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Sample records for surgical suturing apparatus

  1. Development of a penetration friction apparatus (PFA) to measure the frictional performance of surgical suture.

    Science.gov (United States)

    Zhang, Gangqiang; Ren, Tianhui; Lette, Walter; Zeng, Xiangqiong; van der Heide, Emile

    2017-10-01

    Nowadays there is a wide variety of surgical sutures available in the market. Surgical sutures have different sizes, structures, materials and coatings, whereas they are being used for various surgeries. The frictional performances of surgical sutures have been found to play a vital role in their functionality. The high friction force of surgical sutures in the suturing process may cause inflammation and pain to the person, leading to a longer recovery time, and the second trauma of soft or fragile tissue. Thus, the investigation into the frictional performance of surgical suture is essential. Despite the unquestionable fact, little is actually known on the friction performances of surgical suture-tissue due to the lack of appropriate test equipment. This study presents a new penetration friction apparatus (PFA) that allowed for the evaluation of the friction performances of various surgical needles and sutures during the suturing process, under different contact conditions. It considered the deformation of tissue and can realize the puncture force measurements of surgical needles as well as the friction force of surgical sutures. The developed PFA could accurately evaluate and understand the frictional behaviour of surgical suture-tissue in the simulating clinical conditions. The forces measured by the PFA showed the same trend as that reported in literatures. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Development of a penetration friction apparatus (PFA) to measure the frictional performance of surgical suture

    NARCIS (Netherlands)

    Zhang, Gangqiang; Ren, Tianhui; Lette, Walter; Zeng, Xiangqiong; van der Heide, Emile

    2017-01-01

    Nowadays there is a wide variety of surgical sutures available in the market. Surgical sutures have different sizes, structures, materials and coatings, whereas they are being used for various surgeries. The frictional performances of surgical sutures have been found to play a vital role in their

  3. 21 CFR 878.4830 - Absorbable surgical gut suture.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Absorbable surgical gut suture. 878.4830 Section 878.4830 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... surgical gut suture. (a) Identification. An absorbable surgical gut suture, both plain and chromic, is an...

  4. Tissue reactions of abdominal integuments to surgical sutures in sonography

    Directory of Open Access Journals (Sweden)

    Andrzej Smereczyński

    2014-03-01

    Full Text Available Classical abdominal surgeries usually require long incisions of the abdominal integuments followed by tight closure with adequate suturing material. Nonabsorbable sutures may cause various reactions, including granuloma reactions, both sterile and inflammatory. The aim of the study was to analyze prospective ultrasound examinations of the abdominal integuments in order to detect tissue reactions to surgical sutures. Material and methods: For 10 years, ultrasound examinations of the abdominal integuments involved the assessment of surgical scars in all patients who underwent open or closed surgeries for various reasons (in total 2254 patients. Ultrasound examinations were performed only with the use of linear probes with the frequency ranging from 7 to 12 MHz. Each scar in the abdominal integuments was scanned in at least two planes. When a lesion was detected, the image was enlarged and the transducer was rotated by approximately 180° in order to capture the dimensions of the granuloma and the most characteristic image of the suture. Moreover, vascularization of the lesion was also assessed with the use of color Doppler mode set to detect the lowest flows. Results: All granulomas (19 lesions, two in one patient created hypoechoic oval or round nodules, were relatively well-circumscribed and their size ranged from 8 × 4 mm to 40 × 14 mm. In the center of the lesion, it was possible to notice a thread that was coiled to various degrees and presented itself as a double, curved hyperechoic line. In 9 out of 19 granulomas, slight peripheral vascularization was observed. The substantial majority of the lesions (n = 15 were in contact with the fascia. In seven patients, compression with the transducer induced known local pain (n = 4 or intensified pain that had already been present (n = 3; all of these granulomas infiltrated the fascia and showed slight peripheral vascularization. Cutaneous fistulae developed in two patients with purulent

  5. Assessing suturing techniques using a virtual reality surgical simulator.

    Science.gov (United States)

    Kazemi, Hamed; Rappel, James K; Poston, Timothy; Hai Lim, Beng; Burdet, Etienne; Leong Teo, Chee

    2010-09-01

    Advantages of virtual-reality simulators surgical skill assessment and training include more training time, no risk to patient, repeatable difficulty level, reliable feedback, without the resource demands, and ethical issues of animal-based training. We tested this for a key subtask and showed a strong link between skill in the simulator and in reality. Suturing performance was assessed for four groups of participants, including experienced surgeons and naive subjects, on a custom-made virtual-reality simulator. Each subject tried the experiment 30 times using five different types of needles to perform a standardized suture placement task. Traditional metrics of performance as well as new metrics enabled by our system were proposed, and the data indicate difference between trained and untrained performance. In all traditional parameters such as time, number of attempts, and motion quantity, the medical surgeons outperformed the other three groups, though differences were not significant. However, motion smoothness, penetration and exit angles, tear size areas, and orientation change were statistically significant in the trained group when compared with untrained group. This suggests that these parameters can be used in virtual microsurgery training.

  6. 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.

  7. ADVANTAGES OF SURGICAL TREATMENT OF ACHILLES TENDON RUPTURE BY PERCUTANEOUS SUTURE AS OPPOSED TO NONSURGICAL TREATMENT

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    Goran Vidić

    2010-06-01

    Full Text Available The Achilles tendon is the strongest tendon in the body, and its rupture appears to be the most common injury of the tendomuscular apparatus. This type of injury is more frequent in sportsmen, especially those who play tennis, gymnastics, skiing, handball, football, basketball and athletics. Also, the ruptures are common in people who engage in sports activities for recreation. They appear more often in males, in proportion of 3:1. It appears reciprocally in 25- 30% of the cases. The rupture is easily diagnosed by means of clinical examination (Thompson's test and ultrasonography.The aim of the analysis was to point to the advantages of surgical treatment of a fresh Achilles tendon rupture as opposed to non-surgical treatment by plaster immobilization.The examination was performed on 35 patients, of which 16 (45,71% were treated operatively and 19 (54,29% were treated nonoperatively. The average age of the patients was 38.8 years, that is 37.1 for those treated operatively and 40.2 for those treated nonoperatively. Among the examinees, there were 29(82,86% men and 6 (17,14% women. The operative treatment method consisted of percutaneous suturing, whereas the nonoperative treatment involved the circular above the knee plaster immobilization. All operatively treated patients underwent the surgical treatment in the first 48 hours from the time when the injury had occured. Anesthesia was local and infiltrative.The obtained results showed that there were no unhealed ruptures or re-ruptures. In the group of patients who did not undergo the surgery, there was 1 re-rupture and 1 unhealed rupture, after which the surgical treatment had to be performed in both cases. In the group of operated patients there were no infections, however, 1 thromboembolism occured. Recovery of muscular strenght of the tendon and the realization of the full range of movement required less time in the operated patients. The ultrasonographic findings in the operated patients

  8. A multicenter randomized controlled trial comparing absorbable barbed sutures versus conventional absorbable sutures for dermal closure in open surgical procedures.

    Science.gov (United States)

    Rubin, J Peter; Hunstad, Joseph P; Polynice, Alain; Gusenoff, Jeffrey A; Schoeller, Thomas; Dunn, Raymond; Walgenbach, Klaus J; Hansen, Juliana E

    2014-02-01

    Barbed sutures were developed to reduce operative time and improve security of wound closure. The authors compare absorbable barbed sutures (V-Loc, Covidien, Mansfield, Massachusetts) with conventional (smooth) absorbable sutures for soft tissue approximation. A prospective multicenter randomized study comparing barbed sutures with smooth sutures was undertaken between August 13, 2009, and January 31, 2010, in 241 patients undergoing abdominoplasty, mastopexy, and reduction mammaplasty. Each patient received barbed sutures on 1 side of the body, with deep dermal sutures eliminated or reduced. Smooth sutures with deep dermal and subcuticular closure were used on the other side as a control. The primary endpoint was dermal closure time. Safety was assessed through adverse event reporting through a 12-week follow-up. A total of 229 patients were ultimately treated (115 with slow-absorbing polymer and 114 with rapid-absorbing polymer). Mean dermal closure time was significantly quicker with the barbed suture compared with the smooth suture (12.0 vs 19.2 minutes; P<.001), primarily due to the need for fewer deep dermal sutures. The rapid-absorbing barbed suture showed a complication profile equivalent to the smooth suture, while the slow-absorbing barbed suture had a higher incidence of minor suture extrusion. Barbed sutures enabled faster dermal closure quicker than smooth sutures, with a comparable complication profile. 1.

  9. Effect of sensory substitution on suture-manipulation forces for robotic surgical systems.

    Science.gov (United States)

    Kitagawa, Masaya; Dokko, Daniell; Okamura, Allison M; Yuh, David D

    2005-01-01

    Direct haptic (force or tactile) feedback is not yet available in commercial robotic surgical systems. Previous work by our group and others suggests that haptic feedback might significantly enhance the execution of surgical tasks requiring fine suture manipulation, specifically those encountered in cardiothoracic surgery. We studied the effects of substituting direct haptic feedback with visual and auditory cues to provide the operating surgeon with a representation of the forces he or she is applying with robotic telemanipulators. Using the robotic da Vinci surgical system (Intuitive Surgical, Inc, Sunnyvale, Calif), we compared applied forces during a standardized surgical knot-tying task under 4 different sensory-substitution scenarios: no feedback, auditory feedback, visual feedback, and combined auditory-visual feedback. The forces applied with these sensory-substitution modes more closely approximate suture tensions achieved under ideal haptic conditions (ie, hand ties) than forces applied without such sensory feedback. The consistency of applied forces during robot-assisted suture tying aided by visual feedback or combined auditory-visual feedback sensory substitution is superior to that achieved with hand ties. Robot-assisted ties aided with auditory feedback revealed levels of consistency that were generally equivalent or superior to those attained with hand ties. Visual feedback and auditory feedback improve the consistency of robotically applied forces. Sensory substitution, in the form of visual feedback, auditory feedback, or both, confers quantifiable advantages in applied force accuracy and consistency during the performance of a simple surgical task.

  10. 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.

  11. Efficacy of silver coated surgical sutures on bacterial contamination, cellular response and wound healing

    International Nuclear Information System (INIS)

    Gallo, Anna Lucia; Paladini, Federica; Romano, Alessandro; Verri, Tiziano; Quattrini, Angelo; Sannino, Alessandro; Pollini, Mauro

    2016-01-01

    The resistance demonstrated by many microorganisms towards conventional antibiotics has stimulated the interest in alternative antimicrobial agents and in novel approaches for prevention of infections. Silver, a natural braod-spectrum antimicrobial agent known since antiquity, has been widely employed in biomedical field due to its recognized antibacterial, antifungal and antiviral properties. In this work, antibacterial silver coatings were deposited on absorbable surgical sutures through the in situ photo-chemical deposition of silver clusters. Scanning electron microscopy (SEM), Energy dispersive X-ray spectroscopy (EDX) and thermo-gravimetric analysis (TGA) were performed in order to investigate the presence and distribution of the silver clusters on the substrate. The amounts of silver deposited and released by the silver treated sutures were calculated through Inductively Coupled Plasma-Mass Spectroscopy (ICP-MS), and the results were related to the biodegradation of the material. The microbiological properties and the potential cytotoxicity of the silver-treated sutures were investigated in relation with hydrolysis experiments, in order to determine the effect of the degradation on antibacterial properties and biocompatibility. - Highlights: • The in situ photo-deposition of silver nano-coatings was used to develop silver treated PGLA sutures. • The silver particles deposited had good distribution and strong adhesion to the substrate. • The silver treated sutures demonstrated good biocompatibility and antibacterial capability. • The presence of silver promoted cell migration and proliferation in the wound area.

  12. Efficacy of silver coated surgical sutures on bacterial contamination, cellular response and wound healing

    Energy Technology Data Exchange (ETDEWEB)

    Gallo, Anna Lucia [Department of Engineering for Innovation, University of Salento, Via Monteroni, 73100 Lecce (Italy); Paladini, Federica, E-mail: federica.paladini@unisalento.it [Department of Engineering for Innovation, University of Salento, Via Monteroni, 73100 Lecce (Italy); Romano, Alessandro [Neuropathology Unit, Institute of Experimental Neurology and Division of Neuroscience, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132 Milan (Italy); Verri, Tiziano [Di.S.Te.B.A., University of Salento, Via per Monteroni, 73100 Lecce (Italy); Quattrini, Angelo [Neuropathology Unit, Institute of Experimental Neurology and Division of Neuroscience, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132 Milan (Italy); Sannino, Alessandro; Pollini, Mauro [Department of Engineering for Innovation, University of Salento, Via Monteroni, 73100 Lecce (Italy)

    2016-12-01

    The resistance demonstrated by many microorganisms towards conventional antibiotics has stimulated the interest in alternative antimicrobial agents and in novel approaches for prevention of infections. Silver, a natural braod-spectrum antimicrobial agent known since antiquity, has been widely employed in biomedical field due to its recognized antibacterial, antifungal and antiviral properties. In this work, antibacterial silver coatings were deposited on absorbable surgical sutures through the in situ photo-chemical deposition of silver clusters. Scanning electron microscopy (SEM), Energy dispersive X-ray spectroscopy (EDX) and thermo-gravimetric analysis (TGA) were performed in order to investigate the presence and distribution of the silver clusters on the substrate. The amounts of silver deposited and released by the silver treated sutures were calculated through Inductively Coupled Plasma-Mass Spectroscopy (ICP-MS), and the results were related to the biodegradation of the material. The microbiological properties and the potential cytotoxicity of the silver-treated sutures were investigated in relation with hydrolysis experiments, in order to determine the effect of the degradation on antibacterial properties and biocompatibility. - Highlights: • The in situ photo-deposition of silver nano-coatings was used to develop silver treated PGLA sutures. • The silver particles deposited had good distribution and strong adhesion to the substrate. • The silver treated sutures demonstrated good biocompatibility and antibacterial capability. • The presence of silver promoted cell migration and proliferation in the wound area.

  13. Comparison of surgical time and complication rate of subcutaneous and skin closure using barbed suture or traditional knotted suture in dogs.

    Science.gov (United States)

    Nutt, Laura K; Wilson, Megan L; Sakals, Sherisse

    2017-12-01

    This prospective study evaluated the handling, intraoperative and postoperative complication rates of a barbed knotless suture for closure of subcutaneous tissue and skin in 17 client-owned dogs (group A) following a tibial plateau leveling osteotomy procedure. Clinical characteristics, surgical time, and complication rates were compared to a control group of 17 client-owned dogs (group B) with subcutaneous tissue and skin closure using traditional suture material. Signalment was not significantly different between groups and did not have an effect on complication rates. Surgical times were not significantly different for subcutaneous tissue or skin closure between the 2 groups. There were significantly more intraoperative complications in the barbed suture group (A: 4/17; B: 0/17; P = 0.033) but no difference in minor or major postoperative complication rates (minor A: 2/16; B: 1/14; P = 0.626, major A: 2/16; B: 0/14; P = 0.171).

  14. Viable adhered Staphylococcus aureus highly reduced on novel antimicrobial sutures using chlorhexidine and octenidine to avoid surgical site infection (SSI)

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    Schneider, Jochen; Harrasser, Norbert; Tübel, Jutta; Mühlhofer, Heinrich; Pförringer, Dominik; von Deimling, Constantin; Foehr, Peter; Kiefel, Barbara; Krämer, Christina; Stemberger, Axel; Schieker, Matthias

    2018-01-01

    Background Surgical sutures can promote migration of bacteria and thus start infections. Antiseptic coating of sutures may inhibit proliferation of adhered bacteria and avoid such complications. Objectives This study investigated the inhibition of viable adhering bacteria on novel antimicrobially coated surgical sutures using chlorhexidine or octenidine, a critical factor for proliferation at the onset of local infections. The medical need, a rapid eradication of bacteria in wounds, can be fulfilled by a high antimicrobial efficacy during the first days after wound closure. Methods As a pretesting on antibacterial efficacy against relevant bacterial pathogens a zone of inhibition assay was conducted with middle ranged concentrated suture coatings (22 μg/cm). For further investigation of adhering bacteria in detail the most clinically relevant Staphylococcus aureus (ATCC®49230™) was used. Absorbable braided sutures were coated with chlorhexidine-laurate, chlorhexidine-palmitate, octenidine-laurate, and octenidine-palmitate. Each coating type resulted in 11, 22, or 33 μg/cm drug content on sutures. Scanning electron microscopy (SEM) was performed once to inspect the coating quality and twice to investigate if bacteria have colonized on sutures. Adhesion experiments were assessed by exposing coated sutures to S. aureus suspensions for 3 h at 37°C. Subsequently, sutures were sonicated and the number of viable bacteria released from the suture surface was determined. Furthermore, the number of viable planktonic bacteria was measured in suspensions containing antimicrobial sutures. Commercially available sutures without drugs (Vicryl®, PGA Resorba®, and Gunze PGA), as well as triclosan-containing Vicryl® Plus were used as control groups. Results Zone of inhibition assay documented a multispecies efficacy of novel coated sutures against tested bacterial strains, comparable to most relevant S. aureus over 48 hours. SEM pictures demonstrated uniform layers on

  15. Politetrafluorene suture used as artificial mitral chord: mechanical properties and surgical implications.

    Science.gov (United States)

    Caimmi, Philippe P; Sabbatini, Maurizio; Fusaro, Luca; Cannas, Mario

    2017-12-01

    Novel surgical approach to repair degenerative mitral regurgitation such as transapical chordae tendineae replacement and "loop in loop" in loop techniques, need of artificial chordae longer than that used in the older techniques of chordae tendineae replacement. This difference in length has been reported as potential critical point for durability of artificial chordae. In the present paper we have investigated the elastic behavior of different diameter and length politetrafluorene (PTFE) suture threads as substitute of native chordae, to identify their reliability to use as long artificial chordae. PTFE suture threads with different diameters were investigated in their mechanical properties at different length from 2 to 14 cm, by a servo hydraulic testing machine, to test the elastic properties of the sample in their use as mitral chordae substitutes. Our study shows that the chordae length is an important parameter that can change the performance of chordae itself. The analysis of elastic/properties of suture threads specimen, reveals that long PTFE chords have an optimal mechanical behavior in which elongation is accompanied by a safe elastic properties that make them well resistance during multiple tractions. In conclusion the use of PTFE as an artificial chordae may represent a valid choice in case of insertion of artificial chordae with extra anatomic length.

  16. Two Techniques of Intestinal Wall Suture in Surgical Treatment of Ileus in Dogs and the Importance of Omentalisation

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    M. Crha

    2008-01-01

    Full Text Available Model experimental studies focused on the intestinal suture techniques in relation to healing, postoperative narrowing of the intestinal lumen or adhesion formation can not comprise a number of clinical factors (foreign body presence in the intestine, haematological abnormalities, septic peritonitis, different age of patients, etc. that under clinical practice conditions may have an effect on the healing of the intestinal suture. The aim of this clinical study was to confirm in a group of dogs surgically treated for small bowel obstruction, whether different techniques of its wall suture may affect the frequency of possible dehiscence occurrence. This study compares two different techniques of intestinal wall suture in relation to postoperative dehiscence of the intestinal wall closure. Based on the clinical observation with regard to the risk of postoperative dehiscence and possible complications in form of adhesions, also the importance of omentalisation in the suture of small bowel was evaluated. No significant difference was demonstrated (p > 0.05 in the frequency of postoperative dehiscence at the site of the intestinal wall closure between the two-layer inverting and singlelayer appositional techniques of suture. Likewise, no significant difference was demonstrated (p > 0.05 in the frequency of dehiscence of intestinal wall suture between patients that underwent intestinal suture omentalisation and those whose intestinal wall suture was not complemented with omentalisation. Based on the results of this clinical study it may be stated that both manual single-layer approximation technique and two-layer inverting technique of the intestinal wall suture are equally safe from the viewpoint of possible dehiscence, and it depends on the surgeon's preference, which one of the said techniques he or she chooses. Concurrently it may be assumed that an exactly performed suture of the intestinal wall does not necessarily require omentalisation.

  17. Surgical suture braided with a diclofenac-loaded strand of poly(lactic-co-glycolic acid) for local, sustained pain mitigation.

    Science.gov (United States)

    Huh, Beom Kang; Kim, Byung Hwi; Kim, Se-Na; Park, Chun Gwon; Lee, Seung Ho; Kim, Ka Ryeong; Heo, Chan Yeong; Choy, Young Bin

    2017-10-01

    In this work, we propose a surgical suture that can sustainably release diclofenac (DF) for the local pain relief of surgical wounds. We separately fabricated a DF-loaded strand composed of a biodegradable polymer, poly(lactic-co-glycolic acid) (PLGA), which was then braided with a surgical suture already in clinical use, i.e., VICRYL™. In this way, the drug-delivery suture presented herein could release DF in a sustained manner for 10days while maintaining the mechanical strength needed for wound closure. According to the in vivo results of an induced-pain animal model, the drug-delivery suture mitigated pain throughout the period of persistent pain. The histological analysis of tissue around the sutures showed that the drug-delivery suture exhibited biocompatibility comparable to that of the VICRYL™ suture in clinical use. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Results of a prospective randomised study comparing a non-invasive surgical zipper versus intracutaneous sutures for wound closure

    NARCIS (Netherlands)

    Roolker, W.; Kraaneveld, E.; Been, H. D.; Marti, R. K.

    2002-01-01

    A prospective randomised study was undertaken to investigate the advantages and disadvantages of a non-invasive surgical zipper (Medizip) vs intracutaneous sutures skin closure in orthopaedic surgery. The study group consisted of 120 consecutive patients, 45 men and 75 women with a mean age of 47

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

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    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.

  20. In vivo Molecular Evaluation of Guinea Pig Skin Incisions Healing after Surgical Suture and Laser Tissue Welding Using Raman Spectroscopy

    Science.gov (United States)

    Alimova, A.; Chakraverty, R.; Muthukattil, R.; Elder, S.; Katz, A.; Sriramoju, V.; Lipper, Stanley; Alfano, R. R.

    2009-01-01

    The healing process in guinea pig skin following surgical incisions was evaluated at the molecular level, in vivo, by the use of Raman spectroscopy. After the incisions were closed either by suturing or by laser tissue welding (LTW), differences in the respective Raman spectra were identified. The study determined that the ratio of the Raman peaks of the amide III (1247 cm−1) band to a peak at 1326 cm−1 (the superposition of elastin and keratin bands) can be used to evaluate the progression of wound healing. Conformational changes in the amide I band (1633 cm−1 to 1682 cm−1) and spectrum changes in the range of 1450 cm−1 to 1520 cm−1 were observed in LTW and sutured skin. The stages of the healing process of the guinea pig skin following LTW and suturing were evaluated by Raman spectroscopy, using histopathology as the gold standard. LTW skin demonstrated better healing than sutured skin, exhibiting minimal hyperkeratosis, minimal collagen deposition, near-normal surface contour, and minimal loss of dermal appendages. A wavelet decomposition-reconstruction baseline correction algorithm was employed to remove the fluorescence wing from the Raman spectra. PMID:19581109

  1. A Novel Clinical-Simulated Suture Education for Basic Surgical Skill: Suture on the Biological Tissue Fixed on Standardized Patient Evaluated with Objective Structured Assessment of Technical Skill (OSATS) Tools.

    Science.gov (United States)

    Shen, Zhanlong; Yang, Fan; Gao, Pengji; Zeng, Li; Jiang, Guanchao; Wang, Shan; Ye, Yingjiang; Zhu, Fengxue

    2017-06-21

    Clinical-simulated training has shown benefit in the education of medical students. However, the role of clinical simulation for surgical basic skill training such as suturing techniques remains unclear. Forty-two medical students were asked to perform specific suturing tasks at three stations with the different settings within four minutes (Station 1: Synthetic suture pad fixed on the bench, Station 2: Synthetic suture pad fixed on the standardized patient, Station 3: Pig skin fixed on the standardized patient); the OSATS (Objective Structured Assessment of Technical Skill) tool was used to evaluate the performance of students. A questionnaire was distributed to the students following the examination. Mean performance score of Station 3 was significant lower than that of Station 1 and 2 in the general performance including tissue handling, time, and motion. The suturing techniques of students at Station 2 and 3 were not as accurate as that at Station 1. Inappropriate tension was applied to the knot at Station 2 compared with Station 1 and 3. On the questionnaire, 93% of students considered clinical-simulated training of basic surgical skills was necessary and may increase their confidence in future clinical work as surgeons; 98% of students thought the assessment was more objective when OSATS tool was used for evaluation. Clinical simulation examination assessed with OSATS might throw a novel light on the education of basic surgical skills and may be worthy of wider adoption in the surgical education of medical students.

  2. Adjustment of gamma radiation doses for sterilization of Egyptian surgical sutures

    International Nuclear Information System (INIS)

    Tawfik, Z.S.; Helmy, M.M.; Roushdy, H.M.

    1984-01-01

    The adjustment of gamma radiation doses for sterilization of catguts under local manufacturing conditions has been performed. Average total initial counts for aerobic and anaerobic bacteria per item were relatively low, in the range of 1000 counts for aerobic and 10 counts for anaerobic bacteria. The microfiora (aerobic bacteria) of the studied sutures were isolated and identified to be: Bacillus sp.; Micrococcus varians, Micrococcus roseus, and Staphylococcus. Each purified and identified isolate was exposed to gamma radiation both in liquid media (broth) and in the preservative in which the sutures were supplied by the company. The LD values of the most resistant microorganisms in both case of liquid media and preservative, were obtained to be around 5 KGy. Deliberately contaminated sterile sutures with each isolate and with mixture of isolates were studied. The sterilizing dose was obtained to be 20KGy for most heavily contaminated items (10 10 counts) irradiated both in saline and in preservative. This sterilizing dose was found to be dependent of the initial viable counts. This value was considered to be a safe value for radiosterilization of the studied sutures preserved in isopropyl alcohol, glycerin, and water (90:3.5:16)

  3. A Novel Surgical Pre-suturing Technique for the Management of ...

    African Journals Online (AJOL)

    cannot be protruded beyond lower incisor teeth because of a short lingual ... suggests that surgical interventions are absolutely safe at any age including ... Surgical procedures indicated for ankyloglossia are highly predictable but shows poor ...

  4. 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...

  5. SURGICAL TREATMENT OF PATIENTS WITH HALLUX VALGUS BY MINI-APPARATUS OF EXTERNAL FIXATION

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    K.K. Levchenko

    2008-06-01

    Full Text Available The authors of article suggest methods of surgical correction of pathology by means of fixation of the first metatarsal bone with specialconstruction ofmini-apparatus for externalfixation. This approach provides decrease of recovery period, reduces complications riskas well as deformation relapse.

  6. Suture fixation of migrated septal occluder device to prevent further migration: a simple surgical technique

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    Mohite Prashant N

    2013-01-01

    Full Text Available Abstract As the use of percutaneous intervention is increasing for the closure of the atrial septal defect, the procedure related complications are also on rise, migration of the device being most common. The migrated devices with failed percutaneous retrieval must be removed surgically under cardiopulmonary bypass. During establishment of cardiopulmonary bypass, the handling of heart may cause further migration of the device into other chambers of heart which leads to difficulty in finding and retrieval of the device. The authors propose a simple and unique technique to prevent further migration of the septal occluder device.

  7. Suture Coding: A Novel Educational Guide for Suture Patterns.

    Science.gov (United States)

    Gaber, Mohamed; Abdel-Wahed, Ramadan

    2015-01-01

    This study aims to provide a helpful guide to perform tissue suturing successfully using suture coding-a method for identification of suture patterns and techniques by giving full information about the method of application of each pattern using numbers and symbols. Suture coding helps construct an infrastructure for surgical suture science. It facilitates the easy understanding and learning of suturing techniques and patterns as well as detects the relationship between the different patterns. Guide points are fixed on both edges of the wound to act as a guideline to help practice suture pattern techniques. The arrangement is fixed as 1-3-5-7 and a-c-e-g on one side (whether right or left) and as 2-4-6-8 and b-d-f-h on the other side. Needle placement must start from number 1 or letter "a" and continue to follow the code till the end of the stitching. Some rules are created to be adopted for the application of suture coding. A suture trainer containing guide points that simulate the coding process is used to facilitate the learning of the coding method. (120) Is the code of simple interrupted suture pattern; (ab210) is the code of vertical mattress suture pattern, and (013465)²/3 is the code of Cushing suture pattern. (0A1) Is suggested as a surgical suture language that gives the name and type of the suture pattern used to facilitate its identification. All suture patterns known in the world should start with (0), (A), or (1). There is a relationship between 2 or more surgical patterns according to their codes. It can be concluded that every suture pattern has its own code that helps in the identification of its type, structure, and method of application. Combination between numbers and symbols helps in the understanding of suture techniques easily without complication. There are specific relationships that can be identified between different suture patterns. Coding methods facilitate suture patterns learning process. The use of suture coding can be a good

  8. Effectiveness of triclosan-coated PDS Plus versus uncoated PDS II sutures for prevention of surgical site infection after abdominal wall closure: the randomised controlled PROUD trial.

    Science.gov (United States)

    Diener, Markus K; Knebel, Phillip; Kieser, Meinhard; Schüler, Philipp; Schiergens, Tobias S; Atanassov, Vladimir; Neudecker, Jens; Stein, Erwin; Thielemann, Henryk; Kunz, Reiner; von Frankenberg, Moritz; Schernikau, Utz; Bunse, Jörg; Jansen-Winkeln, Boris; Partecke, Lars I; Prechtl, Gerald; Pochhammer, Julius; Bouchard, Ralf; Hodina, René; Beckurts, K Tobias E; Leißner, Lothar; Lemmens, Hans-Peter; Kallinowski, Friedrich; Thomusch, Oliver; Seehofer, Daniel; Simon, Thomas; Hyhlik-Dürr, Alexander; Seiler, Christoph M; Hackert, Thilo; Reissfelder, Christoph; Hennig, René; Doerr-Harim, Colette; Klose, Christina; Ulrich, Alexis; Büchler, Markus W

    2014-07-12

    Postoperative surgical site infections are one of the most frequent complications after open abdominal surgery, and triclosan-coated sutures were developed to reduce their occurrence. The aim of the PROUD trial was to obtain reliable data for the effectiveness of triclosan-coated PDS Plus sutures for abdominal wall closure, compared with non-coated PDS II sutures, in the prevention of surgical site infections. This multicentre, randomised controlled group-sequential superiority trial was done in 24 German hospitals. Adult patients (aged ≥18 years) who underwent elective midline abdominal laparotomy for any reason were eligible for inclusion. Exclusion criteria were impaired mental state, language problems, and participation in another intervention trial that interfered with the intervention or outcome of this trial. A central web-based randomisation tool was used to randomly assign eligible participants by permuted block randomisation with a 1:1 allocation ratio and block size 4 before mass closure to either triclosan-coated sutures (PDS Plus) or uncoated sutures (PDS II) for abdominal fascia closure. The primary endpoint was the occurrence of superficial or deep surgical site infection according to the Centers for Disease Control and Prevention criteria within 30 days after the operation. Patients, surgeons, and the outcome assessors were masked to group assignment. Interim and final analyses were by modified intention to treat. This trial is registered with the German Clinical Trials Register, number DRKS00000390. Between April 7, 2010, and Oct 19, 2012, 1224 patients were randomly assigned to intervention groups (607 to PDS Plus, and 617 to PDS II), of whom 1185 (587 PDS Plus and 598 PDS II) were analysed by intention to treat. The study groups were well balanced in terms of patient and procedure characteristics. The occurrence of surgical site infections did not differ between the PDS Plus group (87 [14·8%] of 587) and the PDS II group (96 [16·1%] of 598

  9. [The speed of nerve-conduction after micro-surgical suture of the tibial nerve of the rabbit (author's transl)].

    Science.gov (United States)

    Weigert, M; Mellerowicz, H; Werhahn, C

    1975-10-01

    Isolated division of the tibial nerve in the thigh preserving the peroneal and sural nerves does not cause loss of normal position of the animal, in particular of sitting. Nor does it lead to pressure sores. The animals are fitter then after division of the sciatic nerve. Microsurgical suture of the isolated tibial nerve in the thigh of the rabbit with 1 or 2 simple sutures with 10 x 0 thread show that an average recovery can be achieved in over 80 per cent. As few sutures as possible should be used. Otherwise there with be scarring and no return of function.

  10. Two Techniques of Intestinal Wall Suture in Surgical Treatment of Ileus in Dogs and the Importance of Omentalisation

    OpenAIRE

    M. Crha; J. Lorenzová; L. Urbanová; T. Fichtel; A. Nečas

    2008-01-01

    Model experimental studies focused on the intestinal suture techniques in relation to healing, postoperative narrowing of the intestinal lumen or adhesion formation can not comprise a number of clinical factors (foreign body presence in the intestine, haematological abnormalities, septic peritonitis, different age of patients, etc.) that under clinical practice conditions may have an effect on the healing of the intestinal suture. The aim of this clinical study was to confirm in a group of do...

  11. Transvaginal Cystocele Repair by Purse-String Technique Reinforced with Three Simple Sutures: Surgical Technique and Results

    Directory of Open Access Journals (Sweden)

    Ho-Sook Song

    2012-09-01

    Full Text Available Purpose Different techniques for cystocele repair including the conventional anterior colporrhaphy and mesh technique are known. Our goal was to evaluate the anatomical success and safety of our method of transvaginal anterior vaginal wall repair by the purse-string technique reinforced with three simple additional sutures in the repair of cystocele over a 4-year follow-up period. Methods This was a retrospective review of 69 consecutive patients (grades 2 to 4 who underwent the above operations between 2001 and 2011, including their success rates as assessed by use of the Baden-Walker halfway classification system. Results Of the patients, 62 patients (98% were completely cured of cystocele and 1 patient showed grade 2 cystocele recurrence that required no further treatment. Two patients with grade 4 cystocele were completely cured. There was no vaginal erosion related to the cystocele repair. Conclusions Transvaginal anterior colporrhaphy by a purse-string technique reinforced with simple additive sutures appears to be a simple, safe, and easily performed approach in cystocele repair. There is no need for other material for reinforcement, even in high-grade cystocele, which is an advantage of our technique.

  12. Biomechanical properties of double- and single-row suture anchor repair for surgical treatment of insertional Achilles tendinopathy.

    Science.gov (United States)

    Beitzel, Knut; Mazzocca, Augustus D; Obopilwe, Elifho; Boyle, James W; McWilliam, James; Rincon, Lina; Dhar, Yasmin; Arciero, Robert A; Amendola, Annunziato

    2013-07-01

    Because of intratendinous ossifications, retrocalcaneal bursitis, or intratendinous necrosis commonly found in insertional tendinosis, it is often necessary to detach the tendon partially or entirely from its tendon-to-bone junction. Double-row repair for insertional Achilles tendinopathy will generate an increased contact area and demonstrate higher biomechanical stability. Controlled laboratory study. Eighteen cadaver Achilles tendons were split longitudinally and detached, exposing the calcaneus; an ostectomy was performed and the tendon was reattached to the calcaneus in 1 of 2 ways: 2 suture anchors (single row) or a 4-anchor (double row) construct. Footprint area measurements over time, displacement after cyclic loading (2000 cycles), and final load to failure were measured. The double-row refixation technique was statistically superior to the single-row technique in footprint area measurement initially and 5 minutes after repair (P = .009 and P = .01, respectively) but not after 24 hours (P = .713). The double-row construct demonstrated significantly improved measures for peak load (433.9 ± 84.3 N vs 212.0 ± 49.7 N; P = .042), load at yield (354.7 ± 106.2 N vs 198.7 ± 39.5 N; P = .01), and slope (51.8 ± 9.9 N/mm vs 66.7 ± 16.2 N/mm; P = .021). Cyclic loading did not demonstrate significant differences between the 2 constructs. Double-row construct for reinsertion of a completely detached Achilles tendon using proximal and distal rows resulted in significantly larger contact area initially and 5 minutes after repair and led to significantly higher peak load to failure on destructive testing. In treatment for insertional Achilles tendinosis, the tendon often has to be detached and anatomically reattached to its insertion at the calcaneus. To our knowledge there is a lack of biomechanical studies supporting either a number or a pattern of suture anchor fixation. Because the stresses going across the insertion site of the Achilles tendon are significant

  13. The suspension (Frost) suture: experience and applications.

    Science.gov (United States)

    Connolly, Karen L; Albertini, John G; Miller, Christopher J; Ozog, David M

    2015-03-01

    The Frost suture is a well-known surgical technique for providing upward tension on the lower lid to prevent or correct ectropion after surgical interventions in the periorbital area. Despite its relatively common use, comprehensive information on executing this technique is not readily available. To review eyelid anatomy, indications, and proper technique for performing the Frost suture, as well as potential complications. A review of the literature on Frost sutures was performed. Cadaveric dissection was performed to demonstrate placement of the Frost suture. The Frost suture is a useful method to reduce the risk of ectropion after surgery near the lower eyelid. Downward pull on the lid can occur with normal wound contracture even if ectropion is not present with the initial repair, reinforcing the need for preventive measures. Potential complications of this technique include superficial skin erosion of the upper lid, corneal abrasion, and blockage of the field of vision while the suture is in place.

  14. Retrospective evaluation of milk production and culling risk following either surgical, toggle-pin suture or conservative treatment of left displaced abomasum in Chilean dairy cows.

    Science.gov (United States)

    Melendez, P; Romero, C; Pithua, P; Marin, M P; Pinedo, P; Duchens, M

    2017-11-01

    AIMS To describe milk yield and culling risk in cows diagnosed with left displacement of abomasum (LDA) treated either conservatively, by right flank pyloric omentopexy, or rolling and toggling, compared with normal herdmates from four Chilean dairy herds. METHODS Historical records were obtained from four commercial dairy farms located in Central Chile for cows with a history of LDA between 2010 and 2012, and healthy herdmates. Cows with LDA were categorised into three groups: cows treated with right omentopexy (ST, n=58), cows treated by toggle suturing (TT, n=15) and cows treated conservatively (CT, n=56). Control cows (n=129) were selected from unaffected cows, matched by days in milk (DIM), parity and herd with affected cows. Groups were compared for risk of culling up to 300 DIM and for milk production up to 5 months of lactation using survival and Cox proportional hazard models and mixed models for repeated measures, respectively. RESULTS Compared with cows in the Control group, the risk of being culled up to 300 DIM was 9.1 (SE 0.62) times greater in ST cows, 10.4 (SE 0.68) times greater in TT cows, and 37.3 (SE 0.61) times greater in CT cows (pcows in the Control group, mean daily milk production was 23.3 (SE 1.5) kg less in ST cows, 15.3 (SE 1.6) kg less in TT cows, and 30.1 (SE 1.3) kg less in CT cows (pCows in four dairy herds in central Chile diagnosed and treated for LDA produced significantly less milk and had a higher risk of culling than healthy herdmates. Although cows treated surgically or with toggle suture never recovered to the extent of healthy cows, they produced more milk than cows treated conservatively. However, the retrospective nature of the data, the inclusion of only four herds and the non-random allocation to treatments means that these conclusions cannot be extrapolated to the overall dairy cattle population in Chile.

  15. The history of barbed sutures.

    Science.gov (United States)

    Ruff, Gregory L

    2013-09-01

    Ligatures have been used for millennia to close wounds. Sterilization and synthetic polymers that degrade in a commensurate fashion with wound healing have been the most significant improvements in these age-old devices. However, the constricting loop of a traditional suture and subsequent ischemia ("approximate, don't strangulate") still account for the most common cause of wound dehiscence-necrosis. Inspired by the quill of the North American porcupine, I envisioned a bidirectional array of barbs that could secure tissue without relying on constricting loops. One set of barbs could anchor the other. In this article, I document the development process of these barbed sutures from concept to patent to manufacture and US Food and Drug Administration approval. Knotless, strong, and easy to place, barbed sutures could foreseeably supplant conventional sutures, particularly as endoscopic procedures become more common. They also offer the intriguing potential to suspend ptotic tissues without surgical intervention.

  16. A randomized clinical trial of knotless barbed suture vs conventional suture for closure of the uterine incision at cesarean delivery.

    Science.gov (United States)

    Peleg, David; Ahmad, Ronan Said; Warsof, Steven L; Marcus-Braun, Naama; Sciaky-Tamir, Yael; Ben Shachar, Inbar

    2018-03-01

    Knotless barbed sutures are monofilament sutures with barbs cut into them. These sutures self-anchor, maintaining tissue approximation without the need for surgical knots. The hypothesis of this study was that knotless barbed suture could be used on the myometrium to close the hysterotomy at cesarean delivery. The objective was to compare uterine closure time, need for additional sutures, and blood loss between this and a conventional suture. This was a prospective, unblinded, randomized controlled trial conducted at the Ziv Medical Center, Zefat, Israel. The primary outcome was the length of time needed to close the uterine incision, which was measured from the start of the first suture on the uterus until obtaining uterine hemostasis. To minimize provider bias, women were randomized by sealed envelopes that were opened in the operating room just prior to uterine closure with either a bidirectional knotless barbed suture or conventional suture. Secondary outcomes included the number of additional hemostatic sutures needed and blood loss during incision closure. Patients were enrolled from August 2016 until March 2017. One hundred two women were randomized. Fifty-one had uterine closure with knotless barbed suture and 51 with conventional suture. The groups were similar for demographics as well as number of previous cesarean deliveries. Uterine closure time using the knotless barbed suture was significantly shorter than the conventional suture by a mean of 1 minute 43 seconds (P barbed sutures were associated with a lower need for hemostatic sutures (median 0 vs 1, P barbed suture is a reasonable alternative to conventional sutures because it reduced the closure time of the uterine incision. There was also less need for additional hemostatic sutures and slightly reduced estimated blood loss. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Visual Measurement of Suture Strain for Robotic Surgery

    Directory of Open Access Journals (Sweden)

    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.

  18. [Bases and methods of suturing].

    Science.gov (United States)

    Vogt, P M; Altintas, M A; Radtke, C; Meyer-Marcotty, M

    2009-05-01

    If pharmaceutic modulation of scar formation does not improve the quality of the healing process over conventional healing, the surgeon must rely on personal skill and experience. Therefore a profound knowledge of wound healing based on experimental and clinical studies supplemented by postsurgical means of scar management and basic techniques of planning incisions, careful tissue handling, and thorough knowledge of suturing remain the most important ways to avoid abnormal scarring. This review summarizes the current experimental and clinical bases of surgical scar management.

  19. Current manufacturing processes of drug-eluting sutures.

    Science.gov (United States)

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

    2017-11-01

    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.

  20. Mechanics of Suture Joints

    Science.gov (United States)

    Li, Yaning; Song, Juha; Ortiz, Christine; Boyce, Mary; Ortiz Group/DMSE/MIT Team; Boyce Group/ME/MIT Team

    2011-03-01

    Biological sutures are joints which connect two stiff skeletal or skeletal-like components. These joints possess a wavy geometry with a thin organic layer providing adhesion. Examples of biological sutures include mammalian skulls, the pelvic assembly of the armored fish Gasterosteus aculeatus (the three-spined stickleback), and the suture joints in the shell of the red-eared slider turtle. Biological sutures allow for movement and compliance, control stress concentrations, transmit loads, reduce fatigue stress and absorb energy. In this investigation, the mechanics of the role of suture geometry in providing a naturally optimized joint is explored. In particular, analytical and numerical micromechanical models of the suture joint are constructed. The anisotropic mechanical stiffness and strength are studied as a function of suture wavelength, amplitude and the material properties of the skeletal and organic components, revealing key insights into the optimized nature of these ubiquitous natural joints.

  1. [Suture simulator - Cleft palate surgery].

    Science.gov (United States)

    Devinck, F; Riot, S; Qassemyar, A; Belkhou, A; Wolber, A; Martinot Duquennoy, V; Guerreschi, P

    2017-04-01

    Cleft palate requires surgery in the first years of life, furthermore repairing anatomically the soft and hard palate is complex on a surgical level because of the fine tissues and the local intraoral configuration. It is valuable to train first on simulators before going to the operating room. However, there is no material dedicated to learning how to perform intraoral sutures in cleft palate surgery. We made one, in an artisanal manner, in order to practice before the real surgical gesture. The simulator was designed based on precise anatomical data. A steel pipe, fixed on a rigid base represented the oral cavity. An adapted split spoon represented the palate. All pieces could be removed in order to apply a hydrocellular dressing before training for sutures. Our simulator was tested by 3 senior surgeons in our department in close to real-life conditions in order to evaluate its anatomical accuracy. It is valuable to have a simulator to train on cleft palate sutures within teaching university hospitals that manage this pathology. Our simulator has a very low cost, it is easy to make and is anatomically accurate. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  2. Reconstruction of displaced acromio-clavicular joint dislocations using a triple suture-cerclage: description of a safe and efficient surgical technique

    Directory of Open Access Journals (Sweden)

    Sandmann Gunther H

    2012-10-01

    Full Text Available Abstract Purpose In this retrospective study we investigated the clinical and radiological outcome after operative treatment of acute Rockwood III-V injuries of the AC-joint using two acromioclavicular (AC cerclages and one coracoclavicular (CC cerclage with resorbable sutures. Methods Between 2007 and 2009 a total of 39 patients fit the inclusion criteria after operative treatment of acute AC joint dislocation. All patients underwent open reduction and anatomic reconstruction of the AC and CC-ligaments using PDS® sutures (Polydioxane, Ethicon, Norderstedt, Germany. Thirty-three patients could be investigated at a mean follow up of 32±9 months (range 24–56 months. Results The mean Constant score was 94.3±7.1 (range 73–100 with an age and gender correlated score of 104.2%±6.9 (88-123%. The DASH score (mean 3.46±6.6 points, the ASES score (94.6±9.7points and the Visual Analogue Scale (mean 0.5±0,6 revealed a good to excellent clinical outcome. The difference in the coracoclavicular distance compared to the contralateral side was Conclusion Open AC joint reconstruction using AC and CC PDS cerclages provides good to excellent clinical results in the majority of cases. However, radiographically, the CC distance increased significantly at final follow up, but neither the amount of re-dislocation nor calcifications of the CC ligaments or osteoarthritis of the AC joint had significant influence on the outcome. Level of evidence Case series, Level IV

  3. Arthroscopic Hip Labral Repair: The Iberian Suture Technique

    OpenAIRE

    Stubbs, Allston J.; Andersen, Jason S.; Mannava, Sandeep; Wooster, Benjamin M.; Howse, Elizabeth A.; Winter, S. Bradley

    2014-01-01

    Arthroscopic hip labral repair has beneficial short-term outcomes; however, debate exists regarding ideal surgical labral repair technique. This technical note presents an arthroscopic repair technique that uses intrasubstance labral suture passage to restore the chondrolabral interface. This “Iberian suture technique” allows for an anatomic repair while posing minimal risk of damage to the labral and chondral tissues.

  4. Comparison of barbed unidirectional suture with figure-of-eight standard sutures in vaginal cuff closure in total laparoscopic hysterectomy.

    Science.gov (United States)

    Karacan, Tolga; Ozyurek, Eser; Usta, Taner; Odacilar, Eylem; Hanli, Ulviye; Kovalak, Ebru; Dayan, Huseyin

    2018-03-24

    The aim of the study was to compare postoperative vaginal cuff complications due to the use of barbed sutures (V-Loc™ 180 unidirectional suture; Covidien, Mansfield, MA) and standard braided sutures (Vicryl ® ; Ethicon Inc., Somerville, MA) during vaginal cuff closure of patients undergoing a total laparoscopic hysterectomy (TLH) due to benign diseases. Eighty-nine patients were in the standard suture group and 208 patients were included in the barbed suture group. Vaginal cuff dehiscence was identified in only three (3.3%) patients within the standard suture group and none in the barbed suture group. Five (5.6%) patients in the standard suture group and two (0.9%) patients in the barbed suture group developed postoperative cuff infection/cellulitis. Duration of the surgery was significantly shorter in the barbed suture group than in the standard suture group (p barbed suture, which is used during TLH for vaginal cuff closure, is an applicable, safe and tolerable alternative to a standard suture. IMPACT STATEMENT What is already known on this subject: Barbed sutures are a relatively new type of suture that include sharp barbs inserted on monofilament material in various configurations, and are used for approximating tissues without any need for surgical knotting. They have increasingly been used in obstetrics and gynaecology in recent years, particularly in total laparoscopic hysterectomy and laparoscopic myomectomy. At present, there are a limited number of studies of V-Loc™ suture in the literature. What the results of this study add: We demonstrated that barbed sutures used for enabling vaginal cuff integrity did not cause major morbidity and mortality for the patient. We suggest that V-Loc™ 180 barbed sutures offer a practical, safe and tolerable alternative for surgeons because they are easy to use, do not cause a significant increase in vaginal cuff complications, and shorten the operating time. Our study with V-Loc™ 180 unidirectional barbed

  5. Outcome of strabismus surgery by nonadjustable suture among ...

    African Journals Online (AJOL)

    Outcome of strabismus surgery by nonadjustable suture among adults attending a ... postoperative residual deviation, 83 patients (86%) had defective vision with amblyopia. ... Conclusion: Surgical treatment of strabismus in Saudi adult with ...

  6. Effects of tag and suture type on survival and growth of brown trout with surgically implanted telemetry tags in the wild

    DEFF Research Database (Denmark)

    Jepsen, Niels; Mikkelsen, Jørgen Skole; Koed, Anders

    2008-01-01

    To test the effects of surgical implants with or without external antennae, 188 wild brown trout Salmo trutta, 150 - 290 mm, were tagged and released in a small river in May 2005. After 5 months, 103 of the fish were recaptured and examined. Thus, information on the relative survival, growth and ...

  7. Nickel-Titanium Wire as Suture Material: A New Technique for the Fixation of Skin.

    Science.gov (United States)

    Li, Haidong; Song, Tao

    2018-01-29

    To introduce nickel-titanium wire as suture material for closure of incisions in cleft lip procedures. Closure of skin incisions using nickel-titanium wire as suture material, with postoperative follow-up wound evaluation. There was excellent patient satisfaction and good cosmetic outcome. Nickel-titanium wire is an excellent alternative for suture closure of cleft lip surgical incisions.

  8. Bidirectional Barbed Sutures for Wound Closure: Evolution and Applications

    Science.gov (United States)

    Paul, Malcolm D.

    2009-01-01

    Traditionally, wound closure sutures have in common the need to tie knots with the inherent risk of extrusion, palpability, microinfarcts, breakage, and slippage. Bidirectional barbed sutures have barbs arrayed in a helical fashion in opposing directions on either side of an unbarbed midsegment. This suture is inserted at the midpoint of a wound and pulled through till resistance is encountered from the opposing barbs; each half of the suture is then advanced to the lateral ends of the wound. This design provides a method of evenly distributing tension along the incision line, a faster suture placement and closure time with no need to tie knots, and the possibility of improved cosmesis. Bidirectional barbed sutures, which are available in both absorbable and nonabsorbable forms, can be used for simple closures, multilayered closures, and closure of high-tension wounds in a variety of surgical settings. PMID:24527114

  9. 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

    various biomedical applications. - Highlights: • This study describes the utilization of ramie plant fiber as surgical suture material for biomedical applications. • The ramie suture possesses excellent biocompatibility and efficiently heals superficial wounds. • The ramie suture is comparable with market available silk suture and the former one has inherent antibacterial property. • Ramie suture is much cost effective than market available sutures which can decrease the healthcare cost by many folds.

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

    International Nuclear Information System (INIS)

    Kandimalla, Raghuram; Kalita, Sanjeeb; Choudhury, Bhaswati; Devi, Dipali; Kalita, Dhaneswar; Kalita, Kasturi; Dash, Suvakanta; Kotoky, Jibon

    2016-01-01

    various biomedical applications. - Highlights: • This study describes the utilization of ramie plant fiber as surgical suture material for biomedical applications. • The ramie suture possesses excellent biocompatibility and efficiently heals superficial wounds. • The ramie suture is comparable with market available silk suture and the former one has inherent antibacterial property. • Ramie suture is much cost effective than market available sutures which can decrease the healthcare cost by many folds.

  11. [Subluxation of scleral-fixated PC IOL caused by polypropylene suture degradation--case report].

    Science.gov (United States)

    Kanigowska, Krystyna; Grałek, Mirosława; Czarnowska, Elzbieta; Zajaczkowska, Agnieszka

    2009-01-01

    The purpose of the study is to evaluate factors related to late-onset of lens subluxation in transscleral sutured posterior chamber IOL. We report a child, which required surgical treatment for dislocation of a scleral-sutured PC IOL. 11 years earlier the secondary lens implantation with scleral fixation was performed in 4 years old boy. The first surgical procedure included an anterior victrectomy and suturing a single- piece PMMA IOL under the scleral flaps with a 10-0 polipropylene suture. The second--included explantation of the dislocated lens. Optic and scanning electron microscopy was used to analyze the surface of the explanted remnants of the breakage suture. Microscopic findings indicate that the late suture breakage and subluxation of suture-fixated PC IOL was due to the degradation of polypropylene suture.

  12. Tensile strength and failure load of sutures for robotic surgery.

    Science.gov (United States)

    Abiri, Ahmad; Paydar, Omeed; Tao, Anna; LaRocca, Megan; Liu, Kang; Genovese, Bradley; Candler, Robert; Grundfest, Warren S; Dutson, Erik P

    2017-08-01

    Robotic surgical platforms have seen increased use among minimally invasive gastrointestinal surgeons (von Fraunhofer et al. in J Biomed Mater Res 19(5):595-600, 1985. doi: 10.1002/jbm.820190511 ). However, these systems still suffer from lack of haptic feedback, which results in exertion of excessive force, often leading to suture failures (Barbash et al. in Ann Surg 259(1):1-6, 2014. doi: 10.1097/SLA.0b013e3182a5c8b8 ). This work catalogs tensile strength and failure load among commonly used sutures in an effort to prevent robotic surgical consoles from exceeding identified thresholds. Trials were thus conducted on common sutures varying in material type, gauge size, rate of pulling force, and method of applied force. Polydioxanone, Silk, Vicryl, and Prolene, gauges 5-0 to 1-0, were pulled till failure using a commercial mechanical testing system. 2-0 and 3-0 sutures were further tested for the effect of pull rate on failure load at rates of 50, 200, and 400 mm/min. 3-0 sutures were also pulled till failure using a da Vinci robotic surgical system in unlooped, looped, and at the needle body arrangements. Generally, Vicryl and PDS sutures had the highest mechanical strength (47-179 kN/cm 2 ), while Silk had the lowest (40-106 kN/cm 2 ). Larger diameter sutures withstand higher total force, but finer gauges consistently show higher force per unit area. The difference between material types becomes increasingly significant as the diameters decrease. Comparisons of identical suture materials and gauges show 27-50% improvement in the tensile strength over data obtained in 1985 (Ballantyne in Surg Endosc Other Interv Tech 16(10):1389-1402, 2002. doi: 10.1007/s00464-001-8283-7 ). No significant differences were observed when sutures were pulled at different rates. Reduction in suture strength appeared to be strongly affected by the technique used to manipulate the suture. Availability of suture tensile strength and failure load data will help define software safety

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

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    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.

  14. Bridge Suture for Successful McDonald Emergency Cerclage.

    Science.gov (United States)

    Tanaka, Masaaki; Hori, Yoshiaki; Shirafuji, Aya; Kato, Mitsunori; Kato, Jyun; Kobayashi, Hiroto; Tsuchida, Toru; Fukae, Tsukasa

    2017-01-01

    To create awareness about a surgical technique termed bridge suture, which is performed as a pretreatment before a McDonald cerclage is performed on an emergency to treat severe cervical insufficiency. Procedures for bridge suture were reviewed in detail and outcomes of 16 patients treated with bridge suture followed by McDonald cerclage were evaluated retrospectively. Using the bridge suture, the edges of uterine cervix were temporarily sutured and the external uterine os was closed, while the hourglass-shaped fetal membranes were concomitantly confined within the cervix; subsequently, a McDonald cerclage was performed. Over a 22-year period, 16 patients with a dilated cervix and bulging fetal membranes were treated using the technique of bridge suture followed by an emergency cerclage. The mean gestational age at cerclage was 22.5 weeks; the mean gestational age at delivery was 30.7 weeks; and the mean interval between cerclage and delivery was 8.2 weeks. In 15 out of 16 cases, cerclage was performed without encountering any complications. No maternal complications, including cervical laceration, were observed. The mean body weight of 17 neonates, including that of a twin, was 1,516 g and of them, 15 neonates survived. The important outcome of bridge suture is the replacement of fetal membranes back into the uterine cavity before McDonald's cerclage is performed. Pretreatment with bridge suture may facilitate the performance of a successful emergency cerclage and contribute to good maternal and neonatal outcomes. © 2016 S. Karger AG, Basel.

  15. 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.

  16. 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 K

    2017-04-01

    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 barbs on Quill. From a microbiological perspective, barbed sutures can be recommended in aseptic surgery, but should only be used carefully in septic surgery. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:925-933, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  17. 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.

