of a wound or a cut. While a shallow wound may heal by itself within a short time, deep wounds require surgical interventions such as suturing for timely healing. To date, suturing practices are based on a surgeon's experience and may vary widely from one situation to another. Understanding the mechanics of wound closure and suturing of the skin is crucial to improve clinical suturing practices and also to plan automated robotic surgeries. In the literature, phenomenological two-dimensional computational skin models have been developed to study the mechanics of wound closure. Additionally, the effect of skin pre-stress (due to the natural tension of the skin) on wound closure mechanics has been studied. However, in most of these analyses, idealistic two-dimensional skin geometries, materials and loads have been assumed, which are far from reality, and would clearly generate inaccurate quantitative results. In this work, for the first time, a biofidelic human skin tissue phantom was developed using a two-part silicone material. A wound was created on the phantom material and sutures were placed to close the wound. Uniaxial mechanical tests were carried out on the phantom specimens to study the effect of varying wound size, quantity, suture and pre-stress on the mechanical behavior of human skin. Also, the average mechanical behavior of the human skin surrogate was characterized using hyperelastic material models, in the presence of a wound and sutures. To date, such a robust experimental study on the effect of injury and sutures on human skin mechanics has not been attempted. The results of this novel investigation will provide important guidelines for surgical planning and validation of results from computational models in the future.

  9. Ab-interno scleral suture loop fixation with cow-hitch knot in posterior chamber intraocular lens decentration

    OpenAIRE

    Ertugrul Can; Nurullah Koçak; Özlem Eski Yücel; Adem Gül; Hilal Eser Öztürk; Osman Sayin

    2016-01-01

    Aim of Study: To describe a simplified ab-interno cow-hitch suture fixation technique for repositioning decentered posterior chamber intraocular lens (PC IOL). Materials and Methods: Two cases are presented with the surgical correction of decentered and subluxated IOL. Ab-interno scleral suture fixation technique with hitch-cow knot in the eye was performed with a ciliary sulcus guide instrument and 1 year follow-up was completed. Results: Both of the patients had well centered lenses postope...

  10. 21 CFR 878.4930 - Suture retention device.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Suture retention device. 878.4930 Section 878.4930 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... button, or a suture bolster, intended to aid wound healing by distributing suture tension over a larger...

  11. Long-term active antimicrobial coatings for surgical sutures based on silver nanoparticles and hyperbranched polylysine.

    Science.gov (United States)

    Ho, Chau Hon; Odermatt, Erich K; Berndt, Ingo; Tiller, Joerg C

    2013-01-01

    The goal of this study was to develop a long-term active antimicrobial coating for surgical sutures. To this end, two water-insoluble polymeric nanocontainers based on hyperbranched polylysine (HPL), hydrophobically modified by either using glycidyl hexadecyl ether, or a mixture of stearoyl/palmitoyl chloride, were synthesized. Highly stabilized silver nanoparticles (AgNPs, 2-5 nm in size) were generated by dissolving silver nitrate in the modified HPL solutions in toluene followed by reduction with L-ascorbic acid. Poly(glycolic acid)-based surgical sutures were dip-coated with the two different polymeric silver nanocomposites. The coated sutures showed high efficacies of more than 99.5% reduction of adhesion of living Staphylococcus aureus cells onto the surface compared to the uncoated specimen. Silver release experiments were performed on the HPL-AgNP modified sutures by washing them in phosphate buffered saline for a period of 30 days. These coatings showed a constant release of silver ions over more than 30 days. After this period of washing, the sutures retained their high efficacies against bacterial adhesion. Cytotoxicity tests using L929 mouse fibroblast cells showed that the materials are basically non-cytotoxic.

  12. Performance of fast-absorbable suture and histo-glue in closing incisions in Brown trout

    DEFF Research Database (Denmark)

    Jepsen, Niels; Larsen, Martin Hage; Aarestrup, Kim

    2017-01-01

    , growth, tag expulsion rate and incision healing was compared among three groups of dummy transmitter-tagged wild brown trout Salmo trutta where incisions were closed with two types of suture material (absorbable vs. fast absorbable) and Histo-glue. The tagged fish were kept in semi-natural ponds for 20...

  13. 可吸收胶原蛋白线与丝线编织非吸收线在口腔种植中的应用%Absorbable collagen suture and non-absorbable silk suture in oral implantation

    Institute of Scientific and Technical Information of China (English)

    徐海洋; 徐昊; 张丽; 曲晓欣; 赵保东

    2014-01-01

    背景:胶原蛋白线由动物的胶原蛋白制备而成,由于其具备可降解、无排异、易于制备、使用方便等优点,现在已开始大量使用于临床。  目的:比较胶原蛋白线与丝线编织线对口腔种植手术切口愈合的影响。  方法:100例种植手术患者随机等分为可吸收胶原蛋白线组和丝线编织非吸收性缝线组,分别使用2-0带圆针可吸收胶原蛋白缝合线与4-0带圆针丝线编织非吸收性缝线对伤口进行间断无张力缝合。植入后3,5,7 d观察缝线及伤口愈合情况,植入后第7天拆线,植入后14 d复诊。  结果与结论:可吸收胶原蛋白线组患者切口甲级愈合率明显多于丝线编织非吸收性缝线组(P OBJECTIVE:To evaluate the effects of col agen suture and silk suture in wound healing after oral implant surgery. METHODS:100 patients undergoing oral implantation were randomly assigned into col agen suture group and silk suture group. A 2-0 circular needle with absorbable col agen sutures and a 4-0 circular needle with non-absorbable silk sutures were employed for tension-free suture in the two groups. After 3, 5, 7 days of oral implantation, suture threads and wound healing were observed. The suture was removed at 14 days, and patients were reviewed at 14 days. RESULTS AND CONCLUSION:The wound healing was better in the col agen suture group than the silk suture group at grade I (P<0.05). At 7 days postoperatively, the suture thread was mostly absorbed in the col agen group but not in the silk suture group. In addition, material alba was invisible in the col agen suture group but clear in the silk suture group. These results indicate that the col agen suture is more proper for tension-free suture than the silk suture, which is better matched to the healing time and keeps a better oral environment.

  14. A pulled sutures technique for bony Bankart lesion.

    Science.gov (United States)

    Lee, Byung Ill; Choi, Hyung Suk; Min, Kyung Dae; Kwon, Sai Won; Kim, Jun Bum; Kim, Yong-Beom; Chun, Dong-Il

    2014-05-01

    In an attempt to present a new surgical technique for arthroscopic bony Bankart fixation, the authors developed the pulled sutures technique. In executing the new method, the authors first passed several non-absorbable sutures through labroligamentous tissue with displaced articular fragment by mimicking transglenoid suture technique. Aimed at achieving a safe and stable fixation, using a knotless anchor rather than transglenoid suture, was deployed. Overall, this pulled sutures technique was shown to be effective with the result of direct reduction, stable, and safe fixation for bony Bankart's lesion.

  15. Biomechanical Comparison of Parallel and Crossed Suture Repair for Longitudinal Meniscus Tears

    Science.gov (United States)

    Milchteim, Charles; Branch, Eric A.; Maughon, Ty; Hughey, Jay; Anz, Adam W.

    2016-01-01

    Background: Longitudinal meniscus tears are commonly encountered in clinical practice. Meniscus repair devices have been previously tested and presented; however, prior studies have not evaluated repair construct designs head to head. This study compared a new-generation meniscus repair device, SpeedCinch, with a similar established device, Fast-Fix 360, and a parallel repair construct to a crossed construct. Both devices utilize self-adjusting No. 2-0 ultra–high molecular weight polyethylene (UHMWPE) and 2 polyether ether ketone (PEEK) anchors. Hypothesis: Crossed suture repair constructs have higher failure loads and stiffness compared with simple parallel constructs. The newer repair device would exhibit similar performance to an established device. Study Design: Controlled laboratory study. Methods: Sutures were placed in an open fashion into the body and posterior horn regions of the medial and lateral menisci in 16 cadaveric knees. Evaluation of 2 repair devices and 2 repair constructs created 4 groups: 2 parallel vertical sutures created with the Fast-Fix 360 (2PFF), 2 crossed vertical sutures created with the Fast-Fix 360 (2XFF), 2 parallel vertical sutures created with the SpeedCinch (2PSC), and 2 crossed vertical sutures created with the SpeedCinch (2XSC). After open placement of the repair construct, each meniscus was explanted and tested to failure on a uniaxial material testing machine. All data were checked for normality of distribution, and 1-way analysis of variance by ranks was chosen to evaluate for statistical significance of maximum failure load and stiffness between groups. Statistical significance was defined as P < .05. Results: The mean maximum failure loads ± 95% CI (range) were 89.6 ± 16.3 N (125.7-47.8 N) (2PFF), 72.1 ± 11.7 N (103.4-47.6 N) (2XFF), 71.9 ± 15.5 N (109.4-41.3 N) (2PSC), and 79.5 ± 25.4 N (119.1-30.9 N) (2XSC). Interconstruct comparison revealed no statistical difference between all 4 constructs regarding maximum

  16. Ab-interno scleral suture loop fixation with cow-hitch knot in posterior chamber intraocular lens decentration

    Science.gov (United States)

    Can, Ertuğrul; Koçak, Nurullah; Yücel, Özlem Eşki; Gül, Adem; Öztürk, Hilal Eser; Sayın, Osman

    2016-01-01

    Aim of Study: To describe a simplified ab-interno cow-hitch suture fixation technique for repositioning decentered posterior chamber intraocular lens (PC IOL). Materials and Methods: Two cases are presented with the surgical correction of decentered and subluxated IOL. Ab-interno scleral suture fixation technique with hitch-cow knot in the eye was performed with a ciliary sulcus guide instrument and 1 year follow-up was completed. Results: Both of the patients had well centered lenses postoperatively. Corrected distant and near visual acuities of the patients were improved. There was no significant postoperative complication. In the follow-up period of 1 year, no evidence of suture erosion was found. Conclusions: Ab-interno scleral suture loop fixation with hitch-cow knot in the eye was effective in repositioning decentered or subluxated PC IOLs with excellent postoperative centered lenses and visual outcomes. PMID:27050346

  17. Ab-interno scleral suture loop fixation with cow-hitch knot in posterior chamber intraocular lens decentration

    Directory of Open Access Journals (Sweden)

    Ertugrul Can

    2016-01-01

    Full Text Available Aim of Study: To describe a simplified ab-interno cow-hitch suture fixation technique for repositioning decentered posterior chamber intraocular lens (PC IOL. Materials and Methods: Two cases are presented with the surgical correction of decentered and subluxated IOL. Ab-interno scleral suture fixation technique with hitch-cow knot in the eye was performed with a ciliary sulcus guide instrument and 1 year follow-up was completed. Results: Both of the patients had well centered lenses postoperatively. Corrected distant and near visual acuities of the patients were improved. There was no significant postoperative complication. In the follow-up period of 1 year, no evidence of suture erosion was found. Conclusions: Ab-interno scleral suture loop fixation with hitch-cow knot in the eye was effective in repositioning decentered or subluxated PC IOLs with excellent postoperative centered lenses and visual outcomes.

  18. The Debrisoft(®) Monofilament Debridement Pad for Use in Acute or Chronic Wounds: A NICE Medical Technology Guidance.

    Science.gov (United States)

    Meads, Catherine; Lovato, Eleonora; Longworth, Louise

    2015-12-01

    As part of its Medical Technology Evaluation Programme, the National Institute for Health and Care Excellence (NICE) invited a manufacturer to provide clinical and economic evidence for the evaluation of the Debrisoft(®) monofilament debridement pad for use in acute or chronic wounds. The University of Birmingham and Brunel University, acting as a consortium, was commissioned to act as an External Assessment Centre (EAC) for NICE, independently appraising the submission. This article is an overview of the original evidence submitted, the EAC's findings and the final NICE guidance issued. The sponsor submitted a simple cost analysis to estimate the costs of using Debrisoft(®) to debride wounds compared with saline and gauze, hydrogel and larvae. Separate analyses were conducted for applications in home and applications in a clinic setting. The analysis took an UK National Health Service (NHS) perspective. It incorporated the costs of the technologies and supplementary technologies (such as dressings) and the costs of their application by a district nurse. The sponsor concluded that Debrisoft(®) was cost saving relative to the comparators. The EAC made amendments to the sponsor analysis to correct for errors and to reflect alternative assumptions. Debrisoft(®) remained cost saving in most analyses and savings ranged from £77 to £222 per patient compared with hydrogel, from £97 to £347 compared with saline and gauze, and from £180 to £484 compared with larvae depending on the assumptions included in the analysis and whether debridement took place in a home or clinic setting. All analyses were severely limited by the available data on effectiveness, in particular a lack of comparative studies and that the effectiveness data for the comparators came from studies reporting different clinical endpoints compared with Debrisoft(®). The Medical Technologies Advisory Committee made a positive recommendation for adoption of Debrisoft(®) and this has been published

  19. Histological Evaluation of the Local Soft Tissue Reaction After Implanting Resorbable and Non-resorbable Monofilament Fibers.

    Science.gov (United States)

    Żywicka, Bogusława; Szymonowicz, Maria; Bryła, Danuta; Rybak, Zbigniew

    2016-01-01

    The development of technologies and scientific disciplines connected with medical implantation devices is dynamically affecting modern treatments by contemporary medicine and veterinary medicine; it also entails a need to monitor their impact on living organisms. The aim of the study was to conduct a comparative histological evaluation of the response of soft tissues after implanting monofilament fibers from resorbable glyconate and from non-resorbable polypropylene (PP) and polyamide (PA) in rats. Non-resorbable polyamide-based fibers were applied to skin anastomoses in rats. Macroscopic and histological evaluations were performed on the 7th, 14th and 30th days. Non-resorbable polypropylene fibers and resorbable glyconate fibers (composed of 72% glycolide, 14% trimethylene carbonate and 4% caprolactone) were implanted in muscle tissue for periods of 7, 14, 30 and 90 days. A semi-quantitative and qualitative histological evaluation found different dynamics and degrees of intensification of cell and tissue response around the resorbable and non-resorbable fibers being tested. The resorption process of the glyconate threads caused a prolonged inflammatory cellular response compared to the non-resorbable threads; it passed, however, without the participation of giant cells. Around the non-resorbable threads the observed cellular response was less intensified, with the formation of single polymorphonuclear macrophages around the PP threads, along with a stronger degree of fibrosis and the presence of fatty infiltrate. During the early period, moderately intensified inflammatory cell response with the presence of single giant cells was observed around the non-degradable PA and PP fibers. In the late period, a band of fibrous connective tissue was present around the PP threads. Glyconate fibers underwent fragmentation and the process of resorption, which was associated with a weakly intensified inflammatory process lasting up to 90 days after implantation.

  20. SKIN STAPLED OR SUTURED: A COMPARATIVE STUDY

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    Veerendra Kumar

    2015-01-01

    Full Text Available BACKGROUND: The choice of wound closure after a surgical procedure has been a surgeon’s dilemma . The concerns have been as to how fast , uneventful , less painful , with minimal complications and comfortable will the patient’s recovery be. A well - known technology is surgical staples which are easier to use , less time consuming and a needle free method o f wound closure. OBJECTIVE: To compare skin staples with non - absorbable skin suture for skin closure in surgical laparotomy procedures for the following character : wound infection , dehiscence , cosmesis and postoperative pain . METHODS: This is a comparative study conducted on 100 patients divided in two groups randomly at Bapuji Hospital for cases undergoing surgical laparotomy procedures. Skin closure was done with 2 - 0 polyamide skin sutures in one group and skin closure was achieved with skin staples in th e other group. The outcome of wound was assessed on 3rd , 5th and 7th postoperative days using ASEPSIS score. Wound cosmesis was assessed on the 7th postoperative day and followed up at 1st month and 3rd month , using modified Hollander cosmesis scale. Postoperative pain was assessed using the visual analogue scale on the 1st , 3rd and 7th postoperative days. RESULTS : The mean wound ASPESIS scores on day 3 for skin staples and sutured group was 0.28 and 0.36 (p=0.7 respectively. The score on day 5 for staples and sutured group was 0.12 and 0.28 (p=0.4 respectively. The results in both the groups were the same , 0.08 on day 7(p=0. Wound cosmesis mean score assessment on day 7 for skin staples suturing group was 5.84 and 5.68 respectively (p=0.3. The mean score for cosmesis assessment at 1 month , and 3 rd month for skin staples and suturing group was 5.92 and 5.68 (p=0.1 and was 6.00 and 5.92 (p=0.36 respectively which was not satistically significant . The visual analogue scale score for postopera tive pain on 1st day , 3 rd and 7 th day for skin staples and suturing group 54

  1. Skin tension related to tension reduction sutures.

    Science.gov (United States)

    Hwang, Kun; Kim, Han Joon; Kim, Kyung Yong; Han, Seung Ho; Hwang, Se Jin

    2015-01-01

    The aim of this study was to compare the skin tension of several fascial/subcutaneous tensile reduction sutures. Six upper limbs and 8 lower limbs of 4 fresh cadavers were used. At the deltoid area (10 cm below the palpable acromion) and lateral thigh (midpoint from the palpable greater trochanter to the lateral border of the patella), and within a 3 × 6-cm fusiform area of skin, subcutaneous tissue defects were created. At the midpoint of the defect, a no. 5 silk suture was passed through the dermis at a 5-mm margin of the defect, and the defect was approximated. The initial tension to approximate the margins was measured using a tensiometer.The tension needed to approximate skin without any tension reduction suture (S) was 6.5 ± 4.6 N (Newton). The tensions needed to approximate superficial fascia (SF) and deep fascia (DF) were 7.8 ± 3.4 N and 10.3 ± 5.1 N, respectively. The tension needed to approximate the skin after approximating the SF was 4.1 ± 3.4 N. The tension needed to approximate the skin after approximating the DF was 4.9 ± 4.0 N. The tension reduction effect of approximating the SF was 38.8 ± 16.4% (2.4 ± 1.5 N, P = 0.000 [ANOVA, Scheffé]). The tension reduction effect of approximating the DF was 25.2% ± 21.9% (1.5 ± 1.4 N, P = 0.001 [ANOVA, Scheffé]). The reason for this is thought to be that the SF is located closely to the skin unlike the DF. The results of this study might be a basis for tension reduction sutures.

  2. Blepharoptosis correction with buried suture method.

    Science.gov (United States)

    Park, Jang Woo; Kang, Moon Seok; Nam, Seung Min; Kim, Yong Bae

    2015-02-01

    Many surgical techniques have been developed to correct blepharoptosis, including the anterior levator resection or advancement, tarsoaponeurectomy, and Fasanella-Servat Müllerectomy. However, to minimize surgical scarring and reduce the postoperative recovery time, the procedure has been developed from a complete incision to a partial incision, which is appealing to patients. To aid the procedural development, this study describes a surgical technique in which the correction of blepharoptosis and a double eyelid fold operation are performed using a buried suture technique during the same operation. A retrospective review was conducted using the medical records and preoperative and postoperative photography of 121 patients who underwent simultaneous correction of blepharoptosis and had a double eyelid fold created between October 2010 and July 2011. All of the patients had mild (1-2 mm) or moderate (3-4 mm) bilateral blepharoptosis and excellent or good levator function (>8 mm). The average preoperative marginal reflex distance (MRD1) measured 1.174 (0.3) mm. No intraoperative complications occurred. The average postoperative MRD1 measured 3.968 (0.2) mm. There was statistical significance improvement between preoperative MRD1 and postoperative MRD1 (Pexposure keratopathy were noted. Blepharoptosis correction using the buried suture technique is an effective technique for young patients experiencing mild to moderate blepharoptosis who want to have the double eyelid fold operation using the buried suture technique.

  3. The use of imbricated sutures in radioactive plaque brachytherapy surgery

    Directory of Open Access Journals (Sweden)

    Kaan Gündüz

    2010-03-01

    Full Text Available Kaan Gündüz1, Jose S Pulido1, Peter D Yeakel2, Michael King3, Kelly L Classic1, Keith M Furutani21Department of Ophthalmology, 2Department of Radiation Oncology, 3Section of Media Support Services, Mayo Clinic, Rochester, MN, USAAbstract: This paper describes a new technique to suture the radioactive plaque to sclera. The radioactive plaque is conventionally sutured to the sclera using 5/0 nylon sutures. The imbricated suture technique involves using a 1/0 silk or 2/0 mersilene suture imbricated with the 5/0 nylon suture when the nylon suture is tied and cut. The imbricated suture technique allows easy identification of the plaque at removal and provides a surface that separates the 5/0 nylon from the surface of the eyelet platform, making suture cutting easier and safer. The radiation exposure times ranged from 9.1 minutes to 14 minutes (mean: 10.8 minutes during plaque insertion and from 2.8 to 3.3 minutes (mean: 3.0 minutes during plaque removal with the imbricated suture technique. This technique may decrease radiation exposure time and may prevent inadvertent scleral damage.Keywords: plaque radiotherapy, Iodine-125, Ruthenium-106, Collaborative Ocular Melanoma Study, choroidal melanoma, ciliary body melanoma, retinoblastoma, plaque placement, plaque removal, radiation exposure

  4. Insertion force in manual and robotic corneal suturing.

    Science.gov (United States)

    Yang, Yang; Xu, Cunliang; Deng, Shijing; Xiao, Jingjing

    2012-03-01

    Due to differences in corneal grafting microsurgery between manual and robotic suturing, new challenges have arisen in testing the insertion force and torque of corneal tissue acting on suturing needles in order to guarantee successful completion of surgical procedures. In order to measure the force during the insertion operation, from the needle entering the cornea through the entry point until the puncturing of the exit point along the circular trajectory, a force measurement system was established, including fresh porcine cornea, a corneal-suturing robot, a circular needle, a micro-forceps manipulator with a force transducer, a computer with a data acquisition board and a medical microscope. The force values in the needle coordinate frames were obtained on the basis of a sensor coordinate frame through D-H coordinate transformation, and an index is proposed here to evaluate the insertion performance. Experiments on both manual and robotic suturing were carried out for comparison. The scale and changes of the needle insertion force were obtained using two different suturing methods. The maximal tangent force in robotic suturing is a little larger than in manual suturing, and the maximal resultant force in robotic suturing is somewhat smaller. Although the difference is not very significant, robotic suturing performs in a more stable way. Moreover, the performance evaluation index M(dmax) (the maximum of square root of the quadratic sum of torque components M(OX) and M(OY)) in robotic suturing is much smaller than that in manual suturing. The force measurement system has been verified to be feasible through experimentation. Compared with conventional manual surgery, robotic suturing has some advantages: more stable suturing, smaller distortion torque and fewer invasions to the corneal tissue, showing that its application in minimally invasive surgery is practical. Copyright © 2011 John Wiley & Sons, Ltd.

  5. Cranial suture biology of the Aleutian Island inhabitants.

    Science.gov (United States)

    Cray, James; Mooney, Mark P; Siegel, Michael I

    2011-04-01

    Research on cranial suture biology suggests there is biological and taxonomic information to be garnered from the heritable pattern of suture synostosis. Suture synostosis along with brain growth patterns, diet, and biomechanical forces influence phenotypic variability in cranial vault morphology. This study was designed to determine the pattern of ectocranial suture synostosis in skeletal populations from the Aleutian Islands. We address the hypothesis that ectocranial suture synostosis pattern will differ according to cranial vault shape. Ales Hrdlicka identified two phenotypes in remains excavated from the Aleutian Island. The Paleo-Aleutians, exhibiting a dolichocranic phenotype with little prognathism linked to artifacts distinguished from later inhabitants, Aleutians, who exhibited a brachycranic phenotype with a greater amount of prognathism. A total of 212 crania representing Paleo-Aleuts and Aleutian as defined by Hrdlicka were investigated for suture synostosis pattern following standard methodologies. Comparisons were performed using Guttmann analyses. Results revealed similar suture fusion patterns for the Paleo-Aleut and Aleutian, a strong anterior to posterior pattern of suture fusion for the lateral-anterior suture sites, and a pattern of early termination at the sagittal suture sites for the vault. These patterns were found to differ from that reported in the literature. Because these two populations with distinct cranial shapes exhibit similar patterns of suture synostosis it appears pattern is independent of cranial shape in these populations of Homo sapiens. These findings suggest that suture fusion patterns may be population dependent and that a standardized methodology, using suture fusion to determine age-at-death, may not be applicable to all populations.

  6. Modality of wound closure after total knee replacement: are staples as safe as sutures? A retrospective study of 181 patients

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    Hammerberg E Mark

    2011-10-01

    Full Text Available Abstract Background Surgical site wound closure plays a vital role in post-operative success. This effect is magnified in regard to commonly performed elective procedures such as total knee arthroplasty. The use of either sutures or staples for skin re-approximation remains a contested subject, which may have a significant impact on both patient safety and surgical outcome. The literature remains divided on this topic. Methods Two cohorts of patients at a level one trauma and regional referral center were reviewed. Cohorts consisted of consecutive total knee arthroplasties performed by two surgeons who achieved surgical wound re-approximation by either staples or absorbable subcuticular sutures. Outcome variables included time of surgery, wound dehiscence, surgical site infection per Center for Disease Control criteria and repeat procedures for debridement and re-closure. Results 181 patients qualified for study inclusion. Staples were employed in 82 cases (45.3% of total and sutures in 99 cases (54.7%. The staples group had no complications while the sutures group had 9 (9.1%. These consisted of: 4 infections (2 superficial, one deep, one organ/space; three patients required re-suturing for dehiscence; one allergic type reaction to suture material; and one gout flare resulting in dehiscence. The mean surgical time with sutures was 122.3 minutes (sd = 33.4 and with staples was 114 minutes (sd = 24.4. Conclusion This study demonstrated significantly fewer complications with staple use than with suture use. While all complications found in this study cannot be directly attributed to skin re-approximation method, the need for further prospective, randomized trials is established.

  7. Bidirectional lift of the anterior midcheek with Gore-Tex cable sutures.

    Science.gov (United States)

    Sasaki, Gordon H; Oberg, Kerby C; Kim, E Yoonah

    2003-01-01

    The reader is presumed to have a broad understanding of the anatomy of the anterior midface. After reading this article, the participant should be able to: Physicians may earn 1 hour of Category 1 CME credit by successfully completing the examination on the basis of material covered in this article. The examination begins on page 257. We have previously described a technique of anterior midface soft tissue repositioning using 2 cable sutures directed only in a superolateral direction. This technique achieves a more normal distribution of subcutaneous fat laterally over the malar bag prominence but does little to overcome central and medial hollowness in the palpebromalar and tear-trough areas. We describe an alteration of our original technique that introduces a vertical lift of the anterior midface soft tissue utilizing Gore-Tex, (W.L. Gore & Associates, Flagstaff, AZ) cable sutures while elevating the preperiosteal soft tissue. We used a transconjunctival approach to expose the postseptal fat, orbital rim, and arcus marginalis. Subperiosteal dissection over the orbital rim was performed to prepare a pocket for the malar fat pads. Using 6.5-cm Keith needles, we placed a braided suture medially, lateral to the location of the infraorbital nerve and foramen, and maneuvered it through the soft tissue until all signs of dimpling at the nasolabial line or upward distortion of the upper lip were removed. A Gore-Tex graft was introduced and seated in a cupped configuration that anchored the caudal fat pad at the nasolabial line. The medial fat pad and vascular pedicle were transposed over the orbital rim into the predissected pocket; the central fat pad was also fashioned into a pedicle and moved into its pocket. The Gore-Tex sutures were tightened, elevating the supraperiosteal soft tissue vertically. A second set of Gore-Tex sutures elevated the anterior midface soft tissue toward the deep temporal fascia. Between 1999 and 2002, 197 patients underwent bidirectional

  8. A study of sutural bones in Gujarati (Indian) crania.

    Science.gov (United States)

    Pal, G P; Bhagwat, S S; Routal, R V

    1986-03-01

    370 adult crania were examined to find the incidence of sutural bones in Gujarati (Indian) crania and to compare it with other populations to establish the distance between them. The mean measure of difference between Indian and other populations was statistically significant. Comparison of cranial capacity in skulls with and without sutural bones showed no significant difference, and this is interpreted as indicating that sutural bones are not formed secondary to stress.

  9. Safety Pin Suture for Management of Atonic Postpartum Hemorrhage

    OpenAIRE

    Zaitoun, Mostafa M.; Mostfa, Ali Abdelhamed M.

    2012-01-01

    Objective. To assess the efficacy of a new suture technique in controlling severe resistant uterine atonic postpartum hemorrhage. Patients and Methods. This is a retrospective observational study that included thirteen women with uterine atony and postpartum bleeding that did not react to usual medical management. All these women underwent compressing vertical suture technique in which the anterior and posterior walls of the uterus were attached so as to compress the uterus. The suture is tra...

  10. Needle Path Planning for Autonomous Robotic Surgical Suturing.

    Science.gov (United States)

    Jackson, Russell C; Cavuşoğlu, M Cenk

    2013-12-31

    This paper develops a path plan for suture needles used with solid tissue volumes in endoscopic surgery. The path trajectory is based on the best practices that are used by surgeons. The path attempts to minimize the interaction forces between the tissue and the needle. Using surgical guides as a basis, two different techniques for driving a suture needle are developed. The two techniques are compared in hardware experiments by robotically driving the suture needle using both of the motion plans.

  11. Visual Measurement of Suture Strain for Robotic Surgery

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    John Martell

    2011-01-01

    Full Text Available Minimally invasive surgical procedures offer advantages of smaller incisions, decreased hospital length of stay, and rapid postoperative recovery to the patient. Surgical robots improve access and visualization intraoperatively and have expanded the indications for minimally invasive procedures. A limitation of the DaVinci surgical robot is a lack of sensory feedback to the operative surgeon. Experienced robotic surgeons use visual interpretation of tissue and suture deformation as a surrogate for tactile feedback. A difficulty encountered during robotic surgery is maintaining adequate suture tension while tying knots or following a running anastomotic suture. Displaying suture strain in real time has potential to decrease the learning curve and improve the performance and safety of robotic surgical procedures. Conventional strain measurement methods involve installation of complex sensors on the robotic instruments. This paper presents a noninvasive video processing-based method to determine strain in surgical sutures. The method accurately calculates strain in suture by processing video from the existing surgical camera, making implementation uncomplicated. The video analysis method was developed and validated using video of suture strain standards on a servohydraulic testing system. The video-based suture strain algorithm is shown capable of measuring suture strains of 0.2% with subpixel resolution and proven reliability under various conditions.

  12. Bone suture and lateral sinus lift surgery

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    Amin Rahpeyma

    2015-01-01

    Full Text Available Bone suture in lateral sinus lift has four indications. Three of them depend on creating a hole in the lateral maxillary sinus wall above the antrostomy window for securing the elevated medial maxillary sinus membrane to manage perforated Schneiderian membrane. Covering the buccal antrostomy window with the buccal fat pad (BFP for better nourishment of the inserted graft and as an alternative for bone tags in fixation of collagen membrane has been reported previously. A new indication for firmly anchoring the BFP to the medial maxillary sinus wall as the last resort for the management of perforated Schneiderian membrane is explained in this article.

  13. A Wireless Sensor for Real-Time Monitoring of Tensile Force on Sutured Wound Sites.

    Science.gov (United States)

    DeRouin, Andrew; Pacella, Nina; Zhao, Chunfeng; An, Kai-Nan; Ong, Keat Ghee

    2016-08-01

    A new wireless sensor was designed, fabricated, and applied for in situ monitoring of tensile force at a wound site. The sensor was comprised of a thin strip of magnetoelastic material with its two ends connected to suture threads for securing the sensor across a wound repair site. Since the sensor was remotely interrogated by applying an ac magnetic field and capturing the resulting magnetic field, it did not require direct wire connections to an external device or internal battery for long-term use. Due to its magnetoelastic property, the application of a tensile force changed the magnetic permeability of the sensor, altering the amplitude of the measured magnetic field. This study presents two sensor designs: one for high and one for low-force ranges. A sensor was fabricated by directly adhering the magnetoelastic strip to the suture. This sensor showed good sensitivity at low force, but its response saturated at about 1.5 N. To monitor high tensile force, the magnetoelastic strip was attached to a metal strip for load sharing. The suture thread was attached to the both ends of the metal strip so only a fraction of the applied force was directed to the sensor, allowing it to exhibit good sensitivity even at 44.5 N. The sensor was applied to two ex vivo models: a sutured section of porcine skin and a whitetail deer Achilles tendon. The results demonstrate the potential for in vivo force monitoring at a wound repair site.

  14. Tensile strength of a weave tendon suture using tendons of different sizes.

    Science.gov (United States)

    Mazurek, Tomasz; Strankowski, Michał; Ceynowa, Marcin; Rocławski, Marek

    2011-05-01

    This study compared the maximum load, stress, elongation at failure and the mode of failure of three kinds of tendons most frequently used for tendon grafting and tendon transfers, using the Pulvertaft weave suture. Sixty tendons were used from fresh human cadaver upper and lower extremities. The performed repairs included: 9 specimens of flexor digitorum superficialis or profundus tendon with flexor digitorum superficialis or profundus tendon (thick-thick suture), 10 specimens of flexor digitorum superficialis or profundus tendon with palmaris longus tendon (thick-medium thin suture), and 10 specimens of flexor digitorum superficialis or profundus tendon with plantaris tendon (thick-thin suture). Material testing machine was used to test repairs to failure. The mean maximum load at failure increased with the thickness of donor tendon. For the thick-thick specimen, the maximum load at failure was 125 newtons (N), for the thick-medium thin specimen it was 86,8N, and for the thick-thin it was 65,2N. These differences were all statistically significant. The active rehabilitation protocol is possible only with thick-thick connections used, the strength of the thick-medium thin connection is on the border of indications for the active rehabilitation protocol, and the thick-thin connection strength is sufficient only for the passive rehabilitation protocol. Copyright © 2010. Published by Elsevier Ltd.

  15. Role of suture anchors in management of fractures of inferior pole of patella

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    Anand Ashish

    2010-01-01

    Full Text Available Background: The traditional recommendation for displaced comminuted inferior pole fractures is excision of the comminuted pole followed by reattachment of the patellar tendon with transosseous suture. To the best of our knowledge there has been no previous published study mentioning the use of suture anchors for fracture inferior pole of patella. We present a retrospective analysis of five cases of patients doing well at final follow-up of two years. Materials and Methods: Five patients treated at our institute using suture anchors for repair of comminuted inferior pole fractures of patella between January 2007 to March 2007. (range 28 years-55 years. There were three males and two females. Results: The average follow-up was 25 months (range 24 months-26 months. The patients were evaluated for range of motion, strength, patellofemoral scores and any alteration of patellar height. The outcome of the procedure was assessed with use of the patellofemoral scoring system of Noyes et al, 5 as adapted by Saltzman et al. 6 The final patellofemoral score (maximum 100 points was 94.6 (range 93-96. Conclusion: We believe it is a novel extended indication of the use of suture anchors and should be in the armament of every trauma surgeon.

  16. Safety pin suture for management of atonic postpartum hemorrhage.

    Science.gov (United States)

    Mostfa, Ali Abdelhamed M; Zaitoun, Mostafa M

    2012-01-01

    Objective. To assess the efficacy of a new suture technique in controlling severe resistant uterine atonic postpartum hemorrhage. Patients and Methods. This is a retrospective observational study that included thirteen women with uterine atony and postpartum bleeding that did not react to usual medical management. All these women underwent compressing vertical suture technique in which the anterior and posterior walls of the uterus were attached so as to compress the uterus. The suture is transfixed at the uterine fundus, thus eliminating the risk of sutures sliding off at the uterine fundus (safety pin suture). Results. safety pin uterine compression suture was a sufficient procedure to stop the bleeding immediately in 92.2% of the women. None of the women developed complications related to the procedure. Conclusion. A new safety pin suture is a simple and effective procedure to control bleeding in patients with treatment-resistant, life-threatening atonic postpartum hemorrhage with the advantage of eliminating the risk of the sutures sliding off at the uterine fundus.

  17. Autoadjustable sutures and modified seldinger technique applied to laparoscopic jejunostomy.

    Science.gov (United States)

    Pili, Diego; Ciotola, Franco; Riganti, Juan Martín; Badaloni, Adolfo; Nieponice, Alejandro

    2015-02-01

    This is a simple technique to be applied to those patients requiring an alternative feeding method. This technique has been successfully applied to 25 patients suffering from esophageal carcinoma. The procedure involves laparoscopic approach, suture of the selected intestinal loop to the abdominal wall and jejunostomy using Seldinger technique and autoadjustable sutures. No morbidity or mortality was reported.

  18. What is the significance of tendon suture purchase?

    Science.gov (United States)

    Kim, J B; de Wit, T; Hovius, S E R; McGrouther, D A; Walbeehm, E T

    2009-08-01

    Repairs have been performed on porcine flexor tendons and subjected to tensile stress measurements to determine the effects and mechanism of core suture purchase (the length of the suture bite). Eighty-four pig trotter flexor profundus tendons were divided and repaired using four lengths of core suture purchase (1.33, 1, 0.66 and 0.33 cm) using a double modified Kessler repair (four strands, two knots) with a peripheral epitendinous suture. Tendon purchase was achieved by either bilateral equal purchase lengths or with one tendon purchase at a fixed depth of 1 cm. A separate group of tendons were incubated in blood for 24 hours to simulate the wound environment prior to testing. Tensile tests demonstrated a progressive increase of repair strength with purchase length. With the exception of the 0.33 cm group, video analysis demonstrated the mode of failure as suture failure and not due to suture pullout. Therefore, the increase in breaking strength cannot be attributed to a better grip of the tendon ends, but to the mechanical characteristics of the suture polymer. The tendency for the incubated tendons to fail more consistently by pullout rather than suture failure, particularly in the shorter purchase lengths, emphasises the importance of studying tendon purchase in vivo. The significance of ex vivo mechanical testing should be considered with caution.

  19. Suture technicians in a children's hospital emergency department.

    Science.gov (United States)

    Apolo, J O; DiCocco, D

    1988-03-01

    A program that employs technicians for suturing lacerations is presented. Careful selection of the candidates, intensive training, and ongoing monitoring of their activities have been major factors in the success of the program. The curriculum of a course for suture technicians and their job description are discussed.

  20. Nose tip refinement using interdomal suture in caucasian nose

    Directory of Open Access Journals (Sweden)

    Pasinato, Rogério

    2012-01-01

    Full Text Available Introduction: Refinement of the nose tip can be accomplished by a variety of techniques, but currently, the use of sutures in the nasal tip with conservative resection of the alar cartilage is the most frequently recommended approach. Objective: To classify the nasal tip and to demonstrate the interdomal suture applied to nasal tip refinement in the Caucasian nose, as well as to provide a simple and practical presentation of the surgical steps. Method: Development of surgical algorithm for nasal tip surgery: 1. Interdomal suture (double binding suture, 2. Interdomal suture with alar cartilage weakening (cross-hatching, 3. Interdomal suture with cephalic removal of the alar cartilage (McIndoe technique based on the nasal tip type classification. This classification assesses the interdomal distance (angle of domal divergence and intercrural distance, domal arch width, cartilage consistency, and skin type. Interdomal suture is performed through endonasal rhinoplasty by basic technique without delivery (Converse-Diamond technique under local anesthesia Conclusion: This classification is simple and facilitates the approach of surgical treatment of the nasal tip through interdomal suture, systematizing and standardizing surgical maneuvers for better refinement of the Caucasian nose.

  1. A seam that sutures the biological to the aesthetic I and II

    Directory of Open Access Journals (Sweden)

    Aliza Shvarts

    2014-01-01

    Full Text Available A seam that sutures the biological to the aesthetic I and II (fat on paper, 2012 are part of a series of prints made with different fats, oils, and other organic materials that explore the skin as a site and surface of reproduction. The diptych stems from Aliza Shvarts interest in printmaking as an exercise of reproductive capacity, the copy as an index of lost origin, and the seam as an eroticized jointure of historically feminized labor.

  2. Signaling mechanisms implicated in cranial sutures pathophysiology: Craniosynostosis

    Directory of Open Access Journals (Sweden)

    Maria A. Katsianou

    2016-12-01

    Full Text Available Normal extension and skull expansion is a synchronized process that prevails along the osteogenic intersections of the cranial sutures. Cranial sutures operate as bone growth sites allowing swift bone generation at the edges of the bone fronts while they remain patent. Premature fusion of one or more cranial sutures can trigger craniosynostosis, a birth defect characterized by dramatic manifestations in appearance and functional impairment. Up until today, surgical correction is the only restorative measure for craniosynostosis associated with considerable mortality. Clinical studies have identified several genes implicated in the pathogenesis of craniosynostosis syndromes with useful insights into the underlying molecular signaling events that determine suture fate. In this review, we exploit the intracellular signal transduction pathways implicated in suture pathobiology, in an attempt to identify key signaling molecules for therapeutic targeting.

  3. Evaluation of cosmetic appearance of herniotomy wound scars in African children: Comparison of tissue glue and subcuticular suturing

    Directory of Open Access Journals (Sweden)

    Ademuyiwa A

    2009-01-01

    Full Text Available Aim: To evaluate the cosmetic appearance of herniotomy wound scars closed using either the tissue glue or subcuticular suturing technique. Materials and Methods: Prospective randomised control study; randomisation into tissue glue and suturing groups. Ethical clearance obtained. Cosmetic outcome were based on visual analogue scale by parents and Hollander wound evaluation scale by a Plastic Surgeon blinded to the wound closure method. Results: Fifty one wounds were evaluated, 26 in the tissue glue group and 25 in the suturing group. Parents′ evaluation using Visual Analogue scale (VAS showed that in the suturing group, 17 parents (68% gave a VAS of 8cm while six parents (24% gave a score of 7cm. Two parents (8% gave a score of 9cm. In the tissue glue group, 22 parents (84.6% scored the scar of their children as 8 or 9cm on the VAS while four parents (15.4% gave a score of 7cm. The median VAS was 8cm for both groups with a range of 7 to 9cm. The Chi- square test showed that the parents preferred tissue glue compared with subcuticular suturing (X2 = 7.90, P < 0.05. The Hollander Wound Evaluation Scale (HWES used by Plastic Surgeon showed 21 herniotomy wounds (84% had a score of 6 in the suturing group while four wounds (16% had a score of 5. In the tissue glue group, 19 wounds (73% had a score of 6, six wounds (23.1% had a score of 5 and a patient (3.8% had a score of 4. The median score is 6 for both groups. There was no statistically significant difference between both groups (X 2 = 1.481, P = 0.393. Conclusion: This study has shown that the cosmetic outcome of wound closure using the tissue glue technique and subcuticular suturing technique are similar.

  4. Development of Absorbable, Antibiotic-Eluting Sutures for Ophthalmic Surgery

    Science.gov (United States)

    Kashiwabuchi, Fabiana; Parikh, Kunal S.; Omiadze, Revaz; Zhang, Shuming; Luo, Lixia; Patel, Himatkumar V.; Xu, Qingguo; Ensign, Laura M.; Mao, Hai-Quan; Hanes, Justin; McDonnell, Peter J.

    2017-01-01

    Purpose To develop and evaluate an antibiotic-eluting suture for ophthalmic surgery. Methods Wet electrospinning was used to manufacture sutures composed of poly(L-lactide), polyethylene glycol (PEG), and levofloxacin. Size, morphology, and mechanical strength were evaluated via scanning electron microscopy and tensile strength, respectively. In vitro drug release was quantified using high performance liquid chromatography. In vitro suture activity against Staphylococcus epidermidis was investigated through bacterial inhibition studies. Biocompatibility was determined via histological analysis of tissue sections surrounding sutures implanted into Sprague-Dawley rat corneas. Results Sutures manufactured via wet electrospinning were 45.1 ± 7.7 μm in diameter and 0.099 ± 0.007 newtons (N) in breaking strength. The antibiotic release profile demonstrated a burst followed by sustained release for greater than 60 days. Increasing PEG in the polymer formulation, from 1% to 4% by weight, improved drug release without negatively affecting tensile strength. Sutures maintained a bacterial zone of inhibition for at least 1 week in vitro and elicited an in vivo tissue reaction comparable to a nylon suture. Conclusions There is a need for local, postoperative delivery of antibiotics following ophthalmic procedures. Wet electrospinning provides a suitable platform for the development of sutures that meet size requirements for ophthalmic surgery and are capable of sustained drug release; however, tensile strength must be improved prior to clinical use. Translational Relevance No antibiotic-eluting suture exists for ophthalmic surgery. A biocompatible, high strength suture capable of sustained antibiotic release could prevent ocular infection and preclude compliance issues with topical eye drops. PMID:28083445

  5. Usefulness of continuous suture using short-thread double-armed micro-suture for cerebral vascular anastomosis

    Directory of Open Access Journals (Sweden)

    Sei Haga

    2014-01-01

    Full Text Available Background: When microvascular anastomosis is performed in a deep, narrow operating field, securing space to throw knots is difficult. To simplify the procedure and avoid obstruction of the anastomosis, we use a continuous suturing with short-thread double-armed micro-suture. Methods: Sixty-four patients (38 cerebral revasculazation, 16 moyamoya disease, and 10 aneurysm surgery undergoing microvaucular anastomosis were included. During anastomosis, a continuous suture was placed with short-thread double-armed micro-suture. Results: During 64 microanastomosis procedures, 64 consecutive continuous sutures were performed with 1-year follow up. All patients showed patency of anastomosis with long-term follow up. Conclusions: This technique is especially useful for anastomosis in a deep, narrow surgical field, such as in superior cerebellar artery anastomosis.

  6. Ectocranial suture fusion in primates: pattern and phylogeny.

    Science.gov (United States)

    Cray, James; Cooper, Gregory M; Mooney, Mark P; Siegel, Michael I

    2014-03-01

    Patterns of ectocranial suture fusion among Primates are subject to species-specific variation. In this study, we used Guttman Scaling to compare modal progression of ectocranial suture fusion among Hominidae (Homo, Pan, Gorilla, and Pongo), Hylobates, and Cercopithecidae (Macaca and Papio) groups. Our hypothesis is that suture fusion patterns should reflect their evolutionary relationship. For the lateral-anterior suture sites there appear to be three major patterns of fusion, one shared by Homo-Pan-Gorilla, anterior to posterior; one shared by Pongo and Hylobates, superior to inferior; and one shared by Cercopithecidae, posterior to anterior. For the vault suture pattern, the Hominidae groups reflect the known phylogeny. The data for Hylobates and Cercopithecidae groups is less clear. The vault suture site termination pattern of Papio is similar to that reported for Gorilla and Pongo. Thus, it may be that some suture sites are under larger genetic influence for patterns of fusion, while others are influenced by environmental/biomechanic influences. Copyright © 2013 Wiley Periodicals, Inc.

  7. Deep Infections After Syndesmotic Fixation With a Suture Button Device.

    Science.gov (United States)

    Fantry, Amanda J; O'Donnell, Seth W; Born, Chris T; Hayda, Roman A

    2017-05-01

    Suture button devices such as the TightRope (Arthrex, Naples, Florida) have been increasingly used for syndesmotic fixation of ankle fractures. Despite proposed advantages, prior studies have shown equivalent outcomes, with a theoretical decreased need for removal of hardware. Complications of suture button fixation of syndesmotic instability may be underreported and include lateral suture knot inflammation with or without granuloma formation, infection, aseptic osteolysis with widening of the tibial drill tunnels, heterotopic ossification, and osteomyelitis. In this case series, the authors review the current literature and describe 3 patients with TightRope fixation for syndesmotic instability who developed deep infection. The authors believe that braided suture within suture button devices may provide an environment conducive to the propagation of infection across the syndesmotic fixation tract. Evidence of suture button migration or osteolysis of the TightRope tract should prompt an infectious workup and removal of hardware. If there is concern for infection associated with the TightRope, the authors recommend removing both metallic buttons and the entirety of the suture to prevent harboring a nidus for further infection. [Orthopedics. 2017; 40(3):e541-e545.]. Copyright 2017, SLACK Incorporated.

  8. Sutures versus staples for wound closure in orthopaedic surgery: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Shantz Jesse A

    2012-06-01

    Full Text Available Abstract Background A recently published meta-analysis comparing metallic staples to sutures in orthopaedic procedures revealed three fold increase in risk for infection in stapled wounds. The studies included in the meta-analysis are at risk of bias due to experimental design limitations. A large randomized controlled trial is proposed to direct orthopaedic surgeons in their choice of wound closure material. Methods/Design A parallel group randomized controlled trial with institutional review board approval will be conducted. Patients will be randomized intraoperatively to have skin wounds closed with sutures or staples. Dressings will be used to maintain blinding outcome assessors. The primary outcome measure will be a composite all-cause wound complication outcome measure composed of: infection, wound drainage, wound necrosis, blistering, dehiscence, suture abscess and material sensitivity reaction. An independent review board blinded to treatment assignment will adjudicate suspected complications based on clinical data. All deceased patients will also be reviewed. An interim analysis of complications will take place after half of the patients have been recruited. All data will be analyzed by a blinded statistician. Dichotomous primary and secondary outcome measures will be analyzed using the Chi-squared statistic. Continuous outcome measures will be analyzed using Student's t-test. Subgroup analysis will compare infection rates using sutures versus staples in each anatomic area (upper extremity, pelvis/acetabulum, hip/femur, knee, ankle. A further subgroup analysis will be conducted comparing trauma patients to elective surgery patients. Non-infected revision surgery will also be compared to primary surgery. Discussion Wound closure material is an afterthought for many orthopaedic surgeons. The combined results of several comparative trials suggests that the choice of wound closure materials may have an impact on the rate of surgical site

  9. Punctal Occlusion with Prolene Suture Material in the Patients with ...

    African Journals Online (AJOL)

    2017-07-26

    Jul 26, 2017 ... MGM Medical College and Hospital, Kamothe, Navi Mumbai, India ... Results: Punctal occlusion has been shown to improve the objective and subjective ..... Schein OD, Munoz B, Tielsch JM, Bandeen-Roche K, West S.

