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Sample records for suture line leak

  1. ISOLDE Off-line Gas Leak Upgrade

    CERN Document Server

    Nielsen, Kristoffer Bested

    2017-01-01

    This study investigates gas injection system of the ISOLDE Off-line separator. A quadrupole mass spectrometer is used to analysis the composition of the gas. Based on these measurements a contamination of the injected gas is found and a system upgrade is purposed. Furthermore a calibration of the leak rate of the leak valve is made.

  2. Comparison of Reinforcement Techniques Using Suture on Staple-Line in Sleeve Gastrectomy.

    Science.gov (United States)

    Rogula, Tomasz; Khorgami, Zhamak; Bazan, Martin; Mamolea, Cristina; Acquafresca, Pablo; El-Shazly, Omar; Aminian, Ali; Schauer, Philip

    2015-11-01

    Sleeve gastrectomy is a common procedure in recent years for treatment of morbid obesity however leak from staple-line is its main challenging complication. Despite numerous studies regarding leak after sleeve gastrectomy, there is still no conclusion on reinforcement of staple-line in this procedure. The purpose of this study was to compare two methods of oversewing staple-line versus no reinforcement. Resected stomachs of 30 patients undergoing laparoscopic sleeve gastrectomy were evaluated for bursting pressure immediately after extraction from the abdomen. Reinforcement technique was applied in random order to 3 segments of the staple-line on each specimen: continuous Lembert's sutures, continuous through-and-through sutures, and no reinforcement. Bursting pressure was determined by injection of methylene blue solution into lumen of resected stomach and recording pressure at which leakage occurs. Location of leak, intragastric pressure, and volume at first leak were recorded. Baseline characteristics of patients were similar in randomized groups for order of reinforcement technique. Mean ischemia time of specimens was 17.4 ± 10.4 min. No leaks were observed in segments reinforced with Lembert's oversewing technique. The through-and-through reinforcement segments were first to leak in 21 out of 30 cases (70 %) with mean leak pressure of 570 mmHg and mean leak volume of 399 ml. Leakage occurred in 9 segments (30 %) with no reinforcement with a leak pressure of 329 mmHg and volume of 380 ml. In vitro, Lembert's suture reinforcement technique on stapled human stomach is associated with less leakage rate in comparison to through-and-through reinforcement and non-reinforced staple-line.

  3. Staple Line Reinforcement Methods in Laparoscopic Sleeve Gastrectomy: Comparison of Burst Pressures and Leaks.

    Science.gov (United States)

    Timucin Aydin, M; Aras, Orhan; Karip, Bora; Memisoglu, Kemal

    2015-01-01

    Laparoscopic sleeve gastrectomy is a technically simple and popular bariatric operation with acceptable results. However, leaks can occur in long staple lines, for which various reinforcement methods are used. We compared nonreinforced stapling in laparoscopic sleeve gastrectomy with 3 staple line reinforcement methods: suturing, absorbable buttressing material, and fibrin glue. From March 1 until September 30, 2014, 118 patients with body mass index >40 kg/m(2) underwent sleeve gastrectomy and were enrolled in 4 groups, depending on the type of reinforcement used. The resected stomach specimens were treated with the same methods of reinforcement as used in the surgeries in the corresponding patients and then insufflated until a burst occurred. The burst pressures of the resected stomach specimens and adverse postoperative events were recorded. Five postoperative leaks occurred in the reinforcement groups (fibrin glue, 2; absorbable buttresses, 2; sutures, 1); no leaks were evident in the no-reinforcement group. Suturing afforded the highest burst pressure and took the longest to perform of the methods. There was no correlation between the leaks and burst pressures. All of the leaks occurred in the proximal fundus in the resected stomach specimens and in the affected patients. Although most surgeons use additional reinforcement on long staple lines in sleeve gastrectomy, there is no consensus about its necessity. We did not show any benefit of such reinforcement methods over proper stapling technique alone. Laparoscopic sleeve gastrectomy without staple line reinforcement is safe and avoids additional costs for reinforcement materials.

  4. 241-AY-102 Leak Detection Pit Drain Line Inspection Report

    Energy Technology Data Exchange (ETDEWEB)

    Boomer, Kayle D. [Hanford Site (HNF), Richland, WA (United States); Engeman, Jason K. [Hanford Site (HNF), Richland, WA (United States); Gunter, Jason R. [Hanford Site (HNF), Richland, WA (United States); Joslyn, Cameron C. [Hanford Site (HNF), Richland, WA (United States); Vazquez, Brandon J. [Hanford Site (HNF), Richland, WA (United States); Venetz, Theodore J. [Hanford Site (HNF), Richland, WA (United States); Garfield, John S. [AEM Consulting, Richland, WA (United States)

    2014-01-20

    This document provides a description of the design components, operational approach, and results from the Tank AY-102 leak detection pit drain piping visual inspection. To perform this inspection a custom robotic crawler with a deployment device was designed, built, and operated by IHI Southwest Technologies, Inc. for WRPS to inspect the 6-inch leak detection pit drain line.

  5. Leaks, Lumps, and Lines: Stigma and Women's Bodies

    Science.gov (United States)

    Chrisler, Joan C.

    2011-01-01

    Women's bodies have often been positioned in art and popular culture as monstrous or defiled and women's bodily products (e.g., menstrual fluid, breast milk) as disgusting. This framing has led to the stigmatization of aspects of women's bodies (e.g., leaking fluids, lumps of fat, and lines in the skin that indicate aging), especially those…

  6. Mitigated Transfer Line Leaks that Result in Surface Pools and Spray Leaks into Pits

    Energy Technology Data Exchange (ETDEWEB)

    HEY, B.E.