  18. Análise da resistência de fios cirúrgicos utilizados no reparo do manguito rotador Strength analysis of surgical sutures used to repair the rotator cuff

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    Marcus Valladares Guimarães

    2008-07-01

    Full Text Available OBJETIVO: Analisar a resistência final suportada por dois tipos de fio e pela interface âncora-fio em três diferentes implantes tipo âncora submetidos à tração contínua, com o propósito de indicar o mais apropriado para sutura de estruturas como o manguito rotador do ombro. MÉTODOS: Os testes foram feitos em três grupos: grupo 1 - parafuso âncora de titânio com fio Ethibond® #2; grupo 2 - parafuso âncora de titânio com fio Fiber Wire® #2; e grupo 3 - parafuso âncora de titânio 5,0mm Corkscrew®. RESULTADOS: No grupo 1, a carga máxima média até a soltura foi de 124,5 newtons (N, sendo a mínima de 105N e a máxima de 180N, com variação de 75N entre os dois extremos e desvio-padrão de 23,03N. No grupo 2, a carga máxima média até a soltura foi de 298N, mínima de 230N, máxima de 375N, com variação de 145N e desvio-padrão de 44,73N. No grupo 3, foi obtida a maior carga máxima média, sendo esta de 272N, a mínima de 205N e a máxima de 340N, com variação de 135N. A análise estatística demonstrou diferença significativa entre as médias de cargas resistidas entre os grupos 1 x 2 e 1 x 3 (p OBJECTIVE: To analyze the final strength withstood by two types of suture threads and by the anchor-suture interface in three different anchor implants submitted to continuous traction for the purpose of choosing the most appropriate to suture structures such as the shoulder rotator cuff. METHOD: Tests were performed in three groups: Group 1 - titanium anchor screw with Ethibond® #2 suture, Group 2 - titanium anchor screw with Fiber Wire® #2 suture, and Group 3 - Corkscrew® 5.0 mm anchor screw. RESULTS: In Group 1, mean maximum load till loosening was 124.5 124,5 Newtons (N, the minimum load was 105 N, and the maximum load was 180 N, with a range of 75 N between the two extremes, and standard deviation of 23.03 N. In Group 2, the mean maximum load till loosening was 298 N, the minimum load was 230 N, the maximum load was 375

  19. Selective laser vaporization of polypropylene sutures and mesh

    Science.gov (United States)

    Burks, David; Rosenbury, Sarah B.; Kennelly, Michael J.; Fried, Nathaniel M.

    2012-02-01

    Complications from polypropylene mesh after surgery for female stress urinary incontinence (SUI) may require tedious surgical revision and removal of mesh materials with risk of damage to healthy adjacent tissue. This study explores selective laser vaporization of polypropylene suture/mesh materials commonly used in SUI. A compact, 7 Watt, 647-nm, red diode laser was operated with a radiant exposure of 81 J/cm2, pulse duration of 100 ms, and 1.0-mm-diameter laser spot. The 647-nm wavelength was selected because its absorption by water, hemoglobin, and other major tissue chromophores is low, while polypropylene absorption is high. Laser vaporization of ~200-μm-diameter polypropylene suture/mesh strands, in contact with fresh urinary tissue samples, ex vivo, was performed. Non-contact temperature mapping of the suture/mesh samples with a thermal camera was also conducted. Photoselective vaporization of polypropylene suture and mesh using a single laser pulse was achieved with peak temperatures of 180 and 232 °C, respectively. In control (safety) studies, direct laser irradiation of tissue alone resulted in only a 1 °C temperature increase. Selective laser vaporization of polypropylene suture/mesh materials is feasible without significant thermal damage to tissue. This technique may be useful for SUI procedures requiring surgical revision.

  20. 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.

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

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    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.

  2. Peer-assisted teaching of basic surgical skills.

    Science.gov (United States)

    Preece, Ryan; Dickinson, Emily Clare; Sherif, Mohamed; Ibrahim, Yousef; Ninan, Ann Susan; Aildasani, Laxmi; Ahmed, Sartaj; Smith, Philip

    2015-01-01

    Basic surgical skills training is rarely emphasised in undergraduate medical curricula. However, the provision of skills tutorials requires significant commitment from time-constrained surgical faculty. We aimed to determine how a peer-assisted suturing workshop could enhance surgical skills competency among medical students and enthuse them towards a career in surgery. Senior student tutors delivered two suturing workshops to second- and third- year medical students. Suturing performance was assessed before and after teaching in a 10-min suturing exercise (variables measured included number of sutures completed, suture tension, and inter-suture distance). Following the workshop, students completed a questionnaire assessing the effect of the workshop on their suturing technique and their intention to pursue a surgical career. Thirty-five students attended. Eighty-one percent believed their medical school course provided insufficient basic surgical skills training. The mean number of sutures completed post-teaching increased significantly (p teaching, to ± 2.6 mm post-teaching. All students found the teaching environment to be relaxed, and all felt the workshop helped to improve their suturing technique and confidence; 87% found the peer-taught workshop had increased their desire to undertake a career in surgery. Peer-assisted learning suturing workshops can enhance medical students' competence with surgical skills and inspire them towards a career in surgery. With very little staff faculty contribution, it is a cheap and sustainable way to ensure ongoing undergraduate surgical skills exposure.

  3. Overcoming the learning curve of single-port total laparoscopic hysterectomy with barbed suture: a single surgeon's initial experience.

    Science.gov (United States)

    Lee, Yoon Hee; Chong, Gun Oh; Kim, Mi Ju; Gy Hong, Dae; Lee, Yoon Soon

    2017-09-01

    Single-port total laparoscopic hysterectomy (TLH) has not been widely used because of its technical difficulty and steep learning curve, especially the laparoscopic suturing of the vaginal stump. Barbed suturing is a new technology that has the potential to greatly facilitate laparoscopic suturing. To compare surgical outcomes and vaginal vault healing between barbed sutures and traditional sutures in the repair of the vaginal vault during single-port TLH. Between August 2013 and June 2015, we performed single-port TLH in 85 consecutive patients for benign or premalignant gynecological conditions. The first 48 patients underwent single-port TLH with traditional interrupted sutures, and the next 37 patients underwent single-port TLH with absorbable unidirectional knotless barbed sutures for repair of the vaginal vault. The patient characteristics (age, body mass index), procedures performed, uterine weight, and uterine disease were similar between the groups. There were no differences in blood loss, hemoglobin change, length of hospital stay, or perioperative complications. Operative time and the time required for vaginal cuff suturing were significantly shorter in the barbed suture group than in the traditional suture group (57.8 ±13.5 vs. 80.1 ±18.7 min, p < 0.001; 5.5 ±1.7 vs. 12.9 ±3.5 min, p < 0.001). Moreover, the use of barbed sutures significantly reduced the incidence of vaginal granulation tissue formation (2.7% vs. 35.4%, p < 0.001). Use of barbed sutures in single-port TLH reduced the operative time, suturing time of the vaginal vault, and formation of vaginal granulation tissue. Barbed suturing may help overcome surgical difficulties and vaginal cuff complications.

  4. Local Delivery of Growth Factors Using Coated Suture Material

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    T. F. Fuchs

    2012-01-01

    Full Text Available The optimization of healing processes in a wide range of tissues represents a central point for surgical research. One approach is to stimulate healing processes with growth factors. These substances have a short half-life and therefore it seems useful to administer these substances locally rather than systemically. One possible method of local delivery is to incorporate growth factors into a bioabsorbable poly (D, L-lactide suspension (PDLLA and coat suture material. The aim of the present study was to establish a procedure for the local delivery of growth factors using coated suture material. Sutures coated with growth factors were tested in an animal model. Anastomoses of the colon were created in a rat model using monofilament sutures. These were either untreated or coated with PDLLA coating alone or coated with PDLLA incorporating insulin—like growth factor-I (IGF-I. The anastomoses were subjected to biomechanical, histological, and immunohistochemical examination. After 3 days the treated groups showed a significantly greater capacity to withstand biomechanical stress than the control groups. This finding was supported by the results of the histomorphometric. The results of the study indicate that it is possible to deliver bioactive growth factors locally using PDLLA coated suture material. Healing processes can thus be stimulated locally without subjecting the whole organism to potentially damaging high systemic doses.

  5. 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.

  6. Relationship between the coronal suture and the central lobe: how important is it and how can we use it in surgical planning? Relação entre a sutura coronária e o lobo central: qual a sua importância e como podemos usá-la no planejamento cirurgico?

    Directory of Open Access Journals (Sweden)

    Stênio Abrantes Sarmento

    2008-12-01

    Full Text Available The surgical treatment of the lesions located in the central lobe is a very difficult task for the neurosurgeon. The overall aim of this study is to verify the correlation of the coronal suture and the structures of the central lobe in 32 cadaver hemisphere brains and the importance of this information in surgical planning. The measurement of the nasion to the coronal suture ranged from 11.5 to 13.5 cm. The distance between the coronal suture in the midline to the central, precentral and paracentral sulcus ranged from 5.0 to 6.6, 2.5 to 4.5 and 1.3 to 4.0 cm respectively. Particularly in the normal cortex these measurements can be used to guide the surgical access. However, the identification of the central sulcus is not easy when the anatomical pattern is distorted or displaced by a lesion or edema. In cases such as these the use of other tools becomes crucial for good surgical planning and cortical mapping or awake craniotomy for a safer resection of the lesion as well.O tratamento cirúrgico de lesões localizadas no lobo central é difícil para o neurocirurgião. O objetivo deste estudo é verificar a relação da sutura coronária com as estruturas do lobo central utilizando-se de dissecção realizada em 32 hemisférios cerebrais de 16 cadáveres, assim como, a importância desta informação no planejamento cirúrgico. A medida da distância entre o nasion e a sutura coronária variou entre 11,5 e 13,5 cm. A distância da sutura coronária na linha média para os sulcos central, pré-central e paracentral variou de 5,0 a 6,6 cm, 2,5 a 4,5 cm e 1,3 a 4,0 cm respectivamente. O conhecimento destas medidas pode ser usado no planejamento cirúrgico principalmente num córtex normal. Porém, a identificação do sulco central é difícil quando as estruturas anatômicas estão deslocadas pela lesão ou quando há edema. Nestes casos a utilização de outros meios diagnósticos para o planejamento cirúrgico torna-se necessária, como também a

  7. EVALUATION OF ADJUSTABLE SUTURE TECHNIQUE IN OUTCOME OF PTOSIS SURGERY

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    Nagaraju

    2015-10-01

    Full Text Available AIM: To evaluate the outcome of adjustable suture technique in ptosis surgery. INTRODUCTION : Surgical management of blepharoptosis is indicated in multiple situations and the post - operative outcomes can be as variable as the indications for surgery. Adjustable suture techniques in ptosis repair have been introduced and variable efficacies have been reported. MATERIALS AND METHODS: A retrospective case review of medical records from June 2010 to May 2011 (12 months of 5 eyes of 5 consecutive patients operated by a single surgeon at a Tertiary Eye care center in South India were reviewed. The clinical profile of patients included was r ecorded and results of adjustable suture technique described by Borman and collegues for these patients was reported. RESULTS: 5 eyes of 5 patients underwent adjustable suture ptosis repair in the study duration. 4 patients with moderate and 1 with severe ptosis, all having good levator function were diagnosed to have c ongenital ptosis in 3 cases and a cquired involutional ptosis in 2 cases. All 5 cases had a satisfactory outcome at day 4 post - operative after adjustment of lid height in the out - patient clini c. 1 patient with acquired involutional ptosis, identified with levator dehiscence intra - operatively had overcorrection at 6 months warranting re - surgery while the other 4 patients had satisfactory cosmetic lid height and functional outcome at 6 months fol low up after the adjustable suture technique for ptosis repair. CONCLUSION: Use of adjustable sutures in ptosis surgery can eliminate the intraoperative lid factors that can lead to unpredictable results. The technique described is easy to adapt and perfor m and can give repeatable and well acceptable results in the properly selected cases

  8. Genipin crosslinker releasing sutures for improving the mechanical/repair strength of damaged connective tissue.

    Science.gov (United States)

    Sundararaj, Sharath; Slusarewicz, Paul; Brown, Matt; Hedman, Thomas

    2017-11-01

    The most common mode of surgical repair of ruptured tendons and ligaments involves the use of sutures for reattachment. However, there is a high incidence of rerupture and repair failure due to pulling out of the suture material from the damaged connective tissue. The main goal of this research was to achieve a localized delivery of crosslinking agent genipin (GP) from rapid-release biodegradable coatings on sutures, for strengthening the repair of ruptured connective tissue. Our hypothesis is that GP released from the suture coating will lead to exogenous crosslinking of native connective tissue resulting in beneficial effects on clinically relevant mechanical parameters such as tear resistance, tissue strength, and energy required to rupture the tissue (toughness). Sutures were successfully coated with a biodegradable polymer layer loaded with the crosslinking agent genipin, without compromising the mechanical properties of the suture. The rapid-release of genipin was achieved under both in vitro and ex vivo conditions. Exogenous crosslinking using these genipin releasing sutures was demonstrated using equine tendons. The tendons treated with genipin releasing sutures showed significant improvement in failure load, energy required for pull-out failure, and stiffness. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2199-2205, 2017. © 2016 Wiley Periodicals, Inc.

  9. 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.

  10. Gastric full-thickness suturing during EMR and for treatment of gastric-wall defects (with video).

    Science.gov (United States)

    von Renteln, Daniel; Schmidt, Arthur; Riecken, Bettina; Caca, Karel

    2008-04-01

    The endoscopic full-thickness Plicator device was initially developed to provide an endoscopic treatment option for patients with GERD. Because the endoscopic full-thickness Plicator enables rapid and easy placement of transmural sutures, comparable with surgical sutures, we used the Plicator device for endoscopic treatment or prevention of GI-wall defects. To describe the outcomes and complications of endoscopic full-thickness suturing during EMR and for the treatment of gastric-wall defects. A report of 4 cases treated with the endoscopic full-thickness suturing between June 2006 and April 2007. A large tertiary-referral center. Four subjects received endoscopic full-thickness suturing. The subjects were women, with a mean age of 67 years. Of the 4 subjects, 3 received endoscopic full-thickness suturing during or after an EMR. One subject received endoscopic full-thickness suturing for treatment of a fistula. Primary outcome measurements were clinical procedural success and procedure-related adverse events. The mean time for endoscopic full-thickness suturing was 15 minutes. In all cases, GI-wall patency was restored or ensured, and no procedure-related complications occurred. All subjects responded well to endoscopic full-thickness suturing. The resection of one GI stromal tumor was incomplete. Because of the Plicator's 60F distal-end diameter, endoscopic full-thickness suturing could only be performed with the patient under midazolam and propofol sedation. The durable Plicator suture might compromise the endoscopic follow-up after EMR. The endoscopic full-thickness Plicator permits rapid and easy placement of transmural sutures and seems to be a safe and effective alternative to surgical intervention to restore GI-wall defects or to ensure GI-wall patency during EMR procedures.

  11. Surgical innovations in canine gonadectomy

    NARCIS (Netherlands)

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated

  12. UTILIZAÇÃO DO ADESIVO METIL-2-CIANOACRILATO E FIO DE NÁILON NA REPARAÇÃO DE FERIDAS CUTÂNEAS DE CÃES E GATOS UTILIZATION OF THE METHYL-2-CYANOACRYLATE ADHESIVE AND THE NYLON SUTURE IN SURGICAL SKIN WOUNDS OF DOGS AND CATS

    Directory of Open Access Journals (Sweden)

    Vanja Andrade Gueiros

    2001-04-01

    Full Text Available Com o objetivo de avaliar e comparar clínica e histologicamente o uso do adesivo metil-2-cianoacrilato e do fio de náilon na reparação de feridas cirúrgicas de pele, foram utilizados cinco cães e cinco gatos adultos, clinicamente sadios. Seguindo o protocolo anestésico e cirúrgico habitual para cada espécie, foram feitas cinco incisões na pele da região costal do lado esquerdo e cinco do lado direito, com aproximadamente dois centímetros de comprimento. As feridas cirúrgicas do lado direito foram suturadas com fio de náilon cirúrgico 3-0 e as do lado esquerdo foram aproximadas e fixadas com o metil-2-cianoacrilato em ambas as espécies. Os animais foram submetidos a avaliações clínicas a cada três dias. Foram retirados fragmentos de pele para realização de biopsias aos três, seis, nove, doze e quinze dias após a cirurgia. Os resultados obtidos, tanto em cães quanto em gatos, não revelaram diferença clínica ou histológica entre os tratamentos utilizados.The purpose of this study is to evaluate and compare clinically and histologically the use of methyl-2-cyanoacrylate adhesive versus the nylon's suture in skin wounds closure. There were five adult mongrel dogs and cats, clinically healthy used. Following anaesthetical routine and surgical protocol, five incisions were made in the left costal region, and other five in right costal region, about 2cm in length, in both especies. The right side costal wounds were sutured with surgical nylon 3-0, and in the left side costal wounds methyl-2-cyanoacrylate was applied, in both species. The animals were submitted to clinical evaluation every three days, and a biopsy was realized at three, six, nine, twelve and fifteen days after the surgery. In both species, the results did not show any clinical or histologic difference when comparing the used treatments.

  13. Pullout strength of cement-augmented and wide-suture transosseous fixation in the greater tuberosity.

    Science.gov (United States)

    Shi, Brendan Y; Diaz, Miguel; Belkoff, Stephen M; Srikumaran, Uma

    2017-12-01

    Obtaining strong fixation in low-density bone is increasingly critical in surgical repair of rotator cuff tears because of the aging population. To evaluate two new methods of improving pullout strength of transosseous rotator cuff repair in low-density bone, we analyzed the effects of 1) using 2-mm suture tape instead of no. 2 suture and 2) augmenting the lateral tunnel with cement. Eleven pairs of osteopenic or osteoporotic cadaveric humeri were identified by dual-energy x-ray absorptiometry. One bone tunnel and one suture were placed in the heads of 22 specimens. Five randomly selected pairs were repaired with no. 2 suture; the other six pairs were repaired with 2-mm suture tape. One side of each pair received lateral tunnel cement augmentation. Specimens were tested to suture pullout. Data were fitted to multivariate models that accounted for bone mineral density and other specimen characteristics. Two specimens were excluded because of knot-slipping during testing. Use of suture tape versus no. 2 suture conferred a 75-N increase (95% CI: 37, 113) in pullout strength (PCement augmentation conferred a 42-N improvement (95% CI: 10, 75; P=0.011). Other significant predictors of pullout strength were age, sex, and bone mineral density. We show two methods of improving the fixation strength of transosseous rotator cuff repairs in low-density bone: using 2-mm suture tape instead of no. 2 suture and augmenting the lateral tunnel with cement. These methods may improve the feasibility of transosseous repairs in an aging patient population. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. [Laparoscopic suture or open suture in perforated duodenal ulcer].

    Science.gov (United States)

    Nicolau, A E; Ionescu, G; Iordache, F; Mehic, R; Spătaru, A

    2002-01-01

    Between Nov. 1994-Jan. 2001 we performed laparoscopic suture with omentoplasty of perforated duodenal ulcer (PDU) in 51 patients out of 56 it was intended (this constituted the laparoscopic group--LG). The selection criteria were young patients, age < 40 years, no associated diseases, onset of the operation under 12 hours from the occurrence of the perforation, absence of clear ulcer history. In the same period, we performed an open suture based on the same criteria in 105 patients (open group--OP). The results showed a difference between needed analgesia (2.8 days for LG vs. 5.2 days for OG) and a hospital stay of 6.1 days in LG vs. 7.7 days in OG. The incidence of postoperative complications was 5.88% in the LG and 7.61% in the OG with 1.96% and respective 1.90% reoperation rate. In conclusion laparoscopic suture of PDU with associated postoperative modern therapy of ulcer disease could be the treatment of choice in young patients.

  15. Popularity of suture materials among residents and faculty members of a postdoctoral periodontology program.

    Science.gov (United States)

    Maksoud, Mohamed; Koo, Samuel; Barouch, Kasumi; Karimbux, Nadeem

    2014-02-01

    The aim of the present study was to determine the favoritism of suture materials among a group of clinicians at a teaching institution. The surveys included 11 absorbable and nine non-absorbable sutures. The surveyor was asked to select his or her suture preferences when it comes to using it in 13 different, commonly-performed surgical procedures. The surveys showed overall preferences for non-absorbable versus absorbable sutures. Chromic Gut with a 4-0 diameter thread reverse cutting FS2 needle was the most favored suture. For periodontal bone grafts and hard tissue ridge augmentation, polytetrafluoroethylene with a 4-0 thread and FS2 needle was preferred. For autogenous gingival grafts, gingival allografts, connective tissue grafts, frenectomy and frenoplasty, Chromic Gut with 5-0 diameter thread reverse cutting P3 needle was favored. For extraction socket preservation, soft tissue canine exposure, ridge augmentation, and dental implants, Chromic Gut with 4-0 diameter thread reverse cutting FS2 needle was preferred, and for sinus augmentation, Vicryl with a 4-0 diameter thread reverse cutting FS2 needle was favored. Absorbable sutures were preferred in the majority of periodontal procedures; however, non-absorbable sutures were favored in procedures that required longer healing or better stability of the flap edges in cases of periodontal and ridge augmentation. © 2013 Wiley Publishing Asia Pty Ltd.

  16. 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.

  17. Correção cirúrgica do aneurisma de ventrículo esquerdo: comparação entre as técnicas de sutura linear e reconstrução geométrica Surgical correction of left ventricular aneurysm: comparison between linear suture and geometric reconstruction techniques

    Directory of Open Access Journals (Sweden)

    Cássio José SGARBI

    2000-12-01

    na evolução dos pacientes revascularizados.OBJECTIVE: To evaluate the evolution up to 15 years of patients who underwent surgical correction of left ventricular aneurysm and to compare the techniques of linear suture and geometric reconstruction. METHODS: We studied 213 patients, of which 166 (77.9% were men. The mean age was 53.1 years (SD=9.9 years. Of these, 145 (68% underwent repair using the linear suture technique and 68 (32% underwent the geometric reconstruction technique. The Kaplan - Meier method was used to evaluate late survival. We evaluated the presence of mural thrombus, in and out of hospital mortality and the possibility of myocardial revascularization in the same procedure. Statistical differences were measured using the Log Rank method for actuarial curves and the nonparametric test in the remaining data compared. RESULTS: Our survival curves after a follow up of 10 years demonstrated that patients submitted to the linear suture and LV geometric reconstruction had a survival of 47.19% (SEM=0.056 and 63,55% (SEM=0.068, respectively, which were not statistically significantly different (p= 0.56. The overall survival in the 2 groups together was 51.34% (SEM=0.0473 at 10 years and 35,77%(SEM=0.0684 at 15 years. The in hospital death was 9.5% for the linear suture and 16.6% for the geometric reconstruction (p=0.17. The removal of LV thrombus was 31.29% and 45.45%, respectively (p=0.07. Revascularization was performed in, 69% of the patients in the linear suture group and 85.3% in the geometric reconstruction group. Comparing patients who were revascularized with those who were not, there was a better survival at 10 years for the first group (p=0.008. CONCLUSIONS: There was no statistically significant difference in the survival of patients who underwent linear suture compared to geometric reconstruction of the LV for aneurysm repair. Our results demonstrated superior survival in those patients who could undergo revascularization in the same procedure.

  18. Gonioscopy-assisted Transluminal Trabeculotomy (GATT): Thermal Suture Modification With a Dye-stained Rounded Tip.

    Science.gov (United States)

    Grover, Davinder S; Fellman, Ronald L

    2016-06-01

    To describe a novel technique for thermally marking the tip of a suture, in preparation for a gonioscopy-assisted transluminal trabeculotomy. One patient was used as an example for this technique. Technique report. The authors introduce a modification of a novel surgical procedure (GATT) in which a suture is marked and thermally blunted allowing a proper visualization while performing an ab interno, minimally invasive, circumferential 360-degree suture trabeculotomy. The authors have previously reported on the GATT surgery with the use of an illuminated microcatheter, which allowed for visualization of the tip of the catheter as it circumnavigated Schlemm canal. This modification allows for similar visualization of the tip of the suture, however, is much more cost-effective while still maintaining similar safety.

  19. Training apparatus

    International Nuclear Information System (INIS)

    Monteith, W.D.

    1983-01-01

    Training apparatus for use in contamination surveillance uses a mathematical model of a hypothetical contamination source (e.g. nuclear, bacteriological or chemical explosion or leak) to determine from input data defining the contamination source, the contamination level at any location within a defined exercise area. The contamination level to be displayed by the apparatus is corrected to real time from a real time clock or may be displayed in response to a time input from a keyboard. In a preferred embodiment the location is defined by entering UTM grid reference coordinates using the keyboard. The mathematical model used by a microprocessor of the apparatus for simulation of contamination levels in the event of a nuclear explosion is described. (author)

  20. Radioimmunoassay apparatus

    International Nuclear Information System (INIS)

    1981-01-01

    Apparatus for performing a quantitative radioimmunoassay comprising: a substantially spherical bead for carrying an antibody and a gripper for gripping said bead, said gripper comprising an integrally formed unit having a single elongate handle portion and a plurality of resilient fingers arranged at the base of the handle so that when said bead is secured within said fingers, said bead may be freely rotated about any diametric axis of the bead. In particular the invention relates to an apparatus for a two site immunoradiometric assay for serum ferritin in human blood samples. (author)

  1. Encephalographic apparatus

    International Nuclear Information System (INIS)

    1981-01-01

    An X-ray apparatus is described for determining the size and location of brain tumours by tomography during pneumoencephalography. The apparatus comprises an image recording device arranged opposite an X-ray source and a frame mounted on a tiltable patient table and rotatable with respect to the table. A patient support is arranged in the frame and is rotatable with respect to the frame. Air injected into the patients' spinal column travels up into the brain and displaces some of the cerebral fluid. Tomographic X-ray exposures are made of the air bubble which moves around in the brain cavities as the patient is rotated. (U.K.)

  2. TRANSFORMER APPARATUS

    Science.gov (United States)

    Wolfgang, F.; Nicol, J.

    1962-11-01

    Transformer apparatus is designed for measuring the amount of a paramagnetic substance dissolved or suspended in a diamagnetic liquid. The apparatus consists of a cluster of tubes, some of which are closed and have sealed within the diamagnetic substance without any of the paramagnetic material. The remaining tubes are open to flow of the mix- ture. Primary and secondary conductors are wrapped around the tubes in such a way as to cancel noise components and also to produce a differential signal on the secondaries based upon variations of the content of the paramagnetic material. (AEC)

  3. Radiotherapy apparatus

    International Nuclear Information System (INIS)

    Leung, P.M.; Webb, H.P.J.

    1985-01-01

    This invention relates to apparatus for applying intracavitary radiotherapy. In previously-known systems radioactive material is conveyed to a desired location within a patient by transporting a chain of balls pneumatically to and from an appropriately inserted applicator. According to this invention a ball chain for such a purpose comprises several radioactive balls separated by non-radioactive tracer balls of radiographically transparent material of lower density and surface hardness than the radioactive balls. The invention also extends to radiotherapy treatment apparatus comprising a storage, sorting and assembly system

  4. Radiography apparatus

    International Nuclear Information System (INIS)

    Sashin, D.; Sternglass, E.J.

    1982-01-01

    The apparatus of the present invention provides radiography apparatus wherein the use of a flat, generally rectangular beam or a fan-shaped beam of radiation in combination with a collimator, scintillator and device for optically coupling a self-scanning array of photodiodes to the scintillator means will permit production of images or image data with high contrast sensitivity and detail. It is contemplated that the self-scanning array of photodiodes may contain from about 60 to 2048, and preferably about 256 to 2048, individual photodiode elements per inch of object width, thereby permitting maximum data collection to produce a complete image or complete collection of image data

  5. Monitoring apparatus

    International Nuclear Information System (INIS)

    Keats, A.B.

    1981-01-01

    An improved monitoring apparatus for use with process plants, such as nuclear reactors, is described. System failure in the acquisition of data from the plant, owing to stuck signals, is avoided by arranging input signals from transducers in the plant in a test pattern. (U.K.)

  6. Prehensile apparatus

    Science.gov (United States)

    Smith, C.M.

    1993-10-12

    The present invention relates to an apparatus for handling a workpiece comprising a vessel that is longitudinally extensible and pressurizable, and a nonextensible and laterally flexible member on the vessel. The member constrains one side of the vessel to be nonextensible, causing the vessel to bend in the direction of the nonextensible member when pressurized. 8 figures.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 21 CFR 886.4100 - Radiofrequency electrosurgical cautery apparatus.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiofrequency electrosurgical cautery apparatus... SERVICES (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4100 Radiofrequency electrosurgical cautery apparatus. (a) Identification. A radiofrequency electrosurgical cautery apparatus is an AC...

  9. Comparison between suture anchor and transosseous suture for the modified-Broström procedure.

    Science.gov (United States)

    Cho, Byung-Ki; Kim, Yong-Min; Kim, Dong-Soo; Choi, Eui-Sung; Shon, Hyun-Chul; Park, Kyoung-Jin

    2012-06-01

    This prospective, randomized study was conducted to compare clinical outcomes of the modified Broström procedure using suture anchor or transosseous suture technique for chronic ankle instability. Forty patients were followed for more than 2 years after modified Broström procedure. Twenty procedures using a suture anchor and 20 procedures using a transosseous suture were performed by one surgeon. The clinical evaluation consisted of the Karlsson scale and the Sefton grading system. Talar tilt and anterior talar translation were measured on anterior and varus stress radiographs. The Karlsson scale had improved significantly to 90.8 points in the suture anchor group, and to 89.2 points in the transosseous suture group. According to Sefton grading system, 18 patients (90%) in suture anchor group and 17 patients (85%) in transosseous suture group achieved satisfactory results. The talar tilt angle and anterior talar translation improved significantly to 5.9 degrees and 4.2 mm in suture anchor group, and to 5.4 degrees and 4.1 mm in transosseous suture group, respectively. No significant differences existed in clinical and functional outcomes between the two techniques for ligament reattachment. Both modified Broström procedures using the suture anchor and transosseous suture seem to be effective treatment methods for chronic lateral ankle instability.

  10. Ultraviolet radiation as disinfection for fish surgical tools

    Energy Technology Data Exchange (ETDEWEB)

    Walker, Ricardo W.; Markillie, Lye Meng; Colotelo, Alison HA; Geist, David R.; Gay, Marybeth E.; Woodley, Christa M.; Eppard, M. B.; Brown, Richard S.

    2013-04-04

    Telemetry is frequently used to examine the behavior of fish, and the transmitters used are normally surgically implanted into the coelomic cavity of fish. Implantation requires the use of surgical tools such as scalpels, forceps, needle holders, and sutures. When fish are implanted consecutively, as in large telemetry studies, it is common for surgical tools to be sterilized or, at minimum, disinfected between each use so that pathogens that may be present are not spread among fish. To determine the efficacy for this application, ultraviolet (UV) radiation was used to disinfect surgical tools exposed to one of four aquatic organisms that typically lead to negative health issues for salmonids. These organisms included Aeromonas salmonicida, Flavobacterium psychrophilum, Renibacterium salmoninarum, and Saprolegnia parasitica, causative agents of furunculosis, coldwater disease, bacterial kidney disease, and saprolegniasis (water mold), respectively. Four experiments were conducted to address the question of UV efficacy. In the first experiment, forceps were exposed to the three bacteria at three varying concentrations. After exposure to the bacterial culture, tools were placed into a mobile Millipore UV sterilization apparatus. The tools were then exposed for three different time periods – 2, 5, or 15 min. UV radiation exposures at all durations were effective at killing all three bacteria on forceps at the highest bacteria concentrations. In the second experiment, stab scalpels, sutures, and needle holders were exposed to A. salmonicida using the same methodology as used in Experiment 1. UV radiation exposure at 5 and 15 min was effective at killing A. salmonicida on stab scalpels and sutures but not needle holders. In the third experiment, S. parasitica, a water mold, was tested using an agar plate method and forceps-pinch method. UV radiation was effective at killing the water mold at all three exposure durations. Collectively, this study shows that UV

  11. A Comfortable Solution To Tracheal Anastomosis Protection: Tracheal Retention Sutures.

    Science.gov (United States)

    Karapolat, Sami; Turkyilmaz, Atila; Seyis, Kubra Nur; Tekinbas, Celal

    2018-04-01

    Fixation of the chin to the anterior chest wall is the most commonly used method of reducing anastomotic tension following a segmental resection of the trachea and reconstruction with primary anastomosis. However, the sutures required for this method may lead to various organic and psychological problems. In five patients who underwent tracheal resection and primary anastomosis, retention sutures were placed on the proximal and distal-lateral edges of the anastomotic line rather than placing a Guardian chin stitch. All patients were mobilised in the early postoperative period and were able to perform their routine daily activities without restrictions. During their average 14.4 months of follow-up, no complications were found in their anastomotic lines during their clinical, radiological, and bronchoscopic assessments. The placement of tracheal retention sutures proved an inexpensive and reliable method to reduce anastomotic tension without additional surgical burden, and was effective in terms of patient comfort. Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  12. EXTRACTION APPARATUS

    Science.gov (United States)

    Ballard, A.E.; Brigham, H.R.

    1958-10-28

    An apparatus whereby relatlvely volatile solvents may be contacted with volatile or non-volatile material without certaln attendant hazards is described. A suitable apparatus for handling relatively volatlle liqulds may be constructed comprising a tank, and a closure covering the tank and adapted to be securely attached to an external suppont. The closure is provided with a rigidly mounted motor-driven agitator. This agitator is connected from the driving motor lnto the lnterlor of the tank through a gland adapted to be cooled witb inert gas thereby eliminating possible hazard due to frictional heat. The closure is arranged so that the tank may be removed from it without materially dlsturbing the closure which, as described, carrles the motor driven agitator and other parts.

  13. Centrifuge apparatus

    Science.gov (United States)

    Sartory, Walter K.; Eveleigh, John W.

    1976-01-01

    A method and apparatus for operating a continuous flow blood separation centrifuge are provided. The hematocrit of the entrant whole blood is continuously maintained at an optimum constant value by the addition of plasma to the entrant blood. The hematocrit of the separated red cells is monitored to indicate the degree of separation taking place, thereby providing a basis for regulating the flow through the centrifuge.

  14. CASTING APPARATUS

    Science.gov (United States)

    Gray, C.F.; Thompson, R.H.

    1958-09-23

    An apparatus is described for casting small quantities of uranlum. It consists of a crucible having a hole in the bottom with a mold positioned below. A vertical rcd passes through the hole in the crucible and has at its upper end a piercing head adapted to break the oxide skin encasing a molten uranium body. An air tight cylinder surrounds the crucible and mold, and is arranged to be evacuated.

  15. Radiography apparatus

    International Nuclear Information System (INIS)

    Redmayne, I.G.B.

    1985-01-01

    Apparatus for the inspection of pipe welds comprises a radiation source for transmitting radiation, say as X-rays, through a pipe weld and a detector in a box arranged diametrically opposite the source, with respect to the pipe, for detecting the transmitted radiation and providing electrical signals which are processed to produce an image of the weld. The source and detector are mounted on a frame which is rotatable about an inner frame clamped to the pipe. (author)

  16. Investigation of the best suture pattern to close a stuffed Christmas turkey.

    Science.gov (United States)

    Verwilghen, D; Busoni, V; van Galen, G; Wilke, M

    Instructions on how to debone and stuff a turkey are available, but what is the best way to close it up? A randomised trial involving 15 turkeys was performed in order to evaluate skin disruption scores and cosmetic outcomes following the use of different suture patterns. Turkeys were deboned, stuffed and cooked according to guidelines of the US Department of Agriculture Food Safety and Inspection Services. After stuffing, they were randomly assigned to one of five closure groups: simple continuous Lembert; simple continuous Cushing; simple continuous Utrecht; simple continuous; or staples. Turkeys were cooked at 180 °C for two hours ensuring core temperature reached 75 °C. Suture line integrity was evaluated after removal of the sutures and the cosmetic aspect was graded. Before cooking, the Utrecht pattern and skin staples offered the best cosmetic result. After removal of the sutures, the skin remained intact only in the stapled group. All other suture patterns disrupted the skin after removal of the sutures, rendering the turkey less cosmetically appealing for serving. Closure of a stuffed turkey was best performed using skin staples to achieve the best cosmetic results. Using this technique you will be able to impress family and friends at a Christmas dinner, and finally show them your surgical skills.

  17. Glue versus suture for mesh fixation in inguinal hernia repair.

    Science.gov (United States)

    Chandrasekar, Shruthi; Jeyakumar, S; Ganapathy, Tharun

    2018-03-22

    Inguinal hernia is one of the most common surgical problem presenting to the surgical OPD. Surgery is the mainstay of treatment for inguinal hernia today. Surgery for inguinal hernia has undergone a great evolution over a period of several centuries. Lichenstein's tension free hernioplasty is the one of the first surgeries taught to a surgical resident. The main aim of surgeries in this era is to give the best possible results with the least possible pain, scar and time. This has given rise to so many modifications to the classical Lichenstein's procedure and also to laparoscopic hernioplasty. Pain after inguinal hernia surgery is found to be debilitating and altering the quality of life in several patients, which has been attributed to the traumatic fixation of the mesh with sutures. This has paved way to the development of various atraumatic methods of fixation, tissue glue is one such development. Hence this study, to compare traumatic and atraumatic methods of mesh fixation in inguinal hernia repair. The aim of this study was to compare suture fixation versus tissue glue fixation of the mesh in inguinal hernia repair. Primary objective was to compare the immediate and chronic post-operative pain. Secondary objective was to compare the time taken for the procedure by the two methods in use and also to compare the presence of any complications. and methodology: This study was done in the General Surgery department of XXX hospital, medical college and research centre, kattangulathur after Ethics committee clearance. It is a single blinded study. The study was done on 51 patients consenting for the study and meeting the inclusion criterias from the period of March 2016 to August 2017 out of which 26 were selected for glue mesh fixation and 25 for suture mesh fixation according to simple randomization. The suture group patients underwent classical Lichenstein's tension free hernioplasty and the glue group underwent Lichenstein's hernioplasty with glue where dots of

  18. Suture, synthetic, or biologic in contaminated ventral hernia repair.

    Science.gov (United States)

    Bondre, Ioana L; Holihan, Julie L; Askenasy, Erik P; Greenberg, Jacob A; Keith, Jerrod N; Martindale, Robert G; Roth, J Scott; Liang, Mike K

    2016-02-01

    Data are lacking to support the choice between suture, synthetic mesh, or biologic matrix in contaminated ventral hernia repair (VHR). We hypothesize that in contaminated VHR, suture repair is associated with the lowest rate of surgical site infection (SSI). A multicenter database of all open VHR performed at from 2010-2011 was reviewed. All patients with follow-up of 1 mo and longer were included. The primary outcome was SSI as defined by the Centers for Disease Control and Prevention. The secondary outcome was hernia recurrence (assessed clinically or radiographically). Multivariate analysis (stepwise regression for SSI and Cox proportional hazard model for recurrence) was performed. A total of 761 VHR were reviewed for a median (range) follow-up of 15 (1-50) mo: there were 291(38%) suture, 303 (40%) low-density and/or mid-density synthetic mesh, and 167(22%) biologic matrix repair. On univariate analysis, there were differences in the three groups including ethnicity, ASA, body mass index, institution, diabetes, primary versus incisional hernia, wound class, hernia size, prior VHR, fascial release, skin flaps, and acute repair. The unadjusted outcomes for SSI (15.1%; 17.8%; 21.0%; P = 0.280) and recurrence (17.8%; 13.5%; 21.5%; P = 0.074) were not statistically different between groups. On multivariate analysis, biologic matrix was associated with a nonsignificant reduction in both SSI and recurrences, whereas synthetic mesh associated with fewer recurrences compared to suture (hazard ratio = 0.60; P = 0.015) and nonsignificant increase in SSI. Interval estimates favored biologic matrix repair in contaminated VHR; however, these results were not statistically significant. In the absence of higher level evidence, surgeons should carefully balance risk, cost, and benefits in managing contaminated ventral hernia repair. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Reinforcement of the pelvic diaphragm using a purse-string suture in dogs: description of technique

    Directory of Open Access Journals (Sweden)

    P.C. Moraes

    Full Text Available ABSTRACT Recurrence of perineal hernias is frequent, and is associated to poor identification of anatomical structures during surgery, inadequate suture placement, and failure of physical support of the pelvic diaphragm after surgical reconstruction. The objective of this work is to describe a novel surgical technique for reinforcement of the pelvic diaphragm after performing the internal obturator transposition technique in dogs with perineal hernia.

  20. 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...... of fascial disruption and incisional hernia after laparotomy in patients with suspected impaired wound healing but the incidence of wound infection may be reduced compared with that of multifilament polyglycolic acid suture....

  1. 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.

  2. Post thyroidectomy suture granuloma: a cytological diagnosis.

    Science.gov (United States)

    Javalgi, Anita P; Arakeri, Surekha U

    2013-04-01

    There are known post thyroidectomized complications, a suture granuloma being less frequent, with its late complication mimicking recurrent thyroid cancer. A suture granuloma is a benign, granulomatous inflammatory reaction that occurs due to the use of non absorbable suture. It constitutes one of the late complications which altogether make up less than 2% of its incidence. A suture granuloma is similar to a foreign body reaction and it usually develops slowly as a painless, palpable asymptomatic mass over the years. It mimics a cancer recurrence or a lymph node metastasis. Here, we are reporting a case of a post thyroidectomy suture granuloma in a 46 years old lady who presented with a painless swelling in the lateral neck, with a past history of thyroidectomy 5 years back.

  3. Effect of Unshaven Hair with Absorbable Sutures and Early Postoperative Shampoo on Cranial Surgery Site Infection.

    Science.gov (United States)

    Oh, Won-Oak; Yeom, Insun; Kim, Dong-Seok; Park, Eun-Kyung; Shim, Kyu-Won

    2018-01-01

    Cranial surgical site infection is a significant cause of morbidity and mortality in hospitals. Preoperative hair shaving for cranial neurosurgical procedures is performed traditionally in an attempt to protect patients against complications from infections at cranial surgical sites. However, preoperative shaving of surgical incision sites using traditional surgical blades without properly washing the head after surgery can cause infections at surgical sites. Therefore, a rapid protocol in which the scalp remains unshaven and absorbable sutures are used for scalp closure with early postoperative shampooing is examined in this study. A retrospective comparative study was conducted from January 2008 to December 2012. A total of 2,641 patients who underwent unshaven cranial surgery with absorbable sutures for scalp closure were enrolled in this study. Data of 1,882 patients who underwent surgery with the traditional protocol from January 2005 to December 2007 were also analyzed for comparison. Of 2,641 patients who underwent cranial surgery with the rapid protocol, all but 2 (0.07%) patients experienced satisfactory wound healing. Of 1,882 patients who underwent cranial surgery with the traditional protocol, 3 patients (0.15%) had infections. Each infection occurred at the superficial incisional surgical site. Unshaven cranial surgery using absorbable sutures for scalp closure with early postoperative shampooing is safe and effective in the cranial neurosurgery setting. This protocol has a positive psychological effect. It can help patients accept neurosurgical procedures and improve their self-image after the operation. © 2017 S. Karger AG, Basel.

  4. Radiography apparatus

    International Nuclear Information System (INIS)

    Vasseur, J.P.

    1976-01-01

    A novel apparatus for radiographic examination purposes comprising an x-ray source emitting a flat beam is described. Detectors are arranged in the plane of the beam in order each to pick up part of the beam. To avoid the Compton effect, each detector has associated with it an auxiliary detector which only receives the rays emitted by the Compton effect. An electrical circuit forms a predetermined linear combination of the signals respectively picked up by each detector and the associated auxiliary detector, this in order to prevent the errors which are due to the Compton effect when the beam passes through the body being analyzed

  5. Surgical innovations in canine gonadectomy

    OpenAIRE

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated negative consequences (lengthy placement, impaired wound healing around bulky knots, and the effect of unsightly knots on cosmetics). A study in 9 dogs found that celiotomy closure was easily achiev...

  6. 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.

  7. Thermoforming apparatus

    International Nuclear Information System (INIS)

    Wallsten, H.I.

    1984-01-01

    Apparatus for manufacturing articles is disclosed in which a preheated sheet of thermoplastic material is intermittently fed to present successive preheated portions of the sheet in a work station having a forming tool for forming articles in each successive sheet portion and a stamping tool for co-operating with the forming tool to stamp the formed articles from the sheet. The forming tool has a plurality of forming dies which are movable successively and cyclically into the work station for forming articles in respective successive sheet portions. After each forming operation the stamping tool is brought into engagement with a resilient counter-surface on the forming die to stamp from the sheet the articles formed by that die

  8. Radiographic apparatus

    International Nuclear Information System (INIS)

    Dalton, B.L.

    1984-01-01

    This patent application describes a radiographic apparatus including an array of radiation sensors, a source of radiation for projecting a beam through a body and means for moving one of said source and array relative to the body and for producing an electrical signal representative of the movement of the other of said source and array needed to bring the array into register with the beam. Drive means are arranged to move the other of said source and array in response to the electrical signal. In one embodiment, the source is rotated by an amount measured by a grating and associated electronics. The required movement of the array to maintain registration is calculated and transmitted to a driver. Alternatively, a laser may be mounted with the same and the array driven so that the laser beam continuously impinges on a photocell mounted with the array. (author)

  9. On the roentgenomorphological correlations of cranial sutures

    International Nuclear Information System (INIS)

    Verkhoglyadova, T.P.; Koval', G.Yu.; Shuaa, T.I.

    1986-01-01

    The authors explain the essence of the zone of excessive transparence along the cranial sutures visualized on the X-ray pictures during the first year of life by presence of large number of rough-fiber bone in the marginal regions. The zone of ''physiological sclerosis'' is postulated as a result of summation of the bone margin shadows consisting of compact substance (osteones). Microscopic examination of skull in brain tumors revealed a delay in the formation of bone margins in the suture region with an excessive amount of connective and osteoid tissue while in craniostenosis closure of cranial sutures being with intensive bone formation as well as by closure of the bone margins by newly formed bone tissue around the vessels of the connective layer of the suture

  10. Roux limb volvulus in laparoscopic Roux-en-Y gastric bypass due to Roux limb stabilization suture: case series.

    Science.gov (United States)

    Marr, Brendan; Yenumula, Panduranga

    2012-01-01

    Complications after laparoscopic Roux-en-Y gastric bypass surgery may be related to the type of surgical technique employed. One technique, the placement of a Roux limb stabilization suture, presumably prevents kink at the gastrojejunal anastomosis. However, it can have an adverse effect and we studied a series of cases presenting with intestinal obstruction secondary to this stitch. A retrospective review of a prospectively collected database of laparoscopic Roux-en-Y gastric bypass cases who had reoperations for Roux limb volvulus was performed at a single bariatric center by a single surgeon. Out of 199 patients who underwent laparoscopic Roux en Y gastric bypass with placement of Roux limb stabilization suture, 4 patients (2.01%) presented with Roux limb volvulus postoperatively. BMI was 45.35 ± 2.95. The postoperative time to presentation was 11 ± 10.6 months. All four patients required surgical exploration to reduce the volvulus. In all cases, the Roux limb volvulus was directly attributable to the presence of the stabilization suture. In subsequent 250 cases where this suture was eliminated, there was no volvulus of Roux limb seen. The use of a stabilization suture can result in volvulus of the Roux limb causing intestinal obstruction and this complication can be prevented by avoiding this suture.

  11. A comparison of single-suture and double-suture incision closures in seaward-migrating juvenile Chinook salmon implanted with acoustic transmitters: implications for research in river basins containing hydropower structures

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Richard S.; Deters, Katherine A.; Cook, Katrina V.; Eppard, M. B.

    2013-07-15

    Reductions in the size of acoustic transmitters implanted in migrating juvenile salmonids have resulted in the ability to make shorter incisions that may warrant using only a single suture for closure. However, it is not known if one suture will sufficiently hold the incision closed, particularly when outward pressure is placed on the surgical site such as when migrating fish experience pressure changes associated with passage at hydroelectric dams. The objective of this research was to evaluate the effectiveness of single-suture incision closures on juvenile Chinook salmon (Oncorhynchus tshawytscha). Juvenile Chinook salmon were surgically implanted with a 2012 Juvenile Salmon Acoustic Telemetry System (JSATS) transmitter (0.30 g) and a passive integrated transponder tag (0.10 g) and incisions were closed with either one suture or two sutures. Mortality and tag retention were monitored and fish were examined after 7 and 14 days to evaluate tissue responses. In a separate experiment, surgically implanted fish were exposed to simulated turbine passage and then examined for expulsion of transmitters, expulsion of viscera through the incision, and mortal injury. With incisions closed using a single suture, there was no mortality or tag loss and similar or reduced tissue reaction compared to incisions closed with two sutures. Further, surgery time was significantly reduced when one suture was used, which leads to less handling and reduced stress. No tags were expelled during pressure scenarios and expulsion of viscera only occurred in two non-mortally injured fish (5%) with single sutures that were also exposed to very high pressure changes. No viscera expulsion was present in fish exposed to pressure scenarios likely representative of hydroturbine passage at many Columbia River dams (e.g. <2.7 ratio of pressure change; an acclimation pressure of 146.2 absolute kpa and a lowest exposure pressure of ~ 53.3 absolute kpa). Based on these results, we recommend the use of a

  12. 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.

  13. Frequency of Dehiscence in Hand-Sutured and Stapled Intestinal Anastomoses in Dogs.

    Science.gov (United States)

    Duell, Jason R; Thieman Mankin, Kelley M; Rochat, Mark C; Regier, Penny J; Singh, Ameet; Luther, Jill K; Mison, Michael B; Leeman, Jessica J; Budke, Christine M

    2016-01-01

    To determine the frequency of dehiscence of hand-sutured and stapled intestinal anastomoses in the dog and compare the surgery duration for the methods of anastomosis. Historical cohort study. Two hundred fourteen client-owned dogs undergoing hand-sutured (n = 142) or stapled (n = 72) intestinal anastomoses. Medical records from 5 referral institutions were searched for dogs undergoing intestinal resection and anastomosis between March 2006 and February 2014. Demographic data, presence of septic peritonitis before surgery, surgical technique (hand-sutured or stapled), surgery duration, surgeon (resident versus faculty member), indication for surgical intervention, anatomic location of resection and anastomosis, and if dehiscence was noted postoperatively were retrieved. Estimated frequencies were summarized and presented as proportions and 95% confidence intervals (CI) and continuous outcomes as mean (95% CI). Comparisons were made across methods of anastomosis. Overall, 29/205 dogs (0.14, 95% CI 0.10-00.19) had dehiscence, including 21/134 dogs (0.16, 0.11-0.23) undergoing hand-sutured anastomosis and 8/71 dogs (0.11, 0.06-0.21) undergoing stapled anastomosis. There was no significant difference in the frequency of dehiscence across anastomosis methods (χ(2), P = .389). The mean (95% CI) surgery duration of 140 minutes (132-147) for hand- sutured anastomoses and 108 minutes (99-119) for stapled anastomoses was significantly different (t-test, P < .001). No significant difference in frequency of dehiscence was noted between hand- sutured and stapled anastomoses in dogs but surgery duration is significantly reduced by the use of staples for intestinal closure. © Copyright 2015 by The American College of Veterinary Surgeons.

  14. 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.

  15. Effect of the use of carprofen in dogs undergoing intense rehabilitation after lateral fabellar suture stabilization.

    Science.gov (United States)

    Gordon-Evans, Wanda J; Dunning, Diane; Johnson, Ann L; Knap, Kim E

    2011-07-01

    To determine whether carprofen, a commercially available NSAID, would decrease perceived exertion and signs of pain in dogs and therefore increase muscle mass and hind limb function without decreasing range of motion after lateral fabellar suture stabilization. Randomized, blinded, controlled clinical trial. 35 dogs with cranial cruciate ligament rupture and lateral fabellar suture stabilization followed by rehabilitation. All dogs underwent surgical stabilization of cranial cruciate ligament rupture by placement of a lateral fabellar suture. Dogs received carprofen (2.2 mg/kg [1 mg/lb], PO, q 12 h) for the first 7 days after surgery and underwent concentrated rehabilitation exercises during weeks 3, 5, and 7 after surgery. Eighteen dogs also received carprofen (2.2 mg/kg, PO, q 12 h) during the weeks of concentrated rehabilitation. Outcomes were measured by a single investigator, who was blinded to group assignments, using pressure platform gait analysis, goniometry, thigh circumference, and mean workout speed at a consistent level of exertion. There were no differences between the 2 groups in ground reaction forces, thigh circumference, or exertion (mean workout speed) over time or at any individual time point. However, both groups improved significantly over time for all outcome measures. Providing carprofen to dogs during concentrated rehabilitation after lateral fabellar suture stabilization did not improve hind limb function, range of motion, or thigh circumference, nor did it decrease perceived exertion, compared with control dogs. Carprofen was not a compulsory component of a physical therapy regimen after lateral fabellar suture stabilization.

  16. The use of quilting suture in abdominoplasty does not require aspiratory drainage for prevention of seroma.

    Science.gov (United States)

    Arantes, Henrique Lopes; Rosique, Rodrigo Gouvêa; Rosique, Marina Junqueira Ferreira; Mélega, Jose Marcos

    2010-02-01

    The formation of seromas after abdominoplasty is a highly prevalent complication that disturbs both the patient and the surgeon. Aspiratory drainage and adhesion sutures (Baroudi suture) are widely used to prevent this complication. This study evaluated the effectiveness of drains in preventing seromas. This retrospective study investigated women submitted to classic abdominoplasty with adhesion sutures. The women were divided into two groups. Group 1 comprised 28 individuals who received no drains, and group 2 consisted of 32 patients that had drains placed. Clinical evaluation of the patients was performed 7 days, 14 days, 1 month, 2 months, 4 months, and 6 months postoperatively. Statistical analysis was accomplished via Fisher's exact test. Group 1 had one case of seroma (3.5%), clinically detected between the first and second postoperative months, whereas group 2 had one case (3.12%) detected 14 days postoperatively. Fisher's test showed a P value of 1.000 (not statistically significant), for a 95% confidence interval of 0.05 to 14.08 and an odds ratio of 0.8387. Clinical evaluation showed no statistical difference in the incidence of seromas after abdominoplasty with adhesion sutures between the patients who received drains and those who did not. The use of adhesion sutures is an effective measure for preventing seromas with no need for additional surgical measures.

  17. 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.

  18. Evaluation of surgical skill of uvulopalato pharyngo plasty (UPPP)

    International Nuclear Information System (INIS)

    Takashima, Masayuki; Oda, Makoto; Itoi, Aya; Tomoda, Kouichi

    2006-01-01

    We evaluated the surgical skill of uvulopalato pharyngo plasty (UPPP) done in 35 cases in our hospital and discussed its efficacy. Our method of UPPP has three characteristics. First, a mattress suture was applied in the tonsillar bed. As a result there was no failure of the suture. Second, we made a raw surface at a little upper part of the root of the uvula and applied the mattress suture to it. This suture has efficacy of soft palate upword to the oral side. Third, no continuous suture has advantage to present scar formation. We also examined the dynamic MRI for obstructive site and images were divided some morphological obstructive pattern, and assess about efficacy of improvement rate of AHI. The efficacy was over 80% in tonsillar type. But there was 31% efficacy not only soft palate but also tongue rotation type. We concluded that the important factor to have good result of UPPP are surgical skill and adequate indication. (author)

  19. Purification apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Mortenson, C.W.

    1982-04-27

    An apparatus is provided for converting sea or other undrinkable waters to drinkable water without the use of driven or moving parts. Reliance upon gradient effects is made to effect the vaporization of, for example, sea water, followed by the condensation of the vapor to form distilled water. Gradient effects are achieved through the provision of differentials in the thermal conductivity, capillary activity, adsorptive, absorptive and/or pressure characteristics of particulate materials, or combinations of such physicals. For example, a column is packed with material graded as to its conductivity, the least thermally conductive material being nearest the cold or ambient water that is to be purified. In packing the column each successive layer of material has a greater thermal conductivity than the layer beneath it with the most conductive being at the top near the outlet arm of the column. The final outlet arm or tube is unheated or is at a temperature lower than that of the topmost conductive material so that vapor reaching the outlet tube gets condensed. This tube leads to a container kept in a cool place as, for example, buried in the ground, as, for instance, at the seashore deep enough to be cooled or to be surrounded by water, thus keeping the condensate cold. Pure water so collected is removed by such means as is desired. Other impure, volatile liquids may be similarly purified.

  20. Major Lung Resections Using Manual Suturing Versus Staplers During Fiscal Crisis.

    Science.gov (United States)

    Potaris, Konstantinos; Kapetanakis, Emmanuil; Papamichail, Konstantinos; Midvighi, Elena; Verveniotis, Alexis; Parissis, Fotios; Apostolou, Demetrios; Tziortziotis, Vaios; Maimani, Spiridoula; Pouliara, Evangelia; Vogiatzis, Gregorios; Kakaris, Stamatis; Konstantinou, Marios

    2015-07-27

    AbstractObjective: During fiscal crisis there was a period of shortage of staplers in our hospital, which drove us to manual suturing of bronchi and pulmonary vessels during major lung resections. We present our experience during that period in comparison to a subsequent period when staplers became available again. A total of 256 lobectomies and 78 pneumonectomies were performed using manual suturing (group A), between September 2009 and September 2010, and compared regarding surgical outcome to 248 lobectomies and 60 pneumonectomies using staplers (group B), between September 2011 and September 2012. Although we did not observe statistically significant differences but only a trend towards less operative time, for both lobectomies (p=0.21) and pneumonectomies (p=0.31), we actually noted a 41 and 47 minutes saving of operative time using staplers (group B), in comparison to manual suturing (group A). We also observed a trend towards less morbidity rates in patients of group B, who underwent lobectomy (10.48%), and pneumonectomy (20%), versus patients of group A, who underwent lobectomy (15.62%), and pneumonectomy (30.76%); we did not observe any substantial differences in the other surgical outcome variables, and in patients' demographics comorbidities, and anatomic allocation of surgical procedures performed. The use of staplers offers safety with secure bronchial or vascular sealing, and saving of operative time. Their unavailability at an interval during fiscal crisis although it did not affect surgical outcome, revealed their usefulness and value.

  1. 'The Closer'-percutaneous vascular suture device: evaluation of safety and performance in neuroangiography

    International Nuclear Information System (INIS)

    Henk, Christine B.; Grampp, Stephan; Heimberger, Karl; Czerny, Christian; Schindler, Erwin; Mostbeck, Gerhard H.

    2003-01-01

    Objective: To evaluate the use of the suture mediated vascular closure device concerning practicability and safety in clinical angiography practice. Material and methods: One hundred and seventeen patients (59 female, 58 male, mean age 40.9±13.4) underwent percutaneous closure of common femoral arterial puncture sites following diagnostic neuroangiography using the suture device 'the Closer' (Perclose Inc., Redwood City, CA, USA). Primary success, early problems (within 24 h) and late complications were evaluated. Complications were graded as minor and severe with or without need of surgical intervention and categorized by type. Parameters such as age, gender, sheath size and number of previous arterial punctures were evaluated with respect to complications. Results: Percutaneous closure was primary successful in 85% (100/117). The overall complication rate was 32% (28% mild n=35, 4% severe n=6, which needed surgical intervention). All but one problem occurred within the first 24 h after the suture. Additional manual compression was necessary in 32 cases (25%). There was no significant difference in age and gender between the groups with and without complications. Sheath size was significantly larger (P<0.01) and numbers of preceding angiograms were significantly higher (P<0.01) in the complications group compared with uncomplicated cases. Conclusion: The evaluated percutaneous vascular suture device is useful in clinical practice but limitations concerning patient selection seem to emerge in order to avoid complications

  2. 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

  3. 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.