  10. "Nara" knot for suturing of cleft lip in children to make removal easy

    Directory of Open Access Journals (Sweden)

    Obaidullah

    2006-01-01

    Full Text Available Cleft patients usually go through a lifetime of repeated hospital admissions and multiple procedures. Suture removal at a tender age and on a sensitive area like the lip becomes a challenge for the nursing staff. It is also emotionally demanding on the part of the parents. Hence, in most centres these patients are at least sedated if not anaesthetised. We have been using a simple knot and running prolene material so that undoing of the knot becomes easy and suture removal more or less atraumatic. We would like to share our experience with readers through this article. An analysis of 53 cleft lip repairs has shown that this knot is safe and easily removable.

  11. An easier method for performing a pancreaticojejunostomy for the soft pancreas using a fast-absorbable suture

    Institute of Scientific and Technical Information of China (English)

    Kenichi Hakamada; Shunji Narumi; Yoshikazu Toyoki; Masaki Nara; Kenosuke Ishido; Takuya Miura; Norihito; Mutsuo Sasaki

    2008-01-01

    AIM:To clarify the usefulness of a new method for performing a pancreaticojejunostomy by using a fastabsorbable suture material irradiated polyglactin 910,and a temporary stent tube for a narrow pancreatic duct with a soft pancreatic texture.METHODS:Among 63 consecutive patients with soft pancreas undergoing a pancreaticoduodenectomy from 2003 to 2006,35 patients were treated with a new reconstructive method.Briefly,after the pancreatic transaction,a stent tube was inserted into the lumen of the pancreatic duct and ligated with it by a fastabsorbable suture.Another tip of the stent tube was introduced into the intestinal lumen at the jejunal limb,where a purse-string suture was made by another fast-absorbable suture to roughly fix the tube.The pancreaticojejunostomy was completed by ligating two fast-absorbable sutures to approximate the ductal end and the jejunal mucosa,and by adding a rough anastomosis between the pancreatic parenchyma and the seromuscular layer of the jejunum.The initial surgical results with this method were retrospectively compared with those of the 28 patients treated with conventional duct-to-mucosa anastomosis.RESULTS:The incidences of postoperative morbidity including pancreatic fistula were comparable between the two groups (new;3%-17% vs conventional;7%-14% according to the definitions).There was no mortality and re-admission.Late complications were also rarely seen.CONCLUSION:A pancreaticojejunostomy using an irradiated polyglactin 910 suture material and a temporary stent is easy to perform and is feasible even in cases with a narrow pancreatic duct and a normal soft pancreas.

  12. Scalp Incision Suturation Technology Improvement%头皮切口缝合技术的改良进展

    Institute of Scientific and Technical Information of China (English)

    周全

    2013-01-01

    Traditional scalp suture only closes the incision,which has high incidence of complications and poor cosmetic effect. So constant improvement of surgical suture method to improve wound healing and aesthetic effects is needed. With the emergence of new suture materials and constantly improving suture methods, the healing of the scalp incision has been significantly improved. The advantages of intradermal suture are the-neat match,small scar,and good apperance;aU subcutaneous and skin sutures adopt absorbable materials , which avoids long term thread end exposure. The method has both reduced the suffering of the patients, and comforted the patient's psychological needs, which is in line with the physiological,psychological,and social model.%传统的头皮缝合方法仅能达到闭合切口的作用,不但并发症高,而且切口美容效果差.为提高切口的愈合率和美观效果,需要不断地改良手术缝合方法.随着新的缝合材料的出现,缝合方法不断改良,头皮切口的愈合效果得到了明显的改善.皮内缝合法的优点是切口对合整齐,瘢痕小,美观;所有皮下及皮内缝线均采用可吸收线、免拆线,也避免了切口远期线头外露.既减轻了患者的痛苦,又安慰了患者的心理,符合生理-心理-社会模式.

  13. Automation of a suturing device for minimally invasive surgery.

    Science.gov (United States)

    Göpel, Tobias; Härtl, Felix; Schneider, Armin; Buss, Martin; Feussner, Hubertus

    2011-07-01

    In minimally invasive surgery, hand suturing is categorized as a challenge in technique as well as in its duration. This calls for an easily manageable tool, permitting an all-purpose, cost-efficient, and secure viscerosynthesis. Such a tool for this field already exists: the Autosuture EndoStitch(®). In a series of studies the potential for the EndoStitch to accelerate suturing has been proven. However, its ergonomics still limits its applicability. The goal of this study was twofold: propose an optimized and partially automated EndoStitch and compare the conventional EndoStitch to the optimized and partially automated EndoStitch with respect to the speed and precision of suturing. Based on the EndoStitch, a partially automated suturing tool has been developed. With the aid of a DC motor, triggered by a button, one can suture by one-fingered handling. Using the partially automated suturing manipulator, 20 surgeons with different levels of laparoscopic experience successfully completed a continuous suture with 10 stitches using the conventional and the partially automated suture manipulator. Before that, each participant was given 1 min of instruction and 1 min for training. Absolute suturing time and stitch accuracy were measured. The quality of the automated EndoStitch with respect to manipulation was tested with the aid of a standardized questionnaire. To compare the two instruments, t tests were used for suturing accuracy and time. Of the 20 surgeons with laparoscopic experience (fewer than 5 laparoscopic interventions, n=9; fewer than 20 laparoscopic interventions, n=7; more than 20 laparoscopic interventions, n=4), there was no significant difference between the two tested systems with respect to stitching accuracy. However, the suturing time was significantly shorter with the Autostitch (P=0.01). The difference in accuracy and speed was not statistically significant considering the laparoscopic experience of the surgeons. The weight and size of the

  14. Use of Absorbable Sutures in Canine Carotid Arteries

    OpenAIRE

    Rey, Alejandro R.; Carrillo-Farga, Joaquin; Velasco, Carlos O.; Valencia, Martin O.V.

    1990-01-01

    To study the functional and microstructural characteristics of polydioxanone sutures in vascular surgery, we created 48 vascular anastomoses in the right and left common carotid arteries of 24 mongrel dogs. In each animal, polydioxanone sutures were used in 1 carotid artery, and polypropylene sutures were used in the contralateral carotid artery. Twelve groups of 2 animals each were then formed. The 1st group was observed for 1 month, the 2nd for 2 months, the 3rd for 3 months, and so on unti...

  15. Bone Suture in Management of Mandibular Degloving Injury

    African Journals Online (AJOL)

    Journal of Surgical Technique and Case Report | Jan-Jun 2013 | Vol-5 | Issue-1. 35 ... bone suture technique. ... Center, Faculty of Dentistry, Mashhad University of Medical. Sciences ... After the administration of local anesthesia (lidocaine 2%.

  16. Corneoscleral abscess resulting from a broken suture after cataract surgery.

    Science.gov (United States)

    Cameron, J A; Huaman, A

    1994-01-01

    An 82-year-old man had pain and decreased vision in his right eye 15 months after uncomplicated cataract surgery. Examination revealed a large corneoscleral abscess with a 2 mm x 1 mm area of fluorescein staining at the base of a broken protruding 10-0 nylon suture. Streptococcus pneumoniae was isolated from both the suture and base of the ulcer. Despite intensive topical, subconjunctival, and systemic antibiotics, a large corneal perforation developed, necessitating a 10 mm tectonic penetrating keratoplasty. Long-term follow-up of patients after cataract surgery is important and should include an inspection of the limbal wound and removal of loose or broken exposed sutures. Suture-related complications will be eliminated if clinical studies prove the safety and efficacy of sutureless cataract surgery.

  17. Prenatal ultrasound parameters in single-suture craniosynostosis

    NARCIS (Netherlands)

    M.J. Cornelissen (Martijn); Apon, I. (Inge); J.J.N.M. van der Meulen (Jacques); I.A.L. Groenenberg (Irene); Kraan – van der Est, M.N. (Mieke N.); I.M.J. Mathijssen (Irene); G.J. Bonsel (Gouke); Cohen – Overbeek, T.E. (Titia E.)

    2017-01-01

    textabstractIntroduction: Although single-suture craniosynostosis is diagnosed sporadically during pregnancy, timely referral is critical for its treatment. Additionally, craniosynostosis leads to increased maternofetal trauma during birth. In the Netherlands, 95% of pregnant women receive a

  18. A comparative study of continuous versus interrupted suturing for repair of episiotomy or second degree perineal tear

    Directory of Open Access Journals (Sweden)

    Lopamudra Jena

    2015-02-01

    Full Text Available Background: This study has been taken up to assess the effects of continuous versus interrupted suturing methods on the incidence of short and long term postpartum maternal morbidity experienced by women following repair of episiotomy or second-degree perineal tears after vaginal birth. Methods: This comparative prospective study was conducted in department of obstetrics and gynaecology of S.C.B. medical college, Cuttack, Odisha to compare continuous suturing technique with interrupted method for the repair of episiotomy and second degree perineal tear following vaginal delivery in 211 women. One group was repaired with continuous non-locking sutures involving the vaginal mucosa, perineal muscles and subcutaneous tissue for skin and other group had continuous locking stitch of vaginal mucosa, interrupted sutures in perineal muscles and interrupted transcutaneous stitches for skin. Identical suture material (catgut supplied by the government was used for both the groups. The mothers were interviewed on the 2nd, 10th and 42nd day following repair regarding pain perception with lying, walking and sitting posture using Visual Analogue Scale (VAS. Results: The pain score measured by VAS on 2nd day showed mild to moderate pain in continuous group compared to moderate and severe pain in interrupted group (P = 0.008 in lying position and (P = 0.000 in sitting and walking position. On 10th day no difference in perception in lying position (P = 0.571 but more subjects of interrupted group had pain in sitting and walking position (P = 0.05. On 42nd day no difference in pain perception in both groups was seen (P = 1.000. There was no difference in wound dehiscence in both the groups (P = 0.361. Subjects in the interrupted group had greater complains of dyspareunia compared to subjects in continuous group (P = 0.009. Less length of suture were required in the continuous group (P = 0.000. Conclusions: Continuous suturing technique for repair of episiotomy and

  19. Failure strengths of repair devices versus meniscus suturing techniques

    OpenAIRE

    Asik, Mehmet; Sener, Nadir; Dikici, Fatih; Sen, Cengiz

    2004-01-01

    Objectives: The purpose of this study was to compare the load to failure of different common suturing techniques with that of repair devices. Methods: Seventy-one calf medial menisci were cut to simulate peripheral longitudinal tears and repaired using either one of the two suture techniques or one of the seven repair devices. Then the two parts of the meniscus were pulled using an Instron tensometer until failure occurred. The techniques and repair devices tested included vertical (0 PDS,...

  20. Fixation in laparoscopic incisional hernia repair: Suture versus tacks

    Directory of Open Access Journals (Sweden)

    Adil Bangash

    2013-01-01

    Full Text Available Aims and Objectives: To compare the frequency of complications of laparoscopic repair of incisional hernia using fixation of mesh with transabdominal sutures tacks. Materials and Methods: This study was conducted as part of an interventional multicenter trial at the Rehman Medical Institute, Peshawar, Peshawar Institute of Medical Sciences, and Pakistan Institute of Medical Science, Islamabad, from the 1 st of November 2008 till 31 st October 2011. The frequency of complications was calculated as the measure of comparing two methods of fixation in laparoscopic repair of incisional hernia using the IPOM technique. These patients were admitted via the outpatient department and their demographic data were collected on a pro forma basis. Forty-five patients were alternately placed in either group, and group I comprised patients with a ventral hernia that was fixed using spiral tacks whereas the other group was fixed with transabdominal sutures. A polytetraflouroethylene (Dual R mesh was applied in all cases. All data were collected onthe individual pro forma of each patient and was loaded on the SPSS R version 13.0. Results: The BMI in both groups was similar (P=0.94 The mean hospital stay was higher in the PTFE mesh group but the values were not significant (P=1.22.No perioperative death was observed in either group. One patient (2.2% from group I was readmitted with varying complaints and was diagnosed as having subacute intestinal obstruction (P>0.05. A higher but insignificant recurrence rate was observed in the polyester group over a one-year period of follow-up. Three patients (6.6% were diagnosed with recurrences in group I. Instead the PTFE group had a similar recurrence rate recurrence (P=1.00. Conclusion: The rate of recurrence in this study showed no significant difference by either mode of fixation. But statistically significant pain scores and increased operative time to fixation favors the use of tacks that limits to the few inner

  1. Development of advanced antimicrobial and sterilized plasma polypropylene grafted muga (Antheraea assama) silk as suture biomaterial.

    Science.gov (United States)

    Gogoi, Dolly; Choudhury, Arup Jyoti; Chutia, Joyanti; Pal, Arup Ratan; Khan, Mojibur; Choudhury, Manash; Pathak, Pallabi; Das, Gouranga; Patil, Dinkar S

    2014-04-01

    Surface modification of silk fibroin (SF) materials using environmentally friendly and non-hazardous process to tailor them for specific application as biomaterials has drawn a great deal of interest in the field of biomedical research. To further explore this area of research, in this report, polypropylene (PP) grafted muga (Antheraea assama) SF (PP-AASF) suture is developed using plasma treatment and plasma graft polymerization process. For this purpose, AASF is first sterilized in argon (Ar) plasma treatment followed by grafting PP onto its surface. AASF is a non-mulberry variety having superior qualities to mulberry SF and is still unexplored in the context of suture biomaterial. AASF, Ar plasma treated AASF (AASFAr) and PP-AASF are subjected to various characterization techniques for better comparison and the results are attempted to correlate with their observed properties. Excellent mechanical strength, hydrophobicity, antibacterial behavior, and remarkable wound healing activity of PP-AASF over AASF and AASFAr make it a promising candidate for application as sterilized suture biomaterial.

  2. Optimal Needle Grasp Selection for Automatic Execution of Suturing Tasks in Robotic Minimally Invasive Surgery

    OpenAIRE

    Liu, Taoming; Çavuşoğlu, M. Cenk

    2015-01-01

    This paper presents algorithms for optimal selection of needle grasp, for autonomous robotic execution of the minimally invasive surgical suturing task. In order to minimize the tissue trauma during the suturing motion, the best practices of needle path planning that are used by surgeons are applied for autonomous robotic surgical suturing tasks. Once an optimal needle trajectory in a well-defined suturing scenario is chosen, another critical issue for suturing is the choice of needle grasp f...

  3. LONG TERM OUTCOME AFTER OPEN INGUINAL HERNIA REPAIR BY CONTINOUS SUTURE VERSUS INTERRUPTED SUTURE TO FIX THE MESH

    Directory of Open Access Journals (Sweden)

    Kuldeep Raj

    2013-12-01

    Full Text Available ABSTRACT : BACK GROUND: Meshplasty is a must in adult patient. P ro lene mesh is widely used and is fixed with prolene suture as well. The aim of this study was to compare the quality of life and pain felt in postoperative phase for 2 years after open inguinal hernia repair by i nterrupted sutures versus continous sutures. METHODS: From Jan 2010 – Dec 2010 , 15 patients were operated using prolene mesh and this mesh was fixed with prolene 2’0’ in continous way starting at pubic tubercle and continues along inguinal ligament beyond deep inguinal r ing and then lateral to deep inguinal ring and above it along conjoint tendon and ends at the pubic tubercle with only single knot , and were compared with 15 patients who underwent same procedure using prolene mesh fixed with p rolene suture but in interrupted way and this creates a lot of knots ( 10 - 12 Av erage . Patients were examined and followed in OPD for 2 years. RESULTS : In the long run the patients treated with continous suture were having comparatively better qua lity of life with less pain and less foreign body sensation of mesh and knots & knots were not felt percutaneously, where as in routine procedure patients were complaining of painful sensation due to pressing of knots in subcutaneous space. CONCLUSION : In this study the quality of life in open hernia repair with prolene suture using continous suture technique versus interrupted suture technique is definitely better , less pain ful and feeling less foreign body sensation.

  4. Free Gingival Grafting; Epiglu VS. Silk Thread Suturing: A Comparative Study

    Directory of Open Access Journals (Sweden)

    M. Paknejad

    2004-06-01

    Full Text Available Statement of the Problem: The routine procedure for immobilization of free gingival graft (FGG is suturing. Due to the successful application of tissue adhesives their employment has also become the subject of interest.Purpose: The aim of present clinical trial was to compare using Epiglu (E.g versus silk thread suturing in FGG.Materials and Methods: This study was a split mouth clinical trial. The study group comprised of 12 patients with symmetrical loss of attached gingiva whom were referred to Faculty of Dentistry, Tehran University of Medical science. In test group, the gingivalgraft were placed on cellophane and after applying one drop of Eg then placed in the proper position. In control group silk suturing was used.Results: The degree of pain had no significant differences in two groups (P>0.05. The rate of bleeding was insignificant at the first day (P=0.5, but in the second (P=0.0425and the third day (P=0.0313 less bleeding was observed in the test group. 10 days after the surgery, grafts in the test group had better healing (P=0.0425, while 3 month later no significant differences observed (P>0.05. Although the mean tissue shrinkage were 41%and 38% for control and test group respectively, Wilcoxon test showed no significant differences 30 days after surgery (P>0.05. The tissue shrinkage also was not significant 3 months after surgery. In addition, no displacement, infection or hypersensitivity werenoted in either of two groups.Conclusion: In FGG, Epiglu is more effective than suturing.

  5. Craniosynostosis of coronal suture in twist1 mice occurs through endochondral ossification recapitulating the physiological closure of posterior frontal suture.

    Science.gov (United States)

    Behr, Björn; Longaker, Michael T; Quarto, Natalina

    2011-01-01

    Craniosynostosis, the premature closure of cranial suture, is a pathologic condition that affects 1/2000 live births. Saethre-Chotzen syndrome is a genetic condition characterized by craniosynostosis. The Saethre-Chotzen syndrome, which is defined by loss-of-function mutations in the TWIST gene, is the second most prevalent craniosynostosis. Although much of the genetics and phenotypes in craniosynostosis syndromes is understood, less is known about the underlying ossification mechanism during suture closure. We have previously demonstrated that physiological closure of the posterior frontal suture occurs through endochondral ossification. Moreover, we revealed that antagonizing canonical Wnt-signaling in the sagittal suture leads to endochondral ossification of the suture mesenchyme and sagittal synostosis, presumably by inhibiting Twist1. Classic Saethre-Chotzen syndrome is characterized by coronal synostosis, and the haploinsufficient Twist1(+/-) mice represents a suitable model for studying this syndrome. Thus, we seeked to understand the underlying ossification process in coronal craniosynostosis in Twist1(+/-) mice. Our data indicate that coronal suture closure in Twist1(+/-) mice occurs between postnatal day 9 and 13 by endochondral ossification, as shown by histology, gene expression analysis, and immunohistochemistry. In conclusion, this study reveals that coronal craniosynostosis in Twist1(+/-) mice occurs through endochondral ossification. Moreover, it suggests that haploinsufficiency of Twist1 gene, a target of canonical Wnt-signaling, and inhibitor of chondrogenesis, mimics conditions of inactive canonical Wnt-signaling leading to craniosynostosis.

  6. Craniosynostosis of coronal suture in Twist1+/- mice occurs through endochondral ossification recapitulating the physiological closure of posterior frontal suture

    Directory of Open Access Journals (Sweden)

    Bjorn eBehr

    2011-07-01

    Full Text Available Craniosynostosis, the premature closure of cranial suture, is a pathologic condition that affects 1/2000 live births. Saethre-Chotzen syndrome is a genetic condition characterized by craniosynostosis. The Saethre-Chotzen syndrome, which is defined by loss-of-function mutations in the TWIST gene, is the second most prevalent craniosynostosis. Although much of the genetics and phenotypes in craniosynostosis syndromes is understood, less is known about the underlying ossification mechanism during suture closure. We have previously demonstrated that physiological closure of the posterior frontal (PF suture occurs through endochondral ossification. Moreover, we revealed that antagonizing canonical Wnt signaling in the sagittal suture leads to endochondral ossification of the suture mesenchyme and sagittal synostosis, presumably by inhibiting Twist1. Classic Saethre-Chotzen syndrome is characterized by coronal synostosis, and the haploinsufficient Twist1+/- mice represents a suitable model for studying this syndrome. Thus, we seeked to understand the underlying ossification process in coronal craniosynostosis in Twist1+/- mice. Our data indicate that coronal suture closure in Twist1+/- mice occurs between postnatal day 9 to 13 by endochondral ossification, as shown by histology, gene expression analysis and immunohistochemistry. In conclusion, this study reveals that coronal craniosynostosis in Twist1+/- mice occurs through endochondral ossification. Moreover, it suggests that haploinsufficency of Twist1 gene, a target of canonical Wnt-signaling, and inhibitor of chondrogenesis, mimics conditions of inactive canonical Wnt-signaling leading to craniosynostosis.

  7. Osteolysis of the Greater Trochanter Caused by a Foreign Body Granuloma Associated with the Ethibond® Suture after Total Hip Arthroplasty

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    Keiji Kamo

    2017-01-01

    Full Text Available The present case shows a case of progression of osteolysis of the greater trochanter caused by a foreign body granuloma associated with the number 5 Ethibond suture in cementless THA with the direct lateral approach that was completely healed by removal of the Ethibond suture. A 55-year-old Japanese woman with secondary osteoarthritis caused by acetabular dysplasia underwent left cementless THA with the direct lateral approach. After setting of the total hip prosthesis, the gluteus medius muscle and vastus lateralis muscle were reattached to the greater trochanter through two bone tunnels using number 5 Ethibond EXCEL sutures. The left hip pain disappeared after surgery, but the bone tunnels enlarged gradually and developed osteolysis at 10 weeks. The removal of the Ethibond sutures and debridement improved the osteolysis. Histological examination showed the granuloma reaction to a foreign body with giant cell formation. The Ethibond suture has the lowest inflammatory tissue reaction and relatively high tension strength among nonabsorbable suture materials. However, number 5 Ethibond has the potential to cause osteolysis due to a foreign body granuloma, as in the present case.

  8. Osteolysis of the Greater Trochanter Caused by a Foreign Body Granuloma Associated with the Ethibond® Suture after Total Hip Arthroplasty.

    Science.gov (United States)

    Kamo, Keiji; Kijima, Hiroaki; Okuyama, Koichiro; Seki, Nobutoshi; Yamada, Shin; Miyakoshi, Naohisa; Shimada, Yoichi

    2017-01-01

    The present case shows a case of progression of osteolysis of the greater trochanter caused by a foreign body granuloma associated with the number 5 Ethibond suture in cementless THA with the direct lateral approach that was completely healed by removal of the Ethibond suture. A 55-year-old Japanese woman with secondary osteoarthritis caused by acetabular dysplasia underwent left cementless THA with the direct lateral approach. After setting of the total hip prosthesis, the gluteus medius muscle and vastus lateralis muscle were reattached to the greater trochanter through two bone tunnels using number 5 Ethibond EXCEL sutures. The left hip pain disappeared after surgery, but the bone tunnels enlarged gradually and developed osteolysis at 10 weeks. The removal of the Ethibond sutures and debridement improved the osteolysis. Histological examination showed the granuloma reaction to a foreign body with giant cell formation. The Ethibond suture has the lowest inflammatory tissue reaction and relatively high tension strength among nonabsorbable suture materials. However, number 5 Ethibond has the potential to cause osteolysis due to a foreign body granuloma, as in the present case.

  9. Disposable circumcision suture device: clinical effect and patient satisfaction

    Directory of Open Access Journals (Sweden)

    Bo-Dong Lv

    2014-06-01

    Full Text Available In our experience patients undergoing circumcision are mostly concerned about pain and penile appearances. We conducted a prospective randomized trial to assess the benefits of a new disposable circumcision suture device (DCSD. A total of 942 patients were equally divided into three groups (conventional circumcision, Shang ring and disposable suture device group. Patients in the DCSD group were anesthetized with compound 5% lidocaine cream, the others with a 2% lidocaine penile block. Operation time, intra-operative blood loss, incision healing time, intra-operative and post-operative pain, the penile appearance and overall satisfaction degree were measured. Operation time and intra-operative blood loss were significantly lower in the Shang ring and suture device groups compared to the conventional group (P < 0.001. Intra-operative pain was less in the suture device group compared with the other two groups (P < 0.001; whereas post-operative pain was higher in the conventional group compared to the other two groups (P < 0.001. Patients in the suture device (80.57% and Shang ring (73.57% groups were more satisfied with penile appearances compared with the conventional circumcision group (20.06%, P < 0.05. Patients in suture device group also healed markedly faster than the conventional group (P < 0.01. The overall satisfaction rate was better in the suture device group (78.66% compared with the conventional (47.13% and Shang ring (50.00% groups (P < 0.05. The combination of DCSD and lidocaine cream resulted in shorter operation and incision healing times, reduced intra-operative and post-operative pain and improved patient satisfaction with the cosmetic appearances.

  10. Disposable circumcision suture device:clinical effect and patient satisfaction

    Institute of Scientific and Technical Information of China (English)

    BoDong Lv; ShiGeng Zhang; XuanWen Zhu; Jie Zhang; Gang Chen; MinFu Chen; HongLiang Shen; ZaiJun Pei; ZhaoDian Chen

    2014-01-01

    In our experience patients undergoing circumcision are mostly concerned about pain and penile appearances. We conducted a prospective randomized trial to assess the beneifts of a new disposable circumcision suture device (DCSD). A total of 942 patients were equally divided into three groups (conventional circumcision, Shang ring and disposable suture device group). Patients in the DCSD group were anesthetized with compound 5%lidocaine cream, the others with a 2%lidocaine penile block. Operation time, intra-operative blood loss, incision healing time, intra-operative and post-operative pain, the penile appearance and overall satisfaction degree were measured. Operation time and intra-operative blood loss were signiifcantly lower in the Shang ring and suture device groups compared to the conventional group (P<0.001). Intra-operative pain was less in the suture device group compared with the other two groups (P<0.001);whereas post-operative pain was higher in the conventional group compared to the other two groups (P<0.001). Patients in the suture device (80.57%) and Shang ring (73.57%) groups were more satisifed with penile appearances compared with the conventional circumcision group (20.06%, P<0.05). Patients in suture device group also healed markedly faster than the conventional group (P<0.01). The overall satisfaction rate was better in the suture device group (78.66%) compared with the conventional (47.13%) and Shang ring (50.00%) groups (P<0.05). The combination of DCSD and lidocaine cream resulted in shorter operation and incision healing times, reduced intra-operative and post-operative pain and improved patient satisfaction with the cosmetic appearances.

  11. Failure strength of repair devices versus meniscus suturing techniques.

    Science.gov (United States)

    Aşík, Mehmet; Sener, Nadir

    2002-01-01

    The purpose of this study was to compare the load to failure of different common suturing techniques with repair devices. Seventy-one calf medial menisci were cut to simulate peripheral longitudinal tears and repaired with one of 13 repair techniques. The two parts of the meniscus were pulled using the Instron tensometer until failure occurred. The techniques and repair devices tested were vertical (0 PDS, 2-0 PDS, 2-0 Ethibond), horizontal (0 PDS, 2-0 PDS, 2-0 Ethibond) suturing, T-fix, Mitek, Clearfix screw, Clearfix dart, Biostinger, S-D-sorb, and Artrex dart. The strongest repair method in our study was the vertical sutures with 0 PDS. In this study the mean failure strength of all meniscal repair devices was lower than that of the vertical and horizontal suturing techniques. All meniscus repair devices except T-fix and in some the Arthrex dart (40% broken up) pulled out of the menisci. Devices which had only horizontally placed barbs had lower mean failure strength. Failure strength of T-fix was similar to horizontal sutures with 2-0 Ethibond and 2-0 PDS. In conclusion, because all meniscal repair devices had inferior results, when such devices are used, postoperative rehabilitation should not be hastened, and their inferior primary stability should be kept in mind.

  12. Alar Suspension Sutures in the Management of Nasal Valve Collapse.

    Science.gov (United States)

    Manickavasagam, Jaiganesh; Iqbal, Isma; Wong, Smeeta; Raghavan, Ullas

    2015-09-01

    This study assesses the efficacy of alar suspension sutures in the management of nasal valve collapse causing nasal obstruction. These sutures are inserted between the vestibular skin and lateral crura and hitched to the periosteum of the medial inferior orbital margin; this is a variation of the alar (change everywhere) suspension suture technique. A retrospective review of patients who underwent alar suspension suture insertion between January 2009 and December 2010 in the management of nasal obstruction was undertaken. Symptoms of nasal obstruction were assessed using the Visual Analogue Scale (VAS) and peak inspiratory flow rate (PIFR). This was measured preprocedure and repeated at 3, 6, and 12 months postoperatively. A total of 35 patients were identified, and 26 were included in the study; 90% of patients were satisfied with the outcome of surgery, supported by improvement in the VAS and PIFR scores. The mean difference in VAS preprocedure and postprocedure was 4.97 (P value = 0.00), and the average improvement in PIFR was 25.5 L/min (P value = 0.00). Our study shows a significant improvement in patient's symptoms following insertion of alar suspension sutures. It is, therefore, a reliable, safe, and effective technique in treating nasal obstruction secondary to nasal valve collapse. © The Author(s) 2015.

  13. Quantitative evaluation of midpalatal suture maturation via fractal analysis

    Science.gov (United States)

    Kwak, Kyoung Ho; Kim, Yong-Il; Kim, Yong-Deok

    2016-01-01

    Objective The purpose of this study was to determine whether the results of fractal analysis can be used as criteria for midpalatal suture maturation evaluation. Methods The study included 131 subjects aged over 18 years of age (range 18.1–53.4 years) who underwent cone-beam computed tomography. Skeletonized images of the midpalatal suture were obtained via image processing software and used to calculate fractal dimensions. Correlations between maturation stage and fractal dimensions were calculated using Spearman's correlation coefficient. Optimal fractal dimension cut-off values were determined using a receiver operating characteristic curve. Results The distribution of maturation stages of the midpalatal suture according to the cervical vertebrae maturation index was highly variable, and there was a strong negative correlation between maturation stage and fractal dimension (−0.623, p Fractal dimension was a statistically significant indicator of dichotomous results with regard to maturation stage (area under curve = 0.794, p fractal dimension was used to predict the resulting variable that splits maturation stages into ABC and D or E yielded an optimal fractal dimension cut-off value of 1.0235. Conclusions There was a strong negative correlation between fractal dimension and midpalatal suture maturation. Fractal analysis is an objective quantitative method, and therefore we suggest that it may be useful for the evaluation of midpalatal suture maturation. PMID:27668195

  14. Evaluation of Sternal Closure with Absorbable Polydioxanone Sutures in Children

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    Hamid Bigdelian

    2014-03-01

    Full Text Available Introduction: Sternal dehiscence, sternal wound infection and mediastinitis are troublesome complications following median sternotomy which are major causes of morbidity and mortality of patients. Synthetic polydioxanone absorbable suture seems effective in prevention of these complications in children undergoing open heart surgery.Methods: During 2 years period, 620 patients who underwent median sternotomy were studied. The efficacy of absorbable polydioxanone suture was tested on patients using figure-of-eight suture technique. The patients’ age ranged from newborn to 15 years old. All surgical interventions were performed according to a standard protocol.Results: No sternal sutures were broken during the sternal closure and no case of mediastinitis was seen. Two patients experienced sternal dehiscence (0.32%. Follow-up period of patients were established between 1 to 132 months after open heart surgery.Conclusion: Sternal closure with the polydioxanone suture in combination with figure-of-eight technique is a safe and suitable method in children with good clinical results.

  15. Biomechanical Study of Two Peripheral Suture Methods on Repaired Tendons

    Science.gov (United States)

    Qiu, Zhenling

    2015-01-01

    Flexor digitorum tendon injuries are challenging conditions to manage to ensure optimal patient outcomes. While several surgical approaches with high success rates have been developed, there remains no gold standard for suture technique for the repair of flexor tendon injuries. In this study, we compared two distinct peripheral suture methods on the strength of repaired tendons. Pig flexor digitorum profundus tendons were used in biomechanical studies and the biomechanical influence on tendon repair of continuous running peripheral suture (CRPS) and continuous locking peripheral suture (CLPS), were compared, using stitch length ranging from 1mm to 5mm. In CRPS, the 1mm stitch length group displayed the highest maximum load and breaking power, which was 1.57 fold higher than the 2mm stitch length group. Pairwise comparison revealed that the 1 and 2mm groups were statistically different from the 3, 4, and 5mm stitch length groups while comparison among the latter groups was not statistically significant. For CLPS, the 1mm group exhibited consistently the highest maximum load strength and breaking power, which was twice the strength displayed by the 2mm group. Pairwise comparisons between groups showed statistical significance. For future repairs of flexor tendon injuries, 1mm stitch length is highly recommended for simple peripheral suture.

  16. Suture-Button Reconstruction of the Interosseous Membrane.

    Science.gov (United States)

    Meals, Clifton G; Forthman, Christopher L; Segalman, Keith A

    2016-08-01

    Reconstruction of the interosseous membrane (IOM) may play a role in the treatment of acute and chronic longitudinal forearm instability. Several reconstruction techniques have been proposed. Suture-button reconstruction is attractive because it obviates donor site morbidity and is relatively easy to perform. How this method compares to its alternatives, however, is unknown. We review literature describing reconstruction of the forearm axis. We describe how we perform suture-button reconstruction of the IOM, summarize our previously published biomechanical data on the subject, and offer a case report. A suture-button is implanted so as to approximate the course of the interosseous ligament. This may be accomplished percutaneously, or when grafting is desired, through an open approach. Data informing the choice of one reconstruction technique over another consist mostly of biomechanical studies and a small number of case reports. Suture-button reconstruction of the IOM may encourage anatomic healing of acute forearm axis injuries especially as an adjunct to radial head replacement or repair. Chronic injuries may benefit from a combination suture-button graft construct and ulnar shortening osteotomy.

  17. Recognizing surgeon's actions during suture operations from video sequences

    Science.gov (United States)

    Li, Ye; Ohya, Jun; Chiba, Toshio; Xu, Rong; Yamashita, Hiromasa

    2014-03-01

    Because of the shortage of nurses in the world, the realization of a robotic nurse that can support surgeries autonomously is very important. More specifically, the robotic nurse should be able to autonomously recognize different situations of surgeries so that the robotic nurse can pass necessary surgical tools to the medical doctors in a timely manner. This paper proposes and explores methods that can classify suture and tying actions during suture operations from the video sequence that observes the surgery scene that includes the surgeon's hands. First, the proposed method uses skin pixel detection and foreground extraction to detect the hand area. Then, interest points are randomly chosen from the hand area so that their 3D SIFT descriptors are computed. A word vocabulary is built by applying hierarchical K-means to these descriptors, and the words' frequency histogram, which corresponds to the feature space, is computed. Finally, to classify the actions, either SVM (Support Vector Machine), Nearest Neighbor rule (NN) for the feature space or a method that combines "sliding window" with NN is performed. We collect 53 suture videos and 53 tying videos to build the training set and to test the proposed method experimentally. It turns out that the NN gives higher than 90% accuracies, which are better recognition than SVM. Negative actions, which are different from either suture or tying action, are recognized with quite good accuracies, while "Sliding window" did not show significant improvements for suture and tying and cannot recognize negative actions.

  18. Improvement in the transport critical current density and microstructure of isotopic Mg11B2 monofilament wires by optimizing the sintering temperature

    Science.gov (United States)

    Qiu, Wenbin; Jie, Hyunseock; Patel, Dipak; Lu, Yao; Luzin, Vladimir; Devred, Arnaud; Somer, Mehmet; Shahabuddin, Mohammed; Kim, Jung Ho; Ma, Zongqing; Dou, Shi Xue; Hossain, Md. Shahriar Al

    2016-11-01

    Superconducting wires are widely used in fabricating magnetic coils in fusion reactors. In consideration of the stability of 11B against neutron irradiation and lower induced radio-activation properties, MgB2 superconductor with 11B serving as boron source is an alternative candidate to be used in fusion reactor with severe irradiation environment. In present work, a batch of monofilament isotopic Mg11B2 wires with amorphous 11B powder as precursor were fabricated using powder-in-tube (PIT) process at different sintering temperature, and the evolution of their microstructure and corresponding superconducting properties was systemically investigated. Accordingly, the best transport critical current density (Jc) = 2 × 104 A/cm2 was obtained at 4.2 K and 5 T, which is even comparable to multi-filament Mg11B2 isotope wires reported in other work. Surprisingly, transport Jc vanished in our wire which was heat-treated at excessively high temperature (800 °C). Combined with microstructure observation, it was found that lots of big interconnected microcracks and voids that can isolate the MgB2 grains formed in this whole sample, resulting in significant deterioration in inter-grain connectivity. The results can be a constructive guide in fabricating Mg11B2 wires to be used as magnet coils in fusion reactor systems such as ITER-type tokamak magnet.

  19. Intercostal thoracotomy closure: transcostal sutures as a less painful alternative to circumcostal suture placement.

    Science.gov (United States)

    Rooney, Matthew B; Mehl, Margo; Monnet, Eric

    2004-01-01

    To determine if transcostal thoracotomy closure resulted in less pain than circumcostal closure. Experimental cadaver and prospective clinical study. Two canine cadavers and 13 adult, 22-29 kg dogs. Phase 1: In 2 cadavers, 4 suture passage techniques were evaluated to determine the incidence of nerve entrapment in circumcostal intercostal thoracotomy closure. Phase 2: Pain after circumcostal closure (7 dogs) or transcostal closure (6 dogs) of a 4th intercostal space thoracotomy was evaluated by use of pain threshold scores, fentanyl administration rates, heart and respiratory rates, and numerical ratings for behavior. Arterial blood gas analyses were obtained 4 hours postoperatively. Transcostal closure was accomplished by drilling 5-6 small holes in the 5th rib and passing sutures through the holes and around the 4th rib to achieve closure. Pain threshold scores (PTS) were measured by an observer unaware of closure assignment, at 2, 4, 12, and 24 hours after closure by applying slowly increasing pressure to the incision line using a load cell. Rates of fentanyl administration were adjusted based on subjective impressions of dog comfort by a second observer unaware of closure assignment. A 70-100% incidence of nerve entrapment was found for all circumcostal techniques. PTS was higher (P=.045) and fentanyl infusion rates were lower (P=.001) for the transcostal group at 2, 4, 12, and 24 hour postoperatively compared with the circumcostal group. There is a high incidence of nerve entrapment using circumcostal closure techniques. A transcostal technique appears to be associated with less pain during the first 24 hours postoperatively. Based on lower pain scores, transcostal thoracotomy closure may be preferable to circumcostal closure techniques.

  20. A comparative study of the effect of suture-less and multiple suture techniques on inflammatory complications following third molar surgery.

    Science.gov (United States)

    Osunde, O D; Adebola, R A; Saheeb, B D

    2012-10-01

    The aim of this prospective randomized study was to evaluate the effect of not using sutures on postoperative pain, swelling and trismus after lower third molar surgery. 80 patients with impacted lower third molars were referred for surgical extraction (42 males; 38 females; aged 18-38 years). The patients were randomly divided into two equal groups (sutures n=40; suture-less n=40). In the experimental group, the flaps were replaced without suturing. The control group was selected using the same criteria and treated under the same surgical protocol as the experimental group, except that the flaps were apposed using multiple sutures. Pain, swelling and trismus were evaluated at 24 h, 48 h and 1 week postoperatively in both groups. The operation time was found to be significantly longer in the multiple sutures group (p0.05). There is less postoperative pain, swelling and trismus with the suture-less technique in third molar surgery.

  1. Intracardiac ultrasonic suture welding for knotless mitral valve replacement.

    Science.gov (United States)

    Ruel, Marc; Streeter, Richard B; de la Torre, Ralph; Liddicoat, John R; Cohn, William E

    2002-02-01

    The difficulty in tying multiple knots with endoscopic instruments constitutes a technical obstacle to the development of closed-chest valve surgery. The following set of experiments was undertaken to ascertain the in-vivo feasibility of using an intracardiac ultrasonic welding device for knotless suture fixation during mitral valve replacement (MVR). Five adult sheep weighing 48-52 kg underwent MVR with a commercially available mechanical prosthesis, using pledgetted interrupted polypropylene sutures. An ultrasonic suture welder designed for intracardiac use was used to adjust suture tension and fuse strands together without knots. Echocardiographic assessment of the mitral prosthesis was carried out at baseline and after maintenance of supraphysiologic arterial pressures for 60 min. Subsequently, the animals' explanted hearts were assessed under sustained left ventricular (LV) pressurization to 180 mmHg in an ex-vivo pressure-loop system. MVR was successfully performed in all animals and welds reliably completed in less than 1 s. One sheep could not successfully be weaned off cardiopulmonary bypass; however, a normal prosthetic valve implant was confirmed at post-mortem examination. Echocardiographic assessment prior to and during LV pressurization revealed normal seating and function of the prosthesis in all cases. At post-mortem examination all valves were adequately implanted, suture tails laid flat on the surface of the prosthesis' sewing ring, welded suture strands were intact and accurately point-fused together, and no evidence of perivalvular leak was found around any of the prostheses despite sustained LV pressurization. This new modality proved reliable in an acute sheep model of MVR and could constitute a promising avenue towards facilitation of total endoscopic valve procedures in humans.

  2. Power scaling of ammonitic suture patterns from the suborder Ancyloceratina

    Science.gov (United States)

    Peterman, D. J.; Barton, C. C.

    2016-12-01

    The spatial scaling of suture patterns from 44 ammonite species of the suborder Ancyloceratina was measured using the fractal box counting method. These specimens were selected from every stage in the Cretaceous and range between approximately 145 Ma to 66 Ma in age. The sutures analyzed in this study were found from published literature where half of the three dimensional paths along the last septal margins were projected on a two dimensional surface. The fractal dimension calculated from the suture patterns ranges from 1.23 to 1.58. These values positively correlate to whorl height (the length between the venter and umbilicus through a transverse cross-section at the last septum of an adult specimen) with a least squares regression analysis correlation coefficient r = 0.617. The fractal dimensions of Cretaceous sutures from Ancyloceratina were compared to a study by Olóriz et al. (2002) where fractal dimensions were measured for suture patterns of 280 species of Late Jurassic ammonites. They found a significant positive correlation (r = 0.500) between fractal dimension and whorl height but only for neritic species (ammonites that inhabit the shallow domain before the drop off of the continental shelf), and a less significant relationship (r = 0.148) for epioceanic species (that occupy the zone beyond the drop off of the continental shelf). Of the 44 sutures from Ancyloceratina analyzed in our study, 41 are presumed to inhabit the epioceanic domain, yet they still exhibit a significant positive relationship (r = 0.617) between fractal dimension and whorl height. This means that this correlation is not restricted to neritic ammonites and may be a function of shell size as proxied by whorl height. There is some inconsistency between these two studies including the vastly different heteromorphic shell forms of Ancyloceratina (with many non-planispiral forms) and temporal variation. Nevertheless, our results provide insight on the role of corrugated septal margins

  3. Biomechanical Comparison of Modified Suture Bridge Using Rip-Stop versus Traditional Suture Bridge for Rotator Cuff Repair

    Directory of Open Access Journals (Sweden)

    ZiYing Wu

    2016-01-01

    Full Text Available Purpose. To compare the biomechanical properties of 3 suture-bridge techniques for rotator cuff repair. Methods. Twelve pair-matched fresh-frozen shoulder specimens were randomized to 3 groups of different repair types: the medially Knotted Suture Bridge (KSB, the medially Untied Suture Bridge (USB, and the Modified Suture Bridge (MSB. Cyclic loading and load-to-failure test were performed. Parameters of elongation, stiffness, load at failure, and mode of failure were recorded. Results. The MSB technique had the significantly greatest load to failure (515.6±78.0 N, P=0.04 for KSB group; P<0.001 for USB group, stiffness (58.0±10.7 N/mm, P=0.005 for KSB group; P<0.001 for USB group, and lowest elongation (1.49±0.39 mm, P=0.009 for KSB group; P=0.001 for USB group among 3 groups. The KSB repair had significantly higher ultimate load (443.5±65.0 N than USB repair (363.5±52.3 N, P=0.024. However, there was no statistical difference in stiffness and elongation between KSB and USB technique (P=0.396 for stiffness and P=0.242 for elongation, resp.. The failure mode for all specimens was suture pulling through the cuff tendon. Conclusions. Our modified suture bridge technique (MSB may provide enhanced biomechanical properties when compared with medially knotted or knotless repair. Clinical Relevance. Our modified technique may represent a promising alternative in arthroscopic rotator cuff repair.

  4. Surgical treatment of traumatic eventration with polyester button and polypropylene mesh to strengthen the suture technique in equine

    OpenAIRE

    Orlandini, Carla Faria; Steiner, Denis; Boscarato, André Giarola; Gimenes, Gabriel Coelho; Alberton, Luiz Romulo

    2016-01-01

    Background Defects in the abdominal wall of horses have high relapse rate. This is mainly in lateral eventrations and hernias caused by trauma from kicks of other horses or installation structures. The eventration region normally becomes swollen and there may be complications due to intestinal loop incarceration. The surgical treatment, consisting of reconstruction of the abdominal wall, frequently require biological or synthetic materials for the reinforcement of the suture line and tension ...

  5. Half-bow sliding knot: modified suture technique for scleral fixation using the corneoscleral pocket.

    Science.gov (United States)

    Chee, Soon-Phaik

    2011-09-01

    A modified suture technique for precise knot placement in the Hoffman corneoscleral pocket technique of scleral fixation is described. Both loops of the polypropylene suture passing from the intraocular device through the sclera and conjunctiva are retrieved from the pocket. A loop of suture is pulled through 3 suture throws made using the second suture loop, forming a half bow. Centration of the intraocular lens (IOL)-capsular bag is checked. If the suture tension is too tight, the surgeon can easily undo the knot of the half-bow knot by pulling it free and can then retie the sliding knot. When the IOL-capsular bag is centered, the suture loop is cut and the free end removed. The second suture end is retrieved from the pocket, and knot tying is completed without further adjustment to the tension. Posterior pressure on the intraocular device centers it and settles the knot within the sclera at the fixation point.

  6. Suture supported P C IOL in a homocystinuric child.

    Directory of Open Access Journals (Sweden)

    Bhatti S

    1996-01-01

    Full Text Available A homocystinuric child presented with a secondary pupillary block glaucoma due to anteriorly subluxated lens. After removal of the subluxated lens, a suture supported posterior chamber IOL was implanted. Postoperative complication of cerebral venous thrombosis following general anaesthesia was managed with high doses of pyridoxine special diet and drugs.

  7. Automatic Detection of Wild-type Mouse Cranial Sutures

    DEFF Research Database (Denmark)

    Ólafsdóttir, Hildur; Darvann, Tron Andre; Hermann, Nuno V.;

    , automatic detection of the cranial sutures becomes important. We have previously built a craniofacial, wild-type mouse atlas from a set of 10 Micro CT scans using a B-spline-based nonrigid registration method by Rueckert et al. Subsequently, all volumes were registered nonrigidly to the atlas. Using...

  8. Cranial suture biology and dental development: genetic and clinical perspectives.

    Science.gov (United States)

    De Coster, P J; Mortier, G; Marks, L A; Martens, L C

    2007-09-01

    Premature fusion of the calvarial bones at the sutures, or craniosynostosis (CS), is a relatively common birth defect (1:2000-3000) frequently associated with limb deformity. Patients with CS may present oral defects, such as cleft soft palate, hypodontia, hyperdontia, and delayed tooth eruption, but also unusual associations of major dental anomalies such as taurodontism, microdontia, multiple dens invaginatus, and dentin dysplasia. The list of genes that are involved in CS includes those coding for the different fibroblast growth factor receptors and a ligand of ephrin receptors, but also genes encoding transcription factors, such as MSX2 and TWIST. Most of these genes are equally involved in odontogenesis, providing a pausible explanation for clinical associations of CS with dental agenesis or tooth malformations. On the basis of the present knowledge on genes and transcription factors that are involved in craniofacial morphogenesis, and from dental clinics of CS syndromes, the molecular mechanisms that control suture formation and suture closure are expected to play key roles in patterning events and development of teeth. The purpose of this article is to review and merge the recent advances in the field of suture research at the genetic and cellular levels with those of tooth development, and to apply them to the dental clinics of CS syndromes. These new perspectives and future challenges in the field of both dental clinics and molecular genetics, more in particular the identification of possible candidate genes involved in both CS and dental defects, are discussed.

  9. Hyperammonemic encephalopathy due to suture line breakdown after bladder operation.

    Science.gov (United States)

    Boogerd, W; Zoetmulder, F A; Moffie, D

    1990-01-01

    A patient is described with a severe encephalopathy and hyperammonemia in absence of liver dysfunction, attributed to urine absorption into the systemic circulation due to suture line breakdown after bladder dome resection. At autopsy characteristic Alzheimer type II astrocytes were found in the basal ganglia.