  4. Surgical anatomy of the nail apparatus.

    NARCIS (Netherlands)

    Haneke, E.

    2006-01-01

    Nail surgery is an integral part of dermatologic surgery. An in-depth knowledge of the anatomy, biology, physiology, and gross pathology of the entire nail unit is essential. In particular, knowledge of nail histopathology is necessary to perform diagnostic nail biopsies and other nail procedures

  5. Comparison of a continuous suture pattern with a simple interrupted pattern for enteric closure in dogs and cats: 83 cases (1991-1997).

    Science.gov (United States)

    Weisman, D L; Smeak, D D; Birchard, S J; Zweigart, S L

    1999-05-15

    To describe and compare a simple continuous suture pattern with a simple interrupted pattern for enterotomy closure or end-to-end intestinal anastomosis. Retrospective study. 58 dogs and 25 cats that underwent enterotomy or intestinal resection and anastomosis. Signalment, surgical procedure, suture pattern, suture material, confirmation of dehiscence, and follow-up were reviewed. Groups were compared by procedure (anastomosis or enterotomy) and by suture pattern. 57 animals underwent continuous closure; 26 had interrupted closure. Only polydioxanone or polypropylene suture materials were used. Overall, 81 (98%) animals had no signs of intestinal dehiscence and survived > 2 weeks. Two animals had confirmed dehiscence after foreign body removal, 1 of 57 (2%) after continuous closure, and 1 of 26 (4%) after interrupted closure. The simple continuous closure pattern is an acceptable alternative to simple interrupted closure for small intestinal anastomosis or enterotomy closure.

  6. 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.

  7. Pectoralis Major Repair With Unicortical Button Fixation And Suture Tape.

    Science.gov (United States)

    Sanchez, Anthony; Ferrari, Marcio B; Frangiamore, Salvatore J; Sanchez, George; Kruckeberg, Bradley M; Provencher, Matthew T

    2017-06-01

    Although injuries of the pectoralis major muscle are generally uncommon, ruptures of the pectoralis major are occasionally seen in younger, more active patients who participate in weightlifting activities. These injuries usually occur during maximal contraction of the muscle, while in extension and external rotation. In the case of a rupture, operative treatment is advocated especially in young, active patients regardless of the chronicity of the injury. Various surgical techniques for reattachment of the avulsed tendon have been described, but bone tunnel and suture anchor repair techniques are most widely used. In this Technical Note, we present our preferred technique for acute pectoralis major rupture repair involving use of cortical buttons for tendon stump-to-bone fixation.

  8. Four-dimensional Microscope-Integrated Optical Coherence Tomography to Visualize Suture Depth in Strabismus Surgery.

    Science.gov (United States)

    Pasricha, Neel D; Bhullar, Paramjit K; Shieh, Christine; Carrasco-Zevallos, Oscar M; Keller, Brenton; Izatt, Joseph A; Toth, Cynthia A; Freedman, Sharon F; Kuo, Anthony N

    2017-02-14

    The authors report the use of swept-source microscope-integrated optical coherence tomography (SS-MIOCT), capable of live four-dimensional (three-dimensional across time) intraoperative imaging, to directly visualize suture depth during lateral rectus resection. Key surgical steps visualized in this report included needle depth during partial and full-thickness muscle passes along with scleral passes. [J Pediatr Ophthalmol Strabismus. 2017;54:e1-e5.]. Copyright 2017, SLACK Incorporated.

  9. Automatically rating trainee skill at a pediatric laparoscopic suturing task.

    Science.gov (United States)

    Oquendo, Yousi A; Riddle, Elijah W; Hiller, Dennis; Blinman, Thane A; Kuchenbecker, Katherine J

    2018-04-01

    Minimally invasive surgeons must acquire complex technical skills while minimizing patient risk, a challenge that is magnified in pediatric surgery. Trainees need realistic practice with frequent detailed feedback, but human grading is tedious and subjective. We aim to validate a novel motion-tracking system and algorithms that automatically evaluate trainee performance of a pediatric laparoscopic suturing task. Subjects (n = 32) ranging from medical students to fellows performed two trials of intracorporeal suturing in a custom pediatric laparoscopic box trainer after watching a video of ideal performance. The motions of the tools and endoscope were recorded over time using a magnetic sensing system, and both tool grip angles were recorded using handle-mounted flex sensors. An expert rated the 63 trial videos on five domains from the Objective Structured Assessment of Technical Skill (OSATS), yielding summed scores from 5 to 20. Motion data from each trial were processed to calculate 280 features. We used regularized least squares regression to identify the most predictive features from different subsets of the motion data and then built six regression tree models that predict summed OSATS score. Model accuracy was evaluated via leave-one-subject-out cross-validation. The model that used all sensor data streams performed best, achieving 71% accuracy at predicting summed scores within 2 points, 89% accuracy within 4, and a correlation of 0.85 with human ratings. 59% of the rounded average OSATS score predictions were perfect, and 100% were within 1 point. This model employed 87 features, including none based on completion time, 77 from tool tip motion, 3 from tool tip visibility, and 7 from grip angle. Our novel hardware and software automatically rated previously unseen trials with summed OSATS scores that closely match human expert ratings. Such a system facilitates more feedback-intensive surgical training and may yield insights into the fundamental

  10. Characterization of the bending strength of craniofacial sutures.

    Science.gov (United States)

    Maloul, Asmaa; Fialkov, Jeffrey; Whyne, Cari M

    2013-03-15

    The complex, thin and irregular bones of the human craniofacial skeleton (CFS) are connected together through bony articulations and connective tissues. These articulations are known as sutures and are commonly divided into two groups, facial and cranial sutures, based on their location in the CFS. CFS sutures can exhibit highly variable degrees of interdigitation and complexity and are believed to play a role in accommodating the mechanical demands of the skull. This study aimed to evaluate the mechanical behavior of CFS bone samples with and without sutures and to determine the effect of sutural interdigitations on mechanical strength. Sagittal, coronal, frontozygomatic and zygomaticotemporal sutures along with adjacent bone samples not containing sutures were excised from six fresh-frozen cadaveric heads. The interdigitation of the sutures was quantified through μCT based analysis. Three-point bending to failure was performed on a total of 29 samples. The bending strength of bone samples without sutures demonstrated a non-significant increase of 14% as compared to samples containing sutures (P=0.2). The bending strength of bones containing sutures was positively correlated to the sutural interdigitation index (R=0.701, P=0.002). The higher interdigitation indices found in human cranial vs. facial sutures may be present to resist bending loads as a functional requirement in protecting the brain. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Surgical treatment for residual or recurrent strabismus

    Directory of Open Access Journals (Sweden)

    Tao Wang

    2014-12-01

    Full Text Available Although the surgical treatment is a relatively effective and predictable method for correcting residual or recurrent strabismus, such as posterior fixation sutures, medial rectus marginal myotomy, unilateral or bilateral rectus re-recession and resection, unilateral lateral rectus recession and adjustable suture, no standard protocol is established for the surgical style. Different surgical approaches have been recommended for correcting residual or recurrent strabismus. The choice of the surgical procedure depends on the former operation pattern and the surgical dosages applied on the patients, residual or recurrent angle of deviation and the operator''s preference and experience. This review attempts to outline recent publications and current opinion in the management of residual or recurrent esotropia and exotropia.

  12. Sustained release of neurotrophin-3 via calcium phosphate-coated sutures promotes axonal regeneration after spinal cord injury.

    Science.gov (United States)

    Hanna, Amgad; Thompson, Daniel L; Hellenbrand, Daniel J; Lee, Jae-Sung; Madura, Casey J; Wesley, Meredith G; Dillon, Natalie J; Sharma, Tapan; Enright, Connor J; Murphy, William L

    2016-07-01

    Because of the dynamics of spinal cord injury (SCI), the optimal treatment will almost certainly be a combination approach to control the environment and promote axonal growth. This study uses peripheral nerve grafts (PNGs) as scaffolds for axonal growth while delivering neurotrophin-3 (NT-3) via calcium phosphate (CaP) coatings on surgical sutures. CaP coating was grown on sutures, and NT-3 binding and release were characterized in vitro. Then, the NT-3-loaded sutures were tested in a complete SCI model. Rats were analyzed for functional improvement and axonal growth into the grafts. The CaP-coated sutures exhibited a burst release of NT-3, followed by a sustained release for at least 20 days. Functionally, the rats with PNGs + NT-3-loaded sutures and the rats treated with PNGs scored significantly higher than controls on day 56 postoperatively. However, functional scores in rats treated with PNGs + NT-3-loaded suture were not significantly different from those of rats treated with PNGs alone. Cholera toxin subunit B (CTB) labeling rostral to the graft was not observed in any controls, but CTB labeling rostral to the graft was observed in almost all rats that had had a PNG. Neurofilament labeling on transverse sections of the graft revealed that the rats treated with the NT-3-loaded sutures had significantly more axons per graft than rats treated with an NT-3 injection and rats without NT-3. These data demonstrate that PNGs serve as scaffolds for axonal growth after SCI and that CaP-coated sutures can efficiently release NT-3 to increase axonal regeneration. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  13. 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.

  14. Large Rotor Test Apparatus

    Data.gov (United States)

    Federal Laboratory Consortium — This test apparatus, when combined with the National Full-Scale Aerodynamics Complex, produces a thorough, full-scale test capability. The Large Rotor Test Apparatus...

  15. Tutoring Trainees to Suture: An Alternative Method for Learning How to Suture and a Way to Compensate for a Lack of Suturing Cases.

    Science.gov (United States)

    Wongkietkachorn, Apinut; Rhunsiri, Peera; Boonyawong, Pangpoom; Lawanprasert, Attaporn; Tantiphlachiva, Kasaya

    2016-01-01

    Tutoring in suturing was developed to compensate for a shortage of suturing cases. The objective of this study was to compare ideal suturing score (ISS; 9 points), suturing time (min:sec), and suture placement error (mm) between medical students completing the suturing tutoring program and medical students attending ordinary medical school training program. Participants consisted of 2 groups of medical students who had never performed suturing. The study group had the role of suturing tutor to teach interested high school students. The control group consisted of volunteers from the ordinary medical school program. Skills measurement was performed by having students from both the groups perform 3 vertical mattress sutures on a model. The study group was tested at weeks 1, 9, and 10 to assess improvement. Both the groups were tested at week 10 to compare final learning outcome. There were 41 and 40 participants in the study group and the control group, respectively. ISS was significantly improved in the study group from week 1-week 10 (7.0 ± 1.3 vs. 8.2 ± 0.9, p = 0.01). At week 10, the study group had a higher mean ISS than the control group (8.2 ± 0.9 vs. 7.8 ± 1.1, p = 0.68). Mean suturing time and mean placement error were also lower in the study group at the end of suturing training (5:1 ± 1:0 vs. 5:2 ± 1:2, p = 0.13; 7.4 ± 7.4 vs. 8.0 ± 10.8, p = 0.44). Tutoring trainees to suture can improve a student's ability to learn how to suture. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  16. The objective assessment of experts' and novices' suturing skills using an image analysis program.

    Science.gov (United States)

    Frischknecht, Adam C; Kasten, Steven J; Hamstra, Stanley J; Perkins, Noel C; Gillespie, R Brent; Armstrong, Thomas J; Minter, Rebecca M

    2013-02-01

    To objectively assess suturing performance using an image analysis program and to provide validity evidence for this assessment method by comparing experts' and novices' performance. In 2009, the authors used an image analysis program to extract objective variables from digital images of suturing end products obtained during a previous study involving third-year medical students (novices) and surgical faculty and residents (experts). Variables included number of stitches, stitch length, total bite size, travel, stitch orientation, total bite-size-to-travel ratio, and symmetry across the incision ratio. The authors compared all variables between groups to detect significant differences and two variables (total bite-size-to-travel ratio and symmetry across the incision ratio) to ideal values. Five experts and 15 novices participated. Experts' and novices' performances differed significantly (P 0.8) for total bite size (P = .009, d = 1.5), travel (P = .045, d = 1.1), total bite-size-to-travel ratio (P algorithm can extract variables from digital images of a running suture and rapidly provide quantitative summative assessment feedback. The significant differences found between groups confirm that this system can discriminate between skill levels. This image analysis program represents a viable training tool for objectively assessing trainees' suturing, a foundational skill for many medical specialties.

  17. Gamma tomography apparatus

    International Nuclear Information System (INIS)

    Span, F.J.

    1988-01-01

    The patent concerns a gamma tomography apparatus for medical diagnosis. The apparatus comprises a gamma scintillation camera head and a suspension system for supporting and positioning the camera head with respect for the patient. Both total body scanning and single photon emission tomography can be carried out with the apparatus. (U.K.)

  18. ROLLER FILTRATION APPARATUS

    DEFF Research Database (Denmark)

    2017-01-01

    The present invention relates to the field of filtering, more precisely the present invention concerns an apparatus and a method for the separation of dry matter from a medium and the use of said apparatus. One embodiment discloses an apparatus for the separation of dry matter and liquid from a m...

  19. Pore roller filtration apparatus

    DEFF Research Database (Denmark)

    2014-01-01

    The present invention relates to the field of filtering, more precisely the present invention concerns an apparatus and a method for the separation of dry matter from a medium and the use of said apparatus. One embodiment discloses an apparatus for the separation of dry matter from a medium, comp...

  20. Gamma apparatuses for radiotherapy

    International Nuclear Information System (INIS)

    Sul'kin, A.G.

    1986-01-01

    Scientific and technical achievements in development and application of gamma therapeutic apparatuses for external and intracavity irradiations are generalized. Radiation-physical parameters of apparatuses providing usability of progressive methods in radiotherapy of onclogical patients are given. Optimization of main apparatus elements, ensurance of its operation reliability, reduction of errors of irradiation plan reproduction are considered. Attention is paid to radiation safety

  1. 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......, the observer traced the sutures on each of the mouse volumes as well. The observer outperforms the automatic approach by approximately 0.1 mm. All mice have similar errors while the suture error plots reveal that suture 1 and 2 are cumbersome, both for the observer and the automatic approach. These sutures can...

  2. The Efficacy of Ultraviolet Radiation for Sterilizing Tools Used for Surgically Implanting Transmitters into Fish

    Energy Technology Data Exchange (ETDEWEB)

    Walker, Ricardo W.; Markillie, Lye Meng; Colotelo, Alison HA; Gay, Marybeth E.; Woodley, Christa M.; Brown, Richard S.

    2013-02-28

    Telemetry is frequently used to examine the behavior of fish, and the transmitters used are normally surgically implanted into the coelom of fish. Implantation requires the use of surgical tools such as scalpels, forceps, needle holders, and sutures. When several fish are implanted consecutively for large telemetry studies, it is common for surgical tools to be sterilized or, at minimum, disinfected between each use so that pathogens that may be present are not spread among fish. However, autoclaving tools can take a long period of time, and chemical sterilants or disinfectants can be harmful to both humans and fish and have varied effectiveness. Ultraviolet (UV) radiation is commonly used to disinfect water in aquaculture facilities. However, this technology has not been widely used to sterilize tools for surgical implantation of transmitters in fish. To determine its efficacy for this application, Pacific Northwest National Laboratory researchers used UV radiation to disinfect surgical tools (i.e., forceps, needle holder, stab scalpel, and suture) that were exposed to one of four aquatic organisms that typically lead to negative health issues for salmonids. These organisms included Aeromonas salmonicida, Flavobacterium psychrophilum, Renibacterium salmoninarum, and Saprolegnia parasitica. Surgical tools were exposed to the bacteria by dipping them into a confluent suspension of three varying concentrations (i.e., low, medium, high). After exposure to the bacterial culture, tools were placed into a mobile Millipore UV sterilization apparatus. The tools were then exposed for three different time periods—2, 5, or 15 min. S. parasitica, a water mold, was tested using an agar plate method and forceps-pinch method. UV light exposures of 5 and 15 min were effective at killing all four organisms. UV light was also effective at killing Geobacillus stearothermophilus, the organism used as a biological indicator to verify effectiveness of steam sterilizers. These

  3. Feasibility of pure EFTR using an innovative new endoscopic suturing device: the Double-arm-bar Suturing System (with video).

    Science.gov (United States)

    Mori, Hirohito; Kobara, Hideki; Fujihara, Shintaro; Nishiyama, Noriko; Rafiq, Kazi; Oryu, Makoto; Fujiwara, Masao; Suzuki, Yasuyuki; Masaki, Tsutomu

    2014-02-01

    Endoscopic full-thickness resection (EFTR) requires a reliable full-thickness suturing device and an endoscopic counter-traction device to prevent the collapse of the digestive tract. The present study aimed to assess the reliability of newly developed flexible endoscopy suturing devices and the feasibility of pure EFTR. A total of 30 EFTRs were performed and allocated to three groups (N = 10 for each group). The full-thickness sutures were placed using over-the-scope clips (OTSCs), hand-sewn sutures, or the Double-arm-bar Suturing System (DBSS). Air leak tests were conducted in the three groups. The times required for the placement of one OTSC suture and single-stitch simple interrupted sutures (hand-sewn and DBSS sutures, respectively) were also compared. All 30 full-thickness sutures were completely and successfully placed. Regarding the air leak tests, the Mann-Whitney U test showed significant differences between OTSC and hand-sewn sutures (p = 0.003). There was also a significant difference between OTSC and DBSS sutures (p = 0.023). There was no significant difference between hand-sewn and DBSS sutures (p = 0.542). A significant difference was found in the suture time for single-stitch simple interrupted sutures among the OTSC, hand-sewn, and DBSS sutures. The Mann-Whitney U test revealed a significant difference between OTSC and hand-sewn sutures (p = 0.0001). There was no significant difference between OTSC and DBSS sutures (p = 0.533), while a significant difference was found between hand-sewn and DBSS sutures (p = 0.0001). Pure EFTR is feasible if the mechanical counter traction system is used to expand a small operative field and DBSS is used to make full-thickness sutures. The high safety of full-thickness resection and full-thickness suturing allows for clinical applications of this method.

  4. Strength of bone tunnel versus suture anchor and push-lock construct in Broström repair.

    Science.gov (United States)

    Giza, Eric; Nathe, Ryan; Nathe, Tyler; Anderson, Matthew; Campanelli, Valentina

    2012-06-01

    incision, less surgical dissection, and improved surgical efficiency. It is up to the discretion of the performing surgeon based on preference, ease of use, operative time, and cost profile to choose either of these constructs for anatomic repair of the lateral ligaments of the ankle. The suture repair at the ligament was significantly strong enough such that the majority of ankles failed at the bone interface.

  5. Achondroplasia and multiple-suture craniosynostosis.

    Science.gov (United States)

    Albino, Frank P; Wood, Benjamin C; Oluigbo, Chima O; Lee, Angela C; Oh, Albert K; Rogers, Gary F

    2015-01-01

    Genetic mutations in the fibroblast growth factor receptor 3 gene may lead to achondroplasia or syndromic forms of craniosynostosis. Despite sharing a common genetic basis, craniosynostosis has rarely been described in cases of confirmed achondroplasia. We report an infant with achondroplasia who developed progressive multiple-suture craniosynostosis to discuss the genetic link between these clinical entities and to describe the technical challenges associated with the operative management.

  6. HANGING BY A THREAD: THE LONG-TERM EFFICACY AND SAFETY OF TRANSSCLERAL SUTURED INTRAOCULAR LENSES IN CHILDREN (AN AMERICAN OPHTHALMOLOGICAL SOCIETY THESIS)

    Science.gov (United States)

    Buckley, Edward G.

    2007-01-01

    Purpose To evaluate the long-term efficacy, safety, and advisability of using transscleral sutured posterior chamber intraocular lenses (IOLs) in pediatric patients with no capsular support and to determine whether 10-0 polypropylene suture should be used for this purpose. Methods A long-term retrospective interventional case series review of 33 eyes of 26 patients who had a sutured IOL at Duke University Eye Center were evaluated for the intraoperative surgical risks, postoperative visual and refractive outcomes, and the number, type, and severity of the postoperative complications. In addition, a survey of pediatric ophthalmologists’ experience with suture breakage was performed. Results Postoperative visual acuity was significantly improved after surgery (P subluxation of the IOL secondary to spontaneous 10-0 polypropylene suture breakage at 3.5, 8, and 9 years after surgery. A survey of pediatric ophthalmologists revealed 10 similar cases (mean, 5 years after surgery). Conclusion Transscleral fixation of an IOL in a child appears to be a safe and effective procedure provided that the suture material used is stable enough to resist significant degradation over time. Caution should be exercised in the use of 10-0 polypropylene suture to fixate an IOL to the sclera in children, and an alternative material or size should be considered. PMID:18427618

  7. Flexor tendon repair with a knotless, bidirectional barbed suture: an in vivo biomechanical analysis.

    Science.gov (United States)

    Maddox, Grady E; Ludwig, Jonathan; Craig, Eric R; Woods, David; Joiner, Aaron; Chaudhari, Nilesh; Killingsworth, Cheryl; Siegal, Gene P; Eberhardt, Alan; Ponce, Brent

    2015-05-01

    To compare and analyze biomechanical properties and histological characteristics of flexor tendons either repaired by a 4-strand modified Kessler technique or using barbed suture with a knotless repair technique in an in vivo model. A total of 25 chickens underwent surgical transection of the flexor digitorum profundus tendon followed by either a 4-strand Kessler repair or a knotless repair with barbed suture. Chickens were randomly assigned to 1 of 3 groups with various postoperative times to death. Harvested tendons were subjected to biomechanical testing or histologic analysis. Harvested tendons revealed failures in 25% of knotless repairs (8 of 32) and 8% of 4-strand Kessler repairs (2 of 24). Biomechanical testing revealed no significant difference in tensile strength between 4-strand Kessler and barbed repairs; however, this lack of difference may be attributed to lower statistical power. We noted a trend toward a gradual decrease in strength over time for barbed repairs, whereas we noticed the opposite for the 4-strand Kessler repairs. Mode of failure during testing differed between repair types. The barbed repairs tended toward suture breakage as opposed to 4-strand Kessler repairs, which demonstrated suture pullout. Histological analysis identified no difference in the degree of inflammation or fibrosis; however, there was a vigorous foreign body reaction around the 4-strand Kessler repair and no such response around the barbed repairs. In this model, knotless barbed repairs trended toward higher in vivo failure rates and biomechanical inferiority under physiologic conditions, with each repair technique differing in mode of failure and respective histologic reaction. We are unable to recommend the use of knotless barbed repair over the 4-strand modified Kessler technique. For the repair techniques tested, surgeons should prefer standard Kessler repairs over the described knotless technique with barbed suture. Copyright © 2015 American Society for Surgery

  8. Single suture iris-to-capsulorhexis fixation for in-the-bag intraocular lens subluxation.

    Science.gov (United States)

    Siegel, Michael J; Condon, Garry P

    2015-11-01

    We present a simplified modification to a technique for early or mild in-the-bag subluxation that avoids conjunctival and scleral incisions and minimizes intraocular manipulation. While the capsulorhexis edge is grasped with an intraocular forceps to stabilize the IOL-capsular bag complex, a 10-0 polypropylene suture on a long curved needle is used to secure the fibrotic superior capsulorhexis edge to the midperipheral iris at 12 o'clock using a combination of a modified McCannel suture and a Siepser sliding knot. Dr. Condon receives speaker and consultant fees from Alcon Surgical, Inc., Allergan, Inc., and Microsurgical Technology. Although the Microsurgical Technology Condon snare instrument is named after him, Dr. Condon reports no patents, fees, or payments related to it. Dr. Siegel has no financial or proprietary interest in any material or method mentioned. Copyright © 2015. Published by Elsevier Inc.

  9. Developing an Objective Structured Assessment of Technical Skills for Laparoscopic Suturing and Intracorporeal Knot Tying.

    Science.gov (United States)

    Chang, Olivia H; King, Louise P; Modest, Anna M; Hur, Hye-Chun

    2016-01-01

    To develop a teaching and assessment tool for laparoscopic suturing and intracorporeal knot tying. We designed an Objective Structured Assessment of Technical Skills (OSATS) tool that includes a procedure-specific checklist (PSC) and global rating scale (GRS) to assess laparoscopic suturing and intracorporeal knot-tying performance. Obstetrics and Gynecology residents at our institution were videotaped while performing a laparoscopic suturing and intracorporeal knot-tying task at a surgical simulation workshop. A total of 2 expert reviewers assessed resident performance using the OSATS tool during live performance and 1 month later using the videotaped recordings. OSATS scores were analyzed using the Wilcoxon rank-sum test. Data are presented as median scores (interquartile range [IQR]). Intrarater and interrater reliabilities were assessed using a Spearman correlation and are presented as an r correlation coefficient and p value. An r ≥ 0.8 was considered as a high correlation. After testing, we received feedback from residents and faculty to improve the OSATS tool as part of an iterative design process. In all, 14 of 21 residents (66.7%) completed the study, with 9 junior residents and 5 senior residents. Junior residents had a lower score on the PSC than senior residents did; however, this was not statistically significant (median = 6.0 [IQR: 4.0-10.0] and median = 13.0 [IQR: 10.0-13.0]; p = 0.09). There was excellent intrarater reliability with our OSATS tool (for PSC component, r = 0.88 for Rater 1 and 0.93 for Rater 2, both p assessment and teaching tool for laparoscopic suturing and intracorporeal knot-tying skills. Overall, good intrarater reliability was demonstrated, suggesting that this tool may be useful for longitudinal assessment of surgical skills. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  10. 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. Copyright © 2011 Wiley-Liss, Inc.

  11. Subcuticular Suture Technique: Alternative to Frost Suture to Prevent Ectropion After Transcutaneous Incision of Lower Eyelid.

    Science.gov (United States)

    Kudva, Adarsh; Kamath, Abhay; Cariappa, K M; Gadicherla, Srikanth; Dhara, B Vasantha

    2017-12-01

    An ectropion is a complication that can arise from reconstruction in the infraorbital region. Often, this complication occurs despite proper positioning of the lower lid at the time of closure. Various transcutaneous approaches to orbit skeleton have investigated in view of complication arising from them. A subtarsal approach with a postoperative Frost suture gives an advantage to reduce the occurrence of ectropion especially after treatment of orbital floor fractures. This case describes a method of subcuticular suturing technique for subtarsal incision of lower lid which can be used to support the lid during healing period, thus decreasing the rate of ectropion. The technique described here is an alterative method for frost suturing with certain advantages.

  12. Surgical Assisting

    Science.gov (United States)

    ... instruction, including: Microbiology Pathophysiology Pharmacology Anatomy and physiology Medical terminology Curriculum . Course content includes: Advanced surgical anatomy Surgical microbiology Surgical pharmacology Anesthesia methods and agents Bioscience Ethical ...

  13. Multipactor discharge apparatus

    International Nuclear Information System (INIS)

    1976-01-01

    The invention deals with a multipactor discharge apparatus which can be used for tuning microwave organs such as magnetron oscillators and other cavity resonators. This apparatus is suitable for delivering an improved tuning effect in a resonation organ wherefrom the working frequency must be set. This apparatus is equipped with two multipactor discharge electrodes set in a configuration such to that a net current flows from one electrode to another. These electrodes are parallel and flat. The apparatus can be used in magnetron devices as well for continuous waves as for impulses

  14. Radiative Gasification Apparatus

    Data.gov (United States)

    Federal Laboratory Consortium — This apparatus, developed at EL, determines gasification rate (mass loss rate) of a horizontally oriented specimen exposed in a nitrogen environment to a controlled...

  15. The frontosphenoidal suture: fetal development and phenotype of its synostosis

    Energy Technology Data Exchange (ETDEWEB)

    Mathijssen, Irene M.J.; Meulen, Jacques J.N.M. van der; Adrichem, Leon N.A. van; Vaandrager, J.M.; Vermeij-Keers, Christl [Erasmus MC, University Medical Centre, Department of Plastic and Reconstructive Surgery, Rotterdam (Netherlands); Hulst, Rene R.W.J. van der [University Hospital Maastricht, Department of Plastic and Reconstructive Surgery, Maastricht (Netherlands); Lequin, Maarten H. [Erasmus MC, University Medical Centre, Department of Radiology, Rotterdam (Netherlands)

    2008-04-15

    Isolated synostosis of the frontosphenoidal suture is very rare and difficult to diagnose. Little has been reported on the clinical presentation and fetal development of this suture. To understand the development of the frontosphenoidal suture and the outcome of its synostosis. We studied the normal fetal development of the frontosphenoidal suture in dry human skulls and the clinical features of four patients with isolated synostosis of the frontosphenoidal suture. The frontosphenoidal suture develops relatively late during the second trimester of pregnancy, which explains the mild phenotype when there is synostosis. This rare craniosynostosis results in a deformity that causes recession of the lateral part of the frontal bone and supraorbital rim, with minimal facial asymmetry. Three-dimensional CT is the best examination to confirm the diagnosis. Isolated frontosphenoidal synostosis should be considered in patients with unilateral flattening of the forehead at birth that does not improve within the first few months of life. (orig.)

  16. 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.

  17. Abortion - surgical

    Science.gov (United States)

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  18. Sutural simplification in Physodoceratinae (Aspidoceratidae, Ammonitina

    Directory of Open Access Journals (Sweden)

    Checa, A.

    1987-08-01

    Full Text Available The estructural analysis of the shell septum interrelationship in sorne Jurassic ammonites allows us to conclude that sutural simplifications occurred throughout the phylogeny, were originated by alterations in the external morphology of the shell. In the case of Physodoceratinae the simplification observed in the morphology of the septal suture may have a double origin. First, an increase in the size of periumbilical tubercles may determine a shallowing of sutural elements and a shortening of saddle and lobe frilling. In other cases, shallowing is determined by a decrease in the whorl expansion rate, an apparent shortening of secondary branching not being observed.El análisis estructural de la interrelación concha-septo en algunos ammonites del Jurásico superior lleva a concluir que las simplificaciones suturales aparecidas a lo largo de la filogenia fueron originadas por alteraciones ocurridas en la morfología externa de la concha. En el caso concreto de la subfamilia Physodoceratinae, la simplificación observada en la morfología de la sutura puede tener un doble origen. En primer lugar, un incremento en el tamaño de los tubérculos periumbilicales puede determinar una pérdida de profundidad de los elementos de la sutura. siempre acompañada de una disminución en las indentaciones (frilling de sillas y lóbulos. En otros casos el acortamiento en profundidad está determinado por una disminución de la tasa de expansión de la espira, sin que se observe un acortamiento aparente de las ramificaciones secundarias.

  19. 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...

  20. Apparatus for Teaching Physics.

    Science.gov (United States)

    Gottlieb, Herbert H., Ed.

    1981-01-01

    Describes: (1) a variable inductor suitable for an inductance-capacitance bridge consisting of a fixed cylindrical solenoid and a moveable solenoid; (2) long-range apparatus for demonstrating falling bodies; and (3) an apparatus using two lasers to demonstrate ray optics. (SK)

  1. Pipework inspection apparatus

    International Nuclear Information System (INIS)

    Wrigglesworth, K.J.; Knowles, J.F.

    1987-01-01

    The patent concerns a pipework inspection apparatus, which is capable of negotiating bends in pipework. The apparatus comprises a TV camera system, which contains an optical section and an electronics section, which are connected by a flexible coupling. The system can be pulled or pushed along the bore of the pipework. (U.K.)

  2. Nuclear core baffling apparatus

    International Nuclear Information System (INIS)

    Cooper, F.W. Jr.; Silverblatt, B.L.; Knight, C.B.; Berringer, R.T.

    1979-01-01

    An apparatus for baffling the flow of reactor coolant fluid into and about the core of a nuclear reactor is described. The apparatus includes a plurality of longitudinally aligned baffle plates with mating surfaces that allow longitudinal growth with temperature increases while alleviating both leakage through the aligned plates and stresses on the components supporting the plates

  3. Fractionation and rectification apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Sauerwald, A

    1932-05-25

    Fractionation and rectifying apparatus with a distillation vessel and a stirring tube, drainage tubes leading from its coils to a central collecting tube, the drainage tubes being somewhat parallel and attached to the outer half of the stirring tube and partly on the inner half of the central collecting tube, whereby distillation and rectification can be effected in a single apparatus.

  4. Comparison of Arterial Repair through the Suture, Suture with Fibrin or Cyanoacrylate Adhesive in Ex-Vivo Porcine Aortic Segment

    Directory of Open Access Journals (Sweden)

    Marcus Vinicius H. de Carvalho

    Full Text Available Abstract Introduction: Tissue adhesives can be used as adjacent to sutures to drop or avoid bleeding in cardiovascular operations. Objective: To verify the efficiency of fibrin and cyanoacrylate adhesive to seal arterial sutures and if the adhesives penetrate through suture line to the inner of arteries. Methods: 20 abdominal aorta segments of pigs were divided into two groups according to the adhesive which would be used as adjacent to the suture. In every arterial segment an arteriotomy was done, followed by a conventional artery closure. Afterwards a colloidal fluid was injected inside the arterial segment with a simultaneous intravascular pressure monitoring up to a fluid leakage through the suture. This procedure was repeated after application of one of the adhesives on the suture in order to check if the bursting pressure increases. The inner aorta segments also were analyzed in order to check if there was intraluminal adhesive penetration. Results: In Suture 1 group, the mean arterial pressure sustained by the arterial suture reached 86±5.35 mmHg and after the fibrin adhesive application reached 104±11.96 (P<0.002. In the Suture 2 group, the mean arterial pressure sustained by the suture reached 83±2.67 mmHg and after the cyanoacrylate adhesive application reached 152±14.58 mmHg (P<0.002. Intraluminal adhesive penetration has not been noticed. Conclusion: There was a significant rise in the bursting pressure when tissue adhesives were used as adjacent to arterial suture, and this rise was higher if the cyanoacrylate adhesive was used. In addition, the adhesives do not penetrate through the suture line into the arteries.

  5. Use of Suture-Mediated Closure Device in Percutaneous Direct Carotid Puncture During Chimney-Thoracic Endovascular Aortic Repair

    International Nuclear Information System (INIS)

    Chan, Gabriel; Quek, Lawrence Hwee Han; Tan, Glenn Leong Wei; Pua, Uei

    2016-01-01

    BackgroundInsertion of a carotid chimney graft during thoracic endovascular aortic repair (Ch-TEVAR) is a recognized technique to extend the proximal landing zone into the aortic arch in the treatment of thoracic aortic disease. Conventional technique requires surgical exposure of the carotid artery for insertion of the carotid chimney graft.MethodologyWe describe our experience in the use of a suture-mediated closure device in percutaneous Ch-TEVAR in four patients.ResultsSuccessful hemostasis was achieved in all four patients. No complications related to the carotid puncture were recorded.ConclusionWe conclude that using suture-mediated closure device for carotid closure appears feasible and deserves further studies as a potential alternative to conventional surgical approach.

  6. Use of Suture-Mediated Closure Device in Percutaneous Direct Carotid Puncture During Chimney-Thoracic Endovascular Aortic Repair

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Gabriel, E-mail: dr.changabriel@gmail.com; Quek, Lawrence Hwee Han, E-mail: lawrence-quek@ttsh.com.sg [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore); Tan, Glenn Leong Wei, E-mail: glenn-tan@ttsh.com.sg [Tan Tock Seng Hospital, Department of General Surgery (Singapore); Pua, Uei, E-mail: druei@yahoo.com [Tan Tock Seng Hospital, Department of Diagnostic Radiology (Singapore)

    2016-07-15

    BackgroundInsertion of a carotid chimney graft during thoracic endovascular aortic repair (Ch-TEVAR) is a recognized technique to extend the proximal landing zone into the aortic arch in the treatment of thoracic aortic disease. Conventional technique requires surgical exposure of the carotid artery for insertion of the carotid chimney graft.MethodologyWe describe our experience in the use of a suture-mediated closure device in percutaneous Ch-TEVAR in four patients.ResultsSuccessful hemostasis was achieved in all four patients. No complications related to the carotid puncture were recorded.ConclusionWe conclude that using suture-mediated closure device for carotid closure appears feasible and deserves further studies as a potential alternative to conventional surgical approach.

  7. Induction Based Training leads to Highly Significant Improvements of Objective and Subjective Suturing Ability in Junior Doctors

    Directory of Open Access Journals (Sweden)

    Kevin Garry

    2018-03-01

    Full Text Available Background: Simulation based training has shown to be of benefit in the education of medical students. However, the impact of induction based clinical simulation on surgical ability of qualified doctors remains unclear.The aim of this study was to establish if a 60 minute teaching session integrated into an Emergency Medicine speciality induction program produces statistically significant improvements in objective and subjective suturing abilities of junior doctors commencing an Emergency Medicine rotation.Methods: The objective suturing abilities of 16 Foundation Year Two doctors were analysed using a validated OSATs scale prior to a novel teaching intervention. The doctors then undertook an intensive hour long workshop receiving one to one feedback before undergoing repeat OSATs assessment.Subjective ability was measured using a 5 point likert scale and self-assessed competency reporting interrupted suturing before and after the intervention. Photographs of wound closure before and after the intervention were recorded for further blinded assessment of impact of intervention. A survey regarding continued ability was repeated at four months following the intervention. The study took place on 7/12/16 during the Belfast Health and Social Care Trust Emergency Medicine induction in the Royal Victoria Hospital Belfast. The hospital is a regional level 1 trauma centre that has annual departmental attendances in excess of 200,000.All new junior doctors commencing the Emergency Medicine rotation were invited to partake in the study. All 16 agreed. The group consisted of a mixture of undergraduate and postgraduate medicaldoctors who all had 16 months experience working in a variety of medical or surgical jobs previously.Results: Following the teaching intervention objective and subjective abilities in interrupted suturing showed statistically significant improvement (P>0.005. Self-reporting of competency of independently suturingwounds improved from 50

  8. COMPARISON OF ABSORBABLE EXTRA LONG TERM POLY HYDROXY BUTYRATE SUTURE VS NON ABSORBABLE (POLYPROPYLENE SUTURE FOR ABDOMINAL WALL CLOSURE

    Directory of Open Access Journals (Sweden)

    Mallikarjun

    2015-07-01

    Full Text Available PURPOSE: The aim of study is to compare Continuous technique with non - absorbable sutures, Interrupted technique with non - absorbable sutures and Continuous technique with slowly absorbable sutures Focusing mainly on incidence of incisional hernias, burst abdomen, wound infections, chronic wound pain, suture sinus, stitch granuloma, time for rectus closure. METHODOLOGY : Study was conducted for a period of one year on 271 randomized patients with primary elective midline laparotomy in our hospital . patients are divided into group I includes 102 patients with continuous technique using non absorbable polypropylene, group II includes 91 patients with interrupted technique using non absorbable polypropylene and group III includes 78 patients with continuous slowly absorbable polyhydroxybutyrate. RESULTS: No significant difference observed in incidence of wound infections and burst abdomen in all the 3 groups but relatively higher incidence of wound infections in noted our hospital. Incidence of stich granuloma suture sinus and chronic wound pain is more with interrupted technique than continuous technique and are more with non - absor bable suture material. CONCLUSION: Incidence of incisional hernias, suture complications like suture sinus, stitch granuloma can be more effectively reduced with slowly absorbable continuous sutures.

  9. The effectiveness of the double B-lynch suture as a modification in the treatment of intractable postpartum haemorrhage.

    Science.gov (United States)

    Şahin, Hanifi; Soylu Karapınar, Oya; Şahin, Eda Adeviye; Dolapçıoğlu, Kenan; Baloğlu, Ali

    2018-03-20

    A broader range of more effective compression techniques are needed in the patients who have an intractable postpartum haemorrhage due to uterine atony despite medical treatment and B-Lynch sutures. The aim of this study was to report the outcome of a series of patients with haemorrhage who were managed by double B-Lynch suture. Fourteen patients who were treated in a tertiary hospital between July 2010 and February 2015 were included in the study. The intractable haemorrhage rate was 0.35% over 5 years (14/4000 births). Bleeding was controlled in all the patients with a double B-Lynch suture. The mean age of the patients was 24 ± 3.4 years. The mean estimated blood loss was 1696 ± 272.075 mL, and the mean transfusion rate was 4.2 ± 2.5 units. Pregnancy was observed in five patients at follow up. The double B-Lynch suture seems to be an effective and reliable solution to an intractable postpartum haemorrhage resulting from uterine atony and has no unfavourable impacts on fertility. It should be considered before the use of any aggressive surgical techniques such as a hypogastric artery ligation or a hysterectomy. This the first study to investigate the effectiveness of the double B-Lynch suture, and we showed that the hysterectomy and/or hypogastric artery ligation rate can be decreased by adding a second B-Lynch suture in cases where the medical treatment or a single B-Lynch has failed. Impact statement What is already known on the subject? Uterine atony is the most common cause of a primary postpartum haemorrhage. When a simple massage of the uterus and medication failed to manage this condition, various surgical solutions have been sought, including uterine compression sutures, uterine artery ligation, devascularisation of the uterus, internal iliac artery ligation and, ultimately, a hysterectomy. The B-Lynch suturing technique is particularly useful because of its simplicity of application, life-saving potential, relative safety and capacity

  10. Geophysical exploration of the Kalahari Suture Zone

    Science.gov (United States)

    Brett, J. S.; Mason, R.; Smith, P. H.

    2000-04-01

    Fancamp Resources Limited of Montreal, Canada, commenced exploration of the Kalahari Suture Zone in southwest Botswana in 1996, following the interpretation of airborne magnetic surveys covering 400 km of strike along the Kalahari Suture Zone. Initial focus was on mafic/ultramafic intrusions associated with the Tshane Complex as potential targets for CuNiPGM mineralization, but these targets are now considered to be too deeply buried (> 700 m) to be of economic significance at this time. The exploration focus has been redirected to several prospective large coincident magnetic/gravity anomalies. These are considered prospective targets for Olympic Dam-type CuCo mineralisation associated with alkaline intrusive complexes, and/or NiCuCoPGM mineralisation associated with basic intrusive complexes. The two most important and prospective targets are the so-called 'Great Red Spot' and Tsetseng Complex. Additional ground geophysical surveys and deep drilling are planned for the next phase of exploration. These large targets are of high priority and represent tremendous potential for mineral development in the sparsely populated area of western Botswana.

  11. Outcomes Associated With Concurrent Iris-Sutured Intraocular Lens Placement and Subluxated Crystalline Lens Extraction.

    Science.gov (United States)

    McClellan, Scott F; Soiberman, Uri; Gehlbach, Peter L; Murakami, Peter N; Stark, Walter J

    2015-08-01

    We have developed a novel surgical technique, to our knowledge, for the management of subluxated crystalline lenses involving preplacement of an iris-sutured posterior chamber intraocular lens (PCIOL) before pars plana vitrectomy and lensectomy. To investigate the outcomes of eyes with subluxated crystalline lenses, predominantly a result of Marfan syndrome (14 eyes [58%]) or trauma (5 eyes [21%]), that underwent pars plana vitrectomy and lensectomy with placement of an iris-sutured PCIOL. We performed a retrospective, noncomparative case series of 24 eyes from 17 consecutive adult patients with surgically treated subluxated crystalline lenses presenting to the Wilmer Eye Institute at Johns Hopkins Hospital from October 6, 2006, through May 1, 2013. The mean (SD) postoperative follow-up was 24.4 (20.5) months for eyes with at least 6 months of follow-up (last date, October 13, 2014). We performed the analysis from January 21, 2014, through January 3, 2015. Improvement in best-corrected visual acuity using an automated Snellen chart and induction of astigmatism for eyes with at least 6 months of follow-up (n = 18) and IOL stability during follow-up for all eyes (n = 24). The mean (SD) age at surgery was 49.4 (10.7 [range, 29-67]) years. We found an improvement in mean (SD [95% CI]) best-corrected visual acuity from 0.66 (0.71 [0.30-1.02]) logMAR preoperatively (Snellen equivalent, approximately 20/90; range, 20/30 to hand motions) to 0.07 (0.11 [95% CI, 0.01-0.12]) logMAR postoperatively (Snellen equivalent, approximately 20/23; range, 20/15 to 20/50). We found little change in astigmatism postoperatively (mean change, -0.1 [95% CI, -0.5 to 0.13] diopters). Postoperative complications included retinal detachment (1 eye [4%]), retained cortical fragment (1 [4%]), cystoid macular edema (2 [8%]), and IOL subluxation (3 [13%]) owing to haptic slippage within 3 months of the procedure. The overall probability of successfully achieving placement of a centered iris-sutured

  12. Suture Anchor Fixation for Fifth Metatarsal Tuberosity Avulsion Fractures: A Case Series and Review of Literature.

    Science.gov (United States)

    Hong, Choon Chiet; Nag, Kushal; Yeow, Huifen; Lin, Adrian Zhigao; Tan, Ken Jin

    2018-05-17

    Fifth metatarsal tuberosity avulsion fractures are common. Despite good outcomes with nonoperative treatment, acute fractures with displacement, intra-articular involvement, comminution, or painful nonunion have been reported to benefit from early open reduction and internal fixation, especially in athletes. No consensus has been reached regarding the best surgical fixation technique. We present a case series of 4 patients with displaced fifth metatarsal tuberosity avulsion fractures and an innovative technique of fixation for the tuberosity avulsion fractures using a suture anchor. Copyright © 2018 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Suture Granuloma Mimicking Renal Cell Carcinoma: Magnetic Resonance Imaging (MRI and Pathologic Correlation

    Directory of Open Access Journals (Sweden)

    İbrahim İlker Öz

    2014-11-01

    Full Text Available Solid renal masses are generally distinguished with contrast enhancement and intratumoral fatty foci by radiological examinations. The present of enhancement is most important criteria for diagnosis of malignant lesions. Generally, a contrast enhanced solid mass in kidney is accepted as a neoplasm. Foreign body granuloma is an extraordinary cause of enhanced solid renal mass. This case of a renal suture granuloma demonstrated peripheral enhanced exophytic renal mass mimic renal cell carcinoma, and underwent surgery. At the solid renal mass with different radiological features, biopsy is an option to determining the necessity of surgery as well as the surgical approach.

  14. Ostomy creation with fewer sutures using tissue adhesives (cyanoacrylates) in inflammatory bowel disease: a pilot study.

    Science.gov (United States)

    Uchino, M; Ikeuchi, H; Bando, T; Sasaki, H; Chohno, T; Horio, Y; Takesue, Y

    2018-03-01

    Introduction Fistula formation around the ostomy site is a stoma-related complication often requiring surgical intervention. This complication may be caused by sutures or may develop as a complication of inflammatory bowel disease. Before conducting a clinical trial, we set out to investigate the safety of ostomy creation with fewer sutures using tissue adhesives in this pilot study. Methods Patients with inflammatory bowel disease who required surgery with ostomy creation at the Hyogo College of Medicine between January 2014 and December 2015 were enrolled. Safety was assessed by evaluating the incidence of stoma-related complications. Ostomy was restricted to loop ileostomy and was created with two sutures and tissue adhesives. Results A total of 14 patients were enrolled. Mean body mass index was 18.9 ± 2.0 kg/m 2 . There were no cases of ostomy retraction and no severe adverse events were observed. Conclusions This pilot study demonstrates that ostomy creation using tissue adhesives is safe. Although retraction and adverse events were not observed, even in patients with inflammatory bowel disease who generally exhibit delayed wound healing, the body mass index was extremely low in this series. This study does not strongly recommend ostomy creation with tissue adhesives; further studies are needed to clarify the efficacy and safety of the procedure.

  15. Characterization of craniofacial sutures using the finite element method.

    Science.gov (United States)

    Maloul, Asmaa; Fialkov, Jeffrey; Wagner, Diane; Whyne, Cari M

    2014-01-03

    Characterizing the biomechanical behavior of sutures in the human craniofacial skeleton (CFS) is essential to understand the global impact of these articulations on load transmission, but is challenging due to the complexity of their interdigitated morphology, the multidirectional loading they are exposed to and the lack of well-defined suture material properties. This study aimed to quantify the impact of morphological features, direction of loading and suture material properties on the mechanical behavior of sutures and surrounding bone in the CFS. Thirty-six idealized finite element (FE) models were developed. One additional specimen-specific FE model was developed based on the morphology obtained from a µCT scan to represent the morphological complexity inherent in CFS sutures. Outcome variables of strain energy (SE) and von Mises stress (σvm) were evaluated to characterize the sutures' biomechanical behavior. Loading direction was found to impact the relationship between SE and interdigitation index and yielded varied patterns of σvm in both the suture and surrounding bone. Adding bone connectivity reduced suture strain energy and altered the σvm distribution. Incorporating transversely isotropic material properties was found to reduce SE, but had little impact on stress patterns. High-resolution µCT scanning of the suture revealed a complex morphology with areas of high and low interdigitations. The specimen specific suture model results were reflective of SE absorption and σvm distribution patterns consistent with the simplified FE results. Suture mechanical behavior is impacted by morphologic factors (interdigitation and connectivity), which may be optimized for regional loading within the CFS. © 2013 Elsevier Ltd. All rights reserved.

  16. Revision with suture-tape augmentation after failed collateral ligament reconstruction for chronic interphalangeal instability of the hallux.

    Science.gov (United States)

    Cho, Byung-Ki; Park, Ji-Kang; Choi, Seung-Myung; SooHoo, Nelson F

    2017-12-01

    Chronic varus instability or recurrent subluxation following isolated interphalangeal dislocation of the hallux is a rare injury. No consensus has been reached regarding the best joint-salvage procedure for patients with the failed collateral ligament reconstruction using tendon graft. We report a case who achieved satisfactory clinical outcome through a modified surgical procedure (revision collateral ligament reconstruction augmented with suture-tape). Copyright © 2017 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  17. 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.

  18. Evaluation of a New Knotless Suture Anchor Repair in Acute Achilles Tendon Ruptures: A Biomechanical Comparison of Three Techniques.

    Science.gov (United States)

    Cottom, James M; Baker, Joseph S; Richardson, Phillip E; Maker, Jared M

    Acute ruptures of the Achilles tendon are a common injury, and debate has continued in published studies on how best to treat these injuries. Specifically, controversy exists regarding the surgical approaches for Achilles tendon repair when one considers percutaneous versus open repair. The present study investigated the biomechanical strength of 3 different techniques for Achilles tendon repair in a cadaveric model. A total of 36 specimens were divided into 3 groups, each of which received a different construct. The first group received a traditional Krackow suture repair, the second group was repaired using a jig-assisted percutaneous suture, and the third group received a repair using a jig-assisted percutaneous repair modified with suture anchors placed into the calcaneus. The specimens were tested with cyclical loading and to ultimate failure. Cyclical loading showed a trend toward a stronger repair with the use of suture anchors after 10 cycles (p = .295), 500 cycles (p = .120), and 1000 cycles (p = .040). The ultimate load to failure was greatest in the group repaired with the modified knotless technique using the suture anchors (p = .098). The results of the present study show a clear trend toward a stronger construct in Achilles repair using a knotless suture anchor technique, which might translate to a faster return to activity and be more resistant to an early and aggressive rehabilitation protocol. Further clinical studies are warranted to evaluate this technique in a patient population. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  19. A comparison of simple continuous versus simple interrupted suture patterns for tracheal anastomosis after large-segment tracheal resection in dogs.

    Science.gov (United States)

    Fingland, R B; Layton, C I; Kennedy, G A; Galland, J C

    1995-01-01

    Two suture techniques for tracheal anastomosis after large-segment tracheal resection were compared. Eight cartilages were resected from the trachea of each of 12 dogs; anastomoses with 4-0 polydioxanone suture were created using a simple continuous suture technique in six dogs and a simple interrupted suture technique in six dogs. Surgical time was shorter but apposition of tracheal segments at the time of surgery was less precise with the simple continuous suture technique. The dogs were evaluated for 150 days after surgery. Clinical abnormalities after tracheal resection and anastomosis were not observed. Percent dorsoventral luminal stenosis was calculated by measuring the tracheal lumen diameter on lateral cervical radiographs. Percent luminal stenosis was calculated planimetrically using a computerized digitizing tablet. Anastomotic stenosis was mild in all dogs; however, the mean percent.luminal stenosis determined planimetrically was significantly greater for dogs that had the simple continuous suture technique. Planimetric measurements of cross-sectional area made before and after formalin fixation were not significantly different. Radiographic determination of percent dorsoventral luminal stenosis was a poor predictor of diminution of cross-sectional area determined planimetrically.

  20. CASTING METHOD AND APPARATUS

    Science.gov (United States)

    Gray, C.F.; Thompson, R.H.

    1958-10-01

    An improved apparatus for the melting and casting of uranium is described. A vacuum chamber is positioned over the casting mold and connected thereto, and a rod to pierce the oxide skin of the molten uranium is fitted into the bottom of the melting chamber. The entire apparatus is surrounded by a jacket, and operations are conducted under a vacuum. The improvement in this apparatus lies in the fact that the top of the melting chamber is fitted with a plunger which allows squeezing of the oxide skin to force out any molten uranium remaining after the skin has been broken and the molten charge has been cast.

  1. Mirror plasma apparatus

    International Nuclear Information System (INIS)

    Moir, R.W.

    1981-01-01

    A mirror plasma apparatus which utilizes shielding by arc discharge to form a blanket plasma and lithium walls to reduce neutron damage to the wall of the apparatus. An embodiment involves a rotating liquid lithium blanket for a tandem mirror plasma apparatus wherein the first wall of the central mirror cell is made of liquid lithium which is spun with angular velocity great enough to keep the liquid lithium against the first material wall, a blanket plasma preventing the lithium vapor from contaminating the plasma

  2. Conduit grinding apparatus

    Science.gov (United States)

    Nachbar, Henry D.; Korytkowski, Alfred S.

    1991-01-01

    A grinding apparatus for grinding the interior portion of a valve stem receiving area of a valve. The apparatus comprises a faceplate, a plurality of cams mounted to an interior face of the faceplate, a locking bolt to lock the faceplate at a predetermined position on the valve, a movable grinder and a guide tube for positioning an optical viewer proximate the area to be grinded. The apparatus can either be rotated about the valve for grinding an area of the inner diameter of a valve stem receiving area or locked at a predetermined position to grind a specific point in the receiving area.

  3. Robot-assisted bronchoplasty using continuous barbed sutures.

    Science.gov (United States)

    Sarsam, Omar Matthieu; Dunning, Joel; Pochulu, Bruno; Baste, Jean-Marc

    2018-01-01

    We describe in this article our bronchoplastic robot-assisted techniques. This consists of using continuous barbed sutures. Our aim is to show the feasibility and the interest of using robotics and this kind of suture material for complex bronchial procedures. We report four cases in France and the UK, two wedge bronchoplasties and two sleeve bronchoplasties for central pulmonary tumors.

  4. Mechanical model of suture joints with fibrous connective layer

    Science.gov (United States)

    Miroshnichenko, Kateryna; Liu, Lei; Tsukrov, Igor; Li, Yaning

    2018-02-01

    A composite model for suture joints with a connective layer of aligned fibers embedded in soft matrix is proposed. Based on the principle of complementary virtual work, composite cylinder assemblage (CCA) approach and generalized self-consistent micro-mechanical models, a hierarchical homogenization methodology is developed to systematically quantify the synergistic effects of suture morphology and fiber orientation on the overall mechanical properties of sutures. Suture joints with regular triangular wave-form serve as an example material system to apply this methodology. Both theoretical and finite element mechanical models are developed and compared to evaluate the overall normal stiffness of sutures as a function of wavy morphology of sutures, fiber orientation, fiber volume fraction, and the mechanical properties of fibers and matrix in the interfacial layer. It is found that generally due to the anisotropy-induced coupling effects between tensile and shear deformation, the effective normal stiffness of sutures is highly dependent on the fiber orientation in the connective layer. Also, the effective shear modulus of the connective layer and the stiffness ratio between the fiber and matrix significantly influence the effects of fiber orientation. In addition, optimal fiber orientations are found to maximize the stiffness of suture joints.

  5. Suture associated corneal abscess three years after cataract surgery ...

    African Journals Online (AJOL)

    The abscess was carefully removed on slit lamp using blunt tipped forceps without breaking the thin membrane covering it. There was a deep corneal depression at the bottom of which was found a loose 10/0 nylon corneoscleral suture. Another loose suture was present at the 12 o'clock position surrounded by stromal ...

  6. Effective and rapid sealing of coronary, aortic and atrial suture lines †.

    Science.gov (United States)

    Skorpil, Jiri; Paraforos, Alexandros; Mandak, Jiri; Cohn, William E; Hajek, Tomas; Friedrich, Ivan

    2015-06-01

    Cardiac surgical procedures carry a high risk of perioperative bleeding. Surgical sealants are often used to prevent suture line bleeding. PreveLeak™ is a surgical sealant composed of bovine serum albumin, a polyaldehyde cross-linker, and other components that forms a soft, flexible, water-tight, mechanical seal that is biocompatible and bioresorbable. A prospective, multicentre study evaluated PreveLeak use in 44 subjects undergoing 63 cardiac procedures, primarily coronary artery bypass grafting (n = 23/63, 36.5%) and aortic valve replacement (n = 19/63, 30.2%). PreveLeak was applied to 127 suture lines and the time to sealing evaluated upon clamp release. The primary safety endpoint was the incidence of significant bleeding, infections, neurological deficits and immune/inflammatory allergic responses within 6 weeks post-treatment; subjects were followed for 3 months. Immediate sealing was achieved at all sites in 42 of 44 subjects (95.5%) and 125 of 127 treatment sites (98.4%). There were nine primary safety events: eight infections and one transient neurological deficit. Most adverse events were mild (n = 46/71, 64.8%) or moderate (n = 18/71, 25.4%) in severity. One adverse event (transient vasospasm) was considered possibly sealant-related. One death occurred due to a cardiac arrest. PreveLeak prevented bleeding at 98.4% of treated sites and was well tolerated; adverse events were consistent with those commonly observed in subjects undergoing surgical procedures. These results compared favourably with published studies of other sealants. The observed prevention of bleeding is clinically important in cardiac surgical patients. A randomized, comparative study is justified to further evaluate PreveLeak and confirm the findings from this study. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  7. Tomographic scanning apparatus

    International Nuclear Information System (INIS)

    1981-01-01

    Details are given of a tomographic scanning apparatus, with particular reference to a multiplexer slip ring means for receiving output from the detectors and enabling interfeed to the image reconstruction station. (U.K.)

  8. Tomographic scanning apparatus

    International Nuclear Information System (INIS)

    1981-01-01

    Details are presented of a tomographic scanning apparatus, its rotational assembly, and the control and circuit elements, with particular reference to the amplifier and multiplexing circuits enabling detector signal calibration. (U.K.)

  9. Tomographic scanning apparatus

    International Nuclear Information System (INIS)

    1981-01-01

    This patent specification relates to a tomographic scanning apparatus using a fan beam and digital output signal, and particularly to the design of the gas-pressurized ionization detection system. (U.K.)

  10. Scintillation counting apparatus

    International Nuclear Information System (INIS)

    Noakes, J.E.

    1978-01-01

    Apparatus is described for the accurate measurement of radiation by means of scintillation counters and in particular for the liquid scintillation counting of both soft beta radiation and gamma radiation. Full constructional and operating details are given. (UK)

  11. Imaging Apparatus And Method

    NARCIS (Netherlands)

    Manohar, Srirang; van Leeuwen, A.G.J.M.

    2010-01-01

    A thermoacoustic imaging apparatus comprises an electromagnetic radiation source configured to irradiate a sample area and an acoustic signal detection probe arrangement for detecting acoustic signals. A radiation responsive acoustic signal generator is added outside the sample area. The detection

  12. IMAGING APPARATUS AND METHOD

    NARCIS (Netherlands)

    Manohar, Srirang; van Leeuwen, A.G.J.M.

    2008-01-01

    A thermoacoustic imaging apparatus comprises an electromagnetic radiation source configured to irradiate a sample area and an acoustic signal detection probe arrangement for detecting acoustic signals. A radiation responsive acoustic signal generator is added outside the sample area. The detection

  13. Thermal Acoustic Fatigue Apparatus

    Data.gov (United States)

    Federal Laboratory Consortium — The Thermal Acoustic Fatigue Apparatus (TAFA) is a progressive wave tube test facility that is used to test structures for dynamic response and sonic fatigue due to...

  14. Light shielding apparatus

    Science.gov (United States)

    Miller, Richard Dean; Thom, Robert Anthony

    2017-10-10

    A light shielding apparatus for blocking light from reaching an electronic device, the light shielding apparatus including left and right support assemblies, a cross member, and an opaque shroud. The support assemblies each include primary support structure, a mounting element for removably connecting the apparatus to the electronic device, and a support member depending from the primary support structure for retaining the apparatus in an upright orientation. The cross member couples the left and right support assemblies together and spaces them apart according to the size and shape of the electronic device. The shroud may be removably and adjustably connectable to the left and right support assemblies and configured to take a cylindrical dome shape so as to form a central space covered from above. The opaque shroud prevents light from entering the central space and contacting sensitive elements of the electronic device.

  15. Tomographic scanning apparatus

    International Nuclear Information System (INIS)

    1981-01-01

    This patent specification describes a tomographic scanning apparatus, with particular reference to the adjustable fan beam and its collimator system, together with the facility for taking a conventional x-radiograph without moving the patient. (U.K.)

  16. Fuel pellet loading apparatus

    International Nuclear Information System (INIS)

    1980-01-01

    Apparatus is described for loading a predetermined amount of nuclear fuel pellets into nuclear fuel elements and particularly for the automatic loading of fuel pellets from within a sealed compartment. (author)

  17. Apparatus for drying sugar cubes

    NARCIS (Netherlands)

    Derckx, H.A.J.; Torringa, H.M.

    1999-01-01

    Device for drying sugar cubes containing a heating apparatus for heating and dehumidifying the sugar cubes, a conditioning apparatus for cooling off and possibly further dehumidifying the sugar cubes and a conveying apparatus for conveying the sugar cubes through the heating apparatus and the

  18. Test sample handling apparatus

    International Nuclear Information System (INIS)

    1981-01-01

    A test sample handling apparatus using automatic scintillation counting for gamma detection, for use in such fields as radioimmunoassay, is described. The apparatus automatically and continuously counts large numbers of samples rapidly and efficiently by the simultaneous counting of two samples. By means of sequential ordering of non-sequential counting data, it is possible to obtain precisely ordered data while utilizing sample carrier holders having a minimum length. (U.K.)

  19. Radiation imaging apparatus

    International Nuclear Information System (INIS)

    1979-01-01

    This invention relates to a radiation imaging apparatus. It relates more particularly to apparatus of this general type which employs stationary X-ray source and detector arrays capable of acquiring multiple ultrafast scans per second to facilitate the dynamic study of moving human organs such as the beating heart. While the invention has many applications, it has particular utility in connection with computerized tomographic (CT) scanners. (Auth.)

  20. X-ray apparatus

    International Nuclear Information System (INIS)

    Tomita, Chuji.

    1980-01-01

    A principal object of the present invention is to provide an X-ray apparatus which is such that the distance between the surface of the patient's table and the floor on which the apparatus is installed is sufficiently small in the horizontal position of the patient's table of the roentgenographical pedestal and that the rotation of the pedestal from the horizontal position to a tilted position and further to the vertical position of the table can be carried out smoothly. (auth)

  1. Sludge recovery apparatus

    International Nuclear Information System (INIS)

    Marmo, A.R.

    1979-01-01

    An improved design of a sludge recovery apparatus used in the fabrication of nuclear fuel is described. This apparatus provides for automatic separation of sludge from the grinder coolant, drying of the sludge into a flowable powder and transfer of the dry powder to a salvage container. It can be constructed to comply with criticality-safe-geometry requirements and to obviate need for operating personnel in its immediate vicinity. (UK)

  2. Infrared microscope inspection apparatus

    Science.gov (United States)

    Forman, Steven E.; Caunt, James W.

    1985-02-26

    Apparatus and system for inspecting infrared transparents, such as an array of photovoltaic modules containing silicon solar cells, includes an infrared microscope, at least three sources of infrared light placed around and having their axes intersect the center of the object field and means for sending the reflected light through the microscope. The apparatus is adapted to be mounted on an X-Y translator positioned adjacent the object surface.

  3. Tendoscopic Double-Row Suture Bridge Peroneal Retinaculum Repair for Recurrent Dislocation of Peroneal Tendons in the Ankle.

    Science.gov (United States)

    Nishimura, Akinobu; Nakazora, Shigeto; Ito, Naoya; Fukuda, Aki; Kato, Ko; Sudo, Akihiro

    2016-06-01

    Traumatic dislocation of peroneal tendons in the ankle is an uncommon lesion that mainly affects young adults. Unfortunately, most cases lead to recurrent dislocation of the peroneal tendons of the ankle (RPTD). Therefore, most cases need operative treatment. One of the most common operative procedures is superior peroneal retinaculum (SPR) repair. Recently, surgery for RPTD has been achieved with less invasive arthroscopic procedures. In this article, tendoscopic surgery for RPTD using a double-row suture bridge technique is introduced. This technique consists of debridement of the lateral aspect of the fibula under an intrasheath pseudo-cavity, suture anchor insertion into the fibular ridge, and reattachment of the SPR to the fibula using a knotless anchor screwed into the lateral aspect of the fibula. This technique mimics the double-row suture bridge technique for rotator cuff tear repair. The double-row suture bridge technique requires more surgical steps than the single-row technique, but it provides a wider bone-SPR contact surface and tighter fixation than the single-row technique. This procedure is an attractive option because it is less invasive and has achieved results similar to open procedures.

  4. Complications with mechanical suture use in colorectal surgery

    International Nuclear Information System (INIS)

    Bruno, G.; Ruso, L.; Gatti, A.; Quiros, F.; Balboa, O.

    1998-01-01

    The great development of mechanical suture and its qualitative impact in colorectal surgery has not been able to avoid persistent mortality due to suture failure which is still about 5% and rectal stenosis, which is significantly higher than with manual sutures.The present paper analyses 63 cases of colorrectal anastomosis performed of coordination with mechanical suture at CASMU, in a period of four years (1991-1995).There were 51 rectum resections and colorrectal anastomosis and 12 reconstruction of intestinal transit.There were 28 females and 35 males with and average age of 66 years.Three patients died (4,7%), 20 (31,7%) suffered various complications among which some are pointed out in relation to mechanical suture to suture failures(3,1%) who died and 8 rectal stenosis(12,9%)with favourable evolution after dilations.The authors analyse the issues that incide on the production of complications in colorrectal surgery and conclude that the incidence of global complications in their series is elevated, although mortality, suture failure and rectal stenosis figures are comparable to those in international literature analysed.The incidence of machine width proximal ostomies and radiotherapy on the development of stenosis in our milieu require a multicentric studie with a greater number of patients

  5. 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.

  6. Surgical lighting

    NARCIS (Netherlands)

    Knulst, A.J.

    2017-01-01

    The surgical light is an important tool for surgeons to create and maintain good visibility on the surgical task. Chapter 1 gives background to the field of (surgical) lighting and related terminology. Although the surgical light has been developed strongly since its introduction a long time ago,

  7. Transcatheter pledget-assisted suture tricuspid annuloplasty (PASTA) to create a double-orifice valve.

    Science.gov (United States)

    Khan, Jaffar M; Rogers, Toby; Schenke, William H; Greenbaum, Adam B; Babaliaros, Vasilis C; Paone, Gaetano; Ramasawmy, Rajiv; Chen, Marcus Y; Herzka, Daniel A; Lederman, Robert J

    2018-02-06

    Pledget-assisted suture tricuspid valve annuloplasty (PASTA) is a novel technique using marketed equipment to deliver percutaneous trans-annular sutures to create a double-orifice tricuspid valve. Tricuspid regurgitation is a malignant disease with high surgical mortality and no commercially available transcatheter solution in the US. Two iterations of PASTA were tested using trans-apical or trans-jugular access in swine. Catheters directed paired coronary guidewires to septal and lateral targets on the tricuspid annulus under fluoroscopic and echocardiographic guidance. Guidewires were electrified to traverse the annular targets and exchanged for pledgeted sutures. The sutures were drawn together and knotted, apposing septal and lateral targets, creating a double orifice tricuspid valve. Twenty-two pigs underwent PASTA. Annular and chamber dimensions were reduced (annular area, 10.1 ± 0.8 cm 2 to 3.8 ± 1.5 cm 2 (naïve) and 13.1 ± 1.5 cm 2 to 6.2 ± 1.0 cm 2 (diseased); septal-lateral diameter, 3.9 ± 0.3 mm to 1.4 ± 0.6 mm (naïve) and 4.4 ± 0.4 mm to 1.7 ± 1.0 mm (diseased); and right ventricular end-diastolic volume, 94 ± 13 ml to 85 ± 14 ml (naïve) and 157 ± 25 ml to 143 ± 20 ml (diseased)). MRI derived tricuspid regurgitation fraction fell from 32 ± 12% to 4 ± 5%. Results were sustained at 30 days. Pledget pull-through force was five-fold higher (40.6 ± 11.7N vs 8.0 ± 2.6N, P PASTA reduces annular dimensions and tricuspid regurgitation in pigs. It may be cautiously applied to selected patients with severe tricuspid regurgitation and no options. This is the first transcatheter procedure, to our knowledge, to deliver standard pledgeted sutures to repair cardiac pathology. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

  8. Comparative analysis on arthroscopic sutures of large and extensive rotator cuff injuries in relation to the degree of osteopenia

    Directory of Open Access Journals (Sweden)

    Alexandre Almeida

    2015-02-01

    Full Text Available OBJECTIVE: To analyze the results from arthroscopic suturing of large and extensive rotator cuff injuries, according to the patient's degree of osteopenia.METHOD: 138 patients who underwent arthroscopic suturing of large and extensive rotator cuff injuries between 2003 and 2011 were analyzed. Those operated from October 2008 onwards formed a prospective cohort, while the remainder formed a retrospective cohort. Also from October 2008 onwards, bone densitometry evaluation was requested at the time of the surgical treatment. For the patients operated before this date, densitometry examinations performed up to two years before or after the surgical treatment were investigated. The patients were divided into three groups. Those with osteoporosis formed group 1 (n = 16; those with osteopenia, group 2 (n = 33; and normal individuals, group 3 (n = 55.RESULTS: In analyzing the University of California at Los Angeles (UCLA scores of group 3 and comparing them with group 2, no statistically significant difference was seen (p = 0.070. Analysis on group 3 in comparison with group 1 showed a statistically significant difference (p = 0.027.CONCLUSION: The results from arthroscopic suturing of large and extensive rotator cuff injuries seem to be influenced by the patient's bone mineral density, as assessed using bone densitometry.

  9. Apparatus for ultrasonic nebulization

    International Nuclear Information System (INIS)

    Olson, K.W.; Haas, W.J. Jr.; Fassel, V.A.

    1978-01-01

    An improved apparatus is described for ultrasonic nebulization of liquid samples or suspensions in which the piezoelectric transducer is protected from chemical attack and erosion. The transducer is protected by being bonded to the inner surface of a glass plate which forms one end wall of a first hollow body provided with apparatus for circulating a fluid for cooling and stabilizing the transducer. The glass plate, which is one-half wavelength in thickness to provide an acoustically coupled outer nebulizing surface, seals an opening in a second hollow body which encloses an aerosol mixing chamber. The second body includes apparatus for delivering the sample solution to the nebulizing surface, a gas inlet for providing a flow of carrier gas for transporting the aerosol of the nebulized sample and an aerosol outlet

  10. Uranium dioxide calcining apparatus

    International Nuclear Information System (INIS)

    Cole, E.A.; Peterson, R.S.

    1978-01-01

    This invention relates to an improved continuous calcining apparatus for consistently and controllably producing from calcinable reactive solid compounds of uranium, such as ammonium diuranate, uranium dioxide (UO 2 ) having an oxygen to uranium ratio of less than 2.2. The apparatus comprises means at the outlet end of a calciner kiln for receiving hot UO 2 , means for cooling the UO 2 to a temperature of below 100 deg C and conveying the cooled UO 2 to storage or to subsequent UO 2 processing apparatus where it finally comes into contact with air, the means for receiving cooling and conveying being sealed to the outlet end of the calciner and being maintained full of UO 2 and so operable as to exclude atmospheric oxygen from coming into contact with any UO 2 which is at elevated temperatures where it would readily oxidize, without the use of extra hydrogen gas in said means. (author)

  11. Electroplating method and apparatus

    International Nuclear Information System (INIS)

    Looney, R.B.; Smith, W.E.L.

    1978-01-01

    Disclosed is an apparatus for high speed electroplating or anodizing tubular members such as nuclear reactor fuel elements. A loading arm positions the member on a base for subsequent support by one of two sets of electrical contacts. A carriage assembly positions electrodes into and around the member. Electrolyte is pumped between the electrodes and the member while electric current is applied. Programmed controls sequentially employ each of the two sets of contacts to expose all surfaces of the member to the electrolyte. The member is removed from the apparatus by an unloading arm

  12. Electroplating method and apparatus

    Science.gov (United States)

    Looney, Robert B.; Smith, William E. L.

    1978-06-20

    An apparatus for high speed electroplating or anodizing tubular members such as nuclear reactor fuel elements. A loading arm positions the member on a base for subsequent support by one of two sets of electrical contacts. A carriage assembly positions electrodes into and around the member. Electrolyte is pumped between the electrodes and the member while electric current is applied. Programmed controls sequentially employ each of the two sets of contacts to expose all surfaces of the member to the electrolyte. The member is removed from the apparatus by an unloading arm.

  13. Outcome of Strabismus Surgery by Nonadjustable Suture among ...

    African Journals Online (AJOL)

    2017-03-06

    years old with strabismus seen ... adult with nonadjustable suture is safe and effective procedure with low risk of ... Strabismus or misalignment of the eyes is a condition that ... with Log MAR, type of refractive error, auto-refraction,.

  14. Biomechanical cadaveric comparison of patellar ligament suture protected by a steel cable versus a synthetic cable.

    Science.gov (United States)

    Bouget, P; Breque, C; Beranger, J S; Faure, J P; Khiami, F; Vendeuvre, T

    2017-12-01

    Purpose and hypothesis: Patellar ligament rupture is a rare disabling pathology requiring a surgical ligament suture protected by a frame. The gold standard is the steel cable, but its rigidity and the necessity of a surgical re-intervention for its removal render it unsatisfactory. The objective of this paper is to quantify the mechanical protection provided by the terylene® in comparison with steel. Twenty-four knees of 12 fresh frozen cadaveric subjects were divided into 2 homogeneous groups (terylene and steel) of 12 knees (mean age = 69.3 years). Proximal ligament repair was performed according to a three-tunnel transosseous reinsertion technique. Mechanical tests were performed in flexion to simulate movement of the knee. The interligament gap and the amplitude angulation of the knee were measured by a system of extensometer and optical goniometer. Mechanical analysis permitted calculation of flexion amplitude for a ligament gap of 1 and 2 mm taking as initial angle the adjusting angle of pretension of the protection frame. Study of deformations of frames was performed. Statistical analysis was performed with a Wilcoxon Mann Whitney test. There is no significant difference in protection of the ligament suture between the "terylene" and "steel" groups. Mean flexion amplitudes (mΔF) show no significant differences between the 2 groups for a distension of the suture of 1 mm (m ΔF terylene1 = 4.74 °; mΔF steel1 = 5.91°; p = 0.198) and 2 mm (mΔF terylene2 = 8.71°; mΔF steel2 = 10.41°; p = 0.114). Elastic deformation of terylene was significantly greater than that of steel (p = 0.0004). Suture protection of the patellar ligament by a terylene wire is not significantly different from that provided by steel frame. The elastic properties of terylene and absence of a need for re intervention to secure its removal lead us towards its use in acute ruptures of the patellar ligament. The main limits involve the properties of

  15. Biomechanical Analysis of an Arthroscopic Broström Ankle Ligament Repair and a Suture Anchor-Augmented Repair.

    Science.gov (United States)

    Giza, Eric; Whitlow, Scott R; Williams, Brady T; Acevedo, Jorge I; Mangone, Peter G; Haytmanek, C Thomas; Curry, Eugene E; Turnbull, Travis Lee; LaPrade, Robert F; Wijdicks, Coen A; Clanton, Thomas O

    2015-07-01

    Secondary surgical repair of ankle ligaments is often indicated in cases of chronic lateral ankle instability. Recently, arthroscopic Broström techniques have been described, but biomechanical information is limited. The purpose of the present study was to analyze the biomechanical properties of an arthroscopic Broström repair and augmented repair with a proximally placed suture anchor. It was hypothesized that the arthroscopic Broström repairs would compare favorably to open techniques and that augmentation would increase the mean repair strength at time zero. Twenty (10 matched pairs) fresh-frozen foot and ankle cadaveric specimens were obtained. After sectioning of the lateral ankle ligaments, an arthroscopic Broström procedure was performed on each ankle using two 3.0-mm suture anchors with #0 braided polyethylene/polyester multifilament sutures. One specimen from each pair was augmented with a 2.9-mm suture anchor placed 3 cm proximal to the inferior tip of the lateral malleolus. Repairs were isolated and positioned in 20 degrees of inversion and 10 degrees of plantarflexion and loaded to failure using a dynamic tensile testing machine. Maximum load (N), stiffness (N/mm), and displacement at maximum load (mm) were recorded. There were no significant differences between standard arthroscopic repairs and the augmented repairs for mean maximum load and stiffness (154.4 ± 60.3 N, 9.8 ± 2.6 N/mm vs 194.2 ± 157.7 N, 10.5 ± 4.7 N/mm, P = .222, P = .685). Repair augmentation did not confer a significantly higher mean strength or stiffness at time zero. Mean strength and stiffness for the arthroscopic Broström repair compared favorably with previous similarly tested open repair and reconstruction methods, validating the clinical feasibility of an arthroscopic repair. However, augmentation with an additional proximal suture anchor did not significantly strengthen the repair. © The Author(s) 2015.

  16. 21 CFR 886.4350 - Manual ophthalmic surgical instrument.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual ophthalmic surgical instrument. 886.4350 Section 886.4350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... suturing needle, lachrymal probe, trabeculotomy probe, cornea-sclera punch, ophthalmic retractor...

  17. Integral Suture-Handling Techniques for Arthroscopic Sliding Knots

    OpenAIRE

    Kanchanatawan, Wichan; Kongtharvonskul, Jatupon; Dorjiee, Gem; Suppauksorn, Sunikom; Pornvoranunt, Umpire; Karchana, Pongsakorn

    2016-01-01

    In arthroscopic tissue repair, the final step is achieving adequate tissue approximation with a secure knot. The sliding knot is widely preferred over the nonsliding knot, with numerous publications describing knot configurations. However, in the literature there are few published descriptions of suture-handling techniques, even though they are fundamental to arthroscopic knot tying. We describe integral suture-handling techniques for arthroscopic sliding knots to improve the surgeon's perfor...

  18. SUTURE NON-SUTSRE CIRCUMFERENTIAL REPAIR OF CAROTID ARTERY

    Directory of Open Access Journals (Sweden)

    Jafar Nader

    1969-01-01

    Full Text Available plastic adhesives, normal butyl cyanoacrylate monomer, isobutyl cyanoacrylate monomer and methyl 2 _ cyaooacrylate monomer, have been utilized in a comparative study with 5-{ silk suture in the repair of transected carotid arteries. Follow _ up arteriog ramS indicate isobutyl cyanoacrylate monomer and normal butyl cyanoacrylate monomer as having the most impressive rerults with only tWO thrombosis each. The silk suture had three thromboses and the adhesive methyl 2 _ cyanoacrylate monomer had nine, one of which a delayed

  19. Fixation of the Achilles tendon insertion using suture button technology.

    Science.gov (United States)

    Fanter, Nathan J; Davis, Edward W; Baker, Champ L

    2012-09-01

    In the operative treatment of Achilles insertional tendinopathy, no guidelines exist concerning which form of fixation of the Achilles tendon insertion is superior. Transcalcaneal drill pin passage does not place any major plantar structures at risk, and the addition of a Krackow stitch and suture button to the fixation technique provides a significant increase in ultimate load to failure in Achilles tendon insertional repairs. Controlled laboratory study. The Achilles tendon insertions in 6 fresh-frozen cadaveric ankles were detached, and transcalcaneal drill pins were passed. Plantar dissection took place to evaluate the drill pin relationship to the plantar fascia, lateral plantar nerve and artery, flexor digitorum longus tendon, and master knot of Henry. The Achilles tendons were then repaired with a double-row suture anchor construct alone or with a suture button and Krackow stitch added to the double-row suture anchor construct. The repairs were then tested to maximum load to failure at 20 mm/min. The mode of failure was recorded, and the mean maximum load to failure was assessed using the Student t test for distributions with equal variance. Transcalcaneal drill pin passage did not place any selected anatomic structures at risk. The mean maximum load to failure for the suture bridge group was 239.2 N; it was 391.4 N for the group with the suture button (P = .014). The lateral plantar artery was the structure placed at greatest risk from drill pin placement, with a mean distance of 22.7 mm (range, 16.5-29.2 mm) between the pin and artery. In this laboratory study, transcalcaneal drill pin passage appeared to be anatomically safe, and the use of suture button technology with a Krackow stitch for Achilles tendon insertional repair significantly increased repair strength. Achilles tendon insertional repair with suture button fixation and a Krackow stitch may facilitate the earlier institution of postoperative rehabilitation and improve clinical outcomes.

  20. The Efficacy of Polydioxanone Monofilament Absorbable Suture for Tracheal Anastomosis

    OpenAIRE

    Kawahara, Katsunobu; Yamasaki, Naoya; Yamamoto, Satoshi; Nagayasu, Takeshi; Kusano, Hiroyuki; Akamine, Shinji; Takahashi, Takao; Tomita, Masao

    1994-01-01

    To evaluate the efficacy of polydioxanon absorbable suture for tracheal anastomoses, we performed an experimental study using dose. Eight adult mongrel dogs underwent sleeve resection of the mediastinal trachea. A length of ten to twelve cartilage rings was resected. An end-to-end anastomosis was performed using either interrupted or continuous running 4-0 polydioxanone (PDS) suture. There was no detectable difference bronchoscopically, microangiografically, or histologically, in tracheal ana...

  1. Arthroscopic suture fixation in patients with a tibial intercondylar eminence fracture using a simple device to penetrate the anterior cruciate ligament

    Directory of Open Access Journals (Sweden)

    Masato Aratake

    2014-04-01

    Full Text Available Displaced tibial intercondylar eminence fractures require early reduction and stable fixation to prevent nonunion, knee instability, and a lack of extension. Many types of surgical procedure are recommended including arthrotomy or an arthroscopic technique to stabilize the fracture segment using Kirschner wire, screws, staples, and suture fixation. However, contemporary arthroscopic techniques and devices can facilitate intra-articular surgery and have been applied to the treatment of this fracture. In our current report, we describe a simple suture fixation method under arthroscopy for the treatment of tibial intercondylar eminence fractures. We treated eight knees of eight patients. One patient had a Type II fracture and seven patients had a Type III fracture according to Meyer's classification. Following the arthroscopic inspection of concomitant injuries, debridement of hematoma, and reduction of the fragment, two nonabsorbable sutures (Ethibond No. 2, Johnson & Johnson, Somerville, NJ, USA were advanced through the suture passer device, which is used to penetrate the anterior cruciate ligament (ACL near to the insertion site of the displaced fragment. Two surgical sutures were pulled out by the suture retriever from the anterior proximal tibia hole and were fixed to the tibia cortex bone with a double-spike plate. At follow-up, radiographic examinations showed that bone union was achieved in all cases. All but one patient could resume normal activities with no restrictions and no ligamentous instability. All knees had a negative Lachman's test and showed a gain of stable ligament function by KT2000 arthrometer evaluation. One patient had an insignificant extension limitation and experienced slight pain after walking but these symptoms were minimal. In conclusion current arthroscopic surgery techniques for tibial intercondylar fractures can be easily performed and reproducibly achieve secure fixation and early mobilization of the knee.

  2. Semiconductor apparatus and method of fabrication for a semiconductor apparatus

    NARCIS (Netherlands)

    2010-01-01

    The invention relates to a semiconductor apparatus (1) and a method of fabrication for a semiconductor apparatus (1), wherein the semiconductor apparatus (1) comprises a semiconductor layer (2) and a passivation layer (3), arranged on a surface of the semiconductor layer (2), for passivating the

  3. A comparison of lateral ankle ligament suture anchor strength.

    Science.gov (United States)

    Barber, F Alan; Herbert, Morley A; Crates, John M

    2013-06-01

    Lateral ankle ligament repairs increasingly use suture anchors instead of bone tunnels. Our purpose was to compare the biomechanical properties of a knotted and knotless suture anchor appropriate for a lateral ankle ligament reconstruction. In porcine distal fibulae, 10 samples of 2 different PEEK anchors were inserted. The attached sutures were cyclically loaded between 10N and 60N for 200 cycles. A destructive pull was performed and failure loads, cyclic displacement, stiffness, and failure mode recorded. PushLock 2.5 anchors failed before 200 cycles. PushLock 100 cycle displacement was less than Morphix 2.5 displacement (panchors completing 200 cycles was 86.5N (PushLock) and 252.1N (Morphix) (panchor breaking and suture breakage. The knotted Morphix demonstrated more displacement and greater failure strength than the knotless PushLock. The PushLock failed consistently with suture breaking. The Morphix anchor failed both by anchor breaking and by suture breaking. Copyright © 2012 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  4. Modified suture-bridge technique to prevent a marginal dog-ear deformity improves structural integrity after rotator cuff repair.

    Science.gov (United States)

    Ryu, Keun Jung; Kim, Bang Hyun; Lee, Yohan; Lee, Yoon Seok; Kim, Jae Hwa

    2015-03-01

    The arthroscopic suture-bridge technique has proved to provide biomechanically firm fixation of the torn rotator cuff to the tuberosity by increasing the footprint contact area and pressure. However, a marginal dog-ear deformity is encountered not infrequently when this technique is used, impeding full restoration of the torn cuff. To evaluate the structural and functional outcomes of the use of a modified suture-bridge technique to prevent a marginal dog-ear deformity compared with a conventional suture-bridge method in rotator cuff repair. Cohort study; Level of evidence 2. A consecutive series of 71 patients aged 50 to 65 years who underwent arthroscopic rotator cuff repair for full-thickness medium-sized to massive tears was evaluated. Patients were divided into 2 groups according to repair technique: a conventional suture-bridge technique (34 patients; group A) versus a modified suture-bridge technique to prevent a marginal dog-ear deformity (37 patients; group B). Radiographic evaluations included postoperative cuff integrity using MRI. Functional evaluations included pre- and postoperative range of motion (ROM), pain visual analog scale (VAS), the University of California, Los Angeles (UCLA) shoulder rating scale, the Constant score, and the American Shoulder and Elbow Surgeons (ASES) score. All patients were followed up clinically at a minimum of 1 year. When the 2 surgical techniques were compared, postoperative structural integrity by Sugaya classification showed the distribution of types I:II:III:IV:V to be 4:20:2:4:4 in group A and 20:12:4:0:1 in group B. More subjects in group B had a favorable Sugaya type compared with group A (P bridge technique repairs were found in the retear group (P = .03). There were significant differences between healed and retear groups in functional outcome scores, with worse results in the retear group. A modified suture-bridge technique to prevent a marginal dog-ear deformity provided better structural outcomes than a

  5. Surgical repair of a rupture of the pectoralis major muscle

    Science.gov (United States)

    Pochini, Alberto De Castro; Andreoli, Carlos Vicente; Ejnisman, Benno; Maffulli, Nicola

    2015-01-01

    Muscle rupture is rarely treated surgically. Few reports of good outcomes after muscular suture have been published. Usually, muscular lesions or partial ruptures heal with few side effects or result in total recovery. We report a case of an athlete who was treated surgically to repair a total muscular rupture in the pectoralis major muscle. After 6 months, the athlete returned to competitive practice. After a 2-year follow-up, the athlete still competes in skateboard championships. PMID:25716033

  6. Effects of eliminating tension by means of epineural stitches: a comparative electrophysiological and histomorphometrical study using different suture techniques in an animal model.

    Science.gov (United States)

    Bustamante, Jorge; Socolovsky, Mariano; Martins, Roberto S; Emmerich, Juan; Pennini, Maria Gabriela; Lausada, Natalia; Domitrovic, Luis

    2011-01-01

    Epineural stitches are a means to avoid tension in a nerve suture. We evaluate this technique, relative to interposed grafts and simple neurorraphy, in a rat model. Twenty rats were allocated to four groups. For Group 1, sectioning of the sciatic nerve was performed, a segment 4 mm long discarded, and epineural suture with distal anchoring stitches were placed resulting in slight tension neurorraphy. For Group 2, a simple neurorraphy was performed. For Group 3, a 4 mm long graft was employed and Group 4 served as control. Ninety days after, reoperation, latency of motor action potentials recording and axonal counts were performed. Inter-group comparison was done by means of ANOVA and the non-parametric Kruskal-Wallis test. The mean motor latency for the simple suture (2.27±0.77 ms) was lower than for the other two surgical groups, but lower than among controls (1.69±0.56 ms). Similar values were founding in both group 1 (2.66±0.71 ms) and group 3 (2.64±0.6 ms). When fibers diameters were compared a significant difference was identified between groups 2 and 3 (p=0.048). Good results can be obtained when suturing a nerve employ with epineural anchoring stitches. However, more studies are needed before extrapolating results to human nerve sutures.

  7. Effects of eliminating tension by means of epineural stitches: a comparative electrophysiological and histomorphometrical study using different suture techniques in an animal model

    Directory of Open Access Journals (Sweden)

    J Bustamante

    2011-01-01

    Full Text Available Epineural stitches are a means to avoid tension in a nerve suture. We evaluate this technique, relative to interposed grafts and simple neurorraphy, in a rat model. METHOD: Twenty rats were allocated to four groups. For Group 1, sectioning of the sciatic nerve was performed, a segment 4 mm long discarded, and epineural suture with distal anchoring stitches were placed resulting in slight tension neurorraphy. For Group 2, a simple neurorraphy was performed. For Group 3, a 4 mm long graft was employed and Group 4 served as control. Ninety days after, reoperation, latency of motor action potentials recording and axonal counts were performed. Inter-group comparison was done by means of ANOVA and the non-parametric Kruskal-Wallis test. RESULTS: The mean motor latency for the simple suture (2.27±0.77 ms was lower than for the other two surgical groups, but lower than among controls (1.69±0.56 ms. Similar values were founding in both group 1 (2.66±0.71 ms and group 3 (2.64±0.6 ms. When fibers diameters were compared a significant difference was identified between groups 2 and 3 (p=0.048. CONCLUSION: Good results can be obtained when suturing a nerve employ with epineural anchoring stitches. However, more studies are needed before extrapolating results to human nerve sutures.

  8. Tomographic scanning apparatus

    International Nuclear Information System (INIS)

    1981-01-01

    Details are given of a tomographic scanning apparatus, with particular reference to the means of adjusting the apparent gain of the signal processing means for receiving output signals from the detectors, to compensate for drift in the gain characteristics, including means for passing a reference signal. (U.K.)

  9. Positioning and locking apparatus

    Science.gov (United States)

    Hayward, M.L.; Harper, W.H.

    1985-06-19

    A positioning and locking apparatus including a fixture having a rotatable torque ring provided with a plurality of cam segments for automatically guiding a container into a desired location within the fixture. Rotation of the ring turns the container into a final position in pressure sealing relation against a hatch member.

  10. Electrolysis apparatus and method

    International Nuclear Information System (INIS)

    1975-01-01

    A procedure in which electrolysis is combined with radiolysis to improve the reaction yield is proposed for the production of hydrogen and oxygen from water. An apparatus for this procedure is disclosed. High-energy electric pulses are applied between the anode and kathode of an electrolytical cell in such a way that short-wave electromagnetic radiation is generated at the same time

  11. Mobile lighting apparatus

    Science.gov (United States)

    Roe, George Michael; Klebanoff, Leonard Elliott; Rea, Gerald W; Drake, Robert A; Johnson, Terry A; Wingert, Steven John; Damberger, Thomas A; Skradski, Thomas J; Radley, Christopher James; Oros, James M; Schuttinger, Paul G; Grupp, David J; Prey, Stephen Carl

    2013-05-14

    A mobile lighting apparatus includes a portable frame such as a moveable trailer or skid having a light tower thereon. The light tower is moveable from a stowed position to a deployed position. A hydrogen-powered fuel cell is located on the portable frame to provide electrical power to an array of the energy efficient lights located on the light tower.

  12. Apparatus for decomposing shale

    Energy Technology Data Exchange (ETDEWEB)

    Gislain, M

    1865-06-20

    The apparatus is designed to fulfill the three following conditions: (1) complete extraction of the mineral oil, by avoiding partial decomposition; (2) purification of the said oil from products formed in the decomposition of the shale; (3) breaking down of the said oil into more products of different density. The separation of the heavy and bituminous products is claimed.

  13. Building scientific apparatus

    National Research Council Canada - National Science Library

    Moore, John H; Davis, Christopher C; Coplan, Michael A; Greer, Sandra C

    2009-01-01

    ... specification of the components of apparatus, many new to this edition. Data on the properties of materials and components used by manufacturers are included. Mechanical, optical, and electronic construction techniques carried out in the laboratory, as well as those let out to specialized shops, are also described. Step-by-step instruc...

  14. A combination of subcuticular suture and sterile Micropore tape compared with conventional interrupted sutures for skin closure. A controlled trial.

    Science.gov (United States)

    Taube, M.; Porter, R. J.; Lord, P. H.

    1983-01-01

    We have conducted a controlled trial to compare skin closure using conventional interrupted sutures with a combination of subcuticular suture and sterile Micropore tape in 169 patients undergoing appendicectomy, inguinal herniorrhaphy, or saphenofemoral ligation. We have found that the combination technique consistently gives a better cosmetic result and that the tape acts well as a dressing, is convenient, and is well tolerated by patients. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 PMID:6344732

  15. Radioactive waste processing apparatus

    Science.gov (United States)

    Nelson, R.E.; Ziegler, A.A.; Serino, D.F.; Basnar, P.J.

    1985-08-30

    Apparatus for use in processing radioactive waste materials for shipment and storage in solid form in a container is disclosed. The container includes a top, and an opening in the top which is smaller than the outer circumference of the container. The apparatus includes an enclosure into which the container is placed, solution feed apparatus for adding a solution containing radioactive waste materials into the container through the container opening, and at least one rotatable blade for blending the solution with a fixing agent such as cement or the like as the solution is added into the container. The blade is constructed so that it can pass through the opening in the top of the container. The rotational axis of the blade is displaced from the center of the blade so that after the blade passes through the opening, the blade and container can be adjusted so that one edge of the blade is adjacent the cylindrical wall of the container, to insure thorough mixing. When the blade is inside the container, a substantially sealed chamber is formed to contain vapors created by the chemical action of the waste solution and fixant, and vapors emanating through the opening in the container. The chamber may be formed by placing a removable extension over the top of the container. The extension communicates with the apparatus so that such vapors are contained within the container, extension and solution feed apparatus. A portion of the chamber includes coolant which condenses the vapors. The resulting condensate is returned to the container by the force of gravity.

  16. 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.

  17. Biomechanical characteristics of single-row repair in comparison to double-row repair with consideration of the suture configuration and suture material

    OpenAIRE

    Baums, M. H.; Buchhorn, G. H.; Spahn, G.; Poppendieck, B.; Schultz, W.; Klinger, H.-M.

    2008-01-01

    The aim of the study was to evaluate the time zero mechanical properties of single- versus double-row configuration for rotator cuff repair in an animal model with consideration of the stitch technique and suture material. Thirty-two fresh-frozen sheep shoulders were randomly assigned to four repair groups: suture anchor single-row repair coupled with (1) braided, nonabsorbable polyester suture sized USP No. 2 (SRAE) or (2) braided polyblend polyethylene suture sized No. 2 (SRAH). The double-...

  18. [Excision and immediate suture technic in the treatment of pilonidal fistula. Our experience].

    Science.gov (United States)

    Calcina, G; Setti, P; Benati, L; Savioli, A; Galli, G

    1995-09-01

    The authors report their personal experience of the "excision and primary suture" operating technique in the surgical treatment of pilonidal sinus. A rapid recovery by postoperative day 10 was achieved in 58 out of 60 cases treated (96.7%). Dehiscence of the surgical wound was observed in 2 cases (3.3%) following ischemic lesion caused by decubitus of the cutaneous margins and healing occurred by second intenti. No cases of short- or long-term recidivation were observed. The advantages of this method are the early return to working activities, minor patient discomfort and the reduced risk that the surgical would might become infected. Three basic stages for the successful outcome of this type of surgery have been identified as follows: 1) Although and accurate tricotomy of the sacro-coccigeal region. Antibiotic therapy is started about 2 hours before surgery. 2) The precise execution of the surgical technique. 3) The continuation of antibiotic therapy until postoperative day 7. Compressive medication is removed on postoperative day 4. If these three basic stages are respected, no cases of recidivation will occur.

  19. 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.

  20. Prior video game exposure does not enhance robotic surgical performance.

    Science.gov (United States)

    Harper, Jonathan D; Kaiser, Stefan; Ebrahimi, Kamyar; Lamberton, Gregory R; Hadley, H Roger; Ruckle, Herbert C; Baldwin, D Duane

    2007-10-01

    Prior research has demonstrated that counterintuitive laparoscopic surgical skills are enhanced by experience with video games. A similar relation with robotic surgical skills has not been tested. The purpose of this study was to determine whether prior video-game experience enhances the acquisition of robotic surgical skills. A series of 242 preclinical medical students completed a self-reported video-game questionnaire detailing the frequency, duration, and peak playing time. The 10 students with the highest and lowest video-game exposure completed a follow-up questionnaire further quantifying video game, sports, musical instrument, and craft and hobby exposure. Each subject viewed a training video demonstrating the use of the da Vinci surgical robot in tying knots, followed by 3 minutes of proctored practice time. Subjects then tied knots for 5 minutes while an independent blinded observer recorded the number of knots tied, missed knots, frayed sutures, broken sutures, and mechanical errors. The mean playing time for the 10 game players was 15,136 total hours (range 5,840-30,000 hours). Video-game players tied fewer knots than nonplayers (5.8 v 9.0; P = 0.04). Subjects who had played sports for at least 4 years had fewer mechanical errors (P = 0.04), broke fewer sutures (P = 0.01), and committed fewer total errors (P = 0.01). Similarly, those playing musical instruments longer than 5 years missed fewer knots (P = 0.05). In the extremes of video-game experience tested in this study, game playing was inversely correlated with the ability to learn robotic suturing. This study suggests that advanced surgical skills such as robotic suturing may be learned more quickly by athletes and musicians. Prior extensive video-game exposure had a negative impact on robotic performance.

  1. Arthroscopic anterior talofibular ligament repair for chronic ankle instability with a suture anchor technique.

    Science.gov (United States)

    Kim, Eung Soo; Lee, Kyung Tai; Park, Jun Sic; Lee, Young Koo

    2011-04-11

    The goal of this study was to retrospectively evaluate the clinical outcomes of arthroscopic repair for chronic ankle instability using a bioabsorbable anchor with 2 sutures. We evaluated the results of 28 ankles treated with arthroscopic anterior talofibular ligament repair using bioabsorbable anchors with a FiberWire and TigerWire suture (Arthrex, Inc, Naples, Florida) placed on the fibula from March 2008 to January 2009. Average follow-up was 15.9 months (range, 13-25 months). Patients were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot ankle score and stress radiographs. Mean AOFAS hindfoot ankle score was 92.48 ± 6.14 at last follow-up compared to the mean preoperative score of 60.78 ± 16.38 (P=.041). Mean postoperative anterior draw test score difference between 2 ankles was 0.61 ± 0.75 compared to the mean preoperative score difference of 3.59 ± 0.68 (P=.00). There was a 14% complication rate, including 3 cases of portal site irritation and 1 case of superficial infection. Stress radiographs revealed 3 cases of anterior displacement >3 mm compared to the other side. All patients returned to their previous activity level.Arthroscopic ligament reconstruction for chronic lateral ankle instability using suture anchors is effective in returning patients to their preinjury function levels. Good clinical results were obtained with some minor complications. This minimally invasive technique is a reasonable alternative to other open surgical procedures for chronic ankle instability. Copyright 2011, SLACK Incorporated.

  2. Surgical smoke.

    Science.gov (United States)

    Fan, Joe King-Man; Chan, Fion Siu-Yin; Chu, Kent-Man

    2009-10-01

    Surgical smoke is the gaseous by-product formed during surgical procedures. Most surgeons, operating theatre staff and administrators are unaware of its potential health risks. Surgical smoke is produced by various surgical instruments including those used in electrocautery, lasers, ultrasonic scalpels, high speed drills, burrs and saws. The potential risks include carbon monoxide toxicity to the patient undergoing a laparoscopic operation, pulmonary fibrosis induced by non-viable particles, and transmission of infectious diseases like human papilloma virus. Cytotoxicity and mutagenicity are other concerns. Minimisation of the production of surgical smoke and modification of any evacuation systems are possible solutions. In general, a surgical mask can provide more than 90% protection to exposure to surgical smoke; however, in most circumstances it cannot provide air-tight protection to the user. An at least N95 grade or equivalent respirator offers the best protection against surgical smoke, but whether such protection is necessary is currently unknown.

  3. Treatment of surgical wounds on the uterus after laparoscopic myomectomy

    Directory of Open Access Journals (Sweden)

    Sedlar Srđan

    2009-01-01

    Full Text Available Introduction. The advantages of laparoscopic removal of a myoma over classical surgical technique are shorter hospital stay, rapid recovery and less pain after surgery, as well as a lower frequency of ileus and thromboembolic complications. The surgical technique of laparoscopic removal of myoma involves four basic stages: incision on the wall of the uterus, separation of the myoma from the healthy uterine tissue, to stop bleeding and removal of the myoma from the abdomen. Apart from these four basic stages, it is also necessary to establish a new integrity of the uterine wall, especially in women planning pregnancy. Objective. The aim of the paper is to present the procedures used in the treatment of uterine wall defect during the laparoscopic removal of the myoma. Methods. We analyzed 96 patients who were indicated for laparoscopic myomectomy. All patients were divided into four groups according to the type of the technique of haemostasis and treatment of the defect on the uterine wall: electrocoagulation, electrocoagulation with application of argon plasma, a single suture and extended suture. Results. In order to stop bleeding, we most often used electrocoagulation by monopolar electricity, i.e. in 39.6% of the patients. To stop bleeding and treat the defect of the uterine wall, we used a single suture in 21.9% and in 11.4% patients we used the extended suture. The manner of uterine wall treatment did not have a statistically significant influence on the results of haematological parameters (p>0.05, consumption of carbon dioxide (p>0.05 and the duration of surgical procedure (p>0.05. The increased use of antibiotics (p<0.05 in the group of patients in whom we treated the defect by sutures on the uterus, the length of postsurgical hospitalization and absence from work (p<0.01 was statistically significant. Conclusion. To achieve a better reconstruction of the uterus, it is recommended to use sutures with laparoscopic removal of myoma.

  4. [Treatment of calcaneal avulsion fractures with twinfix suture anchors fixation].

    Science.gov (United States)

    Zhao, Bin-xiu; Wang, Kun-zheng; Wang, Chun-sheng; Xie, Yue; Dai, Zhi-tang; Liu, Gang; Liu, Wei-dong

    2011-06-01

    For the calcaneal avulsion fracture, the current method is more commonly used screws or Kirschner wire to fix fracture fragment. This article intended to explore the feasibility and clinical efficacy for the treatment of avulsion fractures with TwinFix suture anchors. From July 2007 to November 2010, 21 patients were reviewed, including 15 males and 6 females, ranging in age from 49 to 65 years,with a mean of 58.7 years. Twelve patients had nodules in the right heel and 9 patients had nodules in the left heel. All the patients had closed fractures. The typical preoperative symptoms of the patients included pain in the upper heel and weak in heel lift. Body examination results: palpable sense of bone rubbing in the back of the heel, and swelling in the heel. Surgery treatment with TwinFix suture anchors performed as follows : to fix TwinFix suture anchors into the calcaneal body, then to drill the fracture block, to make the double strand suture through the fracture holes, to knot the suture eachother to fix the block, and to use stitch to fix the remaining suture in the Achilles tendon in order to improve the block fixation. The criteria of the AOFAS Foot and Ankle Surgery by the United States Association of ankle-rear foot functional recovery was used to evaluate the Achilles tendon. Total average score was (95.5 +/- 3.12) points, including pain items of(38.5 +/- 2.18) points,the average score of functional items of (49.5 +/- 3.09) points,and power lines of 10 points in all patients. Twenty-one patients got an excellent result, 16 good and 5 poor. The methods of treatment for the calcaneal avulsion fractures with TwinFix suture anchors is a simple operation, and have excellent clinical effect, which is worthy of promotion.

  5. Nuclear magnetic resonance apparatus

    International Nuclear Information System (INIS)

    Lambert, R.

    1991-01-01

    In order to include the effect of a magnetic object in a subject under investigation, Nuclear Magnetic Resonance (NMR) apparatus is operable at more than one radio frequency (RF) frequency. The apparatus allows normal practice as far as obtaining an NMR response or image from a given nuclear species is concerned, but, in addition, interrogates the nuclear spin system at a frequency which is different from the resonance frequency normally used for the given nuclear species, as determined from the applied magnetic field. The magnetic field close to a magnetised or magnetisable object is modified and the given nuclear species gives a response at the different frequency. Thus detection of a signal at the frequency indicates the presence of the chosen nuclei close to the magnetised or magnetisable object. Applications include validation of an object detection or automatic shape inspection system in the presence of magnetic impurities, and the detection of magnetic particles which affect measurement of liquid flow in a pipe. (author)

  6. Ion implantation apparatus

    International Nuclear Information System (INIS)

    Forneris, J.L.; Hicks, W.W.; Keller, J.H.; McKenna, C.M.; Siermarco, J.A.; Mueller, W.F.

    1981-01-01

    The invention relates to ion bombardment or implantation apparatus. It comprises an apparatus for bombarding a target with a beam of ions, including an arrangement for measuring the ion beam current and controlling the surface potential of the target. This comprises a Faraday cage formed, at least in part, by the target and by walls adjacent to, and electrically insulated from, the target and surrounding the beam. There is at least one electron source for supplying electrons to the interior of the Faraday cage and means within the cage for blocking direct rectilinear radiation from the source to the target. The target current is measured and combined with the wall currents to provide a measurement of the ion beam current. The quantity of electrons supplied to the interior of the cage can be varied to control the target current and thereby the target surface potential. (U.K.)

  7. Improvements in measuring apparatus

    International Nuclear Information System (INIS)

    Casey, W.

    1976-01-01

    Measuring apparatus is described that is suitable for gauging the wall profiles of downwardly extending channels in nuclear reactors, but which is equally applicable to channels such as pipe bores and conduits in other types of plant. The apparatus comprises a probe carrying a measuring transducer giving an electrical output. The probe support may be moved stepwise along the channel along a track between end members. An electrical conductor is provided for transmitting the electrical output of the transducer to an indicator located remote from the probe. The probe support may consist of a cable attached at one end to a winding drum, and incorporating an electrical conductor connected to the transducer. Channel engaging means are provided on the probe that permits free upward movement of the probe when the latter is suspended by the cable and moves into gripping engagement with the channel wall when the tension in the cable is relaxed. (U.K.)

  8. Influence of Force and Torque Feedback on Operator Performance in a VR-Based Suturing Task

    Directory of Open Access Journals (Sweden)

    L. Santos-Carreras

    2010-01-01

    Full Text Available The introduction of Minimally Invasive Surgery (MIS has revolutionised surgical care, considerably improving the quality of many surgical procedures. Technological advances, particularly in robotic surgery systems, have reduced the complexity of such an approach, paving the way for even less invasive surgical trends. However, the fact that haptic feedback has been progressively lost through this transition is an issue that to date has not been solved. Whereas traditional open surgery provides full haptic feedback, the introduction of MIS has eliminated the possibility of direct palpation and tactile exploration. Nevertheless, these procedures still provide a certain amount of force feedback through the rigid laparoscopic tool. Many of the current telemanipulated robotic surgical systems in return do not provide full haptic feedback, which to a certain extent can be explained by the requirement of force sensors integrated into the tools of the slave robot and actuators in the surgeon’s master console. In view of the increased complexity and cost, the benefit of haptic feedback is open to dispute. Nevertheless, studies have shown the importance of haptic feedback, especially when visual feedback is unreliable or absent. In order to explore the importance of haptic feedback for the surgeon’s master console of a novel teleoperated robotic surgical system, we have identified a typical surgical task where performance could potentially be improved by haptic feedback, and investigate performance with and without this feedback. Two rounds of experiments are performed with 10 subjects, six of them with a medical background. Results show that feedback conditions, including force feedback, significantly improve task performance independently of the operator’s suturing experience. There is, however, no further significant improvement when torque feedback is added. Consequently, it is deduced that force feedback in translations improves subject

  9. Wave disc engine apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Muller, Norbert; Piechna, Janusz; Sun, Guangwei; Parraga, Pablo-Francisco

    2018-01-02

    A wave disc engine apparatus is provided. A further aspect employs a constricted nozzle in a wave rotor channel. A further aspect provides a sharp bend between an inlet and an outlet in a fluid pathway of a wave rotor, with the bend being spaced away from a peripheral edge of the wave rotor. A radial wave rotor for generating electricity in an automotive vehicle is disclosed in yet another aspect.

  10. Medical radiological apparatus

    International Nuclear Information System (INIS)

    1980-01-01

    With the apparatus described, images can be obtained by rotation scanning and the image formation from a three dimensional image matrix is converted into an overall picture. Detectors for both X-ray radiation and γ radiation are present and these consist of a row of detector elements, from each of which a separate read-out can be obtained. Therefore both X-ray and γ ray images emitted from the examined object can be obtained. (Th.P.)

  11. Multicusp plasma containment apparatus

    International Nuclear Information System (INIS)

    Limpaecher, R.

    1980-01-01

    It has been discovered that plasma containment by a chamber having multi-pole magnetic cusp reflecting walls in combination with electronic injection for electrostatic containment provides the means for generating magnetic field free quiescent plasmas for practical application in ion-pumps, electronic switches, and the like. 1250 ''alnico v'' magnets 1/2 '' X 1/2 '' X 1 1/2 '' provide containment in one embodiment. Electromagnets embodying toroidal funneling extend the principle to fusion apparatus

  12. Apparatus for obtaining radiographs

    International Nuclear Information System (INIS)

    Frank, L.F.

    1977-01-01

    An apparatus for making x-ray pictures by imagewise exposing a cloud chamber containing a high atomic number gas mixed with a condensate vapor is described. The gas is under sufficiently high pressure to assure substantially complete absorption of the incident x-rays. Optical means are provided so that visible x-ray tracks are viewed from a direction aligned with the tracks

  13. Pyrolysis process and apparatus

    Science.gov (United States)

    Lee, Chang-Kuei

    1983-01-01

    This invention discloses a process and apparatus for pyrolyzing particulate coal by heating with a particulate solid heating media in a transport reactor. The invention tends to dampen fluctuations in the flow of heating media upstream of the pyrolysis zone, and by so doing forms a substantially continuous and substantially uniform annular column of heating media flowing downwardly along the inside diameter of the reactor. The invention is particularly useful for bituminous or agglomerative type coals.

  14. Thermal power measurement apparatus

    International Nuclear Information System (INIS)

    1981-01-01

    Thermal power measurements are important in nuclear power plants, fossil-fuel plants and other closed loop systems such as heat exchangers and chemical reactors. The main object of this invention is to determine the enthalpy of a fluid using only acoustically determined sound speed and correlating the speed with enthalpy. An enthalpy change is measured between two points in the fluid flow: the apparatus is described in detail. (U.K.)

  15. Mechanical Behavior of Bio-inspired Model Suture Joints

    Science.gov (United States)

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

    2012-02-01

    Suture joints of varying degrees of geometric complexity are prevalent throughout nature as a means of joining structural elements while providing locally tailored mechanical performance. Here, micromechanical models of general trapezoidal waveforms of varying hierarchy are formulated to reveal the role of geometric complexity in governing stiffness, strength, toughness and corresponding deformation and failure mechanisms. Physical constructs of model composite suture systems are fabricated via multi-material 3D printing (Object Connex500). Tensile tests are conducted on samples covering a range in geometry, thus providing quantitative measures of stiffness, strength, and failure. The experiments include direct visualization of the deformation and failure mechanisms and their progression, as well as their dependence on suture geometry, showing the interplay between shear and tension/compression of the interfacial layers and tension of the skeletal teeth and the transition in failure modes with geometry. The results provide quantitative guidelines for the design and tailoring of suture geometry to achieve the desired mechanical properties and also facilitate understanding of suture growth and fusion, and evolutionary phenotype.

  16. Air-cleaning apparatus

    International Nuclear Information System (INIS)

    Howard, A.G.

    1981-01-01

    An air-cleaning, heat-exchange apparatus includes a main housing portion connected by means of an air inlet fan to the kitchen exhaust stack of a restaurant. The apparatus includes a plurality of heat exchangers through which a heat-absorptive fluid is circulated, simultaneously, by means of a suitable fluid pump. These heat exchangers absorb heat from the hot exhaust gas, out of the exhaust stack of the restaurant, which flows over and through these heat exchangers and transfers this heat to the circulating fluid which communicates with remote heat exchangers. These remote heat exchangers further transfer this heat to a stream of air, such as that from a cold-air return duct for supplementing the conventional heating system of the restaurant. Due to the fact that such hot exhaust gas is heavily grease laden , grease will be deposited on virtually all internal surfaces of the apparatus which this exhaust gas contacts. Consequently, means are provided for spraying these contacted internal surfaces , as well as the hot exhaust gas itself, with a detergent solution in which the grease is soluble, thereby removing grease buildup from these internal surfaces

  17. Dosimeter charging apparatus

    International Nuclear Information System (INIS)

    Reuter, F.A.; Moorman, Ch.J.

    1985-01-01

    An apparatus for charging a dosimeter which has a capacitor connected between first and second electrodes and a movable electrode in a chamber electrically connected to the first electrode. The movable electrode deflects varying amounts depending upon the charge present on said capacitor. The charger apparatus includes first and second charger electrodes couplable to the first and second dosimeter electrodes. To charge the dosimeter, it is urged downwardly into a charging socket on the charger apparatus. The second dosimeter electrode, which is the dosimeter housing, is electrically coupled to the second charger electrode through a conductive ring which is urged upwardly by a spring. As the dosimeter is urged into the socket, the ring moves downwardly, in contact with the second charger electrode. As the dosimeter is further urged downwardly, the first dosimeter electrode and first charger electrode contact one another, and an insulator post carrying the first and second charger electrodes is urged downwardly. Downward movement of the post effects the application of a charging potential between the first and second charger electrodes. After the charging potential has been applied, the dosimeter is moved further into the charging socket against the force of a relatively heavy biasing spring until the dosimeter reaches a mechanical stop in the charging socket

  18. Minimizing surgical skin incision scars with a latex surgical glove.

    Science.gov (United States)

    Han, So-Eun; Ryoo, Suk-Tae; Lim, So Young; Pyon, Jai-Kyung; Bang, Sa-Ik; Oh, Kap-Sung; Mun, Goo-Hyun

    2013-04-01

    The current trend in minimally invasive surgery is to make a small surgical incision. However, the excessive tensile stress applied by the retractors to the skin surrounding the incision often results in a long wound healing time and extensive scarring. To minimize these types of wound problems, the authors evaluated a simple and cost-effective method to minimize surgical incision scars based on the use of a latex surgical glove. The tunnel-shaped part of a powder-free latex surgical glove was applied to the incision and the dissection plane. It was fixed to the full layer of the dissection plane with sutures. The glove on the skin surface then was sealed with Ioban (3 M Health Care, St. Paul, MN, USA) to prevent movement. The operation proceeded as usual, with the retractor running through the tunnel of the latex glove. It was possible to complete the operation without any disturbance of the visual field by the surgical glove, and the glove was neither torn nor separated by the retractors. The retractors caused traction and friction during the operation, but the extent of damage to the postoperative skin incision margin was remarkably less than when the operation was performed without a glove. This simple and cost-effective method is based on the use of a latex surgical glove to protect the surgical skin incision site and improve the appearance of the postoperative scar. 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 .