  10. Functional influence on sutural bone apposition in the growing rat.

    NARCIS (Netherlands)

    Katsaros, C.; Zissis, A.; Bresin, A.; Kiliaridis, S.

    2006-01-01

    INTRODUCTION: The aim of this study was to quantify the influence of reduced masticatory muscle function on sutural bone apposition in the growing rat. METHODS: Twenty-six growing male albino rats were randomly divided into 2 equal groups; 1 (hard-diet group) received the ordinary diet of hard pelle

  11. Penile torsion correction by diagonal corporal plication sutures

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    Brent W. Snow

    2009-02-01

    Full Text Available Penile torsion is commonly encountered. It can be caused by skin and dartos adherence or Buck’s fascia attachments. The authors suggest a new surgical approach to solve both problems. If Buck’s fascia involvement is demonstrated by artificial erection then a new diagonal corporal plication suture is described to effectively solve this problem.

  12. Tendon Collagen Crosslinking Offers Potential to Improve Suture Pullout in Rotator Cuff Repair: An Ex Vivo Sheep Study.

    Science.gov (United States)

    Camenzind, Roland S; Wieser, Karl; Fessel, Gion; Meyer, Dominik C; Snedeker, Jess G

    2016-08-01

    The suture-tendon interface is often the weakest link in tendon to bone repair of massive rotator cuff tears. Genipin is a low-toxicity collagen crosslinker derived from the gardenia fruit that has been shown to augment collagen tissue strength and mechanically arrest tendon-tear progression. The purpose of the current study was to evaluate whether genipin crosslinking can sufficiently augment the suture-tendon interface to improve suture pullout strength using simple single-loop sutures and the modified Mason-Allen technique. The study also aimed to assess whether time of genipin treatment is a relevant factor in efficacy. In an ex vivo (cadaveric) sheep rotator cuff tendon model, a total of 142 suture pullout tests were performed on 32 infraspinatus tendons. Each tendon was prepared with three single-loop stitches. Two groups were pretreated by incubation in genipin solution for either 4 hours or 24 hours. Two corresponding control groups were incubated in phosphate buffered saline for the same periods. The same test protocol was applied to tendons using modified Mason-Allen technique stitch patterns. Each suture was loaded to failure on a universal materials testing machine. Suture pullout force, stiffness, and work to failure were calculated from force-displacement data, and then compared among the groups. Median single-loop pullout force on tendons incubated for 24 hours in genipin yielded an approximately 30% increase in maximum pullout force for single-loop stitches with a median of 73 N (range, 56-114 N) compared with 56 N (range, 40-69 N; difference of medians = 17 N; p = 0.028), with corresponding increases in the required work to failure but not stiffness. Genipin treatment for 4 hours showed no added benefit for suture-pullout behavior (46 N, [range, 35-95 N] versus 45 N, [range, 28-63 N]; difference of medians, 1 N; p = 1). No tested genipin crosslinking conditions indicated benefit for tendons grasped using the modified Mason-Allen technique after 4

  13. The use of suture anchors to repair the ruptured quadriceps tendon.

    Science.gov (United States)

    Bushnell, Brandon D; Whitener, George B; Rubright, James H; Creighton, R Alexander; Logel, Kevin J; Wood, Mark L

    2007-07-01

    Quadriceps tendon rupture is an incapacitating injury that usually requires surgical repair. Traditional repair methods involve transpatellar suture tunnels, but recent reports have introduced the idea of using suture anchors to repair the ruptured tendon. We present 5 cases of our technique of using suture anchors to repair the ruptured quadriceps tendon.

  14. REACTION OF THE RABBIT CORNEAL ENDOTHELIUM TO NYLON SUTURES - A SEM STUDY

    NARCIS (Netherlands)

    JONGEBLOED, WL; VANDERVEEN, G; KALICHARAN, D; RIJNEVELD, WJ; HOUTMAN, WA; WORST, JGF

    1990-01-01

    Nylon and stainless steel sutures separately placed deeply into rabbit corneas by splitting the stroma for a few millimeters, without closing sutures, remained in the cornea for two, four and six weeks respectively. In contrast to the stainless steel sutures an extensive tissue reaction could be obs

  15. REACTION OF THE RABBIT CORNEAL ENDOTHELIUM TO NYLON SUTURES - A SEM STUDY

    NARCIS (Netherlands)

    JONGEBLOED, WL; VANDERVEEN, G; KALICHARAN, D; RIJNEVELD, WJ; HOUTMAN, WA; WORST, JGF

    1990-01-01

    Nylon and stainless steel sutures separately placed deeply into rabbit corneas by splitting the stroma for a few millimeters, without closing sutures, remained in the cornea for two, four and six weeks respectively. In contrast to the stainless steel sutures an extensive tissue reaction could be

  16. Endoscopic management of common patologies with a new suturing system

    Directory of Open Access Journals (Sweden)

    Fernando González-Panizo-Tamargo

    Full Text Available Background: Overstitch endoscopic suturing system (Apollo Endosurgery. Austin, Texas was created for NOTES procedures. As it demonstrated to be feasible, secure and effective in this field, further studies have evaluated its use in common gastrointestinal disorders in which current therapeutic tools, endoscopic or not, are not efficient or safe enough. Published results are promising. We present our initial experience with this system in the management of pathologies we usually face in our clinical practice. Method: Suturing system was evaluated for: 1. Endoscopic fixation of metallic stent to prevent migration in patients with gastrointestinal non-neoformative pathology. 2. Outlet reduction in patients with weight regain following Roux-en-Y gastric bypass. Results: During a period of 6 months Overstitch endoscopic suturing system was used in 5 patients: For stent fixation in 3 and for outlet reduction in 2. Technical success: Suture was performed in all the patients. Only 1 stitch was lost. Effectiveness: Stent fixation and outlet reduction were achieved in all the patients. However, in 1 patient the final anastomotic size was not close enough. Clinical success: Clinical recovery was achieved in all the patients in whom endoscopic stent fixation was performed. The patient which appropriated outlet closure developed a significant weight loss. The patient in which final size was not close enough did not lose weight. Conclusions: We found Overstitch endoscopic suturing system feasible, safe and effective, as it has been previously described. We encourage the publication of further studies evaluating the real utility of this tool, mostly taking into account that it allows a successful management of usual disorders for which there are not current effective therapies.

  17. Caudal Septal Stabilization Suturing Technique to Treat Crooked Noses.

    Science.gov (United States)

    Baykal, Bahadir; Erdim, Ibrahim; Guvey, Ali; Oghan, Fatih; Kayhan, Fatma Tulin

    2016-10-01

    To rotate the nasal axis and septum to the midline using an L-strut graft and a novel caudal septal stabilization suturing technique to treat crooked noses. Thirty-six patients were included in the study. First, an L-strut graft was prepared by excising the deviated cartilage site in all patients. Second, multiple stabilization suturing, which we describe as a caudal septal stabilization suturing technique with a "fishing net"-like appearance, was applied between the anterior nasal spine and caudal septum in all patients. This new surgical technique, used to rotate the caudal septum, was applied to 22 I-type and 14 C-type crooked noses. Correction rates for the crooked noses were compared between the 2 inclination types with angular estimations. Deviation angles were measured using the AutoCAD 2012 software package and frontal (anterior) views, with the Frankfurt horizontal line parallel to the ground. Nasal axis angles showing angle improvement graded 4 categories as excellent, good, acceptable, and unsuccessful for evaluations at 6 months after surgery in the study. The success rate in the C-type nasal inclination was 86.7% (±21.9) and 88% (±16.7) in the I-type. The overall success rate of L-strut grafting and caudal septal stabilization suturing in crooked nose surgeries was 87.5% (±18.6). "Unsuccessful" results were not reported in any of the patients. L-strut grafting and caudal septal stabilization suturing techniques are efficacious in crooked noses according to objective measurement analysis results. However, a longer follow-up duration in a larger patient population is needed.

  18. Evaluation of opening pattern and bone neoformation at median palatal suture area in patients submitted to surgically assisted rapid maxillary expansion (SARME through cone beam computed tomography

    Directory of Open Access Journals (Sweden)

    Daniel Gomes SALGUEIRO

    2015-08-01

    Full Text Available AbstractSurgically assisted rapid maxillary expansion (SARME is the treatment of choice to adult patients even with severe transversal maxillary discrepancies. However, the adequate retention period to achieve the bone remodeling, thus assuring treatment stability, is controversial.Objective To evaluate the opening pattern and bone neoformation process at the midpalatal suture in patients submitted to surgically assisted (SARME through cone beam computed tomography (CBCT.Material and Methods Fourteen patients were submitted to SARME through subtotal Le Fort I osteotomy. Both the opening pattern and the mean bone density at midpalatal suture area to evaluate bone formation were assessed pre- and post-operatively (15, 60 and 180 days through CBCT.Results Type I opening pattern (from anterior to posterior nasal spine occurred in 12 subjects while type II opening pattern (from anterior nasal spine to transverse palatine suture occurred in 2 individuals. The 180-day postoperative mean (PO 180 of bone density value was 49.9% of the preoperative mean (Pre value.Conclusions The opening pattern of midpalatal suture is more related to patients’ age (23.9 years in type I and 33.5 years in type II and surgical technique. It was not possible to observe complete bone formation at midpalatal suture area at the ending of the retention period studied (180 days.

  19. Effect of caffeic acid phenethyl ester on bone formation in the expanded inter-premaxillary suture

    Directory of Open Access Journals (Sweden)

    Kazancioglu HO

    2015-12-01

    Full Text Available Hakki Oguz Kazancioglu,1 Sertac Aksakalli,2 Seref Ezirganli,1 Muhammet Birlik,2 Mukaddes Esrefoglu,3 Ahmet Hüseyin Acar1 1Department of Oral and Maxillofacial Surgery, 2Department of Orthodontics, Faculty of Dentistry, 3Department of Histology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey Background: Narrow maxilla is a common problem in orthodontics and dentofacial orthopedics. To solve this problem, a procedure called rapid maxillary expansion (RME has been used. However, relapse tendency is a major problem of RME. Although relapse tendency is not clearly understood, various treatment procedures and new application has been investigated. The present study aimed to investigate the possible effectiveness of caffeic acid phenethyl ester (CAPE on new bone formation in rat midpalatal suture after RME.Materials and methods: Twenty male Sprague Dawley rats were used in this study. The animals were randomly divided into two groups as control and CAPE group. In CAPE group, CAPE was administered systemically via intraperitoneal injection. RME procedure was performed on all animals. For this purpose, the springs were placed on the maxillary incisors of rats and activated for 5 days. After then, the springs were removed and replaced with short lengths of rectangular retaining wire for consolidation period of 15 days. At the end of the study, histomorphometric analysis was carried out to assess of new bone formation.Results: New bone formation was significantly greater in CAPE group than the control group (P<0.05. CAPE enhances new bone formation in midpalatal suture after RME.Conclusion: These results show that CAPE may decrease the time needed for retention. Keywords: rapid maxillary expansion, bone formation, caffeic acid phenethyl ester, midpalatal suture, histopathology

  20. Cosmetic outcome and surgical site infection rates of antibacterial absorbable (Polyglactin 910) suture compared to Chinese silk suture in breast cancer surgery: a randomized pilot research

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhong-tao; Jessica Shen; Martin Weisberg; ZHANG Hong-wei; FANG Xue-dong; WANG Li-ming; LI Xiao-xi; LI Ya-fen; SUN Xiao-wei; Judith Carver; Dorella Simpkins

    2011-01-01

    Background The primary objective of this multicenter post-market study was to compare the cosmetic outcome of triclosan-coated VICRYL* Plus sutures with Chinese silk sutures for skin closure of modified radical mastectomy. A secondary objective was to assess the incidence of surgical site infection (SSI).Methods Patients undergoing modified radical mastectomy were randomly assigned to coated VICRYL* Plus antibacterial (Polyglactin 910) suture or Chinese silk suture. Cosmetic outcomes were evaluated postoperatively at days 12 (±2) and 30 (±5), and the evidence of SSI was assessed at days 3, 5, 7, 12 (±2), 30 (±5), and 90 (±7). Cosmetic outcomes were independently assessed via visual analogue scale (VAS) score evaluations of blinded incision photographs (primary endpoint) and surgeon-assessed modified Hollander Scale (mHCS) scores (secondary endpoint).SSI assessments used both CDC criteria and ASEPSIS scores.Results Six Chinese hospitals randomized 101 women undergoing modified radical mastectomy to closure with coated VICRYL* Plus suture (n=51) or Chinese silk suture (n=50). Mean VAS cosmetic outcome scores for antibacterial suture (67.2) were better than for Chinese silk (45.4) at day 30 (P<0.0001)). Mean mHCS cosmetic outcome total scores, were also higher for antibacterial suture (5.7) than for Chinese silk (5.0) at day 30 (P=0.002).Conclusions Patients using coated VICRYL* Plus suture had significantly better cosmetic outcomes than those with Chinese silk sutures. Patients using coated VICRYL* Plus suture had a lower SSI incidence compared to the Chinese silk sutures, although the difference did not reach statistical significance. (ClinicalTrials.gov NCT 00768222)

  1. The 2.5 mm PushLock suture anchor system versus a traditional suture anchor for ulnar collateral ligament injuries of the thumb: a biomechanical study.

    Science.gov (United States)

    Jarrett, C D; McGillivary, G R; Hutton, W C

    2010-02-01

    We compared the biomechanical strength of the 2.5 mm PushLock suture anchor with a traditional Bio-SutureTak suture anchor in repair of ulnar collateral ligament injuries. Iatrogenic ulnar collateral ligament injuries in 18 cadaveric thumbs were repaired and used to test for load to failure and cyclic loading. The average force required to generate a 2 mm gap was 7.7 N for the 2.5 mm PushLock and 6.3 N for the Bio-SutureTak (p = 0.04). The ultimate load to failure was 28.0 N for the 2.5 mm PushLock and 18.8 N for the Bio-SutureTak (p = 0.16). There were no statistical differences between the two suture anchors under cyclic loading. The 2.5 mm PushLock suture anchor provides significantly stronger resistance to 2 mm gap formation at the repair site and is less likely to fail at the suture-ligament interface. However, there was no difference in the load to failure between the two suture anchors.

  2. How we do it:the Running-X suture technique

    Institute of Scientific and Technical Information of China (English)

    Nathaniel L Villanueva; Kyle Sanniec; Ronald Mancini

    2016-01-01

    There are a myriad of suture techniques available to close incisions of the brow and forehead, each with their own advantages and disadvantages. The ideal suture technique would provide excellent cosmetic results, offer expedient wound closure, optimize skin eversion and wound edge apposition, and provide excellent cosmetic results. The authors describe a new suture technique, the Running-X suture, a running horizontal mattress suture that has successfully been used by the senior author for many years to re-approximate surgical wounds of the brow and forehead in an expeditious and aesthetic manner.

  3. Timing of ectocranial suture activity in Gorilla gorilla as related to cranial volume and dental eruption.

    Science.gov (United States)

    Cray, James; Cooper, Gregory M; Mooney, Mark P; Siegel, Michael I

    2011-05-01

    Research has shown that Pan and Homo have similar ectocranial suture synostosis patterns and a similar suture ontogeny (relative timing of suture fusion during the species ontogeny). This ontogeny includes patency during and after neurocranial expansion with a delayed bony response associated with adaptation to biomechanical forces generated by mastication. Here we investigate these relationships for Gorilla by examining the association among ectocranial suture morphology, cranial volume (as a proxy for neurocranial expansion) and dental development (as a proxy for the length of time that it has been masticating hard foods and exerting such strains on the cranial vault) in a large sample of Gorilla gorilla skulls. Two-hundred and fifty-five Gorilla gorilla skulls were examined for ectocranial suture closure status, cranial volume and dental eruption. Regression models were calculated for cranial volumes by suture activity, and Kendall's tau (a non-parametric measure of association) was calculated for dental eruption status by suture activity. Results suggest that, as reported for Pan and Homo, neurocranial expansion precedes suture synostosis activity. Here, Gorilla was shown to have a strong relationship between dental development and suture activity (synostosis). These data are suggestive of suture fusion extending further into ontogeny than brain expansion, similar to Homo and Pan. This finding allows for the possibility that masticatory forces influence ectocranial suture morphology.

  4. Assessment of the role of sutures in a lizard skull: a computer modelling study.

    Science.gov (United States)

    Moazen, Mehran; Curtis, Neil; O'Higgins, Paul; Jones, Marc E H; Evans, Susan E; Fagan, Michael J

    2009-01-01

    Sutures form an integral part of the functioning skull, but their role has long been debated among vertebrate morphologists and palaeontologists. Furthermore, the relationship between typical skull sutures, and those involved in cranial kinesis, is poorly understood. In a series of computational modelling studies, complex loading conditions obtained through multibody dynamics analysis were imposed on a finite element model of the skull of Uromastyx hardwickii, an akinetic herbivorous lizard. A finite element analysis (FEA) of a skull with no sutures revealed higher patterns of strain in regions where cranial sutures are located in the skull. From these findings, FEAs were performed on skulls with sutures (individual and groups of sutures) to investigate their role and function more thoroughly. Our results showed that individual sutures relieved strain locally, but only at the expense of elevated strain in other regions of the skull. These findings provide an insight into the behaviour of sutures and show how they are adapted to work together to distribute strain around the skull. Premature fusion of one suture could therefore lead to increased abnormal loading on other regions of the skull causing irregular bone growth and deformities. This detailed investigation also revealed that the frontal-parietal suture of the Uromastyx skull played a substantial role in relieving strain compared with the other sutures. This raises questions about the original role of mesokinesis in squamate evolution.

  5. A STUDY ON METOPIC SUTURE IN CADAVERIC SKULLS OF ASSAMESE PEOPLE

    Directory of Open Access Journals (Sweden)

    Rubi

    2014-09-01

    Full Text Available Metopic suture is formed due to failure of union of the two halves of the frontal bone. Usually the suture disappears by early childhood, but in some cases it persists as complete or incomplete metopic suture throughout life. A complete metopic suture extends from anterior aspect of bregma to the nasion which is known as metopism. The present study is carried out in 126 dry human cadaveric skulls collected from the Dept. of Anatomy, Dept. of Forensic Medicine and Institute of Pharmacy at Assam Medical College & Hospital, Dibrugarh, Assam, and India. Metopic suture was found in 46(36.5% skulls. Metopism was found in 4(3.17% skulls and incomplete metopic suture was seen in 42(33.33% skulls. 80(63.49% skulls did not have metopic suture in any form.

  6. Modified versus classic alar base sutures after LeFort I osteotomy: a systematic review.

    Science.gov (United States)

    Liu, Xianwen; Zhu, Songsong; Hu, Jing

    2014-01-01

    The purpose of this systematic review is to evaluate the efficacy of a new modified alar base cinch suture by comparing it with the commonly used classic alar base suture after LeFort I osteotomy. A comprehensive search strategy was performed to include interventional studies involving the comparisons of alar base suturing methods after LeFort I osteotomy. Data analyses were conducted using the random-effects model. Three studies with 146 participants undergoing LeFort I maxillary osteotomy were included in this review. The results showed that, compared with the classic method, both modified transseptal alar base suture and modified reinsertion sutures significantly decreased postoperative alar and alar base widening. The modified alar base cinch suture was more effective than the classic alar base suture in maintaining preoperative alar and alar base width after LeFort I osteotomy. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Randomized clinical trial comparing manual suture and different models of mechanical suture in the mimicking of bariatric surgery in swine

    Directory of Open Access Journals (Sweden)

    Fernandes MA

    2014-02-01

    Full Text Available Marcos AP Fernandes,1 Bruno MT Pereira,2 Sandra M Guimarães,1 Aline Paganelli,3 Carlos Manoel CT Pereira,1 Claudio Sergio Batista4 1Institute of Obesity and Advanced Video Laparoscopic Surgery of Petropolis, Rio de Janeiro, Brazil; 2Division of Trauma, University of Campinas, São Paulo, Brazil; 3Laboratório de Patologia Micron Cell Diagnóstico, Rio de Janeiro, Brazil; 4Department of Gynecology and Obstetrics, Faculty of Medicine of Petropolis, Rio de Janeiro, Brazil Context and objective: Variations in the ability of surgeons served as motivation for the development of devices that, overcoming individual differences, allow the techniques to be properly performed, and of which the end result was the best possible. Every technique must be reproduced reliably by the majority of surgeons for their results to be adopted and recognized as effective. The aim of this study was to compare the results, from the point of view of anatomic pathology, of manual sutures versus mechanical sutures using different models of linear mechanical staplers, in the procedure of gastroenteroanastomosis and enteroanastomosis in swine. Methods: Thirty-six healthy, adult, male Sus scrofa domesticus pigs, weighing between 20.7 and 25.5 kg, were used. The swine were randomly divided into four groups of nine pigs, according to the type of suture employed: group A, manual suture with Polysorb® 3-0 wire; group B, 80-shear linear stapler (Covidien® Gia 8038-S; group C, 75-shear linear stapler (Ethicon® Tlc 75; and group D, 75-shear linear stapler (Resource® Yq 75-3. A temporal study was established on the seventh postoperative day for histopathological analysis, and the degree of inflammation, fibrosis, and newly formed vessels, as well as the presence or absence of granulation tissue, foreign body granuloma, and necrosis were all evaluated qualitatively and semiquantitatively. The results were analyzed statistically. Results: Observations during the histopathological

  8. Rehabilitation of long-standing facial nerve paralysis with percutaneous suture-based slings.

    Science.gov (United States)

    Alam, Daniel

    2007-01-01

    Long-standing facial paralysis creates significant functional and aesthetic problems for patients affected by this deficit. Traditional approaches to correct this problem have involved aggressive open procedures such as unilateral face-lifts and sling procedures using fascia and implantable materials. Unfortunately, our results with these techniques over the last 5 years have been suboptimal. The traditional face-lift techniques did not address the nasolabial fold to our satisfaction, and suture-based techniques alone, while offering excellent short-term results, failed to provide a long-term solution. This led to the development of a novel percutaneous technique combining the minimally invasive approach of suture-based lifts with the long-term efficacy of Gore-Tex-based slings. We report our results with this technique for static facial suspension in patients with long-standing facial nerve paralysis and our surgical outcomes in 13 patients. The procedure offers re-creation of the nasolabial crease and suspension of the oral commissure to its normal anatomic relationships. The recovery time is minimal, and the operation is performed as a short outpatient procedure. Long-term 2-year follow-up has shown effective preservation of the surgical results.

  9. A Case of Intraocular Erosion and Intrusion by an Arruga Suture

    Directory of Open Access Journals (Sweden)

    Takakuni Kitagaki

    2016-03-01

    Full Text Available Purpose: To report a case of intraocular erosion and intrusion by an Arruga suture. Case Report: This study involved a 62-year-old male who had undergone scleral buckling surgery 40 or more years ago at another hospital for rhegmatogenous retinal detachment, as well as trabeculectomy 20 years ago for primary open-angle glaucoma, in his left eye at the same hospital. However, he recently became aware of blurred vision in that eye. Upon examination, iritis was observed in the anterior portion of his left eye, as well as a great number of pigment cell keratoprecipitates on the posterior surface of the cornea. In the ocular fundus, extensive atrophy of the retinal pigment epithelium and partial hyperpigmentation was observed, accompanied by subretinal strands, yet the retina remained attached. Around the entire peripheral area of the retina we observed a ring-shaped protrusion, but we also saw a shiny, filamentous material in the vitreous cavity that penetrated the sclera and choroid, completely extending from the 4- to 8-o'clock position of the scleral buckle protrusion. To treat the iritis in the patient's left eye, we began to administrate low-concentration steroid eye drops, after which the inflammation disappeared. Conclusion: In this study, we experienced a case of intraocular erosion and intrusion by an Arruga suture, and opted to treat the patient with steroid eye drops and conservative follow-up observations unless retinal redetachment and/or vitreous hemorrhage occurs.

  10. A Case of Intraocular Erosion and Intrusion by an Arruga Suture

    Science.gov (United States)

    Kitagaki, Takakuni; Morishita, Seita; Kohmoto, Ryohsuke; Fukumoto, Masanori; Suzuki, Hiroyuki; Sato, Takaki; Kobayashi, Takatoshi; Kida, Teruyo; Nakajima, Masayuki; Ikeda, Tsunehiko

    2016-01-01

    Purpose To report a case of intraocular erosion and intrusion by an Arruga suture. Case Report This study involved a 62-year-old male who had undergone scleral buckling surgery 40 or more years ago at another hospital for rhegmatogenous retinal detachment, as well as trabeculectomy 20 years ago for primary open-angle glaucoma, in his left eye at the same hospital. However, he recently became aware of blurred vision in that eye. Upon examination, iritis was observed in the anterior portion of his left eye, as well as a great number of pigment cell keratoprecipitates on the posterior surface of the cornea. In the ocular fundus, extensive atrophy of the retinal pigment epithelium and partial hyperpigmentation was observed, accompanied by subretinal strands, yet the retina remained attached. Around the entire peripheral area of the retina we observed a ring-shaped protrusion, but we also saw a shiny, filamentous material in the vitreous cavity that penetrated the sclera and choroid, completely extending from the 4- to 8-o'clock position of the scleral buckle protrusion. To treat the iritis in the patient's left eye, we began to administrate low-concentration steroid eye drops, after which the inflammation disappeared. Conclusion In this study, we experienced a case of intraocular erosion and intrusion by an Arruga suture, and opted to treat the patient with steroid eye drops and conservative follow-up observations unless retinal redetachment and/or vitreous hemorrhage occurs. PMID:27099609

  11. Modification of the Bankart reconstruction using a suture anchor.

    Science.gov (United States)

    Traina, S M; Holtgrewe, J L; King, S

    1998-01-01

    A prospective study was done to determine the effectiveness of a suture anchor in doing a Modified Bankart Reconstruction on the traumatic unidirectional Bankart lesion shoulder. From 1989 to 1991, 26 patients encompassing 27 shoulders with recurrent instability had modified Bankart reconstructions. A minimum 18-month follow-up was obtained by examination of 24 patients with telephone interviews done on two patients. The average follow-up was 23.6 months. A 93.1% good-to-excellent result was obtained using the Bankart rating scale. There were no failures or complications. The surgeon involved in the study thought the suture anchor facilitated the attachment of the avulsed capsulolabral complex in doing the Bankart procedure.

  12. Dynamic Observation on the Effects of Different Suture Techniques on the Biomechanical Properties in the Healing of Tendons

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    To identify the best suture techniques for the tendon repair, the biomechanical properties of tendons sutured by different methods were dynamically examined. 140 chickens were divided into 2 groups equally: group A and group B. The tendon of the right side was subjected to injury-repair process, and the tendons of the left sides served as controls in both groups. In group A, "figure-of8" suture, modified Kessler suture and Bunnell suture were used for the 2nd to 4th paws respectively, while in group B, Kleinert suture, Tsuge suture and Ikuta suture were used. On the day 0, 3,7, 14, 21, 28, 42 after operation, 10 animals were sacrificed and the flexor tendons of both sides were harvested for strength test. The results showed that the initial strength of the repaired tendons and the strength after 6 weeks following tendon cut were far below those of intact tendons, irrespective of suture techniques used. With the 6 techniques, the Pmax of tendons repaired by Tsuge suture was increased continually, reaching the highest value on the 42nd day. The Pmax of tendons sutured by the modified Kessler suture was slightly lower than that by Tsuge suture, but it was increased steadily in healing. The tendons repaired by figure-of-8 suture yielded the lowest Pmax. It was concluded that Tsuge suture and modified Kessler suture were the best techniques for tendon repair.

  13. Transcutaneous Serdev Suture For Buttock’s Lift

    OpenAIRE

    Nikolay Serdev

    2012-01-01

    This article presents the author's technique and experience in the treatment of the flaccid "unhappy buttock" form with his surgical procedure of buttock lift by suture, without incision scars. The author first presented this new operation technique on a national level at the 2nd Annual Meeting of the National Bulgarian Society for Aesthetic Surgery and Aesthetic Medicine in Sofia on March 18, 1994 [1] and internationally at many scientific meetings over the world [2, 3, 4…]. The result is a ...

  14. Microsurgical transverse 2-suture intussusception vasoepididymostomy: effectiveness and rationality

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hao; HUANG Wen-tao; RUAN Xing-xing; LI Liao-yuan; DI Jin-ming; LIU Xiao-peng; XIAO Heng-jun

    2013-01-01

    Background 2-Suture longitudinal vasoepididymostomy shows superiority to transverse technique in an animal study; to date,this has not been consistently confirmed in human body.In the present study,we evaluated the effectiveness of 2-suture transverse intussusception vasoepididymostomy and compared the rationality between transverse and longitudinal techniques.Methods From May 2007 to December 2008,we performed 2-suture transverse vasoepididymostomy in 19 consecutive patients,as described by Marmar with modification.Between March 2009 and January 2010,the internal diameter of the vas lumen and the outer diameter of the epididymal tube were measured using microruler (21 patients and 37 sides).Results Three patients lost to follow-up.At the first follow-up period (ranged from 10 to 24 months),the patency rate was 56.3% (9/16) and the natural pregnancy rate was 25% (4/16).At the second follow-up period (ranged from 46 to 63months),the patency rate was 68.8% (11/16),the natural pregnancy rate was 37.5% (6/16),respectively,and the takehome baby rate was 31.3% (5/16).The diameter of the vas lumen and the outer diameter of the epididymal tubule were (0.512±0.046) mm and (0.572±0.051) mm (P <0.001),respectively.Conclusion Transverse 2-suture intussusception vasoepididymostomy is still an effective technique in treating obstructive azoospermia.

  15. The south Zagros suture zone in teleseismic images

    Science.gov (United States)

    Motaghi, K.; Shabanian, E.; Tatar, M.; Cuffaro, M.; Doglioni, C.

    2017-01-01

    The geometry of intra-continental lithosphere boundaries along the Zagros orogenic belt in the Arabia-Eurasia collision is investigated by means of teleseismic data. The data are gathered over a seismic linear profile extending across south Zagros, the Sanandaj-Sirjan metamorphic zone, the Urumieh-Dokhtar magmatic arc, Central Iran, and the Kopeh Dagh - Binalud mountains. We exploit the P and S receiver functions leading to map the geometry of the crustal and subcrustal interfaces. The migrated depth sections reveal an abrupt crustal thickening and a gentle crustal thinning 60 km north and 30 km south of the Zagros suture, respectively. Associated to the buckled antiformal Moho south of the suture, a deeper synform in the lithospheric lid of the lower Arabia plate is shown by migrated depth sections affecting the lithospheric mantle of the Arabia plate beneath the suture zone. This geometry implies an unexpected intra-lid decoupling. These features imply that the Central Iran lithosphere acts as a relatively strong backstop producing significant internal deformation expressed by shortening and thickening at the edge of the Arabian lithosphere. The 410 km and 660 km transition zones are imaged by P to S converted phases and showed lateral continuity implying an originally low dip angle subduction of the oceanic Arabian plate beneath Central Iran.

  16. Self-directed practice schedule enhances learning of suturing skills.

    Science.gov (United States)

    Safir, Oleg; Williams, Camille K; Dubrowski, Adam; Backstein, David; Carnahan, Heather

    2013-12-01

    Most preoperative surgical training programs experience challenges with the availability of expert surgeons to teach trainees. Some research suggests that trainees may benefit from being allowed to actively shape their learning environments, which could alleviate some of the time and resource pressures in surgical training. The purpose of this study was to investigate the effects of self-directed or prescribed practice schedules (random or blocked) on learning suturing skills. Participants watched an instructional video for simple interrupted, vertical mattress and horizontal mattress suturing then completed a pretest to assess baseline skills. Participants were assigned to 1 of 4 practice groups: self-directed practice schedule, prescribed blocked practice schedule, prescribed random practice schedule or matched to the self-directed group (control). Practice of the skill was followed by a delayed (1 h) posttest. Improvement from pretest to posttest was determined based on differences in performance time and expert-based assessments. Analyses revealed a significant effect of group for difference in performance time of the simple interrupted suture. Random practice did not show the expected advantage for skill learning, but there was an advantage of self-directed practice. Self-directed practice schedules may be desirable for optimal learning of simple technical skills, even when expert instruction is available. Instructors must also take into account the interaction between task difficulty and conditions of practice to develop ideal training environments.

  17. The role of antimicrobial sutures in preventing surgical site infection.

    Science.gov (United States)

    Leaper, D; Wilson, P; Assadian, O; Edmiston, C; Kiernan, M; Miller, A; Bond-Smith, G; Yap, J

    2017-07-01

    INTRODUCTION Healthcare associated infections (HCAIs) are falling following widespread and enforced introduction of guidelines, particularly those that have addressed antibiotic resistant pathogens such as methicillin resistant Staphylococcus aureus or emergent pathogens such as Clostridium difficile, but no such decline has been seen in the incidence of surgical site infection (SSI), either in the UK, the EU or the US. SSI is one of the HCAIs, which are all avoidable complications of a surgical patient's pathway through both nosocomial and community care. METHODS This report is based on a meeting held at The Royal College of Surgeons of England on 21 July 2016. Using PubMed, members of the panel reviewed the current use of antiseptics and antimicrobial sutures in their specialties to prevent SSI. FINDINGS The group agreed that wider use of antiseptics in surgical practice may help in reducing reliance on antibiotics in infection prevention and control, especially in the perioperative period of open elective colorectal, hepatobiliary and cardiac operative procedures. The wider use of antiseptics includes preoperative showering, promotion of hand hygiene, (including the appropriate use of surgical gloves), preoperative skin preparation (including management of hair removal), antimicrobial sutures and the management of dehisced surgical wounds after infection. The meeting placed emphasis on the level I evidence that supports the use of antimicrobial sutures, particularly in surgical procedures after which the SSI rate is high (colorectal and hepatobiliary surgery) or when a SSI can be life threatening even when the rate of SSI is low (cardiac surgery).

  18. Stress and strain analysis on the anastomosis site sutured with either epineurial or perineurial sutures after simulation of sciatic nerve injury

    Institute of Scientific and Technical Information of China (English)

    Guangyao Liu; Qiao Zhang; Yan Jin; Zhongli Gao

    2012-01-01

    The magnitude of tensile stress and tensile strain at an anastomosis site under physiological stress is an important factor for the success of anastomosis following suturing in peripheral nerve injury treatment.Sciatic nerves from fresh adult cadavers were used to create models of sciatic nerve injury.The denervated specimens underwent epineurial and perineurial suturing.The elastic modulus (40.96 ± 2.59 MPa) and Poisson ratio (0.37 ± 0.02) of the normal sciatic nerve were measured by strain electrical measurement.A resistance strain gauge was pasted on the front,back,left,and right of the edge of the anastomosis site after suturing.Strain electrical measurement results showed that the stress and strain values of the sciatic nerve following perineurial suturing were lower than those following epineurial suturing.Scanning electron microscopy revealed that the sciatic nerve fibers were disordered following epineurial compared with perineurial suturing.These results indicate that the effect of perineurial suturing in sciatic nerve injury repair is better than that of epineurial suturing.

  19. An in-vitro study of rotator cuff tear and repair kinematics using single- and double-row suture anchor fixation

    Directory of Open Access Journals (Sweden)

    Angela E Kedgley

    2013-01-01

    Full Text Available Purpose: Double-row suture anchor fixation of the rotator cuff was developed to reduce repair failure rates. The purpose of this study was to determine the effects of simulated rotator cuff tears and subsequent repairs using single- and double-row suture anchor fixation on three-dimensional shoulder kinematics. It was hypothesized that both single- and double-row repairs would be effective in restoring active intact kinematics of the shoulder. Materials and Methods: Sixteen fresh-frozen cadaveric shoulder specimens (eight matched pairs were tested using a custom loading apparatus designed to simulate unconstrained motion of the shoulder. In each specimen, the rotator cuff was sectioned to create a medium-sized (2 cm tear. Within each pair, one specimen was randomized to a single-row suture anchor repair, while the contralateral side underwent a double-row suture anchor repair. Joint kinematics were recorded for intact, torn, and repaired scenarios using an electromagnetic tracking device. Results: Active kinematics confirmed that a medium-sized rotator cuff tear affected glenohumeral kinematics when compared to the intact state. Single- and double-row suture anchor repairs restored the kinematics of the intact specimen. Conclusions: This study illustrates the effects of medium-sized rotator cuff tears and their repairs on active glenohumeral kinematics. No significant difference ( P ≥ 0.10 was found between the kinematics of single- and double-row techniques in medium-sized rotator cuff repairs. Clinical Relevance: Determining the relative effects of single- and double-row suture anchor repairs of the rotator cuff will allow physicians to be better equipped to treat patients with rotator cuff disease.

  20. Comparison between stainless steel staples and silk sutures for primary closure of skin in patients undergoing neck dissection: A comparative clinical study

    Directory of Open Access Journals (Sweden)

    Abhishek Ghosh

    2015-01-01

    Full Text Available Introduction: Comparison between stainless steel staples and silk sutures for primary closure of skin in patients undergoing neck dissection, in context of rapid application, approximation of the skin edges, economy and aesthetics of the resultant scar. Aim: (1 To compare surgical stainless steel staples and silk sutures for primary wound closure, with respect to presence/absence of wound infection and dehiscence (2 To compare the resultant scar following the two different methods of the closure at 3 rd month postoperatively with the help of visual analog scale and analyze the result statistically Design: This study was designed to compare skin closure using staples and silk sutures in patients undergoing neck dissection, using both methods in one-half of the same wound; thus each wound affording its own control. Materials and Methods: The study was conducted on patients requiring collar line incision (high submandibular incision with or without a cephalad extension of midline lower lip split incision for surgical access, who presented to the Department of Oral and Maxillo-Facial Surgery. (1 Sample size: 10 (2 Study design: Prospective Comparative study (3 Study duration: One and half years (4 Surgical stainless steel staples: Proximate Plus MD 35 W, Ethicon Endo Surgery (5 Sutures: 3-0 Ethiprime NW 5003, Non-Absorbable Surgical Suture, Mersilk-90 cm, Ethicon, (16 mm 3/8 circle cutting needle. Conclusion: It wass concluded that there is no significant difference between the scars observed in the regions of incision which underwent primary closure by two different methods, that is surgical stainless steel staples and 3-0 Mersilk Sutures.

  1. ASTIGMATIC OUTCOME & POST OPERATIVE RECOVERY IN PAT IENTS UNDERGOING PTERYGIUM EXCISION WITH CONJUNCTIVAL AUTOGRAFTS. COMPARISION BETWEEN SUTURE & AUTOLOGUS BLOOD FIBRIN

    Directory of Open Access Journals (Sweden)

    Smita Dileep

    2013-06-01

    Full Text Available ABSTRACT : AIMS: To review the effect of surgery type on the postop erative recovery & astigmatism in pterygium surgery. SETTINGS AND DESIGN: Randomized comparative clinical trial. MATERIALS AND METHODS: Forty six patients (46 eyes with primary pterygiu m were randomised to undergo pterygium surgery using eithe r autologous fibrin glue (23 eyes or 10-0 nylon sutures (23 eyes to attach the conjunctival autograft. The patients were followed up 1day, 1wk, 2wks & 6 w eeks. Outcome measures were keratometry changes & postope rative recovery.. The preoperative and postoperative keratometric measurements, evaluated using keratometer, were noted. RESULTS: Corneal astigmatism was significantly reduced in th e total group from 2.94(SD- 0.52 diopter to 1.91 (sd 0.57 diopter (p 0.05. The intensity of the postoperative watering, itchin g, were significantly lower in the autologous fibrin glue group than in the suture gro up (p<0.001. Postoperative redness was absent in 47.82% (11cases and mild in 52.18% (13 cases 2 weeks postoperatively in the autologous fibrin group while in sutured group 17.4% (4cases had mild redness and 82.6% (19 cases had moderate redness 2weeks postoperatively.

  2. Ultrastructure, Histochemistry, and Mineralization Patterns in the Ecdysial Suture of the Blue Crab, Callinectes sapidus

    Science.gov (United States)

    Priester, Carolina; Dillaman, Richard M.; Gay, D. Mark

    2005-12-01

    The ecdysial suture is the region of the arthropod exoskeleton that splits to allow the animal to emerge during ecdysis. We examined the morphology and composition of the intermolt and premolt suture of the blue crab using light microscopy and scanning electron microscopy. The suture could not be identified by routine histological techniques; however 3 of 22 fluorescein isothiocyanate-labeled lectins tested (Lens culinaris agglutinin, Vicia faba agglutinin, and Pisum sativum agglutinin) differentiated the suture, binding more intensely to the suture exocuticle and less intensely to the suture endocuticle. Back-scattered electron (BSE) and secondary electron observations of fracture surfaces of intermolt cuticle showed less mineralized regions in the wedge-shaped suture as did BSE analysis of premolt and intermolt resin-embedded cuticle. The prism regions of the suture exocuticle were not calcified. X-ray microanalysis of both the endocuticle and exocuticle demonstrated that the suture was less calcified than the surrounding cuticle with significantly lower magnesium and phosphorus concentrations, potentially making its mineral more soluble. The presence or absence of a glycoprotein in the organic matrix, the extent and composition of the mineral deposited, and the thickness of the cuticle all likely contribute to the suture being removed by molting fluid, thereby ensuring successful ecdysis.

  3. Keratometric astigmatism after ECCE in eastern Nepal. Continuous versus interrupted sutures.

    Science.gov (United States)

    Sood, Archana; Thakur, Sanjay Kumar D; Kumar, Sandeep; Badhu, Badri

    2003-03-01

    The study aimed to compute and compare the keratometric astigmatism induced by wound closure with continuous and interrupted sutures in conventional extracapsular cataract extraction with intraocular lens implantation at a single centre in eastern Nepal. Sixty eyes of 60 patients were included in the study. All patients received conventional extracapsular cataract extraction and single piece modified C-loop posterior chamber intraocular lens. Thirty eyes were sutured with continuous (Group 1) and 30 eyes with interrupted sutures (Group 2). The results were analysed by the unpaired student's t-test. At the end of 6 weeks, Group 1 patients had significantly higher astigmatism (3.53 +/- 2.19D) compared to Group 2 patients (1.7 +/- 1.35). A majority of patients in both groups had with-the-rule astigmatism throughout the postoperative period. Interrupted sutures cause less astigmatism than continuous suture. The factors responsible for high astigmatism in continuous sutures call for further analysis.

  4. 3D printed, bio-inspired prototypes and analytical models for structured suture interfaces with geometrically-tuned deformation and failure behavior

    Science.gov (United States)

    Lin, Erica; Li, Yaning; Ortiz, Christine; Boyce, Mary C.

    2014-12-01

    Geometrically structured interfaces in nature possess enhanced, and often surprising, mechanical properties, and provide inspiration for materials design. This paper investigates the mechanics of deformation and failure mechanisms of suture interface designs through analytical models and experiments on 3D printed polymer physical prototypes. Suture waveforms with generalized trapezoidal geometries (trapezoidal, rectangular, anti-trapezoidal, and triangular) are studied and characterized by several important geometric parameters: the presence or absence of a bonded tip region, the tip angle, and the geometry. It is shown that a wide range (in some cases as great as an order of magnitude) in stiffness, strength, and toughness is achievable dependent on tip bonding, tip angle, and geometry. Suture interfaces with a bonded tip region exhibit a higher initial stiffness due to the greater load bearing by the skeletal teeth, a double peak in the stress-strain curve corresponding to the failure of the bonded tip and the failure of the slanted interface region or tooth, respectively, and an additional failure and toughening mechanism due to the failure of the bonded tip. Anti-trapezoidal geometries promote the greatest amplification of properties for suture interfaces with a bonded tip due the large tip interface area. The tip angle and geometry govern the stress distributions in the teeth and the ratio of normal to shear stresses in the interfacial layers, which together determine the failure mechanism of the interface and/or the teeth. Rectangular suture interfaces fail by simple shearing of the interfaces. Trapezoidal and triangular suture interfaces fail by a combination of shear and tensile normal stresses in the interface, leading to plastic deformation, cavitation events, and subsequent stretching of interface ligaments with mostly elastic deformation in the teeth. Anti-trapezoidal suture interfaces with small tip angles have high stress concentrations in the teeth

  5. Estudo comparativo do tratamento de ferimento de colon de coelho com reparo seroso da parede de jejunum e sutura primária Comparative study of colon wound repair using jejunal serosal wall and primary suture, in rabbits

    Directory of Open Access Journals (Sweden)

    Carlos Edmundo Fontes

    2000-03-01

    Full Text Available Os animais foram submetidos a procedimento operatório sob anestesia geral para a produção de dois ferimentos padronizados em colo não preparado, usando instrumento desenvolvido para esta finalidade. O primeiro ferimento foi produzido a 2 cm do ceco e o segundo 20 cm eqüidistante deste, no sentido caudal. Estes ferimentos foram reparados obedecendo a resultado de sorteio que determinou a técnica a ser usada, se com o lado seroso da parede de jejuno ou por sutura primária. Nas duas técnicas foram usados pontos separados de fio monofilamentar de poliglecaprone 4-0 , sendo que o animal serviu de controle para si mesmo. Realizou-se eutanásia no 7º P.O. para os animais do sub-grupo A e no 30º P.O. para os animais do sub-grupo B para avaliação macroscópica e microscópica. O experimento demonstrou que é viável o uso do lado seroso da parede de jejuno para reparar ferimento em colo não preparado e apresentou resultados com tendências a serem superiores aos da sutura primária , não dual de MaringáThe present research aimed to compare the repair of colon wound using both the jejunal wall and the primary suture . Thirty young rabbits white New Zeland were used, weighing about 3,2 Kg. and were born and raised at the University of Maringá's Experimental farm. The animals were deeply anaesthetized and then submited to a surgery during wich two similar wounds were made in unprepared colon . An instrument created for this purpose was used. The first wound was made 2 cm away from the ceco , and the second one was made 20 cm from the first wound in the caudal location. The wounds were repaired using either the jejunal serosal wall or the primary suture. In both techniques were used separated stitches , made by monofilament poliglecaprone 4-0. The animal was used to control itself. The animals were submited to euthanasia either in the 7th or in 30th day after surgery, at random.Then a macroscopic and microscopic study was made. This research

  6. Photometric analysis of absorbable barbed suture for periareolar closure in mastopexy

    Institute of Scientific and Technical Information of China (English)

    Allen D Rosen; Alanna M Guzman; Teresa Hartman

    2016-01-01

    Aim:The primary author previously described his technique for periareolar closure in mastopexy using a pinwheel interlocking purse string with absorbable barbed suture and now reports the results of a retrospective photometric analysis comparing this technique with the same closure using Gortex® suture. This study is designed to compare the degree of areolar widening and safety proifle of using absorbable barbed sutures for periareolar closure versus permanent smooth suture. Methods:A retrospective chart review was conducted of all patients whose periareolar closures were performed using an interlocking purse-string technique over a 10-year period. Only patients undergoing circumvertical mastopexy were included. All had photometric evaluation and follow-up performed within 6-24 months. Results:In total, 20 patients (40 areolas), which were closed with absorbable barbed suture, were analyzed photometrically. In this suture group, areola size increased a mean of 4.9%from baseline, and no complications (0%) were observed. This compared favorably with previously reported complication rates using permanent sutures and with a series of cases presented herein in which permanent smooth suture was used for purse string closure. The degree to which absorbable barbed suture controls areolar spread was shown to be signiifcantly better than those where permanent smooth purse string techniques were employed. Conclusion:Circumvertical mastopexy closures using absorbable barbed suture was shown to be safe and effective and compared favorably to older techniques using permanent smooth suture for similar closures. This paper lends support to the safety of using absorbable barbed suture in circumareolar closures to limit areolar spread.

  7. Clinical Outcomes After Suture Anchor Repair of Recalcitrant Medial Epicondylitis.

    Science.gov (United States)

    Grawe, Brian M; Fabricant, Peter D; Chin, Christopher S; Allen, Answorth A; DePalma, Brian J; Dines, David M; Altchek, David W; Dines, Joshua S

    2016-01-01

    This study evaluated clinical and patient-reported outcomes and return to sport after surgical treatment of medial epicondylitis with suture anchor fixation. Consecutive patients were evaluated after undergoing debridement and suture anchor repair of the flexor-pronator mass for the treatment of medial epicondylitis. Demographic variables, a short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, Oxford Elbow Score (OES), and 10-point pain and satisfaction scales were collected. Ability and time to return to sport after surgery were evaluated, and the relationship between predictor variables and both elbow function and return to sport was investigated. Median age at the time of surgery was 55 years (range, 29-65 years), with median follow-up of 40 months (range, 12-67 months). Median QuickDASH score and OES at final follow-up were 2.3 (range, 0-38.6) and 45 (range, 22-48), respectively. Most patients returned to premorbid sporting activities at a median of 4.5 months (range, 2.5-12 months), whereas 4 patients (14%) reported significant limitations at final follow-up. Older age at the time of surgery was predictive of better QuickDASH score and OES (P=.05 and P=.02, respectively). Patients who underwent surgery after a shorter duration of symptoms had better outcomes, but the difference did not reach statistical significance (QuickDASH, P=.09; OES, P=.10). Surgical treatment of recalcitrant medial epicondylitis with suture anchor fixation offers good pain relief and patient satisfaction, with little residual disability. Older age at the time of surgery predicts a better outcome.