  19. Spring-action Apparatus for Fixation of Eyeball (SAFE): a novel, cost-effective yet simple device for ophthalmic wet-lab training.

    Science.gov (United States)

    Ramakrishnan, Seema; Baskaran, Prabu; Fazal, Romana; Sulaiman, Syed Mohammad; Krishnan, Tiruvengada; Venkatesh, Rengaraj

    2016-10-01

    Achieving a formed and firm eyeball which is stably fixed in a holding device is a major challenge of surgical wet-lab training. Our innovation, the 'Spring-action Apparatus for Fixation of Eyeball (SAFE)' is a robust, simple and economical device to solve this problem. It consists of a hollow iron cylinder to which a spring-action syringe is attached. The spring-action syringe generates vacuum and enables reliable fixation of a human or animal cadaveric eye on the iron cylinder. The rise in intraocular pressure due to vacuum fixation can be varied as per need or nature of surgery being practised. A mask-fixed version of this device is also designed to train surgeons for appropriate hand positioning. An experienced surgeon performed various surgeries including manual small incision cataract surgery (MSICS), phacoemulsification, laser in situ keratomileusis (LASIK), femtosecond LASIK docking, Descemet's stripping endothelial keratoplasty, deep anterior lamellar keratoplasty, penetrating keratoplasty and trabeculectomy on this device, while a trainee surgeon practised MSICS and wound suturing. Skill-appropriate comfort level was much higher with SAFE than with conventional globe holders for both surgeons. Due to its stability, pressure adjustability, portability, cost-efficiency and simplicity, we recommend SAFE as the basic equipment for every wet lab. 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/

  20. Water-tight knee arthrotomy closure: comparison of a novel single bidirectional barbed self-retaining running suture versus conventional interrupted sutures.

    Science.gov (United States)

    Nett, Michael; Avelar, Rui; Sheehan, Michael; Cushner, Fred

    2011-03-01

    Standard medial parapatellar arthrotomies of 10 cadaveric knees were closed with either conventional interrupted absorbable sutures (control group, mean of 19.4 sutures) or a single running knotless bidirectional barbed absorbable suture (experimental group). Water-tightness of the arthrotomy closure was compared by simulating a tense hemarthrosis and measuring arthrotomy leakage over 3 minutes. Mean total leakage was 356 mL and 89 mL in the control and experimental groups, respectively (p = 0.027). Using 8 of the 10 knees (4 closed with control sutures, 4 closed with an experimental suture), a tense hemarthrosis was again created, and iatrogenic suture rupture was performed: a proximal suture was cut at 1 minute; a distal suture was cut at 2 minutes. The impact of suture rupture was compared by measuring total arthrotomy leakage over 3 minutes. Mean total leakage was 601 mL and 174 mL in the control and experimental groups, respectively (p = 0.3). In summary, using a cadaveric model, arthrotomies closed with a single bidirectional barbed running suture were statistically significantly more water-tight than those closed using a standard interrupted technique. The sample size was insufficient to determine whether the two closure techniques differed in leakage volume after suture rupture.

  1. Water intake fish diversion apparatus

    International Nuclear Information System (INIS)

    Taft, E.P. III; Cook, T.C.

    1995-01-01

    A fish diversion apparatus uses a plane screen to divert fish for variety of types of water intakes in order to protect fish from injury and death. The apparatus permits selection of a relatively small screen angle, for example ten degrees, to minimize fish injury. The apparatus permits selection of a high water velocity, for example ten feet per second, to maximize power generation efficiency. The apparatus is especially suitable retrofit to existing water intakes. The apparatus is modular to allow use plural modules in parallel to adjust for water flow conditions. The apparatus has a floor, two opposite side walls, and a roof which define a water flow passage and a plane screen within the passage. The screen is oriented to divert fish into a fish bypass which carries fish to a safe discharge location. The dimensions of the floor, walls, and roof are selected to define the dimensions of the passage and to permit selection of the screen angle. The floor is bi-level with a level upstream of the screen and a level beneath screen selected to provide a uniform flow distribution through the screen. The apparatus may include separation walls to provide a water flow channel between the apparatus and the water intake. Lead walls may be used to adjust water flow conditions into the apparatus. The apparatus features stoplog guides near its upstream and downstream ends to permit the water flow passage to be dewatered. 3 figs

  2. Use of an all-suture anchor for re-creation of the anterior talofibular ligament: a case report.

    Science.gov (United States)

    Piraino, Jason A; Busch, Elliot L; Sansosti, Laura E; Pettineo, Steven J; Creech, Corine

    2015-01-01

    The lateral ankle ligament complex is typically injured during athletic activity caused by an inversion force on a plantar flexed foot. Numerous open surgical procedures to reconstruct the lateral ankle complex have been described. In contrast, we present a case report in which an all-suture anchor was used arthroscopically to re-create the anterior talofibular ligament in conjunction with ankle arthroscopy. A retrospective analysis of a 55-year-old male with a work-related inversion ankle sprain was performed with 14 months of follow-up. Objective and subjective assessments were obtained using range of motion measures, a strength assessment, and the Foot Function Index. An all-suture anchor was deployed through the anterolateral portal and secured in both the fibula and talus, re-creating the anterior talofibular ligament at its origin and insertion. Active range of motion physical therapy began at 2 weeks postoperatively. The patient started a neuromuscular re-education program at 5 weeks with minimal pain or discomfort. A return to full duty was achieved at 3 months postoperatively. To our knowledge, the use of an all-suture anchor has not been previously reported for lateral ankle complex re-creation. It is hoped that this approach to anterior talofibular ligament repair will decrease the incidence of complications and improve outcomes. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Laparoscopic Longitudinal Pancreaticojejunostomy Using Barbed Sutures: an Efficient and Secure Solution for Pancreatic Duct Obstructions in Patients with Chronic Pancreatitis.

    Science.gov (United States)

    Kim, Eun Young; Hong, Tae Ho

    2016-04-01

    We describe our laparoscopic longitudinal pancreaticojejunostomy (LPJ) technique using barbed sutures to manage a pancreatic duct obstruction. We performed laparoscopic longitudinal anterior pancreaticojejunostomy using barbed sutures (3-0 absorbable wound closure device, V-Loc, Covidien, Minneapolis, MN, USA) in 11 patients who presented with signs of a pancreas ductal obstruction and chronic pancreatitis. The surgical outcomes and follow-up records at the outpatient department were reviewed, and the effectiveness and feasibility of this method were analyzed. Mean patient age was 54.4 ± 9.5 years, and pancreatic duct stones were removed from all patients without conversion to laparotomy. Overall operative time was 200.7 ± 56.4 min, and estimated blood loss was 42.2 ± 11.2 ml. No pancreatic anastomosis leakage or postoperative bleeding was detected. Mean length of hospital stay was 6.5 ± 0.8 days, and mean time to start a soft diet was 4.8 ± 0.7 days. No patient complained of postoperative abdominal pain, and all patients recovered without significant complications or relapse of pancreatitis. The follow-up period was 4-21 months. Our new laparoscopic longitudinal anterior pancreaticojejunostomy technique (Puestow procedure) using barbed sutures is a potentially efficient and minimally invasive procedure for patients who suffer from pancreatic duct obstruction and chronic pancreatitis.

  4. Modified Longo's stapled hemorrhoidopexy with additional traction sutures for the treatment of residual prolapsed piles.

    Science.gov (United States)

    Chen, Chuang-Wei; Kang, Jung-Cheng; Wu, Chang-Chieh; Hsiao, Cheng-Wen; Jao, Shu-Wen

    2008-03-01

    Residual prolapsed piles is a problem after the stapled hemorrhoidopexy, especially in large third- or fourth-degree hemorrhoids. We have developed a method using additional traction sutures along with modified Longo's procedure to manage this problem. From January 2005 to October 2005, 30 consecutive patients with symptomatic third- or fourth-degree hemorrhoids who underwent the modified Longo's stapled hemorrhoidopexy with additional traction sutures in a single institution were collected. The demographics, postoperative pain score, surgical features, outcomes, and early and late complications were recorded. All patients were followed for a mean duration of 8.8 (range, 4-15) months. Thirty patients (17 males) with a mean age of 45 (range, 27-63) years were identified. The mean postoperative pain score on the morning of the first postoperative day was 2.8 (range, 1-4). The mean duration of operation was 30.7 (range, 25-37) min. The mean duration of hospital stay was 2 (range, 1-3) days. The mean days for patients to resume normal work was 6.7 (range, 4-9) days. No other procedure-related complications occurred in all patients. There was no early complication except for fecal urgency found in one patient during the first postoperative days. Regarding the late complications, no residual prolapsed piles, persistent anal pain, incontinence, anal stenosis, or recurrent symptoms were found. Our preliminary experiences indicated that this modified procedures truly contributed to reduce the residual internal hemorrhoids and maintained the benefits of stapled hemorrhoidopexy. Randomized trial and long-term follow-up warrant to determine possible surgical and functional outcome.

  5. A reusable suture anchor for arthroscopy psychomotor skills training.

    Science.gov (United States)

    Tillett, Edward D; Rogers, Rainie; Nyland, John

    2003-03-01

    For residents to adequately develop the early arthroscopy psychomotor skills required to better learn how to manage the improvisational situations they will encounter during actual patient cases, they need to experience sufficient practice repetitions within a contextually relevant environment. Unfortunately, the cost of suture anchors can be a practice repetition-limiting factor in learning arthroscopic knot-tying techniques. We describe a technique for creating inexpensive reusable suture anchors and provide an example of their application to repair the anterior glenoid labrum during an arthroscopy psychomotor skills laboratory training session.

  6. 360-degree suture trabeculotomy ab interno to treat open-angle glaucoma: 2-year outcomes

    Science.gov (United States)

    Sato, Tomoki; Kawaji, Takahiro; Hirata, Akira; Mizoguchi, Takanori

    2018-01-01

    Purpose The purpose of this study was to evaluate the efficacy of 360-degree suture trabeculotomy (360S-LOT) ab interno for treating open-angle glaucoma (OAG). Risk factors of surgical failure were examined. Patients and methods 360S-LOT ab interno alone was performed for patients with uncontrolled OAG, and combined 360S-LOT ab interno/phacoemulsification was performed for patients with controlled OAG with a visually significant cataract between March 2014 and September 2015 at a single center. The patients were prospectively followed for 2 years. The main outcome measures included 2-year intraocular pressure (IOP), number of anti-glaucoma medications used, postoperative complications, and predictive factors of surgical failure. Kaplan–Meier analysis was performed, with surgical success (with or without medication use) defined as postoperative IOP ≤15 mmHg and IOP reduction ≥20% (criterion A) or IOP ≤12 mmHg and IOP reduction ≥30% (criterion B). Predictive factors were evaluated using Cox proportional hazard ratios. Results A total of 64 eyes of 64 patients were included, and 50 (78%) eyes of 64 eyes underwent a phacoemulsification combination procedure. Surgery significantly reduced IOP from 18.4 ± 2.9 mmHg before surgery to 13.4 ± 3.0 mmHg after surgery (P interno procedure is a favorable option for treating eyes with mild or moderate OAG. PMID:29844656

  7. Effect of robotic manipulation on unidirectional barbed suture integrity: evaluation of tensile strength and sliding force.

    Science.gov (United States)

    Kaushik, Dharam; Clay, Kevin; Hossain, S G M; Park, Eugene; Nelson, Carl A; LaGrange, Chad A

    2012-06-01

    One of the more challenging portions of robot-assisted radical prostatectomy (RARP) is the urethrovesical anastomosis. Because of this, a unidirectional absorbable barbed suture (V-Loc(™)) has been used to complete the anastomosis with better efficiency and less tension. The effect of robotic needle driver manipulation on barbed suture is unknown. Therefore, the aim of this study is to determine whether robotic manipulation decreases the tensile strength and peak sliding force of V-Loc barbed suture. Fifty-six V-Loc sutures were compared with 56 Maxon sutures. All sutures were 3-0 caliber. Half of the sutures in each group were manipulated with a da Vinci(®) robot large needle driver five times over a 5 cm length of suture. The other half was not manipulated. Breaking force was determined by placing sutures in a Bose ElectroForce load testing device. For sliding force testing, 28 V-Loc sutures were manipulated in the same fashion and compared with 28 nonmanipulated V-Loc sutures. Peak force needed to make the suture slip backward in porcine small intestine was determined to be the sliding force. Scanning electron microscopy of the barbs before and after robotic manipulation was also performed. The mean difference in breaking forces for manipulated vs nonmanipulated Maxon sutures was 4.52 N (P=0.004). The mean difference in breaking forces for manipulated vs nonmanipulated V-Loc sutures was 1.30 N (P=0.046). The manipulated V-Loc group demonstrated a lower peak sliding force compared with the nonmanipulated group (0.76 vs 0.88 N, P=0.199). Electron microscopy revealed minor structural damage to the barbs and suture. Tensile strength and peak sliding force of V-Loc suture is decreased by robotic manipulation. This is likely because of structural damage to the suture and barbs. This structural damage, however, is likely not clinically significant.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. 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.

  10. A comparative study of tissue glue and vicryl suture for conjunctival and scleral closure in conventional 20-gauge vitrectomy.

    Science.gov (United States)

    Batman, C; Ozdamar, Y; Mutevelli, S; Sonmez, K; Zilelioglu, G; Karakaya, J

    2009-06-01

    To describe the use of tissue glue to close scleral and conjunctival wounds, and to compare the clinical outcomes using tissue glue and vicryl suture for closing these areas in conventional 20-gauge (G) vitrectomy. Thirty eyes of 30 patients were included in this study. The indications for vitreoretinal surgery were diabetic vitreous haemorrhage with severe vitreoretinal traction in 10 eyes, retinal detachment and proliferative vitreoretinopathy in 14 eyes, and vitreous opacity in 6 eyes. Tissue glue (Tisseel, Baxter AG Industries, Vienna, Austria) was used to attach scleral and conjunctival wounds in 15 eyes and vicryl sutures in 15 eyes. The patients were allotted into two subgroups as tissue glue group (TG) and vicryl suture group (VG). The sclerotomy sites were evaluated with ultrasound biomicroscopy (UBM) postoperatively in TG. Follow-up period was 2 months. The groups were statistically compared for ocular signs and symptoms by Mann-Whitney U-test. No scleral wound leakage and conjunctival reattachment were observed at the end of the surgical procedure and during the follow-up period. No adverse effects were seen in TG. Abnormal fibrous ingrowth was not detected at the sclerotomy sites by means of UBM in TG. Patient comfort was significantly higher in TG than VG (P<0.05). Tissue glue has no adverse effects on ocular tissue and can be used as a substitute for suture materials, and the use of tissue glue decreases patient symptoms during the postoperative period after 20-G vitrectomy. Tissue glue can enable to perform sutureless surgery in the conventional 20-G vitrectomy.

  11. Informationization nuclear apparatus communication technique

    International Nuclear Information System (INIS)

    Yu Tiqi; Fang Zongliang; Wen Qilin

    2006-01-01

    The paper explains the request of communication ability in nuclear technique application area. Based on the actuality of nuclear apparatus communication ability, and mainly combining with the development of communication technique, the authors analyzes the application trend of communication technique applying in nuclear apparatus, for the apparatus and system needing communication ability, they need selecting suitable communication means to make them accomplish the task immediately and effectively. (authors)

  12. Real-time inextensible surgical thread simulation.

    Science.gov (United States)

    Xu, Lang; Liu, Qian

    2018-03-27

    This paper discusses a real-time simulation method of inextensible surgical thread based on the Cosserat rod theory using position-based dynamics (PBD). The method realizes stable twining and knotting of surgical thread while including inextensibility, bending, twisting and coupling effects. The Cosserat rod theory is used to model the nonlinear elastic behavior of surgical thread. The surgical thread model is solved with PBD to achieve a real-time, extremely stable simulation. Due to the one-dimensional linear structure of surgical thread, the direct solution of the distance constraint based on tridiagonal matrix algorithm is used to enhance stretching resistance in every constraint projection iteration. In addition, continuous collision detection and collision response guarantee a large time step and high performance. Furthermore, friction is integrated into the constraint projection process to stabilize the twining of multiple threads and complex contact situations. Through comparisons with existing methods, the surgical thread maintains constant length under large deformation after applying the direct distance constraint in our method. The twining and knotting of multiple threads correspond to stable solutions to contact and friction forces. A surgical suture scene is also modeled to demonstrate the practicality and simplicity of our method. Our method achieves stable and fast simulation of inextensible surgical thread. Benefiting from the unified particle framework, the rigid body, elastic rod, and soft body can be simultaneously simulated. The method is appropriate for applications in virtual surgery that require multiple dynamic bodies.

  13. 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.

  14. Thermal stir welding apparatus

    Science.gov (United States)

    Ding, R. Jeffrey (Inventor)

    2011-01-01

    A welding method and apparatus are provided for forming a weld joint between first and second elements of a workpiece. The method includes heating the first and second elements to form an interface of material in a plasticized or melted state interface between the elements. The interface material is then allowed to cool to a plasticized state if previously in a melted state. The interface material, while in the plasticized state, is then mixed, for example, using a grinding/extruding process, to remove any dendritic-type weld microstructures introduced into the interface material during the heating process.

  15. Magnetic resonance imaging apparatus

    International Nuclear Information System (INIS)

    Ehnholm, G.J.

    1991-01-01

    This patent describes an electron spin resonance enhanced magnetic resonance (MR) imaging (ESREMRI) apparatus able to generate a primary magnetic field during periods of nuclear spin transition excitation and magnetic resonance signal detection. This allows the generation of ESREMRI images of a subject. A primary magnetic field of a second and higher value generated during periods of nuclear spin transition excitation and magnetic resonance signal detection can be used to generate conventional MR images of a subject. The ESREMRI and native MR images so generated may be combined, (or superimposed). (author)

  16. Improvements in radiological apparatus

    International Nuclear Information System (INIS)

    Grady, J.K.

    1985-01-01

    Improvements in radiological apparatus are described which allow better unilateral access to the patient. A base mounts ring supports for rotation about an axis and a table for supporting a subject is fitted to the ring support. An X-ray tube and receptor are held on opposite ends of a two-limbed carriage and radiation axis. The carriage is mounted on a sliding arm carried on the ring support and extending parallel to the rotational axis of the support. The carriage also pivots on the arm about an axis perpendicular to the rotational axis and to the radiation axis. (author)

  17. Tomographic scanning apparatus

    International Nuclear Information System (INIS)

    Abele, M.

    1983-01-01

    A computerized tomographic scanning apparatus suitable for diagnosis and for improving target identification in stereotactic neurosurgery is described. It consists of a base, a source of penetrating energy, a detector which produces scanning signals and detector positioning means. A frame with top and bottom arms secures the detector and source to the top and bottom arms respectively. A drive mechanism rotates the frame about an axis along which the frame may also be moved. Finally, the detector may be moved relative to the bottom arm in a direction contrary to the rotation of the frame. (U.K.)

  18. Control rod testing apparatus

    International Nuclear Information System (INIS)

    Gaunt, R.R.; Ashman, C.M.

    1987-01-01

    A control rod testing apparatus is described comprising: a first guide means having a vertical cylindrical opening for grossly guiding a control rod; a second guide means having a vertical cylindrical opening for grossly guiding a control rod. The first and second guide means are supported at axially spaced locations with the openings coaxial; and a substantially cylindrical subassembly having a vertical cylindrical opening therethrough. The subassembly is trapped coaxial with and between the first and second guide means, and the subassembly radially floats with respect to the first and second guide means

  19. Apparatus for chemical synthesis

    Science.gov (United States)

    Kong, Peter C [Idaho Falls, ID; Herring, J Stephen [Idaho Falls, ID; Grandy, Jon D [Idaho Falls, ID

    2011-05-10

    A method and apparatus for forming a chemical hydride is described and which includes a pseudo-plasma-electrolysis reactor which is operable to receive a solution capable of forming a chemical hydride and which further includes a cathode and a movable anode, and wherein the anode is moved into and out of fluidic, ohmic electrical contact with the solution capable of forming a chemical hydride and which further, when energized produces an oxygen plasma which facilitates the formation of a chemical hydride in the solution.

  20. The ATHENA Antihydrogen Apparatus

    CERN Document Server

    Amoretti, M; Bonomi, G; Bouchta, A; Bowe, P; Carraro, C; Charlton, M; Collier, M; Doser, Michael; Filippini, V; Fine, K S; Fontana, A; Fujiwara, M C; Funakoshi, R; Genova, P; Glauser, A; Grögler, D; Hangst, Jeffrey S; Hayano, R S; Higaki, H; Holzscheiter, Michael H; Joffrain, W; Jørgensen, L V; Lagomarsino, V; Landua, Rolf; Cesar, C L; Lindelöf, D; Lodi-Rizzini, E; Macri, M; Madsen, N; Manuzio, D; Manuzio, G; Marchesotti, M; Montagna, P; Pruys, H S; Regenfus, C; Riedler, P; Rochet, J; Rotondi, A; Rouleau, G; Testera, G; Van der Werf, D P; Variola, A; Watson, T L; Yamazaki, T; Yamazaki, Y

    2004-01-01

    The ATHENA apparatus that recently produced and detected the first cold antihydrogen atoms is described. Its main features, which are described herein, are: an external positron accumulator, making it possible to accumulate large numbers of positrons; a separate antiproton catching trap, optimizing the catching, colling and handling of antiprotons: a unique high resolution antihydrogen annihilation detector, allowing a clear determination that antihydrogen has been produced; an open, modular design making variations in the experimental approach possible and a "nested" Penning trap situated in a cryogenic, 3T magnetic field environment used for the mixing of the antiprotons and positrons.

  1. Isotope diagnostics apparatus

    International Nuclear Information System (INIS)

    Herrschaft, H.

    1976-01-01

    The invention relates to a measuring probe for an isotope diagnostics apparatus to determine the distribution of radioactive substances in a body by measuring the radiation emanating from this body by means of a multiplicity of measuring probes directed simultaneously towards areas of measuring surfae and carried in guidances of a holding block. The measuring results of the individual probes are recorded separately, thus allowing the possibility of being evaluated separately, too. Measuring probes of this kind are used in multi-channel measuring objects and are useful particularly for determining the regional cerebral blood flow. (orig./ORU) [de

  2. X-ray apparatus

    International Nuclear Information System (INIS)

    Grady, J.K.

    1985-01-01

    X-ray apparatus is described which has a shutter between the X-ray source and the patient. The shutter controls the level of radiation to which the patient is exposed instead of merely discontinuing the electric power supplied to the source. When the shutter is opened a radiation sensor senses the level of X-radiation. When a preset quantity of X-radiation has been measured an exposure control closes the shutter. Instead of using the radiation sensor, the integrated power supplied to the anode of the X-ray source may be measured. (author)

  3. Remote docking apparatus

    International Nuclear Information System (INIS)

    Dent, T.H.; Sumpman, W.C.; Wilhelm, J.J.

    1981-01-01

    The remote docking apparatus comprises a support plate with locking devices mounted thereon. The locking devices are capable of being inserted into tubular members for suspending the support plate therefrom. A vertical member is attached to the support plate with an attachment mechanism attached to the vertical member. A remote access manipulator is capable of being attached to the attachment mechanism so that the vertical member can position the remote access manipulator so that the remote access manipulator can be initially attached to the tubular members in a well defined manner

  4. Borehole sealing method and apparatus

    International Nuclear Information System (INIS)

    Hartley, J.N.; Jansen, G. Jr.

    1977-01-01

    A method and apparatus is described for sealing boreholes in the earth. The borehole is blocked at the sealing level, and a sealing apparatus capable of melting rock and earth is positioned in the borehole just above seal level. The apparatus is heated to rock-melting temperature and powdered rock or other sealing material is transported down the borehole to the apparatus where it is melted, pooling on the mechanical block and allowed to cool and solidify, sealing the hole. Any length of the borehole can be sealed by slowly raising the apparatus in the borehole while continuously supplying powdered rock to the apparatus to be melted and added to the top of the column of molten and cooling rock, forming a continuous borehole seal. The sealing apparatus consists of a heater capable of melting rock, including means for supplying power to the heater, means for transporting powdered rock down the borehole to the heater, means for cooling the apparatus and means for positioning the apparatus in the borehole. 5 claims, 1 figure

  5. Apparatus for gamma ray radiography

    International Nuclear Information System (INIS)

    Kobayashi, Masatoshi; Enomoto, Shigemasa; Oga, Hiroshi

    1979-01-01

    This is the standard of Japan Non-Destructive Inspection Society, NDIS 1101-79, which stipulates on the design, construction and testing method of the apparatuses for gamma ray radiography used for taking industrial radiograms. The gamma ray apparatuses stipulated in this standard are those containing sealed radioactive isotopes exceeding 100 μCi, which emit gamma ray. The gamma ray apparatuses are classified into three groups according to their movability. The general design conditions, the irradiation dose rate and the sealed radiation sources for the gamma ray apparatuses are stipulated. The construction of the gamma ray apparatuses must be in accordance with the notification No. 52 of the Ministry of Labor, and safety devices and collimators must be equipped. The main bodies of the gamma ray apparatuses must pass the vibration test, penetration test, impact test and shielding efficiency test. The method of each test is described. The attached equipments must be also tested. The tests according to this standard are carried out by the makers of the apparatuses. The test records must be made when the apparatuses have passed the tests, and the test certificates are attached. The limit of guarantee by the endurance test must be clearly shown. The items to be shown on the apparatuses are stipulated. (Kako, I.)

  6. Achondroplasia with multiple-suture craniosynostosis: a report of a new case of this rare association

    NARCIS (Netherlands)

    Bessenyei, Beáta; Nagy, Andrea; Balogh, Erzsébet; Novák, László; Bognár, László; Knegt, Alida C.; Oláh, Eva

    2013-01-01

    We report on a female patient with an exceedingly rare combination of achondroplasia and multiple-suture craniosynostosis. Besides the specific features of achondroplasia, synostosis of the metopic, coronal, lambdoid, and squamosal sutures was found. Series of neurosurgical interventions were

  7. Video and accelerometer-based motion analysis for automated surgical skills assessment.

    Science.gov (United States)

    Zia, Aneeq; Sharma, Yachna; Bettadapura, Vinay; Sarin, Eric L; Essa, Irfan

    2018-03-01

    Basic surgical skills of suturing and knot tying are an essential part of medical training. Having an automated system for surgical skills assessment could help save experts time and improve training efficiency. There have been some recent attempts at automated surgical skills assessment using either video analysis or acceleration data. In this paper, we present a novel approach for automated assessment of OSATS-like surgical skills and provide an analysis of different features on multi-modal data (video and accelerometer data). We conduct a large study for basic surgical skill assessment on a dataset that contained video and accelerometer data for suturing and knot-tying tasks. We introduce "entropy-based" features-approximate entropy and cross-approximate entropy, which quantify the amount of predictability and regularity of fluctuations in time series data. The proposed features are compared to existing methods of Sequential Motion Texture, Discrete Cosine Transform and Discrete Fourier Transform, for surgical skills assessment. We report average performance of different features across all applicable OSATS-like criteria for suturing and knot-tying tasks. Our analysis shows that the proposed entropy-based features outperform previous state-of-the-art methods using video data, achieving average classification accuracies of 95.1 and 92.2% for suturing and knot tying, respectively. For accelerometer data, our method performs better for suturing achieving 86.8% average accuracy. We also show that fusion of video and acceleration features can improve overall performance for skill assessment. Automated surgical skills assessment can be achieved with high accuracy using the proposed entropy features. Such a system can significantly improve the efficiency of surgical training in medical schools and teaching hospitals.

  8. Isotope separation apparatus

    International Nuclear Information System (INIS)

    Lyon, R.K.; Eisner, P.N.; Thomas, W.R.I.

    1983-01-01

    This application discloses a method for and an apparatus in which isotopes of an element in a compared are separated from each other while that compound, i.e., including a mixture of such isotopes, flows along a predetermined path. The apparatus includes a flow tube having a beginning and an end. The mixture of isotopes is introduced into the flow tube at a first introduction point between the beginning and the end thereof to flow the mixture toward the end thereof. A laser irradiates the flow tube dissociating compounds of a preselected one of said isotopes thereby converting the mixture in an isotopically selective manner. The dissociation products are removed from the tube at a first removal point between the first introduction point and the end. The dissociation product removed at the the first removal point are reconverted back into the comound thereby providing a first stage enriched compound. This first stage enriched compound is reintroduced into the flow tube at a second introduction point between the beginning thereof and the first introduction point. Further product is removed from the flow tube at a second removal point between the second introduction point and the first introduction point. The second introduction point is chosen so that the isotope composition of the first stage enriched compound is approximately the same as that of the compound in the flow tube

  9. Apparatus for fuel replacement

    International Nuclear Information System (INIS)

    Imada, Takahiko.

    1974-01-01

    Object: To support a telescope mast such that no deforming load is applied to it even during massive vibration, it is held fixed at the time of fuel replacement to permit satisfactory remote control operation by automatic operation. Structure: The body of the fuel replacement apparatus is provided with telescope mast fixing means comprising a slide base supported for reciprocal movement with respect to a telescope mast, an operating arm pivoted at the slide base, a wrist member mounted on the free end of the operating arm and an engagement member for restricting the slide base and operating arm at the time of loading and unloading the fuel. When loading and unloading the fuel, the slide base and operating arm are restrained by the engagement member to reliably restrict the vibration of the telescope mast. When the fuel replacement apparatus is moved, the means provided on the operating arm is smoothly displaced to follow the swing (vibration) of the telescope mast to prevent the deforming load from being applied to the support portion or other areas. The wrist member supports the telescope mast such that it can be rotated while restraining movement in the axial direction, and it is provided with revolution drive means for rotating the telescope mast under remote control. (Kamimura, M.)

  10. Radiographic scanner apparatus

    International Nuclear Information System (INIS)

    Wake, R.H.

    1980-01-01

    The preferred embodiment of this invention includes a hardware system, or processing means, which operates faster than software. Moreover the computer needed is less expensive and smaller. Radiographic scanner apparatus is described for measuring the intensity of radiation after passage through a planar region and for reconstructing a representation of the attenuation of radiation by the medium. There is a source which can be rotated, and detectors, the output from which forms a data line. The detectors are disposed opposite the planar region from the source to produce a succession of data lines corresponding to the succession of angular orientations of the source. There is a convolver means for convolving each of these data lines, with a filter function, and a means of processing the convolved data lines to create the representation of the radiation attenuation in the planar region. There is also apparatus to generate a succession of data lines indicating radiation attenuation along a determinable path with convolver means. (U.K.)

  11. Apparatus for gamma radiography

    International Nuclear Information System (INIS)

    1983-06-01

    The aim of the present standard is to fix the rules for the construction of gamma radiography instrumentation without prejudice to the present regulations. These apparatus have to be fitted with only sealed sources conformable to the experimental standard M 61-002. The present standard agrees with the international standard ISO 3999 of 1977 dealing with the same subject. Nevertheless, it is different on the three main following points: it does not accept the same limits of absorbed dose rates in the air calculated on the external surface of projectors; it precribes tightness, bending, crushing and tensile tests for some components of the gamma radiography it prescribes tests of endurance and resistance to breaking for the locking systems of the gamma radiography apparatus. The present standard also specifies the following points: symbols and indications to put on projectors and on the source-holder; identification of the source contained in the projector; and, accompanying documents. The regulation references are given in annexe [fr

  12. Fuel exchanging apparatus

    International Nuclear Information System (INIS)

    Imada, Takahiko; Sato, Hideo.

    1975-01-01

    Object: To provide a centripetal device, which has an initial spring force greater than a frictional force in an oscillating direction of a telescope mast, on a mast fixing device mounted on a body of fuel exchanging apparatus so that the telescope mast may be secured quickly returning to a predetermined initial position. Structure: When the body of fuel exchanging apparatus is stopped at a predetermined position, a tension spring, which has an initial spring force greater than a frictional force in an oscillating direction of the telescope mast, causes a lug to be forced by means of a push rod to position a sliding base plate to its original position. At the same time, a device of similar structure causes an operating arm to be positioned to the original position, and a lock pin urged by a cylinder is inserted into a through hole in the sliding base plate and operating arm so that the telescope mast may be fixed and retained. (Hanada, M.)

  13. Healing of the suture line in the irradiated small intestine

    International Nuclear Information System (INIS)

    Da Costa, S.A.

    1989-01-01

    With the help of data from literature the author goes more deeply into the aetiology, treatment and possible prevention of lesions of the small intestine related to preceding irradiation. In a clinical retrospective study at twenty patients who, after irradiation of the abdominal and pelvic areas, have been submitted to abdominal surgery, the relation is studied between predistion factors for gastrointestinal complications after irradiation, the surgeries applied in case of small-intestine problems and postoperative complications. The third part of the thesis covers an experimental part in which the healing process of suture line in the terminal ileum has been studied after resection and reanastomosis in previously irradiated bowel of the rat. It was investigated whether differences occurred in the healing process of suture line after various periods - 4, 10 and 40 weeks, after irradiation. Also comparison took place with a control group which underwent a similar procedure with the exception of the radiation treatment, which was simulated in this group. In a second experiment it was investigated if the healing process of suture line depends on the type of anastomosis. An end-to-end anastomosis was chosen versus side-to-side anastomosis. Also in this experiment an irradiated group was compared with a control group. Furthermore a method was developed for performing micro-angiographies of the rat intestine in order to demonstrate obliteration of blood vessels in irradiated intestine and to assess neovascularization in the intestinal wall at the suture line. (author). 84 refs.; 18 figs.; 27 tabs

  14. Comparison of Subcuticular Suture Materials in Cesarean Skin Closure

    Directory of Open Access Journals (Sweden)

    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.

  15. non absorbable sutures in the urinary bladder resulting

    African Journals Online (AJOL)

    The vesical calculus. Urol Clin North AM. 2000, 27:333-346. 3. Evans JW, Chapple CR, Ralph DJ, Millory EJ: Bladder calculus formation as a complication of the Stamey procedure. Br J Urol 1990,. 65:580-582. 4. Sheng-Tsun Su, He-Fu Haung, Shu-Fen. Chang. Encrusted Bladder stone on Non- absorbable sutures after a ...

  16. Polymeric Medical Sutures: An Exploration of Polymers and Green Chemistry

    Science.gov (United States)

    Knutson, Cassandra M.; Schneiderman, Deborah K.; Yu, Ming; Javner, Cassidy H.; Distefano, Mark D.; Wissinger, Jane E.

    2017-01-01

    With new K-12 national science standards emerging, there is an increased need for experiments that integrate engineering into the context of society. Here we describe a chemistry experiment that combines science and engineering principles while introducing basic polymer and green chemistry concepts. Using medical sutures as a platform for…

  17. 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.

  18. Single-suture scleral fixation of subluxated foldable intraocular lenses.

    Science.gov (United States)

    Yarangumeli, Alper; Alp, Mehmet Numan; Kural, Gulcan

    2012-01-01

    To evaluate the results of single-suture scleral fixation of subluxated foldable intraocular lenses (IOL) in eyes with sufficient residual capsular support. The results of IOL repositioning by single-suture scleral fixation in 6 eyes of 6 patients with IOL subluxation were included. All subluxated IOLs were single-piece hydrophilic acrylic. Subluxation resulted from posterior capsule tears in 3 eyes, zonular dialyses in 2 eyes, and zonular dialysis with a capsulorhexis tear in 1 eye. A similar technique was used in all eyes in which one haptic was externalized through a superior clear corneal incision and tied with a Pair-PAK 10-0 polypropylene suture, and was finally retracted and fixated behind the iris close to the ciliary sulcus at the 12:00 meridian. All patients were followed up for at least 6 months. Best-corrected visual acuities ranged between finger counting and 20/70 (mean logMAR 1.02±0.64) preoperatively, and between 20/100 and 20/20 (mean logMAR 0.22±0.26) at the final postoperative visit. All IOLs remained centered and no significant postoperative complications were encountered except for an IOL tilt which resulted in a considerable oblique astigmatism in one eye. Subluxated foldable IOLs may safely be repositioned and secured with a single scleral fixation suture in selected cases with adequate amount of capsular remnants.

  19. 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.

  20. A Simple Suturing Technique for Laparoscopic Ligation of Vascular Pedicles

    Directory of Open Access Journals (Sweden)

    Keith A. Aqua

    1996-01-01

    Full Text Available We report on the performance of 348 adnexectomies and 35 uterine artery ligations for both benign and malignant disease using a simple laparoscopic suturing technique. Only 5-mm ports are required, and there was no morbidity directly associated with this approach. The procedure can be performed quickly, is relatively inexpensive, and allows hysterectomy and oophorectomy to be performed without bipolar electrocautery.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Use of the Toric Surgical Marker to Aid in Intraoperative Plaque Placement for the USC Eye Physics Plaques to Treat Uveal Melanoma: A New Surgical Technique.

    Science.gov (United States)

    Berry, Jesse L; Kim, Jonathan W; Jennelle, Richard; Astrahan, Melvin

    2015-09-01

    To describe a new surgical technique for intraoperative placement of Eye Physics (EP) plaques for uveal melanoma using a toric marker. A toric marker is designed for cataract surgery to align the axis of astigmatism; its use was modified in this protocol to mark the axis of suture coordinates as calculated by Plaque Simulator (PS) software. The toric marker can be used to localize suture coordinates, in degrees, during intraoperative plaque placement. Linear marking using the toric marker decreases potential inaccuracies associated with the surgeon estimating 'clock-hours' by dot placement. Use of the toric marker aided surgical placement of EP plaques. The EP planning protocol is now designed to display the suture coordinates either by clock-hours or degrees, per surgeon preference. Future research is necessary to determine whether routine use of the toric marker improves operative efficiency. [Ophthalmic Surg Lasers Imaging Retina. 2015;46:866-870.]. Copyright 2015, SLACK Incorporated.

  3. Nonsuturing or Skin Adhesives versus Suturing of the Perineal Skin After Childbirth: A Systematic Review

    NARCIS (Netherlands)

    Seijmonsbergen-Schermers, A.E.; Sahami, S.; Lucas, C.; de Jonge, A.

    2015-01-01

    Background: Suturing of perineal trauma after childbirth can cause problems such as pain, discomfort because of tight sutures, the need for suture removal, and dyspareunia. It is unclear whether leaving the perineal skin unsutured or using skin adhesives might prevent these problems. Methods:

  4. Nonsuturing or Skin Adhesives versus Suturing of the Perineal Skin After Childbirth: A Systematic Review

    NARCIS (Netherlands)

    Seijmonsbergen-Schermers, Anna E.; Sahami, Saloomeh; Lucas, Cees; Jonge, Ank de

    2015-01-01

    Suturing of perineal trauma after childbirth can cause problems such as pain, discomfort because of tight sutures, the need for suture removal, and dyspareunia. It is unclear whether leaving the perineal skin unsutured or using skin adhesives might prevent these problems. CENTRAL, MEDLINE, EMBASE,

  5. Treatment of chronic deltoid ligament injury using suture anchors.

    Science.gov (United States)

    Wang, Xu; Ma, Xin; Zhang, Chao; Wang, Chen; Huang, Jia-zhang

    2014-08-01

    To explore the efficacy of overlapping suture-anchor fixation for treatment of chronic deltoid ligament injury. Seventeen patients (11 men, 6 women of mean age 32.1 years [range, 18-58 years]) who had undergone surgery for chronic deltoid ligament injury from January 2007 to December 2011 were retrospectively analyzed. Preoperatively, they had undergone bilateral weight-bearing posterior-anterior radiographs, (MRI) and ultrasound examinations of the ankle. Ankle arthroscopy was performed to confirm the diagnosis, followed by surgery to clear intra-articular proliferating synovial tissues and remove cartilage debris and scar tissue. The deep layer of the deltoid ligament was sutured onto the tip of the medial malleolus and its superficial layer sutured onto its periosteum and fixed with suture anchors. American Orthopedic Foot and Ankle Society (AOFAS) scoring system for the ankle-hindfoot was used to evaluate the ankles pre- and post-operatively. The 17 patients were followed up for 12-34 months (mean 20.1 months). The angle between the long axes of the talus and first metatarsal and the hindfoot angle measured in a hindfoot alignment view (as described by Saltzman) were reduced from 5.4° ± 1.8° and 8.2° ± 2.6° preoperatively to 4.0° ± 0.9° and 5.3° ± 1.3° postoperatively, respectively. The mean AOFAS ankle-hindfoot score was 76.8 ± 7.0 preoperatively and 94.1 ± 3.3 at the last follow-up visit. Ten patients were scored as excellent, six as good, and one as fair. Pain was relieved in all patients and no patients had recurrent deltoid ligament injury. Using suture anchors to treat chronic deltoid ligament injury has relatively satisfactory outcomes. © 2014 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

  6. Arthroscopic repair of lateral ankle ligament complex by suture anchor.

    Science.gov (United States)

    Wang, Jingwei; Hua, Yinghui; Chen, Shiyi; Li, Hongyun; Zhang, Jian; Li, Yunxia

    2014-06-01

    Arthroscopic repair of the lateral ligament complex with suture anchors is increasingly used to treat chronic ankle instability (CAI). Our aims are (1) to analyze and evaluate the literature on arthroscopic suture anchor repair of the anterior talofibular ligament and (2) to conduct a systematic review of the clinical evidence on the reported outcomes and complications of treating CAI with this technique. We performed a systematic review of the literature using PubMed, Ovid, Elsevier ScienceDirect, Web of Science-Conference Proceedings Citation Index, and the Cochrane Database of Systematic Reviews from 1987 to September 2013. Clinical studies using the arthroscopic suture anchor technique to treat CAI were included. Outcome measures consisted of clinical assessment of postoperative ligament stability and complications. In addition, the methodologic quality of the included studies was assessed by use of the modified Coleman Methodology Score. After reviewing 371 studies, we identified 6 studies (5 retrospective case series and 1 prospective case series, all Level IV) that met the inclusion criteria, with a mean Coleman Methodology Score of 71.8 ± 7.52 (range, 63 to 82). In these studies 178 patients (179 ankles) underwent arthroscopic suture anchor repair of the anterior talofibular ligament with a mean follow-up period of 38.9 months (range, 6 to 117.6 months). All patients were reported to have subjective improvement of their ankle instability, with complications in 31 cases. Studies of arthroscopic suture anchor technique to treat CAI are sparse, with moderate mean methodologic quality. The included studies suggest that the arthroscopic technique is a feasible procedure to restore ankle stability; however, on the basis of our review, this technique seems to be associated with a relatively high complication rate. Extensive cadaveric studies, clinical trials, and comparative studies comparing arthroscopic and open repair should be performed in the future. Level

  7. Surgical orthodontics.

    Science.gov (United States)

    Strohl, Alexis M; Vitkus, Lauren

    2017-08-01

    The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability.

  8. Surgical managements of radiation enteritis

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Tsuguo; Naito, Kazuyo; Noomi, Shinppachiro; Kurioka, Hideaki; Yamagishi, Hisakazu (Kyoto Prefectural Univ. of Medicine (Japan))

    1983-02-01

    Radiation injury to the digestive tract was surgically treated in 22 cases. Six of them died shortly after surgery. Major symptoms were ileus or perforative peritonitis in 20 of the 22 cases, and surgery was performed for ileal lesion in 18 cases, indicating the significance of lesions in the small intestine. Seven patients underwent resection of the injured portion of the intestinal tract and anastomotic reconstruction in one stage, but 3 of them died from rupture of sutures. It was highly probable that anastomosis was made using an injured portion of the intestine. Intraoperative judgement of intestinal injury is made by palpation and inspection. If judgement is difficult, an artificial anus should be constructed first, and anastomotic reconstruction should be done in the 2nd stage. Since delayed injury of this disease is an ischemic change due to vascular obliteration, conservative therapy never leads to complete recovery, but active resection and anastomosis seem to produce a satisfactory result.

  9. Surgical managements of radiation enteritis

    International Nuclear Information System (INIS)

    Tanaka, Tsuguo; Naito, Kazuyo; Noomi, Shinppachiro; Kurioka, Hideaki; Yamagishi, Hisakazu

    1983-01-01

    Radiation injury to the digestive tract was surgically treated in 22 cases. Six of them died shortly after surgery. Major symptoms were ileus or perforative peritonitis in 20 of the 22 cases, and surgery was performed for ileal lesion in 18 cases, indicating the significance of lesions in the small intestine. Seven patients underwent resection of the injured portion of the intestinal tract and anastomotic reconstruction in one stage, but 3 of them died from rupture of sutures. It was highly probable that anastomosis was made using an injured portion of the intestine. Intraoperative judgement of intestinal injury is made by palpation and inspection. If judgement is difficult, an artificial anus should be constructed first, and anastomotic reconstruction should be done in the 2nd stage. Since delayed injury of this disease is an ischemic change due to vascular obliteration, conservative therapy never leads to complete recovery, but active resection and anastomosis seem to produce a satisfactory result. (Chiba, N.)

  10. Microelectromechanical acceleration-sensing apparatus

    Science.gov (United States)

    Lee, Robb M [Albuquerque, NM; Shul, Randy J [Albuquerque, NM; Polosky, Marc A [Albuquerque, NM; Hoke, Darren A [Albuquerque, NM; Vernon, George E [Rio Rancho, NM

    2006-12-12

    An acceleration-sensing apparatus is disclosed which includes a moveable shuttle (i.e. a suspended mass) and a latch for capturing and holding the shuttle when an acceleration event is sensed above a predetermined threshold level. The acceleration-sensing apparatus provides a switch closure upon sensing the acceleration event and remains latched in place thereafter. Examples of the acceleration-sensing apparatus are provided which are responsive to an acceleration component in a single direction (i.e. a single-sided device) or to two oppositely-directed acceleration components (i.e. a dual-sided device). A two-stage acceleration-sensing apparatus is also disclosed which can sense two acceleration events separated in time. The acceleration-sensing apparatus of the present invention has applications, for example, in an automotive airbag deployment system.

  11. 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.

  12. Suture-free technique for canine ureteral resection-anastomosis using a microvascular anastomotic system: a cadaveric study.

    Science.gov (United States)

    Wavreille, Vincent; Adin, Christopher A; Arango, Johnattan; Ham, Kathleen L; Byron, Julie K; McLoughlin, Mary A

    2015-01-01

    To describe a suture-free technique for canine ureteral resection-anastomosis using a microvascular anastomotic system (MAS) and to compare surgical time and burst pressure of hand-sewn (HS) ureteral end-to-end anastomosis with the MAS technique. Experimental ex vivo study. Canine cadavers (n = 8). For each cadaver, 1 ureter was randomly assigned to undergo HS anastomosis and the contralateral ureter had MAS anastomosis. The first 3 cadavers (6 ureters) were used to refine the MAS technique. In the other 5 dogs, surgical time and ureteral burst pressure were compared between groups (n = 5 ureters/group). Preliminary procedures showed that selective impaling of the mucosa and submucosa (without muscularis and adventitia) is necessary to allow complete mechanical interlock of the anastomotic rings for the MAS technique. Median anastomotic time was significantly shorter for MAS (7.6 min) than HS (16.6 min; p = .029) and burst pressure higher for MAS (393 cm H2 O) than HS (180 cm H2 O; p = .012). This study demonstrated the feasibility of a suture-free technique of canine ureteral resection-anastomosis using a commercially available MAS. The MAS anastomosis was faster and had higher burst strength compared with the HS anastomosis. © Copyright 2014 by The American College of Veterinary Surgeons.

  13. The Incidence and Topographic Distribution of Sutures Including Wormian Bones in Human Skulls.

    Science.gov (United States)

    Cirpan, Sibel; Aksu, Funda; Mas, Nuket

    2015-07-01

    The Wormian Bones are accessory bones located within the cranial sutures and fontanelles. The present article examines the incidence of Wormian Bones and compares the number and topographic distribution between the sutures including Wormian Bones in skulls of West Anatolian Population. One hundred fifty crania were examined. The parameters evaluated in the present study were as follows: the rate of skulls including Wormian Bones; the topographic distribution and frequencies of the sutures including Wormian Bones; the number of these sutures for each skull; the name and number of sutures that were bilaterally and symmetrically located on the right and left side of skull (paired sutures) and which coincidentally had Wormian Bones for each skull; the differences of frequencies between the paired sutures including Wormian Bones. The rate of skulls including Wormian Bones was determined as 59.3%. The maximum and minimum numbers of sutures, including Wormian Bones, were 6 in 1 skull and 1 in each of 30 skulls, respectively. The maximum and minimum rates of sutures that had Wormian Bones were found in left lambdoid 40.7% and right occipitomastoid 1.3% sutures, respectively. There was only a significant difference between the rate of right and left squamous sutures (P = 0.04). Forty-five skulls were including 55 pairs of bilaterally and symmetrically located sutures that coincidentally had Wormian Bones in each pair. Each of 35 skulls had 1 pair of sutures including Wormian Bones and each of 10 skulls had 2 pairs. In the present study, the rate of Wormian Bones was determined as 59.3% in West Anatolian Population. This incidence rate is considerably lower than the other reports, and it may be as a result of racial variations. These divergent bones were more frequently found in left lambdoid sutures (40.7%) and less frequently in right occipitomastoid sutures (1.3%). This study may guide the investigators dealing with the neurosurgery, orthopedy, radiology, anatomy, and

  14. Nuclear reactor control apparatus

    International Nuclear Information System (INIS)

    Sridhar, B.N.

    1983-01-01

    Nuclear reactor safety rod release apparatus comprises a ring which carries detents normally positioned in an annular recess in outer side of the rod, the ring being held against the lower end of a drive shaft by magnetic force exerted by a solenoid carried by the drive shaft. When the solenoid is de-energized, the detent-carrying ring drops until the detents contact a cam surface associated with the lower end of the drive shaft, at which point the detents are cammed out of the recess in the safety rod to release the rod from the drive shaft. In preferred embodiments of the invention, an additional latch is provided to release a lower portion of a safety rod under conditions that may interfere with movement of the entire rod

  15. Multichannel Thomson scattering apparatus

    International Nuclear Information System (INIS)

    Bretz, N.; Dimock, D.; Foote, V.; Johnson, D.; Long, D.; Tolnas, E.

    1977-07-01

    A Thomson scattering apparatus for measuring the electron temperature and density along a 90 cm diameter of the PLT plasma has been built. A wide angle objective images the 3 mm x 900 mm ruby laser beam onto an image dissector which rearranges the 300 : 1 image to 20 : 1 forming the input slit of a spectrometer. The stigmatic spectrometer provides 20 wavelength elements of approximately 70 A each. A micro-channel-plate image intensifier optically coupled to a cooled SIT tube provides detection with single frame linearity and 1000 : 1 dynamic range. Spatial profiles of N/sub e/ and T/sub e/ in the range 10 13 - 10 14 cm -3 and 0.05 - 3 keV have an accuracy of 30 √10 13 /N/sub e/ (cm -3 ) percent per 1.2 cm element

  16. Apparatus for stereotactic surgery

    International Nuclear Information System (INIS)

    Koslow, M.A.M.

    1982-01-01

    Apparatus for stereotactic surgery consisting of a probe and a computerized tomographic scanning system is described. The scanning system comprises a display and means for reconstructing cross-sectional images on the display using data from partial circumferential scans of source and detectors. It operates on the data with an algorithm that provides the difference between the local values of the linear attenuation coefficient and average of these values within a circle centered at each reconstruction point. The scanning system includes a means of maintaining the frames of reference of the probe and scanning system rigid with respect to one another. The position of the probe, which may be a cryogenic probe, with respect to the actual anatomical structure of the body, particularly a human head, may thus be viewed by the surgeon. (author)

  17. Radiation imaging apparatus

    International Nuclear Information System (INIS)

    Cooperstein, G.; Lanza, R.C.; Sohval, A.R.

    1980-01-01

    Radiation imaging apparatus especially suited for use in a computerized tomographic (CT) scanner is specified. It employs a fixed array of discrete X-ray sources, each being a cold cathode diode having an impedance in excess of about 100 ohms and an adjacent fixed array of closely packed radiation detectors to produce images of rapidly moving body organs such as the beating heart. The X-ray source is pulsed by a 120 to 130 kv pulse of 150 to 160 ns duration, derived from an unregulated DC source, of output voltage 15 to 30 kv. Each X-ray source may comprise a cold cathode pulse or may be constituted by a pair of annular cathodes having radially extending anodes therebetween. (author)

  18. Radiation measuring apparatus

    International Nuclear Information System (INIS)

    Schmid, C.J.

    1983-01-01

    A colorimeter in which a light source, a collimating lens and a band pass filter are supported by a housing that is movable with respect to a stationary beam dividing assembly in a direction at least substantially transverse to the optical axis of the light from the source. The assembly separates the incoming collimated and filtered light into a sample beam and a reference beam which are directed back toward the housing in directions parallel to the optical axis. The movement of the housing toward or away from the sample produces an increase or decrease in the intensity of the light illuminating the sample and a corresponding decrease or increase in the intensity of the light at the reference detector. The arrangement is such that the apparatus may be readily adjusted to obtain accurate colorimeter readings even for samples having abnormally high or low density characteristics

  19. Apparatus for extracting petroleum

    Energy Technology Data Exchange (ETDEWEB)

    Coogan, J

    1921-01-18

    An apparatus for extracting petroleum from petroleum bearing sand or shale is described comprising a container for liquids, the container being divided into a plurality of compartments, an agitator mounted within the container and below the liquid level and having its forward end opening into one of the compartments, means for delivering sand or shale to the forward end of the agitator, means for subjecting the sand or shale to the action of a solvent for the petroleum while the sand or shale is being agitated and is submerged, the first-mentioned compartment being adapted to receive the extracted petroleum and means for removing the treated sand or shale from adjacent the rear end of the agitator.

  20. Radiation shielding apparatus

    International Nuclear Information System (INIS)

    McCullagh, R.J.

    1977-01-01

    The disclosure pertains to a clamping apparatus having a stud capturing portion and a stud facing portion bolted together so as to compressively support a radiation-proof sheet material, such as lead sheeting, there-in-between. The interior wall covering material, such as panelling or wall board, is secured to the external surface of the stud facing portion. No nails are required to support the radiation-proof sheeting material, thereby minimizing accidental leakage due to harmful radiation passing through openings inadvertently disposed in the radiation-proof sheeting in the conventional nail securing supporting thereof. A pair of radiation-proof tracks capture the free ends of the stud capturing portion and the stud facing portion

  1. Radioactive waste treatment apparatus

    International Nuclear Information System (INIS)

    Abrams, R.F.; Chellis, J.G.

    1983-01-01

    Radioactive waste treatment apparatus is disclosed in which the waste is burned in a controlled combustion process, the ash residue from the combustion process is removed and buried, the gaseous effluent is treated in a scrubbing solution the pH of which is maintained constant by adding an alkaline compound to the solution while concurrently extracting a portion of the scrubbing solution, called the blowdown stream. The blowdown stream is fed to the incinerator where it is evaporated and the combustibles in the blowdown stream burned and the gaseous residue sent to the scrubbing solution. Gases left after the scrubbing process are treated to remove iodides and are filtered and passed into the atmosphere

  2. Capacitive gauging apparatus

    International Nuclear Information System (INIS)

    Walton, H.

    1985-01-01

    Apparatus for gauging physical dimensions of solid or tubular bodies (e.g. a nuclear fuel pellet) comprises a capacitive transducer having electrodes forming diametrically arranged pairs of capacitors and means for connecting the pairs, preferably sequentially, in an arm of a four arm electrical network. For circumferential scanning of a solid body along its length, the body is moved along a path of travel through head assembly including the transducer by means of plungers with the axis of the body being coincident with the axis of the transducer. As the body moves through the transducer the diametrically arranged pairs of capacitors scan the surface to result in a surface profile of the body. For scanning the bore of a pipe or tube the transducer is inserted as a probe and moved along the bore of the pipe or tube, means being provided for maintaining the probe coaxial with the pipe or tube. (author)

  3. Nuclear fusion apparatus

    International Nuclear Information System (INIS)

    Takizawa, Teruhiro.

    1975-01-01

    Object: To provide a nuclear fusion apparatus which can make a disorderly magnetic field due to shell current as small as possible, thereby enhancing efficiency. Structure: On each divided end of each shell is integrally projected an auxiliary shell which has thick greater than the other portion of shell. These auxiliary shells are made of a material of high electric conductivity, and the shape of the auxiliary shells may properly be selected so that electric resistance of the auxiliary shell at the divided end of the shell to the shell current may be made smaller than the electric resistance of intermediate of the shell to the shell current. With this, the shell current is concentrated on the auxiliary shell at the divided end of the shell to form an adjacent reciprocating current between it and the shell current opposite the auxiliary shell, thus reducing the disorderly magnetic field. (Yoshihara, H.)

  4. Reactor head shielding apparatus

    International Nuclear Information System (INIS)

    Schukei, G.E.; Roebelen, G.J.

    1992-01-01

    This patent describes a nuclear reactor head shielding apparatus for mounting on spaced reactor head lifting members radially inwardly of the head bolts. It comprises a frame of sections for mounting on the lifting members and extending around the top central area of the head, mounting means for so mounting the frame sections, including downwardly projecting members on the frame sections and complementary upwardly open recessed members for fastening to the lifting members for receiving the downwardly projecting members when the frame sections are lowered thereto with lead shielding supported thereby on means for hanging lead shielding on the frame to minimize radiation exposure or personnel working with the head bolts or in the vicinity thereof

  5. Foil changing apparatus

    International Nuclear Information System (INIS)

    Crist, C.E.; Ives, H.C.; Leifeste, G.T.; Miller, R.B.

    1988-01-01

    A self-contained foil changer apparatus for replenishing foil material across the path of a high energy particle beam is described comprising: a cylindrical hermetically sealed housing comprising an end plate having an aperture defining a beam passageway therethrough; foil supply means disposed inside the housing for storing a foil web and supporting a portion of the web across the beam passageway to form a plane perpendicular to the beam path; a barrel assembly disposed inside the housing; web control means extending through the housing and operably connected to the foil supply means for selectively advancing the foil web to replenish a portion across the beam passageway; and barrel control means extending through the housing and operably connected to the barrel assembly for selectively moving the barrel to and from the advanced and retracted positions

  6. Spine immobilization apparatus

    Science.gov (United States)

    Lambson, K. H.; Vykukal, H. C. (Inventor)

    1981-01-01

    The apparatus makes use of a normally flat, flexible bladder filled with beads or micro-balloons that form a rigid mass when the pressure within the bladder is decreased below ambient through the use of a suction pump so that the bladder can be conformed to the torso of the victim and provide the desired restraint. The bladder is strapped to the victim prior to being rigidified by an arrangement of straps which avoid the stomach area. The bladder is adapted to be secured to a rigid support, i.e., a rescue chair, so as to enable removal of a victim after the bladder has been made rigid. A double sealing connector is used to connect the bladder to the suction pump and a control valve is employed to vary the pressure within the bladder so as to soften and harden the bladder as desired.

  7. Apparatus for proton radiography

    International Nuclear Information System (INIS)

    Martin, R.L.

    1976-01-01

    An apparatus for effecting diagnostic proton radiography of patients in hospitals comprises a source of negative hydrogen ions, a synchrotron for accelerating the negative hydrogen ions to a predetermined energy, a plurality of stations for stripping extraction of a radiography beam of protons, means for sweeping the extracted beam to cover a target, and means for measuring the residual range, residual energy, or percentage transmission of protons that pass through the target. The combination of information identifying the position of the beam with information about particles traversing the subject and the back absorber is performed with the aid of a computer to provide a proton radiograph of the subject. In an alternate embodiment of the invention, a back absorber comprises a plurality of scintillators which are coupled to detectors. 10 claims, 7 drawing figures

  8. Radioactive gas solidification apparatus

    International Nuclear Information System (INIS)

    Kobayashi, Yoshihiro; Seki, Eiji; Yabu, Tomohiko; Matsunaga, Hiroyuki.

    1990-01-01

    Handling of a solidification container from the completion for the solidifying processing to the storage of radioactive gases by a remote control equipment such as a manipulator requires a great cost and is difficult to realize. In a radioactive gas solidification device for injection and solidification in accumulated layers of sputtered metals by glow discharge, radiation shieldings are disposed surrounding the entire container, and cooling water is supplied to a cooling vessel formed between the container and the shielding materials. The shielding materials are divided into upper and lower shielding materials, so that solidification container can be taken out from the shielding materials. As a result, the solidification container after the solidification of radioactive gases can be handled with ease. Further, after-heat can be removed effectively from the ion injection electrode upon solidifying treatment upon storage, to attain a radioactive gas solidifying processing apparatus which is safe, economical and highly reliable. (N.H.)

  9. Induction melter apparatus

    Science.gov (United States)

    Roach, Jay A [Idaho Falls, ID; Richardson, John G [Idaho Falls, ID; Raivo, Brian D [Idaho Falls, ID; Soelberg, Nicholas R [Idaho Falls, ID

    2008-06-17

    Apparatus and methods of operation are provided for a cold-crucible-induction melter for vitrifying waste wherein a single induction power supply may be used to effect a selected thermal distribution by independently energizing at least two inductors. Also, a bottom drain assembly may be heated by an inductor and may include an electrically resistive heater. The bottom drain assembly may be cooled to solidify molten material passing therethrough to prevent discharge of molten material therefrom. Configurations are provided wherein the induction flux skin depth substantially corresponds with the central longitudinal axis of the crucible. Further, the drain tube may be positioned within the induction flux skin depth in relation to material within the crucible or may be substantially aligned with a direction of flow of molten material within the crucible. An improved head design including four shells forming thermal radiation shields and at least two gas-cooled plenums is also disclosed.

  10. Sutura de menisco com implantes absorvíveis Meniscus suture with absorbable implants

    Directory of Open Access Journals (Sweden)

    Arnaldo José Hernandez

    2006-01-01

    Full Text Available Os autores avaliam clinicamente 19 pacientes (19 joelhos - 15 meniscos mediais e 5 laterais submetidos à sutura de menisco, utilizando 2 tipos de implantes absorvíveis (ácido polilático Arrow® e Clear fix®. O estudo compõe-se de 15 homens e 4 mulheres com idades entre 16 e 44 anos, com média de 26,8 anos. O tempo de seguimento médio foi de 24 meses, com mínimo de 18 e máximo de 32 meses. A técnica operatória constituiu-se da sutura de um ou ambos os meniscos (1 caso, via artroscópica com Arrow® em 15 pacientes e Clear fix® em 4. Dos 19 indivíduos, 6 foram submetidos à sutura meniscal isolada, 11 associada à reconstrução do LCA e 2 à reconstrução do LCA com osteotomia valgizante da tíbia. Os resultados foram avaliados segundo exame físico incluindo as manobras de Appley e Mc Murray. A avaliação funcional pré e pós-operatória do joelho foi realizada pela escala de Lysholm modificada. Todos os pacientes tiveram suas manobras meniscais negativadas no pós-operatório. A pontuação média pré-operatória segundo a escala de Lysholm foi de 39,8 subindo para 91,5 no pós-operatório. Os autores concluem que a sutura de menisco, utilizando implantes absorvíveis, tem se mostrado eficiente até o momento, e que tecnicamente ela é mais simples que a sutura convencional.The authors clinically assessed 19 patients (19 knees - 15 medial meniscus and 5 lateral meniscus submitted to meniscus suture using 2 kinds of absorbable implants (polylactic acid Arrow® and Clear fix®. The study is composed of 15 males and 4 females, ages ranging 16 - 44 years old (average = 26.8 years old. The mean follow-up time was 24 months, ranging from 18 to 32 months, at most. The surgical technique was constituted of a suture in one or both meniscus (1 case, through arthroscopy with Arrow® in 15 patients and Clear fix® in 4. From the 19 individuals, 6 were submitted to isolated meniscal suture, 11 combined to ACL reconstruction and 2 to ACL

  11. Locking plate fixation provides superior fixation of humerus split type greater tuberosity fractures than tension bands and double row suture bridges.

    Science.gov (United States)

    Gaudelli, Cinzia; Ménard, Jérémie; Mutch, Jennifer; Laflamme, G-Yves; Petit, Yvan; Rouleau, Dominique M

    2014-11-01

    This paper aims to determine the strongest fixation method for split type greater tuberosity fractures of the proximal humerus by testing and comparing three fixation methods: a tension band with No. 2 wire suture, a double-row suture bridge with suture anchors, and a manually contoured calcaneal locking plate. Each method was tested on eight porcine humeri. A osteotomy of the greater tuberosity was performed 50° to the humeral shaft and then fixed according to one of three methods. The humeri were then placed in a testing apparatus and tension was applied along the supraspinatus tendon using a thermoelectric cooling clamp. The load required to produce 3mm and 5mm of displacement, as well as complete failure, was recorded using an axial load cell. The average load required to produce 3mm and 5mm of displacement was 658N and 1112N for the locking plate, 199N and 247N for the double row, and 75N and 105N for the tension band. The difference between the three groups was significant (Prow (456N) and tension band (279N) (Prow (71N/mm) and tension band (33N/mm) (Pbiomechanical fixation for split type greater tuberosity fractures. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Surgical management of radiation enterocolitis

    International Nuclear Information System (INIS)

    Sakaguchi, Masahiro; Katsumi, Masaharu; Ishimoto, Kiwao; Yamamoto, Shinji; Yukawa, Hirofumi; Koh, Kenzo; Yamaguchi, Kazuya; Ohta, Masataka; Hayashido, Motonori

    1986-01-01

    Radiotherapy for malignant tumors is effective and established. However, there are many complications in radiotherapy. A typical complication is radiation enterocolitis. It is difficult to treat severe histological damage to the irradiated tissues. This paper reports our experience with 26 patients with radiation enterocolitis for whom surgical treatment was given during a period of 16 years in our surgical department. The most frequent original disease requiring irradiation was cancer of the cervix uteri (15 cases) which was followed by cancer of the urinary bladder (7 cases). All of these patients had received external 60 Co irradiation. The ileum was the most frequent site of the lesion, followed by the rectum, sigmoid and descending colon. The period between the end of irradiation and the onset of enterocolitis ranged from 2 months to 10 years, with an average of 28 months. The main symptoms were intestinal obstruction in the ileum, and melena and fistula in the rectum and sigmoid colon. Intestinal resection was performed in 10 patients, a bypass operation in 4, and colostomy in 12. As to types of intestinal suture in these cases, Gambee's single layer method was thought useful from our experience. Colostomy as surgical management of melena and fistula did not yield satisfactory results. (author)

  13. [Surgical tactics in duodenal trauma].

    Science.gov (United States)

    Ivanov, P A; Grishin, A V

    2004-01-01

    Results of surgical treatment of 61 patients with injuries of the duodenum are analyzed. The causes of injuries were stab-incised wounds in 24 patients, missile wound -- in 7, closed abdominal trauma -- in 26, trauma of the duodenum during endoscopic papillosphincterotomy -- in 4. All the patients underwent surgery. Complications were seen in 32 (52.5%) patients, 21 patients died, lethality was 34.4%. Within the first 24 hours since the trauma 7 patients died due to severe combined trauma, blood loss, 54 patients survived acute period of trauma, including 28 patients after open trauma, 26 -- after closed and 4 -- after trauma of the duodenum during endoscopic papillosphincterotomy. Diagnostic and surgical policies are discussed. Results of treatment depending on kind and time of surgery are regarded. It is demonstrated that purulent complications due to retroperitoneal phlegmona, traumatic pancreatitis, pneumonia are the causes of significant number of unfavorable outcomes. Therefore, it is important to adequately incise and drainage infected parts of retroperitoneal fat tissue with two-lumen drainages. Decompression through duodenal tube is the effective procedure for prophylaxis of suture insufficiency and traumatic pancreatitis. Suppression of pancreatic and duodenal secretion with octreotid improves significantly surgical treatment results.

  14. Virtual reality in surgical education.

    Science.gov (United States)

    Ota, D; Loftin, B; Saito, T; Lea, R; Keller, J

    1995-03-01

    Virtual reality (VR) is an emerging technology that can teach surgeons new procedures and can determine their level of competence before they operate on patients. Also VR allows the trainee to return to the same procedure or task several times later as a refresher course. Laparoscopic surgery is a new operative technique which requires the surgeon to observe the operation on a video-monitor and requires the acquisition of new skills. VR simulation could duplicate the operative field and thereby enhance training and reduce the need for expensive animal training models. Our preliminary experience has shown that we have the technology to model tissues and laparoscopic instruments and to develop in real time a VR learning environment for surgeons. Another basic need is to measure competence. Surgical training is an apprenticeship requiring close supervision and 5-7 years of training. Technical competence is judged by the mentor and has always been subjective. If VR surgical simulators are to play an important role in the future, quantitative measurement of competence would have to be part of the system. Because surgical competence is "vague" and is characterized by such terms as "too long, too short" or "too close, too far," it is possible that the principles of fuzzy logic could be used to measure competence in a VR surgical simulator. Because a surgical procedure consists of a series of tasks and each task is a series of steps, we will plan to create two important tasks in a VR simulator and validate their use. These tasks consist of laparoscopic knot tying and laparoscopic suturing. Our hypothesis is that VR in combination with fuzzy logic can educate surgeons and determine when they are competent to perform these procedures on patients.

  15. 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. © 2011 The Authors. Journal of Anatomy © 2011 Anatomical Society of Great Britain and Ireland.

  16. Technique of ‘suture less’ appendicectomy by laparoscopy in children: Preliminary communication

    Science.gov (United States)

    Bajpai, Minu

    2014-01-01

    Objective: Objective of this study is to present our experience by harmonic scalpel enabled, single external port appendicectomy using extracorporeally inserted ‘pick and fix’ stitch in three cases. Materials and Methods: Of the eighteen appendicectomies performed with only the use of harmonic scalpel in the last 11 months, the last three were performed using a single external port with the second port accessed under the subcutaneous tissues. The procedure consists of anchoring the mesoappendix to anterior abdominal wall by an extracorporeally inserted ‘pick and fix’ stitch followed by dissection and division of mesoappendix and appendix only with harmonic scalpel. Results: There were three patients, one female and two males aged 5, 7, and 11 years, respectively. Two were elective and one was emergency appendicectomy. Mean operating time was 30 min without any surgical complications. All patients are in follow-up with no complications. Conclusion: This study demonstrates the combined virtue of single external port, use of harmonic scalpel, and ‘pick and fix’ suture in laparoscopic appendicectomy in children. This approach avoids the use of an additional port as well as endosuture; and is safe, efficient, cost-effective, and is associated with reduced surgical time. PMID:24604981

  17. Technique of ′suture less′ appendicectomy by laparoscopy in children: Preliminary communication

    Directory of Open Access Journals (Sweden)

    Minu Bajpai

    2014-01-01

    Full Text Available Objective: Objective of this study is to present our experience by harmonic scalpel enabled, single external port appendicectomy using extracorporeally inserted ′pick and fix′ stitch in three cases. Materials and Methods: Of the eighteen appendicectomies performed with only the use of harmonic scalpel in the last 11 months, the last three were performed using a single external port with the second port accessed under the subcutaneous tissues. The procedure consists of anchoring the mesoappendix to anterior abdominal wall by an extracorporeally inserted ′pick and fix′ stitch followed by dissection and division of mesoappendix and appendix only with harmonic scalpel. Results: There were three patients, one female and two males aged 5, 7, and 11 years, respectively. Two were elective and one was emergency appendicectomy. Mean operating time was 30 min without any surgical complications. All patients are in follow-up with no complications. Conclusion: This study demonstrates the combined virtue of single external port, use of harmonic scalpel, and ′pick and fix′ suture in laparoscopic appendicectomy in children. This approach avoids the use of an additional port as well as endosuture; and is safe, efficient, cost-effective, and is associated with reduced surgical time.

  18. Technique of 'suture less' appendicectomy by laparoscopy in children: Preliminary communication.

    Science.gov (United States)

    Bajpai, Minu

    2014-01-01

    Objective of this study is to present our experience by harmonic scalpel enabled, single external port appendicectomy using extracorporeally inserted 'pick and fix' stitch in three cases. Of the eighteen appendicectomies performed with only the use of harmonic scalpel in the last 11 months, the last three were performed using a single external port with the second port accessed under the subcutaneous tissues. The procedure consists of anchoring the mesoappendix to anterior abdominal wall by an extracorporeally inserted 'pick and fix' stitch followed by dissection and division of mesoappendix and appendix only with harmonic scalpel. There were three patients, one female and two males aged 5, 7, and 11 years, respectively. Two were elective and one was emergency appendicectomy. Mean operating time was 30 min without any surgical complications. All patients are in follow-up with no complications. This study demonstrates the combined virtue of single external port, use of harmonic scalpel, and 'pick and fix' suture in laparoscopic appendicectomy in children. This approach avoids the use of an additional port as well as endosuture; and is safe, efficient, cost-effective, and is associated with reduced surgical time.

  19. Arthroscopic Suture Anchor Fixation of Bony Bankart Lesions: Clinical Outcome, Magnetic Resonance Imaging Results, and Return to Sports.

    Science.gov (United States)

    Plath, Johannes E; Feucht, Matthias J; Bangoj, Robert; Martetschläger, Frank; Wörtler, Klaus; Seppel, Gernot; Aboalata, Mohamed; Tischer, Thomas; Imhoff, Andreas B; Vogt, Stephan

    2015-08-01

    remaining glenoid defect size averaged 6.8% ± 7.3%. Full-thickness cartilage defects of the anterior glenoid were detected in 70% of patients. Arthroscopic suture anchor repair may enable an anatomic reduction of bony Bankart lesions with no or only minimal articular steps and provides successful midterm outcomes concerning clinical scores, recurrence, and patient satisfaction. The return to activity is limited for various, mostly non-shoulder-related causes. Chronic lesions may have an inferior healing potential; therefore early surgical stabilization of acute Bankart fragments is suggested to avoid possible nonunion. Level IV, therapeutic case series. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  20. 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

  1. Visual acuity after trans-scleral sutured posterior chamber intraocular lens

    International Nuclear Information System (INIS)

    Mahmood, S.A.; Zafar, S.

    2014-01-01

    To determine the changes in visual acuity in patients undergoing Trans-Scleral Sutured Posterior Chamber Intra-Ocular Lens (TSSPCIOL) implantation at a tertiary care hospital in Karachi, Pakistan. Study Design: Case series. Place and Duration of Study: LRBT Tertiary Eye Hospital, Karachi, from January 2006 to December 2010. Methodology: Records of all patients undergoing implantation of TSSPCIOL were reviewed. Patients with diagnosed glaucoma, diabetic retinopathy, macular degeneration, history of recurrent uveitis, corneal haze or central corneal scars were excluded. For the final analysis, 70 eyes out of a total of 75 were selected. Main outcomes of interest were pre and postoperative visual acuities and surgical complications. SPSS 21 was used for data analysis. Results: Pre-operatively, the average Best Spectacle-Corrected Visual Acuity (BSCVA) was 6/36 on the Snellen chart. This improved to 6/12 postoperatively. The mean improvement seen was 2.4 lines on the Snellen chart (p < 0.05). Complications include transient intraocular pressure elevation in 25 eyes (36%), IOL tilt in 4 eyes (7.1%), Cystoid Macular Edema (CME) in 4 eyes (5.7%), vitreous haemorrhage in 2 eyes (2.9%), hyphema in 2 eyes (2.9%), uveitis in 1 eye (1.4%), and retinal detachment 1 eye (1.4%). No IOL subluxation, suture erosion, iris capture, choroidal effusion or endophthalmitis was encountered and no re-operations were needed. Conclusion: TSSPCIOLs are a good management option for patients with aphakia in whom PC IOLs cannot be placed. (author)

  2. Use of an Automated Suture Fastening Device in Minimally Invasive Aortic Valve Replacement.

    Science.gov (United States)

    Beute, Tyler J; Orem, Matthew D; Schiller, Timothy M; Goehler, Matthew; Parker, Jessica; Willekes, Charles L; Timek, Tomasz

    2018-03-01

    Minimally invasive aortic valve replacement (mAVR) is gaining clinical acceptance, however, it is associated with increased operative times due to limited surgical field and access. The Cor-Knot is an automated fastening device designed to facilitate suture fastening, but clinical data in mAVR are lacking. From May 2014 to February 2017, 92 patients underwent mAVR at our center with 39 valves secured with manually-tied (MT) sutures and 53 valves entirely secured with the Cor-Knot (CK). Pre-operative characteristics and 30-day outcomes data were extracted from our local Society of Thoracic Surgeons database and the electronic medical record. Survival data were obtained from the Michigan State Social Security Death Index. No significant difference in pre-operative characteristics were noted between the two groups. Aortic cross-clamp time (72±12 min vs 82±15 min, p=0.001) was significantly shorter with CK. There was no difference in post-operative mortality (0% vs 0%), stroke (0% vs 1.9%), atrial fibrillation (28% vs 33%), renal failure (0% vs 3.8%), or pacemaker implantation (5.1% vs 5.7%) between MT and CK. Valve function on post-operative echocardiography and 1-year patient survival were similar. In minimally invasive aortic valve replacement, the Cor-Knot device was associated with reduced aortic cross-clamp time while providing equivalent clinical outcomes. Larger studies are needed to confirm efficacy, safety, and cost-effectiveness of the Cor-Knot device in minimally invasive aortic valve surgery. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Estudo sobre a eficácia da aerostasia pulmonar, em modelo animal, utilizando diferentes tipos de suturas Study about the ability of the pulmonary aerostasia, in animal model, using differents parenchymal pulmonary types of the sutures

    Directory of Open Access Journals (Sweden)

    Darcy Ribeiro Pinto Filho

    2003-10-01

    Full Text Available INTRODUÇÃO: A busca de um modelo perfeito de aerostasia pulmonar, após cirurgias que envolvam ressecções parciais, permanece um desafio para a prática da cirurgia torácica. OBJETIVO: Avaliar e comparar, em um modelo animal (suínos, a eficácia de quatro diferentes tipos de sutura pulmonar em manter aerostasia. MÉTODO: Estudo experimental, ex vivo, em pulmões de suínos, realizado no biotério da Universidade de Caxias do Sul. Quatro tipos de sutura pulmonares foram avaliadas: tipo 1, sutura manual com fios cirúrgicos absorvíveis; tipo 2, grampeador exclusivo; tipo 3, grampeador recoberto por pericárdio bovino e tipo 4, grampeador recoberto por cola biológica. As suturas foram submetidas a níveis crescentes de pressão, que variaram de 10cmH2O a 60cmH2O. O teste do borracheiro avaliou o hermetismo das suturas. RESULTADOS: A média de pressão em que se observou perda do hermetismo pulmonar foi de 29cmH2O no tipo 1 (n = 10; 38,5cmH2O no tipo 2 (n = 10; 44cmH2O no tipo 3 (n = 10 e 51,4cmH2O no tipo 4 (n = 10. A comparação entre as médias mostrou diferença estatística apenas entre as suturas tipo 1 e as suturas tipo 3 e 4, p = 0,04 e p BACKGROUND: The search for an ideal procedure to accomplish aerostasis, after partial surgical resection of the lung parenchyma, remains a practical challenge for the thoracic surgeon. OBJECTIVE: The objective of this study was to compare the ability of four types of parenchymal pulmonary sutures in preventing air leaks, using a porcine model with incremental endobronchial pressures. METHOD: Ex vivo experimental study in porcine lungs (n = 5 at the Laboratory of Experimental Surgery of the Universidade de Caxias do Sul. Four different parenchymal pulmonary types of suture were analyzed: type 1 (absorbable suture, type 2: (stapled suture, type 3 (stapled suture with bovine pericardium and type 4 (stapled suture with biologic glue. The surgical sutures (n = 40 were exposed to different intrabronchial

  4. Analysis the prospects of use of mobile X-ray diagnostic apparatus of the C-arm type

    International Nuclear Information System (INIS)

    Blinov, N.N.; Mazurov, A.I.

    2000-01-01

    The efficiency of using the mobile X-ray apparatus with the C-arm multi-positional support, equipped with a medium-frequency generator and roentgen image amplifier with a digital channel, and device for obtaining hard copies in the diagnostic, surgical and therapeutic practice, is shown and the basis requirements, imposed in various areas on the apparatus of this type (traumatology, orthopedics, hospital wards studies, X-ray endoscopy, X-ray operational units, intervention roentgenology, angiography), are formulated. The technical characteristics are presented and the operation of the national surgical mobile apparatus RTS-612 is described. The experience in the apparatus operation showed, that x-ray surgical complexes, meeting the requirements of the modern public health in the area of traumatology, orthopedics, cardiosurgery, endoscopy, urology and other areas, wherein the X-ray control during the operation is accomplished, may be created on its basis [ru

  5. New developments for the surgical treatment of shoulder problems

    International Nuclear Information System (INIS)

    Anderl, W.

    2004-01-01

    Tremendous advancement has been made in the surgical treatment of the shoulder within the last years. Arthroscopic techniques for treatment of rotator cuff lesions, instability problems and biceps tendon lesions are today established because of significant improvement of instruments, suture materials and anchor techniques. The 4th generation of shoulder prosthesis systems guarantee today anatomical and biomechanical advantages with significant functional improvement for the patient. (orig.) [de

  6. Efficacy of b-lynch brace suture in postpartum haemorrhage

    International Nuclear Information System (INIS)

    Tarique, S.; Wazir, S.; Moeen, G.

    2011-01-01

    Massive uncontrolled haemorrhage after childbirth is the leading cause of maternal death in developing countries. Postpartum haemorrhage is traditionally defined as blood loss of more than 500 ml after vaginal delivery and more than 1000 ml after caesarean section, but intraoperative estimation of blood loss is inaccurate. Uterine atony alone accounts for 75 - 90% of PPH. To estimate the effectiveness and safety of B-Lynch brace Suture in the management of primary postpartum haemorrhage (PPH). (author)

  7. Subgaleal Retention Sutures: Internal Pressure Dressing Technique for Dolenc Approach.

    Science.gov (United States)

    Burrows, Anthony M; Rayan, Tarek; Van Gompel, Jamie J

    2017-08-01

    Extradural approach to the cavernous sinus, the "Dolenc" approach recognizing its developing Dr. Vinko Dolenc, is a critically important skull base approach. However, resection of the lateral wall of the cavernous sinus, most commonly for cavernous sinus meningiomas, results commonly in a defect that often cannot be reconstructed in a water-tight fashion. This may result in troublesome pseudomeningocele postoperatively. To describe a technique designed to mitigate the development of pseudomeningocele. We found the Dolenc approach critical for resection of cavernous lesions. However, a number of pseudomeningoceles were managed with prolonged external pressure wrapping in the early cohort. Therefore, we incorporated subgaleal to muscular sutures, which were designed to close this potential space and retrospectively analyzed our results. Twenty-one patients treated with a Dolenc approach and resection of the lateral wall of the cavernous sinus over a 2-year period were included. Prior to incorporation of this technique, 12 patients were treated and 3 (25%) experienced postoperative pseudomeningoceles requiring multiple clinic visits and frequent dressing. After incorporation of subgaleal retention sutures, no patient (0%) experienced this complication. Although basic, subgaleal to temporalis muscle retention sutures likely aid in eliminating this potential dead space, thereby preventing patient distress postoperatively. This technique is simple and further emphasizes the importance of dead space elimination in complex closures. Copyright © 2017 by the Congress of Neurological Surgeons

  8. Traction suture modification to tongue-in-groove caudal septoplasty.

    Science.gov (United States)

    Indeyeva, Y A; Lee, T S; Gordin, E; Chan, D; Ducic, Y

    2018-02-01

    Caudal septal deviation leads to unfavorable esthetic as well as functional effects on the nasal airway. A modification to the tongue-in-groove (TIG) technique to correct these caudal septal deformities is described. With placement of a temporary suspension suture to the caudal septum, manual traction is applied, assuring that the caudal septum remains in the midline position while it is being secured with multiple through-and-through, trans-columellar and trans-septal sutures. From 2003 to 2016, 148 patients underwent endonasal septoplasty using this modified technique, with excellent functional and cosmetic outcomes and a revision rate of 1.4%. This modified TIG technique replaces the periosteal suture that secures the caudal septum to the midline nasal crest in the original TIG technique. This simplifies the procedure and minimizes the risk of securing the caudal septum off-midline when used in endonasal septoplasty. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. Submersible energy storage apparatus

    International Nuclear Information System (INIS)

    Mccartney, J.F.; Rowe, R.A.

    1980-01-01

    A submersible energy storage apparatus for an electrical power source is provided which includes an electrolysis unit feed water gas collection assembly and a fuel cell. The electrolysis unit feed water gas collection assembly includes a hydrogen container and an oxygen container wherein each container has a gas outlet and is capable of containing feed water as well as hydrogen and oxygen gases respectively. An electrolysis cell is provided which has a hydrogen outlet, an oxygen outlet and a feed water inlet. The hydrogen outlet is located in the hydrogen container, the oxygen outlet is located in the oxygen container, and the feed water inlet is located in one of the containers. Each of the containers has an opening to the submersible environment so as to be pressure responsive thereto. A barrier device is provided in association with the opening in each container for isolating the feed water in the container from water in the submersible environment. The fuel cell is operatively connected to the hydrogen and oxygen containers, and the electrical power source is operatively connected to the electrolysis cell. With this arrangement the electrolysis cell is capable of utilizing power from the power source during low electrical energy demand, and the fuel cell is capable of utilizing the hydrogen and oxygen gases for generating electricity during high demand periods

  10. Belt conveyor apparatus

    Science.gov (United States)

    Oakley, David J.; Bogart, Rex L.

    1987-01-01

    A belt conveyor apparatus according to this invention defines a conveyance path including a first pulley and at least a second pulley. An endless belt member is adapted for continuous travel about the pulleys and comprises a lower portion which engages the pulleys and an integral upper portion adapted to receive objects therein at a first location on said conveyance path and transport the objects to a second location for discharge. The upper belt portion includes an opposed pair of longitudinally disposed crest-like members, biased towards each other in a substantially abutting relationship. The crest-like members define therebetween a continuous, normally biased closed, channel along the upper belt portion. Means are disposed at the first and second locations and operatively associated with the belt member for urging the normally biased together crest-like members apart in order to provide access to the continuous channel whereby objects can be received into, or discharged from the channel. Motors are in communication with the conveyance path for effecting the travel of the endless belt member about the conveyance path. The conveyance path can be configured to include travel through two or more elevations and one or more directional changes in order to convey objects above, below and/or around existing structures.

  11. Nuclear fusion apparatus

    International Nuclear Information System (INIS)

    Nagata, Daizaburo; Yamada, Masao.

    1974-01-01

    Object: To provide a nuclear fusion apparatus in which a magnetic limiter is disposed within a vacuum vessel, said magnetic limiter being supported in such a manner so as to not to exert mechanical action upon said vacuum vessel, thereby minimizing a force applied to the vacuum vessel to easily manufacture the vacuum vessel. Structure: The magnetic limiter disposed within the vacuum vessel is connected to one end of a supporting post which extends through the wall of the vacuum vessel through a seal portion, the other end of the supporting post being secured to a structure such as a house outside the vacuum vessel. The seal portion comprises a bellows of high spring elasticity mounted on the vacuum vessel and a seal element comprised of an electric insulator such as ceramic for connecting the bellows to the supporting post, the supporting post extending through the wall of the vacuum vessel in vacuum-tight fashion, the force applied to the magnetic limiter exerting no influence upon the vacuum vessel. (Kamimura, M.)

  12. Computed tomography apparatus

    International Nuclear Information System (INIS)

    Fairbairn, I.A.

    1984-01-01

    In fan-beam computed tomography apparatus, timing reference pulses, normally occurring at intervals t, for data transfer and reset of approx. 500 integrators in the signal path from the detector array, are generated from the scan displacement, e.g. using a graticule and optical sensor to relate the measurement paths geometrically to the body section. Sometimes, a slow scan rate is required to provide a time-averaged density image, e.g. for planning irradiation therapy, and then the sensed impulses will occur at extended intervals and can cause integrator overload. An improvement is described which provides a pulse generator which responds to a reduced scan rate by generating a succession of further transfer and reset pulses at intervals approximately equal to t starting a time t after each timing reference pulse. Then, using an adding device and RAM, all the transferred signals integrated in the interval t' between two successive slow scan reference pulses are accumulated in order to form a corresponding measurement signal. (author)

  13. Apparatus for diffusion separation

    International Nuclear Information System (INIS)

    Nierenberg, W.A.

    1976-01-01

    A diffuser separator apparatus is described which comprises a plurality of flow channels in a single stage. Each of said channels has an inlet port and an outlet port and a constant cross sectional area between said ports. At least a portion of the defining surface of each of said channels is a diffusion separation membrane, and each of said channels is a different cross sectional area. Means are provided for connecting said channels in series so that each successive channel of said series has a smaller cross sectional area than the previous channel of said series. Also provided are a source of gaseous mixture, individual means for flowing said gaseous mixture to the inlet port of each of said channels, gas receiving and analyzing means, individual means for flowing gas passing from each of said outlet ports and means for flowing gas passing through said membranes to said receiving and analyzing means, and individual means for connecting the outlet port of each channel with the inlet port of the channel having the next smaller cross sectional area

  14. Plastic waste disposal apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Kito, S

    1972-05-01

    A test plant plastic incinerator was constructed by the Takuma Boiler Manufacturing Co. for Sekisui Chemical Industries, and the use of a continuous feed spreader was found to be most effective for prevention of black smoke, and the use of a venturi scrubber proved to be effective for elimination of hydrogen chloride gas. The incinerator was designed for combustion of polyvinyl chloride exclusively, but it is also applicable for combustion of other plastics. When burning polyethylene, polypropylene, or polystyrene, (those plastics which do not produce toxic gases), the incinerator requires no scrubber for the combustion gas. The system may or may not have a pretreatment apparatus. For an incinerator with a pretreatment system, the flow chart comprises a pit, a supply crane, a vibration feeder, a metal eliminator, a rotation shredder, a continuous screw feeder with a quantitative supply hopper, a pretreatment chamber (300 C dry distillation), a quantitative supply hopper, and the incinerator. The incinerator is a flat non-grid type combustion chamber with an oil burner and many air nozzles. From the incinerator, ashes are sent by an ash conveyor to an ash bunker. The combustion gas goes to the boiler, and the water supplied the boiler water pump creates steam. The heat from the gas is sent back to the pretreatment system through a heat exchanger. The gas then goes to a venturi scrubber and goes out from a stack.

  15. Radiographic examination apparatus

    International Nuclear Information System (INIS)

    Beetham, S.; Hogg, J.

    1983-01-01

    Tube examination apparatus has a head actuated by fluid pressure, for centralising a radioactive source. Preferably the source is shielded during transport from its storage unit to the head. A body attached to a drive-wire has hollow shield-parts which define a radiation window therebetween, and closure shield-parts which have the source located therebetween and which are a sliding fit. A spring biases the closure shields towards a first position relative to the body in which the source is enclosed. When the body moves along a guide in the head, the closure shield engages an abutment surface which arrests the closure shields. Further movement of the body to engage an abutment surface causes relative movement between the shield parts to a second position relative to the body in which the source is exposed at the window. Retraction of the body along the guide allows the spring to restore the closure shield parts to the first position. (U.K.)

  16. Sample-taking apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Tanov, Y I; Ismailov, R A; Orazov, A

    1980-10-07

    The invention refers to the equipment for testing water-bearing levels in loose rocks. Its purpose is to simultaneously remove with the rock sample a separate fluid sample from the assigned interval. The sample-taking apparatus contains a core lifter which can be submerged into the casting string with housing and front endpiece in the form of a rod with a piston which covers the cavity of the core lifter, as well as mechanism for fixing and moving the endpiece within the core lifter cavity. The device differs from the known similar devices because the upper part of the housing of the core lifter is equipped with a filter and mobile casting which covers the filter. In this case the casing is connected to the endpiece rod and the endpiece is installed with the possibility of movement which is limited with fixing in the upper position and in the extreme upper position it divides the core lifter cavity into two parts, filter settling tank and core-receiving cavity.

  17. Medical radiographic apparatus

    International Nuclear Information System (INIS)

    Fetter, R.W.

    1980-01-01

    An invention is described which relates to computer-assisted tomography. The apparatus provides for investigating a cross-section slice of a patient's body and includes a source of fan-shaped distribution of penetrating radiation and a means for locating the source, in relation to the patient's body so that the radiation is directed towards a slice of the body. The source can be rotated about the patient's body and radiation detected by a number of detectors situated in an arc around the body. The number, and thus the cost, of detectors can be reduced by putting the ring of detectors between the x-ray source and the patient's body. This presents a problem in that if the detectors are on the same side of the body as the source and if no steps are taken to the contrary, the detectors will interupt the radiation so that it does not pass through the patient's body. This invention overcomes that problem. (OT)

  18. Controlled nuclear fusion apparatus

    International Nuclear Information System (INIS)

    Bussard, R.W.; Coppi, B.

    1982-01-01

    A fusion power generating device is disclosed having a relatively small and inexpensive core region which may be contained within an energy absorbing blanket region. The fusion power core region contains apparatus of the toroidal type for confining a high density plasma. The fusion power core is removable from the blanket region and may be disposed and/or recycled for subsequent use within the same blanket region. Thermonuclear ignition of the plasma is obtained by feeding neutral fusible gas into the plasma in a controlled manner such that charged particle heating produced by the fusion reaction is utilized to bootstrap the device to a region of high temperatures and high densities wherein charged particle heating is sufficient to overcome radiation and thermal conductivity losses. The high density plasma produces a large radiation and particle flux on the first wall of the plasma core region thereby necessitating replacement of the core from the blanket region from time to time. A series of potentially disposable and replaceable central core regions are disclosed for a large-scale economical electrical power generating plant

  19. Surgical competence.

    Science.gov (United States)

    Patil, Nivritti G; Cheng, Stephen W K; Wong, John

    2003-08-01

    Recent high-profile cases have heightened the need for a formal structure to monitor achievement and maintenance of surgical competence. Logbooks, morbidity and mortality meetings, videos and direct observation of operations using a checklist, motion analysis devices, and virtual reality simulators are effective tools for teaching and evaluating surgical skills. As the operating theater is also a place for training, there must be protocols and guidelines, including mandatory standards for supervision, to ensure that patient care is not compromised. Patients appreciate frank communication and honesty from surgeons regarding their expertise and level of competence. To ensure that surgical competence is maintained and keeps pace with technologic advances, professional registration bodies have been promoting programs for recertification. They evaluate performance in practice, professional standing, and commitment to ongoing education.

  20. Radioactive waste material melter apparatus

    Science.gov (United States)

    Newman, D.F.; Ross, W.A.

    1990-04-24

    An apparatus for preparing metallic radioactive waste material for storage is disclosed. The radioactive waste material is placed in a radiation shielded enclosure. The waste material is then melted with a plasma torch and cast into a plurality of successive horizontal layers in a mold to form a radioactive ingot in the shape of a spent nuclear fuel rod storage canister. The apparatus comprises a radiation shielded enclosure having an opening adapted for receiving a conventional transfer cask within which radioactive waste material is transferred to the apparatus. A plasma torch is mounted within the enclosure. A mold is also received within the enclosure for receiving the melted waste material and cooling it to form an ingot. The enclosure is preferably constructed in at least two parts to enable easy transport of the apparatus from one nuclear site to another. 8 figs.

  1. Radiographic film cassette unloading apparatus

    International Nuclear Information System (INIS)

    Stievenart, E.F.; Plessers, H.S.; Neujens, G.J.

    1980-01-01

    Apparatus for unloading cassettes, containing exposed radiographic films, has means for unfastening the cassettes, an inclined pathway for gravity feeding and rotating feed members (rollers or belts) to propel the films into the processor. (UK)

  2. INFLATE: INFlate Landing Apparatus Technology

    Science.gov (United States)

    Koryanov, V. V. K.; Da-Poian, V. D. P.

    2018-02-01

    Our project, named INFLATE (INFlatable Landing Apparatus Technology), aims at reducing space landing risks and constraints and so optimizing space missions (reducing cost, mass, and risk and in the same time improving performance).

  3. Tandem mirror plasma confinement apparatus

    International Nuclear Information System (INIS)

    Fowler, T.K.

    1978-01-01

    Apparatus and method are described for confining a plasma in a center mirror cell by use of two end mirror cells as positively charged end stoppers to minimize leakage of positive particles from the ends of the center mirror cell

  4. Tandem mirror plasma confinement apparatus

    Science.gov (United States)

    Fowler, T. Kenneth

    1978-11-14

    Apparatus and method for confining a plasma in a center mirror cell by use of two end mirror cells as positively charged end stoppers to minimize leakage of positive particles from the ends of the center mirror cell.

  5. Radioactive waste material melter apparatus

    International Nuclear Information System (INIS)

    Newman, D.F.; Ross, W.A.

    1990-01-01

    An apparatus for preparing metallic radioactive waste material for storage is disclosed. The radioactive waste material is placed in a radiation shielded enclosure. The waste material is then melted with a plasma torch and cast into a plurality of successive horizontal layers in a mold to form a radioactive ingot in the shape of a spent nuclear fuel rod storage canister. The apparatus comprises a radiation shielded enclosure having an opening adapted for receiving a conventional transfer cask within which radioactive waste material is transferred to the apparatus. A plasma torch is mounted within the enclosure. A mold is also received within the enclosure for receiving the melted waste material and cooling it to form an ingot. The enclosure is preferably constructed in at least two parts to enable easy transport of the apparatus from one nuclear site to another. 8 figs

  6. Apparatus for washing out halogens

    Energy Technology Data Exchange (ETDEWEB)

    Pier, M; Hahn, J; Kroenig, W

    1941-03-26

    An apparatus is described for washing out of halogens and the like or liquid halogen compounds from the products, which are formed on pressure hydrogenation or splitting of carbon-containing material in the presence of halogens or halogen compounds, consisting of a washing apparatus installed between the reaction vessel and the hot separator, which is inclined in relatively small space for steam regulation and contains, with the steam, arranged baffles, especially spirals.

  7. Optimal suture anchor direction in arthroscopic lateral ankle ligament repair.

    Science.gov (United States)

    Yoshimura, Ichiro; Hagio, Tomonobu; Noda, Masahiro; Kanazawa, Kazuki; Minokawa, So; Yamamoto, Takuaki

    2017-05-26

    In this study, the distance between the insertion point of the suture anchors and posterior surface of the fibula during arthroscopic lateral ankle ligament repair was investigated on computed tomography (CT) images. The hypothesis of this study was that there is an optimal insertional direction of the suture anchor to avoid anchor-related complications. One hundred eleven ankles of 98 patients who had undergone three-dimensional CT scans for foot or ankle disorders without deformity of the fibula were assessed (59 males, 52 females; median age 25.5 years; age range 12-78 years). The shortest distance from the insertion point of the suture anchor to the deepest point of the fossa/top of the convex aspect of the fibula was measured on the axial plane, tilting from the longitudinal axis of the fibula at 90°, 75°, 60°, and 45°. The distance from the insertion point of the suture anchor to the posterior surface of the fibula was also measured in a direction parallel to the sagittal plane of the lateral surface of the talus on the axial plane, tilting from the longitudinal axis of the fibula at 90°, 75°, 60°, and 45°. The posterior fossa was observed in all cases on the 90° and 75° images. The distance from the insertion point to the posterior surface of the fibula in the parallel direction was 15.0 ± 3.4 mm at 90°, 17.5 ± 3.2 mm at 75°, 21.7 ± 3.3 mm at 60°, and 25.7 ± 3.6 mm at 45°. The posterior points in the parallel direction were located on the posterior fossa in 36.0% of cases at 90°, in 12.6% at 75°, and in 0.0% at 60° and 45°. The suture anchor should be directed from anterior to posterior at an angle of <45° to the longitudinal axis of the fibula, parallel to the lateral surface of the talus, to avoid passing through the fibula. Cohort study, Level III.

  8. Laser tissue welding in genitourinary reconstructive surgery: assessment of optimal suture materials.

    Science.gov (United States)

    Poppas, D P; Klioze, S D; Uzzo, R G; Schlossberg, S M

    1995-02-01

    Laser tissue welding in genitourinary reconstructive surgery has been shown in animal models to decrease operative time, improve healing, and decrease postoperative fistula formation when compared with conventional suture controls. Although the absence of suture material is the ultimate goal, this has not been shown to be practical with current technology for larger repairs. Therefore, suture-assisted laser tissue welding will likely be performed. This study sought to determine the optimal suture to be used during laser welding. The integrity of various organic and synthetic sutures exposed to laser irradiation were analyzed. Sutures studied included gut, clear Vicryl, clear polydioxanone suture (PDS), and violet PDS. Sutures were irradiated with a potassium titanyl phosphate (KTP)-532 laser or an 808-nm diode laser with and without the addition of a light-absorbing chromophore (fluorescein or indocyanine green, respectively). A remote temperature-sensing device obtained real-time surface temperatures during lasing. The average temperature, time, and total energy at break point were recorded. Overall, gut suture achieved significantly higher temperatures and withstood higher average energy delivery at break point with both the KTP-532 and the 808-nm diode lasers compared with all other groups (P welding appears to be between 60 degrees and 80 degrees C. Gut suture offers the greatest margin of error for KTP and 808-nm diode laser welding with or without the use of a chromophore.

  9. Evaluation of a novel suture material for closure of intestinal anastomoses in canine cadavers.

    Science.gov (United States)

    Hansen, Lane A; Monnet, Eric L

    2012-11-01

    To compare leakage and maximum intraluminal pressures for a novel suture material with pressures for comparable suture material when used in closure of intestinal anastomoses in canine cadavers. Healthy intestines from cadavers of dogs euthanized for reasons unrelated to the study. 18 anastomoses were performed on intestinal sections within 72 hours after dogs were euthanized and intestinal samples collected. Anastomoses were performed with a simple continuous suture pattern. Leakage and maximum intraluminal pressures were measured and recorded for 6 control segments and 18 anastomosed sections. A barbed glycomer 631 suture (size 4-0 United States Pharmacopeia [USP]) was compared with glycomer 631 sutures (sizes 3-0 and 4-0 USP). Results for leakage and maximum intraluminal pressures were compared via an ANOVA. The barbed glycomer 631 suture material leaked at a significantly higher pressure than did the comparable glycomer 631 suture materials. Maximum intraluminal pressures were not significantly different among the suture materials. Barbed glycomer 631 4-0 USP suture material was as effective as glycomer 631 suture materials and may be a safe alternative for use in closure of enterectomies in dogs.

  10. Skull morphometry and vault sutures of Myrmecophaga tridactyla and Tamandua tetradactyla

    Directory of Open Access Journals (Sweden)

    Camila M. de S. Hossotani

    2017-10-01

    Full Text Available ABSTRACT This study aimed to examine the relationship between skull size and the level of cranial vault suture closure. A total of 50 Myrmecophaga tridactyla Linnaeus, 1758 and 178 Tamandua tetradactyla Linnaeus, 1758 skulls were analyzed in relation to 18 skull dimensions. The skulls were grouped into three levels of suture closure: no sutures closed (level 0, one or all the fallowing sutures closed: interfrontalis, sagitalis and coronalis (level 1 and all sutures closed (level 2. The results indicated that among the 18 variables measured, 17 showed significant differences (p ≤ 0.01 between level 0 and level 1 skulls of T. tetradactyla; as well as between level 0 and level 1, and level 0 and level 2 skulls of M. tridactyla. M. tridactyla level 1 and level 2 had no significant difference among any of the 18 dimensions. The foramen magnum height in both species showed no significant difference (p > 0.05 among any suture categories. In principle, suture closure level and cranial dimensions are related. The specimens with larger cranial dimensions showed greater number of cranial vault sutures closed for both species of anteaters. Tamandua tetradactyla and M. tridactyla specimens with none of the cranial vault suture closed have a foramen magnum height similar to those with cranial vault suture closed.

  11. A modified surgical technique for reconstruction of an acute acromioclavicular joint dislocation

    Science.gov (United States)

    Marchie, Anthony; Kumar, Arun; Catre, Melanio

    2009-01-01

    We report a modified surgical technique for reconstruction of coracoclavicular and acromioclavicular ligaments after acute dislocation of acromioclavicular joint using suture anchors. We have repaired 3 consecutive type III acromioclavicular dislocations with good results. This technique is simple and safe and allows anatomical reconstruction of the ligaments in acute dislocations. PMID:20671868

  12. A modified surgical technique for reconstruction of an acute acromioclavicular joint dislocation

    OpenAIRE

    Marchie, Anthony; Kumar, Arun; Catre, Melanio

    2009-01-01

    We report a modified surgical technique for reconstruction of coracoclavicular and acromioclavicular ligaments after acute dislocation of acromioclavicular joint using suture anchors. We have repaired 3 consecutive type III acromioclavicular dislocations with good results. This technique is simple and safe and allows anatomical reconstruction of the ligaments in acute dislocations.

  13. Surgical Navigation

    DEFF Research Database (Denmark)

    Azarmehr, Iman; Stokbro, Kasper; Bell, R. Bryan

    2017-01-01

    Purpose: This systematic review investigates the most common indications, treatments, and outcomes of surgical navigation (SN) published from 2010 to 2015. The evolution of SN and its application in oral and maxillofacial surgery have rapidly developed over recent years, and therapeutic indicatio...

  14. Surgical Instrument

    NARCIS (Netherlands)

    Dankelman, J.; Horeman, T.

    2009-01-01

    The present invention relates to a surgical instrument for minimall-invasive surgery, comprising a handle, a shaft and an actuating part, characterised by a gastight cover surrounding the shaft, wherein the cover is provided with a coupler that has a feed- through opening with a loskable seal,

  15. Apparatus Development In Maros

    Directory of Open Access Journals (Sweden)

    H. Aras Solong

    2015-03-01

    Full Text Available ABSTRACT This study aims to identify and describe 1 Development of Administrative through education and training training promotion transfer and rotation and the application of demotion system non-title under Law No. 43 of 1999 on the development of career civil servants based merit system and work performance and Government Regulation No. 101 of 2000 on Education and Training Training for Civil Servants. 2 Revealing differences in work motivation based on the intensity of the education or training training using Herzbergs Two Factor Theory of extrinsic factors hygiene and intrinsic factors motivator that influence employees motivation Maros regency government in carrying out its duties and functions as members civil in public service. This study uses a quantitative approach to date collection techniques through a questionnaire Questionnaire. Informant are civil servants who occupied echelon II III. And IV while the analysis of the date used quantitative analysis to uncover the implementation of personnel development and employees motivation difference Maros region based on the intensity of the education or training training to get job satisfaction in the public service. The results of this study will reveal that 1 Development of Apparatus for improving the knowledge ability professionalism competence skills can work as a reformer change attitude eager to work motivated to do the work get satisfaction in work and getting justice in employment. 2 The difference in work motivation Maros local government employees affected by extrinsic factors hygiene and intrinsic factor motivator is the variable gain high salary H occupies the first ranking while serving the community satisfaction variables M occupy the last ranking. That is that the satisfaction of serving the people affected by the high salaries earned by the employees to do the job.

  16. A rapid and systematic review of the clinical effectiveness and cost-effectiveness of debriding agents in treating surgical wounds healing by secondary intention

    NARCIS (Netherlands)

    Lewis, R.; Whiting, P.; ter Riet, G.; O'Meara, S.; Glanville, J.

    2001-01-01

    BACKGROUND: Most surgically sutured wounds heal without any complication. However, in some cases wound healing can be delayed due to the presence of infection or wound breakdown. This can result in the wounds becoming cavity wounds and thus necessitate healing by secondary intention. Other surgical

  17. [Knapp procedure and modified Knapp procedure with Foster suture for the treatment of double elevator palsy].

    Science.gov (United States)

    Li, Y P; Zhang, W; Ding, J; Ma, H Z; Zhao, K X

    2017-12-11

    Objective: To investigate the efficacy of Knapp procedure and modified Knapp procedure with Foster suture in the treatment of double elevator palsy(DEP). Methods: Retrospective study. Twenty-two patients with congenital DEP were underwent Knapp procedure ( n= 15) and modified Knapp procedure( n= 7). The clinical data were retrospectively analyzed, including the preoperative and postoperative vertical deviation in the primary position, ocular motility, and binocular vision. Results: The average vertical deviation in the primary position was (34.7±8.6) prism diopters(PD) before surgery and (6.5±6.5) PD after surgery ( t= 30.41, P= 0.00) in the group underwent Knapp procedure. The mean preoperative and postoperative deviations of the group underwent modified procedure were respectively (38.6±14.6) PD and (5.7±9.3)PD ( t= 15.33, P= 0.00). The mean corrected vertical deviation of the latter (32.8±5.7) PD was greater than that of the former (28.1±3.6) PD( t=- 2.39, P= 0.03). The mean improved upgaze in the modified group (2.6±0.5) was more obvious than that in the Knapp group (1.9±0.6) ( t= 2.41, P= 0.02). There is no significant difference in the surgical effect on downgaze between two groups ( U =43.00, P= 0.54). Seven patients having binocular vision with abnormal head posture (AHP) before surgery obtained binocular single vision in the primary position and reading position after operations. AHP disappeared or reduced to less than 5°. The surgical outcomes were satisfied in 72.7% patients. But the patients with ≥40 PD preoperative vertical deviation were under-corrected and needed the further operations. Conclusions: Knapp procedure and modified Knapp procedure with Foster suture were the efficient procedures for treatment of DEP without restriction of ipsilateral inferior rectus. Both procedures can obviously correct the vertical deviation and improve upgaze without remarkable limitation of downgaze, which is good to obtain the binocular single vision in

  18. Testing of a new prototype surgical stapler that automates the rollover sleeve technique for venous anastomoses

    Directory of Open Access Journals (Sweden)

    PATRICIA B CARROLL

    2006-01-01

    Full Text Available The creation of successful vascular anastomoses is of primary importance in many surgical fields. Numerous attempts to automate this process have been made. These techniques have slowly gained acceptance, but their use is still limited. This report details feasibility testing of a new prototype stapler that automates the rollover sleeve technique for venous vascular anastomoses. Male and female mongrel dogs (n=7 (25-32 kg were used. A segment of the right (n=5 or left (n=2 iliac vein was harvested for interposition grafts after the contra lateral side was transected. In each dog, two end-to-end venous anastomoses at the interposition grafts were performed. The standard anastomosis employed continuous mattress sutures. The experimental anastomosis was performed with a new prototype surgical stapler. The stapled anastomosis was proximal and the sutured was distal. In all experiments, it was possible to perform the experimental anastomosis with the stapler. Complications included two small leaks, one due to misfiring of a single pin in one experimental site. These leaks required suture reinforcement. One dog died of hemorrhage due to a slipped suture at the vein harvest site. One vein had thrombus seen at the sutured site although no technical abnormalities at either of the anastomoses could be found. After two weeks, grafts were inspected grossly and histologically. Healing appeared normal. There was a trend for less inflammatory cells infiltrating stapled sites; however, this was not statistically significant. The experiments demonstrate that this device can automate the rollover sleeve technique for venous anastomoses.

  19. Testing of a new prototype surgical stapler that automates the rollover sleeve technique for venous anastomoses.

    Science.gov (United States)

    Carroll, Patricia B; Defaria, Werviston; Gandia, Carlos; Berho, Mariana; Misiakos, Evangelos; Tzakis, Andreas G

    2006-01-01

    The creation of successful vascular anastomoses is of primary importance in many surgical fields. Numerous attempts to automate this process have been made. These techniques have slowly gained acceptance, but their use is still limited. This report details feasibility testing of a new prototype stapler that automates the rollover sleeve technique for venous vascular anastomoses. Male and female mongrel dogs (n=7) (25-32 kg) were used. A segment of the right (n=5) or left (n=2) iliac vein was harvested for interposition grafts after the contra lateral side was transected. In each dog, two end-to-end venous anastomoses at the interposition grafts were performed. The standard anastomosis employed continuous mattress sutures. The experimental anastomosis was performed with a new prototype surgical stapler. The stapled anastomosis was proximal and the sutured was distal. In all experiments, it was possible to perform the experimental anastomosis with the stapler. Complications included two small leaks, one due to misfiring of a single pin in one experimental site. These leaks required suture reinforcement. One dog died of hemorrhage due to a slipped suture at the vein harvest site. One vein had thrombus seen at the sutured site although no technical abnormalities at either of the anastomoses could be found. After two weeks, grafts were inspected grossly and histologically. Healing appeared normal. There was a trend for less inflammatory cells infiltrating stapled sites; however, this was not statistically significant. The experiments demonstrate that this device can automate the rollover sleeve technique for venous anastomoses.

  20. A simple suture-retrieval device for the placement of u-stitches during laparoscopic gastrostomy.

    Science.gov (United States)

    Mattei, Peter

    2009-02-01

    During minimally invasive operations, it is sometimes necessary to retrieve the end of a suture or a suture needle and bring it out through the abdominal wall. Using a standard needle and a length of suture, we have developed a simple device that allows the retrieval of a suture end during minimally invasive operations that require the placement of U-or stay stitches. The author has used the device described during more than 100 laparoscopic gastrostomy placement procedures and other operations involving the placement of U- or stay stitches with excellent results and no complications. Using a beveled hollow-bore needle and a loop of polypropylene suture, one can construct a simple device that allows the retrieval of a suture from within a body cavity during minimally invasive surgery, making the placement of U- and stay stitches easier and more precise.

  1. A simple method to take urethral sutures for neobladder reconstruction and radical prostatectomy

    Directory of Open Access Journals (Sweden)

    B Satheesan

    2007-01-01

    Full Text Available For the reconstruction of urethra-vesical anastamosis after radical prostatectomy and for neobladder reconstruction, taking adequate sutures to include the urethral mucosa is vital. Due to the retraction of the urethra and unfriendly pelvis, the process of taking satisfactory urethral sutures may be laborious. Here, we describe a simple method by which we could overcome similar technical problems during surgery using Foley catheter as the guide for the suture.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Biomechanical testing of new meniscal repair techniques containing ultra high-molecular weight polyethylene suture.