  8. Effects of suture position on left ventricular fluid mechanics under mitral valve edge-to-edge repair.

    Science.gov (United States)

    Du, Dongxing; Jiang, Song; Wang, Ze; Hu, Yingying; He, Zhaoming

    2014-01-01

    Mitral valve (MV) edge-to-edge repair (ETER) is a surgical procedure for the correction of mitral valve regurgitation by suturing the free edge of the leaflets. The leaflets are often sutured at three different positions: central, lateral and commissural portions. To study the effects of position of suture on left ventricular (LV) fluid mechanics under mitral valve ETER, a parametric model of MV-LV system during diastole was developed. The distribution and development of vortex and atrio-ventricular pressure under different suture position were investigated. Results show that the MV sutured at central and lateral in ETER creates two vortex rings around two jets, compared with single vortex ring around one jet of the MV sutured at commissure. Smaller total orifices lead to a higher pressure difference across the atrio-ventricular leaflets in diastole. The central suture generates smaller wall shear stresses than the lateral suture, while the commissural suture generated the minimum wall shear stresses in ETER.

  9. Extrusion of bone anchor suture following flexor digitorum profundus tendon avulsion injury repair.

    LENUS (Irish Health Repository)

    Tiong, William H C

    2011-09-01

    Flexor digitorum profundus (FDP) zone I tendon avulsion injury is traditionally repaired with a pullout suture technique. More recently, bone anchor sutures have been used as a viable alternative and have largely replaced areas in hand surgery where pullout suture technique was once required. To date, there have been very few complications reported related to bone anchor suture use in FDP tendon reattachment to the bone. We report a very unusual case of extrusion of bone anchor through the nailbed, 6 years after zone I FDP tendon avulsion injury repair and a brief review of literature.

  10. Suture anchor repair of quadriceps tendon rupture after total knee arthroplasty.

    Science.gov (United States)

    Kim, Tae Won B; Kamath, Atul F; Israelite, Craig L

    2011-08-01

    Disruption of the extensor mechanism after total knee arthroplasty (TKA) is a devastating complication, usually requiring surgical repair. Although suture anchor fixation is well described for repair of the ruptured native knee quadriceps tendon, no study has discussed the use of suture anchors in quadriceps repair after TKA. We present an illustrative case of successful suture anchor fixation of the quadriceps mechanism after TKA. The procedure has been performed in a total of 3 patients. A surgical technique and brief review of the literature follows. Suture anchor fixation of the quadriceps tendon is a viable option in the setting of rupture after TKA.

  11. Effect of residents' previous laparoscopic surgery experience on initial robotic suturing experience.

    Science.gov (United States)

    Kilic, Gokhan Sami; Walsh, Teresa M; Borahay, Mostafa; Zeybek, Burak; Wen, Michael; Breitkopf, Daniel

    2012-01-01

    Objective. To assess the impact of gynecology residents' previous laparoscopic experience on the learning curve of robotic suturing techniques and the value of initial structured teaching in dry lab prior to surgery. Methods. Thirteen gynecology residents with no previous robotic surgery experience were divided into Group 1, consisting of residents with 2 or fewer laparoscopic experiences, and Group 2, consisting of residents with 3 or more laparoscopic experiences. Group 1 had a dry-laboratory training in suturing prior to their initial experience in the operating room. Results. For all residents, it took on average 382 ± 159 seconds for laparoscopic suturing and 326 ± 196 seconds for robotic suturing (P = 0.12). Residents in Group 1 had a lower mean suture time than residents in Group 2 for laparoscopic suturing (P = 0.009). The residents in Group 2, however, had a lower mean suture time on the robot compared to Group 1 (P = 0.5). Conclusion. Residents with previous laparoscopic suturing experience may gain more from a robotic surgery experience than those with limited laparoscopic surgery experience. In addition, dry lab training is more efficient than hands-on training in the initial phase of teaching for both laparoscopic and robotic suturing skills.

  12. Radiographic and microscopic anatomy of the mid-palatal suture in the elderly.

    Science.gov (United States)

    N'Guyen, T; Ayral, X; Vacher, C

    2008-02-01

    In a previous radiological study of the mid-palatal suture, it has been demonstrated that its obliteration was occurring during adult life and varied. In order to determine the histological status of mid-palatal suture in elderly men, 20 human palates aged more than 70 were examined by occlusal radiographs and histological study of the suture. In all palates the suture was ossified in the anterior thirds and made of conjunctive tissue in the posterior third. This particular evolution could be correlated to the mastication forces acting on the maxillary bones during the entire life.

  13. Effectivity of intraoperative adjustable suture technique in horizontal strabismus

    Directory of Open Access Journals (Sweden)

    Ayse Gul Kocak Altintas

    2013-08-01

    Full Text Available AIM:To compare the long-term effectivity of intraoperative adjustable suture technique with traditional non-adjustable strabismus surgery.METHODS:Two hundred and thirty-three patients, who underwent strabismus surgery either with traditional procedures or one-stage intraoperative adjustable suture technique, were included in our long-term follow-up study. One hundred and eighteen patients were evaluated in traditional surgery group (TSG and 115 who underwent adjustable suture were in the one-stage intraoperative adjustable surgery group (ASG. In this group 9 patients had paralytic strabismus and 16 had reoperations, 2 patients had restrictive strabismus related to thyroid eye disease. The mean follow up in the TSG was 26.2 months and it was 24.8 months in the ASG group.RESULTS:In patients with exotropia (XT the mean correction of deviation for near fixation in ASG (32.4±13.2PD and in TSG (26.4±8.2PD were similar (P=0.112. The correction for distant fixation in ASG (33.2±11.4PD and TSG (30.9±7.2PD were not significantly different (P=0.321. In patients with esotropia (ET even the mean correction of deviation for both near (31±12PD and distant (30.6±12.8PD fixations were higher in ASG than in TSG, for both near (28.27±14.2PD and distant (28.9±12.9PD fixations, the differences were not significant (P=0.346, 0.824 respectively. The overall success rate of XT patient was 78.9% in TSG and 78.78% in ASG, the difference was not significant (P=0.629. The success rates were 78.75% in TSG and 75.51% in ASG in ET patient, which was also not significantly different (P=0.821.CONCLUSION:Although patients in ASG had more complex deviation such as paralysis, reoperations and restrictive strabismus, success rates of this tecnique was as high as TSG which did not contain complicated deviation. One-stage intraoperative adjustable suture technique is a safe and effective method for cooperative patient who has complex deviation.

  14. Paleomagnetic reconstruction of the Neotethyan Suture in Central Anatolia (Turkey)

    Science.gov (United States)

    Ozkaptan, M.; Gulyuz, E.; Kaymakci, N.; Langereis, C. G.

    2016-12-01

    The consumption of the Neo-Tethyan Ocean and the accretion of intervening continental blocks such as the Taurides and Kırşehir Block in the south and the Pontides in the north since the Mesozoic occurred along two sutures. The İzmir-Ankara Suture Zone (IASZ) between the Pontides in the north and the Taurides in the south and Intra-Tauride suture Zone (ITSZ) between the Taurides and the Kırşehir block meets around the Haymana Basin. The IASZ follows roughly an E-W trend and makes a sharp bend of approximately of 90° along the western margin of the Çankırı Basin. The ITSZ, on the other hand, follows a NW-SE trend parallel to the Tuz Gölü Fault Zone and overprinted by the structures related to the İASZ in the north. From West to East; the Haymana, Tuz Gölü and Çankırı basins straddle these suture zones and are developed in relation to the subduction and collision processes, which make them invaluable for unraveling deformation history and evolution of the Neotethys. In this regard we have conducted a very detailed paleomagnetic study to determine vertical axis rotations in the region, mainly on the Late Cretaceous to Recent infill of these basins. Results have shown that the region undergone strong clockwise (CW) and counter-clockwise (CCW) rotations, up to ±90° in places, resulting in the present geometry of the region. The central part of the Haymana Basin rotated as much as 90° CCW sense while its northern parts and the Tuz Gölü basin rotated 30° CW sense, which contradicts with almost all the published paleomagnetic results from the region. The restored geometries, based on new paleomagnetic data indicate that Haymana, Tuz Gölü basins and the SW margin of the Çankırı Basin were initially oriented in N-S direction prior to the Eocene. These results indicate that the most of the paleogeographical maps and evolutionary scenarios and models proposed for the region previously requires major re-thinking and serious revisions.

  15. Comparative study of Ksharasutra suturing and Lord's anal dilatation in the management of Parikartika (chronic fissure-in-ano)

    OpenAIRE

    2014-01-01

    Background: Parikartika resembles fissure-in-ano which is very common among all ano-rectal disorders. In Ayurvedic texts, Parikartika is described as a complication of Vamana and Virechana as well as complication of Atisara. Ksharasutra was proved successful in the management of fistula-in-ano, piles, and there is a need to try its efficacy in fissure-in-ano. Aim: To evaluate the role of Ksharasutra suturing (KSS) in fissure bed in chronic fissure-in-ano. Materials and Methods: Total 100 pati...

  16. Trabeculectomy combined with deep sclerectomy and scleral flap suture tension adjustment under an anterior chamber maintainer: a new modification of trabeculectomy.

    Science.gov (United States)

    Kayikcioglu, Ozcan R; Emre, Sinan; Kaya, Ziya

    2010-06-01

    The objective of this study was to investigate the efficacy and safety of trabeculectomy combined with deep sclerectomy in patients with primary open angled glaucoma (POAG) and to compare the results with those from conventional trabeculectomy. In the study 12 eyes of 10 patients operated with trabeculectomy combined with deep sclerectomy (Group I) and 16 eyes of 16 patients operated with conventional trabeculectomy surgery (Group II) were included. In the described form of combined deep sclerectomy with the trabeculectomy technique the superficial scleral flap was sutured with 10/0 monofilament, the number and tension of sutures were adjusted according to the outflow dynamics, under the scleral flap, of balanced salt solution (BSS) provided by an anterior chamber maintainer. In groups I and II all the patients were male POAG cases with mean ages of 60.0 +/- 19.4 and 67.0 +/- 7.1 years, respectively. The mean follow-up periods were 8.3 +/- 3.5 months for group I and 16.6 +/- 7.0 months for group II. Preoperative mean IOP were 29.7 +/- 8.3 and 29.1 +/- 12.8 mmHg mmHg, and average topical antiglaucomatous medications were 2.9 +/- 0.7 and 2.7 +/- 1.1 for groups I and II, respectively. Postoperatively mean IOP measurements were reduced in groups I and II to 10.5 +/- 2.9 vs. 9.6 +/- 4.8 mmHg at 1 week, 13.7 +/- 5.6 vs. 16.0 +/- 9.8 at 1st month, 12.3 +/- 6.4 vs. 17.3 +/- 8.0 at 3rd month, 11.0 +/- 4.1 vs. 15.3 +/- 5.8 at 6th month, 10.8 +/- 1.6 vs. 16.1 +/- 4.4 at 12th month, and 11.0 +/- 1.0 vs. 16.7 +/- 5.0 at 18th month. Statistical analysis revealed that mean postoperative IOP measurements for group I were significantly lower than for group II for all measurements except the first week (P < 0.05). At 12th month, the complete (IOP <22 mmHg without medication) and qualified (IOP <22 mmHg with medication) success rates were 83.3 and 100% for group I and 63.6 and 90.9% for group II. Postoperatively at 12th month, the mean number of antiglaucoma medications had fallen to

  17. In vitro evaluation of novel antimicrobial coatings for surgical sutures using octenidine.

    Science.gov (United States)

    Obermeier, A; Schneider, J; Föhr, P; Wehner, S; Kühn, K-D; Stemberger, A; Schieker, M; Burgkart, R

    2015-09-24

    Sutures colonized by bacteria represent a challenge in surgery due to their potential to cause surgical site infections. In order to reduce these type of infections antimicrobially coated surgical sutures are currently under development. In this study, we investigated the antimicrobial drug octenidine as a coating agent for surgical sutures. To achieve high antimicrobial efficacy and required biocompatibility for medical devices, we focused on optimizing octenidine coatings based on fatty acids. For this purpose, antimicrobial sutures were prepared with either octenidine-laurate or octenidine-palmitate at 11, 22, and 33 μg/cm drug concentration normalized per length of sutures. Octenidine containing sutures were compared to the commercial triclosan-coated suture Vicryl® Plus. The release of octenidine into aqueous solution was analyzed and long-term antimicrobial efficacy was assessed via agar diffusion tests using Staphylococcus aureus. For determining biocompatibility, cytotoxicity assays (WST-1) were performed using L-929 mouse fibroblasts. In a 7 days elution experiment, octenidine-palmitate coated sutures demonstrated much slower drug release (11 μg/cm: 7%; 22 μg/cm: 5%; 33 μg/cm: 33%) than octenidine-laurate sutures (11 μg/cm: 82%; 22 μg/cm: 88%; 33 μg/cm: 87%). Furthermore sutures at 11 μg/cm drug content were associated with acceptable cytotoxicity according to ISO 10993-5 standard and showed, similar to Vicryl® Plus, relevant efficacy to inhibit surrounding bacterial growth for up to 9 days. Octenidine coated sutures with a concentration of 11 μg/cm revealed high antimicrobial efficacy and biocompatibility. Due to their delayed release, palmitate carriers should be preferred. Such coatings are candidates for clinical testing in regard to their safety and efficacy.

  18. Revisiting the Variscan transpressional tectonics in the Southwestern Iberian suture

    Science.gov (United States)

    Pérez Cáceres, Irene; Martínez Poyatos, David; Simancas, José Fernando; Azor, Antonio

    2014-05-01

    The boundary between the Ossa-Morena Zone (OMZ) and the South Portuguese Zone (SPZ) in southwest Iberia is a Variscan collisional suture with transpressive left-lateral kinematics, contrasting with the dextral component that characterizes most of the Variscan convergence in other regions of the Orogen. Recent work including new structural and radiometric data has improved our knowledge on the geometry and timing of deformations affecting the OMZ/SPZ suture, which can be summarized as follows: Closure of the Rheic Ocean in Late Devonian time is attested by high-pressure and ophiolitic thin allochthonous units emplaced on the southern border of the OMZ. The kinematic interpretation of early stretching lineations and tectonic fabrics indicate that these units were emplaced in a tectonic regime of oblique left-lateral convergence. Transient transtension in Early Carboniferous time gave way to a narrow aisle of newly-formed oceanic-like crust just over the foregoing Rheic Ocean suture, accompanied by mafic magmatism intruded/extruded at both continental sides. Radiometric dating has yielded the same age of around 340 Ma for the oceanic-like mafic protholiths and their granulite/amphibolite facies tectonic fabric, thus indicating the very ephemeral life of the oceanic-like strip. Oblique convergence was resumed immediately after transtension, first causing northward obduction of the oceanic-like unit and north-verging folding in metasedimentary units of the southern border of the suture. Later on, a south-vergent regional fold was developed synchronous with left-lateral granulite-amphibolite facies shearing. Finally, shear deformation gave way to a low pitch stretching lineation, thrusting the OMZ over SPZ, concentrated on the southern limb of this regional fold and constituting a complex ductile 2-3 km-thick shear band evolving from amphibolite to greenschist facies, developing: (i) high-temperature greenschists at the southern border of the mafic oceanic-like unit

  19. Two-port laparoscopic cholecystectomy with modified suture retraction of the fundus: A practical approach

    Directory of Open Access Journals (Sweden)

    Ming G Tian

    2013-01-01

    Full Text Available Context: Although transumbilical single incision laparoscopic cholecystectomy (SILC has been demonstrated to be superior cosmetic, it is only limited to simple cases at present. In complex cases, the standard four- or three-port LC is still the treatment of choice. Aim: To summarize the clinical effect of a modified technique in two-port LC. Settings and Design: A consecutive series of patients with benign gallbladder diseases admitted to the provincial teaching hospital who underwent LC in the past 4 years were included. A modified two-port LC was the first choice except for those requiring laparoscopic common bile duct exploration (LCBDE. Materials and Methods: The operation was done with suture retraction of the fundus by a needle-like retractor. The patients′ data, including the operative time, time consumed by gallbladder retraction, operative bleeding, conversion rate, rate of adding trocars, and postoperative complications were recorded. Statistical Analysis: Data were expressed as percentage and mean with standard deviation. Results: Total 107 patients with chronic calculous cholecystitis (N = 61, acute calculous cholecystitis (N = 43, and cholecystic polyps (N = 3 received two-port LC. The procedure was successful in 99 out of 107 cases (success rate, 92.5%, and a third trocar was added in the remaining 8 cases (7.5% due to severe pathological changes. The operative time was 47.2 (±13.21 min. There was no conversion to open surgery. Conclusion: Two-port LC using a needle-like retractor for suture retraction of the gallbladder fundus is a practical approach when considering the safety, convenience, and indications as well as relatively minimal invasion.

  20. Healing of periodontal flaps when closed with silk sutures and N-butyl cyanoacrylate: A clinical and histological study

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    Kulkarni Sudhindra

    2007-01-01

    Full Text Available Background: The closure of the periodontal flaps post-surgery is a necessity for attainment of a primary union between the flap margins and the establishment of a healthy dentogingival junction. N-butyl cyanoacrylate is a tissue adhesive, which can be used for the closure of the incised wounds to overcome the problems associated with conventional suture materials like silk. Objective: The present study was carried out to assess the healing of the periodontal flaps when closed with the conventional silk sutures and N-butyl cyanoacrylate. Materials and Methods: The study was carried out on 24 patients who needed flap surgical procedure for pocket therapy. Results: It was found that healing with the cyanoacrylate is associated with less amount of inflammation during the first week when compared with silk. However, over a period of 21 days to 6 weeks, the sites treated with both the materials showed similar healing patterns. Conclusion: It can be concluded that cyanoacrylate aids in early initial healing.

  1. Estudo comparativo entre as técnicas de sutura total e serosubmucosa em anastomoses colônicas na presença de um protetor intraluminar em cães Comparative study of all-layers suture and extramucosal single layer suture with an intraluminal protector in dogs

    Directory of Open Access Journals (Sweden)

    Cíntia Lourenço Santos

    2007-08-01

    Full Text Available OBJETIVO: Avaliar a cicatrização comparando as técnicas de sutura total e parcial em anastomoses colônicas término-terminais na presença de um protetor intraluminar confeccionado a partir de um dreno de Penrose. MÉTODOS: Foram realizadas anastomoses colônicas em 10 cães nos quais foi suturado a mucosa / submucosa um protetor intraluminar por meio da eversão do segmento intestinal proximal em 10 cm. Os animais foram distribuidos em dois grupos experimentais: Grupo 1 - sutura total e Grupo 2 - sutura serosubmucosa. Os animais foram reoperados com sete dias de pós-operatório para coleta de material e subseqüente análise histopatológica. RESULTADOS: Observamos no exame histopatológico das anastomoses realizadas com sutura serosubmucosa (Grupo 2 uma melhor cicatrização caracterizada por um menor infiltrado inflamatório e por uma maior integridade das camadas intestinais quando comparadas com o Grupo 1. CONCLUSÃO: O uso da técnica de sutura parcial mostrou-se superior a de sutura total nas anastomoses colônicas na presença de protetor intraluminar.BACKGROUND: This study aims to evaluate the colonic anastomotic healing testing of all layers suture and single layer suture using an intraluminal protector. The intraluminal protector was shaped from a Penrose drain and then fixed 10 cm from the superior end of the anastomotic site. METHODS: Colonic anastomoses were done in 10 dogs, which were sutured, in the proximal segment with an intraluminal protector made of Penrose n.3 drain, using interrupted mucosal / submucosal suture. In the subsequent anastomoses, the animals were subdivided in two experimental groups: 1 - in all layers and 2 - extramucosal. In the seventh postoperative day, a tissue fragment was collected for histopathological analysis. RESULTS: Group 2 histopathological examinations had a better scar (extramucosal suture, characterized by a lesser inflammatory process than in animals in which all layers suture was used

  2. Interactive Virtual Suturing Simulations: Enhancement of Student Learning in Veterinary Medicine

    Science.gov (United States)

    Staton, Amy J.; Boyd, Christine B.

    2013-01-01

    This capstone addresses an instructional gap in the Morehead State University Veterinary Technology Program and in other similar programs around the globe. Students do not retain the knowledge needed to proficiently complete suture patterns nor do students receive sufficient instructional time during the year to master each suture pattern that is…

  3. Interactive Virtual Suturing Simulations: Enhancement of Student Learning in Veterinary Medicine

    Science.gov (United States)

    Staton, Amy J.; Boyd, Christine B.

    2013-01-01

    This capstone addresses an instructional gap in the Morehead State University Veterinary Technology Program and in other similar programs around the globe. Students do not retain the knowledge needed to proficiently complete suture patterns nor do students receive sufficient instructional time during the year to master each suture pattern that is…

  4. Laparoscopic suturing learning curve in an open versus closed box trainer

    NARCIS (Netherlands)

    Rodrigues, S.P.; Horeman, T.; Blomjous, M.S.H.; Hiemstra, E.; Van den Dobbelsteen, J.J.; Jansen, F.W.

    2015-01-01

    Background The aim of this study was to examine the influence of training under direct vision prior to training with indirect vision on the learning curve of the laparoscopic suture task. Methods Novices were randomized in two groups. Group 1 performed three suturing tasks in a transparent laparosc

  5. Early secondary suture versus healing by second intention of incisional abscesses

    DEFF Research Database (Denmark)

    Hermann, G G; Bagi, P; Christoffersen, I

    1988-01-01

    A controlled trial was set up to compare the treatment of wound abscesses, occurring after laparotomy, with either early secondary suture combined with cefuroxime and metronidazole given intravenously or by healing by second intention. The secondary suture was performed two days after wound...... drainage and resulted in a significant reduction (p less than 0.01) in healing time without complications. No reinfections occurred....

  6. Prospective randomized controlled trial investigating the type of sutures used during hepatectomy

    Institute of Scientific and Technical Information of China (English)

    Norifumi Harimoto; Ken Shirabe; Tomoyuki Abe; Takafumi Yukaya; Eiji Tsujita; Tomonobu Gion; Kiyoshi Kajiyama; Takashi Nagaie

    2011-01-01

    AIM: To determine whether absorbable sutures or non-absorbable sutures are better in preventing surgical site infection (SSI), in this paper we discuss the results of a randomized clinical trial which examined the type of sutures used during hepatectomy. METHODS: All hepatic resections performed from January 2007 to November 2008 at the Department of Surgery at Iizuka Hospital in Japan were included in this study. There were 125 patients randomly assigned to an absorbable sutures (Vicryl) group or non-absorbable sutures (Silk) group. RESULTS: SSI was observed in 13.6% (17/125) patients participating in this study, 11.3% in the Vicryl group and 15.8% in the Silk group. Incisional SSI including superficial and deep SSI, was observed in 8% of the Vicryl group and 9.5% of the Silk group. Organ/ space SSI was observed in 3.2% of the Vicryl group and 6.0% of the Silk group. There were no significant differences, but among the patients with SSI, the period for recovery was significantly shorter for the Vicryl group compared to the Silk group. CONCLUSION: The incidence of SSI in patients receiving absorbable sutures and silk sutures is not significantly different in this randomized controlled study; however, the period for recovery in patients with SSI was significantly shorter for absorbable sutures.

  7. Intracorporeal Suturing and Knot Tying Broadens the Clinical Applicability of Laparoscopy

    Science.gov (United States)

    Rivas, Homero; Cacchione, Robert N.; Ferzli, George S.

    2003-01-01

    Objective: As surgeons become more experienced with basic laparoscopic procedures like cholecystectomy, they are able to expand this approach to less common operations. However, without laparoscopic suturing skills, like those obtained with Nissen fundoplication, many operations cannot be completed laparoscopically. We present a series of 10 patients with less common surgical illnesses who were successfully treated with minimal access techniques and intracorporeal suturing. Methods: Over a 6-month period at 2 medical centers, 10 patients underwent operations with laparoscopic intracorporeal suturing and knot tying. Diagnoses included bowel obstruction due to gallstone ileus (n=1), perforated uterus from an intrauterine device (n=1), urinary bladder diverticulum (n=1), bleeding Meckel's diverticulum (n=3), and perforated duodenal ulcer (n=4). Results: Each patient was treated with standard surgical interventions performed entirely laparoscopically with intracorporeal suturing. No morbidity or mortality occurred in any patient due to the operation. Conclusions: Although each of these operations has been previously reported, as a series, they point out the importance of mastering laparoscopic suturing. Although devices are commercially available to facilitate certain suturing scenarios, we encourage residents and fellows to sew manually. We believe that none of these operations could have been completed as effectively by using a suture device. The ability to suture laparoscopically markedly broadens the number of clinical scenarios in which minimal access techniques can be used. PMID:12856844

  8. A novel technique of rotator cuff repair using spinal needle and suture loop

    Directory of Open Access Journals (Sweden)

    Muzaffar Nasir

    2010-11-01

    Full Text Available Abstract Background We present a simple technique of arthroscopic rotator cuff repair using a spinal needle and suture loop. Methods With the arthroscope laterally, a spinal needle looped with PDS is inserted percutaneously into the shoulder posteriorly and penetrated through the healthy posterior cuff tear margin. Anteriorly, another spinal needle loaded with PDS is inserted percutaneously to engage the healthy tissue at the anterior tear margin. The suture in the anterior needle is then delivered into the suture loop of the posterior needle using a suture retriever. The posterior needle and loop are then pulled out carrying the anterior suture with it. The two limbs of this suture are then retrieved through a cannula for knotting. The same procedure is then repeated for additional suturing. Suture anchors placed over the greater tuberosity are used to complete the repair. Conclusion This is an easy method of rotator cuff repair using simple instruments and lesser time, hence can be employed at centers with less equipment and at reduced cost to the patient.

  9. 21 CFR 878.4494 - Absorbable poly(hydroxybutyrate) surgical suture produced by recombinant DNA technology.

    Science.gov (United States)

    2010-04-01

    ... produced by recombinant DNA technology. 878.4494 Section 878.4494 Food and Drugs FOOD AND DRUG... recombinant DNA technology. (a) Identification. An absorbable poly(hydroxybutyrate) surgical suture is an...) Surgical Suture Produced by Recombinant DNA Technology.” For the availability of this guidance document...

  10. Evaluation of Using Interdomal Suture and Crescentic Skin Excision with Standard Cleft Lip Repair for Correction of Cleft Lip-Nose Simultaneously with Primary Lip Repair

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    Mert Çalış

    2017-06-01

    Full Text Available Objective: The aim of this study is to compare the postoperative correction rates in the follow-up after simultaneous cleft lip nose (CLN repair with cleft lip repair using either interdomal suture or crescentic skin excision. Material and Methods: Eighty-three unilateral cleft lip patients were operated using modified Millard rotation advancement technique for cleft lip repair and simultaneous cleft lip repair using either interdomal suture or crescentic skin excision. The evaluation of the patients was made using routine standardized preoperative and early and later postoperative caudal nasal photographs. The distance between the nasal base and the most projectile point of the nostril was measured, and the ratio of the cleft side to the non-cleft side was calculated. Results: The highest rate was calculated in the early postoperative period in the crescentic skin excision group (1.07±0.29. The ratio was found to be 0.87±0.22 in patients with interdomal suture placement. The lowest rate was observed in patients who did not have any nasal reshaping procedure other than a standard cleft lip repair (0.71±0.16. The highest rate of recurrence was observed among the patients who had crescentic skin excision (0.39 ± 0.16. When recurrence rates were compared, a significant difference was observed in the crescentic skin excision group compared to the interdomal suture placed patients (p=0.005. Conclusion: The simultaneous primary rhinoplasty approach with cleft lip repair appears to be necessary for CLN repair in the long term. Although crescentic skin excision and placement of interdomal suture for this purpose achieve symmetry with the noncleft side and successful results in the early postoperative period, the probability of recurrence should always be taken in consideration. If either of these two techniques is to be preferred for CLN repair, then overcorrection should always be taken in consideration.

  11. Systematic review and meta-analysis of sutures coated with triclosan for the prevention of surgical site infection after elective colorectal surgery according to the PRISMA statement.

    Science.gov (United States)

    Sandini, Marta; Mattavelli, Ilaria; Nespoli, Luca; Uggeri, Fabio; Gianotti, Luca

    2016-08-01

    Several randomized clinical trials (RCTs) conducted to evaluate the effect of triclosan-coated suture on surgical site infection (SSI) yield to controversial results. The primary purpose of this systematic review and meta-analysis was to analyze the available RCTs, comparing the effect of triclosan-coated suture with uncoated suture on the incidence of SSI after elective colorectal operations. As secondary endpoint of the analysis, we considered length of hospital stay after surgery. We performed a systematic literature review through Medline, Embase, Pubmed, Scopus, Ovid, ISI Web of Science, and the Cochrane Controlled Trials Register searching for RCTs published from 1990 to 2015. To conduct these meta-analyses, we followed the guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Study inclusion criteria were as follows: parallel-group RCTs in adult populations reporting the closure of the abdominal wall after elective colorectal operation with triclosan-coated suture or noncoated suture, and reporting the outcomes considered in the meta-analysis. Six trials including 2168 patients (1102 treated and 1066 controls) provided data on SSIs. The overall rate was 11.7% (129/1102) in the triclosan group and 13.4% (143/1066) in the control group (odds ratio 0.81, 95% confidence interval [CI] 0.58-1.13, P = 0.220). Heterogeneity among studies was moderate (I = 44.9%). No evidence of publication bias was detectable. Five RCTs (1783 patients; 914 treated and 689 controls) described hospital length of stay with no significant effect (mean difference: -0.02, 95% CI -0.11 to -0.07, P = 0.668). The I test for heterogeneity was 0% (P = 0.836). Moderator analyses showed no significant differences were detected in analyses comparing the suture materials (polydioxanone vs polyglactin). In open-label trials, the odds ratio for SSI risk was 0.62 (95% CI 0.20-1.93, P = 0.413), 0.77 in single-blind (95% CI 0.31-1.95, P

  12. Effect of recombinant human platelet-derived growth factor-BB-coated sutures on Achilles tendon healing in a rat model: A histological and biomechanical study

    Directory of Open Access Journals (Sweden)

    Stephen H Cummings

    2012-12-01

    scores were comparable in all groups, although there was a trend for improved collagen organization in the recombinant human platelet-derived growth factor-BB-treated groups (p = 0.054. Conclusions: The results of this study suggest that recombinant human platelet-derived growth factor-BB can be used to reproducibly coat Vicryl sutures and improve remodeling in a rat Achilles tendon transection model by significantly decreasing the resulting cross-sectional area, thus improving the material properties of the repaired tendon.

  13. Responses of intramembranous bone and sutures upon in vivo cyclic tensile and compressive loading.

    Science.gov (United States)

    Peptan, Alexandra I; Lopez, Aurora; Kopher, Ross A; Mao, Jeremy J

    2008-02-01

    Cranial vault and facial sutures interpose between mineralized bones of the skull, and may function analogously to appendicular and cranial base growth plates. However, unlike growth plates that are composed of chondrocyte lineage, cranial and facial sutures possess heterogeneous cell lineages such as mesenchymal cells, fibroblasts, and osteoblasts, in addition to vascular-derived cells. Despite recently intensified effort, the biological responses of intramembranous bone and sutures to mechanical loading are not well understood. This study was designed to investigate whether brief doses of tensile or compressive forces induce modeling and growth responses of intramembranous bone and sutures. In different groups of growing rabbits in vivo, cyclic tensile or compressive forces at 1 N and 8 Hz were applied to the maxilla for 20 min/day over 12 consecutive days. Computerized histomorphometric analyses revealed that the average sutural widths of both the premaxillomaxillary suture (PMS) and nasofrontal suture (NFS) loaded in either tension or compression were significantly higher than age- and sex-matched sham controls (P<0.01). The average cell densities of tension- or compression-loaded PMS and NFS were significantly higher than sham controls (P<0.01). The average osteoblast occupied sutural bone surface loaded under tension was significantly higher than that of sham control (P<0.05). Interestingly, tensile loading significantly reduced the average osteoclast surface, in comparison to sham control (P<0.05). For the NFS, tensile loading significantly increased the average osteoblast occupied sutural bone surface, in comparison with that of sham control (P<0.05). Also for the NFS suture, compression significantly reduced the average sutural osteoclast surface in comparison with sham control (P<0.05). Taken together, the present data suggest that high-frequency cyclic forces in either tension or compression induce modeling and growth changes in cranial sutures. Due to

  14. Transcutaneous Serdev Suture For Buttock’s Lift

    Directory of Open Access Journals (Sweden)

    Nikolay Serdev

    2012-10-01

    Full Text Available This article presents the author's technique and experience in the treatment of the flaccid "unhappy buttock" form with his surgical procedure of buttock lift by suture, without incision scars. The author first presented this new operation technique on a national level at the 2nd Annual Meeting of the National Bulgarian Society for Aesthetic Surgery and Aesthetic Medicine in Sofia on March 18, 1994 [1] and internationally at many scientific meetings over the world [2, 3, 4…]. The result is a visual change in the buttock position to a higher one, which elongates the lower limbs and changes the proportions between lower and upper half of the body. The aim of this study is to describe a mini-invasive procedure of beautification of the buttock form without scars by creating a lifting effect on the buttock's subcutaneous tissue, using a suture that takes the inferiorly positioned deep fibrose tissue and fixes it upwards to the sacro-cutaneous fascia, discovered by the author. Aesthetic and technical considerations required properly sculpting the buttocks into a higher position, demonstrating nicely rounded form. Preoperative shape is discussed and patient evaluations, operative techniques, postoperative management and results after 4 years of experience are emphasized. 1032 female patients, and 26 male patients aged 18-62 years, with ptosis and cellulite on the buttocks were treated since 1993 on an outpatient basis by the "Serdev suture technique without visible scars". Important instrumentarium is a long, curved, elastic needle and Polycon semi-elastic Bulgarian antimicrobial polycaproamide long term (in 2 years absorbable surgical threads Polycon, produced in Bulgaria. This operation has been performed either alone or after ultrasonic assisted liposculpture (UAL that reduces the amount of fat and heaviness. All patients reported a high degree of satisfaction. A stable improvement in the buttock position and form was observed for the period

  15. Optimal Needle Grasp Selection for Automatic Execution of Suturing Tasks in Robotic Minimally Invasive Surgery.

    Science.gov (United States)

    Liu, Taoming; Çavuşoğlu, M Cenk

    2015-05-01

    This paper presents algorithms for optimal selection of needle grasp, for autonomous robotic execution of the minimally invasive surgical suturing task. In order to minimize the tissue trauma during the suturing motion, the best practices of needle path planning that are used by surgeons are applied for autonomous robotic surgical suturing tasks. Once an optimal needle trajectory in a well-defined suturing scenario is chosen, another critical issue for suturing is the choice of needle grasp for the robotic system. Inappropriate needle grasp increases operating time requiring multiple re-grasps to complete the desired task. The proposed methods use manipulability, dexterity and torque metrics for needle grasp selection. A simulation demonstrates the proposed methods and recommends a variety of grasps. Then a realistic demonstration compares the performances of the manipulator using different grasps.

  16. SR and LR Union Suture for the Treatment of Myopic Strabismus Fixus: Is Scleral Fixation Necessary?

    Directory of Open Access Journals (Sweden)

    Carol P. S. Lam

    2015-01-01

    Full Text Available Purpose. To evaluate and compare the effectiveness of scleral fixation SR and LR union suture and nonscleral fixation union suture for the treatment of myopic strabismus fixus. Methods. Retrospective review of 32 eyes of 22 patients with myopic strabismus fixus who had undergone union suture of superior rectus (SR and lateral rectus (LR with or without scleral fixation, and follow-up longer than 6 months at Hong Kong Eye Hospital from 2006 to 2013. Surgical techniques and outcomes in terms of ocular alignment are analyzed. Results. There is significant overall improvement both in postoperative angle of esodeviation (P0.05. Conclusions. Union suture of SR and LR is an effective procedure in correcting myopic strabismus fixus. Fixation of the union suture to the sclera does not improve surgical outcome.

  17. Nonabsorbable-Suture-Induced Osteomyelitis: A Case Report and Review of the Literature

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    Cheng Hong Yeo

    2012-01-01

    Full Text Available We are reporting a case of nonabsorbable suture-induced osteomyelitis in patient who had an open rotator cuff repair with nonabsorbable Ethibond anchor suture. Patient in this case presented with very subtle clinical features of osteomyelitis of the left proximal humerus 15 years after initial rotator cuff repair surgery. Literature had shown that deep infection following rotator cuff repairs, although rare, can be easily missed and can cause severe complications. Absorbable suture had been demonstrated to be more superior, in terms of rate of deep infection, as compared to nonabsorbable suture when used in rotator cuff repair surgery. Both absorbable and nonabsorbable suture had been demonstrated to have similar mechanical properties by several different studies. The case demonstrated that initial presentation of deep infection can be subtle and easily missed by clinicians and leads to further complications.

  18. Basal joint osteoarthritis of the thumb: comparison of suture button versus abductor pollicis longus suspensionplasty.

    Science.gov (United States)

    Avant, Kristopher R; Nydick, Jason A; White, Brian D; Vaccaro, Lisa; Hess, Alfred V; Stone, Jeffrey D

    2015-03-01

    Our purpose was to compare the outcomes of patients with severe basilar thumb osteoarthritis treated with trapeziectomy and suspensionplasty using abductor pollicis longus (APL) tendon versus a suture button device. A retrospective study was performed for patients undergoing trapeziectomy and suspensionplasty with APL tendon or suture button fixation. Outcome measures included disabilities of the arm, shoulder, and hand (DASH); visual analog score (VAS); grip strength; key pinch; tip pinch; and thumb opposition. Radiographic measurements, surgical times, and complications were recorded. Thirty-three patients in the APL tendon group and 27 patients in the suture button group had a minimum 6-month follow-up. VAS, DASH, and functional measurements improved after surgery for both groups. Mean operative time was 68 min for the APL tendon group and 48 min for the suture button group. Complications were similar between groups. The use of suture button fixation when compared to APL tendon suspensionplasty offers similar clinical outcomes. Therapeutic III.

  19. Lateral intercrural suture in the caucasian nose: Decreased domal divergence angle in endonasal rhinoplasty without delivery

    Directory of Open Access Journals (Sweden)

    Berger, Cezar Augusto Sarraf

    2012-01-01

    Full Text Available Introduction: Several techniques can be performed to improve nasal tip definition such as cartilage resection, tip grafts, or sutures. Objective: To evaluate the outcome of lateral intercrural suture at the lower lateral cartilage by endonasal rhinoplasty with a basic technique without delivery in decreasing the angle of domal divergence and improving the nasal tip definition. Method: This prospective study was performed in 64 patients in which a suture was made on the board head of the lower lateral cartilage in the joint between the dome and lateral crus, using polydioxanone (PDS with sharp, curved needle. Results: In all of the cases, better definition of the nasal tip was achieved by intercrural suturing for at least 6 months postoperatively. Conclusion: Lateral intercrural suture of the lower lateral cartilage provides improved nasal tip definition and can be performed by endonasal rhinoplasty without delivery in the Caucasian nose.

  20. The primary factor for suture configuration at rotator cuff repair: Width of mattress or distance from tear edge

    Directory of Open Access Journals (Sweden)

    Onur Hapa

    2016-08-01

    Conclusion: Bite size from the edge of the tendon seems to be more important than the width of the mattress. The curve of the suture passing device may also have an effect on the strength of the suture tendon interface.

  1. Absorbable versus silk sutures for surgical treatment of trachomatous trichiasis in Ethiopia: a randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Saul N Rajak

    2011-12-01

    Full Text Available Trachoma causes blindness through an anatomical abnormality called trichiasis (lashes touching the eye. Trichiasis can recur after corrective surgery. We tested the hypothesis that using absorbable sutures instead of silk sutures might reduce the risk of recurrent disease among patients with major trichiasis in a randomised trial.1,300 individuals with major trichiasis from rural villages in the Amhara Region of Ethiopia were recruited and assigned (1:1 by computer-generated randomisation sequence to receive trichiasis surgery using either an absorbable suture (polyglactin-910 or silk sutures (removed at 7-10 days in an otherwise identical surgical technique. Participants were examined every 6 months for 2 years by clinicians masked to allocation. The primary outcome measure was recurrent trichiasis (≥one lash touching the eye at 1 year. There was no difference in prevalence of recurrent trichiasis at 1 year (114 [18.2%] in the absorbable suture group versus 120 [19.7%] in the silk suture group; odds ratio = 0.90, 95% CI 0.68-1.20. The two groups also did not differ in terms of corneal opacification, visual acuity, conjunctival inflammation, and surgical complications.There was no evidence that use of absorbable polyglactin-910 sutures was associated with a lower prevalence of trichiasis recurrence at 1 year postsurgery than silk sutures. However, from a programmatic perspective, polyglactin-910 offers the major advantage that patients do not have to be seen soon after surgery for suture removal. The postoperative review after surgery using absorbable polyglactin-910 sutures can be delayed for 3-6 months, which might allow us to better determine whether a patient needs additional surgery.ClinicalTrials.gov NCT00522860.

  2. A 3-D CT Analysis of Screw and Suture-Button Fixation of the Syndesmosis.

    Science.gov (United States)

    Schon, Jason M; Williams, Brady T; Venderley, Melanie B; Dornan, Grant J; Backus, Jonathon D; Turnbull, Travis Lee; LaPrade, Robert F; Clanton, Thomas O

    2017-02-01

    Historically, syndesmosis injuries have been repaired with screw fixation; however, some suggest that suture-button constructs may provide a more accurate anatomic and physiologic reduction. The purpose of this study was to compare changes in the volume of the syndesmotic space following screw or suture-button fixation using a preinjury and postoperative 3-D computed tomography (CT) model. The null hypothesis was that no difference would be observed among repair techniques. Twelve pairs of cadaveric specimens were dissected to identify the syndesmotic ligaments. Specimens were imaged with CT prior to the creation of a complete syndesmosis injury and were subsequently repaired using 1 of 3 randomly assigned techniques: (a) one 3.5-mm cortical screw, (b) 1 suture-button, and (c) 2 suture-buttons. Specimens were imaged postoperatively with CT. 3-D models of all scans and tibiofibular joint space volumes were calculated to assess restoration of the native syndesmosis. Analysis of variance and Tukey's method were used to compare least squares mean differences from the intact syndesmosis among repair techniques. For each of the 3 fixation methods, the total postoperative syndesmosis volume was significantly decreased relative to the intact state. The total mean decreases in volume compared with the intact state for the 1-suture-button construct, 2-suture-button construct, and syndesmotic screw were -561 mm(3) (95% CI, -878 to -244), -964 mm(3) (95% CI, -1281 to -647) and -377 mm(3) (95% CI, -694 to -60), respectively. All repairs notably reduced the volume of the syndesmosis beyond the intact state. Fixation with 1 suture-button was not significantly different from screw or 2-suture-button fixation; however, fixation with 2 suture-buttons resulted in significantly decreased volume compared with screw fixation. The results of this study suggest that the 1-suture-button repair technique and the screw fixation repair technique were comparable for reduction of syndesmosis

  3. Single-incision laparoscopic splenectomy with innovative gastric traction suture

    Directory of Open Access Journals (Sweden)

    Srikanth G

    2011-01-01

    Full Text Available Laparoscopic splenectomy is now the gold standard for patients with idiopathic thrombocytopenic purpura (ITP undergoing splenectomy. There are a few reports in literature on single-incision laparoscopic (SIL splenectomy. Herein, we describe a patient undergoing SIL splenectomy for ITP without the use of a disposable port device. We report a 20-year-old female patient with steroid-refractory ITP having a platelet count of 14,000/cmm who underwent a SIL splenectomy. Dissection was facilitated by the use of a single articulating grasper and a gastric traction suture and splenic vessels were secured at the hilum with an endo-GIA stapler. She made an uneventful postoperative recovery and was discharged on the second postoperative day. She is doing well with no visible scar at 8-month follow-up.

  4. [Refixation of sternoclavicular luxation with a suture anchor system].

    Science.gov (United States)

    Lehmann, W; Laskowski, J; Grossterlinden, L; Rueger, J M

    2010-05-01

    Luxations of the sternoclavicular joint are rare injuries. We present a case of anterior dislocation which was caused by a minor fall onto the right shoulder. Diagnosis was delayed by 2 weeks which prevented treatment by closed reduction. As an alternative surgical treatment a PDS cord around the clavicle and the first rib was used to stabilize the clavicle at the vertical level. Subsequently, fixation to the medial side was achieved by a suture anchor that was placed into the manubrium. The presented case highlights this simple and safe method to treat dislocations of the sternoclavicular joint in which standard treatment cannot be performed. A detailed description for each operation step is given and our experience in terms of aftercare and outcome is reported.

  5. Application analysis on different suture of scleral flap in trabeculectomy

    Directory of Open Access Journals (Sweden)

    Ning Liu

    2014-05-01

    Full Text Available AIM: To research the application of scleral flap suture in trabeculectomy. METHODS: Totally 114 primary angle-closure glaucoma patients, aged from 36-72 years old, were selected as the objects, and randomly divided into research group and control group. The two groups received different administration methods. Traditional sewing method of sclera flap was used in research group and improved sewing method of sclera flap was used in control group. RESULTS: There was statistical differences between postoperative intraocular pressure of the patients in the observation group and the control group after 1d; 2wk; 1, 3mo(PPP>0.05.CONCLUSION: It is safe and effective that the improved sewing method of sclera flap for trabeculectomy of acute angle-closure glaucoma, and it is a better method to avoid the occurrence of shallow anterior chamber than the traditional sewing method in the early stage after operation.

  6. The functional significance of the squamosal suture in Australopithecus boisei.

    Science.gov (United States)

    Rak, Y

    1978-07-01

    A juvenile Australopithecus boisei specimen from the Omo basin, southern Ethiopia, is found to exhibit and extraordinarily large overlap of the temporal squama on the parietal, a phenomenon shared with at least two adult specimens of A. boisei. An attempt is made to interpret the overlap as a structural (bony/ligamentous) adaptation necessitated by the unique combination of certain components of the masticatory system of A. boisei. These are: (1) the massiveness and strength of the temporalis muscle, (2) its relatively anterior location, and (3) the lateral position of the masseter muscle due to the flaring of the zygomatic arches. The effect of the temporalis muscle is to create excessive pressure on the portion of the squamosal suture along the parietal, while the lateral placement of the masseter and the resultant increase of pressure on the temporal squama via the zygomatic arch tend to "loosen" the contact between the temporal and parietal bones.

  7. [Percutaneus Suture of Achilles Tendon Rupture--Operation for Beginners?].

    Science.gov (United States)

    Prokop, A; Dolezych, R; Chmielnicki, M

    2016-02-01

    Acute rupture of the Achilles tendon is the most common tendon injury, with an incidence of 30/100,000 population. With the Dresden instruments, operative tendon suture can be standardised and is safe, quick and minimally invasive. With post-operative functional therapy in a walking boot, very good clinical results can be achieved. Is this operation suitable as an educational procedure and is its performance still economic? Between 1 January 2007 and 31 December 2013, 212 patients with acute rupture of the Achilles tendon were operated using the Dresden instruments. There were 167 males and 45 females, with an average age of 46 years. 99 operations were performed by trainees, 46 by attending surgical staff, and 57 by a senior surgeon. With the trainees, the mean duration of the operation was 29:53 minutes, and with the attending staff 29:10 minutes (n. s., p > 0.1). The rate of complications (re-rupture, infection, and sural nerve damage) was 5/99 (5 %) for the trainees, 4/46 (8.7 %) for the attending staff, and 3/57 (5.3 %) for the senior surgeon. A total cost analysis yielded a total operative cost of 445.76 € for outpatient surgery. With a billed sum of 490.11 €, net income of 44.35 € per case is generated. In patients with reasonable indications for 2-day short inpatient treatment, total treatment cost was 3232.70 €. Percutaneous suture of the Achilles tendon with the Dresden instruments is a standardised and cost-effective surgical procedure. It is suitable as a "beginner's" procedure that can be performed quickly, safely, and cost-effectively. Georg Thieme Verlag KG Stuttgart · New York.

  8. Shyok Suture Zone, N Pakistan: late Mesozoic Tertiary evolution of a critical suture separating the oceanic Ladakh Arc from the Asian continental margin

    Science.gov (United States)

    Robertson, Alastair H. F.; Collins, Alan S.