    Science.gov (United States)

    Barber, F Alan; Herbert, Morley A; Schroeder, F Alexander; Aziz-Jacobo, Jorge; Sutker, Michael J

    2009-09-01

    To evaluate the biomechanical characteristics of current meniscal repair techniques containing ultra high-molecular weight polyethylene (UHMWPE) suture with and without cyclic loading. Vertical longitudinal cuts made in porcine menisci were secured with a single repair device. Noncycled and cycled (500 cycles) biomechanical tests were performed on the following groups: group 1, No. 2-0 Mersilene vertical suture (Ethicon, Somerville, NJ); group 2, No. 2-0 Orthocord vertical suture (DePuy Mitek, Westwood, MA); group 3, No. 0 Ultrabraid vertical suture (Smith & Nephew Endoscopy, Andover, MA); group 4, No. 2-0 FiberWire vertical suture (Arthrex, Naples, FL); group 5, vertically oriented mattress suture by use of an Ultra FasT-Fix device (Smith & Nephew Endoscopy) with No. 0 Ultrabraid; group 6, vertically oriented mattress suture by use of a RapidLoc A2 device (DePuy Mitek) with No. 2-0 Orthocord suture; group 7, vertically oriented stitch by use of a MaxFire device with MaxBraid PE suture (Biomet Sports Medicine, Warsaw, IN); and group 8, an obliquely oriented stitch of No. 0 UHMWPE suture inserted by use of a CrossFix device (Cayenne Medical, Scottsdale, AZ). Endpoints were failure loads, failure modes, stiffness, and cyclic displacement. Mean single-pull loads were calculated for Ultra FasT-Fix (121 N), FiberWire (110 N), MaxFire (130 N), Mersilene (84 N), Orthocord (124 N), RapidLoc A2 (86 N), CrossFix (77 N), and Ultrabraid (109 N). After 500 cyclic loads, the Orthocord (222 N) repair was stronger than the others: Ultra FasT-Fix (110 N), FiberWire (117 N), MaxFire (132 N), Mersilene (89 N), RapidLoc A2 (108 N), CrossFix (95 N), and Ultrabraid (126 N) (P Fix, RapidLoc A2, and MaxFire) were comparable to the isolated UHMWPE-containing suture repairs on single-failure load testing. UHMWPE-containing suture repairs are stronger than braided polyester suture repairs, but pure UHMWPE suture (Ultrabraid) elongated more during cycling. Orthocord suture is significantly

  4. Rhinoplasty: a simplified, three-stitch, open tip suture technique. Part I: primary rhinoplasty.

    Science.gov (United States)

    Daniel, R K

    1999-04-01

    Tip suture techniques offer a reliable and dramatic method of tip modification without needing to interrupt the alar rim strip or add tip grafts. The present simplified three-stitch technique consists of the following: (1) a strut suture to fix the columella strut between the crura, (2) bilateral domal creation sutures to create tip definition, and (3) a domal equalization suture to narrow and align the domes. If required, columella septal sutures can be added; either a dorsal rotational suture or a transfixion projection suture can be used. This simplified method represents a refinement based on more than 13 years of experience with tip suture techniques. It does not require a complex operative sequence or specialized sutures. Primary indications are moderate tip deformities of inadequate definition and excessive width and certain specific tip deformities, including the parenthesis tip and nostril/tip disproportion. The primary contraindications are for patients with minor tip deformities that are best done through a closed approach and those with severe tip deformities requiring an open structure graft. The technique is simple, efficacious, and easily learned.

  5. Ureteroscopic holmium laser cutting for inadvertently sutured drainage tube (report of five cases).

    Science.gov (United States)

    Gao, Xu; Lu, Xin; Ren, Shancheng; Xu, Chuanliang; Sun, Yinghao

    2008-07-01

    The aim of this paper is to report a simple solution for inadvertently sutured drainage tube after urological surgery and discuss the different managements according to different types of this embarrassing complication. From September 2001 to January 2007, five inadvertently sutured drainage tubes were treated with ureteroscopic holmium laser cutting for the suture. All drainage tubes were removed after the operation without other complications. Holmium laser cutting via ureteroscope is a simple solution for the embarrassing problem of inadvertently sutured drainage tube. It can save the patient from undergoing another open surgery.

  6. Elasticity and breaking strength of synthetic suture materials incubated in various equine physiological and pathological solutions.

    Science.gov (United States)

    Kearney, C M; Buckley, C T; Jenner, F; Moissonnier, P; Brama, P A J

    2014-07-01

    Selection of suture material in equine surgery is often based on costs or subjective factors, such as the surgeon's personal experience, rather than objective facts. The amount of objective data available on durability of suture materials with regard to specific equine physiological conditions is limited. To evaluate the effect of various equine physiological and pathological fluids on the rate of degradation of a number of commonly used suture materials. In vitro material testing. Suture materials were exposed in vitro to physiological fluid, followed by biomechanical analysis. Three absorbable suture materials, glycolide/lactide copolymer, polyglactin 910 and polydioxanone were incubated at 37°C for 7, 14 or 28 days in phosphate-buffered saline, equine serum, equine urine and equine peritoneal fluid from an animal with peritonitis. Five strands of each suture material type were tested to failure in a materials testing machine for each time point and each incubation medium. Yield strength, strain and Young's modulus were calculated, analysed and reported. For all suture types, the incubation time had a significant effect on yield strength, percentage elongation and Young's modulus in all culture media (Ptype was also shown significantly to influence changes in each of yield strength, percentage elongation and Young's modulus in all culture media (Ptype of fluid have significant effects on the biomechanical properties of various suture materials. These findings are important for evidence-based selection of suture material in clinical cases. © 2013 EVJ Ltd.

  7. 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.

  8. Effects of diode laser welding with dye-enhanced glue on tensile strength of sutures commonly used in urology.

    Science.gov (United States)

    Kirsch, A J; Chang, D T; Kayton, M L; Libutti, S K; Connor, J P; Hensle, T W

    1996-01-01

    Tissue welding using laser-activated protein solders may soon become an alternative to sutured tissue approximation. In most cases, approximating sutures are used both to align tissue edges and provide added tensile strength. Collateral thermal injury, however, may cause disruption of tissue alignment and weaken the tensile strength of sutures. The objective of this study was to evaluate the effect of laser welding on the tensile strength of suture materials used in urologic surgery. Eleven types of sutures were exposed to diode laser energy (power density = 15.9 W/cm2) for 10, 30, and 60 seconds. Each suture was compared with and without the addition of dye-enhanced albumin-based solder. After exposure, each suture material was strained (2"/min) until ultimate breakage on a tensometer and compared to untreated sutures using ANOVA. The strength of undyed sutures were not significantly affected; however, violet and green-dyed sutures were in general weakened by laser exposure in the presence of dye-enhanced glue. Laser activation of the smallest caliber, dyed sutures (7-0) in the presence of glue caused the most significant loss of tensile strength of all sutures tested. These results indicate that the thermal effects of laser welding using our technique decrease the tensile strength of dyed sutures. A thermally resistant suture material (undyed or clear) may prevent disruption of wounds closed by laser welding techniques.

  9. Surgical instruction for general practitioners: how, who and how often?

    LENUS (Irish Health Repository)

    Collins, Anne M

    2010-07-01

    Educational programmes, designed to meet the training needs of General Practitioners (GPs) performing minor surgical procedures, have previously been shown to increase their surgical workload. The change in the level of competence following these programmes has not been assessed. The aims of this study were two-fold: to evaluate the vertical mattress suture for construct validity and to assess the impact of plastic surgery training on the surgical skill of GPs. Thirty non-consultant hospital doctors and 27 self-selected GPs were included. Using a modified objective structured assessment of technical skills (OSATS) scoring system, construct validity of the vertical mattress suture was confirmed. The median total OSATS score was 16 points (26.7%) in the novice group (medical registrars), 38.5 points (64.2%) in the intermediate group (surgical SHOs) and 59 points (98.3%) in the expert group (surgical registrars, p<0.001, Kruskal-Wallis test). Objective assessment in the GP group immediately following practical instruction revealed a median overall improvement of 31.7% (19 points) in total OSATS scores (p<0.001, Friedman non-parametric test, F). At six months follow-up all course participants had improved compared to their baseline. A median overall improvement of 13 points (21.7%) was noted (p<0.001, F). However, the majority (80%, n=20) had deteriorated from the standard set immediately after the course with a median overall reduction in total OSATS scores of six points (10%, p=0.001, F). Plastic surgery training is immediately efficacious in improving the technical proficiency of GPs. Through objective assessment of a standardised suture task we demonstrated a low rate of educational decay of 10% over a six-month period.

  10. Optical fiber stripper positioning apparatus

    Science.gov (United States)

    Fyfe, Richard W.; Sanchez, Jr., Amadeo

    1990-01-01

    An optical fiber positioning apparatus for an optical fiber stripping device is disclosed which is capable of providing precise axial alignment between an optical fiber to be stripped of its outer jacket and the cutting blades of a stripping device. The apparatus includes a first bore having a width approximately equal to the diameter of an unstripped optical fiber and a counter bore axially aligned with the first bore and dimensioned to precisely receive a portion of the stripping device in axial alignment with notched cutting blades within the stripping device to thereby axially align the notched cutting blades of the stripping device with the axis of the optical fiber to permit the notched cutting blades to sever the jacket on the optical fiber without damaging the cladding on the optical fiber. In a preferred embodiment, the apparatus further includes a fiber stop which permits determination of the length of jacket to be removed from the optical fiber.

  11. The Conservation Ideological State Apparatus

    Directory of Open Access Journals (Sweden)

    Jared D Margulies

    2018-01-01

    Full Text Available This article considers Louis Althusser's theory of the ideological state apparatuses (ISAs for advancing political ecology scholarship on the functioning of the state in violent environments. I reflect on a series of events in which a state forest department in South India attempted to recast violent conflicts between themselves and local communities over access to natural resources and a protected area as a debate over human-wildlife conflicts. Through the example of conservation as ideology in Wayanad, Kerala, I show how the ISAs articulate the functioning of ideology within the state apparatuses in order for us to understand the larger mechanics of the state apparatus and the reproduction of the relations of production necessary for the reproduction of capitalism. Revisiting the ISAs as a theoretical framework for studies in political ecology and conservation is timely given the resurgence of militarised conservation tactics, the emancipatory aims of Althusser's theory, and political ecology's turn towards praxis.

  12. Apparatus for filtering radioactive fluids

    International Nuclear Information System (INIS)

    Gischel, E.H.

    1975-01-01

    Apparatus is provided for filtering radioactive particles from the cooling and/or auxiliary process water of a nuclear reactor, or nuclear fuel processing plant, or other installations wherein radioactive fluid systems are known to exist. The apparatus affords disposal of the captured particles in a manner which minimizes the exposure of operating personnel to radioactivity. The apparatus comprises a housing adapted to contain a removable filter cartridge assembly, a valve normally closing the lower end of the housing, an upwardly-open shipping cask located below the valve, and an elongated operating rod assembly projecting upwardly from the filter cartridge assembly and through the upper end of the housing to enable a workman to dismount the filter cartridge assembly from its housing and to lower the filter cartridge assembly through the valve and into the cask from a remote location above the housing. (U.S.)

  13. Concentration of anesthetic for long-term exposure and the effects of inter-suture distance in the goldfish Carassius auratus - DOI: 10.4025/actascibiolsci.v31i2.802 Concentration of anesthetic for long-term exposure and the effects of inter-suture distance in the goldfish Carassius auratus - DOI: 10.4025/actascibiolsci.v31i2.802

    Directory of Open Access Journals (Sweden)

    Eduardo Shimoda

    2009-05-01

    Full Text Available This study aimed to determine the minimum concentration of 2-phenoxyethanol for long-term exposure and evaluate the effect of inter-suture distance on wound healing in the goldfish Carassius auratus. Twenty adult goldfish (standard length = 12.4 ± 1.1 cm; weight = 58.7 ± 17.2 g were anesthetized in 2-phenoxiethanol at 1.2‰ and placed in an anesthesia delivery system at the following concentrations of 2-phenoxiethanol: 0.0 (control; 0.1; 0.2; 0.3 and 0.4‰, and the duration of sedation was measured. Fifteen days later, fishes were anesthetized using the same procedure, and a 36 mm incision was performed in the ventro-lateral region. The incision was sutured using a simple-interrupted pattern with 3, 6 or 9 mm as inter-suture distances. Results demonstrated that 2-phenoxiethanol at 0.4‰ maintain the sedation for surgical procedures up to 60 minutes, and 9 mm as inter-suture distance optimized the wound healing in goldfish.This study aimed to determine the minimum concentration of 2-phenoxyethanol for long-term exposure and evaluate the effect of inter-suture distance on wound healing in the goldfish Carassius auratus. Twenty adult goldfish (standard length = 12.4 ± 1.1 cm; weight = 58.7 ± 17.2 g were anesthetized in 2-phenoxiethanol at 1.2‰ and placed in an anesthesia delivery system at the following concentrations of 2-phenoxiethanol: 0.0 (control; 0.1; 0.2; 0.3 and 0.4‰, and the duration of sedation was measured. Fifteen days later, fishes were anesthetized using the same procedure, and a 36 mm incision was performed in the ventro-lateral region. The incision was sutured using a simple-interrupted pattern with 3, 6 or 9 mm as inter-suture distances. Results demonstrated that 2-phenoxiethanol at 0.4‰ maintain the sedation for surgical procedures up to 60 minutes, and 9 mm as inter-suture distance optimized the wound healing in goldfish.

  14. Total Laparoscopic Hysterectomy: Evaluation of an Evidence-Based Educational Strategy Using a Novel Simulated Suture and Knot-Tying Challenge, the “Holiotomy”

    Directory of Open Access Journals (Sweden)

    Katherine A. O'Hanlan

    2012-01-01

    Full Text Available Objective. The purpose of this study was to evaluate perceptions of skills and practice patterns of gynecologists attending a course on total laparoscopic hysterectomy (TLH. This course employed extensive use of pelvic trainer boxes to accomplish the Holiotomy Challenge. The “Holiotomy Challenge” entailed suturing two plastic pieces with six figure-of-N sutures tied with four square knots each. Methods. A survey was administered before the course and 3 months later. Data were analyzed by paired t-tests, McNemar’s Chi Squares, and ANCOVAs with significance set P<.05. Results. At baseline, 216 surgeons and at 3 months 102 surgeons returned the survey. Surgeons’ self-perceptions of their skills significantly increased from 6.24 to 7.28. Their reports of their surgical practice at home revealed significantly increased rates of minimally invasive procedures, from 42% to 54%. Significantly more surgeons reported having the ability to close the vagina, or a small cystotomy or enterotomy. Participation in the cadaver lab and presence of their practice partner did not impact these rates. Conclusions. A comprehensive course employing laparoscopic surgical simulation focused on basic surgical skills essential to TLH has a positive impact on attendees' self-rated skill level and rate of laparoscopic approaches. Many had begun performing TLH after the course.

  15. Apparatus for control of mercury

    Science.gov (United States)

    Downs, William; Bailey, Ralph T.

    2001-01-01

    A method and apparatus for reducing mercury in industrial gases such as the flue gas produced by the combustion of fossil fuels such as coal adds hydrogen sulfide to the flue gas in or just before a scrubber of the industrial process which contains the wet scrubber. The method and apparatus of the present invention is applicable to installations employing either wet or dry scrubber flue gas desulfurization systems. The present invention uses kraft green liquor as a source for hydrogen sulfide and/or the injection of mineral acids into the green liquor to release vaporous hydrogen sulfide in order to form mercury sulfide solids.

  16. Apparatus for blending small particles

    International Nuclear Information System (INIS)

    Bradley, R.A.; Reese, C.R.; Sease, J.D.

    1975-01-01

    An apparatus is described for blending small particles and uniformly loading the blended particles in a receptacle. Measured volumes of various particles are simultaneously fed into a funnel to accomplish radial blending and then directed onto the apex of a conical splitter which collects the blended particles in a multiplicity of equal subvolumes. Thereafter the apparatus sequentially discharges the subvolumes for loading in a receptacle. A system for blending nuclear fuel particles and loading them into fuel rod molds is described in a preferred embodiment

  17. Apparatus for controlling fluidized beds

    Science.gov (United States)

    Rehmat, A.G.; Patel, J.G.

    1987-05-12

    An apparatus and process are disclosed for control and maintenance of fluidized beds under non-steady state conditions. An ash removal conduit is provided for removing solid particulates from a fluidized bed separate from an ash discharge conduit in the lower portion of the grate supporting such a bed. The apparatus and process of this invention is particularly suitable for use in ash agglomerating fluidized beds and provides control of the fluidized bed before ash agglomeration is initiated and during upset conditions resulting in stable, sinter-free fluidized bed maintenance. 2 figs.

  18. Nuclear fuel pellet loading apparatus

    International Nuclear Information System (INIS)

    Gerkey, K.S.

    1979-01-01

    An automatic apparatus for loading a predetermined amount of nuclear fuel pellets into a nuclear fuel element to be used in a nuclear reactor is described. The apparatus consists of a vibratory bed capable of supporting corrugated trays containing rows of nuclear fuel pellets and arranged in alignment with the open ends of several nuclear fuel elements. A sweep mechanism is arranged above the trays and serves to sweep the rows of fuel pellets onto the vibratory bed and into the fuel element. A length detecting system, in conjunction with a pellet stopping mechanism, is also provided to assure that a predetermined amount of nuclear fuel pellets are loaded into each fuel element

  19. Single versus double row suture anchor fixation for greater tuberosity fractures - a biomechanical study.

    Science.gov (United States)

    Seppel, Gernot; Saier, Tim; Martetschläger, Frank; Plath, Johannes E; Guevara-Alvarez, Alberto; Henschel, Julia; Winkler, Martin; Augat, Peter; Imhoff, Andreas B; Buchmann, Stefan

    2017-12-01

    Fractures of the humeral greater tuberosity (GT) are a frequent injury progressively treated with arthroscopic suture anchor repair. Yet, no biomechanical study has been performed comparing fixation strength of arthroscopic single- (SR) vs. double row (DR) fixation. Standardized fractures of the greater tuberosity were created in 12 fresh frozen proximal humeri. After random assignation to the SR or DR group the fixed humeri were tested applying cyclic loading to the supraspinatus and infraspinatus tendon. Load to failure and fragment displacement were assessed by means of an electrodynamic material testing machine using an optical tracking system. Load to failure values were higher in the DR group (649 N; ±176) than in the SR group (490 N; ±145) however without statistical significance (p = .12). In greater tuberosity displacement of 3-5 mm surgical treatment is recommended. The fixing constructs in this study did not reach displacement landmarks of 3 or 5 mm before construct failure as shown in previous studies. Thus the applied traction force (N) at 1 mm displacement was analyzed. In the SR group the load at 1 mm displacement was 277 N; ±46 compared to 260 N; ±62 in the DR group (p = .65). The results suggest that both techniques are viable options for refixation of greater tuberosity fractures. Laboratory study.

  20. Suture anchor tenodesis in repair of distal Achilles tendon injuries.

    Science.gov (United States)

    Kiliçoğlu, Onder; Türker, Mehmet; Yildız, Fatih; Akalan, Ekin; Temelli, Yener

    2014-01-01

    Distal Achilles tendon avulsions are in the form of either bony and nonbony avulsion of Achilles tendon from its calcaneal insertion. Four patients with distal Achilles tendon avulsions or ruptures which were treated with tendon to bone repair using suture anchors are presented here. Operated leg was immobilized in above-knee cast for 4 weeks while the patient walked non-weight-bearing. Then, cast was changed to below knee, and full weight-bearing was allowed. Patients underwent gait analysis minimum at first postoperative year. Mean American Orthopedics Foot Ankle Society ankle/hindfoot score of patients at last visit was 88.75 (range 85-100), and Achilles tendon total rupture score was 77.75 (range 58-87). Mean passive dorsiflexion of injured ankles (14° ± 5°) was lower than uninjured ankles (23° ± 9°). All the kinematic parameters of gait analysis were comparable to the uninjured side. Maximum plantar flexion power of injured ankle was 1.40 W/kg, and this was significantly lower than the contralateral side value 2.38 W/kg; (P = 0.0143). There were no visually altered gait or problems in daily life. Suture anchor tenodesis technique of distal Achilles tendon avulsions was successful in achieving durable osteotendinous repairs.

  1. A Huge Morel-Lavallée Lesion Treated Using a Quilting Suture Method: A Case Report and Review of the Literature.

    Science.gov (United States)

    Seo, Bommie F; Kang, In Sook; Jeong, Yeon Jin; Moon, Suk Ho

    2014-06-01

    The Morel-Lavallée lesion is a collection of serous fluid that develops after closed degloving injuries and after surgical procedures particularly in the pelvis and abdomen. It is a persistent seroma and is usually resistant to conservative methods of treatment such as percutaneous drainage and compression. Various methods of curative treatment have been reported in the literature, such as application of fibrin sealant, doxycycline, or alcohol sclerodhesis. We present a case of a huge recurrent Morel-Lavallée lesion in the lower back and buttock region that was treated with quilting sutures, fibrin sealant, and compression, with a review of the literature. © The Author(s) 2014.

  2. Subluxation of suture-fixated posterior chamber intraocular lenses a clinicopathologic study.

    Science.gov (United States)

    Parekh, Parag; Green, W Richard; Stark, Walter J; Akpek, Esen Karamursel

    2007-02-01

    To report the occurrence of subluxation of suture-fixated posterior chamber (PC) intraocular lenses (IOL) and elucidate the mechanisms involved. Prospective clinicopathologic study. A single 10-0 Prolene suture explanted from a patient who experienced subluxation of his PC-IOL, 11.5 years after placement. Furthermore, multiple 10-0 Prolene sutures and PC-IOLs used for iris fixation were studied as controls. Scanning electron microscopy (SEM) was used to analyze the surface of the explanted suture. In addition, randomly selected 10-0 Prolene sutures cut with Vannas scissors and cut with the positioning holes of a randomly selected PC-IOL identical to that implanted in the patient's eye were examined as controls. Finally, the positioning holes of several randomly selected, iris-fixated PC-IOLs were studied using SEM with particular attention to surface quality and edge finish. Presence of any signs of suture degradation, the character of the cut edge of the suture, as well as the characteristics of the positioning holes of the PC-IOLs. Scanning electron microscopy of the explanted suture revealed sharply cut edges, without significant degradation of the suture, and no intact loop. Scanning electron microscopy of the control suture cut with a PC-IOL demonstrated a similarly cut edge. The positioning holes of the examined PC-IOLs had a sharp edge, and some also had an imperfect finish. We conclude that the surface properties of the positioning holes lead to cutting of the suture, and subsequent subluxation of the PC-IOL.

  3. Advantages of Arthroscopic Rotator Cuff Repair With a Transosseous Suture Technique: A Prospective Randomized Controlled Trial.

    Science.gov (United States)

    Randelli, Pietro; Stoppani, Carlo Alberto; Zaolino, Carlo; Menon, Alessandra; Randelli, Filippo; Cabitza, Paolo

    2017-07-01

    Rotator cuff tear is a common finding in patients with painful, poorly functioning shoulders. The surgical management of this disorder has improved greatly and can now be fully arthroscopic. To evaluate clinical and radiological results of arthroscopic rotator cuff repair using 2 different techniques: single-row anchor fixation versus transosseous hardware-free suture repair. Randomized controlled trial; Level of evidence, 1. Sixty-nine patients with rotator cuff tears were enrolled: 35 patients were operated with metal anchors and 34 with standardized transosseous repair. The patients were clinically evaluated before surgery, during the 28 days after surgery, and at least 1 year after the operation by the use of validated rating scores (Constant score, QuickDASH, and numerical rating scale [NRS]). Final follow-up was obtained at more than 3 years by a QuickDASH evaluation to detect any difference from the previous follow-up. During the follow-up, rotator cuff integrity was determined through magnetic resonance imaging and was classified according to the 5 Sugaya categories. Patients operated with the transosseous technique had significantly less pain, especially from the 15th postoperative day: In the third week, the mean NRS value for the anchor group was 3.00 while that for transosseous group was 2.46 ( P = .02); in the fourth week, the values were 2.44 and 1.76, respectively ( P rotator cuff repair integrity, based on Sugaya magnetic resonance imaging classification, no significant difference was found between the 2 techniques in terms of retear rate ( P = .81). No significant differences were found between the 2 arthroscopic repair techniques in terms of functional and radiological results. However, postoperative pain decreased more quickly after the transosseous procedure, which therefore emerges as a possible improvement in the surgical repair of the rotator cuff. Registration: NCT01815177 ( ClinicalTrials.gov identifier).

  4. Surgical repair of a congenital sternal cleft in a cat.

    Science.gov (United States)

    Schwarzkopf, Ilona; Bavegems, Valerie C A; Vandekerckhove, Peter M F P; Melis, Sanne M; Cornillie, Pieter; de Rooster, Hilde

    2014-07-01

    To describe the clinical findings, diagnosis, and treatment of an incomplete cleft of the 5th-8th sternebra and a cranioventral abdominal wall hernia in a 2 month old Ragdoll kitten and to evaluate the short- and long-term outcome. Clinical report. Ragdoll cat (n = 1), 2 months old. Sternal cleft was confirmed by thoracic radiographs. Computed tomography (CT) was used to plan an optimal surgical approach. A ventral median incision was made, starting at the 3rd sternebra and extended into the abdomen. Ostectomy of the proximal part of the 5th left sternebra was performed. Lateral periosteal flaps were created, unfolded, and absorbable monofilament sutures preplaced to facilitate closure and the repair was reinforced by 2 peristernal sutures. A bone graft was applied, and the free margin of the omentum was sutured to the cranial aspect of the wound. No major complications occurred. At 3 weeks, CT scan confirmed approximation of the hemisternebrae and at 10 months, complete fusion of the hemisternebrae had not occurred, but a strong connection of the sternal bars was present. Sternal cleft is a rare congenital abnormality that can be corrected surgically with favorable outcome. © Copyright 2014 by The American College of Veterinary Surgeons.

  5. The effect of music on robot-assisted laparoscopic surgical performance.

    Science.gov (United States)

    Siu, Ka-Chun; Suh, Irene H; Mukherjee, Mukul; Oleynikov, Dmitry; Stergiou, Nick

    2010-12-01

    Music is often played in the operating room to increase the surgeon's concentration and to mask noise. It could have a beneficial effect on surgical performance. Ten participants with limited experience with the da Vinci robotic surgical system were recruited to perform two surgical tasks: suture tying and mesh alignment when classical, jazz, hip-hop, and Jamaican music were presented. Kinematics of the instrument tips of the surgical robot and surface electromyography of the subjects were recorded. Results revealed that a significant music effect was found for both tasks with decreased time to task completion (P = .005) and total travel distance (P = .021) as well as reduced muscle activations ( P = .016) and increased median muscle frequency (P = .034). Subjects improved their performance significantly when they listened to either hip-hop or Jamaican music. In conclusion, music with high rhythmicity has a beneficial effect on robotic surgical performance. Musical environment may benefit surgical training and make acquisition of surgical skills more efficient.

  6. APPARATUS FOR ELECTRON BEAM HEATING CONTROL

    Science.gov (United States)

    Jones, W.H.; Reece, J.B.

    1962-09-18

    An improved electron beam welding or melting apparatus is designed which utilizes a high voltage rectifier operating below its temperature saturation region to decrease variations in electron beam current which normally result from the gas generated in such apparatus. (AEC)

  7. Waste Water Treatment Apparatus and Methods

    Science.gov (United States)

    Littman, Howard (Inventor); Plawsky, Joel L. (Inventor); Paccione, John D. (Inventor)

    2014-01-01

    An improved draft tube spout fluid bed (DTSFB) mixing, handling, conveying, and treating apparatus and systems, and methods for operating are provided. The apparatus and systems can accept particulate material and pneumatically or hydraulically conveying the material to mix and/or treat the material. In addition to conveying apparatus, a collection and separation apparatus adapted to receive the conveyed particulate material is also provided. The collection apparatus may include an impaction plate against which the conveyed material is directed to improve mixing and/or treatment. The improved apparatus are characterized by means of controlling the operation of the pneumatic or hydraulic transfer to enhance the mixing and/or reacting by controlling the flow of fluids, for example, air, into and out of the apparatus. The disclosed apparatus may be used to mix particulate material, for example, mortar; react fluids with particulate material; coat particulate material, or simply convey particulate material.

  8. Cluster Implantation and Deposition Apparatus

    DEFF Research Database (Denmark)

    Hanif, Muhammad; Popok, Vladimir

    2015-01-01

    In the current report, a design and capabilities of a cluster implantation and deposition apparatus (CIDA) involving two different cluster sources are described. The clusters produced from gas precursors (Ar, N etc.) by PuCluS-2 can be used to study cluster ion implantation in order to develop...

  9. X-ray examination apparatus

    NARCIS (Netherlands)

    2000-01-01

    The invention relates to an X-ray apparatus which includes an adjustable X-ray filter. In order to adjust an intensity profile of the X-ray beam, an X-ray absorbing liquid is transported to filter elements of the X-ray filter. Such transport is susceptible to gravitational forces which lead to an

  10. The ALPHA antihydrogen trapping apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Amole, C. [Department of Physics and Astronomy, York University, Toronto ON Canada, M3J 1P3 (Canada); Andresen, G.B. [Department of Physics and Astronomy, Aarhus University, DK-8000 Aarhus C (Denmark); Ashkezari, M.D. [Department of Physics, Simon Fraser University, Burnaby, BC Canada, V5A 1S6 (Canada); Baquero-Ruiz, M. [Department of Physics, University of California at Berkeley, Berkeley, CA 94720-7300 (United States); Bertsche, W. [Department of Physics, College of Science, Swansea University, Swansea SA2 8PP (United Kingdom); School of Physics and Astronomy, University of Manchester, Manchester M13 9PL (United Kingdom); The Cockcroft Institute, Warrington WA4 4AD (United Kingdom); Bowe, P.D. [Department of Physics and Astronomy, Aarhus University, DK-8000 Aarhus C (Denmark); Butler, E. [Physics Department, CERN, CH-1211 Geneva 23 (Switzerland); Capra, A. [Department of Physics and Astronomy, York University, Toronto ON Canada, M3J 1P3 (Canada); Carpenter, P.T. [Department of Physics, Auburn University, Auburn, AL 36849-5311 (United States); Cesar, C.L. [Instituto de Física, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-972 (Brazil); Chapman, S. [Department of Physics, University of California at Berkeley, Berkeley, CA 94720-7300 (United States); Charlton, M.; Deller, A.; Eriksson, S. [Department of Physics, College of Science, Swansea University, Swansea SA2 8PP (United Kingdom); Escallier, J. [Brookhaven National Laboratory, Upton, NY 11973 (United States); Fajans, J. [Department of Physics, University of California at Berkeley, Berkeley, CA 94720-7300 (United States); Friesen, T. [Department of Physics and Astronomy, University of Calgary, Calgary AB, Canada, T2N 1N4 (Canada); Fujiwara, M.C.; Gill, D.R. [TRIUMF, 4004 Wesbrook Mall, Vancouver BC, Canada V6T 2A3 (Canada); Gutierrez, A. [Department of Physics and Astronomy, University of British Columbia, Vancouver BC, Canada V6T 1Z4 (Canada); and others

    2014-01-21

    The ALPHA collaboration, based at CERN, has recently succeeded in confining cold antihydrogen atoms in a magnetic minimum neutral atom trap and has performed the first study of a resonant transition of the anti-atoms. The ALPHA apparatus will be described herein, with emphasis on the structural aspects, diagnostic methods and techniques that have enabled antihydrogen trapping and experimentation to be achieved.

  11. X-ray examination apparatus

    International Nuclear Information System (INIS)

    Bernstein, S.; Griswa, P.J.; Halter, P. Jr.; Kidd, H.J.

    1980-01-01

    Apparatus for x-ray cardiovascular examination and which can also be used for general purpose examination is described. An advantage of the system is that there is no mechanical connection between the image intensifier and source to interfere with the medical examiner or emergency procedures. (U.K.)

  12. A FILTRATION METHOD AND APPARATUS

    DEFF Research Database (Denmark)

    2003-01-01

    The present invention concerns a method and an apparatus for separating dry matter from liquid, comprising providing an enclosed separation environment capable of being pressure regulated, and in said enclosed separation environment contacting at least one filter with a suspension accumulating dr...

  13. Nuclear fuel rod loading apparatus

    International Nuclear Information System (INIS)

    King, H.B.

    1981-01-01

    A nuclear fuel loading apparatus, incorporating a microprocessor control unit, is described which automatically loads nuclear fuel pellets into dual fuel rods with a minimum of manual involvement and in a manner and sequence to ensure quality control and accuracy. (U.K.)

  14. Apparatus for measuring fluid flow

    Science.gov (United States)

    Smith, J.E.; Thomas, D.G.

    Flow measuring apparatus includes a support loop having strain gages mounted thereon and a drag means which is attached to one end of the support loop and which bends the sides of the support loop and induces strains in the strain gages when a flow stream impacts thereon.

  15. Support of nuclear fusion apparatus

    International Nuclear Information System (INIS)

    Watarai, Tetsuo; Ito, Yutaka.

    1975-01-01

    Object: To integrally form a bed for a body for supporting a vacuum container, coil and the like and a bed for a current transformer for supporting the current transformer prior to installation thereof on the floor thereby facilitating assembly and installation. Structure: To provide a base common to a current transformer bed and a body bed without direct installation thereof on the floor. Prior to installation of the current transformer bed and body bed, they are fastened to the base by means of bolts and welded integrally, and the thus formed base is fixed to the floor by means of anchor bolts. Since the current transformer bed and the body bed are formed integrally through the common base, apparatus may easily be carried in and disassembling and re-assembling of apparatus become unnecessary when installed. Further, since the positional relation of the current transformer bed and body bed does not depend on accuracy at the time of installation but depends on accuracy when apparatus manufactured, the toroidal type nuclear fusion apparatus of good accuracy may be obtained. (Yoshihara, H.)

  16. Nuevo método de sutura subcutánea percutánea continua New method of continuous percutaneous subcutaneous suture

    Directory of Open Access Journals (Sweden)

    Germán Brito Sosa

    2012-06-01

    Full Text Available Objetivos: realizar un método de sutura continua, en las personas operadas en el Hospital "Julio Trigo López", que disminuya los granulomas a nivel de la herida quirúrgica, y compararlas con el método tradicional. Métodos: se realizó un estudio experimental sobre la aplicación de un método de sutura subcutánea percutánea continua, en un grupo de pacientes operados de diversas enfermedades, ya sea de urgencia, electivo o ambulatorio, en el Hospital "Julio Trigo López", en los años 2008 y 2009. Resultados: con el método de sutura subcutánea percutánea continua con nylon no se forman granulomas, mientras que con el método tradicional, sí ocurre en un porcentaje no despreciable. Las ventajas del método de sutura subcutánea percutánea continua con nylon son: en el plano celular subcutáneo de la pared abdominal no queda sutura, no se producen granulomas y es más económica. Conclusiones: la sutura de nylon es menos rechazada que la del cromado, ya que no se producen granulomas. El método de sutura subcutánea percutánea continua es una sutura más hemostática que el método tradicional, ya que el por ciento de hematomas es menor. El gasto económico es menor con el método de sutura subcutánea percutánea continua. Con el método de sutura subcutánea percutánea continua la sutura es extraída al 10mo. día de haberla aplicado.Objectives: to apply a continuous suture method to reduce granulomas in surgical wounds in patients operated on at "Julio Trigo Lopez" hospital, and to compare the results with those of the traditional method. Methods: an experimental study was conducted on the application of a continuous percutaneous subcutaneous suture in a group of patients operated on from several diseases, either under emergency, elective or outpatient conditions at "Julio Trigo Lopez" hospital during 2008 and 2009. Results: the continuous percutaneous subcutaneous suture method with nylon prevents formation of granulomas, whereas

  17. Management of a type two avulsion fracture of the tibial intercondylar eminence in children: arthroscopic suture fixation versus conservative immobilization.

    Science.gov (United States)

    Zhao, Chen; Bi, Qing; Bi, Mingguang

    2018-06-01

    Treatment of a type II tibial eminence avulsion fracture was controversial. The aim of this study was to compare the clinical outcomes of a modified arthroscopic suture fixation versus conservative immobilization in treatment of this type fracture in immature population. A total of 43 type II avulsion fractures of tibial intercondylar eminence in immature patients were retrospectively enrolled in the study. Twenty-two (13 males, 9 females) were treated with arthroscopic suture fixation and 21(12 males, 9 females) with conservative cast immobilization. Radiograph, Lachman test, anterior drawer test (ADT), International Knee Documentation Committee (IKDC) 2000 subjective score, and Lysholm score were used to evaluate clinical outcomes in follow-up. All 43 paediatric or adolescent patients with a mean of 11.3 years (range, 8-16 years) were followed up for a median period of 34.5 months (range, 24-46 months). Radiographic evaluation showed optimal reduction immediately after surgery and bone union within three months. At the final follow-up, no limitation of knee motion range was found in any children. Grade II laxity was found in one case from surgical group and six from conservation group, showing significant difference based on ADT (χ2 = 7.927, P = 0.005) and Lachman tests (χ2 = 9.546, P = 0.002). IKDC and Lysholm scores were significantly improved; however, there were significant differences in the IKDC score (91.7 ± 4.34 vs. 84.7 ± 6.11, t = 4.35, P < 0.001) and Lysholm score (93.4 ± 4.04 vs. 87.1 ± 5.24, t = 4.53, P < 0.001), and the improvement of IKDC value (40.2 ± 7.83 vs. 31.4 ± 8.4, t = 3.57, P = 0.001) and Lysholm value (43.8 ± 6.55 vs. 35.4 ± 5.97, t = 4.36, P < 0.001) between the surgical group and the nonsurgical group. In treatment of type II tibial eminence avulsion fracture, a modified, 8 shape suture fixation under arthroscopy showed superior clinical

  18. Biomechanical comparison of an all-soft suture anchor with a modified Broström-Gould suture repair for lateral ligament reconstruction.

    Science.gov (United States)

    Brown, Christopher A; Hurwit, Daniel; Behn, Anthony; Hunt, Kenneth J

    2014-02-01

    Anatomic repair is indicated for patients who have recurrent lateral ankle instability despite nonoperative measures. There is no difference in repair stiffness, failure torque, or failure angle between specimens repaired with all-soft suture anchors versus the modified Broström-Gould technique with sutures only. Controlled laboratory study. In 10 matched pairs of human cadaveric ankles, the anterior talofibular ligament (ATFL) was incised from its origin on the fibula. After randomization, 1 ankle was repaired to its anatomic insertion using two 1.4-mm JuggerKnot all-soft suture anchors; the other ankle was repaired with a modified Broström-Gould technique using 2-0 FiberWire. All were augmented using the inferior extensor retinaculum. All ankles were mounted to the testing machine in 20° of plantar flexion and 15° of internal rotation and loaded to failure after the repair. Stiffness, failure torque, and failure angle were recorded and compared using a paired Student t test with a significance level set at P anchors pulled out of bone. The primary mode of failure was pulling through the ATFL tissue. There was no statistical difference in strength or stiffness between a 1.4-mm all-soft suture anchor and a modified Broström-Gould repair with 2-0 FiberWire. The primary mode of failure was at the tissue level rather than knot failure or anchor pullout. The particular implant choice (suture only, tunnel, anchor) in repairing the lateral ligament complex may not be as important as the time to biological healing. The suture-only construct as described in the Broström-Gould repair was as strong as all-soft suture anchors, and the majority of the ankles failed at the tissue level. For those surgeons whose preference is to use anchor repair, this novel all-soft suture anchor may be an alternative to other larger anchors, as none failed by pullout.

  19. Critical Anatomy Relative to the Sacral Suture: A Postoperative Imaging Study After Robotic Sacrocolpopexy.

    Science.gov (United States)

    Crisp, Catrina C; Herfel, Charles V; Pauls, Rachel N; Westermann, Lauren B; Kleeman, Steven D

    2016-01-01

    This study aimed to characterize pertinent anatomy relative to the sacral suture placed at time of robotic sacrocolpopexy using postoperative computed tomography and magnetic resonance imaging. A vascular clip was placed at the base of the sacral suture at the time of robotic sacrocolpopexy. Six weeks postoperatively, subjects returned for a computed tomography scan and magnetic resonance imaging. Ten subjects completed the study. The middle sacral artery and vein coursed midline or to the left of midline in all the subjects. The left common iliac vein was an average of 26 mm from the sacral suture. To the right of the suture, the right common iliac artery was 18 mm away. Following the right common iliac artery to its bifurcation, the right internal iliac was on average 10 mm from the suture. The bifurcations of the inferior vena cava and the aorta were 33 mm and 54 mm further cephalad, respectively.The right ureter, on average, was 18 mm from the suture. The thickness of the anterior longitudinal ligament was 2 mm.The mean angle of descent of the sacrum was 70 degrees. Lastly, we found that 70% of the time, a vertebral body was directly below the suture; the disc was noted in 30%. We describe critical anatomy surrounding the sacral suture placed during robotic sacrocolpopexy. Proximity of both vascular and urologic structures within 10 to 18 mm, as well as anterior ligament thickness of only 2 mm highlights the importance of adequate exposure, careful dissection, and surgeon expertise.

  20. 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....

  1. 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…

  2. 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.

  3. Comparison of clinical outcomes of multi-point umbrella suturing and single purse suturing with two-point traction after procedure for prolapse and hemorrhoids (PPH) surgery.

    Science.gov (United States)

    Jiang, Huiyong; Hao, Xiuyan; Xin, Ying; Pan, Youzhen

    2017-11-01

    To compare the clinical outcomes of multipoint umbrella suture and single-purse suture with two-point traction after procedure for prolapse and hemorrhoids surgery (PPH) for the treatment of mixed hemorrhoids. Ninety patients were randomly divided into a PPH plus single-purse suture group (Group A) and a PPH plus multipoint umbrella suture (Group B). All operations were performed by an experienced surgeon. Operation time, width of the specimen, hemorrhoids retraction extent, postoperative pain, postoperative bleeding, and length of hospitalization were recorded and compared. Statistical analysis was conducted by t-test and χ2 test. There were no significant differences in sex, age, course of disease, and degree of prolapse of hemorrhoids between the two groups. The operative time in Group A was significantly shorter than that in Group B (P hemorrhoid core retraction were significantly lower in Group B (P  0.05 for all comparisons) was observed. The multipoint umbrella suture showed better clinical outcomes because of its targeted suture according to the extent of hemorrhoid prolapse. Copyright © 2017. Published by Elsevier Ltd.

  4. Sutures coated with antiseptic pomade to prevent bacterial colonization: a randomized clinical trial.

    Science.gov (United States)

    Cruz, Fernando; Leite, Fabiola; Cruz, Gustavo; Cruz, Silvia; Reis, Juarez; Pierce, Matthew; Cruz, Mauro

    2013-08-01

    The aim of this study was to assess if an antiseptic pomade could reduce the bacterial colonization on multifilament sutures. A randomized clinical trial was conducted with 40 volunteer patients of both sexes aged 18-70, randomly separated into experimental (n = 20) and control (n = 20) groups. The experimental group received pomade-coated sutures (iodoform + calendula) and the control group uncoated sutures. Two millimeters of the suture was harvested from each patient from the 1st to the 15th postoperative day. The bacteria that had adhered to them were cultured. The number of colony-forming units per milliliter (CFU/mL) was determined and the groups were compared using the Mann-Whitney statistical test (P antiseptic pomade was effective in reducing bacterial colonization on silk braided sutures. Copyright © 2013 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 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.

  7. Novel Technique to Overcome the Nonavailability of a Long Needle 9-0 Polypropylene Suture for Sutured Scleral Fixation of the Posterior Chamber Intraocular Lens Using a Single Fisherman’s Knot

    Directory of Open Access Journals (Sweden)

    Yong Un Shin

    2017-01-01

    Full Text Available Purpose. To describe a method to overcome the nonavailability of a long needle 9-0 polypropylene suture for sutured scleral fixation of the posterior chamber intraocular lens (PC-IOL using a single fisherman’s knot (SFK. Methods. First, a 10-0 polypropylene suture was passed from the sclera to the ciliary sulcus using a long needle. A 9-0 suture was tied to the unpassed portion of the 10-0 suture with an SFK. We pulled the 10-0 suture to pass the SFK through the sclera, and then we cut the knot and removed the 10-0 suture. IOL fixation with 9-0 sutures used the conventional techniques used for sutured scleral-fixated IOL. Preoperative and postoperative visual acuity, corneal astigmatism, and endothelial cell count and intraoperative/postoperative complications were evaluated. Results. An SFK joining the two sutures was passed through the sclera without breakage or slippage. A total of 35 eyes from 35 patients who underwent sutured scleral fixation of the IOL. An intraoperative complication (minor intraocular hemorrhage was recorded in four cases. Knot exposure, IOL dislocation, subluxation, and retinal detachment were not observed. Conclusions. The SFK offers the opportunity to use 9-0 sutures for the long-term safety and may not require the surgeon to learn any new technique.

  8. Novel Technique to Overcome the Nonavailability of a Long Needle 9-0 Polypropylene Suture for Sutured Scleral Fixation of the Posterior Chamber Intraocular Lens Using a Single Fisherman's Knot.

    Science.gov (United States)

    Shin, Yong Un; Seong, Mincheol; Cho, Hee Yoon; Kang, Min Ho

    2017-01-01

    To describe a method to overcome the nonavailability of a long needle 9-0 polypropylene suture for sutured scleral fixation of the posterior chamber intraocular lens (PC-IOL) using a single fisherman's knot (SFK). First, a 10-0 polypropylene suture was passed from the sclera to the ciliary sulcus using a long needle. A 9-0 suture was tied to the unpassed portion of the 10-0 suture with an SFK. We pulled the 10-0 suture to pass the SFK through the sclera, and then we cut the knot and removed the 10-0 suture. IOL fixation with 9-0 sutures used the conventional techniques used for sutured scleral-fixated IOL. Preoperative and postoperative visual acuity, corneal astigmatism, and endothelial cell count and intraoperative/postoperative complications were evaluated. An SFK joining the two sutures was passed through the sclera without breakage or slippage. A total of 35 eyes from 35 patients who underwent sutured scleral fixation of the IOL. An intraoperative complication (minor intraocular hemorrhage) was recorded in four cases. Knot exposure, IOL dislocation, subluxation, and retinal detachment were not observed. The SFK offers the opportunity to use 9-0 sutures for the long-term safety and may not require the surgeon to learn any new technique.

  9. Load response and gap formation in a single-row cruciate suture rotator cuff repair.

    Science.gov (United States)

    Huntington, Lachlan; Richardson, Martin; Sobol, Tony; Caldow, Jonathon; Ackland, David C

    2017-06-01

    Double-row rotator cuff tendon repair techniques may provide superior contact area and strength compared with single-row repairs, but are associated with higher material expenses and prolonged operating time. The purpose of this study was to evaluate gap formation, ultimate tensile strength and stiffness of a single-row cruciate suture rotator cuff repair construct, and to compare these results with those of the Mason-Allen and SutureBridge repair constructs. Infraspinatus tendons from 24 spring lamb shoulders were harvested and allocated to cruciate suture, Mason-Allen and SutureBridge repair groups. Specimens were loaded cyclically between 10 and 62 N for 200 cycles, and gap formation simultaneously measured using a high-speed digital camera. Specimens were then loaded in uniaxial tension to failure, and construct stiffness and repair strength were evaluated. Gap formation in the cruciate suture repair was significantly lower than that of the Mason-Allen repair (mean difference = 0.6 mm, P = 0.009) and no different from that of the SutureBridge repair (P > 0.05). Both the cruciate suture repair (mean difference = 15.7 N/mm, P = 0.002) and SutureBridge repair (mean difference = 15.8 N/mm, P = 0.034) were significantly stiffer than that of the Mason-Allen repair; however, no significant differences in ultimate tensile strength between repair groups were discerned (P > 0.05). The cruciate suture repair construct, which may represent a simple and cost-effective alternative to double-row and double-row equivalent rotator cuff repairs, has comparable biomechanical strength and integrity with that of the SutureBridge repair, and may result in improved construct longevity and tendon healing compared with the Mason-Allen repair. © 2017 Royal Australasian College of Surgeons.

  10. Sequential selective same-day suture removal in the management of post-keratoplasty astigmatism.

    Science.gov (United States)

    Fares, U; Mokashi, A A; Elalfy, M S; Dua, H S

    2013-09-01

    In a previous study, we proposed that corneal topography performed 30-40 min after the initial suture removal can identify the next set of sutures requiring removal, for the treatment of post-keratoplasty astigmatism. The aim of this study was to evaluate the effect of removing subsequent sets of sutures at the same sitting. 10/0 nylon interrupted sutures were placed, to secure the graft-host junction, at the time of keratoplasty. Topography was performed using Pentacam (Oculus) before suture removal. The sutures to be removed in the steep semi-meridians were identified and removed at the slit-lamp biomicroscope. Topography was repeated 30-40 min post suture removal, the new steep semi-meridians determined, and the next set of sutures to be removed were identified and removed accordingly. Topography was repeated 4-6 weeks later and the magnitude of topographic astigmatism was recorded. A paired-samples t-test was used to evaluate the impact of selective suture removal on reducing the magnitude of topographic and refractive astigmatism. Twenty eyes of 20 patients underwent sequential selective same-day suture removal (SSSS) after corneal transplantation. This study showed that the topographic astigmatism decreased by about 46.7% (3.68 D) and the refractive astigmatism decreased by about 37.7% (2.61 D) following SSSS. Vector calculations also show a significant reduction of both topographic and refractive astigmatism (P<0.001). SSSS may help patients to achieve satisfactory vision more quickly and reduce the number of follow-up visits required post keratoplasty.

  11. Intraoperative technique as a factor in the prevention of surgical site infection.

    LENUS (Irish Health Repository)

    McHugh, S M

    2012-02-01

    Approximately five percent of patients who undergo surgery develop surgical site infections (SSIs) which are associated with an extra seven days as an inpatient and with increased postoperative mortality. The competence and technique of the surgeon is considered important in preventing SSI. We have reviewed the evidence on different aspects of surgical technique and its role in preventing SSI. The most recent guidelines from the National Institute for Health and Clinical Excellence in the UK recommend avoiding diathermy for skin incision even though this reduces incision time and blood loss, both associated with lower infection rates. Studies comparing different closure techniques, i.e. continuous versus interrupted sutures, have not found a statistically significant difference in the SSI rate, but using continuous sutures is quicker. For contaminated wounds, the surgical site should be left open for four days to allow for treatment of local infection before subsequent healing by primary intention. Surgical drains should be placed through separate incisions, closed suction drains are preferable to open drains, and all drains should be removed as soon as possible. There are relatively few large studies on the impact of surgical techniques on SSI rates. Larger multicentre prospective studies are required to define what aspects of surgical technique impact on SSI, to better inform surgical practice and support education programmes for surgical trainees.

  12. Intraoperative technique as a factor in the prevention of surgical site infection.

    LENUS (Irish Health Repository)

    McHugh, S M

    2011-02-28

    Approximately five percent of patients who undergo surgery develop surgical site infections (SSIs) which are associated with an extra seven days as an inpatient and with increased postoperative mortality. The competence and technique of the surgeon is considered important in preventing SSI. We have reviewed the evidence on different aspects of surgical technique and its role in preventing SSI. The most recent guidelines from the National Institute for Health and Clinical Excellence in the UK recommend avoiding diathermy for skin incision even though this reduces incision time and blood loss, both associated with lower infection rates. Studies comparing different closure techniques, i.e. continuous versus interrupted sutures, have not found a statistically significant difference in the SSI rate, but using continuous sutures is quicker. For contaminated wounds, the surgical site should be left open for four days to allow for treatment of local infection before subsequent healing by primary intention. Surgical drains should be placed through separate incisions, closed suction drains are preferable to open drains, and all drains should be removed as soon as possible. There are relatively few large studies on the impact of surgical techniques on SSI rates. Larger multicentre prospective studies are required to define what aspects of surgical technique impact on SSI, to better inform surgical practice and support education programmes for surgical trainees.

  13. Laparoscopic cystostomy in pigs: Technique and comparison with traditional open cystostomy for surgical stress

    Directory of Open Access Journals (Sweden)

    Hua Zhang

    2014-01-01

    Full Text Available Cystostomy is a common procedure in veterinary surgery. We describe a technique for laparoscopic cystostomy (LC group; n = 7 in Bama miniature pigs and compare the surgical stress induced by this procedure to open cystostomy (OC group; n = 7. A three-portal approach was used for laparoscopic cystostomy. First, we placed 2 simple interrupted sutures between the ventral body wall and urinary bladder. Then, a purse-string suture was placed in the urinary bladder wall, approximately 1 cm cranially to the two sutures. A stab incision was made at the center of the purse-string suture and a 12-F Foley catheter advanced into the urinary bladder; the suture was then pulled tightly and tied. Again, two interrupted sutures were placed 1 cm cranially to the catheter, between the ventral body wall and the bladder, to establish cystopexy. The extracorporeal portion of the catheter was fixed to the skin by a finger-trap suture. Blood samples were collected to measure the white blood cell count and serum concentrations of cortisol, interleukin-6, and C-reactive protein; follow-up laparoscopy was performed 1 month after the surgery. Laparoscopic cystotomy was successfully performed in all the pigs; the mean operating time was 43 ± 5 min. The levels of the stress markers reflected a lower stress response for LC than OC. Thus, LC appears to be better than OC both in terms of technique and physiological responses elicited, and may be more suitable than OC in the creation of experimental animal models for investigations on urinary diseases and those requiring diversion of urine flow.

  14. 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.

  15. Surgical and procedural skills training at medical school - a national review.

    Science.gov (United States)

    Davis, Christopher R; Toll, Edward C; Bates, Anthony S; Cole, Matthew D; Smith, Frank C T

    2014-01-01

    This national study quantifies procedural and surgical skills training at medical schools in the United Kingdom (UK), a stipulated requirement of all graduates by the General Medical Council (GMC). A questionnaire recorded basic procedural and surgical skills training provided by medical schools and surgical societies in the UK. Skills were extracted from (1) GMC Tomorrows Doctors and (2) The Royal College of Surgeons Intercollegiate Basic Surgical Skills (BSS) course. Data from medical school curricula and extra-curricular student surgical societies were compared against the national GMC guidelines and BSS course content. Data were analysed using Mann-Whitney U tests. Representatives from 23 medical schools completed the survey (71.9% response). Thirty one skills extracted from the BSS course were split into 5 categories, with skills content cross referenced against GMC documentation. Training of surgical skills by medical schools was as follows: Gowning and gloving (72.8%), handling instruments (29.4%), knot tying (17.4%), suturing (24.7%), other surgical techniques (4.3%). Surgical societies provided significantly more training of knot tying (64.4%, P = 0.0013) and suturing (64.5%, P = 0.0325) than medical schools. Medical schools provide minimal basic surgical skills training, partially supplemented by extracurricular student surgical societies. Our findings suggest senior medical students do not possess simple surgical and procedural skills. Newly qualified doctors are at risk of being unable to safely perform practical procedures, contradicting GMC Guidelines. We propose a National Undergraduate Curriculum in Surgery and Surgical Skills to equip newly qualified doctors with basic procedural skills to maximise patient safety. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  16. Biomechanical advantages of triple-loaded suture anchors compared with double-row rotator cuff repairs.

    Science.gov (United States)

    Barber, F Alan; Herbert, Morley A; Schroeder, F Alexander; Aziz-Jacobo, Jorge; Mays, Matthew M; Rapley, Jay H

    2010-03-01

    To evaluate the strength and suture-tendon interface security of various suture anchors triply and doubly loaded with ultrahigh-molecular weight polyethylene-containing sutures and to evaluate the relative effectiveness of placing these anchors in a single-row or double-row arrangement by cyclic loading and then destructive testing. The infraspinatus muscle was reattached to the original humeral footprint by use of 1 of 5 different repair patterns in 40 bovine shoulders. Two single-row repairs and three double-row repairs were tested. High-strength sutures were used for all repairs. Five groups were studied: group 1, 2 triple-loaded screw suture anchors in a single row with simple stitches; group 2, 2 triple-loaded screw anchors in a single row with simple stitches over a fourth suture passed perpendicularly ("rip-stop" stitch); group 3, 2 medial and 2 lateral screw anchors with a single vertical mattress stitch passed from the medial anchors and 2 simple stitches passed from the lateral anchors; group 4, 2 medial double-loaded screw anchors tied in 2 mattress stitches and 2 push-in lateral anchors capturing the medial sutures in a "crisscross" spanning stitch; and group 5, 2 medial double-loaded screw anchors tied in 2 mattress stitches and 2 push-in lateral anchors creating a "suture-bridge" stitch. The specimens were cycled between 10 and 180 N at 1.0 Hz for 3,500 cycles or until failure. Endpoints were cyclic loading displacement (5 and 10 mm), total displacement, and ultimate failure load. A single row of triply loaded anchors was more resistant to stretching to a 5- and 10-mm gap than the double-row repairs with or without the addition of a rip-stop suture (P row repair (P row created by 2 medial double-loaded suture anchors and 2 lateral push-in anchors stretched more than any other group (P row repairs with either crossing sutures or 4 separate anchor points were more likely to fail (5- or 10-mm gap) than a single-row repair loaded with 3 simple sutures

  17. Construction of shallow land simulation apparatuses

    International Nuclear Information System (INIS)

    Yamamoto, Tadatoshi; Ohtsuka, Yoshiro; Takebe, Shinichi; Ohnuki, Toshihiko; Ogawa, Hiromichi; Harada, Yoshikane; Saitoh, Kazuaki; Wadachi, Yoshiki

    1984-07-01

    Shallow land simulation apparatuses in which natural soil can be used as testing soil have been constructed to investigate the migration characteristics of radionuclides in a disposal site. These apparatuses consist of aerated zone apparatus and aquifer zone one. In the aerated zone apparatus, aerated soil upon ground water level is contained in the soil column (d: 30cm x h: 120cm). In the aquifer zone apparatus, aquifer soil laying ground water level is contained in the soil vessel (b: 90cm x l: 270cm x h: 45cm). This report describes the outline of shallow land simulation apparatuses : function of apparatuses and specification of devices, analysis of obstructions, safety rules, analysis of accidents and operation manual. (author)

  18. A combination of subcuticular sutures and a drain for skin closure reduces wound complications in obese women undergoing surgery using vertical incisions.

    Science.gov (United States)

    Inotsume-Kojima, Y; Uchida, T; Abe, M; Doi, T; Kanayama, N

    2011-02-01

    Obesity is a risk factor for surgical site or wound complications in women undergoing surgery involving vertical incisions. Several investigators have reported the efficacy of subcutaneous drains in minimising the complication rate but there is no consensus on using these for surgery in obese patients. In 2006, the Scottish Surveillance of Healthcare Associated Infection Programme showed that using subcuticular sutures rather than staples to close incisions significantly reduced the risk of surgical site infection. Before January 2008 (group 1; N = 40), wound complications occurred in some obese patients in our hospital after obstetric and gynaecological surgery when only staples were used for skin closure. In January 2008 (group 2; N = 31), we changed the method of skin closure for obese patients [body mass index (BMI) > 28 kg/m(2)] and we now use a subcutaneous drain with four channels along the running tube and subcuticular sutures with interrupted, buried 4-0 polydioxanone sutures. The aim of this study was to assess the effects of these interventions for skin closure in obese women. The general characteristics (age, weight and BMI) were similar between the two groups. There were no wound complications in group 2. In group 1, wound disruptions and a seroma occurred in five (12.5%) and one (2.5%) patients, respectively. The wound complication rate in group 2 was significantly lower than that in group 1 (P = 0.0319). Thus, new materials and techniques for skin closure can reduce the wound complication rate in obese women. Copyright © 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

  19. Variable frequency microwave heating apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Bible, D.W.; Lauf, R.J.; Johnson, A.C.; Thigpen, L.T.