    2002-02-01

    The Shyok Suture Zone (Northern Suture) of North Pakistan is an important Cretaceous-Tertiary suture separating the Asian continent (Karakoram) from the Cretaceous Kohistan-Ladakh oceanic arc to the south. In previously published interpretations, the Shyok Suture Zone marks either the site of subduction of a wide Tethyan ocean, or represents an Early Cretaceous intra-continental marginal basin along the southern margin of Asia. To shed light on alternative hypotheses, a sedimentological, structural and igneous geochemical study was made of a well-exposed traverse in North Pakistan, in the Skardu area (Baltistan). To the south of the Shyok Suture Zone in this area is the Ladakh Arc and its Late Cretaceous, mainly volcanogenic, sedimentary cover (Burje-La Formation). The Shyok Suture Zone extends northwards (ca. 30 km) to the late Tertiary Main Karakoram Thrust that transported Asian, mainly high-grade metamorphic rocks southwards over the suture zone. The Shyok Suture Zone is dominated by four contrasting units separated by thrusts, as follows: (1). The lowermost, Askore amphibolite, is mainly amphibolite facies meta-basites and turbiditic meta-sediments interpreted as early marginal basin rift products, or trapped Tethyan oceanic crust, metamorphosed during later arc rifting. (2). The overlying Pakora Formation is a very thick (ca. 7 km in outcrop) succession of greenschist facies volcaniclastic sandstones, redeposited limestones and subordinate basaltic-andesitic extrusives and flow breccias of at least partly Early Cretaceous age. The Pakora Formation lacks terrigenous continental detritus and is interpreted as a proximal base-of-slope apron related to rifting of the oceanic Ladakh Arc; (3). The Tectonic Melange (Nanga Parbat syntaxis (Hunza River) reveals notable differences, including the presence of terrigenous quartz-rich conglomerates, serpentinite debris-flow deposits and a contrasting structural history. The Shyok Suture Zone in the Skardu area is

  9. Arthroscopic suture bridge technique for intratendinous tear of rotator cuff in chronically painful calcific tendinitis of the shoulder.

    Science.gov (United States)

    Ji, Jong-Hun; Shafi, Mohamed; Moon, Chang-Yun; Park, Sang-Eun; Kim, Yeon-Jun; Kim, Sung-Eun

    2013-11-01

    Arthroscopic removal, now the main treatment option, has almost replaced open surgery for treatment of resistant calcific tendinitis. In some cases of chronic calcific tendinitis of the shoulder, the calcific materials are hard and adherent to the tendon. Removal of these materials can cause significant intratendinous tears between the superficial and deep layers of the degenerated rotator cuff. Thus far, there are no established surgical techniques for removing the calcific materials while ensuring cuff integrity. Good clinical results for rotator cuff repair were achieved by using an arthroscopic suture bridge technique in patients with long-standing calcific tendinitis. Intact rotator cuff integrity and recovery of signal change on follow-up magnetic resonance imaging scans were confirmed. This is a technical note about a surgical technique and its clinical results with a review of relevant published reports. © 2013 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

  10. Techniques and materials for skin closure in caesarean section

    DEFF Research Database (Denmark)

    Mackeen, A Dhanya; Berghella, Vincenzo; Larsen, Mie-Louise

    2012-01-01

    Caesarean section is a common operation with no agreed upon standard regarding certain operative techniques or materials to use. With regard to skin closure, the skin incision can be re-approximated by a subcuticular suture immediately below the skin layer, by an interrupted suture, or by staples....... A great variety of materials and techniques are used for skin closure after caesarean section and there is a need to identify which provide the best outcomes for women....

  11. ARTHROSCOPIC REPAIR OF BANKART’S LESION USING SUTURE ANCHORS IN RECURRENT ANTERIOR SHOULDER INSTABILITY

    Directory of Open Access Journals (Sweden)

    Santosh Kumar

    2015-06-01

    Full Text Available BACKGROUND : Shoulder instability and its treatment were described even in ancient times by the Greek and Egyptian physicians. Evidence of shoulder dislocation has been found in archaeological and paleopathological examinations of human shoulders several thousand years old. 1 Many techniques have been described in literature for treatment of recurrent shoulder dislocation. Arthroscopic repair of Bankart’s lesion using suture anchors is a noble technique. A suture anchor is a tiny screw with a thread attached to it. The screw is inserted into the bone over the glenoid rim while the sutures hold onto the labral tissue. These anchors provide a stable base for reattachment of the capsulolabral complex. We conducted a study on evaluation of long term effe ct of arthroscopic repair of Bankart’s lesion using suture anchors and compared our results with other studies published in literature . MATERIALS & METHODS : Since June 2012, arthroscopic Bankart’s repair using suture anchors was performed on 35 patients, who presented with recurrent anterior dislocation of shoulder. 34 man and 1 woman patients were included in the study. METHOD OF COLLECTION OF DATA: Adult patients with recurrent dislocations of shoulder with . INCLUSION CRITERIA: All patients > 15 years but =2 . EXCLUSION CRITERIA: Age group 60 years. Clinical evidence of multidirectional instability. Surgery of injured shou lder before 1 st episode of traumatic shoulder dislocation. Number o f dislocations <2 . Generalised ligamentous laxity. Presence of neuromuscular disorders. Presence of other comorbid conditions . Majority of patients were in the age group between 17 years to 49years, with mean age of 27.43 years. Most patients were young active individuals in the age group of 25 to 35 years. 20 patients (57% were involved in significant occupation requiring overhead activity such as students with sporting activities, agricul turists. 21(60% patients had their Right shoulder involved

  12. 前交叉韧带重建过程中韧带末端缝合固定的生物力学特征%Biomechanical characteristics of suturing the ligament end during anterior cruciate ligament reconstruction

    Institute of Scientific and Technical Information of China (English)

    陈啸; 黄竟敏

    2014-01-01

    BACKGROUND:During autologous tendon grafting, the ultimate tensile strength used for suturing the end of the ligament is important for successful surgery. Improving suturing strength and increasing the number of stitches is a good choice for increasing the fixed intensity. But excess amount of stitches can produce too many thread residues, thereby affecting tendon healing. OBJECTIVE:To investigate the essential number of suturing pins for the anterior cruciate ligament revascularization in ligament end suture fixation to reduce suturing thread exposure. METHODS:(1) In vitro biomechanics test:12 patel ar ligament specimens were divided into two groups:the specimens were sutured with 5 or 3 stitches using Krackow suture method. The suturing thread was J&J tendon suture thread. The strength of tensile was compared between the two groups by Tensile mechanical test was conducted to compare the strength of tensile between the two groups and to explore the optimal number of stitches and suturing method. (2) Clinical application:According to the results of in vitro experiments, modified Krackow suture method was used clinical y for arthroscopic anterior cruciate ligament reconstruction in 125 cases, including 62 cases receiving 3-stitch suture, and 63 cases undergoing 5-stitch suture. RESULTS AND CONCLUSION:The fixed strength of tensile at suture sites was over 100 N for 3-stitch double-lock suture and 110 N for 5-stitch double-lock suture. There was no significant difference in the fixed strength between the two groups, but their strength values were both over the breaking strength of suturing materials. Moreover, the fixed strength could not be reduced by suturing throughout the ligament at the first stitch. Al the 125 cases were fol owed for 6.4 months averagely, and both 3-stitch and 5-stitch suture methods achieved good outcomes. The satisfaction rate was up to 99%, and no suture breakage or loosing occurred at early and late stages. These findings suggest that

  13. Effectiveness of ultrasonographic evaluation of the cranial sutures in children with suspected craniosynostosis

    Energy Technology Data Exchange (ETDEWEB)

    Simanovsky, Natalia; Hiller, Nurith; Koplewitz, Benjamin; Rozovsky, Katya [Hadassah Hebrew University Medical Center, Department of Medical Imaging, Mount, Scopus, P.O. Box 24035, Jerusalem (Israel)

    2009-03-15

    Computed tomography (CT) is the 'gold standard' for evaluation of the cranial sutures. While prenatal cranial suture evaluation with ultrasound (US) is common, US has not been established as a postnatal screening tool. We evaluated the effectiveness of US for diagnosis of craniosynostosis (CS). During 2006, 24 infants with questionable CS were assessed with US of the sagittal, metopic, and bilateral coronal and lambdoid sutures. US findings and clinical records were reviewed retrospectively. Sixteen boys and eight girls (ages 1-11 months, mean 4.3) underwent US. The correct diagnosis was provided in 23 (95%), with equivocal findings in one patient. Cranial sutures appeared normal in 15 infants, who had normal clinical presentation at mean 5.8 months follow-up; CT confirmation was obtained in two. In eight children, US identified premature closure of one or more cranial sutures. Three-dimensional CT was performed as a preparation for surgery in four, with classical CS findings. In one case with inconclusive US findings, CT showed narrow but open sutures. Sonographic examination of cranial sutures may serve as a first imaging tool for evaluation of craniosynostosis. CT may be reserved for children with abnormal or equivocal ultrasound and for preoperative planning. (orig.)

  14. Immunostimulatory sutures that treat local disease recurrence following primary tumor resection

    Energy Technology Data Exchange (ETDEWEB)

    Intra, Janjira; Zhang Xueqing; Salem, Aliasger K [Division of Pharmaceutics, College of Pharmacy, University of Iowa, Iowa City, IA 52242 (United States); Williams, Robin L; Zhu Xiaoyan [Department of Surgery, Roy J and Lucille Carver College of Medicine, University of Iowa, Iowa City, IA 52242 (United States); Sandler, Anthony D, E-mail: aliasger-salem@uiowa.edu [Department of Surgery and Center for Cancer and Immunology Research, Children' s National Medical Center, Washington DC 20010 (United States)

    2011-02-15

    Neuroblastoma is a common childhood cancer that often results in progressive minimal residual disease after primary tumor resection. Cytosine-phosphorothioate-guanine oligonucleotides (CpG ODN) have been reported to induce potent anti-tumor immune responses. In this communication, we report on the development of a CpG ODN-loaded suture that can close up the wound following tumor excision and provide sustained localized delivery of CpG ODN to treat local disease recurrence. The suture was prepared by melt extruding a mixture of polylactic acid-co-glycolic acid (PLGA 75:25 0.47 dL g{sup -1}) pellets and CpG ODN 1826. Scanning electron microscopy images showed that the sutures were free of defects and cracks. UV spectrophotometry measurements at 260 nm showed that sutures provide sustained release of CpG ODN over 35 days. Syngeneic female A/J mice were inoculated subcutaneously with 1 x 10{sup 6} Neuro-2a murine neuroblastoma wild-type cells and tumors were grown between 5 to 10 mm before the tumors were excised. Wounds from the tumor resection were closed using CpG ODN-loaded sutures and/or polyglycolic acid Vicryl suture. Suppression of neuroblastoma recurrence and mouse survival were significantly higher in mice where wounds were closed using the CpG ODN-loaded sutures relative to all other groups. (communication)

  15. Anatomy-Based navigation for ventriculostomy: Nasion-coronal suture distance measurement

    Directory of Open Access Journals (Sweden)

    Mevci Özdemir

    2014-09-01

    Full Text Available Objective: In this study we aimed to determine a landmark that can be measured through the skin with nasal mid-point (bregma to coronal suture, and additionally an average value was calculated. We report, to our knowledge, the distance between the nasion-coronal sutures is reported for the first time in Turkish population. Methods: The study included 30 craniums and 30 frontal bones. Each skull from midline nasal suture to coronal suture curved up at the distance was measured with tape measure. Results: Mean values were determined. Nasal suture between coronal suture distance average 12,2 cm (min10,3 cm, up to 13,5 cm were detected. Conclusion: Nasal suture is an easily palpable area through the skin. A small incision is carried down through skin to bone at the spot 12 cm back from the nasion 3 cm lateral to the midline for ventricular drainage operation. This data provide practical information for neurosurgeon and is available everywhere. J Clin Exp Invest 2014; 5 (3: 368-370

  16. Normal Development of Sutures and synchondroses in the central skull base : CT study

    Energy Technology Data Exchange (ETDEWEB)

    Roh, Hong Gee; Kim, Hyung Jin; Kang, Jee Hee; Lee, Kyung Hee; Lim, Myung Kwan; Cho, Young Kuk; Ok, Cheol Su; Suh, Chang Hae [College of Medicine, Inha University, Inchon (Korea, Republic of)

    2000-02-01

    To evaluate the developmental patterns of the sutures and synchondroses in the central skull base. We evaluated the CT scans of 109 children (age range 29 days to 15 years) with no skull base abnormality who had undergone axial CT of the skull base with 1-mm collimation. Using a five-tier scheme, we analyzed the developmental patterns of the 18 sutures and synchondroses related to the sphenoid and occipital bones. Fusion of the sutures and synchondroses related to the sphenoid bone progressed rapidly during the first two years. Thereafter, changes in the sphenoid bone were dominated by pneumatization of the sphenoid sinus. Fusion of the synchondroses within the sphenoid body, including intersphenoidal, intrapresphenoidal, intrapostsphenoidal synchondrosis occurred early and in most cases was graded {>=}3D4. Fusion of the sphenosquamosal, sphenoethmoidal, and frontosphenoidal sutures was delayed, and residual sclerosis was a common finding. Except for Kerckring-supraoccipital synchondrosis, fusion of the six sutures and synchondroses related to the occipital bone occurred more gradually than that of those related to the sphenoid bone. Among these, fusion of the occipitomastoidal suture and petro-occipital synchondrosis was the last to occur. A knowledge of the developmental patterns of sutures and synchondroses can help differentiate normal conditions from those such as fracture, osseous dysplasia, or congenital malformation, which are abnormal. Our results provide certain basic information about skull base maturity in children. (author)

  17. Midpalatal suture maturation: Classification method for individual assessment before rapid maxillary expansion

    Science.gov (United States)

    Angelieri, Fernanda; Cevidanes, Lucia H. S.; Franchi, Lorenzo; Gonçalves, João R.; Benavides, Erika; McNamara, James A.

    2014-01-01

    Introduction In this study, we present a novel classification method for individual assessment of midpalatal suture morphology. Methods Cone-beam computed tomography images from 140 subjects (ages, 5.6-58.4 years) were examined to define the radiographic stages of midpalatal suture maturation. Five stages of maturation of the midpalatal suture were identified and defined: stage A, straight high-density sutural line, with no or little interdigitation; stage B, scalloped appearance of the high-density sutural line; stage C, 2 parallel, scalloped, high-density lines that were close to each other, separated in some areas by small low-density spaces; stage D, fusion completed in the palatine bone, with no evidence of a suture; and stage E, fusion anteriorly in the maxilla. Intraexaminer and interexaminer agreements were evaluated by weighted kappa tests. Results Stages A and B typically were observed up to 13 years of age, whereas stage C was noted primarily from 11 to 17 years but occasionally in younger and older age groups. Fusion of the palatine (stage D) and maxillary (stage E) regions of the midpalatal suture was completed after 11 years only in girls. From 14 to 17 years, 3 of 13 (23%) boys showed fusion only in the palatine bone (stage D). Conclusions This new classification method has the potential to avoid the side effects of rapid maxillary expansion failure or unnecessary surgically assisted rapid maxillary expansion for late adolescents and young adults. PMID:24182592

  18. BCL11B expression in intramembranous osteogenesis during murine craniofacial suture development.

    Science.gov (United States)

    Holmes, Greg; van Bakel, Harm; Zhou, Xueyan; Losic, Bojan; Jabs, Ethylin Wang

    2015-01-01

    Sutures, where neighboring craniofacial bones are separated by undifferentiated mesenchyme, are major growth sites during craniofacial development. Pathologic fusion of bones within sutures occurs in a wide variety of craniosynostosis conditions and can result in dysmorphic craniofacial growth and secondary neurologic deficits. Our knowledge of the genes involved in suture formation is poor. Here we describe the novel expression pattern of the BCL11B transcription factor protein during murine embryonic craniofacial bone formation. We examined BCL11B protein expression at E14.5, E16.5, and E18.5 in 14 major craniofacial sutures of C57BL/6J mice. We found BCL11B expression to be associated with all intramembranous craniofacial bones examined. The most striking aspects of BCL11B expression were its high levels in suture mesenchyme and increasingly complementary expression with RUNX2 in differentiating osteoblasts during development. BCL11B was also expressed in mesenchyme at the non-sutural edges of intramembranous bones. No expression was seen in osteoblasts involved in endochondral ossification of the cartilaginous cranial base. BCL11B is expressed to potentially regulate the transition of mesenchymal differentiation and suture formation within craniofacial intramembranous bone.

  19. Comparison of different fixation methods of the suture-button implant for tibiofibular syndesmosis injuries.

    Science.gov (United States)

    Teramoto, Atsushi; Suzuki, Daisuke; Kamiya, Tomoaki; Chikenji, Takako; Watanabe, Kota; Yamashita, Toshihiko

    2011-10-01

    Suture-button fixation for tibiofibular syndesmosis injuries is a relatively new surgical technique thought to provide semirigid dynamic stabilization. However, adequate information is still not available and there are controversies as to whether it provides enough fixation for syndesmosis injuries. Optimally directed suture-button fixation brings physiologic dynamic stabilization of the ankle syndesmosis. Controlled laboratory study. Stabilization of the ankle syndesmosis fixed by a suture-button construct was examined using 6 normal fresh-frozen cadaver legs. After initial tests of intact and injured models, suture-button fixation and screw surgical techniques were performed sequentially for each specimen, with single suture-button fixation, double suture-button fixation, anatomic suture-button fixation, and metal screw. Anterior and medial traction forces, as well as external rotation force, were applied to the tibia; the diastasis of the syndesmosis and the rotational angle of the fibula related to the tibia were measured using a magnetic tracking system. Each traction and rotation force significantly increased the diastasis and fibular rotational angles in the created injury models. With single fixation, the diastases increased significantly compared with the intact model with an anterior traction force (P button can provide adequate stabilization of the ankle and could benefit athletes with syndesmosis injuries.

  20. Assessment of Anatomic Risk During Syndesmotic Stabilization With the Suture Button Technique.

    Science.gov (United States)

    Pirozzi, Kelly M; Creech, Corine L; Meyr, Andrew J

    2015-01-01

    The suture button technique represents an accepted method of fixation for acute or chronic injury to the tibiofibular syndesmosis. The objective of the present investigation was to assess the anatomic risk to the superficial medial neurovascular structure with insertion of a syndesmotic suture button and to measure the distance of the button to the greater saphenous vein during a standardized insertion. A syndesmotic suture button was inserted with a standardized technique in 20 fresh frozen cadaveric limbs. Of 20 suture buttons, 14 (70.0%) were inserted posterior to the greater saphenous vein, 2 (10.0%) were inserted anterior to the greater saphenous vein, and 4 (20.0%) were inserted directly onto the greater saphenous vein. A total of 11 suture buttons (55.0%) were inserted with some entrapment of a medial neurovascular structure. The absolute mean ± standard deviation distance of the suture button to the greater saphenous vein was 4.88 ± 4.44 mm. The results of the present investigation have indicated that a risk of entrapment of superficial medial neurovascular structures exists with insertion of a suture button for syndesmotic fixation and that a medial incision should be used to ensure that structures are not entrapped. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Trapezium excision and suture suspensionplasty (TESS) for the treatment of thumb carpometacarpal arthritis.

    Science.gov (United States)

    Putnam, Matthew D; Meyer, Nicholas J; Baker, Daniel; Brehmer, Jess; Carlson, Brent D

    2014-06-01

    Basilar thumb arthritis, or first carpometacarpal arthritis, is a common condition affecting older women and some men. It is estimated that as many as one third of postmenopausal woman are affected. Surgical treatment of this condition includes options ranging from arthrodesis to prosthetic arthroplasty. Intermediate options include complete or partial trapezial excision with or without interposition of a cushioning/stabilizing material (auto source, allo source, synthetic source). A multitude of methods appear to offer similar end results, although some methods definitely involve more surgical work and perhaps greater patient risk. Through retrospective evaluation of a cohort of patients who underwent suture suspensionplasty, we determined the postoperative effect on strength, motion, patient satisfaction, complications, and radiographic maintenance of the scaphoid-metacarpal distance. This review shows the method to be clinically effective and, by comparison with a more traditional ligament reconstruction trapezial interposition arthroplasty, the method does not require use of autograft or allograft tendon and has fewer surgical steps. Forty-four patients were included in this retrospective study. The results showed that 91% of patients were satisfied with the procedure. Pinch and grip strength remained the same preoperatively and postoperatively. A Disabilities of the Arm, Shoulder, and Hand patient-reported outcome instrument (DASH) scores averaged 30 at final follow-up. Three patients developed a late complication requiring further surgical intervention. In summary, this technique appears to be technically reproducible, requires no additional tendon material, and achieves objectively and subjectively similar results to other reported procedures used to manage first CMC Arthritis.

  2. Ameloblastin inhibits cranial suture closure by modulating MSX2 expression and proliferation.

    Directory of Open Access Journals (Sweden)

    Phimon Atsawasuwan

    Full Text Available Deformities of cranial sutures such as craniosynostosis and enlarged parietal foramina greatly impact human development and quality of life. Here we have examined the role of the extracellular matrix protein ameloblastin (Ambn, a recent addition to the family of non-collagenous extracellular bone matrix proteins, in craniofacial bone development and suture formation. Using RT-PCR, western blot and immunohistochemistry, Ambn was localized in mouse calvarial bone and adjacent condensed mesenchyme. Five-fold Ambn overexpression in a K14-driven transgenic mouse model resulted in delayed posterior frontal suture fusion and incomplete suture closure. Moreover, Ambn overexpressor skulls weighed 13.2% less, their interfrontal bones were 35.3% thinner, and the width between frontal bones plus interfrontal suture was 14.3% wider. Ambn overexpressing mice also featured reduced cell proliferation in suture blastemas and in mesenchymal cells from posterior frontal sutures. There was a more than 2-fold reduction of Msx2 in Ambn overexpressing calvariae and suture mesenchymal cells, and this effect was inversely proportionate to the level of Ambn overexpression in different cell lines. The reduction of Msx2 expression as a result of Ambn overexpression was further enhanced in the presence of the MEK/ERK pathway inhibitor O126. Finally, Ambn overexpression significantly reduced Msx2 down-stream target gene expression levels, including osteogenic transcription factors Runx2 and Osx, the bone matrix proteins Ibsp, ColI, Ocn and Opn, and the cell cycle-related gene CcnD1. Together, these data suggest that Ambn plays a crucial role in the regulation of cranial bone growth and suture closure via Msx 2 suppression and proliferation inhibition.

  3. Triclosan-coated sutures and sternal wound infections: a prospective randomized clinical trial.

    Science.gov (United States)

    Steingrimsson, S; Thimour-Bergström, L; Roman-Emanuel, C; Scherstén, H; Friberg, Ö; Gudbjartsson, T; Jeppsson, A

    2015-12-01

    Surgical site infection is a common complication following cardiac surgery. Triclosan-coated sutures have been shown to reduce the rate of infections in various surgical wounds, including wounds after vein harvesting in coronary artery bypass grafting patients. Our purpose was to compare the rate of infections in sternotomy wounds closed with triclosan-coated or conventional sutures. A total of 357 patients that underwent coronary artery bypass grafting were included in a prospective randomized double-blind single-center study. The patients were randomized to closure of the sternal wound with either triclosan-coated sutures (Vicryl Plus and Monocryl Plus, Ethicon, Inc., Somerville, NJ, USA) (n = 179) or identical sutures without triclosan (n = 178). Patients were followed up after 30 days (clinical visit) and 60 days (telephone interview). The primary endpoint was the prevalence of sternal wound infection according to the Centers for Disease Control and Prevention (CDC) criteria. The demographics in both groups were comparable, including age, gender, body mass index, and rate of diabetes and smoking. Sternal wound infection was diagnosed in 43 patients; 23 (12.8%) sutured with triclosan-coated sutures compared to 20 (11.2%) sutured without triclosan (p = 0.640). Most infections were superficial (n = 36, 10.1%), while 7 (2.0%) were deep sternal wound infections. There were 16 positive cultures in the triclosan group and 17 in the non-coated suture group (p = 0.842). The most commonly identified main pathogens were Staphylococcus aureus (45.4%) and coagulase-negative staphylococci (36.4%). Skin closure with triclosan-coated sutures did not reduce the rate of sternal wound infection after coronary artery bypass grafting. (clinicaltrials.gov: NCT01212315).

  4. Effects of rapid maxillary expansion on the cranial and circummaxillary sutures

    Science.gov (United States)

    Ghoneima, Ahmed; Abdel-Fattah, Ezzat; Hartsfield, James; El-Bedwehi, Ashraf; Kamel, Ayman; Kula, Katherine

    2016-01-01

    Introduction The aim of this study was to determine whether the orthopedic forces of rapid maxillary expansion cause significant quantitative changes in the cranial and the circummaxillary sutures. Methods Twenty patients (mean age, 12.3 ± 1.9 years) who required rapid maxillary expansion as a part of their comprehensive orthodontic treatment had preexpansion and postexpansion computed tomography scans. Ten cranial and circummaxillary sutures were located and measured on one of the axial, coronal, or sagittal sections of each patient’s preexpansion and postexpansion computed tomography scans. Quantitative variables between the 2 measurements were compared by using the Wilcoxon signed rank test. A P value less than 0.05 was considered statistically significant. Results Rapid maxillary expansion produced significant width increases in the intermaxillary, internasal, maxillonasal, frontomaxillary, and frontonasal sutures, whereas the frontozygomatic, zygomaticomaxillary, zygomaticotemporal, and pterygomaxillary sutures showed nonsignificant changes. The greatest increase in width was recorded for the intermaxillary suture (1.7 ± 0.9 mm), followed by the internasal suture (0.6 ± 0.3 mm), and the maxillonasal suture (0.4 ± 0.2 mm). The midpalatal suture showed the greatest increase in width at the central incisor level (1.6 ± 0.8 mm) followed by the increases in width at the canine level (1.5 ± 0.8 mm) and the first molar level (1.2 ± 0.6 mm). Conclusions Forces elicited by rapid maxillary expansion affect primarily the anterior sutures (intermaxillary and maxillary frontal nasal interfaces) compared with the posterior (zygomatic interface) craniofacial structures. PMID:21967938

  5. Simple versus horizontal suture anchor repair of Bankart lesions: which better restores labral anatomy?

    Science.gov (United States)

    Hagstrom, Lindsey S; Marzo, John M

    2013-02-01

    The goal of this study was to determine which suture repair technique better restores glenoid labrum height: horizontal sutures or simple sutures. Sixteen cadaveric glenoids, 8 per repair technique, were used to measure native labral height at the 3:00 to 6:00 positions in half-hour increments. A Bankart lesion was then created from 3:00 to 6:30. Height measurements at each time point were again taken after creation of the Bankart lesion. Repair with a 3-mm knotted suture anchor was then performed at 3:30, 4:30, and 5:30 with either a simple or horizontal suture technique, and postrepair heights were measured across all time points. Significant decreases in height, as compared with native height, were observed at 3:30, 4:30, and 5:30 in the simple repair group. Decreases in height of 1.4 mm (P = .044), 2.1 mm (P = .030), and 1.1 (P = .034) were observed at 3:30, 4:30, and 5:30. There was no significant decrease in height at these respective time points in the horizontal repair group. The in vitro horizontal mattress suture technique better restores labral height and anatomy when compared with a simple suture technique in the repair of acute Bankart lesions. Compared with the simple suture technique, horizontal suture repair may provide increased stability to the glenohumeral construct. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  6. Evaluating the Effectiveness of the Lateral Intercrural Suture to Decrease the Interdomal Distance to Improve the Definition of the Nasal Tip in Primary Rhinoplasty

    Directory of Open Access Journals (Sweden)

    Soares, Caio Márcio Correia

    2014-04-01

    Full Text Available Introduction Several surgical techniques emphasizing sutures on the lower lateral cartilage have been studied by surgeons as instruments to improve nasal tip remodeling. It is already known that the domal divergence angle and its definition angle can be modified by lateral intercrural suture (LIS. Techniques for measuring these structures are not yet standardized. Objectives Assess the efficacy of LIS using polydioxanone 4–0 absorbable thread by interdomal distance and systematize the LIS technique to improve nasal tip definition. Materials and Methods This prospective study measured and analyzed interdomal distances measured preoperatively and perioperatively compared with 3- and 6-month postoperative measurements. Results LIS was efficient on reducing interdomal distances. Conclusion LIS is statistically safe and efficient and has low morbidity when utilized in patients with mild to moderate deformities, because it reduces the domal divergence angle, effectively sustaining the nasal tip.

  7. Brief communication: age and fractal dimensions of human sagittal and coronal sutures

    DEFF Research Database (Denmark)

    Lynnerup, Niels; Jacobsen, Jens Christian Brings

    2003-01-01

    The fractal dimensions of human sagittal and coronal sutures were calculated on 31 complete skulls from the Terry Collection. The aim was to investigate whether the fractal dimension, relying on the whole sutural length, might yield a better description of age-related changes in sutural morphology......, as opposed to other methods of quantification, which generally rely on more arbitrary scoring systems. However, the fractal dimension did not yield better age correlations than other previously described methods. At best, the results reflected the general observation that young adults below age 40 years...

  8. Perspectives on craniosynostosis: sutural biology, some well-known syndromes, and some unusual syndromes.

    Science.gov (United States)

    Cohen, M Michael

    2009-03-01

    Perspectives on craniosynostosis are discussed under the following headings: sutural biology (anatomic and genetic categories of synostosis; sutures, suture systems, and types of craniosynostosis; well-known syndromes (Muenke syndrome and Pfeiffer syndrome); and unusual syndromes (thanatophoric dysplasia, Beare-Stevenson cutis gyrata syndrome, Crouzonodermoskeletal syndrome, Carpenter syndrome, Elejalde syndrome, hypomandibular faciocranial syndrome, and craniorhiny). Five of these syndromes are caused by fibroblast growth factor receptor (FGFR) mutations; one is caused by ras-like in rat brain 23 (RAB23) mutations; and three have Mendelian patterns of inheritance, but the molecular basis remains unknown to date.

  9. Suture anchor repair of patellar tendon rupture after total knee arthroplasty.

    Science.gov (United States)

    Kamath, Atul F; Shah, Roshan P; Summers, Nathan; Israelite, Craig L

    2013-12-01

    Extensor mechanism disruption after total knee arthroplasty (TKA) is a complex problem that often requires surgical repair for functional deficits. We present a brief technical note on suture anchor fixation of a patellar tendon rupture after TKA. A surgical technique and literature review follows. Although suture anchor fixation is well described for tendinous repairs in other areas of orthopedic surgery, no study has discussed the use of suture anchors in patellar tendon repair after TKA. The technique must be evaluated in more patients with longer follow-up before adoption.

  10. An intriguing case of gallstone ileus after hepaticojejunostomy caused by a "stone on a suture"

    Directory of Open Access Journals (Sweden)

    Mahir Gachabayov

    2016-01-01

    Full Text Available Gallstone ileus (GI is a mechanical obstruction of small or large bowel caused by gallstone passed to the intestinal lumen through spontaneous or postoperative biliodigestive fistula. A 42-year-old female patient was admitted with the clinical presentation of small bowel obstruction. She underwent hepaticojejunostomy 4 years prior to admission for primary sclerosing cholangitis. Barium meal follows through revealed Rigler′s triad. The patient underwent laparotomy which revealed GI. A "stone on a suture" was removed through enterotomy. Patients after cholecystectomy and hepaticojejunostomy can develop GI. Nonabsorbable suture used to create biliodigestive anastomosis can appear to become the frame of a "stone on a suture."

  11. Materials

    Science.gov (United States)

    Glaessgen, Edward H.; Schoeppner, Gregory A.

    2006-01-01

    NASA Langley Research Center has successfully developed an electron beam freeform fabrication (EBF3) process, a rapid metal deposition process that works efficiently with a variety of weldable alloys. The EBF3 process can be used to build a complex, unitized part in a layer-additive fashion, although the more immediate payoff is for use as a manufacturing process for adding details to components fabricated from simplified castings and forgings or plate products. The EBF3 process produces structural metallic parts with strengths comparable to that of wrought product forms and has been demonstrated on aluminum, titanium, and nickel-based alloys to date. The EBF3 process introduces metal wire feedstock into a molten pool that is created and sustained using a focused electron beam in a vacuum environment. Operation in a vacuum ensures a clean process environment and eliminates the need for a consumable shield gas. Advanced metal manufacturing methods such as EBF3 are being explored for fabrication and repair of aerospace structures, offering potential for improvements in cost, weight, and performance to enhance mission success for aircraft, launch vehicles, and spacecraft. Near-term applications of the EBF3 process are most likely to be implemented for cost reduction and lead time reduction through addition of details onto simplified preforms (casting or forging). This is particularly attractive for components with protruding details that would require a significantly large volume of material to be machined away from an oversized forging, offering significant reductions to the buy-to-fly ratio. Future far-term applications promise improved structural efficiency through reduced weight and improved performance by exploiting the layer-additive nature of the EBF3 process to fabricate tailored unitized structures with functionally graded microstructures and compositions.

  12. Antimicrobial activity of Calendula officinalis, Camellia sinensis and chlorhexidine against the adherence of microorganisms to sutures after extraction of unerupted third molars

    Directory of Open Access Journals (Sweden)

    Raquel Lourdes Faria

    2011-10-01

    Full Text Available OBJECTIVE: The objective of this study was to compare the antimicrobial effect of mouthwashes containing Calendula officinalis L., Camellia sinensis (L. Kuntze and 0.12% chlorhexidine digluconate on the adherence of microorganisms to suture materials after extraction of unerupted third molars. MATERIAL AND METHODS: Eighteen patients with unerupted maxillary third molars indicated for extraction were selected (n=6 per mouthwash. First, the patients were subjected to extraction of the left tooth and instructed not to use any type of antiseptic solution at the site of surgery (control group. After 15 days, the right tooth was extracted and the patients were instructed to use the Calendula officinalis, Camellia sinensis or chlorhexidine mouthwash during 1 week (experimental group. For each surgery, the sutures were removed on postoperative day 7 and placed in sterile phosphate-buffered saline. Next, serial dilutions were prepared and seeded onto different culture media for the growth of the following microorganisms: blood agar for total microorganism growth; Mitis Salivarius bacitracin sucrose agar for mutans group streptococci; mannitol agar for Staphylococcus spp.; MacConkey agar for enterobacteria and Pseudomonas spp., and Sabouraud dextrose agar containing chloramphenicol for Candida spp. The plates were incubated during 24-48 h at 37ºC for microorganism count (CFU/mL. RESULTS: The three mouthwashes tested reduced the number of microorganisms adhered to the sutures compared to the control group. However, significant differences between the control and experimental groups were only observed for the mouthwash containing 0.12% chlorhexidine digluconate. CONCLUSIONS: Calendula officinalis L. and Camellia sinensis (L. Kuntze presented antimicrobial activity against the adherence of microorganisms to sutures but were not as efficient as chlorhexidine digluconate.

  13. Antimicrobial activity of Calendula officinalis, Camellia sinensis and chlorhexidine against the adherence of microorganisms to sutures after extraction of unerupted third molars

    Science.gov (United States)

    FARIA, Raquel Lourdes; CARDOSO, Lincoln Marcelo Lourenço; AKISUE, Gokithi; PEREIRA, Cristiane Aparecida; JUNQUEIRA, Juliana Campos; JORGE, Antonio Olavo Cardoso; SANTOS JÚNIOR, Paulo Villela

    2011-01-01

    Objective The objective of this study was to compare the antimicrobial effect of mouthwashes containing Calendula officinalis L., Camellia sinensis (L.) Kuntze and 0.12% chlorhexidine digluconate on the adherence of microorganisms to suture materials after extraction of unerupted third molars. Material and Methods Eighteen patients with unerupted maxillary third molars indicated for extraction were selected (n=6 per mouthwash). First, the patients were subjected to extraction of the left tooth and instructed not to use any type of antiseptic solution at the site of surgery (control group). After 15 days, the right tooth was extracted and the patients were instructed to use the Calendula officinalis, Camellia sinensis or chlorhexidine mouthwash during 1 week (experimental group). For each surgery, the sutures were removed on postoperative day 7 and placed in sterile phosphate-buffered saline. Next, serial dilutions were prepared and seeded onto different culture media for the growth of the following microorganisms: blood agar for total microorganism growth; Mitis Salivarius bacitracin sucrose agar for mutans group streptococci; mannitol agar for Staphylococcus spp.; MacConkey agar for enterobacteria and Pseudomonas spp., and Sabouraud dextrose agar containing chloramphenicol for Candida spp. The plates were incubated during 24-48 h at 37ºC for microorganism count (CFU/mL). Results The three mouthwashes tested reduced the number of microorganisms adhered to the sutures compared to the control group. However, significant differences between the control and experimental groups were only observed for the mouthwash containing 0.12% chlorhexidine digluconate. Conclusions Calendula officinalis L. and Camellia sinensis (L.) Kuntze presented antimicrobial activity against the adherence of microorganisms to sutures but were not as efficient as chlorhexidine digluconate. PMID:21986652

  14. An alternative tectonic model for the Yarlung Zangbo suture zone

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    The new field investigations along the Yarlung Zangbo ophiolites zone show that these series underwent low green-schist metamorphism and were then fractured and occurred as slabs in tectonic melanges,without regional tectonic polarity.No large shear zone in north-south direction has been identified between ophiolite bodies and flysch layers on both side and a conformable contact relationship can be observed locally between them.A great mass of tectonic mélange has been substantiated as submarine olistolith bodies.The Mesozoic sedimentary facies and its evolution in both north and south of the ophiolite zone are corresponding in time.The ophiolite zone has often been divided into parallel branches,separated by narrow flysch slats.There is also a similarity of the Paleozoic and the basement of the High Himalaya,Lhasa and Qiangtang Terranes,and they are distinctly different from those of the Indian continent.The geologic information does not warrant a postulate that the Himalaya and Tibet were once separated by a great ocean;it is therefore consistent with an alternative tectonic model by back-arc basin collapse with its juvenile narrow oceanic crust.The real plate tectonic suture,the Neotethys might be covered under the Miocene Siwalik molasse in the southern slope of the High Himalaya range.Based on the new model,the Neotethyan ocean floor was subducted beneath the Asia since the Late Triassic.The outer continental margin of Eurasia was split from the Lhasa Terrane so that a back-arc basin came into existence.Hemi-pelagic and deep sea sediments were deposited before the Late Cretaceous flysch sedimentation,with the linear juvenile oceanic crust when back-arc volcanism occurred in the Gandese region.The Yarlung Zangbo back-arc basin was eventually eliminated when the High Himalayas were sutured onto Eurasia.The ocean floor lightly underthrusted to north and south sides,sediments of the basin were deformed as fold-thrusting.The Neotethys was eliminated during the

  15. Electrosurgical bipolar vessel sealing versus conventional clamping and suturing for total abdominal hysterectomy: a randomized trial.

    NARCIS (Netherlands)

    Lakeman, M.; Kruitwagen, R.F.P.M.; Vos, M.C.; Roovers, J.P.

    2008-01-01

    STUDY OBJECTIVE: To compare the effects of bipolar vessel sealing versus conventional clamping and suturing in women undergoing total abdominal hysterectomy. DESIGN: A randomized controlled trial was performed. Patients were randomized to vessel sealing or conventional surgery. Postoperative pain wa

  16. [Mechanical versus manual suture in the jejunal esophageal anastomosis after total gastrectomy in gastric cancer].

    Science.gov (United States)

    Celis, J; Ruiz, E; Berrospi, F; Payet, E

    2001-01-01

    To compare the leakage rate of esophagojejunal anastomosis performed with stapler or hand sutures. We studied a series of 367 patients who underwent total gastrectomy for gastric cancer at the Instituto de Enfermedades Neoplásicas (Lima-Peru) from 1986 to 1999. In 197 patients esophagojejunal anastomosis was performed with stapler and in 170 with manual sutures. There were no differences between both groups with regard to age, TNM stage, operating time and hospital stay. There were 8 anastomotic leakage (4.1%) in the stapler group and 4 (2.4%) in the hand sutures group (p> 0.05). Of these 12 cases, 2 patients (16%) died of causes directly related to the leak of the esophagojejunal anastomosis. There were no statistical differences in the rate of leakage of the esophagojejunal anastomosis performed with stapler or hand sutures, thus both techniques should be accepted as standard procedures.

  17. Combined suture and clipping for the reconstruction of a ruptured blister-like aneurysm.

    Science.gov (United States)

    Kantelhardt, Sven R; Archavlis, Eleftherios; Giese, Alf

    2016-10-01

    Blister-like aneurysms of the internal carotid artery (ICA) present a severe therapeutical challenge. While several reconstructive techniques are in use in case of acute rupture sacrifice of the parent vessel may be required. We present a combined technique of micro-sutures and clip application to repair the parent vessel in an intraoperatively ruptured blister-like aneurysm. Following temporary trapping of an intraoperatively ruptured 7-mm blister-like aneurysm four 8-0 nylon sutures were applied to adapt the vessel walls and support the branches of subsequently applied mini-clips. The combination of micro-sutures and mini-clips might be a valuable alternative to direct clipping or suturing in some cases with intraoperative rupture of blister-like aneurysms.

  18. Glottal configuration, acoustic, and aerodynamic changes induced by variation in suture direction in arytenoid adduction procedures.

    Science.gov (United States)

    Inagi, Katsuhide; Connor, Nadine P; Suzuki, Tatsutoshi; Ford, Charles N; Bless, Diane M; Nakajima, Masami

    2002-10-01

    Arytenoid adduction is a phonosurgical procedure in which the arytenoid cartilages are approximated to reduce posterior glottal gap size and improve voice. Voice outcomes following arytenoid adduction are not always optimal. The goal of this study was to systematically vary suture direction and force of pull on the arytenoid cartilages in a human excised laryngeal model to determine the optimal combination of factors for reducing glottal gap and improving voice. Several factors demonstrated significant effects. Changes in suture direction and force of pull affected glottal configuration in both the horizontal and vertical planes. Increased force of pull on the muscular process resulted in increased adduction of the vocal process for all suture directions. Changes in suture direction and force of pull also affected acoustic and aerodynamic measures of induced voice. Therefore, voice outcomes can be optimized with arytenoid adduction if the vocal fold plane is accurately adjusted.

  19. Graft Suturing for Lenticule Dislocation after Descemet Stripping Automated Endothelial Keratoplasty

    Directory of Open Access Journals (Sweden)

    Wai-Kwan Wu

    2011-01-01

    Full Text Available Purpose: To report the mid-term outcomes of graft suturing in a patient with lenticule dislocation after Descemet stripping automated endothelial keratoplasty (DSAEK. Case Report: A 78-year old woman was found to have graft dislocation involving the nasal half of the cornea after uneventful DSAEK. Graft repositioning, refilling the anterior chamber with air, and placement of four full-thickness 10/0 nylon sutures over the detached area were performed two weeks after the initial surgery. The sutures were removed 6 weeks later. Serial specular microscopy and anterior segment optical coherence tomography were performed. At 18 months, there was good lenticule apposition and a clear graft. Conclusion: Anchoring sutures seem to be effective for management of graft detachment following DSAEK.

  20. 77 FR 8117 - Medical Devices; Cardiovascular Devices; Classification of the Endovascular Suturing System

    Science.gov (United States)

    2012-02-14

    ... Testing Incompatibility with endograft Bench testing Migration or fracture of the endovascular Bench testing suture. Animal testing Clinical evaluation Imaging Incompatibility Bench testing Labeling... Testing Labeling Corrosion Bench testing Improper deployment or inability to deploy.. Bench testing Animal...

  1. Stem cells of the suture mesenchyme in craniofacial bone development, repair and regeneration.

    Science.gov (United States)

    Maruyama, Takamitsu; Jeong, Jaeim; Sheu, Tzong-Jen; Hsu, Wei

    2016-02-01

    The suture mesenchyme serves as a growth centre for calvarial morphogenesis and has been postulated to act as the niche for skeletal stem cells. Aberrant gene regulation causes suture dysmorphogenesis resulting in craniosynostosis, one of the most common craniofacial deformities. Owing to various limitations, especially the lack of suture stem cell isolation, reconstruction of large craniofacial bone defects remains highly challenging. Here we provide the first evidence for an Axin2-expressing stem cell population with long-term self-renewing, clonal expanding and differentiating abilities during calvarial development and homeostastic maintenance. These cells, which reside in the suture midline, contribute directly to injury repair and skeletal regeneration in a cell autonomous fashion. Our findings demonstrate their true identity as skeletal stem cells with innate capacities to replace the damaged skeleton in cell-based therapy, and permit further elucidation of the stem cell-mediated craniofacial skeletogenesis, leading to revealing the complex nature of congenital disease and regenerative medicine.

  2. Evaluation of endoscopic laser excision of polypropylene mesh/sutures following anti-incontinence procedures.

    LENUS (Irish Health Repository)

    Davis, N F

    2012-11-01

    We reviewed our experience with and outcome of the largest series to our knowledge of patients who underwent endoscopic laser excision of eroded polypropylene mesh or sutures as a complication of previous anti-incontinence procedures.

  3. Loss of rotator cuff tendon-to-bone interface pressure after reattachment using a suture anchor.

    Science.gov (United States)

    Brassart, Nicolas; Sanghavi, Sanjay; Hansen, Ulrich N; Emery, Roger J; Amis, Andrew A

    2008-01-01

    The purpose of this study was to examine the tendon-to-bone interface pressure, contact area, and force after reattaching a tendon to bone by use of a suture and suture anchor. Repairs were made in 8 ovine shoulders in vitro, by use of 3 suture types in each: Ethibond, polydioxanone, or Orthocord. A Tekscan pressure sensor was placed between the tendon and bone and monitored for 1 hour after the repair. The principal finding was a significant loss of approximately 60% of the contact parameters immediately after the suture was tied, followed by further significant loss over the next hour to a mean of only 14% of the initial readings. We concluded that pressure measurement systems that only record the initial maximum pressure would yield overly optimistic results for the actual repair pressure after the repair is completed. The Tekscan system, however, allowed us to monitor pressure reductions that occurred both during and after the repair.

  4. Longitudinal parallel compression suture to control postopartum hemorrhage due to placenta previa and accrete

    Directory of Open Access Journals (Sweden)

    Guang-Tai Li

    2016-04-01

    Conclusion: Longitudinal parallel compression suture is a safe, easy, effective, practical, and conservative surgical technique to stop intractable PPH from the lower uterine segment, particularly in women who have a cesarean scar and placenta previa/accreta.

  5. Bilateral squamosal suture synostosis: A rare form of isolated craniosynostosis in Crouzon syndrome

    Institute of Scientific and Technical Information of China (English)

    Yasmeen; K; Tandon; Michael; Rubin; Mohamed; Kahlifa; Gaby; Doumit; Lena; Naffaa

    2014-01-01

    Craniosynostosis is a pathologic condition which is characterized by the premature fusion of cranial sutures.It may occur alone or in association with other anomalies making up various syndromes.Crouzon syndrome is the most common craniosynostosis syndrome.Bicoronal sutures fusion is most commonly involved in Crouzon syndrome.There have only been a handful of cases of squamosal suture synostosis described in the surgery literature with the few ones described in Crouzon syndrome associated with other types of craniosynostosis.To the best of our knowledge,we are presenting the first case of isolated bilateral squamosal suture synostosis in a patient with Crouzon syndrome in a radiology journal with emphasis on its radiological appearance.

  6. A Study of the Kunlun-Qilian-Qinling Suture System

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The Late Neoproterozoic-Early Palaeozoic suture zones within theCentral Orogenic Belt of China can be considered a system-the Kunlun-Qilian-Qinling suture system (KQQ suture system). It is basically divided into the western, central and eastern sectors. The western sector consists of the Küda-Subashi suture zone, the Mazar Kangxiwar suture and the central West Kunlun microblock. The central sector covers the following five suture zones: the Altun, North Qilian, Qaidam northern marginal, Qimantag-Wutuo and East Kunlun southern marginal sutures, in addition to some microblocks such as the mid-south Qilian, Qaidam, Ayakkum and Maqen microblocks. The eastern sector is composed of the Shangdan suture zone, Mianlüe suture zone and central Qinling-Dabie microblock. The KQQ suture system experienced (1) extending-rifting of the Rodinia super-continent in the early-middle Sinian (~780-600 Ma); (2) the formation and evolution of the KQQ archipelagic ocean during the Late Sinian-Ordovician (~600-440 Ma), and (3) closing of the KQQ ocean and forming of the KQQ suture system during the Late Ordovician-early Silurian (~440-400 Ma). As a system comprising many suture zones and microblocks, the KQQ suture system consti tutes the foundation of the Central Orogenic Belt of China.CLC Number:P5 Document ID:Afoundation Item:This study was supported by the National Natural Science Foundation of China (grants 49872077 and 49572153), and the Lu Jiaxi Foundation of the Chinese Academy of Sciences.Author Resume:Bian Qiantao Born in 1945; graduated from the Department of Geology, South-Central University of Technology in 1970, and obtained his master's degree and doctor's degree at the Graduate School and the Institute of Geology, Chinese Academy of Sciences in 1981 and 1987, respectively. He is currently a professor of the Institute of Geology and Geophysics, Chinese Academy of Sciences, and has long been engaged in the research of tectonics, petrology, mineral deposits and

  7. Comparisons of the suture zones along a geotraverse from the Scythian Platform to the Arabian Platform

    Directory of Open Access Journals (Sweden)

    Ali Yılmaz

    2014-11-01

    Full Text Available The area from the Greater Caucasus to the southeast Turkey is characterized and shaped by several major continental blocks. These are Scythian Platform, Pontian–Transcaucasus Continent-Arc System (PTCAS, the Anatolian–Iranian and the Arabian Platforms. The aim of this paper is to define these continental blocks and describe and also compare their boundary relationships along the suture zones. The Scythian Platform displays the evidence of the Hercynian and Alpine orogens. This platform is separated from the PTCAS by the Greater Caucasus Suture Zone. The incipient collision began along this suture zone before middle–late Carboniferous whereas the final collision occurred before Oligocene. The PTCAS can be divided into four structural units: (1 the Georgian Block – northern part of the Pontian–Transcaucasian island-arc, (2 the southern and eastern Black Sea Coast–Adjara–Trialeti Unit, (3 the Artvin–Bolnisi Unit, comprising the northern part of the southern Transcaucasus, and (4 the Imbricated Bayburt–Garabagh Unit. The PTCAS could be separated from the Anatolian–Iranian Platform by the North Anatolian–Lesser Caucasus Suture (NALCS zone. The initial collision was developed in this suture zone during Senonian–early Eocene and final collision before middle Eocene or Oligocene–Miocene. The Anatolian–Iranian Platform (AIP is made up of the Tauride Platform and its metamorphic equivalents together with Iranian Platform. It could be separated from the Arabian Platform by the Southeastern Anatolian Suture (SEAS zone. The collision ended before late Miocene along this suture zone. The southernmost continental block of the geotraverse is the Arabian Platform, which constitutes the northern part of the Arabian–African Plate. This platform includes a sequence from the Precambrian felsic volcanic and clastic rocks to the Campanian–early Maastrichtian flyschoidal clastics. All the suture zones include MORB and SSZ

  8. [Mechanical suture during resection of the rectum through the abdomen (author's transl)].

    Science.gov (United States)

    Gauthier-Benoît, C; Prat, A

    1979-01-01

    A mechanical suture using the URSS PKZ 28 or SPTU stapler was used in 30 low colo-rectal anastomoses. There were two deaths related to anastomotic complications. It is safe to establish a colostomy when the colon is not well prepared. Fistulae are frequent after palliative operations: this is a poor indication. Local recurrences are no more frequent with stapling than with manual suture.

  9. Kestenbaum procedure with posterior fixation suture for anomalous head posture in infantile nystagmus

    OpenAIRE

    2009-01-01

    Background The purpose of this study was to report the effect of combining the Kestenbaum procedure with posterior fixation suture for infantile horizontal nystagmus with anomalous head posture (AHP) in children. Methods Nine consecutive patients who underwent combined Kestenbaum procedure plus posterior fixation suture to the recessed muscles at the same time were retrospectively studied. All patients were orthotropic before surgery and were followed for at least 6 months. Pre- and postopera...

  10. Clinical inquiries. How does tissue adhesive compare with suturing for superficial lacerations?

    Science.gov (United States)

    Aukerman, Douglas F; Sebastianelli, Wayne J; Nashelsky, Joan

    2005-04-01

    Tissue adhesives are effective and yield results comparable to those with conventional suturing of superficial, linear, and low-tension lacerations. The cosmetic outcome is similar; wound complications, such as infection and dehiscence, may be lower with tissue adhesives. Wound closure of superficial lacerations by tissue adhesives is quicker and less painful compared with conventional suturing (strength of recommendation: A, systematic reviews of randomized trials).

  11. Post-Operative Pancreatic Fistula in Pancreatico-Duodenectomy with Pancreato-Gastrostomy using Barbed Sutures

    OpenAIRE

    2016-01-01

    Objective To demonstrate safety of barbed sutures for pancreatogastrostomy after pancreaticoduodenectomy, analyzing our results with worldwide literature exclusively about post-operative pancreatic fistula, according to the International Study Group for Pancreatic Fistula definition. Methods From 1st January 2013 to 30th June 2015, 39 patients underwent pancreaticoduodenectomy with PG reconstruction (but only 36 using barbed sutures). We evaluated demographic details of the patients (age, sex...

  12. Acute distal tibiofibular syndesmosis injury: A systematic review of suture-button versus syndesmotic screw repair

    OpenAIRE

    Schepers, Tim

    2012-01-01

    textabstractPurpose: Recently, a new suture-button fixation device has emerged for the treatment of acute distal tibiofibular syndesmotic injuries and its use is rapidly increasing. The current systematic review was undertaken to compare the biomechanical properties, functional outcome, need for implant removal, and the complication rate of syndesmotic disruptions treated with a suture-button device with the current 'gold standard', i.e. the syndesmotic screw. Method: A literature search in t...

  13. Comperative analysis of unilateral cleft lip closure using absorbable and nonabsorbable sutures: a randomised clinical study

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    Abhay Nilkanth Datarkar

    2014-09-01

    Full Text Available Aim: Patients with cleft lip usually undergo multiple procedures that require hospitalization resulting in emotional stress to their family members. Young patients often require sedation or general anesthesia (GA for suture removal on a sensitive area to prevent disruption of the repair. In this study, we compared absorbable and nonabsorbable sutures for primary cleft lip repair. Methods: Patients with cleft lip who presented to Smile Train Unit, Child Hospital and Research Institute, Nagpur, India, were randomly assigned to two groups and underwent surgical repair using either Vicryl Rapid suture (Group 1 or Prolene suture (Group 2. Patients were followed up at 1 month, 6 months, and 1 year. Photographs of the patients were obtained at these visits and rated using a validated 100-mm cosmesis visual analogue scale (VAS by three people (social worker, surgeon, and patient's mother. A VAS score of 15 mm or greater was considered as clinically important difference. Results: A total of 60 patients were enrolled in this study, and they were equally divided into two groups. There was no difference in age, race, sex, wound length, number of sutures, and layered repair rates between the groups. The average age of the patient was 3 months. There was no significant difference in the rates of infection which was 6% in this study, wound dehiscence, and hypertrophic scar formation. No significant difference was found in cosmetic outcome in both the mean VAS score of 90.3 in Group 1 and 91.7 in Group 2. Conclusion: Absorbable sutures are a viable alternative to nonabsorbable sutures in the repair of primary cleft lip repair. We prefer absorbable sutures because they do not require removal under GA or sedation.

  14. [Iris suture fixation of posterior-chamber elastic intraocular lens in ligament apparatus laxity].

    Science.gov (United States)

    Pashtaev, N P; Bat'kov, E N; Zotov, V V

    2010-01-01

    An original MIOL-23 multifocal elastic intraocular lens (IOL) was used to operate 5 eyes with acquired lens dislocation and traumatic cataract. By making self-sealing tunnel incision, ILO was implanted into the capsular sac and sutured to the iris. MIOL-23 implantation caused an increase in mean visual acuity. The IOL took up a correct position. Elastic IOL implantation with iris suture fixation is an efficient and safe mode of additional ILO support.

  15. Longitudinal parallel compression suture to control postopartum hemorrhage due to placenta previa and accrete.

    Science.gov (United States)

    Li, Guang-Tai; Li, Xiao-Fan; Wu, Baoping; Li, Guangrui

    2016-04-01

    To assess the efficacy and safety of longitudinal parallel compression suture to control heavy postpartum hemorrhage (PPH) in patients with placenta previa/accreta. Fifteen women received a longitudinal parallel compression suture to stop life-threatening PPH due to placenta previa with or without accreta during cesarean section. The suture apposed the anterior and posterior walls of the lower uterine segment together using an absorbable thread A 70-mm round needle with a Number-1 absorbable thread was used. The point of needle entry was 1 cm above the upper margin of the cervix and 1 cm from the right lateral border of the lower segment of the anterior wall. The suture was threaded through the uterine cavity to the serosa of the posterior wall. Then, it was directed upward and threaded from the posterior to the anterior wall at ∼1-2 cm above the upper boundary of the lower uterine segment and 3-cm medial to the right margin of the uterus. Both ends of the suture were tied on the anterior aspect of uterus. The left side was sutured in the same way. The success rate of the procedure was 86.7% (13/15). Two of 15 cases were concurrently administered gauze packing and achieved satisfactory hemostasis. All patients resumed a normal menstrual flow, and no postoperative anatomical or physiological abnormalities related to the suture were observed. Three women achieved further pregnancies after the procedure. Longitudinal parallel compression suture is a safe, easy, effective, practical, and conservative surgical technique to stop intractable PPH from the lower uterine segment, particularly in women who have a cesarean scar and placenta previa/accreta. Copyright © 2016. Published by Elsevier B.V.

  16. [Application and development of suture-dragging therapy for anal fistula].

    Science.gov (United States)

    Wang, Chen; Yao, Yibo; Dong, Qingjun; Liang, Hongtao; Guo, Xiutian; Cao, Yongqing; Lu, Jingen

    2015-12-01

    Traditional Chinese surgical treatment "suture-dragging" therapy is based on medical thread therapy and tight seton drainage in combination of minimal invasive surgical principle. It can preserve the integrity of anal sphincter musculature involved in fistulous tract or abscess and maintain anal function. This article not only describes in detail about the operation points and mechanisms of "suture-dragging" therapy of anorectal fistula, but also reviews the application and modification of anorectal disease.

  17. No-drain DIEP Flap Donor-site Closure Using Barbed Progressive Tension Sutures

    OpenAIRE

    Nagarkar, Purushottam; Lakhiani, Chrisovalantis; Cheng, Angela; Lee, Michael; Teotia, Sumeet; Saint-Cyr, Michel

    2016-01-01

    Background: The use of progressive tension sutures has been shown to be comparable to the use of abdominal drains in abdominoplasty. However, the use of barbed progressive tension sutures (B-PTSs) in deep inferior epigastric artery perforator (DIEP) flap donor-site closure has not been investigated. Methods: A retrospective chart review was performed on patients with DIEP flap reconstruction in a 3-year period at 2 institutions by 2 surgeons. Patients were compared by method of DIEP donor-sit...

  18. Eğirdir Gölü'nde Gümüşi Havuz Balığı, Carassius gibelio (Bloch, 1782 Avcılığında Kullanılan Monofilament Fanyalı Ağların Seçiciliği

    Directory of Open Access Journals (Sweden)

    Bayram KORKMAZ

    2014-09-01

    Full Text Available In this study, it has been investigated that the characteristics of the selectivity of monofilament trammel nets having 50, 55, 60 mm bar length. This study was carried out on prussian carp Carassius gibelio (Bloch,1782 caught in Lake Eğirdir. An indirect method developed by Holt (1963 was used for determining the selectivity parameters. Common selection factor as SF=4.753 and common standard deviation as SD=2.347 were calculated for monofilament trammel nets. Common selection factor used of the optimum catch lengths of prussian carp in 50, 55 and 60 mm bar length were 23.77; 26.14 and 28.52 cm respectively. The optimum catch lengths were compared with lenghts at first maturity of prussian carp in Lake Eğirdir. Trammel nets of this study do not cause the overfishing on the prussian carp stock

  19. Iatrogenic Ulnar Nerve Injury post Laceration Suturing – An Unusual Presentation

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    Murali Mothilal

    2013-07-01

    Full Text Available Introduction: Nerve entrapment while suturing a lacerated wound is a complication that is easily avoidable. We report a case low ulnar nerve palsy due to nerve entrapment while suturing a lacerated wound. Case Report: A 48 year old lady came with complaints of pain and a lacerated wound over the dorsomedial aspect of lower third of the left forearm. The lacerated wound was sutured elsewhere one week back. She had fracture of lower third of the ulna which was stabilised with plates and screws using a separate dorsal incision. She developed ulnar claw hand on the third postoperative day. Strength duration curve revealed neurotmesis of ulnar nerve. Ulnar nerve exploration was done and the nerve was found to be ligated at the site of original laceration. The ligature was released and nerve was found to be thinned out at the site. There was no neurological recovery at 5 months follow up and reconstruction procedures in form of tendon tranfer are planned for the patient. Conclusion: This is a case of iatrogenic ulnar nerve palsy which is very rare in our literature. This can be easily avoided if proper care is taken while suturing the primary laceration. A nerve can be mistakenly sutured for a bleeding vein and proper exposure while suturing will be necessary especially at areas where nerves are superficial. Keywords: Iatrogenic, ulnar nerve palsy

  20. Virtual reality robotic surgery simulation curriculum to teach robotic suturing: a randomized controlled trial.

    Science.gov (United States)

    Kiely, Daniel J; Gotlieb, Walter H; Lau, Susie; Zeng, Xing; Samouelian, Vanessa; Ramanakumar, Agnihotram V; Zakrzewski, Helena; Brin, Sonya; Fraser, Shannon A; Korsieporn, Pira; Drudi, Laura; Press, Joshua Z

    2015-09-01

    The objective of this randomized, controlled trial was to assess whether voluntary participation in a proctored, proficiency-based, virtual reality robotic suturing curriculum using the da Vinci(®) Skills Simulator™ improves robotic suturing performance. Residents and attending surgeons were randomized to participation or non-participation during a 5 week training curriculum. Robotic suturing skills were evaluated before and after training using an inanimate vaginal cuff model, which participants sutured for 10 min using the da Vinci(®) Surgical System. Performances were videotaped, anonymized, and subsequently graded independently by three robotic surgeons. 27 participants were randomized. 23 of the 27 completed both the pre- and post-test, 13 in the training group and 10 in the control group. Mean training time in the intervention group was 238 ± 136 min (SD) over the 5 weeks. The primary outcome (improvement in GOALS+ score) and the secondary outcomes (improvement in GEARS, total knots, satisfactory knots, and the virtual reality suture sponge 1 task) were significantly greater in the training group than the control group in unadjusted analysis. After adjusting for lower baseline scores in the training group, improvement in the suture sponge 1 task remained significantly greater in the training group and a trend was demonstrated to greater improvement in the training group for the GOALS+ score, GEARS score, total knots, and satisfactory knots.

  1. The Double-Row Suture Technique: A Better Option for the Treatment of Haglund Syndrome.

    Science.gov (United States)

    Jiang, Yiqiu; Li, Yang; Tao, Tianqi; Li, Wang; Zhang, Kaibin; Gui, Jianchao; Ma, Yong

    2016-01-01

    Purpose. The purpose of this study is to investigate whether double-row suture technique is a better option for the treatment of Haglund syndrome than single-row suture technique regarding the surgical outcomes. Methods. Thirty-two patients with Haglund syndrome were recruited in this study. Patients were divided into Group 1 (treated with single-row suture technique) and Group 2 (treated with double-row suture technique). There were 16 patients in each group. The AOFAS-ankle-hindfoot scale, VISA-A scores, and Arner-Lindholm standard were used to assess the clinical outcomes. The pre- and postoperative X-rays were used to assess the radiological outcome. Results. Both AOFAS-ankle-hindfoot scale score and VISA-A score had varying degrees of improvement in both groups. In latest follow-up assessment, the Arner-Lindholm standard investigation showed there were 7 excellent, 7 good, and 2 bad outcomes in Group 1 and 12 excellent and 4 good outcomes in Group 2. In Group 2 patients, there were no more posterosuperior bony prominence of the calcaneum in post-op X-rays and there were no recurrent cases. The ankle-related scale score was statistically significantly higher in Group 2 than in Group 1 (P = 0.029). Conclusion. The double-row suture technique seems to be a better option to treat Haglund syndrome than single-row suture technique.

  2. The Double-Row Suture Technique: A Better Option for the Treatment of Haglund Syndrome

    Directory of Open Access Journals (Sweden)

    Yiqiu Jiang

    2016-01-01

    Full Text Available Purpose. The purpose of this study is to investigate whether double-row suture technique is a better option for the treatment of Haglund syndrome than single-row suture technique regarding the surgical outcomes. Methods. Thirty-two patients with Haglund syndrome were recruited in this study. Patients were divided into Group 1 (treated with single-row suture technique and Group 2 (treated with double-row suture technique. There were 16 patients in each group. The AOFAS-ankle-hindfoot scale, VISA-A scores, and Arner-Lindholm standard were used to assess the clinical outcomes. The pre- and postoperative X-rays were used to assess the radiological outcome. Results. Both AOFAS-ankle-hindfoot scale score and VISA-A score had varying degrees of improvement in both groups. In latest follow-up assessment, the Arner-Lindholm standard investigation showed there were 7 excellent, 7 good, and 2 bad outcomes in Group 1 and 12 excellent and 4 good outcomes in Group 2. In Group 2 patients, there were no more posterosuperior bony prominence of the calcaneum in post-op X-rays and there were no recurrent cases. The ankle-related scale score was statistically significantly higher in Group 2 than in Group 1 (P=0.029. Conclusion. The double-row suture technique seems to be a better option to treat Haglund syndrome than single-row suture technique.

  3. Keratometric astigmatism after ECCE in eastern Nepal. Continuous versus interrupted sutures.

    Directory of Open Access Journals (Sweden)

    Sood Archana

    2003-01-01

    Full Text Available Purpose: The study aimed to compute and compare the keratometric astigmatism induced by wound closure with continuous and interrupted sutures in conventional extracapsular cataract extraction with intraocular lens implantation at a single centre in eastern Nepal. Methods: Sixty eyes of 60 patients were included in the study. All patients received conventional extracapsular cataract extraction and single piece modified C-loop posterior chamber intraocular lens. Thirty eyes were sutured with continuous (Group 1 and 30 eyes with interrupted sutures (Group 2. The results were analysed by the unpaired student′s t-test. Results: At the end of 6 weeks, Group 1 patients had significantly higher astigmatism (3.53 ± 2.19D compared to Group 2 patients (1.7 ± 1.35. A majority of patients in both groups had with-the-rule astigmatism throughout the postoperative period. Conclusion: Interrupted sutures cause less astigmatism than continuous suture. The factors responsible for high astigmatism in continuous sutures call for further analysis.

  4. Asymmetric six-strand core sutures enhance tendon fatigue strength and the optimal asymmetry.

    Science.gov (United States)

    Kozono, N; Okada, T; Takeuchi, N; Hanada, M; Shimoto, T; Iwamoto, Y

    2016-10-01

    Under cyclic loading, we recorded the fatigue strength of a six-strand tendon repair with different symmetry in the lengths of suture purchase in two stumps of 120 dental rolls and in 30 porcine tendons. First, the strengths of the repairs with 1, 2, 3, 4 and 5 mm asymmetry were screened using the dental rolls. The asymmetric core suture repairs were then made with a Kessler repair of equal suture purchase (10 mm) in two tendon stumps, and shifting two other Kessler repairs by 1, 3 or 5 mm, respectively, along the longitudinal axis of the tendon in relation to the first (symmetric) Kessler repair. The core repairs with 3 mm or more asymmetry in suture purchases in two tendon ends showed significantly greater fatigue strength and significantly smaller gaps compared with 1 mm asymmetry in core suture repair. Our results support that asymmetric placement of core sutures in two tendon ends favour resisting gapping at the repair site and 3 mm or more asymmetry is needed to produce such beneficial effects. © The Author(s) 2016.

  5. Cranial Suture Closure in Domestic Dog Breeds and Its Relationships to Skull Morphology.

    Science.gov (United States)

    Geiger, Madeleine; Haussman, Sinah

    2016-04-01

    Bulldog-type brachycephalic domestic dog breeds are characterized by a relatively short and broad skull with a dorsally rotated rostrum (airorhynchy). Not much is known about the association between a bulldog-type skull conformation and peculiar patterns of suture and synchondrosis closure in domestic dogs. In this study, we aim to explore breed-specific patterns of cranial suture and synchondrosis closure in relation to the prebasial angle (proxy for airorhynchy and thus bulldog-type skull conformation) in domestic dogs. For this purpose, we coded closure of 18 sutures and synchondroses in 26 wolves, that is, the wild ancestor of all domestic dogs, and 134 domestic dogs comprising 11 breeds. Comparisons of the relative amount of closing and closed sutures and synchondroses (closure scores) in adult individuals showed that bulldog-type breeds have significantly higher closure scores than non-bulldog-type breeds and that domestic dogs have significantly higher closure scores than the wolf. We further found that the prebasial angle is significantly positively correlated with the amount of closure of the basispheno-presphenoid synchondrosis and sutures of the nose (premaxillo-nasal and maxillo-nasal) and the palate (premaxillo-maxillary and interpalatine). Our results show that there is a correlation between patterns of suture and synchondrosis closure and skull shape in domestic dogs, although the causal relationships remain elusive.

  6. The Development of the Calvarial Bones and Sutures and the Pathophysiology of Craniosynostosis.

    Science.gov (United States)

    Ishii, Mamoru; Sun, Jingjing; Ting, Man-Chun; Maxson, Robert E

    2015-01-01

    The skull vault is a complex, exquisitely patterned structure that plays a variety of key roles in vertebrate life, ranging from the acquisition of food to the support of the sense organs for hearing, smell, sight, and taste. During its development, it must meet the dual challenges of protecting the brain and accommodating its growth. The bones and sutures of the skull vault are derived from cranial neural crest and head mesoderm. The frontal and parietal bones develop from osteogenic rudiments in the supraorbital ridge. The coronal suture develops from a group of Shh-responsive cells in the head mesoderm that are collocated, with the osteogenic precursors, in the supraorbital ridge. The osteogenic rudiments and the prospective coronal suture expand apically by cell migration. A number of congenital disorders affect the skull vault. Prominent among these is craniosynostosis, the fusion of the bones at the sutures. Analysis of the pathophysiology underling craniosynostosis has identified a variety of cellular mechanisms, mediated by a range of signaling pathways and effector transcription factors. These cellular mechanisms include loss of boundary integrity, altered sutural cell specification in embryos, and loss of a suture stem cell population in adults. Future work making use of genome-wide transcriptomic approaches will address the deep structure of regulatory interactions and cellular processes that unify these seemingly diverse mechanisms.

  7. Performance Assessment of Bi-Directional Knotless Tissue-Closure Devices in Juvenile Chinook Salmon Surgically Implanted with Acoustic Transmitters, 2009 - Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Woodley, Christa M.; Wagner, Katie A.; Bryson, Amanda J.

    2012-11-09

    The purpose of this report is to assess the performance of bi-directional knotless tissue-closure devices for use in tagging juvenile salmon. This study is part of an ongoing effort at Pacific Northwest National Laboratory (PNNL) to reduce unwanted effects of tags and tagging procedures on the survival and behavior of juvenile salmonids, by assessing and refining suturing techniques, suture materials, and tag burdens. The objective of this study was to compare the performance of the knotless (barbed) suture, using three different suture patterns (treatments: 6-point, Wide “N”, Wide “N” Knot), to the current method of suturing (MonocrylTM monofilament, discontinuous sutures with a 2×2×2×2 knot) used in monitoring and research programs with a novel antiseptic barrier on the wound (“Second Skin”).

  8. Dynamics and Preservation Potential of Subduction Complexes in Continental Sutures: A Case Study from the Sedimentary-Marix Mélange of the Indus-Yarlung Suture Zone in Southern Tibet

    Science.gov (United States)

    Metcalf, K.; Kapp, P. A.; Orme, D. A.

    2015-12-01

    Intra-continental sutures are the geologic record of ancient subduction zones. Subduction complexes are a useful record of ancient continental collisions because they preserve sediments and/or blocks from units which have since eroded and are the first point of contact during collision. The India-Asia collision is one of the most-studied collisional orogens, but how much of the original subduction complex is preserved and what we can determine about the dynamics of the ancient subduction zone along the southern margin of Asia is poorly understood. Compared to other subduction complexes around the world, the complex preserved in the Indus Yarlung Suture Zone (IYSZ) of southern Tibet is anomalous. Blueschist facies metamorphism, a prominent mineral assemblage along intra-continental suture zones, is common in the northwest Himalaya, but not found along the central segment of the IYSZ. Most of the subduction complex is greenschist facies, inconsistent with the geotherm for a subduction zone. We present a metamorphic history for the greenschist facies rocks to reconcile this contradiction. A deep forearc basin (~5-8 km) developed during the Cretaceous, requiring an accretionary subduction zone, a topographic or structural outer forearc high behind which to trap sediment, and/or basal subduction erosion. The preserved subduction complex is almost entirely tectonic sedimentary-matrix mélange with minor outcrops of overlying turbidites. We present evidence from detrital zircon U-Pb geochronology of sandstones that indicate along-strike variability in the provenance of the sedimentary-matrix mélange. For example, both lower and upper plate material are present near the town of Ngamring, while regions along-strike to the west contain little to no upper plate material. The blocks in the sedimentary-matrix mélange are well-mixed throughout kilometers of exposed width. Sandstone blocks of Tethyan affinity, which could have entered the trench only at the onset of collision

  9. Percutaneous suturing of the ruptured Achilles tendon with endoscopic control.

    Science.gov (United States)

    Doral, Mahmut Nedim; Bozkurt, Murat; Turhan, Egemen; Ayvaz, Mehmet; Atay, Ozgür Ahmet; Uzümcügil, Akin; Leblebicioğlu, Gürsel; Kaya, Defne; Aydoğ, Tolga

    2009-08-01

    A prospective study of modified percutaneous Achilles tendon repair performed between 1999 and 2005 under local infiltration anesthesia is presented; the study evaluated the results of percutaneous repair technique by visualization of the synovia under endoscopic control, followed by early functional postoperative treatment for surgical intervention of acute Achilles tendon ruptures. Sixty-two patients (58 males, 4 females, mean age 32) were treated by percutaneous suturing with modified Bunnel technique under endoscopic control within 10 days after acute total rupture. Physiotherapy was initiated immediately after the operation and patients were encouraged to weight-bearing ambulation with a walking brace-moon boot as tolerated. Full weight-bearing was allowed minimum after 3 weeks postoperatively without brace. The procedure was tolerated in all patients. There were no significant ROM limitation was observed. Two patients experienced transient hypoesthesia in the region of sural nerve that spontaneously resolved in 6 months. Fifty-nine patients (95%) including professional athletes returned to their previous sportive activities, while 18 of them (29%) had some minor complaints. The interval from injury to return to regular work and rehabilitation training was 11.7 weeks (10-13 weeks). At the latest follow-up (mean: 46 months; range: 12-78 months), all the patients had satisfactory results with a mean American Orthopedic Foot and Ankle Society's ankle-hindfoot score of 94.6. No re-ruptures, deep venous thrombosis or wound problems occurred. The proposed method offers a reasonable treatment option for acute total Achilles tendon rupture with a low number of complications. The rerupture rate and return to preinjury activities are comparable to open and percutaneous without endoscopic control procedures.

  10. 三种缝线材料对人肺腺癌细胞A549增殖和细胞周期的影响%Effect of three suture lines on the proliferation and cell cycle of lung adenocarcinoma cell A549 in vitro

    Institute of Scientific and Technical Information of China (English)

    Lianhua Ye; Yunchao Huang; Qilin Jin; Feng Hua; Guangqiang Zhao

    2011-01-01

    Objective: The interaction of cell and medical biomaterial is one of the significant factors to affect clinical application of medical biomaterial. This research is to investigate three of suture lines how to affect the proliferation and cell cycle of lung adenocarcinoma cell A549 in vitro. Methods: Three of suture lines were respectively cultivated with lung adenocarcinoma cell A549, after of 72 hours, we detected absorptions of each group by MTT method in order to reflect the proliferation of lung adenocarcinoma cell A549, and also examined percentage of G1 period cells and S period cells of each group by flow cytometry. Results: Different of suture lines had different effects on the proliferation and cell cycle of lung adenocarcinoma cell A549 (P < 0.05). The effect of absorbent suture line was the strongest on the proliferation and cell cycle of lung adenocarcinoma cell A549, the effect of chorda serica chirurgicalis was medium, and the effect of slide wire was poor. Different length of each suture line had different effects on the proliferation and cell cycle of lung adenocarcinoma cell A549 (P < 0.05).Conclusion: Three of suture line materials have different effects on the proliferation and cell cycle of lung adenocarcinoma cell A549, with dose-effect relationship.

  11. Clinical Observation of Two Kinds of Suture of the Perineal Suture%两种缝线两种会阴缝合的临床观察

    Institute of Scientific and Technical Information of China (English)

    王建华

    2014-01-01

    Objective To investigate the clinical ef ect of legitimate perineal suture. Methods 200 cases of vaginal delivery. Were randomly divided into observation group and control group two groups, each of 100 cases. The two group contains perineal incision 50 people left and perineal tear 50 nature. 2% lidocaine local infiltration anesthesia. The observation group 2-0 catgut suture, perineal suture. The control with 4 silk interrupted perineal suture. Results The two groups in the post natal maternal incision pain, 72 hours of activity level dif erences were statistical y significant ( <0.05). The observation group 2-0 catgut, continuous suture applies to the perineum wound (including side cut and split wound).Conclusion Tthe observation group using continuous suture in postpartum postpartum incision pain and activity limitation is superior to the control group of the suture.%目的探讨会阴缝合法的临床应用效果。方法选择阴道分娩产妇200例。随机分成观察组和对照组两组,各100例。两组均包含会阴左侧切口50例及会阴自然撕裂口50例。2%的利多卡因局部浸润麻醉。观察组2-0医用羊肠线,连续缝合法行会阴缝合术。对照用4号丝线间断会阴缝合法。结果两组在产后切口疼痛,产妇72h活动程度方面差异均有统计学意义(均<0.05)。采用观察组2-0医用羊肠线,连续缝合法适用于会阴伤口(包括侧切及裂开伤口)。结论观察组采用连续缝合法在产后切口疼痛及产后活动受限方面明显优于对照组的间断缝合法。

  12. Mesoproterozoic suturing of Archean crustal blocks in western peninsular India: Implications for India-Madagascar correlations

    Science.gov (United States)

    Ishwar-Kumar, C.; Santosh, M.; Wilde, S. A.; Tsunogae, T.; Itaya, T.; Windley, B. F.; Sajeev, K.

    2016-10-01

    The Kumta and Mercara suture zones welding together Archean crustal blocks in western peninsular India offer critical insights into Precambrian continental juxtapositions and the crustal evolution of eastern Gondwana. Here we present the results from an integrated study of the structure, geology, petrology, mineral chemistry, metamorphic P-T conditions, zircon U-Pb ages and Lu-Hf isotopes of metasedimentary rocks from the two sutures. The dominant rocks in the Kumta suture are greenschist- to amphibolite-facies quartz-phengite schist, garnet-biotite schist, chlorite schist, fuchsite schist and marble. The textural relations, mineral chemistry and thermodynamic modelling of garnet-biotite schist from the Kumta suture indicate peak metamorphic P-T conditions of ca. 11 kbar at 790 °C, with detrital SHRIMP U-Pb zircon ages ranging from 3420 to 2547 Ma, εHf (t) values from - 9.2 to 5.6, and TDMc model ages from 3747 to 2792 Ma. The K-Ar age of phengite from quartz-phengite schist is ca. 1326 Ma and that of biotite from garnet-biotite schist is ca. 1385 Ma, which are interpreted to broadly constrain the timing of metamorphism related to the suturing event. The Mercara suture contains amphibolite- to granulite-facies mylonitic quartzo-feldspathic gneiss, garnet-kyanite-sillimanite gneiss, garnet-biotite-kyanite-gedrite-cordierite gneiss, garnet-biotite-hornblende gneiss, calc-silicate granulite and metagabbro. The textural relations, mineral chemistry and thermodynamic modelling of garnet-biotite-kyanite-gedrite-cordierite gneiss from the Mercara suture indicate peak metamorphic P-T conditions of ca. 13 kbar at 825 °C, followed by isothermal decompression and cooling. For pelitic gneisses from the Mercara suture, LA-ICP-MS U-Pb zircon ages vary from 3249 to 3045 Ma, εHf (t) values range from - 18.9 to 4.2, and TDMc model ages vary from 4094 to 3314 Ma. The lower intercept age of detrital zircons in the pelitic gneisses from the Mercara suture ranges from 1464 to 1106

  13. Acute Achilles tendon rupture: Mini-incision repair with double-Tsuge loop suture vs. open repair with modified Kessler suture.

    Science.gov (United States)

    Fu, Chongyang; Qu, Wei

    2015-08-01

    Achilles tendon rupture is a common injury of the foot and ankle. However, the optimal treatment strategy for Achilles tendon rupture is still not established. This study was conducted to compare the efficacy and complications of mini-incision repair with double-Tsuge loop sutures and open repair with modified Kessler sutures. We evaluated data from 60 patients with acute closed Achilles tendon ruptures who underwent mini-incision repair with double-Tsuge loop sutures (n = 30) or open repair with modified Kessler sutures (n = 30) from 2006 to 2010 in an ongoing prospective study conducted by us and have finished at least 18-month follow-up or finished the study. The AOFAS Ankle-Hindfoot score, ATRS, maximal ankle range of motion and the time to achieve 20 continuous single heel raises after operation were recorded to compare the efficacy. The complications were also evaluated. During a mean follow-up of 25 months after surgery, the time to achieve 20 continuous single heel raises after operation of patients in Group Mini was significantly shorter than patients in Group Open. Moreover, the mini-incision with double-Tsuge repair was associated with a significantly shorter operating time, smaller incision length, and lower rate of complications. The mini-incision with double-Tsuge suture method in our study was shown to provide earlier strength recovery, as well as shorter operation time, less complications and improved cosmetic appearance. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  14. Biomechanical Performance of Medial Row Suture Placement Relative to the Musculotendinous Junction in Transosseous Equivalent Suture Bridge Double-Row Rotator Cuff Repair.

    Science.gov (United States)

    Virk, Mandeep S; Bruce, Benjamin; Hussey, Kristen E; Thomas, Jacqueline M; Luthringer, Tyler A; Shewman, Elizabeth F; Wang, Vincent M; Verma, Nikhil N; Romeo, Anthony A; Cole, Brian J

    2017-02-01

    To compare the biomechanical performance of medial row suture placement relative to the musculotendinous junction (MTJ) in a cadaveric transosseous equivalent suture bridge (TOE-SB) double-row (DR) rotator cuff repair (RCR) model. A TOE-SB DR technique was used to reattach experimentally created supraspinatus tendon tears in 9 pairs of human cadaveric shoulders. The medial row sutures were passed either near the MTJ (MTJ group) or 10 mm lateral to the MTJ (rotator cuff tendon [RCT] group). After the supraspinatus repair, the specimens underwent cyclic loading and load to failure tests. The localized displacement of the markers affixed to the tendon surface was measured with an optical tracking system. The MTJ group showed a significantly higher (P = .03) medial row failure (5/9; 3 during cyclic testing and 2 during load to failure testing) compared with the RCT group (0/9). The mean number of cycles completed during cyclic testing was lower in the MTJ group (77) compared with the RCT group (100; P = .07) because 3 specimens failed in the MTJ group during cyclic loading. There were no significant differences between the 2 study groups with respect to biomechanical properties during the load to failure testing. In a cadaveric TOE-SB DR RCR model, medial row sutures through the MTJ results in a significantly higher rate of medial row failure. In rotator cuff tears with tendon tissue loss, passage of medial row sutures through the MTJ should be avoided in a TOE-SB RCR technique because of the risk of medial row failure. Copyright © 2016. Published by Elsevier Inc.

  15. The effect of suture-button fixation on simulated syndesmotic malreduction: a cadaveric study.

    Science.gov (United States)

    Westermann, Robert W; Rungprai, Chamnanni; Goetz, Jessica E; Femino, John; Amendola, Annunziato; Phisitkul, Phinit

    2014-10-15

    The accuracy of reduction of distal tibiofibular syndesmosis disruptions has been associated with the clinical outcome. Suture-button fixation of the syndesmosis is a dynamic alternative mode of fixation. We hypothesized that with deliberate clamp-induced malreduction, suture-button fixation of the syndesmosis would allow a more anatomic post-fixation position compared with screw fixation. Forty-eight syndesmotic fixations were performed on twelve through-knee cadaveric specimens. The syndesmosis was destabilized and off-axis clamping was used to produce both anterior and posterior malreduction patterns. In twelve scenarios (six anterior and six posterior malreductions), syndesmotic screw fixation was used, followed by computed tomography. With tenacula holding the malreduction, the syndesmosis screws were exchanged for a suture-button construct and the specimens underwent a subsequent computed tomography scan. In the other twelve scenarios, the suture-button fixation was achieved first, followed by screw fixation. Standardized measurements of anterior-posterior and medial-lateral fibular displacement were performed by two observers blinded to the method of fixation. With anterior off-axis clamping, the mean sagittal malreduction was 2.7 ± 2.0 mm with screw fixation and 1.0 ± 1.0 mm with suture-button fixation (p = 0.02). With posterior off-axis clamping, the sagittal malreduction was 7.2 ± 2.3 mm with screw fixation and 0.5 ± 1.4 mm with suture-button fixation (p button fixation of the syndesmosis results in less post-fixation displacement compared with screw fixation. The suture button's ability to allow for natural correction of deliberate malreduction was greatest with posterior off-axis clamping. Although the clinical relevance is unknown, dynamic syndesmotic fixation may mitigate clamp-induced malreduction. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

  16. Biomechanical analysis of suture locations of the distal plantar fascia in partial foot.

    Science.gov (United States)

    Guo, Jun-Chao; Wang, Li-Zhen; Mo, Zhong-Jun; Chen, Wei; Fan, Yu-Bo

    2015-12-01

    The aim of this study was to evaluate the rationality of the suture locations of distal plantar fascia (DPF) after foot amputation to avoid the risk factors of re-amputation or plantar fasciitis. The tensile strain of plantar fascia (PF) in the different regions was measured by uni-axial tensile experiment. A three-dimensional (3D) finite element model was also developed to simulate tensile behaviour of PF in weight bearing conditions. The model includes 12 bones, ligaments, PF, cartilage and soft tissues. Four suture location models for the DPF were considered: the fourth and fifth DPF were sutured on the third metatarsal, the cuboid, and both the third metatarsal and the cuboid, and one un-sutured model. The peak tensile strain of the first, second and third PF was 0.134, 0.128 and 0.138 based on the mechanical test, respectively. The fourth and fifth DPF sutured at the cuboid and the third metatarsal could offer more favourable outcomes. The peak strain of 4.859 × 10(-2), 2.347 × 10(-2) and 1.364 × 10(-2) in the first, second and third PF showed the least outcomes in stance phase. Also, peak strain and stress of the residual PF reduced to 4.859 × 10(-2) and 1.834 MPa, respectively. The stress region was redistributed on the mid-shaft of the first and third PF and the peak stress of medial cuneiform bone evidently decreased. The fourth and fifth DPF suture at the third metatarsal and cuboid was appropriate for the partial foot. The findings are expected to suggest optimal surgical plan of the DPF suture and guide further therapeutic planning of partial foot patients.

  17. Prediction of rapid maxillary expansion by assessing the maturation of the midpalatal suture on cone beam CT

    Directory of Open Access Journals (Sweden)

    Fernanda Angelieri

    Full Text Available ABSTRACT Rapid maxillary expansion (RME primarily involves the mechanical opening of the midpalatal suture of the maxillary and palatine bones. The fusion of the midpalatal suture determines the failure of RME, a common event in late adolescents and young adults. Recently, the assessment of the maturation of midpalatal suture as viewed using cone beam computed tomography (CBCT has been introduced. Five maturational stages of the midpalatal suture have been presented: Stage A = straight high-density sutural line, with no or little interdigitation; Stage B = scalloped appearance of the high-density sutural line; Stage C = two parallel, scalloped, high-density lines that lie close to each other, separated in some areas by small low-density spaces; Stage D = fusion of the palatine bone where no evidence of a suture is present; and Stage E = complete fusion that extends also anteriorly in the maxilla. At Stage C, less skeletal response would be expected than at Stages A and B, as there are many bony bridges along the suture. For patients at Stages D and E, surgically assisted RME would be necessary, as the fusion of the midpalatal suture already has occurred either partially or totally. This diagnostic method can be used to estimate the prognosis of the RME, mainly for late adolescents and young adults for whom this procedure is unpredictable clinically.

  18. Prediction of rapid maxillary expansion by assessing the maturation of the midpalatal suture on cone beam CT

    Science.gov (United States)

    Angelieri, Fernanda; Franchi, Lorenzo; Cevidanes, Lucia H. S.; Bueno-Silva, Bruno; McNamara, James A.

    2016-01-01

    ABSTRACT Rapid maxillary expansion (RME) primarily involves the mechanical opening of the midpalatal suture of the maxillary and palatine bones. The fusion of the midpalatal suture determines the failure of RME, a common event in late adolescents and young adults. Recently, the assessment of the maturation of midpalatal suture as viewed using cone beam computed tomography (CBCT) has been introduced. Five maturational stages of the midpalatal suture have been presented: Stage A = straight high-density sutural line, with no or little interdigitation; Stage B = scalloped appearance of the high-density sutural line; Stage C = two parallel, scalloped, high-density lines that lie close to each other, separated in some areas by small low-density spaces; Stage D = fusion of the palatine bone where no evidence of a suture is present; and Stage E = complete fusion that extends also anteriorly in the maxilla. At Stage C, less skeletal response would be expected than at Stages A and B, as there are many bony bridges along the suture. For patients at Stages D and E, surgically assisted RME would be necessary, as the fusion of the midpalatal suture already has occurred either partially or totally. This diagnostic method can be used to estimate the prognosis of the RME, mainly for late adolescents and young adults for whom this procedure is unpredictable clinically. PMID:28125147

  19. Suture-button versus screw fixation of the syndesmosis: a biomechanical analysis.

    Science.gov (United States)

    Klitzman, Robert; Zhao, Heng; Zhang, Li-Qun; Strohmeyer, Greg; Vora, Anand

    2010-01-01

    The treatment of ankle fractures with syndesmotic injuries associated with disruption of the deltoid ligament complex is controversial. The purpose of this study was to compare both the biomechanical and physiologic properties of suture-button fixation to the intact syndesmosis and screw fixation. Eight fresh frozen human cadaveric ankles were used in three different groups. One group had an intact syndesmosis and deltoid ligamentous complex and two groups had fixation of the syndesmosis after its disruption along with disruption of the deltoid ligaments. One fixation group used a suture-button and the other used a 3.5-mm tricortical syndesmotic screw. The syndesmotic gap after cycling at submaximal loads, laxity due to cycling, and fibular movement allowed in the sagittal plane were all measured and analyzed for statistical significance. The syndesmotic gap after cycling was not significantly different between the intact group (9.1 mm) and the suture-button group (8.8 mm) (p = 0.1509). The screw fixation group had a significantly smaller gap (7.9 mm) as compared to the other two groups (screw versus intact, p = 0.00004; screw versus suture-button, p = 0.0004). The intact group did not demonstrate a significant difference in laxity before (9.0 mm) and after (9.1 mm) cycling (p = 0.0670), whereas the suture-button group did have a significant difference (before, 8.01 mm; after, 8.28 mm) (p = 0.000251). The movement of the fibula in the sagittal plane was significantly greater in the suture-button group (3.17 mm) as compared to the intact group (2.77 mm) (p = 0.00554). Screw fixation allowed significantly less fibular movement in the sagittal plane (1.16 mm) as compared to the intact (p = 0.00014) and suture-button (p = 0.0000012) groups. Suture-button fixation maintained reduction after cycling with submaximal loads that compared favorably to the intact syndesmosis. It also allowed more physiologic movement of the fibula in the sagittal plane when compared to

  20. Tram-Track Suture Technique for Pupillary Capture of a Scleral Fixated Intraocular Lens

    Science.gov (United States)

    Kim, Sung In; Kim, Kiseok

    2016-01-01

    Purpose To report a new technique using tram-track suture for pupillary capture of a scleral fixated posterior chamber intraocular lens (PC-IOL) to reposition the tilted IOL. Methods In this prospective interventional case series, we describe a tram-track suture for pupillary capture of a scleral fixated PC-IOL. A long straight needle with double-armed 10-0 polypropylene is passed behind the iris and just above the optic portion (tilted forward) of the IOL. The other straight needle with double-armed 10-0 polypropylene is passed just below the optic portion (tilted backward) of the IOL. After the IOL is repositioned properly, the polypropylene sutures are gently pulled and tied. Results Four eyes of 4 patients underwent tram-track suture for pupillary capture of a scleral fixated PC-IOL. No intra- or postoperative complications were noted, and no pupillary captures were detected during the follow-up period. Conclusions The tram-track suture technique provides good centration and stability of a PC-IOL. This technique is an easy and effective way to reposition pupillary capture of an IOL. Further, it is also minimally invasive as it maintains a closed system. PMID:27462257

  1. Mitral valve repair: is there still a place for suture annuloplasty?

    Science.gov (United States)

    Fundarò, Pino; Tartara, Paolo M; Villa, Emmanuel; Fratto, Pasquale; Campisi, Salvatore; Vitali, Ettore O

    2007-08-01

    Prosthetic ring annuloplasty is considered the gold standard technique for mitral valve repair, but it has been associated with some drawbacks. Suture annuloplasty is less expensive and may have some physiopathologic advantages. We reviewed the literature to assess clinical results of mitral suture annuloplasty. Thirteen series, each reporting more than 50 patients and published in the last 10 years, were included in the analysis. They comprised 1,648 patients with cumulative follow-up of 5,607 patient-years. Our review suggests that suture annuloplasty is a safe procedure, but a trend toward recurrence of annular dilatation with time was reported. In selected cases, suture annuloplasty is effective, and its mid-term clinical results are encouraging and compare well with those of prosthetic ring repair series. The quality of the results varies according to the particular annuloplasty technique used and to the mitral valve pathology treated. Recent technical modifications have been found to decrease the incidence of repair failure and promise to improve the reproducibility of the procedure. Further investigations are warranted to better assess the long-term results of suture annuloplasty, and to determine whether its theoretical functional advantages translate into a real clinical benefit.

  2. Vascular anomalies, sutures and small canals of the temporal bone on axial CT

    Energy Technology Data Exchange (ETDEWEB)

    Koesling, Sabrina [Department of Diagnostic Radiology, University of Halle, E. Grube Str. 40, 06097 Halle (Germany)]. E-mail: sabrina.koesling@medizin.uni-halle.de; Kunkel, Petra [Department of Diagnostic Radiology, University of Leipzig (Germany); Schul, Thomas [Department of Diagnostic Radiology, University of Leipzig (Germany)

    2005-06-01

    Purpose: Subtle bony structures, small canals and fine sutures cause sometimes problems in the analysis of CTs of the temporal bone. The aim of this study was: to analyze the visibility of subtle structures and to estimate the incidence of vascular anomalies. Patients and method: We retrospectively analyzed axial scans of 223 high-resolution CTs of the temporal bone obtained as single slice or spiral CT with 1 mm slice thickness. All CTs had clinical indications. Two experienced radiologists studied CTs regarding the visibility of the fine sutures, fissures and small canals and the occurrence of vascular anomalies. Results: The following structures were seen commonly: sphenosquamosal suture (76%), arcuate artery canal (93%), vestibular aqueduct (89%), mastoid emissary vein (82%), singular canal (56%). Not so commonly were observed: tympanosquamosal suture (31%), mastoid canaliculus (28%), lateral sigmoid sinus (28%), petrotympanic fissure (24%), tympanomastoid suture (10%). Seldom we identified: the inferior tympanic canaliculus (6%), high jugular bulb (6%), anterior sigmoid sinus (5%), dehiscent internal carotid artery canal (2%), persistent petrosquamosal sinus (1%), dehiscent jugular bulb (1%). Persistent stapedial artery, aberrant internal carotid artery, dehiscent jugular bulb, high jugular bulb with diverticulum, anterior and dehiscent sigmoid sinus were detected in below 1% of the analyzed temporal bones. The frequency of asymmetry of the jugular foramen, which varied between 3% and 42%, depended on different criterions of size. Conclusion: A profound knowledge of normal anatomy and anomalies of the temporal bone avoids misinterpretation as pathological lesions and iatrogenic bleedings.

  3. Visibility of sutures of the orbit and periorbital region using multidetector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Gufler, Hubert; Preis, Markus; Koesling, Sabrina [Dept. of Diagnostic Radiology, Martin-Luther-University Halle-Wittenberg, Halle (Germany)

    2014-12-15

    Knowledge of cranial suture morphology is crucial in emergency medicine, forensic medicine, and maxillofacial reconstructive surgery. This study assessed the visibility of sutures of the orbit and periorbital region on multidetector computed tomography. Multidetector computed tomography scans of 200 patients (127 males, 73 females; mean age 51.3 years; range, 6-92 years) were evaluated retrospectively. The slice thicknesses varied from 0.5 to 1 mm, and the tube current from 25 to 370 mAs, depending on the CT indication. The visibility of sutures was estimated according to a 4-point scale from 'not visible to well visible' The chi-squared test was used to test the association of the visibility of sutures with the slice thickness, tube current, and age of patients. Statistical significance was assumed at p < 0.05. Overall, best visibility was found for the sutura frontozygomatica (98%), sutura frontonasalis (88.5%), and sutura sphenozygomatica (71.5%), followed by the sutura zygomaticomaxillaris (65.8%), sutura temporozygomatica (41.8%), sutura frontomaxillaris (44.5%), and sutura sphenofrontalis (31%). Poor visibility was found for the sutura frontolacrimalis (16.8%) and sutura frontoethmoidalis (1.3%). The sutura ethmoidomaxillaris, sutura lacrimomaxillaris, and sutura ethmoidolacrimalis were not visible. Although the sutures of the superior, lateral, and inferior orbit are well visible, those of the medial orbit are poorly visible on CT scans.