    1999-10-05

    A variable frequency microwave heating apparatus (10) designed to allow modulation of the frequency of the microwaves introduced into a multi-mode microwave cavity (34) for testing or other selected applications. The variable frequency microwave heating apparatus (10) includes a microwave signal generator (12) and a high-power microwave amplifier (20) or a high-power microwave oscillator (14). A power supply (22) is provided for operation of the high-power microwave oscillator (14) or microwave amplifier (20). A directional coupler (24) is provided for detecting the direction and amplitude of signals incident upon and reflected from the microwave cavity (34). A first power meter (30) is provided for measuring the power delivered to the microwave furnace (32). A second power meter (26) detects the magnitude of reflected power. Reflected power is dissipated in the reflected power load (28).

  20. Biomechanical characteristics of single-row repair in comparison to double-row repair with consideration of the suture configuration and suture material.

    Science.gov (United States)

    Baums, M H; Buchhorn, G H; Spahn, G; Poppendieck, B; Schultz, W; Klinger, H-M

    2008-11-01

    The aim of the study was to evaluate the time zero mechanical properties of single- versus double-row configuration for rotator cuff repair in an animal model with consideration of the stitch technique and suture material. Thirty-two fresh-frozen sheep shoulders were randomly assigned to four repair groups: suture anchor single-row repair coupled with (1) braided, nonabsorbable polyester suture sized USP No. 2 (SRAE) or (2) braided polyblend polyethylene suture sized No. 2 (SRAH). The double-row repair was coupled with (3) USP No. 2 (DRAE) or (4) braided polyblend polyethylene suture No. 2 (DRAH). Arthroscopic Mason-Allen stitches were used (single-row) and combined with medial horizontal mattress stitches (double-row). Shoulders were cyclically loaded from 10 to 180 N. Displacement to gap formation of 5- and 10-mm at the repair site, cycles to failure, and the mode of failure were determined. The ultimate tensile strength was verified in specimens that resisted to 3,000 cycles. DRAE and DRAH had a lower frequency of 5- (P = 0.135) and 10-mm gap formation (P = 0.135). All DRAE and DRAH resisted 3,000 cycles while only three SRAE and one SRAH resisted 3,000 cycles (P row specimens was significantly higher than in others (P 0.05). Double-row suture anchor repair with arthroscopic Mason-Allen/medial mattress stitches provides initial strength superior to single-row repair with arthroscopic Mason-Allen stitches under isometric cyclic loading as well as under ultimate loading conditions. Our results support the concept of double-row fixation with arthroscopic Mason-Allen/medial mattress stitches in rotator cuff tears with improvement of initial fixation strength and ultimate tensile load. Use of new polyblend polyethylene suture material seems not to increase the initial biomechanical aspects of the repair construct.

  1. Radiation scatter apparatus and method

    International Nuclear Information System (INIS)

    Molbert, J. L.; Riddle, E. R.

    1985-01-01

    A radiation scatter gauge includes multiple detector locations for developing separate and independent sets of data from which multiple physical characteristics of a thin material and underlying substrate may be determined. In an illustrated embodiment, the apparatus and method of the invention are directed to determining characteristics of resurfaced pavement by nondestructive testing. More particularly, the density and thickness of a thin asphalt overlay and the density of the underlying pavement may be determined

  2. Torque application technique and apparatus

    Science.gov (United States)

    Pineault, Raymond P.

    1993-11-01

    A tool which produces a measured torque is coupled to a bolt head or nut, located in a relatively inaccessible area, by apparatus which includes a wrench member affixed to an adaptor. The wrench member is sized and shaped to engage the fastener to be operated upon and the adaptor has a tubular construction with a tool engaging socket at one end. The adaptor is provided with an elongated slot which accommodates any wires which may pass through the fastener.

  3. Nuclear reactor vessel inspection apparatus

    International Nuclear Information System (INIS)

    Blackstone, E.G.; Lofy, R.A.; Williams, L.P.

    1979-01-01

    Apparatus for the in situ inspection of a nuclear reactor vessel to detect the location and character of flaws in the walls of the vessel, in the welds joining the various sections of the vessel, in the welds joining attachments such as nozzles, elbows and the like to the reactor vessel and in such attachments wherein an inspection head carrying one or more ultrasonic transducers follows predetermined paths in scanning the various reactor sections, welds and attachments

  4. Vibration damping method and apparatus

    Science.gov (United States)

    Redmond, James M.; Barney, Patrick S.; Parker, Gordon G.; Smith, David A.

    1999-01-01

    The present invention provides vibration damping method and apparatus that can damp vibration in more than one direction without requiring disassembly, that can accommodate varying tool dimensions without requiring re-tuning, and that does not interfere with tool tip operations and cooling. The present invention provides active dampening by generating bending moments internal to a structure such as a boring bar to dampen vibration thereof.

  5. Apparatus for making molten silicon

    Science.gov (United States)

    Levin, Harry (Inventor)

    1988-01-01

    A reactor apparatus (10) adapted for continuously producing molten, solar grade purity elemental silicon by thermal reaction of a suitable precursor gas, such as silane (SiH.sub.4), is disclosed. The reactor apparatus (10) includes an elongated reactor body (32) having graphite or carbon walls which are heated to a temperature exceeding the melting temperature of silicon. The precursor gas enters the reactor body (32) through an efficiently cooled inlet tube assembly (22) and a relatively thin carbon or graphite septum (44). The septum (44), being in contact on one side with the cooled inlet (22) and the heated interior of the reactor (32) on the other side, provides a sharp temperature gradient for the precursor gas entering the reactor (32) and renders the operation of the inlet tube assembly (22) substantially free of clogging. The precursor gas flows in the reactor (32) in a substantially smooth, substantially axial manner. Liquid silicon formed in the initial stages of the thermal reaction reacts with the graphite or carbon walls to provide a silicon carbide coating on the walls. The silicon carbide coated reactor is highly adapted for prolonged use for production of highly pure solar grade silicon. Liquid silicon (20) produced in the reactor apparatus (10) may be used directly in a Czochralski or other crystal shaping equipment.

  6. The Apparatus of Digital Archaeology

    Directory of Open Access Journals (Sweden)

    Jeremy Huggett

    2017-06-01

    Full Text Available Digital Archaeology is predicated upon an ever-changing set of apparatuses – technological, methodological, software, hardware, material, immaterial – which in their own ways and to varying degrees shape the nature of Digital Archaeology. Our attention, however, is perhaps inevitably more closely focused on research questions, choice of data, and the kinds of analyses and outputs. In the process we tend to overlook the effects the tools themselves have on the archaeology we do beyond the immediate consequences of the digital. This article introduces cognitive artefacts as a means of addressing the apparatus more directly within the context of the developing archaeological digital ecosystem. It argues that a critical appreciation of our computational cognitive artefacts is key to understanding their effects on both our own cognition and on the creation of archaeological knowledge. In the process, it defines a form of cognitive digital archaeology in terms of four distinct methods for extracting cognition from the digital apparatus layer by layer.

  7. Staple Line Reinforcement During Laparoscopic Sleeve Gastrectomy: Absorbable Monofilament, Barbed Suture, Fibrin Glue, or Nothing? Results of a Prospective Randomized Study.

    Science.gov (United States)

    Carandina, S; Tabbara, M; Bossi, M; Valenti, A; Polliand, C; Genser, L; Barrat, Christophe

    2016-02-01

    Laparoscopic sleeve gastrectomy (LSG) is associated with serious complications, such as staple line (SL) leaks and bleeding. In order to prevent the occurrence of these complications, surgeons have advocated the need to strengthen the staple line. The aim of this randomized controlled study was to compare the efficacy of three different ways of strengthening of the SL in LSG in preventing surgical post-operative complications. Between April 2012 and December 2014, 600 patients (pts) scheduled for LSG were prospectively randomized into groups without SL reinforcement (group A) or with SL reinforcement including fibrin glue coverage (group B), or oversewn SL with imbricating absorbable (Monocryl™; group C) or barbed (V lock®) running suture (group D). Primary endpoints were post-operative leaks, bleeding, and stenosis, while secondary outcomes consisted of the time to perform the staple line reinforcement (SLR) and total operative time. Mean SLR operative time was lower for group B (3.4 ± 1.3 min) compared with that for groups C (26.8 ± 8.5 min) and D (21.1 ± 8.4 min) (p running suture or with fibrin glue, is an unrewarding surgical act with the sole effect of prolonging the operative time.

  8. 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.)

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

    International Nuclear Information System (INIS)

    Simanovsky, Natalia; Hiller, Nurith; Koplewitz, Benjamin; Rozovsky, Katya

    2009-01-01

    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.)

  10. FGFR2c-mediated ERK-MAPK activity regulates coronal suture development

    Science.gov (United States)

    Pfaff, Miles J.; Xue, Ke; Li, Li; Horowitz, Mark C.; Steinbacher, Derek M.; Eswarakumar, Jacob V.P.

    2017-01-01

    Fibroblast growth factor receptor 2 (FGFR2) signaling is critical for proper craniofacial development. A gain-of-function mutation in the 2c splice variant of the receptor’s gene is associated with Crouzon syndrome, which is characterized by craniosynostosis, the premature fusion of one or more of the cranial vault sutures, leading to craniofacial maldevelopment. Insight into the molecular mechanism of craniosynostosis has identified the ERK-MAPK signaling cascade as a critical regulator of suture patency. The aim of this study is to investigate the role of FGFR2c-induced ERK-MAPK activation in the regulation of coronal suture development. Loss-of-function and gain-of-function Fgfr2c mutant mice have overlapping phenotypes, including coronal synostosis and craniofacial dysmorphia. In vivo analysis of coronal sutures in loss-of-function and gain-of-function models demonstrated fundamentally different pathogenesis underlying coronal suture synostosis. Calvarial osteoblasts from gain-of-function mice demonstrated enhanced osteoblastic function and maturation with concomitant increase in ERK-MAPK activation. In vitro inhibition with the ERK protein inhibitor U0126 mitigated ERK protein activation levels with a concomitant reduction in alkaline phosphatase activity. This study identifies FGFR2c-mediated ERK-MAPK signaling as a key mediator of craniofacial growth and coronal suture development. Furthermore, our results solve the apparent paradox between loss-of-function and gain-of-function FGFR2c mutants with respect to coronal suture synostosis. PMID:27034231

  11. 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

  12. Radiological assessment of skull base changes in children with syndromic craniosynostosis: role of ''minor'' sutures

    International Nuclear Information System (INIS)

    Calandrelli, Rosalinda; D'Apolito, Gabriella; Gaudino, Simona; Stefanetti, Mariangela; Colosimo, Cesare; Massimi, Luca; Di Rocco, Concezio

    2014-01-01

    This study aims to identify the premature synostosis of ''major'' and ''minor'' sutures of the four ''sutural arches'' of the skull and to perform a morphometric analysis in children with syndromic craniosynostosis in order to evaluate changes in the skull base linked with premature suture synostosis. We reviewed multiplanar high-resolution CT images, implemented with 3D reconstructions, from 18 patients with complex syndromic craniosynostosis and compared them with 18 age-matched healthy subjects. We assessed the calvarial sutures and their extension to the skull base, and then we correlated specific types of synostosis with the size, shape and symmetry of the cranial fossae. We found a marked asymmetry of the skull base growth in all patients. The synostotic involvement around the coronal ring caused a reduction in the growth of the anterior and middle fossae. The size of the posterior cranial fossa was related not only to ''major'' but also to ''minor'' suture synostosis of the lambdoid and parieto-squamosal arches. Changes in the skull base and craniofacial axis symmetry are due to structural and functional relationships between ''major'' and ''minor'' skull sutures, suggesting a structural and functional relationship between the neurocranium and basicranium. The early recognition of prematurely closed skull base sutures may help clinicians and neurosurgeons to establish correct therapeutic approaches. (orig.)

  13. 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)

  14. Basic interrupted versus continuous suturing techniques in bronchial anastomosis following sleeve lobectomy in dogs.

    Science.gov (United States)

    Bayram, Ahmet Sami; Erol, Mehmet Muharrem; Salci, Hakan; Ozyiğit, Ozgür; Görgül, Sacit; Gebitekin, Cengiz

    2007-12-01

    Sleeve resection with or without lung resection is a valid conservative operation for patients with benign or malignant tumors; it enables the preservation of lung parenchyma. The aim of this prospective randomized study was to compare complications, operating time, and bronchial healing between the techniques of interrupted and continuous suturing for bronchial anastomosis in dogs. Twenty adult mongrel dogs each weighing 18-22 kg (average: 20 kg) were divided into two groups according to the anastomosis technique performed: group A, interrupted suturing and group B, continuous suturing. Each group comprised of 10 dogs. Following right thoracotomy, sleeve resection of the right cranial lobe was performed in all dogs. Basic interrupted sutures using 4/0 Vicryl (Ethicon, USA) were used in group A, and continuous sutures were used in group B. The median anastomosis time was 15.2 min (range: 13-21 min) in group A and 9.6 min (range: 8-13 min) in group B. In all dogs, the anastomosis line was resected via right pneumonectomy for histopathological investigation 1 month after sleeve resection. Histopathological examination revealed that the healing of the anastomosis was not affected by the suturing technique applied. One dog from each group died on the fourth postoperative day; Fisher's exact test, p=0.763. Our research revealed that the healing of the anastomosis was not affected by the suturing technique performed.

  15. 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

  16. [An experimental assessment of methods for applying intestinal sutures in intestinal obstruction].

    Science.gov (United States)

    Akhmadudinov, M G

    1992-04-01

    The results of various methods used in applying intestinal sutures in obturation were studied. Three series of experiments were conducted on 30 dogs--resection of the intestine after obstruction with the formation of anastomoses by means of double-row suture (Albert--Shmiden--Lambert) in the first series (10 dogs), by a single-row suture after V. M. Mateshchuk [correction of Mateshuku] in the second series, and bu a single-row stretching suture suggested by the author in the third series. The postoperative complications and the parameters of physical airtightness of the intestinal anastomosis were studied in dynamics in the experimental animals. The results of the study: incompetence of the anastomosis sutures in the first series 6, in the second 4, and in the third series one. Adhesions occurred in all animals of the first and second series and in 2 of the third series. Six dogs of the first series died, 4 of the second, and one of the third. Study of the dynamics of the results showed a direct connection of the complications with the parameters of the physical airtightness of the anastomosis, and the last-named with the method of the intestinal suture. Relatively better results were noted in formation of the anastomosis by means of our suggested stretshing continuous suture passed through the serous, muscular, and submucous coats of the intestine.

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

    International Nuclear Information System (INIS)

    Roh, Hong Gee; Kim, Hyung Jin; Kang, Jee Hee; Lee, Kyung Hee; Lim, Myung Kwan; Cho, Young Kuk; Ok, Cheol Su; Suh, Chang Hae

    2000-01-01

    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)

  18. Medical Students Teaching Medical Students Surgical Skills: The Benefits of Peer-Assisted Learning.

    Science.gov (United States)

    Bennett, Samuel Robert; Morris, Simon Rhys; Mirza, Salman

    2018-04-10

    Teaching surgical skills is a labor intensive process, requiring a high tutor to student ratio for optimal success, and teaching for undergraduate students by consultant surgeons is not always feasible. A surgical skills course was developed, with the aim of assessing the effectiveness of undergraduate surgical peer-assisted learning. Five surgical skills courses were conducted looking at eight domains in surgery, led by foundation year doctors and senior medical students, with a tutor to student ratio of 1:4. Precourse and postcourse questionnaires (Likert scales 0-10) were completed. Mean scores were compared precourse and postcourse. Surgical skills courses took place within clinical skills rooms in the Queen Elizabeth Hospital Birmingham (UK). Seventy students (59 medical, 2 dental, and 9 physician associate students) from a range of academic institutions across the UK completed the course. There was an overall increase in mean scores across all eight domains. Mean improvement score precourse and postcourse in WHO surgical safety checklist (+3.94), scrubbing (+2.99), gowning/gloving (+3.34), knot tying (+5.53), interrupted sutures (+5.89), continuous sutures (+6.53), vertical mattress sutures (+6.46), and local anesthesia (+3.73). Peer-assisted learning is an effective and feasible method for teaching surgical skills in a controlled environment, subsequently improving confidence among healthcare undergraduates. Such teaching may provide the basis for feasibly mass-producing surgical skills courses for healthcare students. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. 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.

  20. Influence of suture technique and suture material selection on the mechanics of end-to-end and end-to-side anastomoses.

    Science.gov (United States)

    Baumgartner, N; Dobrin, P B; Morasch, M; Dong, Q S; Mrkvicka, R

    1996-05-01

    Experiments were performed in dogs to evaluate the mechanics of 26 end-to-end and 42 end-to-side artery-vein graft anastomoses constructed with continuous polypropylene sutures (Surgilene; Davis & Geck, Division of American Cyanamid Co., Danbury, Conn.), continuous polybutester sutures (Novafil; Davis & Geck), and interrupted stitches with either suture material. After construction, the grafts and adjoining arteries were excised, mounted in vitro at in situ length, filled with a dilute barium sulfate suspension, and pressurized in 25 mm Hg steps up to 200 mm Hg. Radiographs were obtained at each pressure. The computed cross-sectional areas of the anastomoses were compared with those of the native arteries at corresponding pressures. Results showed that for the end-to-end anastomoses at 100 mm Hg the cross-sectional areas of the continuous Surgilene anastomoses were 70% of the native artery cross-sectional areas, the cross-sectional areas of the continuous Novafil anastomoses were 90% of the native artery cross-sectional areas, and the cross-sectional areas of the interrupted anastomoses were 107% of the native artery cross-sectional areas (p anastomoses demonstrated no differences in cross-sectional areas or compliance for the three suture techniques. This suggests that, unlike with end-to-end anastomoses, when constructing an end-to-side anastomosis in patients any of the three suture techniques may be acceptable.

  1. Interfascicular suture with nerve autografts for median, ulnar and radial nerve lesions.

    Science.gov (United States)

    Pluchino, F; Luccarelli, G

    1981-05-01

    Interfascicular nerve suture with autografts is the operation of choice for repairing peripheral nerve injuries because it ensures more precise alignment of the fasciculi and so better chances of reinnervation of the sectioned nerve. The procedure as described by Millesi et al has been used at the Istituto Neurologico di Milano in 30 patients with traumatic lesions of the median, ulnar and radial nerves. All have been followed up for 2 to 7 years since operation. The results obtained are compared with those of other series obtained with interfascicular suture and with epineural suture. Microsurgery is essential. The best time to operate is discussed.

  2. 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...

  3. Congenital branchial apparatus malformation in a Haflinger colt.

    Science.gov (United States)

    David, Florent; Savard, Claudine; Drolet, Richard; Alexander, Kate; Pang, Daniel S J; Laverty, Sheila

    2008-01-01

    To report the diagnosis and treatment of a branchial apparatus anomaly (BAA) associated with a mandibular malformation in a foal. Clinical report. Haflinger foal. A 6-day-old foal had a fluctuating cystic mass in the pharyngeal (throatlatch) region, which changed in appearance after ingestion of milk. Upper airway endoscopy and diagnostic imaging (ultrasonography, radiography, computed tomography) permitted identification of the anatomic location of a communicating tract between the lumen of the cystic mass and the pharynx. The mass was surgically removed and communication with the pharynx ligated. Histologic appearance of this mass was consistent with a branchial cyst or sinus. The mandibular malformation was managed conservatively. Surgical resection of a third branchial sinus resulted in an excellent functional and cosmetic outcome. There was no evidence of any mandibular deformity 2 years later. BAA may induce secondary mandibular deformation in utero and may cause respiratory compromise postpartum. Careful surgical dissection and removal of BAA resulted in an excellent outcome. BAAs should be included in the differential diagnosis of a throatlatch region mass in equine neonates. Complete surgical excision is recommended and full recovery of any associated mandibular deformity may be anticipated without additional treatment in very young patients.

  4. Celastrol nanoparticles inhibit corneal neovascularization induced by suturing in rats

    Directory of Open Access Journals (Sweden)

    Li ZR

    2012-03-01

    Full Text Available Zhanrong Li1, Lin Yao1, Jingguo Li2, Wenxin Zhang1, Xianghua Wu1, Yi Liu1, Miaoli Lin1, Wenru Su1, Yongping Li1, Dan Liang11State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 2School of Chemistry and Chemical Engineering, Sun Yat-Sen University, Guangzhou, People's Republic of ChinaPurpose: Celastrol, a traditional Chinese medicine, is widely used in anti-inflammation and anti-angiogenesis research. However, the poor water solubility of celastrol restricts its further application. This paper aims to study the effect of celastrol nanoparticles (CNPs on corneal neovascularization (CNV and determine the possible mechanism.Methods: To improve the hydrophilicity of celastrol, celastrol-loaded poly(ethylene glycol-block-poly(ε-caprolactone nanopolymeric micelles were developed. The characterization of CNPs was measured by dynamic light scattering and transmission electron microscopy analysis. Celastrol loading content and release were assessed by ultraviolet-visible analysis and high performance liquid chromatography, respectively. In vitro, human umbilical vein endothelial cell proliferation and capillary-like tube formation were assayed. In vivo, suture-induced CNV was chosen to evaluate the effect of CNPs on CNV in rats. Immunohistochemistry for CD68 assessed the macrophage infiltration of the cornea on day 6 after surgery. Real-time quantitative reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay were used to evaluate the messenger ribonucleic acid and protein levels, respectively, of vascular endothelial growth factor, matrix metalloproteinase 9, and monocyte chemoattractant protein 1 in the cornea.Results: The mean diameter of CNPs with spherical shape was 48 nm. The celastrol loading content was 7.36%. The release behavior of CNPs in buffered solution (pH 7.4 showed a typical two-phase release profile. CNPs inhibited the proliferation of human umbilical vein endothelial

  5. Ability of the Tightrope® and percutaneous lateral fabellar suture techniques to control cranial tibial translation.

    Science.gov (United States)

    Biskup, Jeffery J; Griffon, Dominique J; Socie, Mike; Schaeffer, David J; Kurath, Peter

    2014-11-01

    To compare the ability of the Tightrope® (TR) cranial cruciate ligament (CCL) technique, percutaneous lateral fabella suture (pLFS) technique, and normal CCL to control cranial tibial translation (CTT). In vitro biomechanical study. Cadaveric canine pelvic limbs (n = 18 pairs). Six small animal surgical residents (1 pair each) and a Diplomate of the American College of Veterinary Surgeons (10 pairs) performed TR and pLFS techniques on paired limbs. Two intact limb pairs served as controls. Limbs were assessed by palpation, radiographs, and dissection before mechanical testing of resistance to CTT. Forces resisted during displacement were compared between groups with a mixed ANOVA and post hoc tests. With 5 mm of displacement, the pLFS resisted 72 ± 45 N and the TR resisted 66 ± 48 N of load. The intact CCL resisted 400 ± 35 N. The intact CCL resisted displacement significantly more than either surgical technique. TR and pLFS had similar ability to resist CTT but neither restored the biomechanical properties of an intact CCL. © Copyright 2014 by The American College of Veterinary Surgeons.

  6. A rare case of persistent metopic suture in an elderly individual: Incidental autopsy finding with clinical implications

    Directory of Open Access Journals (Sweden)

    S Vikram

    2014-01-01

    Full Text Available Metopic suture is a dense fibrous joint extending from the nasion to the bregma. Normally, closure of this suture takes place between 1-8 years of age. Failure of this closure beyond 8 years leads to persistent metopic suture. A rare case of persistent metopic suture in a 60-year-old male is documented, who committed suicide by alleged consumption of organophosphorous compound at District Govt. Wenlock Hospital, Mangalore, Karnataka, India. Metopic suture may mimic skull fracture and may mislead an inexperienced forensic expert. Neurosurgeon should also be aware of this anatomical variation while performing frontal craniotomy, as the persistent metopic suture may mimic vertical fracture of the skull. Hence, in this case report, the clinical and medico-legal implications of the persistent metopic sutures have been discussed.

  7. [Surgical management, prognostic factors, and outcome in hepatic trauma].

    Science.gov (United States)

    Ott, R; Schön, M R; Seidel, S; Schuster, E; Josten, C; Hauss, J

    2005-02-01

    Hepatic trauma is a rare surgical emergency with significant morbidity and mortality. Extensive experience in liver surgery is a prerequisite for the management of these injuries. The medical records of 68 consecutive patients with hepatic trauma were retrospectively reviewed for the severity of liver injury, management, morbidity, mortality, and risk factors. Of the patients, 14 were treated conservatively and 52 surgically (24 suture/fibrin glue, 16 perihepatic packing, 11 resections, 1 liver transplantation). Two patients died just before emergency surgery could be performed. Overall mortality was 21% (14/68), and 13, 14, 6, 27, and 50% for types I, II, III, IV, and V injuries, respectively. Only nine deaths (all type IV and V) were liver related, while four were caused by extrahepatic injuries and one by concomitant liver cirrhosis. With respect to treatment, conservative management, suture, and resection had a low mortality of 0, 4, and 9%, respectively. In contrast, mortality was 47% in patients in whom only packing was performed (in severe injuries). Stepwise multivariate regression analysis proved prothrombin values 30, and transfusion requirements of more than 10 red packed cells to be significant risk factors for post-traumatic death. Type I-III hepatic injuries can safely be treated by conservative or simple surgical means. However, complex hepatic injuries (types IV and V) carry a significant mortality and may require hepatic surgery, including liver resection or even transplantation. Therefore, patients with severe hepatic injuries should be treated in a specialized institution.

  8. 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

  9. Surgical efficiencies and quality in the performance of voluntary medical male circumcision (VMMC procedures in Kenya, South Africa, Tanzania, and Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Dino Rech

    Full Text Available This analysis explores the association between elements of surgical efficiency in voluntary medical male circumcision (VMMC, quality of surgical technique, and the amount of time required to conduct VMMC procedures in actual field settings. Efficiency outcomes are defined in terms of the primary provider's time with the client (PPTC and total elapsed operating time (TEOT.Two serial cross-sectional surveys of VMMC sites were conducted in Kenya, Republic of South Africa, Tanzania and Zimbabwe in 2011 and 2012. Trained clinicians observed quality of surgical technique and timed 9 steps in the VMMC procedure. Four elements of efficiency (task-shifting, task-sharing [of suturing], rotation among multiple surgical beds, and use of electrocautery and quality of surgical technique were assessed as explanatory variables. Mann Whitney and Kruskal Wallis tests were used in the bivariate analysis and linear regression models for the multivariate analyses to test the relationship between these five explanatory variables and two outcomes: PPTC and TEOT. The VMMC procedure TEOT and PPTC averaged 23-25 minutes and 6-15 minutes, respectively, across the four countries and two years. The data showed time savings from task-sharing in suturing and use of electrocautery in South Africa and Zimbabwe (where task-shifting is not authorized. After adjusting for confounders, results demonstrated that having a secondary provider complete suturing and use of electrocautery reduced PPTC. Factors related to TEOT varied by country and year, but task-sharing of suturing and/or electrocautery were significant in two countries. Quality of surgical technique was not significantly related to PPTC or TEOT, except for South Africa in 2012 where higher quality was associated with lower TEOT.SYMMACS data confirm the efficiency benefits of task-sharing of suturing and use of electrocautery for decreasing TEOT. Reduced TEOT and PPTC in high volume setting did not result in decreased

  10. Comparing the Use of 3D Photogrammetry and Computed Tomography in Assessing the Severity of Single-Suture Nonsyndromic Craniosynostosis.

    Science.gov (United States)

    Ho, Olivia A; Saber, Nikoo; Stephens, Derek; Clausen, April; Drake, James; Forrest, Christopher; Phillips, John

    2017-05-01

    Single-suture nonsyndromic craniosynostosis is diagnosed using clinical assessment and computed tomography (CT). With increasing awareness of the associated risks of radiation exposure, the use of CT is particularly concerning in patients with craniosynostosis since they are exposed at a younger age and more frequently than the average child. Three-dimensional (3D) photogrammetry is advantageous-it involves no radiation, is conveniently obtainable within clinic, and does not require general anaesthesia. This study aims to assess how 3D photogrammetry compares to CT in the assessment of craniosynostosis severity, to quantify surgical outcomes, and analyze the validity of 3D photogrammetry in craniosynostosis. Computed tomography images and 3D photographs of patients who underwent craniosynostosis surgery were assessed and aligned to best fit. The intervening area between the CT and 3D photogrammetry curves at the supraorbital bar (bandeau) level in axial view was calculated. Statistical analysis was performed using Student t test. Ninety-five percent confidence intervals were determined and equivalence margins were applied. In total, 41 pairs of CTs and 3D photographs were analyzed. The 95% confidence interval was 198.16 to 264.18 mm 2 and the mean was 231.17 mm 2 . When comparisons were made in the same bandeau region omitting the temporalis muscle, the 95% confidence interval was 108.94 to 147.38 mm 2 , and the mean was 128.16 mm 2 . Although statistically significant difference between the modalities was found, they can be attributable to the dampening effect of soft tissue. Within certain error margins, 3D photogrammetry is comparable to CT in assessing the severity of single-suture nonsyndromic craniosynostosis. However, a dampening effect can be attributable to the soft tissue. Three-dimensional photogrammetry may be more applicable for severe cases of craniosynostosis but not milder deformity. It may also be beneficial for assessing the overall appearance and

  11. Undergraduate basic surgical skills education: impact on attitudes to a career in surgery and surgical skills acquisition.

    Science.gov (United States)

    McAnena, P F; O'Halloran, N; Moloney, B M; Courtney, D; Waldron, R M; Flaherty, G; Kerin, M J

    2018-05-01

    Basic surgical skills modules in medical education are effective in teaching skills and increasing confidence among students approaching surgery. However, these modules are not delivered universally and their effect on the professional development of graduates has not been established. We aimed to assess the impact of a 10-week basic surgical skills module on attitudes and technical skills of first year medical students compared to interns. Eighteen students participated and were assessed using a 4-part questionnaire. Technical skills were assessed by observing students perform a basic interrupted suture, using the objective structured assessment of technical skills (OSATS) tool. Fourteen interns were recruited. Students were more confident in surgical scrubbing (mean score 4.0 vs. 2.86, p = 0.001), and performing a basic suture (4.05 vs. 1.93, p = 0.000), more enthusiastic about assisting with an operation (4.5 vs. 3.0, p = 0.001) and more likely to consider a career in surgery (4.16 vs. 2.28, p = 0.000). Technical skills were greater in the student group (mean score 30.8 vs. 19.6, p = 0.001). Five interns had taken part in surgical skills modules as undergraduates. Their technical skills were significantly higher compared to interns who had not (n = 9) (28.8 vs. 14.5, p = 0.006), and they were more likely to consider a career in surgery (3.6 vs. 1.5, p = 0.036). The introduction of surgical skills teaching to the undergraduate medical curriculum has a positive impact on students' attitudes towards surgery and accelerates basic technical skills development. Consideration should be given to development of a standardised undergraduate core curriculum in basic surgical skills teaching.

  12. Surgical management of palatine Torus - case series

    Directory of Open Access Journals (Sweden)

    Thaís Sumie Nozu Imada

    Full Text Available INTRODUCTION: Torus palatinus is a specific name to identify exostoses developed in the hard palate along the median palatine suture. Despite of not being a pathological condition, its presence requires attention and knowledge regarding its management. Surgical removal of exostoses is indicated when the patient frequently traumatizes the area of palatine torus during mastication and speech or when it is necessary for the rehabilitation of the upper arcade with complete dentures. OBJECTIVE: The aim of this article is to present three cases of Torus palatinus and to discuss the management of them. CASE REPORT: In the first case, a 57-year-old Caucasian man sought oral rehabilitation of his edentulous maxilla but presented a hard nodules in the hard palate; in the second case, a 40-year-old Caucasian woman was referred for frequent trauma of palatal mucosa during mastication, aesthetic complaint, and discomfort caused by the trauma of her tongue in this area; and in the third case, a 45-year-old Caucasian woman presented with a lesion on the palate that caused difficulty swallowing. When the Torus palatinus was impairing the basic physiological functions of the patients, all cases were surgically treated, improving the patients' quality of life. FINAL CONSIDERATION: The dentist should be properly prepared to choose the best from among the existing surgical approaches for each individual lesion in order to improve the results and avoid possible complications.

  13. A new surgical technique for traumatic dislocation of posterior tibial tendon with avulsion fracture of medial malleolus.

    Science.gov (United States)

    Jeong, Soon-Taek; Hwang, Sun-Chul; Kim, Dong-Hee; Nam, Dae-Cheol

    2015-01-01

    We introduce a case of traumatic dislocation of the posterior tibial tendon with avulsion fracture of the medial malleolus in a 52-year-old female patient who was treated surgically with periosteal flap and suture anchor fixation. Based in the posteromedial ridge of the distal tibia, a quadrilateral periosteal flap was created and folded over the tendon, followed by fixation on the lateral aspect of the groove by use of multiple suture anchors. Clinical and radiological findings 25 months postoperatively showed well-preserved function of the ankle joint with stable tendon gliding.

  14. Apparatuses And Systems For Embedded Thermoelectric Generators

    KAUST Repository

    Hussain, Muhammad M.

    2013-08-08

    An apparatus and a system for embedded thermoelectric generators are disclosed. In one embodiment, the apparatus is embedded in an interface where the ambient temperatures on two sides of the interface are different. In one embodiment, the apparatus is fabricated with the interface in integrity as a unitary piece. In one embodiment, the apparatus includes a first thermoelectric material embedded through the interface. The apparatus further includes a second thermoelectric material embedded through the interface. The first thermoelectric material is electrically coupled to the second thermoelectric material. In one embodiment, the apparatus further includes an output structure coupled to the first thermoelectric material and the second thermoelectric material and configured to output a voltage.

  15. Apparatuses And Systems For Embedded Thermoelectric Generators

    KAUST Repository

    Hussain, Muhammad M.; Inayat, Salman Bin; Smith, Casey Eben

    2013-01-01

    An apparatus and a system for embedded thermoelectric generators are disclosed. In one embodiment, the apparatus is embedded in an interface where the ambient temperatures on two sides of the interface are different. In one embodiment, the apparatus is fabricated with the interface in integrity as a unitary piece. In one embodiment, the apparatus includes a first thermoelectric material embedded through the interface. The apparatus further includes a second thermoelectric material embedded through the interface. The first thermoelectric material is electrically coupled to the second thermoelectric material. In one embodiment, the apparatus further includes an output structure coupled to the first thermoelectric material and the second thermoelectric material and configured to output a voltage.

  16. 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 (ocean ridge-type volcanics and recrystallised radiolarian cherts, interpreted as accreted oceanic crust. (4). The Bauma-Harel Group (structurally highest) is a thick succession (several km) of Ordovician and Carboniferous to Permian-Triassic, low

  17. ACL Surgical Technique — Staying Out of Trouble

    Directory of Open Access Journals (Sweden)

    Predescu Vlad

    2016-11-01

    Full Text Available The incidence of ACL tear and reconstruction has increased over time, and failure of ACL reconstruction is not perfectly defined among surgeons. Atraumatic failure of ACL surgery represents approximately 70% of causes, and occurs in diagnostic errors, technical errors and problems of ACL graft integrations. Regarding surgical technique, we should answer certain questions about our choice of surgery, tunnel position, graft type, graft suture, tensioning the graft, and how we deal with certain incidents or intraoperative accidents. The purpose of this article is to review the current information and trends of ACL reconstruction, and presents some tips and tricks we use in our current practice.

  18. Query-by-example surgical activity detection.

    Science.gov (United States)

    Gao, Yixin; Vedula, S Swaroop; Lee, Gyusung I; Lee, Mija R; Khudanpur, Sanjeev; Hager, Gregory D

    2016-06-01

    Easy acquisition of surgical data opens many opportunities to automate skill evaluation and teaching. Current technology to search tool motion data for surgical activity segments of interest is limited by the need for manual pre-processing, which can be prohibitive at scale. We developed a content-based information retrieval method, query-by-example (QBE), to automatically detect activity segments within surgical data recordings of long duration that match a query. The example segment of interest (query) and the surgical data recording (target trial) are time series of kinematics. Our approach includes an unsupervised feature learning module using a stacked denoising autoencoder (SDAE), two scoring modules based on asymmetric subsequence dynamic time warping (AS-DTW) and template matching, respectively, and a detection module. A distance matrix of the query against the trial is computed using the SDAE features, followed by AS-DTW combined with template scoring, to generate a ranked list of candidate subsequences (substrings). To evaluate the quality of the ranked list against the ground-truth, thresholding conventional DTW distances and bipartite matching are applied. We computed the recall, precision, F1-score, and a Jaccard index-based score on three experimental setups. We evaluated our QBE method using a suture throw maneuver as the query, on two tool motion datasets (JIGSAWS and MISTIC-SL) captured in a training laboratory. We observed a recall of 93, 90 and 87 % and a precision of 93, 91, and 88 % with same surgeon same trial (SSST), same surgeon different trial (SSDT) and different surgeon (DS) experiment setups on JIGSAWS, and a recall of 87, 81 and 75 % and a precision of 72, 61, and 53 % with SSST, SSDT and DS experiment setups on MISTIC-SL, respectively. We developed a novel, content-based information retrieval method to automatically detect multiple instances of an activity within long surgical recordings. Our method demonstrated adequate recall

  19. [Surgical management of animal bites in children].

    Science.gov (United States)

    Touzet-Roumazeille, S; Jayyosi, L; Plenier, Y; Guyot, E; Guillard, T; François, C

    2016-10-01

    Children represent a population at risk, because of their short size, their naivety and their attraction to animals. The face and hands are the most specific locations in young children. Wounds are often multiple. In more than half the cases, the child knows the animal, which are dogs and cats by frequency argument. The bite episode occurs mostly when the child is alone with the pet without direct supervision, while playing or stroking the animal. As in all bites, pediatric lesions are infectious, functional and aesthetic emergencies, but the goal of this work was primarily to make a point on principles of surgical management of animal bites in children, highlighting pediatric specificities. Animal bites require psychological, anesthetic and surgical treatment, adapted to the child, in a specialized structure. Hospitalization and general anesthesia are more frequent in children. Any suspicion of mistreatment (and/or abuse) should lead to the child's hospitalization, even if wounds do not justify monitoring in a surgical environment. Emergency surgery is essential to limit functional and aesthetic consequences. The healing capacities of the child and the frequent lack of co-morbidity allow a conservative surgical treatment with suture, repositioning skin flaps and controlled healing in the first place. Immobilization, drainage, and antibiotics will complete the surgery. The healing process, however, leads to a specific management during scar remodeling phase and growth. Psychological care of the child and parents should not be forgotten, and has to start at the same time as surgical treatment at in acute phase. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  20. The suture provides a niche for mesenchymal stem cells of craniofacial bones

    Science.gov (United States)

    Zhao, Hu; Feng, Jifan; Ho, Thach-Vu; Grimes, Weston; Urata, Mark; Chai, Yang

    2015-01-01

    Bone tissue undergoes constant turnover supported by stem cells. Recent studies showed that perivascular mesenchymal stem cells (MSCs) contribute to the turnover of long bones. Craniofacial bones are flat bones derived from a different embryonic origin than the long bones. The identity and regulating niche for craniofacial bone MSCs remain unknown. Here, we identify Gli1+ cells within the suture mesenchyme as the major MSC population for craniofacial bones. They are not associated with vasculature, give rise to all craniofacial bones in the adult and are activated during injury repair. Gli1+ cells are typical MSCs in vitro. Ablation of Gli1+ cells leads to craniosynostosis and arrest of skull growth, indicating these cells are an indispensible stem cell population. Twist1+/− mice with craniosynostosis show reduced Gli1+ MSCs in sutures, suggesting that craniosynostosis may result from diminished suture stem cells. Our study indicates that craniofacial sutures provide a unique niche for MSCs for craniofacial bone homeostasis and repair. PMID:25799059

  1. Editorial Commentary: All-Suture Anchors, Foam Blocks, and Biomechanical Testing.

    Science.gov (United States)

    Brand, Jefferson C

    2017-06-01

    Barber's biomechanical work is well known to Arthroscopy's readers as thorough, comprehensive, and inclusive of new designs as they become available. In "All-Suture Anchors: Biomechanical Analysis of Pullout Strength, Displacement, and Failure Mode," the latest iteration, Barber and Herbert test all-suture anchors in both porcine femurs and biphasic foam. While we await in vivo clinical trials that compare all-suture anchors to currently used anchors, Barber and Herbert have provided data to inform anchor choice, and using their biomechanical data at time zero from all-suture anchor trials in an animal model, we can determine the anchors' feasibility for human clinical investigations. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  2. Shape memory alloy fixator system for suturing tissue in minimal access surgery.

    Science.gov (United States)

    Xu, W; Frank, T G; Stockham, G; Cuschieri, A

    1999-01-01

    A new technique for suturing human tissue is described in which tissue closure is achieved by means of small fixators made from shape memory alloy. The aim of the development is to provide an alternative to thread suturing in minimal access surgery, which is quicker and requires less skill to achieve the required suturing quality. The design of the fixators is described in terms of the thermal shape recovery of shape memory alloy and a novel form of finite element analysis, which uses a nonlinear elastic element for the material property. Thermal analysis of the fixators and surrounding tissue is used to predict the temperature distribution during and after the application of electric current heating. This was checked in an in vitro experiment, which confirmed that deployment caused no detectable collateral damage to surrounding tissue. In vivo animal studies on the use of the shape memory alloy fixator for suturing tissue are ongoing to establish safety and healing effects.

  3. 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.

  4. Safety and efficacy of unidirectional barbed suture in mini-laparotomy myomectomy

    Directory of Open Access Journals (Sweden)

    Ming-Chao Huang

    2013-03-01

    Conclusion: The unidirectional knotless barbed suture may facilitate the repair of uterine defects during mini-laparotomy myomectomy by significantly lowering operative time. It may also reduce the intraoperative blood loss.

  5. Apparatus for producing laser targets

    International Nuclear Information System (INIS)

    Jarboe, T.R.; Baker, W.R.

    1975-01-01

    This patent relates to an apparatus and method for producing deuterium targets or pellets of 25u to 75u diameter. The pellets are sliced from a continuously spun solid deuterium thread at a rate of up to 10 pellets/second. The pellets after being sliced from the continuous thread of deuterium are collimated and directed to a point of use, such as a laser activated combustion or explosion chamber wherein the pellets are imploded by laser energy or laser produced target plasmas for neutral beam injection

  6. X-ray photographic apparatus

    International Nuclear Information System (INIS)

    1977-01-01

    The X-ray photographic system is designed for medical applications. Two detectors are used for surveys in different planes, and produce electrical signals which are supplied to a comparator. The electron beams are examined according to a system of reference time steps. The apparatus includes a light source and a photo-detector and enables a reference signal to be produced against which the detected signals are compared. The beam source is formed from an electron gun, an extractor electrode and an anode; beam then passes through a collimator. (G.C.)

  7. Apparatus for measuring radioactive emissions

    International Nuclear Information System (INIS)

    Bohme, R.C.; Lazerson, M.M.

    1984-01-01

    Apparatus for measuring radioactive emissions from moving radioactive material comprises at least one radiation detector in a housing serving as a first radiation shield and in which at least one groove is formed to expose at least a portion of a receptor surface of the detector. The groove extends transverse to the direction of movement of the material over the detector. A second radiation shield may be located between at least a portion of the first shield and the detector. The material of the second shield is inherently less contaminated and emits secondary excitation radiation of lower energy than the first material. (author)

  8. Strip casting apparatus and method

    Science.gov (United States)

    Williams, R.S.; Baker, D.F.

    1988-09-20

    Strip casting apparatus including a molten-metal-holding container and a nozzle to deposit molten metal onto a moving chill drum to directly cast continuous metallic strip. The nozzle body includes a slot bounded between a back and a front lip. The slot width exceeds about 20 times the gap distance between the nozzle and the chill drum surface. Preferably, the slot width exceeds 0.5 inch. This method of strip casting minimizes pressure drop, insuring better metal-to-chill-drum contact which promotes heat transfer and results in a better quality metallic strip. 6 figs.

  9. Specifications for surface reaction analysis apparatus

    International Nuclear Information System (INIS)

    Teraoka, Yuden; Yoshigoe, Akitaka

    2001-03-01

    A surface reaction analysis apparatus was installed at the JAERI soft x-ray beamline in the SPring-8 as an experimental end-station for the study of surface chemistry. The apparatus is devoted to the study concerning the influence of translational kinetic energy of incident molecules to chemical reactions on solid surfaces with gas molecules. In order to achieve the research purpose, reactive molecular scattering experiments and photoemission spectroscopic measurements using synchrotron radiation are performed in that apparatus via a supersonic molecular beam generator, an electron energy analyzer and a quadrupole mass analyzer. The detail specifications for the apparatus are described in this report. (author)

  10. Comparable biomechanical results for a modified single-row rotator cuff reconstruction using triple-loaded suture anchors versus a suture-bridging double-row repair.

    Science.gov (United States)

    Lorbach, Olaf; Kieb, Matthias; Raber, Florian; Busch, Lüder C; Kohn, Dieter; Pape, Dietrich

    2012-02-01

    To compare the biomechanical properties and footprint coverage of a single-row (SR) repair using a modified suture configuration versus a double-row (DR) suture-bridge repair in small to medium and medium to large rotator cuff tears. We created 25- and 35-mm artificial defects in the rotator cuff of 24 human cadaveric shoulders. The reconstructions were performed as either an SR repair with triple-loaded suture anchors (2 to 3 anchors) and a modified suture configuration or a modified suture-bridge DR repair (4 to 6 anchors). Reconstructions were cyclically loaded from 10 to 60 N. The load was increased stepwise up to 100, 180, and 250 N. Cyclic displacement and load to failure were determined. Furthermore, footprint widths were quantified. In the 25-mm rupture, ultimate load to failure was 533 ± 107 N for the SR repair and 681 ± 250 N for the DR technique (P ≥ .21). In the 35-mm tear, ultimate load to failure was 792 ± 122 N for the SR reconstruction and 891 ± 174 N for the DR reconstruction (P ≥ .28). There were no statistically significant differences for both tested rupture sizes. Cyclic displacement showed no significant differences between the tested configurations at 60 N (P = .563), 100 N (P = .171), 180 N (P = .211), and 250 N (P = .478) for the 25-mm tear. For the 35-mm tear, cyclic displacement showed significantly lower gap formation for the SR reconstruction at 180 N (P = .037) and 250 N (P = .020). No significant differences were found at 60 N (P = .296) and 100 N (P = .077). A significantly greater footprint width (P = .028) was seen for the DR repair (16.2 mm) compared with the SR repair (13.8 mm). However, both reconstructions were able to achieve complete footprint coverage compared with the initial footprint. The tested SR repair using a modified suture configuration was similar in load to failure and cyclic displacement to the DR suture-bridge technique independent of the tested initial sizes of the rupture. The tested DR repair

  11. Surgical excision of Infantile Haemangiomas: a technical refinement to prevent bleeding complications

    Directory of Open Access Journals (Sweden)

    F. Leone

    2014-06-01

    Full Text Available Purpose: The aim of the study is to improve operative speed and precision of haemangiomas excision. Methods: Case-report: haemangioma is a common affection of the 8% of the population during the neonatal period. In complicated cases and involution sequelae surgical treatment is the first choice. The Authors propose a surgical refinement to prevent intraoperative bleeding. Methods: several suture stitches were placed around the hemangioma. The edges of the lesion became more defined, thus allowing accurate excision. Results and Conclusions: Haemangiomas are characterized by rich blood supply. Surgery is often hindered by massive bleeding and Temporary placement of full-thickness sutures, surrounding the hemangioma, allowed a noticeable improvement in hemostasis precision and greater definition of the margins of the hemangioma.

  12. [Surgical solutions to luxation of the IOL--capsular bag--capsular tension ring complex].

    Science.gov (United States)

    Berthout, A; Turut, P; Taboureau, E; Denimal, F; Milazzo, S

    2007-02-01

    The spontaneous luxation of the intraocular lens-capsular bag-capsular tension ring complex is a serious but fortunately rare complication. The authors report a combined surgical procedure to reposition the complex in a patient who was operated on for bilateral lens subluxation 4 years before and whose enophthalmia made surgery difficult. Two surgical techniques can be considered to reposition the complex and avoid explantation. The McCannel modified stitch can capture the complex with the help of a transcorneal point and then a transscleral suture on the 12 o'clock meridian, despite the enophthalmia of the patient; the Moreno transscleral stitch. Both techniques suture the complex to the ciliary sulcus. Moreno's technique is easy and safe for the endothelium and must therefore be attempted first. In case of failure, the McCannel modified stitch remains a useful and satisfying procedure allowing transscleral fixation of the complex to the sulcus at the cost of a minimal corneal trauma.

  13. Contact area and pressure in suture bridge rotator cuff repair using knotless lateral anchors.

    Science.gov (United States)

    Tompkins, Marc; Monchik, Keith O; Plante, Matthew J; Fleming, Braden C; Fadale, Paul D

    2011-10-01

    To evaluate whether the use of knotless lateral anchors in a suture bridge construct produces better contact area and pressure parameters than a suture bridge construct with standard lateral anchors that require knots or a double-row repair. The hypothesis was that knotless lateral anchors would produce better contact area and pressure parameters than the other two constructs. A total of fifteen matched pairs of cadaveric shoulders were divided into three groups. In Group 1, a suture bridge using knotless anchors for the lateral row was performed on five shoulders. A suture bridge using standard lateral row anchors that require knots was performed on the contralateral shoulders. In Group 2, suture bridge with knotless lateral row anchors was compared with double-row repair. In Group 3, suture bridge using standard lateral row anchors was compared with double-row repair. The contact conditions of the rotator cuff footprint were measured using pressure-sensitive film. There were no statistically significant differences between any of the techniques regarding contact area F(2, 15.7) = 3.09, P = 0.07 or mean contact pressure F(2, 15.1) = 2.35, P = 0.12. A post hoc power analysis suggests differences between techniques are likely less than 91-113 mm(2) for area and 0.071-0.089 N for pressure. The use of knotless anchors in the lateral row of a suture bridge repair did not increase the footprint contact area or contact pressure when compared to a suture bridge repair requiring knots laterally or to a double-row repair.

  14. 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.

  15. Experimental studies on the influence of irradiation (60Co) on wound healing of colonic suture

    International Nuclear Information System (INIS)

    Shoji, Munehiro

    1980-01-01

    Effects of preoperative 60 Co irradiation on wound healing of colonic suture in adult dogs of mixed breed were discussed. Wound healing 7 days after colonic suture was compared among dogs which received colonic suture immediately, or 3 days, or 7 days after the 60 Co irradiation. As a result, there was not a big difference in their wound healing among these dogs, and disorders of wound healing were not found. Bursting pressure at sutured sites was always lower in irradiated dogs than controls. Recovery of the bursting pressure was 2 days slower in irradiated dogs than non-irradiated dogs for 7 days after the suture. Bursting pressure was the lowest on the 3rd day after the suture in both groups. As to fine changes in irradiated dogs, appearance of recommunicating phenomena in blood vessels, delay of a decrease in avascular regions, delay of granulation, and hypertrophy of vascular walls seemed to be influenced by 60 Co irradiation, but there was not a big difference in these results between irradiated and non-irradiated dogs. An increase in postoperative concentration of hydroproline tended to be little lower in irradiated dogs than controls, which seemed to be influenced by the 60 Co irradiation. This result was also suggested from delay of granulation and remaining inflammations. Effects of 60 Co irradiation on wound healing of colonic suture seemed to be slight generally, because ruptured suture scarecely occurred in the irradiated dogs. When doses used in this experiment were calculated roughly by Ellis's method, irradiation of 60 Co seemed not to influence seriously wound healing if the total of 2,000 to 2,500 rad was irradiated in 8 to 10 doses to human colon. (Tsunoda, M.)

  16. Self-propelled pulse X-ray apparatus Sirena-1

    International Nuclear Information System (INIS)

    Danil'chenko, N.T.; Ershov, L.S.; Il'chenko, A.V.; Krasil'nikov, S.B.; Kristalinskij, A.L.; Lozovoj, L.N.; Markov, S.N.; Morgovskij, L.Ya.

    1984-01-01

    The structure and specifications of a self-propelled pulse X-ray apparatus ''Sirena-1'' for testing oilt and gas pipelines welded joints are described. The apparatus is designed on the base of pulse X-ray apparatus MIRA. Apparatus control is realized by means of the 137 Cs source or manual control desk. The apparatus ensures perfect control sensitivity

  17. Identification and dynamics of a cryptic suture zone in tropical rainforest

    Science.gov (United States)

    Moritz, C.; Hoskin, C.J.; MacKenzie, J.B.; Phillips, B.L.; Tonione, M.; Silva, N.; VanDerWal, J.; Williams, S.E.; Graham, C.H.

    2009-01-01

    Suture zones, shared regions of secondary contact between long-isolated lineages, are natural laboratories for studying divergence and speciation. For tropical rainforest, the existence of suture zones and their significance for speciation has been controversial. Using comparative phylogeographic evidence, we locate a morphologically cryptic suture zone in the Australian Wet Tropics rainforest. Fourteen out of 18 contacts involve morphologically cryptic phylogeographic lineages, with mtDNA sequence divergences ranging from 2 to 15 per cent. Contact zones are significantly clustered in a suture zone located between two major Quaternary refugia. Within this area, there is a trend for secondary contacts to occur in regions with low environmental suitability relative to both adjacent refugia and, by inference, the parental lineages. The extent and form of reproductive isolation among interacting lineages varies across species, ranging from random admixture to speciation, in one case via reinforcement. Comparative phylogeographic studies, combined with environmental analysis at a fine-scale and across varying climates, can generate new insights into suture zone formation and to diversification processes in species-rich tropical rainforests. As arenas for evolutionary experimentation, suture zones merit special attention for conservation. PMID:19203915

  18. Endoscopic stent suture fixation for prevention of esophageal stent migration during prolonged dilatation for achalasia treatment.

    Science.gov (United States)

    Rieder, E; Asari, R; Paireder, M; Lenglinger, J; Schoppmann, S F

    2017-04-01

    The aim of this study is to compare endoscopic stent suture fixation with endoscopic clip attachment or the use of partially covered stents (PCS) regarding their capability to prevent stent migration during prolonged dilatation in achalasia. Large-diameter self-expanding metal stents (30 mm × 80 mm) were placed across the gastroesophageal junction in 11 patients with achalasia. Stent removal was scheduled after 4 to 7 days. To prevent stent dislocation, endoscopic clip attachment, endoscopic stent suture fixation, or PCS were used. The Eckardt score was evaluated before and 6 months after prolonged dilatation. After endoscopic stent suture fixation, no (0/4) sutured stent migrated. When endoscopic clips were used, 80% (4/5) clipped stents migrated (p = 0.02). Of two PCS (n = 2), one migrated and one became embedded leading to difficult stent removal. Technical adverse events were not seen in endoscopic stent suture fixation but were significantly correlated with the use of clips or PCS (r = 0.828, p = 0.02). Overall, 72% of patients were in remission regarding their achalasia symptoms 6 months after prolonged dilatation. Endoscopic suture fixation of esophageal stents but not clip attachment appears to be the best method of preventing early migration of esophageal stents placed at difficult locations such as at the naive gastroesophageal junction. © The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Augmentation of tendon healing with butyric acid-impregnated sutures: biomechanical evaluation in a rabbit model.

    Science.gov (United States)

    Leek, Bryan T; Tasto, James P; Tibor, Lisa M; Healey, Robert M; Freemont, Anthony; Linn, Michael S; Chase, Derek E; Amiel, David

    2012-08-01

    Butyric acid (BA) has been shown to be angiogenic and to enhance transcriptional activity in tissue. These properties of BA have the potential to augment biological healing of a repaired tendon. To evaluate this possibility both biomechanically and histologically in an animal tendon repair model. Controlled laboratory study. A rabbit Achilles tendon healing model was used to evaluate the biomechanical strength and histological properties at 6 and 12 weeks after repair. Unilateral tendon defects were created in the middle bundle of the Achilles tendon of each rabbit, which were repaired equivalently with either Ultrabraid BA-impregnated sutures or control Ultrabraid sutures. After 6 weeks, BA-impregnated suture repairs had a significantly increased (P Tendons repaired with BA-impregnated sutures demonstrated improved biomechanical properties at 6 weeks relative to control sutures, suggesting a neoangiogenic mechanism of enhanced healing through an increased myofibroblast presence. These findings demonstrate that a relatively simple alteration of suture material may augment early tendon healing to create a stronger repair construct during this time.

  20. Symbol "&" suture to control atonic postpartum hemorrhage with placenta previa accreta.

    Science.gov (United States)

    Li, Guang Tai; Li, Xiao Fan; Liu, Ya Jing; Li, Wei; Xu, Hong Mei

    2015-02-01

    To evaluate the efficacy and safety of a symbol "&" compression suture technique in controlling severe atonic postpartum hemorrhage with placenta previa accreta during cesarean delivery. Nine women with heavy postpartum bleeding from uterine inertia and placenta previa percret, which did not react to conventional initial management protocols, were underwent the suture in the shape of symbol "&" in China Meitan General Hospital. The suture procedure was to staple the anterior and posterior walls (of the lower uterine segment as well as corpus uterus) together using number 1 chromic catgut, with a cross at about 2 cm above the upper boundary of lower uterine segment. Symbol "&" compression suture was capable of stanching the postpartum hemorrhage immediately in all nine women. None of these patients developed complications related to this method. Subsequent pregnancies after the suture were occurred in two women and delivered with repeat cesarean section. Symbol "&" compression suture is a simple, safe and highly effective technique to control the treatment-resistant uterine atonic bleeding, particularly in previous cesarean scar at lower segment and placenta previa accreta.