  4. Low incidence of failure after proximal biceps tenodesis with unicortical suture button.

    Science.gov (United States)

    Cook, Jay B; Sedory, David M; Freidl, Michael C; Adams, Douglas R

    2017-09-01

    Recent interest in suture button fixation has developed with regard to proximal biceps tenodesis fixation. Biomechanical studies have demonstrated viability of a unicortical suture button technique in vitro. Despite this, no clinical data has been reported to validate the biomechanical data. The purpose of this study is to report on complication and failure rates in the early postoperative period after bicep tenodesis with a unicortical suture button. A retrospective review was performed of all biceps tenodesis performed at our institution over a 36-month period using a unicortical suture button for fixation. All included patients had a minimum 12 weeks follow up. Failures were defined as complete loss of fixation, change in biceps contour during the early postoperative period, acute pain at the tenodesis site, or acute loss of supination strength. 145 of 166 biceps tenodesis procedures performed by the 4 surgeons at our institution met inclusion criteria. 80.1% of the patients were active duty military at the time of surgery. The average age was 38.2 years. There were 7 total complications (4.8%), including one failure (0.7%) requiring revision. Failure and complication rates in the early postoperative period using a unicortical suture button for biceps tenodesis fixation are consistent with other reported techniques. This study adds clinical data to the existing biomechanical reports that this technique is strong enough to provide stable fixation of the biceps tendon to allow healing of the tendon to the humerus.

  5. Suture knot on the repair splint: a simple method to facilitate reconstruction of the sella turcica during endonasal endoscopic transsphenoidal surgery. Technical note.

    Science.gov (United States)

    Kubo, Shigeki; Hasegawa, Hiroshi; Inui, Toshihiko; Tominaga, Shinsuke; Yoshimine, Toshiki

    2005-05-01

    Reconstruction of the sellar floor after pituitary tumor removal is sometimes difficult because the repair graft is difficult to handle in the narrow space. This is especially problematic if the endonasal endoscopic approach is used. The authors devised a technique to facilitate this procedure by placing a suture knot on the repair splint. This allows the material to be grasped securely with forceps and improves manipulation even within the narrow nasal cavity. This technique has proved useful when performing the endonasal endoscopic approach, and it is also expected to be useful when conducting the conventional sublabial transsphenoidal approach.

  6. Entrapment of Common Peroneal Nerve by Surgical Suture following Distal Biceps Femoris Tendon Repair

    Directory of Open Access Journals (Sweden)

    Aki Fukuda

    2016-01-01

    Full Text Available We describe entrapment of the common peroneal nerve by a suture after surgical repair of the distal biceps femoris tendon. Complete rupture of the distal biceps femoris tendon of a 16-year-old male athlete was surgically repaired. Postoperative common peroneal nerve palsy was evident, but conservative treatment did not cause any neurological improvement. Reexploration revealed that the common peroneal nerve was entrapped by the surgical suture. Complete removal of the suture and external neurolysis significantly improved the palsy. The common peroneal nerve is prone to damage as a result of its close proximity to the biceps femoris tendon and it should be identified during surgical repair of a ruptured distal biceps femoris tendon.

  7. Can we save a follow up appointment by leaving nylon sutures under plaster for 6 weeks

    Directory of Open Access Journals (Sweden)

    Randeep Aujla

    2010-02-01

    Full Text Available Randeep Aujla, Abhinav Gulihar, Andrew Chandraraj, Graham TaylorOrthopaedic Department, Glenfield Hospital, Groby Road, Leicester, EnglandBackground: The purpose of this study was to highlight the potential resource saving method of leaving nylon sutures under plaster for 6 weeks after forefoot surgery. Methods: We gathered patient data from 72 cases of forefoot surgery over a 5-year period and analyzed the complications encountered. Only patients who required at least 6 weeks of plaster were included.Results: There were two cases of wound infection and one of flap necrosis. The infection rates are comparable to previous studies into forefoot surgery infection rates. There was no difficulty in removing the sutures and scarring was not noted to be a problem.Conclusions: Financial, convenience and time benefits could be obtained if this technique was in common practice.Keywords: elective forefoot surgery, wound infections, wound complications, nylon sutures

  8. [Intraligamentous suture of a scapholunar ligament lesion in a 9-year-old child].

    Science.gov (United States)

    Alt, V; Sicre, G; Schad, A

    2002-10-01

    Scapholunate dissociation is a well-known injury in adult patients. In pediatric patients, repair of this injury in the skeletally immature carpus has been previously reported. However, in none of these case studies is single ligamentous suture performed. We report a case of scapholunate dissociation in a 9-year-old boy after an initial Salter I injury of the distal radius. After 6 weeks of wrist immobilization, arthroscopy was performed due to persisting pain over the scapholunate gap, a positive Watson sign, and limited range of motion. This arthroscopy revealed intraligamentous rupture of the scapholunate ligament. Suture repair of the scapholunate ligament was performed. The suture was protected by a temporary K-wire arthrodesis for 8 weeks. One year after removal of the K-wire, the patient is completely free of symptoms and resumes all sport activities.

  9. Randomized clinical trial of self-gripping mesh versus sutured mesh for Lichtenstein hernia repair

    DEFF Research Database (Denmark)

    Jorgensen, L N; Sommer, T; Assaadzadeh, S;

    2012-01-01

    between the groups in postoperative complications (33·7 versus 40·4 per cent; P = 0·215), rate of recurrent hernia within 1 year (1·2 per cent in both groups) or quality of life. CONCLUSION: The avoidance of suture fixation using a self-gripping mesh was not accompanied by a reduction in chronic symptoms......BACKGROUND: Many patients develop discomfort after open repair of a groin hernia. It was hypothesized that suture fixation of the mesh is a cause of these symptoms. METHODS: This patient- and assessor-blinded randomized multicentre clinical trial compared a self-gripping mesh (Parietene Progrip......(®) ) and sutured mesh for open primary repair of uncomplicated inguinal hernia by the Lichtenstein technique. Patients were assessed before surgery, on the day of operation, and at 1 and 12 months after surgery. The primary endpoint was moderate or severe symptoms after 12 months, including a combination...

  10. Diaphragmatic suture with tubular stomach to prevent early delayed gastric emptying after esophagectomy

    Institute of Scientific and Technical Information of China (English)

    Chao Sun; Weiping Shi; Yusheng Shu; Hongcan Shi; Shichun Lu; Kang Wang

    2015-01-01

    Objective The objective of this study was to evaluate the clinical ef icacy of a diaphragmatic suture with tubular stomach to prevent delayed gastric emptying (DGE) after esophagectomy through the cervico-tho-racoabdominal approach. Methods A total of 980 patients with esophageal cancer undergoing esophagectomy through the cer-vico-thoracoabdominal approach were retrospectively included in this study and divided into two groups. Al patients underwent tubular stomach creation (group A; n = 530) or a diaphragmatic suture and tubular stomach creation (group B; n = 450). The incidence of early DGE was observed. Results The incidence of early DGE in group A was significantly higher than that in group B (P Conclusion This observation study suggests that the use of a diaphragmatic suture with tubular stomach through the cervico-thoracoabdominal approach can decrease the incidence of early DGE after esopha-gectomy.

  11. Novel high efficient coatings for anti-microbial surgical sutures using chlorhexidine in fatty acid slow-release carrier systems.

    Directory of Open Access Journals (Sweden)

    Andreas Obermeier

    Full Text Available Sutures can cause challenging surgical site infections, due to capillary effects resulting in bacteria permeating wounds. Anti-microbial sutures may avoid these complications by inhibiting bacterial pathogens. Recently, first triclosan-resistances were reported and therefore alternative substances are becoming clinically relevant. As triclosan alternative chlorhexidine, the "gold standard" in oral antiseptics was used. The aim of the study was to optimize novel slow release chlorhexidine coatings based on fatty acids in surgical sutures, to reach a high anti-microbial efficacy and simultaneously high biocompatibility. Sutures were coated with chlorhexidine laurate and chlorhexidine palmitate solutions leading to 11, 22 or 33 µg/cm drug concentration per length. Drug release profiles were determined in aqueous elutions. Antibacterial efficacy against Staphylococcus aureus was assessed in agar diffusion tests. Biocompatibility was evaluated via established cytotoxicity assay (WST-1. A commercially triclosan-containing suture (Vicryl Plus, was used as anti-microbial reference. All coated sutures fulfilled European Pharmacopoeia required tensile strength and proved continuous slow drug release over 96 hours without complete wash out of the coated drug. High anti-microbial efficacy for up to 5 days was observed. Regarding biocompatibility, sutures using 11 µg/cm drug content displayed acceptable cytotoxic levels according to ISO 10993-5. The highest potential for human application were shown by the 11 µg/cm chlorhexidine coated sutures with palmitic acid. These novel coated sutures might be alternatives to already established anti-microbial sutures such as Vicryl Plus in case of triclosan-resistance. Chlorhexidine is already an established oral antiseptic, safety and efficacy should be proven for clinical applications in anti-microbial sutures.

  12. Upper lid crease approach for margin rotation in trachomatous cicatricial entropion without external sutures

    Directory of Open Access Journals (Sweden)

    Antonio Augusto Velasco e Cruz

    2015-12-01

    Full Text Available ABSTRACT Purpose: To describe the use of a lid crease incision for upper eyelid margin rotation in cicatricial entropion combining internal traction on the anterior lamella, tarsotomy, and tarsal overlap without external sutures. Methods: Surgical description: The main steps of the procedure consisted of exposure of the entire tarsal plate up to the eyelashes followed by tarsotomy through the conjunctiva. A double-armed 6.0 polyglactin suture was then passed through the distal tarsal fragment to the marginal section of the orbicularis oculi muscle. As the sutures were tied, the distal tarsus advanced over the marginal section, and traction was exerted on the marginal strip of the orbicularis muscle. There were no bolsters or external knots. The pretarsal skin-muscle flap was closed with a 6.0 plain gut suture. Results: We used this procedure at a tertiary hospital in Saudi Arabia from 2013 to 2014. Sixty upper lids of 40 patients (23 women and 17 men were operated on, with an age range of 44-99 years [mean ± standard deviation (SD = 70.9 ± 13.01 years]. Bilateral surgery was performed on 21 patients. Follow-up ranged from 1 to 12 months (mean 3.0 ± 2.71 months. Forty percent of the patients (24 lids had more than 3 months' follow-up. The postoperative lid margin position was good in all cases. Trichiasis (two lashes was observed in only one patient with unilateral entropion on the medial aspect of the operated lid. Conclusions: The upper lid margin can be effectively rotated through a lid crease incision with internal sutures. The technique combines the main mechanisms of the Wies and Trabut approaches and avoids the use of bolsters or external sutures, which require a second consultation to be removed. Some other lid problems, such as ptosis, retraction, or dermatochalasis, can be concomitantly addressed during the procedure.

  13. Suture-Button Device Stabilization Following Ring Finger Ray Amputation: A Comparative Cadaver Study.

    Science.gov (United States)

    Morgan, Emily N; Means, Kenneth R; Paez, Adrian G; Parks, Brent G; Innis, Peter C

    2017-06-01

    The purpose of this study was to determine whether placing the suture-button device between the long and small finger metacarpals following ring finger ray amputation may better close the intermetacarpal gap and allow early range of motion without increasing the risk of malrotation than soft tissue repair alone. We performed ray amputation of the ring finger of 14 cadaver specimens by performing an osteotomy of the base of the ring finger metacarpal and then excising the remainder of the digit. We first performed a soft tissue repair of the transverse metacarpal ligaments and then cycled the fingers in simulated active flexion and extension on a custom computer-controlled device to re-create 6 weeks of range of motion. We then placed a suture-button device across the long and small finger metacarpals and tested the specimens again, thereby using each hand as an internal control. The distance between the ring and small finger metacarpals was reduced following suture-button device placement compared with the initial control; this spacing was maintained following complete cycling of the fingers. The angle between the metacarpals was divergent following soft tissue repair, and then became slightly convergent after insertion of the suture-button device. None of the hands developed clinically relevant scissoring of the digits before or after application of the suture-button device. The suture-button device provides stable fixation to withstand early range of motion following ring finger ray amputation and significantly closes the gap and angle between the adjacent metacarpals without causing scissoring.

  14. Intimal Surface Suture Line (End-Product) Assessment of End-to-Side Microvascular Anastomosis.

    Science.gov (United States)

    Pafitanis, Georgios; Veljanoski, Damjan; Ghanem, Ali M; Myers, Simon

    2017-07-01

    Microsurgery simulation courses increasingly use assessment methodologies to evaluate the quality of microvascular anastomosis and to provide constructive feedback in competency-based training. Assessment tools evaluating the "journey" of skill acquisition in anastomosis have evolved, including global rating scores, hand motion analysis, and evaluation of the final outcome, that is, "end-product" assessment. Anastomotic patency is the gold standard end-product in clinical microvascular surgery, and in vivo end-to-side anastomosis, which can be confirmed using the Acland-test. Microsurgery simulation training is moving to include nonliving models, where possible, according to the principles of the replacement, reduction, and refinement of the use of animals in research. While a standardized end-product assessment tool for nonliving end-to-end anastomosis exists, there is no similar tool for end-to-side anastomosis. Intimal surface suture line assessment is an error list-based tool, which involves exposing the intimal surface of a vessel and analysis of the quality of suture placement. Errors in end-to side anastomosis were classified according to the potential clinical significance (high, medium, or low) perceived by the senior authors. Intimal surface suture line assessment provides constructive feedback during microsurgery training, helping to minimize technical errors, which are likely to impact on the final outcome in a clinical environment. Intimal surface suture line assessment lends itself to nonliving simulation training courses as an end-product self-assessment tool, especially during the early learning curve, to demonstrate progression. It has intraoperative relevance by assessment of the intimal surface suture line as the final sutures are placed in an end-to-side anastomosis to provide objective feedback to trainees in relation to likely physiological anastomotic outcome.

  15. Detrital Thermochronology of the Indus-Yarlung suture zone and implications for the tectonic and surface evolution of southern Tibet

    Science.gov (United States)

    Carrapa, B.; Hassim, F.; Kapp, P. A.

    2015-12-01

    Detrital thermochronology has the unique potential to resolve the timing of source cooling associated with magmatic, tectonic and surface processes. Correct interpretation of the detrital signature requires a multi-dating approach involving chronometers sensitive to different temperatures and processes. A multi-dating study of modern river sands from southern Tibet reveals distinct cooling signals that provide significant information about tectonic and erosional evolution of the Indus-Yarlung suture (IYS) after the India-Asia collision with implications for the Cenozoic topographic evolution of the Tibetan Plateau. Modern sands from tributaries of the Yarlung River provide an opportunity to broadly sample source rocks exposed within the suture zone, including the Gangdese batholith, Xigaze forearc, Cenozoic basins, and Tethyan Himalayan rocks, and to investigate their regional geochemical signatures. Samples from rivers along the IYS in southern Tibet, between Xigaze and Mt. Kailas, were analyzed for detrital geochronology and low-temperature thermochronology. Comparison between ages recorded in the source and the detrital signature indicates that both the ages and their proportions directly reflect the ages and relative areas of source rocks in the catchment basins. Apatite fission track ages show two main cooling signals at 22-18 Ma and 12 Ma, which are consistent with accelerated exhumation of the Gangdese batholith and Oligo-Miocene Kailas basin and indicate significant regional exhumation of the IYS during the Miocene. Regional exhumation recorded throughout the IYS is likely the combined product of active Miocene tectonics and erosion of a paleo-Yarlung River. Efficient incision and evacuation of material from the IYS zone by a paleo-Yarlung River during the Miocene suggests a significantly different paleoenvironment than that which exists today. Miocene capture of the Yarlung River by the Brahmaputra River may have enhanced erosion in the IYS zone.

  16. An Alternative Bundle-to-Bundle Suturing Technique for Repairing Fresh Achilles Tendon Rupture.

    Science.gov (United States)

    Zhao, Jingjing; Yu, Bin; Xie, Ming; Huang, Ruokun; Xiao, Kai

    2016-01-01

    The main concern about conventional Achilles tendon repair surgical techniques is how to maintain the initial strength of the ruptured Achilles tendon through complicated suturing methods. The primary surgical problem lies in the properties of the soft tissue; the deterioration of the Achilles tendon, especially in its elasticity; and the surface lubricity of the local tissues. In the present study, we describe an innovative bundle-to-bundle suturing method that addresses these potential problems. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Chronic complaints after simple sutured repair for umbilical or epigastric hernias may be related to recurrence

    DEFF Research Database (Denmark)

    Westen, Mikkel; Christoffersen, Mette W; Jorgensen, Lars N

    2014-01-01

    PURPOSE: Umbilical and epigastric hernia repairs are minor, but are commonly conducted surgical procedures. Long-term results have only been sparsely investigated. Our objective was to investigate the risk of chronic complaints after a simple sutured repair for small umbilical and epigastric...... hernias. METHODS: A retrospective cohort study with a 5-year questionnaire and clinical follow-up was conducted. Patients undergoing primary elective, open non-mesh umbilical or epigastric sutured hernia repair were included. Patients completed a structured questionnaire regarding chronic complaints...

  18. Suture Granuloma Showing False-Positive Findings on FDG-PET

    Directory of Open Access Journals (Sweden)

    Kohei Takahara

    2013-01-01

    Full Text Available We report a case of a 33-year-old male with a mixed germ-cell testicular tumor. Postoperative follow-up FDG-PET revealed concentration of FDG in the left inguinal area which is not tumor metastasis or local recurrence but suture reactivity granuloma. In this paper, we reviewed suture granulomas associated with false-positive findings on FDG-PET after surgery. If FDG-PET will be used more frequently in the future, it will be necessary to refrain from using silk thread in order to prevent any unnecessary surgery.

  19. Estudio comparativo de microsutura vascular en ratas: punto simple y punto de colchonero horizontal Comparative study about vascular microsurgery on rats: classic interrupted suture versus horizontal mattress suture

    Directory of Open Access Journals (Sweden)

    C. Casado Sánchez

    2009-09-01

    Full Text Available La Microcirugía es la técnica empleada para la realización de la microanastomosis vascular. El objetivo del presente estudio es comparar dos tipos de técnicas de microsutura: los puntos simples clásicos, de empleo habitual en la microcirugía vascular, y los puntos de colchonero horizontales, no evaluados habitualmente para este tipo de cirugía. Fueron intervenidas 20 ratas albinas de la cepa Wistar (peso medio de 250 - 300 gr. bajo anestesia general; realizamos sección transversal en la arteria femoral, procediendo a su reparación microquirúrgica inmediata. Se establecieron 2 grupos de animales: en el grupo A (n=10, la microsutura se hizo mediante 6 puntos sueltos simples, y en el grupo B (n=10, empleando 3 puntos de colchonero horizontal. Comprobamos la patencia en el desclampado inmediato y tras una hora del desclampado (para ambas técnicas fue positiva en el 100% de los casos, y la hemorragia en ambos tiempos (se registró un único caso de sangrado en el postoperatorio inmediato en el grupo B, que requirió la revisión de la microsutura. El tiempo medio de ejecución de la sutura en el grupo B, 15 minutos aproximadamente, fue más corto que en el grupo A, 21 minutos aproximadamente, diferencia estadísticamente significativa (p Microsurgery is the procedure of choice for vascular microanastamoses. The objective of this study was to compare two types of suture techniques: classic interrupted suture anastomoses, commonly used for vascular anastamoses in microsurgery, and another technique using horizontal mattress sutures, rarely evaluated in this type of surgery. Twenty albino Wistar rats were operated (average weight: 250 - 300 gr. under general anaesthesia. A transverse section of the femoral artery was performed and immediately followed by an anastamoses. The animals were placed into two groups of ten. The classic 6 interrupted suture anastomoses technique was performed in group A (n = 10 and another technique using 3

  20. Operative treatment of acromioclavicular joint dislocation: a new technique with suture anchors

    Directory of Open Access Journals (Sweden)

    Zhang Jingwei

    2014-07-01

    Full Text Available 【Abstract】Objective: To evaluate clinical outcome of suture anchors in strengthening both acromioclavicular and coracoclavicular ligaments in the surgical treatment of acromioclavicular joint dislocation. Methods: Twenty-eight patients with acute traumatic Rockwood III, IV and V dislocations of the acromioclavicular joint surgically treated at our institute between October 2010 and January 2012 were recruited. All patients underwent open reduction combined with suture anchors. Function was evaluated using the ConstantMurley shoulder score. Clinical and radiographic shoulder ratings were evaluated using Taft criteria at 3, 6 and 12 months. Results:Two cases with fixation loosening were not included in final statistical analysis. Other patients obtained full joint reposition on immediate postoperative radiographs. Follow-up was performed with an average of 15.6 months (range, 12-19. After early range of motion exercises, 96.2% of the patients (25/26 could abduct and elevate their shoulders more than 90 degrees within postoperative 3 months. There was no infection. Average Constant-Murley score was 96.3 points (range, 94-100 and mean Taft shoulder rating was 10.7 points (range, 8-12 at 12 months. Conclusion: The suture anchor is a relatively simple technique and can avoid screw removal which is helpful in reconstructing both acromioclavicular and coracoclavicular ligaments in acute traumatic acromioclavicular joint dislocation. Key words: Acromioclavicular joint; Dislocations; Surgery; Suture anchors

  1. A novel suture method to place and adjust peripheral nerve catheters

    DEFF Research Database (Denmark)

    Rothe, C.; Steen-Hansen, C.; Madsen, M. H.;

    2015-01-01

    We have developed a peripheral nerve catheter, attached to a needle, which works like an adjustable suture. We used in-plane ultrasound guidance to place 45 catheters close to the femoral, saphenous, sciatic and distal tibial nerves in cadaver legs. We displaced catheters after their initial...

  2. Transpressive suture and flower structure: the Tomar-Badajoz-Cordoba shear zone, SW Iberia

    Science.gov (United States)

    Marti Linares, D.; Palomeras, I.; Perez-Estaun, A.; Carbonell, R.; Simancas, F.; Ayarza, P.; Tejero, R.; Martín-Parra, L.; Matas, J.; Lodeiro, F.; Mansilla, L.

    2009-12-01

    The Tomar-Badajoz-Córdoba shear Zone (TBCSZ) is a major structural element located in SW-Iberia. This is considered a suture that separates the Central Iberian Zone (CIZ) in NE and Ossa Morena Zone (OMZ) in SW. It is at least 380km in length and 10 to 20km width. It is a left lateral transpressive flower structure. The strike-slip displacement decays from SE to NW. Its axial zone includes a high grade metamorphic rock unit known as the Central Unit (CU) containing eclogites, and also suture lithotypes as ophiolites. It has been interpreted as a Variscan suture or a reworked Cadomian suture in intraplate regime during the Variscan cycle. This important structure has been imaged by 2 deep seismic reflection transects, the IBERSEIS in 2003 and more recently by ALCUDIA. The good quality of the seismic data sets constrains the internal architecture of this transpressional zone imaging a crustal scale flower structure. The structure features a north dipping wedge limited by two bands of reflectors that reach the middle crust (5 s). Beneath that and slightly to the north a wedge of relatively high amplitude reflectivity dips to the south into the mantle for 10-15 km. This structure is most probably the seismic signature of a complex structure result of deformation associated to a strike slip fault.

  3. Interference Screw vs. Suture Anchor Fixation for Open Subpectoral Biceps Tenodesis: Does it Matter?

    Directory of Open Access Journals (Sweden)

    Gobezie Reuben

    2008-09-01

    Full Text Available Abstract Background Bioabsorbable interference screw fixation has superior biomechanical properties compared to suture anchor fixation for biceps tenodesis. However, it is unknown whether fixation technique influences clinical results. Hypothesis We hypothesize that subpectoral interference screw fixation offers relevant clinical advantages over suture anchor fixation for biceps tenodesis. Study Design Case Series. Methods We performed a retrospective review of a consecutive series of 88 patients receiving open subpectoral biceps tenodesis with either interference screw fixation (34 patients or suture anchor fixation (54 patients. Average follow up was 13 months. Outcomes included Visual Analogue Pain Scale (0–10, ASES score, modified Constant score, pain at the tenodesis site, failure of fixation, cosmesis, deformity (popeye and complications. Results There were no failures of fixation in this study. All patients showed significant improvement between their preoperative and postoperative status with regard to pain, ASES score, and abbreviated modified Constant scores. When comparing IF screw versus anchor outcomes, there was no statistical significance difference for VAS (p = 0.4, ASES score (p = 0.2, and modified Constant score (P = 0.09. One patient (3% treated with IF screw complained of persistent bicipital groove tenderness, versus four patients (7% in the SA group (nonsignificant. Conclusion Subpectoral biceps tenodesis reliably relieves pain and improves function. There was no statistically significant difference in the outcomes studied between the two fixation techniques. Residual pain at the site of tenodesis may be an issue when suture anchors are used in the subpectoral location.

  4. Acute distal tibiofibular syndesmosis injury: A systematic review of suture-button versus syndesmotic screw repair

    NARCIS (Netherlands)

    T. Schepers (Tim)

    2012-01-01

    textabstractPurpose: Recently, a new suture-button fixation device has emerged for the treatment of acute distal tibiofibular syndesmotic injuries and its use is rapidly increasing. The current systematic review was undertaken to compare the biomechanical properties, functional outcome, need for imp

  5. A comparison of the effects of packing or transseptal suture on polysomnographic parameters in septoplasty.

    Science.gov (United States)

    Turhan, Murat; Bostancı, Aslı; Akdag, Mehmet; Dinc, Oktay

    2013-03-01

    Our objective is to examine the effects of using nasal packing or transseptal suture in septoplasty in young patients, specifically on the polysomnographic parameters in the post-operative period. A total of 43 patients who had undergone septoplasty surgery after a diagnosis of septum deviation were included in the study. Packing was inserted in 23 patients, and transseptal suture was performed in the other 20 patients. A polysomnography test was performed on the patients on the first day after surgery and during the post-operative period. A post-operative increase was found in the apnea-hypopnea index (AHI) within both the packing and suture groups. The AHI increase in the packing group was statistically significant (p packing group was significantly higher compared to suture group (p packing group (p packing in young patients after septoplasty surgery reduced the quality of life after surgery and had negative effects on respiration during sleep. The finding that nasal packing caused obstructive sleep apnea syndrome even in young patients leads us to hypothesise that the effect of the packing on comorbid patients' respiratory function during sleep would be even more severe.

  6. Scleral fixation of intraocular lenses using Gore-Tex suture: clinical outcomes and safety profile.

    Science.gov (United States)

    Khan, M Ali; Gupta, Omesh P; Smith, Ryan G; Ayres, Brandon D; Raber, Irving M; Bailey, Robert S; Hsu, Jason; Spirn, Marc J

    2016-05-01

    To report the short-term safety profile and clinical outcomes of scleral fixation of intraocular lenses (IOLs) using Gore-Tex suture. Retrospective, interventional case series. 85 eyes of 84 patients undergoing ab externo scleral fixation of a Bausch and Lomb Akreos AO60 or Alcon CZ70BD IOL using Gore-Tex suture. Primary outcome measures were change in visual acuity and occurrence of intraoperative and postoperative complications with minimum follow-up of 90 days. 85 eyes of 84 patients were identified. Mean logarithm of the minimum angle of resolution visual acuity improved from 1.43±0.72 (20/538 Snellen equivalent) preoperatively to 0.64±0.61 (20/87 Snellen equivalent) postoperatively (pGore-Tex suture was well tolerated in all cases. No suture-related complications were encountered. This procedure led to improvement in visual acuity and was not associated with significant intraoperative or postoperative complications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. Subtotal cranial vault remodelling in anterior sagittal suture closure: impact of age on surgical outcome

    NARCIS (Netherlands)

    Engel, M.; Hoffmann, J.; Muhling, J.; Castrillon-Oberndorfer, G.; Seeberger, R.; Freudlsperger, C.

    2012-01-01

    Isolated fusion of the sagittal suture is usually treated before 1 year of age, but some patients present at a later age. The aim of this study was to evaluate the impact of children's age on the surgical outcome. The authors investigated 46 patients with isolated nonsyndromic sagittal craniosynosto

  8. Parental estimation of early psychological development in children operated on for single suture synostosis.

    Science.gov (United States)

    Knudsen, Elisabet; Maltese, Giovanni; Tarnow, Peter; Tovetjärn, Robert; Kölby, Lars

    2012-09-01

    Impaired psychological development in children with single suture craniosynostosis is often described in the literature. The authors' own experience was that these children appeared to have normal psychological development during their first years of life. The aim of the present study was, therefore, to evaluate if parental estimation would reveal any shortcomings in psychological development. All consecutive patients operated on for non-syndromal single suture synostosis between October 2002 and June 2006 were included (n = 66). A questionnaire was filled out by the parents when the child was 3 years old. The questions concerned development of speech, motor control, personal abilities, and emotional development. The results were compared with randomly selected controls of the same age (n = 180) whose parents answered the same questionnaire. The results showed that children operated on for single suture synostosis did not show any signs of lasting disadvantages due to craniofacial surgery. The children did not in any respect suffer from a hampered psychological development up to 3 years of age. In summary the psychological development of patients operated on for single suture synostosis seems to be normal up to 3 years of age as far as parental estimation can reveal.

  9. Subcuticular absorbable suture with subcutaneous drainage system prevents incisional SSI after hepatectomy for hepatocellular carcinoma.

    Science.gov (United States)

    Tsujita, Eiji; Yamashita, Yo-Ichi; Takeishi, Kazuki; Matsuyama, Ayumi; Tsutsui, Shin-Ichi; Matsuda, Hiroyuki; Taketomi, Akinobu; Shirabe, Ken; Ishida, Teruyoshi; Maehara, Yoshihiko

    2012-07-01

    The effectiveness of subcuticular absorbable suture with subcutaneous drainage to decrease the risk of postoperative incisional surgical site infection (SSI) in hepatocellular carcinoma (HCC) patients was evaluated. A total of 149 patients with HCC who underwent hepatectomy (Hx) were retrospectively investigated. Patients were divided into two groups: the patients with subcuticular suture combined with subcutaneous drainage (the drainage group; 61 patients) and the patients with nylon suture without subcutaneous drainage (the nylon group; 88 patients). After the operations, the complication rate of postoperative incisional SSI was analyzed and compared between the two groups. In the drainage group the rate of incisional SSI was significantly lower compared to the nylon group: 14-3 % (p = 0.033), respectively. Patients with incisional SSI needed significantly longer postoperative hospital care than the patients without incisional SSI: 28 versus 15 days (p SSI (odds ratio; 0.15; p = 0.034). We have demonstrated that the subcuticular suture with subcutaneous drainage is effective in preventing incisional SSI in patients undergoing Hx for HCC.

  10. Effect of end-to-end invagination pancreaticojejunostomy with circle discontinuous U suture in pancreatic surgery

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xuewen; XUAN Wei; JIANG Tao; JI Degang; YANG Yongsheng; ZHANG Dan; XIE Yingjun; MENG Zihui; ZHAO Jisheng

    2007-01-01

    The aim of this paper is to summarize the methods of pancreaficojejunostomy in the pancreatic operation and to study the safety and feasibility of a new operative method called end-to-end invagination pancreaticojejunostomy with circle discontinuous U suture to prevent fistula of pancreaticojejunostomy.Eight-three patients with pancreaticoduodenectomy in the 3rd Hospital,Jilin University from 2001 January to 2006 April were reviewed.The incidences of pancreatic fistula with different types of pancreaticojejunostomy were compared.The overall incidence rate of pancreatic fistula was 26.5% (22/83).No pancreatic fistula occurred in end-to-end invagination pancreaticojejunostomy with circle discontinuous U suture.The incidence rate of the fistula following end-to-end invagination pancreaticojejunostomy with circle discontinuous U suture was significantly lower than that of traditional end-to-end pancreaticojejunostomy [40%,(10/25),P<0.01] and end-to-side pancreaticojejunostomy [27.3%,(12/44),P < 0.05],but no significant difference (P>0.05) between traditional end-to-end pancreaticojejunostomy and end-to-side pancreaticojejunostomywas discovered.End-to-end invagination pancreaticojejunostomy with circle discontinuous U suture has a definite effect on avoiding pancreatic fistula following pancreaticojejunostomy and is worth being recommended.But the cases were limited,so this method would still need to be observed and confirmed further in the future.

  11. 'Suture zones' in peninsular Malaysia and Thailand: implications for palaeotectonic reconstruction of southeast Asia

    Science.gov (United States)

    Tan, B. K.

    The existence of one or more long suture zones extending from Thailand to peninsular Malaysia has been widely accepted in almost all palaeotectonic reconstruction of southeast Asia. Geological evidence from the areas where suture zones have been proposed in these two countries are not reconcilable with many of the inferences and interpretations of the geology on which the palaeotectonic models are based. With the possible exception of the Nan-Uttaradit suture in Thailand, the relationship of the other proposed 'suture' to subduction processses must be regarded as highly doubtful. Correlating geological belts from north Thailand to southern peninsular Malaysia is extremely difficult, given the present limited state of our knowledge of the geology in these two geologically complex regions. Correlation, based on simple classification of granites and their implied geotectonic setting can be misleading. The timing of the proposed collision event to bring together the Gondwana terrain with the Asian terrain, as envisaged in the popular reconstruction scheme, remains one of the most crucial problem which needs to be addressed by those advocating this concept. Palaeontological, stratigraphical, igneous, metamorphic and structural evidence, which can shed light on this difficult question, give conflicting ages for the major orogenic events in this region.

  12. [Curative effect of arthroscopic suture anchor fixation on shoulder bankart injury].

    Science.gov (United States)

    Li, Anping; Chen, You; Huang, Guoliang; Huang, Tianlong

    2013-03-01

    To determine the curative effect of arthroscopic suture anchor fixation on shoulder bankart injury. Sixteen patients with shoulder recurrent dislocation and diagnosed bankart injury were treated with suture anchor fixed by shoulder arthroscopy. Both shoulders of the patients had X-ray, MRI, physical examination before the operation. Suture anchors were used to fix the lesion labrum by shoulder arthroscopy. University of California at Los Angeles (UCLA) score and visual analogue scale (VAS) score were adopted for the final evaluation at the latest follow-up. All patients were followed for a period of 25 (7-68) months. At the latest follow-up, no redislocation and instability occured. The pre- and post-operation UCLA score was (20.8 ± 0.8) vs (32.9 ± 1.5), excellent in 6, good in 10, with no poor score, while the pre- and post-operation VAS score was (3.3 ± 0.8) vs (0.6 ± 0.5). Suture anchor fixation guided by arthroscopy is good for bankart injury caused by recurrent shoulder dislocation, which has many advantages, such as mini-invasion, rapid recovery and a satisfactory outcome in function and motion.

  13. Arthroscopic double-row suture anchor fixation of minimally displaced greater tuberosity fractures.

    Science.gov (United States)

    Ji, Jong-Hun; Kim, Weon-Yoo; Ra, Ki-Hang

    2007-10-01

    In cases of displaced greater tuberosity fractures, treatments by arthroscopic-assisted reduction and percutaneous screw fixation have been reported. However, in cases in which there is a comminuted fracture or a minimally displaced fracture combined with concomitant lesions such as rotator cuff tear or labral pathology, it is difficult to reduce the fracture and to treat other pathologies by use of a percutaneous screw. Recently, many surgeons have used the double-row repair method in rotator cuff repair, which provides a tendon-bone interface better suited for biologic healing and restoring normal anatomy. In accordance with this method, we used the arthroscopic technique of double-row suture anchor fixation for a minimally displaced greater tuberosity fracture without additional incision. Initially, debridement was performed on the fracture surface by use of a shaver, and the medial-row anchor was inserted through the anterior portal or the intact cuff. Two lateral-row anchors were inserted just anterior and posterior to the lower margin of the fractured fragment under C-arm guidance. The medial-row sutures and lateral-row sutures were then placed. Arthroscopic double-row suture anchor fixation of a displaced greater tuberosity fracture restores the original footprint of the rotator cuff and normal tendon-bone interface of the displaced greater tuberosity fracture.

  14. Acute distal tibiofibular syndesmosis injury: A systematic review of suture-button versus syndesmotic screw repair

    NARCIS (Netherlands)

    T. Schepers (Tim)

    2012-01-01

    textabstractPurpose: Recently, a new suture-button fixation device has emerged for the treatment of acute distal tibiofibular syndesmotic injuries and its use is rapidly increasing. The current systematic review was undertaken to compare the biomechanical properties, functional outcome, need for

  15. Differential expression of extracellular matrix-mediated pathways in single-suture craniosynostosis.

    Directory of Open Access Journals (Sweden)

    Brendan D Stamper

    Full Text Available Craniosynostosis is a disease defined by premature fusion of one or more cranial sutures. The mechanistic pathology of single-suture craniosynostosis is complex and while a number of genetic biomarkers and environmental predispositions have been identified, in many cases the causes remain controversial and inconclusive. In this study, gene expression data from 199 patients with isolated sagittal (n = 100, unilateral coronal (n = 50, and metopic (n = 49 synostosis are compared against both a control population (n = 50, as well as each other. After controlling for variables contributing to potential bias, FGF7, SFRP4, and VCAM1 emerged as genes associated with single-suture craniosynostosis due to their significantly large changes in gene expression compared to the control population. Pathway analysis implicated focal adhesion and extracellular matrix (ECM-receptor interaction as differentially regulated gene networks when comparing all cases of single-suture synostosis and controls. Lastly, overall gene expression was found to be highly conserved between coronal and metopic cases, as evidenced by the fact that WNT2 and IGFBP2 were the only genes differentially regulated to a significantly large extent in a direct comparison. The identification of genes and gene networks associated with Fgf/Igf/Wnt signaling and ECM-mediated focal adhesion not only support the involvement of biomarkers previously reported to be related to craniosynostosis, but also introduce novel transcripts and pathways that may play critical roles in its pathogenesis.

  16. A novel suturing approach for tissue displacement within minimally invasive periodontal plastic surgery.

    Science.gov (United States)

    Ronco, Vincent; Dard, Michel

    2016-08-01

    This paper describes a novel suturing approach that achieves harmonious and atraumatic soft tissue displacement in periodontal plastic surgery and soft tissue management around implants. The technique relies on a combination of horizontal and vertical mattress that are anchored at the splinted incisal contact points.

  17. A novel suturing approach for tissue displacement within minimally invasive periodontal plastic surgery

    OpenAIRE

    Ronco, Vincent; Dard, Michel

    2016-01-01

    Key Clinical Message This paper describes a novel suturing approach that achieves harmonious and atraumatic soft tissue displacement in periodontal plastic surgery and soft tissue management around implants. The technique relies on a combination of horizontal and vertical mattress that are anchored at the splinted incisal contact points.

  18. Patella fracture fixation with suture and wire: you reap what you sew.

    Science.gov (United States)

    Egol, Kenneth; Howard, Daniel; Monroy, Alexa; Crespo, Alexander; Tejwani, Nirmal; Davidovitch, Roy

    2014-01-01

    Operative fixation of displaced inferior pole patella fractures has now become the standard of care. This study aims to quantify clinical, radiographic and functional outcomes, as well as identify complications in a cohort of patients treated with non-absorbable braided suture fixation for inferior pole patellar fractures. These patients were then compared to a control group of patients treated for mid-pole fractures with K-wires or cannulated screws with tension band wiring. In this IRB approved study, we identified a cohort of patients who were diagnosed and treated surgically for a displaced patella fracture. Demographic, injury, and surgical information were recorded. All patients were treated with a standard surgical technique utilizing non-absorbable braided suture woven through the patellar tendon and placed through drill holes to achieve reduction and fracture fixation. All patients were treated with a similar post-operative protocol and followed up at standard intervals. Data were collected concurrently at follow up visits. For purpose of comparison, we identified a control cohort with middle third patella fractures treated with either k-wires or cannulated screws and tension band technique. Patients were followed by the treating surgeon at regular follow-up intervals. Outcomes included self-reported function and knee range of motion compared to the uninjured side. Forty-nine patients with 49 patella fractures identified retrospectively were treated over 9 years. This cohort consisted of 31 females (63.3%) and 18 males (36.7%) with an average age of 57.1 years (range 26-88 years). Patients had an average BMI of 26.48 (range 19-44.08). Thirteen patients with inferior pole fractures underwent suture fixation and 36 patients with mid-pole fractures underwent tension band fixation (K-wire or cannulated screws with tension band). In the suture cohort, one fracture failed open repair (7.6%), which was revised again with sutures and progressed to union. Of the 36

  19. Ten-year follow up after laparoscopic suture rectopexy for full-thickness rectal prolapse.

    Science.gov (United States)

    Foppa, C; Martinek, L; Arnaud, J P; Bergamaschi, R

    2014-10-01

    Studies have shown that recurrence rates of full-thickness rectal prolapse (FTRP) 5 years after surgery can quadruple at 10 years. This study aimed to evaluate the impact of laparoscopic suture rectopexy for FTRP on recurrence rates and functional outcome at a median follow up of 10 years. Prospectively collected data for patients who underwent laparoscopic suture rectopexy for FTRP between 1993 and 2006 were analysed. Laparoscopic rectopexy consisted of circumferential mobilization of the rectum down to the levator followed by suture suspension to promontory. Patients with preexisting constipation or who were unfit for general anaesthesia were not included. Incontinence, quality of life and constipation were assessed by validated scores. Recurrence-free curves were generated using the Kaplan-Meier method. One hundred and seventy-nine patients with a median age of 62 (15-93) years including 174 women and five men underwent laparoscopic suture rectopexy. There was no mortality. The 30-day complication rate was 4% (partial transection of the left ureter, pneumonia, urinary tract infection, urinary retention, superficial surgical site infection). Data on 172 patients (96%) were available at follow up. There were 10 recurrences of FTRP at 5-year follow up giving a crude recurrence rate of 6%. The actuarial 10-year recurrence rate was 20% (95% CI, 10.8-20.1). Follow-up continence (P < 0.0001) and quality of life were better than preoperatively: lifestyle (P < 0.001), coping (P < 0.001), self-perception (P < 0.005), embarrassment (P < 0.06). Constipation was unchanged. Laparoscopic suture rectopexy led to few complications, a recurrence rate of 20%, improved continence and quality of life with no worsening of constipation at 10 years. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  20. Infections in traumatic wounds sutured at a Norwegian Accident and Emergency Department.

    Science.gov (United States)

    Brudvik, Christina; Tariq, Hina; Bernardshaw, Soosaipillai V; Steen, Knut

    2015-05-05

    Different countries have different wound treatment traditions. We have studied the incidence and different factors related to infections in wound injuries sutured at a Norwegian A&E department. In this prospective study, clinical data were collected on 102 patients with traumatic wound injuries treated with sutures at Bergen Accident and Emergency Department between 30 February 2011 and 30 June 2011. Any wound infections in 97 of these patients at the time of suture removal were assessed and classified according to severity on a scale of grade 0 to grade 4. There were no serious infections, but mild clinical wound infections occurred in 15% of patients: 11% grade 1 and 4% grade 2 infections. Patients less than 65 years old had often cut themselves with knives (n = 33, 37%), and on their hands (n = 60, 67%), Men were most frequently injured at work (n = 38, 54%) and women most often at home (n = 18, 56%). No statistically significant correlation was found between the incidence of wound infections and the length of the wound, the time elapsed before suturing, the wound's location on the body, contamination or underlying chronic diseases. Two of the three self-inflictors in our study had clinical wound infections. Half of the bacteriological samples from ten of 15 wounds with clinical infection had plentiful growth of Staphylococcus aureus. One patient received oral antibiotic treatment for wound infection, and two had local antibiotic treatment. Mild clinical infections were found in almost one of six wounds sutured at a Norwegian A&E department. More studies are necessary to provide basic data to enable targeted improvements in wound treatment in the primary healthcare service.

  1. Microbiological analysis of bacterial plaque on three different threads in oral surgery.

    Science.gov (United States)

    Bucci, Marco; Borgonovo, Andrea; Bianchi, Albino; Zanellato, Anna; Re, Dino

    2017-02-01

    Suture is the final act of most oral surgery procedures. The quality of healing after the operation depends on its efficiency. Sutures must not cause inflammation - neither directly nor indirectly. The objective of this study is to compare the bacterial colonization on different suture materials after a third molar extraction. Thirty patients were randomly selected among people going under third molar extraction; they were divided into 3 groups and one suture type was used on each group. After 7 days distal stitches were removed by a single operator, placed in physiologic solution and analyzed after 2 or 3 hours. Patients followed the same postsurgical protocols; materials used were: Ethicon Silk® 4/0, B. Braun Dafilon® 4/0, and B. Braun Safil® 4/0. The amount of cocci and bacilli on the sutures analyzed shows that silk (Ethicon Silk) is the higher level of retention material where monofilament (B. Braun Dafilon) is the lower. There is a difference between monofilament and polyglycolide (B. Braun Safil), as the former is less retentive than the latter, although not significantly so. A less plaque retention, and consequently a fewer bacterial presence, is crucial to minimize the inflammatory process and allow a better tissue healing. Since the capability of brushing and, of course, the final personal hygiene depends on multiple variables, we must use surgical protocols able to minimize the effect of improper cleaning on the healing process: this statement implies the use of low plaque retention materials. The use of monofilament or polyglycolide threads in sutures can help reducing bacterial concentration and therefore promotes a faster and better healing.

  2. Intravital imaging of the cellular dynamics of LysM-positive cells in a murine corneal suture model.

    Science.gov (United States)

    Ueta, Mayumi; Koga, Ayaka; Kikuta, Junichi; Yamada, Keiko; Kojima, Sachi; Shinomiya, Katsuhiko; Ishii, Masaru; Kinoshita, Shigeru

    2016-03-01

    Corneal suturing is a surgical procedure used in patients with corneal trauma or transplants. It was reported that endogenous neutrophils are brightly labelled in gene-targeted mice expressing enhanced green fluorescent protein (eGFP) under the control of the endogenous lysozyme M promoter (LysM-eGFP mice). We applied intravital imaging methods to analyse in vivo the dynamics of LysM-positive granulocytes (neutrophils) in LysM-eGFP mice with corneal sutures and examined their role in the elicitation of neutrophil infiltration. We found that in the presuturing state, neutrophils strongly positive for LysM were located in the periphery of the corneal stromal layer; none were present in the centre of the cornea. After introducing a corneal suture, neutrophils accumulated in limbal vessels and then migrated to the corneal side and the conjunctival side, suggesting that they derived from limbal vessels. Thereafter they accumulated towards the central corneal area, arriving at the suture about 7 h after its placement. Although corneal sutures may elicit the continuous infiltration of neutrophils, their number was markedly decreased by day 1 after suture removal and continued to decrease thereafter. Our results showed that corneal sutures may elicit the continuous infiltration of neutrophils. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Relationship between maturation indices and morphology of the midpalatal suture obtained using cone-beam computed tomography images

    Science.gov (United States)

    Jang, Hong-Ik; Kim, Sang-Cheol; Chae, Jong-Moon; Kang, Kyung-Hwa; Cho, Jin-Woo; Chang, Na-Young; Lee, Keun-Young

    2016-01-01

    Objective The purpose of this study was to determine whether predicting maturation of the midpalatal suture is possible by classifying its morphology on cone-beam computed tomography (CBCT) images and to investigate relationships with other developmental age indices. Methods The morphology of the midpalatal suture was assessed by using CBCT images of 99 patients. Axial plane images of the midpalatal suture were classified into five stages according to the classification scheme. To make the assessment more accurate, the morphology and fusion of the midpalatal suture were additionally investigated on coronal cross-sectional planar images and volume-rendered images. Bone age was evaluated using the hand and wrist method (HWM) and cervical vertebrae method (CVM); dental age (Hellman's index), sex, and chronological age were also assessed. To evaluate relationships among variables, Spearman's rho rank test was performed along with crosstabs using contingency coefficients. Results The HWM and CVM showed strong correlations with the maturation stage of the midpalatal suture, while other indices showed relatively weak correlations (p CBCT stage; the HWM demonstrated slightly higher values (p < 0.0001). Based on the HWM, the midpalatal suture was not fused until stage 6 in both sexes. Conclusions Among developmental age indices, the HWM and CVM showed strong correlations and high associations, suggesting that they can be useful in assessing maturation of the midpalatal suture. PMID:27896208

  4. Suture Button装置修复下胫腓联合损伤的初步报告%Fixation of distal tibiofibular syndesmosis rupture with Suture Button device

    Institute of Scientific and Technical Information of China (English)

    秦煜; Henry DeGroot Ⅲ

    2008-01-01

    [目的] 探讨Suture Button装置治疗下胫腓联合损伤后的手术方法及临床效果.[方法] 对截止于2007年9月利用Suture Button装置固定的下胫腓联合急、慢性损伤的13例病人进行连续随访观察,通过术后X线片数字化测量和标准的踝足功能评分,评估其疗效并探讨临床应用前景.[结果] 除1例病人因术后短期再次创伤意外,行2次手术更换为传统螺钉内固定外,其余病人均在术后6周开始部分负重功能锻炼,术后第3个月功能平均评分达到满意,术后第6、12个月功能平均评分达到优良,X线片未发现内固定失效.[结论] Suture Button装置治疗下胫腓联合损伤具有技术简单、手术时间短、内固定器物理特性符合人体正常解剖生理、固定强度足够、无需2次手术取出等多项优势,可能成为下胫腓联合损伤新的治疗标准.

  5. The potential of photoacoustic microscopy as a tool to characterize the in vivo degradation of surgical sutures.

    Science.gov (United States)

    Aguirre, Juan; Morales-Dalmau, Jordi; Funk, Lutz; Jara, Francesc; Turon, Pau; Durduran, Turgut

    2014-08-01

    The ex vivo and in vivo imaging, and quantitative characterization of the degradation of surgical sutures (∼500 μm diameter) up to ∼1cm depth is demonstrated using a custom dark-field photo-acoustic microscope (PAM). A practical algorithm is developed to accurately measure the suture diameter during the degradation process. The results from tissue simulating phantoms and mice are compared to ex vivo measurements with an optical microscope demonstrating that PAM has a great deal of potential to characterize the degradation process of surgical sutures. The implications of this work for industrial applications are discussed.

  6. COMBINED PARS PLANA VITRECTOMY AND SCLERAL FIXATION OF AN INTRAOCULAR LENS USING GORE-TEX SUTURE: One-Year Outcomes.

    Science.gov (United States)

    Khan, M Ali; Samara, Wasim A; Gerstenblith, Adam T; Chiang, Allen; Mehta, Sonia; Garg, Sunir J; Hsu, Jason; Gupta, Omesh P

    2017-05-10

    To report the 1-year clinical outcomes of combined pars plana vitrectomy and ab externo scleral fixation of an intraocular lens using Gore-Tex suture. Retrospective, interventional case series. Outcome measures were change in visual acuity and occurrence of intraoperative and postoperative complications with minimum follow-up of 1 year. Eighty-four eyes of 83 patients were identified. The mean best available visual acuity improved from 20/782 preoperatively to 20/65 postoperatively (P Gore-Tex suture was well tolerated at a minimum of 1-year follow-up. No suture-related complications were encountered.

  7. Can We Use the Disposable Laparoscopic Clip Appliers as Suture Anchors? An In Vitro Feasibility Study.

    Science.gov (United States)

    Buchholz, Vered; Sadot, Eran; Spivak, Hadar

    2015-08-01

    Intracorporeal suturing is time-consuming and could be difficult in certain operative circumstances. Instead of knot tying, specially designed clips have been introduced to anchor and secure the end of a single strand or suture. Although these clips provide a maximal required holding grip (HG), they considerably increase the cost of the procedure. The aim of this in vitro study was to identify the feasibility, and means of achieving the best HG, of commonly used disposable automatic clip appliers (LCAs) over regular strands. We placed 2-0 PDS (rigid) and 2-0 Vicryl (soft) sutures through fresh gastric wall specimens. Six different commercial-type LCAs, all having large or medium/large clips, were applied at the distal end of each suture. An IMDA manual digital force gauge was used to measure the HG of each clip at 2 positions: the middle clip position and the angle (at the crouch) position. A total of 192 measurements were taken. The results were classified into 3 HG levels measured by Newton units (N): the strongest grip (> 1 N), medium grip (> 0.5 and < 1 N), and weak grip (< 0.5 N). The strongest HG was obtained by applying 10 to 12 mm LCAs with large or medium/large clips over PDS at an angle position (HG = 1.1 ± 0.2 to 1.6 ± 0.3 N). The weakest grip was obtained by applying any type of LCA over Vicryl at the middle position (HG = 0.08 ± 0.04 to 0.2 ± 0.06 N, P < 0.001). The latter was associated with clips freely falling off the sutures even before applying any force. In general, more force was needed to dislodge any brand clip from the PDS compared with Vicryl suture (0.8 ± 0.6 vs. 0.4 ± 0.3 N, P < 0.001). The angle position was always stronger than the middle position (0.9 ± 0.6 vs. 0.3 ± 0.2 N, P < 0.001). There was a trend for the 10 to 12 mm LCA to have a better HG than the 5 mm ones (0.65 ± 0.5 vs. 0.51 ± 0.5 N, P = 0.08). We propose that 10 to 12 mm LCAs generate enough HG to secure a single strand when clips are placed at the angle position

  8. Surgical staples compared with subcuticular suture for skin closure after cesarean delivery: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Sahar Assadi

    2016-03-01

    Full Text Available Background: Cesarean delivery is the most common surgical procedure and this prevalence is on the rise. Given these trends, cesarean wound complications, such as disruption or infection, remain an important cause of post-cesarean morbidity. Methods: We conducted a single-center randomized controlled trial that included women with viable pregnancies (≥24 weeks undergoing cesarean delivery at Motahary University Hospital, Urmia, Iran from April to November 2014. All cesarean types were included: scheduled or unscheduled and primary or repeat cesareans. Women were excluded for the following reasons: inability to obtain informed consent, immune compromising disease (e.g. AIDS, chronic steroid use, diabetic mellitus and BMI≥30. Of 266 women, 133 were randomized to staples and 133 women to suture group. Results: The mean±SD age of the staples group was 27.6±5.4 years and mean±SD age of suture was 28.7±5.9 years. Multiparity is the most frequent in both groups that by using Chi-square test, no significant differences were observed between the two groups (P=0.393. The most frequent indication for cesarean section in both groups was history of cesarean section in staple 40 cases (30.1% and suture 32 cases (24.1%. The survey was conducted using the Chi-square test was not significant (P=0.381. Pain at 6 weeks postoperatively was significantly less in the staple group (P=0.001. Operative time was longer with suture closure (4.68±0.67 versus 1.03±0.07 minute, P<0.001. The Vancouver scale score was significantly less in suture closure (6.6±0.8 versus 7.5±0.9, P=0.001. Wound disruption was significantly less in suture closure (3.8% versus 11.3%, P=0.017. Conclusion: The staple group had low pain and operation time but had a significant wound disruption and scar. The patients who have suffered a significant wound disruption were affected by age (P=0.022 and BMI (P=0.001 at compared those who were not affected by factors such as age or high BMI as

  9. Functional Effects of Delivering Human Mesenchymal Stem Cell-Seeded Biological Sutures to an Infarcted Heart

    Directory of Open Access Journals (Sweden)

    Katrina J. Hansen

    2016-08-01

    Full Text Available Stem cell therapy has the potential to improve cardiac function after myocardial infarction (MI; however, existing methods to deliver cells to the myocardium, including intramyocardial injection, suffer from low engraftment rates. In this study, we used a rat model of acute MI to assess the effects of human mesenchymal stem cell (hMSC-seeded fibrin biological sutures on cardiac function at 1 week after implant. Biological sutures were seeded with quantum dot (Qdot-loaded hMSCs for 24 h before implantation. At 1 week postinfarct, the heart was imaged to assess mechanical function in the infarct region. Regional parameters assessed were regional stroke work (RSW and systolic area of contraction (SAC and global parameters derived from the pressure waveform. MI (n = 6 significantly decreased RSW (0.026 ± 0.011 and SAC (0.022 ± 0.015 when compared with sham operation (RSW: 0.141 ± 0.009; SAC: 0.166 ± 0.005, n = 6 (p  0.05; however, there was a trend toward improved function with the addition of either unseeded or seeded biological suture. Histology demonstrated that Qdot-loaded hMSCs remained present in the infarcted myocardium after 1 week. Analysis of serial sections of Masson's trichrome staining revealed that the greatest infarct size was in the infarct group (7.0% ± 2.2%, where unseeded (3.8% ± 0.6% and hMSC-seeded (3.7% ± 0.8% suture groups maintained similar infarct sizes. Furthermore, the remaining suture area was significantly decreased in the unseeded group compared with that in the hMSC-seeded group (p < 0.05. This study demonstrated that hMSC-seeded biological sutures are a method to deliver cells to the infarcted myocardium and have treatment potential.

  10. Evaluation of Reduction Accuracy of Suture-Button and Screw Fixation Techniques for Syndesmotic Injuries.

    Science.gov (United States)

    Kocadal, Onur; Yucel, Mehmet; Pepe, Murad; Aksahin, Ertugrul; Aktekin, Cem Nuri

    2016-12-01

    Among the most important predictors of functional results of treatment of syndesmotic injuries is the accurate restoration of the syndesmotic space. The purpose of this study was to investigate the reduction performance of screw fixation and suture-button techniques using images obtained from computed tomography (CT) scans. Patients at or below 65 years who were treated with screw or suture-button fixation for syndesmotic injuries accompanying ankle fractures between January 2012 and March 2015 were retrospectively reviewed in our regional trauma unit. A total of 52 patients were included in the present study. Fixation was performed with syndesmotic screws in 26 patients and suture-button fixation in 26 patients. The patients were divided into 2 groups according to the fixation methods. Postoperative CT scans were used for radiologic evaluation. Four parameters (anteroposterior reduction, rotational reduction, the cross-sectional syndesmotic area, and the distal tibiofibular volumes) were taken into consideration for the radiologic assessment. Functional evaluation of patients was done using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale at the final follow-up. The mean follow-up period was 16.7 ± 11.0 months, and the mean age was 44.1 ± 13.2. There was a statistically significant decrease in the degree of fibular rotation (P = .03) and an increase in the upper syndesmotic area (P = .006) compared with the contralateral limb in the screw fixation group. In the suture-button fixation group, there was a statistically significant increase in the lower syndesmotic area (P = .02) and distal tibiofibular volumes (P = .04) compared with the contralateral limbs. The mean AOFAS scores were 88.4 ± 9.2 and 86.1 ± 14.0 in the suture-button fixation and screw fixation group, respectively. There was no statistically significant difference in the functional ankle joint scores between the groups. Although the functional outcomes were similar, the

  11. Clinical Study of the Value of PCT, ABI and 128 Hz Tuning Fork Combined with 10 g Monofilament in Evaluating the Prognosis of Diabetic Foot%PCT、 ABI、128 Hz音叉联合10克单丝对糖尿病足预后评估价值

    Institute of Scientific and Technical Information of China (English)

    刘强; 游东; 梁永

    2016-01-01

    目的:探讨降钙素原(PCT)、踝肱指数(ABI)、 Rydel-seifer分级音叉(128 Hz音叉)联合10 g单丝对糖尿病足预后评估的临床价值。方法选择243例糖尿病患者,其中观察组为糖尿病足患者50例,对照组为非糖尿病足183例,对其临床资料进行回顾性分析糖尿病足的相关因素。根据患者预后分为两组,比较其PCT水平、 ABI、128 Hz音叉联合10 g单丝结果。结果多因素 Logistic 回归分析显示,肥胖、空腹血糖、128 Hz音叉及PCT升高、 ABI、10 g单丝降低是糖尿病足的危险因素。截肢组患者PCT水平及128 Hz音叉结果高于非截肢组, ABI、10 g单丝结果低于非截肢组,两组比较,差异具有统计学意义, P<0.05。结论肥胖、空腹血糖、128 Hz音叉及PCT升高、 ABI、10 g单丝降低在糖尿病的进展过程中起着重要作用,应给予足够重视,积极对症治疗,降低其截肢率。%Objective To investigate the clinical value of procalcitonin (PCT), ankle brachial index (ABI) and Rydel-seifer tuning fork rating (128 Hz tuning fork) combined with 10 g monofilament in evaluating the prognosis of diabetic foot. Methods 243 cases of patients with diabetes were selected, the observation group of 50 patients with diabetic foot, compared with the control group of 183 cases of non diabetic foot. The clinical data were retrospectively analyzed and the related factors of diabetic foot were analyzed by SPSS19. 0 statistics software. The patients were divided into 2 groups according to the prognosis of the patients and the results of the level of PCT, ABI, and 128 Hz fork combined with 10g monofilament. Results Multivariate logistic regression analysis showed that the increase of obesity, fasting blood glucose, 128 Hz tuning fork and PCT and the decrease of ABI and 10 g monofilament were the risk factors for diabetic foot. The scores of the level of PCT level and 128 Hz tuning fork of the patients in amputation group

  12. Comparative study of suture and cyanoacrylates in skin closure of rats Estudo comparativo entre sutura e cianoacrilatos no fechamento de pele de ratos

    Directory of Open Access Journals (Sweden)

    Sandro Cilindro de Souza

    2007-08-01

    Full Text Available PURPOSE: To compare the biocompatibility of ethyl-cyanoacrylate (ECA and octylcyanoacrylate (OCA wound closures to sutures in rat skin. METHODS: Twenty-four male Wistar rats were subjected to three incisions which were closed using ECA, OCA or sutures . Rats were divided into four groups which received biopsies on the 3rd, 7th, 14th or 21st post-operative days. Necrosis, inflammation, dermatitis, infection, dehiscence, cicatricial enlargement and costs were examined; the histopathology evaluated was epithelialization, deep openings, foreign substance reaction, residues of synthesis material, fibrosis, inflammation, dehiscence and necrosis. RESULTS: The tissue adhesives presented the largest dehiscence levels, and ECA the lowest cost while the other measures were similar. Regarding histopathology, deep openings were more common with OCA and granulomas were most frequently obtained with ECA. The two tissue adhesives produces less inflammation than the inicial suture from post-operative day 7, while ECA and OCA cause similar inflammatory reactions. ECA did not differ significantly from OCA and sutures on other measures. CONCLUSION: ECA was well tolerated in this study and did not induce necrosis, allergic reactions or infections, presenting several advantages in relation to OCA and sutures, including lower costs and fewer complications.OBJETIVO: Investigar a biocompatibilidade do etil-cianoacrilato (ECA em fechamento de pele em ratos comparativamente ao octil-cianoacrilato (OCA e à sutura. MÉTODOS: Rattus norvegicus albinus (n=24 foram submetidos a três incisões, cada uma fechada por um dos métodos de síntese estudados. Quatro grupos (n=6 foram feitos, conforme o dia pós-operatório (DPO em que foram eutanasiados: 3DPO, 7DPO,14DPO e 21DPO. Necrose, edema, eritema, dermatite, infecção, deiscência, alargamento cicatricial e custos foram os itens examinados; histopatologicamente avaliou-se epitelização, abertura profunda, reação de corpo

  13. The Pan-African orogenic belt of southern Mauritanides and northern Rokelides (southern Senegal and Guinea, West Aftica): gravity evidence for a collisional suture

    Science.gov (United States)

    Ponsard, J. F.; Roussel, J.; Villeneuve, M.; Lesquer, A.

    The geological history in southern Senegal and Guinea results in the existence, on the western margin of the West African craton, of a Pan-African orogenic belt which is capped in part with late Proterozoic and Paleozoic terranes. In addition to geological features, the gravity signature and deduced crustal model bear evidence of an eastern crustal block corresponding to the old rigid craton and a denser and thicker western block related to the reactivated basement province. The discontinuity in density between both is interpreted as the Pan-African suture which dips westward beneath the reactivated block. The short wavelength gravity highs superimposed to the gravity gradient in the central domain are interpreted as west-dipping wedge-shaped dense bodies squeezed at depth along the suture. These may reflect either remains of oceanic crust or granulite facies rocks derived from the crustal overthrusting process. Finally using both geological and geophysical materials, the Pan-African belt of southern Mauritanides and northern Rokelides appears to be consistent with a continental collision-basement reactivation model.

  14. All-inside arthroscopic suturing technique for meniscal ruptures.

    Science.gov (United States)

    Darabos, Nikica; Dovzak-Bajs, Ivana; Bilić, Vide; Darabos, Anela; Popović, Iva; Cengić, Tomislav

    2012-03-01

    The most frequent indication for surgical treatment of the knee is lesion of the meniscus. The "all inside" arthroscopic technique with bioresorptive material for meniscus lesion is becoming the most popular treatment. This prospective study included 10 patients with posterior meniscal horn lesion operatively treated at Sports Traumatology Department. The "all inside" technique was performed by intra-articular application of bioresorptive pins-Darts sticks or Meniscus Viper and bioresorptive string. Patients were followed up for 2-6 months postoperatively and graded according to the IKDC 2000 scale. All surgical treatments showed satisfactory results. Young patients with acute longitudinal peripheral lesion-posterior horn lesions, in the red-red or red-white meniscal zone, 1-2 centimeters long are most appropriate for this type of treatment. In these patients, this technique proved to be superior and free from the risk of neurovascular damage. For better authentication of this conclusion, additional prospective randomized studies should be performed.

  15. The influence of stenosis degrees and graft suture position on local hemodynamics of coronary bypass

    Science.gov (United States)

    Totorean, A. F.; Bernad, S. I.; Susan-Resiga, R. F.

    2016-06-01

    Bypass graft failure is mainly caused by intimal hyperplasia (IH) that occurs at the graft anastomosis after coronary artery bypass grafting (CABG) surgery. It has been shown that local hemodynamics influences the process of IH initiation and progression. A main concern at this type of surgery is to increase the graft patency, respectively to improve the local hemodynamics. This paper analyzes the influence of different degree of stenosis severity and graft suture position on graft patency, taking into consideration the local hemodynamics. Bypass configurations with anastomosis angle of 45° were numerically investigated, with respect to wall shear stress and pressure variation. We can assume that in the conditions of our study, different stenosis degrees and position of the graft suture influence the local blood flow conditions, and, nevertheless, the graft patency.

  16. Traction endurance biomechanical study of metallic suture anchors at different insertion angles

    Directory of Open Access Journals (Sweden)

    Azato Flávia Namie

    2003-01-01

    Full Text Available The suture anchors' insertion angle and its traction resistance are the main subjects of this study. Twenty trials were realized using threaded suture anchors in four diferents angulations (30º /45º /60º /90º in human bone (distal femur and another twenty trials in artificial bone (SawboneTM. The anchors were pulled out being tractioned uprightly from its bone surface by a Kratos Universal test machine. The human bone results found no relation between the main subjects of this study, so whithout statistical value. On the other hand at the artificial bone the insertion angle of 90º beared more traction, being statistically significant compared to the other angles.

  17. Teflon-buttressed sutures plus pericardium patch repair left ventricular rupture caused by radiofrequency catheter ablation

    Science.gov (United States)

    Cao, Hao; Zhang, Qi; He, Yanzhong; Feng, Xiaodong; Liu, Zhongmin

    2016-01-01

    Abstract Background: Cardiac rupture often occurs after myocardial infarction or chest trauma with a high mortality rate. However, left ventricular rupture caused by radiofrequency catheter ablation (RFCA) is extremely rare. Methods: We describe a case of a 61-year-old male who survived from left ventricular rupture caused by a RFCA procedure for frequent ventricular premature contractions. Surgical exploration with cardiopulmonary bypass (CPB) was performed when the signs of cardiac tamponade developed 7 hours after the ablation surgery. Results: Teflon-buttressed sutures of the tear in the left ventricular posterolateral wall and pericardium patch applied to the contusion region on the wall repaired the rupture safely and effectively. Conclusion: Timely surgical intervention under CPB facilitated the survival of the patient. Teflon-buttressed sutures plus pericardium patch achieved the successful repair of the rupture. PMID:27661047

  18. Crustal architecture and tectonic evolution of the Cauvery Suture Zone, southern India

    Science.gov (United States)

    Chetty, T. R. K.; Yellappa, T.; Santosh, M.

    2016-11-01

    The Cauvery suture zone (CSZ) in southern India has witnessed multiple deformations associated with multiple subduction-collision history, with incorporation of the related accretionary belts sequentially into the southern continental margin of the Archaean Dharwar craton since Neoarchean to Neoproterozoic. The accreted tectonic elements include suprasubduction complexes of arc magmatic sequences, high-grade supracrustals, thrust duplexes, ophiolites, and younger intrusions that are dispersed along the suture. The intra-oceanic Neoarchean-Neoproterozoic arc assemblages are well exposed in the form of tectonic mélanges dominantly towards the eastern sector of the CSZ and are typically subjected to complex and multiple deformation events. Multi-scale analysis of structural elements with detailed geological mapping of the sub-regions and their structural cross sections, geochemical and geochronological data and integrated geophysical observations suggest that the CSZ is an important zone that preserves the imprints of multiple cycles of Precambrian plate tectonic regimes.

  19. Rejuvenation of Fossil Sutures and Related Mesozoic Intracontinental Orogenies in South China

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The Huanan (South China) subcontinent was created by amalgamation of the Yangtze, Xianggan, Cathaysia and Zhemin microcontinents by the Guangxi orogeny in the Early Palaeozoic. The closure of the Tethyan Ocean and subsequent collision event outside the amalgamated continent reactivated fossil sutures and resulted in intracontinental (ensialic) orogenies in the Mesozoic. Based on evidence from deformation, molasse and granitoids, the Sichuan-Guizhou-Hunan-southern Hubei and Hunan-Jiangxi-Fujian Yanshanian fold-thrust systems and the Lower Yangtze-northwestern Fujian Indosinian fold-thrust system are thought to be intracontinental orogens. Their main features are as follows: intracontinental orogenies occurred areally, thrusting propagated towards the interior of the continental, they extend parallelly to the strikes of the fossil sutures, and the details of the temporal-spatial evolution of the orogens depend on subduction-collision events.

  20. Calvarial and sutural re-development following craniectomy in the neonatal rabbit.

    Science.gov (United States)

    Mabbutt, L W; Kokich, V G

    1979-01-01

    In the present investigation extensive calvariectomy was performed on neonatal rabbits and the subsequent regeneration of the calvarium was followed grossly, radiographically and histologically. The results indicate that regeneration of the calvarium is a gradual process which exhibits a definite pattern and rate. Furthermore, although the sutural articulations re-develop in their proper anatomical positions and exhibit normal histological structure, they tend to synostose earlier than controls. Of perhaps greater biological significance is the apparent importance of the periosteal envelope during the regenerative process. Maintenance of dural integrity during operation, and the re-establishment of pericranial continuity post-operatively, seem to be essential for restoration of normal sutural and skeletal architecture. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 11 Fig. 12 Fig. 13 Fig. 14 Fig. 15 Fig. 16 PMID:500496

  1. Ultrasound biomicroscopy confirmation of corneal overriding due to improper suturing of full-thickness corneal laceration

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    Murat Kucukevcilioglu

    2014-12-01

    Full Text Available We herein present a case with corneal overriding due to improper suturing of a full-thickness corneal laceration. There was a 2.5-mm difference between horizontal and vertical white-to-white measurements in the cornea. However, slit lamp examination failed to demonstrate the exact architecture of the laceration. Ultrasound biomicroscopy defined the wound edges thoroughly and confirmed the presence of corneal overriding. Six weeks after suture enhancement, the abnormal oval appearance of the cornea was absent and correct apposition of the corneal edges was seen on ultrasound biomicroscopy. Ultrasound biomicroscopy can be used in preoperative surgical planning of cases with complicated corneal lacerations. It can be used to adjust and enhance wound architecture in eyes with penetrating injury.

  2. The “excluding” suture technique for surgical closure of ventricular septal defects: A retrospective study comparing the standard technique

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    Roy Varghese

    2016-01-01

    Conclusion: Surgical closure of VSDs can be accomplished by placing sutures along the margins or away with comparable results. The incidence of CHB, however, seems to be less when the “excluding” technique is employed.

  3. Rapidly resorbable vs. non-resorbable suture for experimental colonic anastomoses in rats--a randomized experimental study

    DEFF Research Database (Denmark)

    Klein, Mads; Pommergaard, Hans-Christian; Gögenur, Ismail;

    2011-01-01

    Anastomotic dehiscence remains an important challenge for colorectal surgeons worldwide. Extensive research focused on performing a safe anastomosis is conducted with rats being the most used model when examining colorectal anastomoses. In daily clinical practice resorbable sutures are used when...

  4. LigaSure versus Conventional Suture Ligature for Vaginal Hysterectomy: a Randomized Controlled Trial

    OpenAIRE

    Mohamed Abd Elzaher, a, b, Ashraf Moawad, a, c and Hanaa Abu-Ria

    2011-01-01

    Introduction: Vaginal hysterectomy is considered to be the method of choice for removal of the uterus. Of particular concern for the vaginal surgeon is the ability to access, visualize, and legate structures while maintaining adequate hemostasis. Surgical hemostasis can be secured by a variety of methods, including mechanical means (sutures) or vessel coagulation (diathermy). Electro-surgical vessel sealing (LigaSure) is a new hemostatic system based on the combination of pressure and bipolar...

  5. Mini-plate fixation versus suture suspensory fixation in cervical laminoplasty

    Science.gov (United States)

    Liu, Feng-Yu; Ma, Lei; Huo, Li-Shuang; Cao, Yan-Xiang; Yang, Da-Long; Wang, Hui; Yang, Si-Dong; Ding, Wen-Yuan

    2017-01-01

    Abstract Background: Both the mini-plate fixation and suture suspensory fixation techniques are extensively applied in cervical laminoplasty, but which technique is superior has not been ascertained. The purpose of this meta-analysis is to compare the results between mini-plate fixation and suture suspensory fixation in cervical laminoplasty for the patients with multilevel cervical compressive myelopathy. Methods: PubMed, Embase, the Cochrane library, CNKI, and WANFANG were searched for studies that compared mini-plate fixation and suture suspensory fixation in cervical laminoplasty up to November 1, 2016. We calculated odds ratio (OR) with 95% confidence interval (CI) for dichotomous outcomes and mean difference (MD) with 95% CI for continuous outcomes. Review Manager 5.3 was used for the statistical analyses. Results: A total of 25 studies, involving 1603 participants, were included in this review. The results of this meta-analysis indicated that there were statistically significant differences in postoperative Japanese Orthopedic Association (JOA) scores (MD = 0.67, 95% CI: 0.34–0.99, P statistically significant difference in C5 palsy (OR = 0.82, 95% CI: 0.37–1.84, P = 0.63). Conclusions: As compared with suture suspensory fixation, mini-plate fixation in cervical laminoplasty appears to achieve better clinical and radiographic outcomes with fewer surgical complications. However, mini-plate fixation is associated with bigger surgical trauma. This conclusion should be interpreted cautiously and more high-quality, randomized controlled trials are needed in the future. PMID:28151906

  6. A novel suture method to place and adjust peripheral nerve catheters

    DEFF Research Database (Denmark)

    Rothe, C.; Steen-Hansen, C.; Madsen, M. H.;

    2015-01-01

    We have developed a peripheral nerve catheter, attached to a needle, which works like an adjustable suture. We used in-plane ultrasound guidance to place 45 catheters close to the femoral, saphenous, sciatic and distal tibial nerves in cadaver legs. We displaced catheters after their initial plac...... successful and 42/43 secondary placements successful by ultrasound, confirmed in 10/10 cases by magnetic resonance imaging....

  7. Elastic suture (shoelace technique) for fasciotomy closure after treatment of compartmental syndrome associated to tibial fracture.

    Science.gov (United States)

    Branco, Paulo Sergio Martins Castelo; Cardoso Junior, Mauricio; Rotbande, Isaac; Ciraudo, José Antonio Fraga; Silva, Celso Ricardo Correa de Melo; Leal, Paulo Cesar Dos Santos

    2017-01-01

    This article reports the use of elastic suture as an adjuvant in surgical wound closure caused by decompressive fasciotomy after compartment syndrome associated with a compound fracture of the tibia. Widely used in other medico-surgical specialties, this technique is unusual in orthopedics surgery, but the simplicity of the procedure and the successful outcome observed in this case allows for its consideration as indicated for situations similar to that presented in this study.

  8. Conduction Disorders in Continuous Versus Interrupted Suturing Technique in Ventricular Septal Defect Surgical Repair

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    Gholampour-Dehaki

    2016-01-01

    Full Text Available Background Ventricular septal defects (VSD is one of the most frequent congenital cardiac malformations and cardiac conduction disorders are still one of the serious postoperative complications in this surgery. Objectives This study aimed to compare the incidence of conduction disorders with the use of continuous compared to interrupted suturing techniques in VSD surgical repair. Patients and Methods Previously recorded data of 231 patients who underwent surgical closure of VSD between January 2009 and January 2012 at the Rajaie cardiovascular medical and research center were retrospectively reviewed. VSD surgical repair was performed using continues suturing technique in group A patients (n = 163, 70.6% and interrupted suturing technique in group B patients (n = 68, 29.4%. Results The most common concomitant congenital anomaly was Tetralogy of Fallot (27.3%. Twenty-four (10.4% patients had intraoperative cardiac arrhythmia, including 19 (8.2% transient and 5 (2.2 % permanent arrhythmia. During their ICU stay, ventricular arrhythmia and complete heart block were observed in 34 (14.7% and 5 patients (2.2%, respectively. At the time of the last follow-up, incomplete right bundle branch block (RBBB, complete RBBB, RBBB with left anterior hemi-block, and complete heart block were identified in 84 (36.4%, 42 (18.2%, 29 (12.6%, and 5 patients (2.2%, respectively. The results revealed that group A patients were most likely to have had cardiac arrhythmias during their ICU stay and at the time of last follow-up (P < 0.001, while the intraoperative incidence of cardiac arrhythmia during surgery was not statistically significant between the two groups (P = 0.06. Conclusions In the absence of any statistical differences in the other risk factors between the two groups, the difference in the incidence of conduction disorders can be attributed to the type of suturing used during the procedure.

  9. Traumatic lumbar hernia repair: a laparoscopic technique for mesh fixation with an iliac crest suture anchor.

    Science.gov (United States)

    Links, D J R; Berney, C R

    2011-12-01

    Traumatic lumbar hernia (TLH) is a rare presentation. Traditionally, these have been repaired via an open approach. Recurrence can be a problem due to the often limited tissue available for mesh fixation at the inferior aspect of the hernia defect. We report the successful use of bone suture anchors placed in the iliac crest during transperitoneal laparoscopy for mesh fixation to repair a recurrent TLH. This technique may be particularly useful after previous failed attempts at open TLH repair.

  10. Effects of different sutures on fibrosis and wound healing in a rabbit model of corneal wounds.

    Science.gov (United States)

    Li, Ying; Chen, Hui J; Zhang, Hua; Wu, Jian G; Hu, Yun T; Ma, Zhi Z

    2016-11-01

    The aim of the study was to investigate wound healing and scar formation in rabbit corneal lamellar wounds repaired with simple interrupted sutures (SIS) or horizontal mattress sutures (HMS). Two parallel 'I'-shaped lamellar cornea wounds were created in one eye of 40 white New Zealand rabbits, while 5 uninjured rabbits were sacrificed to serve as normal controls. One side of the wounds, in the test rabbits, was closed with SIS, while the other side was treated with HMS. Ten days later, the stitches were removed under anesthesia. The animals were sacrificed on days 14 and 21, and months 3 and 6 after the suturing surgery, and corneal samples were subjected to histological and immunofluorescent studies: α-smooth muscle actin (α-SMA) and vimentin were used to detect myofibroblasts and fibroblasts, respectively, and collagen type I and III was used to detect extracellular matrix (ECM) deposition. Relevant mRNA levels were assessed by quantitative polymerase chain reaction (qPCR) to elucidate the differences in wound healing and formation of fibrosis. Macroscopic and hematoxylin and eosin staining observations showed that the two sides of the wounds developed the most prominent fibrotic tissue on day 21. The immunofluorescence and qPCR results showed that HMS wounds produced increased α-SMA, vimentin and collagen type III compared to the SIS wounds on day 14 or 21. The collagen type I expression showed no distinctive difference in SIS and HMS wounds. In conclusion, corneal lamellar wounds treated with SIS developed less fibrotic-related proteins and related mRNA in the early stages of wound healing than wounds treated with HMS. Although differences were not distinct after 3 months, the results of the present study suggest a benefit in choosing SIS over HMS, as at least the initial fibrotic process seems more benign with SIS. Corneal wounds should be carefully sutured, ensuring the tissue is well aligned.

  11. Continuous suture of the pancreatic stump and Braun enteroenterostomy in pancreaticoduodenectomy

    Science.gov (United States)

    Meng, Hong-Bo; Zhou, Bo; Wu, Fan; Xu, Jie; Song, Zhen-Shun; Gong, Jian; Khondaker, Mahbuba; Xu, Bin

    2015-01-01

    AIM: To investigate a new modification of pancreaticoduodenectomy (PD)-a mesh-like running suturing of the pancreatic remnant and Braun’s enteroenterostomy. METHODS: Two hundred and three patients underwent PD from 2009 to 2014 and were classified into two groups: Group A (98 patients), who received PD with a mesh-like running suturing for the pancreatic remnant, and Braun’s enteroenterostomy; and Group B (105 patients), who received standard PD. Demographic data, intraoperative findings, postoperative morbidity and perioperative mortality between the two groups were compared by univariate and multivariate analysis. RESULTS: Demographic characteristics between Group A and Group B were comparable. There were no significant differences between the two groups concerning perioperative mortality, and operative blood loss, as well as the incidence of the postoperative morbidity, including reoperation, bile leakage, intra-abdominal fluid collection or infection, and postoperative bleeding. Clinically relevant postoperative pancreatic fistula (POPF) and delayed gastric emptying (DGE) were identified more frequently in Group B than in Group A. Technique A (PD with a mesh-like running suturing of the pancreatic remnant and Braun’s enteroenterostomy) was independently associated with decreased clinically relevant POPF and DGE, with an odds ratio of 0.266 (95%CI: 0.109-0.654, P = 0.004) for clinically relevant POPF and 0.073 (95%CI: 0.010-0.578, P = 0.013) for clinically relevant DGE. CONCLUSION: An additional mesh-like running suturing of the pancreatic remnant and Braun’s enteroenterostomy during PD decreases the incidence of postoperative complications and is beneficial for patients. PMID:25759543

  12. Tracking the Archean-Proterozoic suture zone in the northeastern Great Basin, Nevada and Utah

    Science.gov (United States)

    Rodriguez, B.D.; Williams, J.M.

    2008-01-01

    It is important to know whether major mining districts in north-central Nevada are underlain by crust of the Archean Wyoming craton, known to contain major orogenic gold deposits or, alternatively, by accreted crust of the Paleoproterozoic Mojave province. Determining the location and orientation of the Archean-Proterozoic suture zone between these provinces is also important because it may influence subsequent patterns of sedimentation, deformation, magmatism, and hydrothermal activity. The suture zone is exposed in northeastern Utah and south-western Wyoming and exhibits a southwest strike. In the Great Basin, the suture zone strike is poorly constrained because it is largely concealed below a Neoproterozoic-Paleozoic miogeocline and Cenozoic basin fill. Two-dimensional resistivity modeling of three regional north-south magnetotelluric sounding profiles in western Utah, north-central Nevada, and northeastern Nevada, and one east-west profile in northeastern Nevada, reveals a deeply penetrating (>10 km depth), broad (tens of kilometers) conductor (1-20 ohm-meters) that may be the Archean-Proterozoic suture zone, which formed during Early Proterozoic rifting of the continent and subsequent Proterozoic accretion. This major crustal conductor changes strike direction from southwest in Utah to northwest in eastern Nevada, where it broadens to ???100 km width that correlates with early Paleozoic rifting of the continent. Our results suggest that the major gold belts may be over-isolated blocks of Archean crust, so Phanerozoic mineral deposits in this region may be produced, at least in part, from recycled Archean gold. Future mineral exploration to the east may yield large gold tonnages. ?? 2008 Geological Society of America.

  13. Suture Button Fixation Treatment of Chronic Lisfranc Injury in Professional Dancers and High-Level Athletes.

    Science.gov (United States)

    Charlton, Timothy; Boe, Chelsea; Thordarson, David B

    2015-12-01

    Chronic Lisfranc injury is a subtle and severe injury in high-level athletes, including dancers. This patient population is generally intolerant of intra-articular screw fixation and can develop significant post-traumatic arthritis with potentially career ending complications. Flexible fixation with suture-button devices provides potential restoration of physiologic motion at the joint, with appropriate support for healing that may facilitate return to en pointe activities for dancers. We hypothesized that the suture-button device would restore motion at the Lisfranc joint and allow for return to activities in this particular population without the limitations and complications of rigid fixation. We operated on seven dancers and high-level athletes with diagnosed Lisfranc injuries by installing a suture-button device. All patients had failed conservative management after late presentation. They were allowed to return to sport in 6 months, preoperative and postoperative American Orthopaedic Foot and Ankle Score (AOFAS) foot scores were obtained, and patients were followed for a minimum of 15 months. All seven returned to full activities in 6 months, with radiographic evidence of fixation and no complications to date. AOFAS foot scores improved from an average of 65 preoperatively to an average of 97 postoperatively at latest follow-up. It is concluded that flexible fixation with suture-button type device represents a viable alternative to screw fixation or fusion that may allow dancers and athletes to return to previous levels of activity after Lisfranc injury. This case series represents to our knowledge the first application of this device to a unique population that requires flexibility at the Lisfranc joint for performance.

  14. Side-to-side anastomosis using 4 interrupted sutures in small coronary arteries.

    Science.gov (United States)

    Kawahito, Koji; Muraoka, Arata; Misawa, Yoshio

    2014-01-01

    Side-to-side anastomosis in sequential bypass grafting of coronary arteries 1.0 mm in diameter or smaller, requires delicate surgical techniques with a high degree of technical difficulty. However, using only 4 interrupted sutures, we have performed side-to-side anastomosis in sequential grafting without difficulty in a short operative duration. We applied this technique in 58 distal anastomosis procedures, achieving an early angiographic graft patency rate of 100%.

  15. Smart tissue anastomosis robot (STAR): a vision-guided robotics system for laparoscopic suturing.

    Science.gov (United States)

    Leonard, Simon; Wu, Kyle L; Kim, Yonjae; Krieger, Axel; Kim, Peter C W

    2014-04-01

    This paper introduces the smart tissue anastomosis robot (STAR). Currently, the STAR is a proof-of-concept for a vision-guided robotic system featuring an actuated laparoscopic suturing tool capable of executing running sutures from image-based commands. The STAR tool is designed around a commercially available laparoscopic suturing tool that is attached to a custom-made motor stage and the STAR supervisory control architecture that enables a surgeon to select and track incisions and the placement of stitches. The STAR supervisory-control interface provides two modes: A manual mode that enables a surgeon to specify the placement of each stitch and an automatic mode that automatically computes equally-spaced stitches based on an incision contour. Our experiments on planar phantoms demonstrate that the STAR in either mode is more accurate, up to four times more consistent and five times faster than surgeons using state-of-the-art robotic surgical system, four times faster than surgeons using manual Endo360(°)®, and nine times faster than surgeons using manual laparoscopic tools.

  16. Sulcus vocalis: excision, primary suture and medialization laryngoplasty: personal experience with 44 cases.

    Science.gov (United States)

    Yılmaz, Taner

    2012-11-01

    This is a prospective, cohort study to present personal experience on excision of sulcus, primary suture of defect and medialization laryngoplasty. An article about this subject is not present in medical literature. Forty-four patients with sulcus vocalis who were operated on by excision, primary suture of epithelial defect and medialization laryngoplasty were included. Pre- and postoperative evaluations included GRBAS, VHI-30, stroboscopy, aerodynamic and acoustic analysis. Grade, roughness and breathiness of GRBAS were significantly better postoperatively (p  0.05). All VHI-30 results decreased significantly after surgery (p  0.05). Maximum phonation time, mean airflow rate, mean efficiency and mean pressure of aerodynamic analysis improved significantly after surgery (p  0.05). All parameters, except F (0) and soft phonation index during acoustic analysis with /a/, and except F (0), voice turbulence index and soft phonation index during acoustic analysis with constant phrase improved significantly after surgery (p sulcus vocalis are not satisfactory enough, yet. Excision of sulcus, primary suture of epithelial defect and medialization laryngoplasty is one of the successful surgical options. Intact vocal ligament at the bottom of sulcus is a good prognostic sign for good postoperative voice result. Success appears to depend on how long, how wide and how deep sulcus is. Good patient selection may increase the percentage of happy patients.

  17. Inferring the viscous and elastic properties of a suture zone in Larsen C

    Science.gov (United States)

    O'Leary, Martin; Kulessa, Bernd; Booth, Adam; Holland, Paul; Jansen, Daniela; King, Ed; Luckman, Adrian; McGrath, Dan; Zwinger, Thomas

    2016-04-01

    After the collapse of its neighbours, Larsen A and B, the Larsen C ice shelf is widely considered at risk of future climate-driven instability. Recent work has shown that the ice shelf is stabilized by soft melange in its suture zones, where adjacent flow units merge. Little is known about the mechanical properties of melange however, so that the quantification of its effect on the stability of Larsen C Ice Shelf has remained challenging. To identify the structural and elastic properties of the Joerg Peninsula suture zone in Larsen C Ice Shelf, we integrate seismic reflection and ground-penetrating radar (GPR) geophysical measurements. GPR transects reveal the presence of a stiff layer of meteoric ice, trapped between the softer melange beneath and the firn layer above. Monte Carlo analysis reveals that the seismic velocity of this melange is noticeably reduced compared to meteoric ice. By applying Hashin-Shtrikman bounds on the elastic moduli of a two-phase mixture of ice and water to the velocities, we are able to derive the elastic properties of the melange. We ascertain, significantly, that the melange is softer than meteoric ice because it contains a substantial volume fraction of water. The meteoric ice layer is buckling due to compressive lateral stresses. We suggest this process is analogous to fold buckling in sedimentary rocks. Using the ice flow model Elmer/Ice we are able to replicate this process, and thereby derive bounds on the rheological properties of the suture zone melange.

  18. Adjustable versus non-adjustable suture techniques for concomitant horizontal strabismus: a comparative study

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    Galton C. Vasconcelos

    2015-12-01

    Full Text Available ABSTRACT Purpose: To compare the surgical results of adjustable and non-adjustable horizontal strabismus surgery for concomitant horizontal strabismus. Methods: The charts of 231 patients, who underwent horizontal strabismus surgery, selected using probabilistic sampling, were retrospectively reviewed. Patients were divided into two groups according to the surgical technique used and strabismus type. The adjustable suture technique was used for 107 patients (Group 1, and non-adjustable or conventional surgery was performed in the remaining 124 patients (Group 2. Patients with esotropia (ET or exotropia (XT of 5 PD, syndromes, restrictive or paretic strabismus, reoperations, botulinum toxin injection, and patients postoperatively followed up for 50% was present in all subgroups. Significant differences between strabismus groups submitted to adjustable technique and non-adjustable on postoperative day 1 were observed (p=0.00 for ET and p=0.01 for XT and at the last visit for the XT group with a follow-up of at least 1 year (p=0.05. Conclusion: The adjustable suture technique produced a higher success rate than non-adjustable strabismus surgery for both ET and XT groups on postoperative day 1. For XT patients, the adjustable suture technique appears to produce better surgical results than non-adjustable surgery, when the surgical goal is long-lasting maintenance of a small hypercorrection.

  19. Strikingly variable divergence times inferred across an Amazonian butterfly ‘suture zone’

    Science.gov (United States)

    Whinnett, Alaine; Zimmermann, Marie; Willmott, Keith R; Herrera, Nimiadina; Mallarino, Ricardo; Simpson, Fraser; Joron, Mathieu; Lamas, Gerardo; Mallet, James

    2005-01-01

    Suture zones’ are areas where hybrid and contact zones of multiple taxa are clustered. Such zones have been regarded as strong evidence for allopatric divergence by proponents of the Pleistocene forest refugia theory, a vicariance hypothesis frequently used to explain diversification in the Amazon basin. A central prediction of the refugia and other vicariance theories is that the taxa should have a common history so that divergence times should be coincident among taxa. A suture zone for Ithomiinae butterflies near Tarapoto, NE Peru, was therefore studied to examine divergence times of taxa in contact across the zone. We sequenced 1619 bp of the mitochondrial COI/COII region in 172 individuals of 31 species from across the suture zone. Inferred divergence times differed remarkably, with divergence between some pairs of widespread species (each of which may have two or more subspecies interacting in the zone, as in the genus Melinaea) being considerably less than that between hybridizing subspecies in other genera (for instance in Oleria). Our data therefore strongly refute a simple hypothesis of simultaneous vicariance and suggest that ongoing parapatric or other modes of differentiation in continuous forest may be important in driving diversification in Amazonia. PMID:16271979

  20. Arthroscopic Double-Row Suture Anchor Repair of Acute Posterior Bony Bankart Lesion.

    Science.gov (United States)

    Ly, Justin A; Coleman, Erin M; Kropf, Eric J

    2016-08-01

    The treatment of anterior shoulder instability is well described with various techniques, including arthroscopic double-row repair, an alternative to open stabilization procedures in high-risk groups. The surgical management of posterior instability in high-risk and athletic populations is a less-explored entity. We describe our technique for an all arthroscopic double-row suture anchor repair of a large posterior bony Bankart lesion. We prefer this technique over percutaneous cannulated screw fixation because the double-row suture technique allows for incorporation of capsular plication with bony fixation in an effort to better restore normal anatomy for capsulolabral complex. Double-row repair capsulolabral repair or fixation of the bony Bankart is performed via a suture-bridge technique. Medial row anchors are placed down the glenoid neck and shuttled around the bony fragment and labrum. The lateral-row anchor is placed at the rim of the native glenoid. This repair technique has been shown to increase the surface area for healing and more closely reconstruct the native anatomic capsulolabral complex footprint, improve force distribution, and potentially impart enhanced posterior stability to the glenohumeral joint.

  1. [Reconstructing coracoclavicular ligament in treating Rockwood - III Acromioclavicular dislocation by palmaris longus muscle with polyester suture].

    Science.gov (United States)

    Huang, Jian-lin; Mo, Huan-peng

    2015-06-01

    To explore therapeutic effects of reconstructing coracoclavicular ligament for the treatment of Rockwood-III Acromioclavicular dislocation by palmaris longus muscle with polyester suture. From August 2011 to November 2013,37 cases with Rockwood-III acromioclavicular dislocation were treated with reconstructing coracoclavicular ligament by palmaris longus muscle with polyester suture. Among patients, 24 were males and 13 were females, ranging the age from 19 to 46 years old, with an average of 32 years old. There were 11 cases on the left side and 26 cases on the right side. Twenty-nine cases were fresh dislocation and 8 cases were old dislocation. Blood loss, operative time were observed, and Karlsson evaltae standard were applied for assessing postoperative recovery of shoulder joint function. All patients were followed up from 2.5 to 5 months with an average of 3.5 months. Operative time ranged from 52 to 98 (meaned 72) min, blood loss ranged from 50 to 180 (meaned 75) ml. All operative incision were healed at the satge I . According to Karlsson standard, 32 cases obtained excellent results and 5 cases were moderate. For Rockwood-III acromioclavicular dislocation,reconstructing coracoclavicular ligament by palmaris longus muscle with polyester suture has advantages of simple operation, and rapid recovery of shoulder joint function.

  2. Bioabsorbable Suture Anchor Migration to the Acromioclavicular Joint: How Far Can These Implants Go?

    Directory of Open Access Journals (Sweden)

    Giovanna Medina

    2014-01-01

    Full Text Available Few complications regarding the use of bioabsorbable suture anchors in the shoulder have been reported. What motivated this case report was the unusual location of the anchor, found in the acromioclavicular joint which, to our knowledge, has never been reported so far. A 53-year old male with previous rotator cuff (RC repair using bioabsorbable suture anchors presented with pain and weakness after 2 years of surgery. A suspicion of retear of the RC led to request of a magnetic resonance image, in which the implant was found located in the acromioclavicular joint. The complications reported with the use of metallic implants around the shoulder led to the development of bioabsorbable anchors. Advantages are their absorption over time, minimizing the risk of migration or interference with revision surgery, less artifacts with magnetic resonance imaging, and tendon-to-bone repair strength similar to metallic anchors. Since the use of bioabsorbable suture anchors is increasing, it is important to know the possible complications associated with these devices.

  3. Operative treatment of acromioclavicular joint dislocation: a new technique with suture anchors.

    Science.gov (United States)

    Zhang, Jing-Wei; Li, Min; He, Xian-Feng; Yu, Yi-Hui; Zhu, Li-Mei

    2014-01-01

    To evaluate clinical outcome of suture anchors in strengthening both acromioclavicular and coracoclavicular ligaments in the surgical treatment of acromioclavicular joint dislocation. Twenty-eight patients with acute traumatic Rockwood III, IV and V dislocations of the acromioclavicular joint surgically treated at our institute between October 2010 and January 2012 were recruited.All patients underwent open reduction combined with suture anchors. Function was evaluated using the Constant- Murley shoulder score. Clinical and radiographic shoulder ratings were evaluated using Taft criteria at 3, 6 and 12 months. Two cases with fixation loosening were not included in final statistical analysis. Other patients obtained full joint reposition on immediate postoperative radiographs. Follow-up was performed with an average of 15.6 months (range, 12-19). After early range of motion exercises, 96.2% of the patients (25/26) could abduct and elevate their shoulders more than 90 degrees within postoperative 3 months. There was no infection. Average Constant-Murley score was 96.3 points (range, 94-100) and mean Taft shoulder rating was 10.7 points (range, 8-12) at 12 months. The suture anchor is a relatively simple technique and can avoid screw removal which is helpful in reconstructing both acromioclavicular and coracoclavicular ligaments in acute traumatic acromioclavicular joint dislocation.

  4. Maintenance of reduction with suture button fixation devices for ankle syndesmosis repair.

    Science.gov (United States)

    Peterson, Kyle S; Chapman, W Drew; Hyer, Christopher F; Berlet, Gregory C

    2015-06-01

    Malreduction of the syndesmosis can lead to increased peak pressures and subsequent arthritis. The purpose of this study was to evaluate the initial syndesmotic reduction and radiographic maintenance when using a knotless suture button fixation device for treatment of syndesmotic injury. A retrospective chart and radiographic review was performed to identify patients who underwent open reduction internal fixation of ankle syndesmosis ruptures treated with a knotless, suture button fixation system. Radiographic measurements included medial clear space, tibiofibular overlap, tibiofibular clear space, and the distance between buttons. Fifty-six patients underwent repair of an ankle fracture with syndesmotic rupture over a 3-year period, with a mean follow-up of 160.9 days. The tibiofibular clear space and tibiofibular overlap significantly improved from pre- to first p