    1999-12-07

    This analysis provides radiological and toxicological consequence calculations for postulated mitigated leaks during transfers of six waste compositions. Leaks in Cleanout Boxes equipped with supplemental covers and leaks in pits are analyzed.

  7. Sutures - ridged

    Science.gov (United States)

    Ridged sutures ... The borders where these plates intersect are called sutures or suture lines. In an infant only a few minutes ... This makes the bony plates overlap at the sutures and creates a small ridge. This is normal ...

  8. 49 CFR 192.717 - Transmission lines: Permanent field repair of leaks.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Transmission lines: Permanent field repair of... § 192.717 Transmission lines: Permanent field repair of leaks. Each permanent field repair of a leak on a transmission line must be made by— (a) Removing the leak by cutting out and replacing a...

  9. Suture Line Response of End-to-Side Anastomosis: A Stress Concentration Methodology.

    Science.gov (United States)

    Roussis, P C; Giannakopoulos, A E; Charalambous, H P

    2015-03-01

    End-to-side vascular anastomosis has a considerable complexity regarding the suturing of the juncture line between the artery and the graft. The present study proposes a stress-concentration methodology for the prediction of the stress distribution at the juncture line, aiming to provide generic expressions describing the response of an end-to-side anastomosis. The proposed methodology is based on general results obtained from the analysis of pipe connections, a topic that has been investigated in recent years in the field of offshore structural engineering. A key aspect for implementing the stress-concentration-factor approach is the recognition that the axial load due to pressure and flow dynamics exerted along the graft axis controls the "hot spots" on the juncture line, which in turn affects the mechanical response of the sutures. Several parameters, identified to influence the suture line response, are introduced in closed-form expressions for the suture line response calculations. The obtained results compare favorably with finite element results published in the literature. The proposed model predicts analytically the suture line response of end-to-side anastomosis, while capturing the influence of and interdependence among the problem parameters. Lower values of the graft radius, the distance between sequential stitches, and the intersecting angle between the artery and the graft are some of the key parameters that reduce the suture line response. The findings of this study are broad in scope and potentially applicable to improving the end-to-side anastomosis technique through improved functionality of the sutures and optimal selection of materials and anastomosis angle.

  10. Intimal Surface Suture Line (End-Product) Assessment of End-to-Side Microvascular Anastomosis.

    Science.gov (United States)

    Pafitanis, Georgios; Veljanoski, Damjan; Ghanem, Ali M; Myers, Simon

    2017-07-01

    Microsurgery simulation courses increasingly use assessment methodologies to evaluate the quality of microvascular anastomosis and to provide constructive feedback in competency-based training. Assessment tools evaluating the "journey" of skill acquisition in anastomosis have evolved, including global rating scores, hand motion analysis, and evaluation of the final outcome, that is, "end-product" assessment. Anastomotic patency is the gold standard end-product in clinical microvascular surgery, and in vivo end-to-side anastomosis, which can be confirmed using the Acland-test. Microsurgery simulation training is moving to include nonliving models, where possible, according to the principles of the replacement, reduction, and refinement of the use of animals in research. While a standardized end-product assessment tool for nonliving end-to-end anastomosis exists, there is no similar tool for end-to-side anastomosis. Intimal surface suture line assessment is an error list-based tool, which involves exposing the intimal surface of a vessel and analysis of the quality of suture placement. Errors in end-to side anastomosis were classified according to the potential clinical significance (high, medium, or low) perceived by the senior authors. Intimal surface suture line assessment provides constructive feedback during microsurgery training, helping to minimize technical errors, which are likely to impact on the final outcome in a clinical environment. Intimal surface suture line assessment lends itself to nonliving simulation training courses as an end-product self-assessment tool, especially during the early learning curve, to demonstrate progression. It has intraoperative relevance by assessment of the intimal surface suture line as the final sutures are placed in an end-to-side anastomosis to provide objective feedback to trainees in relation to likely physiological anastomotic outcome.

  11. Intimal Surface Suture Line (End-Product Assessment of End-to-Side Microvascular Anastomosis

    Directory of Open Access Journals (Sweden)

    Georgios Pafitanis, MD

    2017-07-01

    Full Text Available Summary:. Microsurgery simulation courses increasingly use assessment methodologies to evaluate the quality of microvascular anastomosis and to provide constructive feedback in competency-based training. Assessment tools evaluating the “journey” of skill acquisition in anastomosis have evolved, including global rating scores, hand motion analysis, and evaluation of the final outcome, that is, “end-product” assessment. Anastomotic patency is the gold standard end-product in clinical microvascular surgery, and in vivo end-to-side anastomosis, which can be confirmed using the Acland-test. Microsurgery simulation training is moving to include nonliving models, where possible, according to the principles of the replacement, reduction, and refinement of the use of animals in research. While a standardized end-product assessment tool for nonliving end-to-end anastomosis exists, there is no similar tool for end-to-side anastomosis. Intimal surface suture line assessment is an error list-based tool, which involves exposing the intimal surface of a vessel and analysis of the quality of suture placement. Errors in end-to side anastomosis were classified according to the potential clinical significance (high, medium, or low perceived by the senior authors. Intimal surface suture line assessment provides constructive feedback during microsurgery training, helping to minimize technical errors, which are likely to impact on the final outcome in a clinical environment. Intimal surface suture line assessment lends itself to nonliving simulation training courses as an end-product self-assessment tool, especially during the early learning curve, to demonstrate progression. It has intraoperative relevance by assessment of the intimal surface suture line as the final sutures are placed in an end-to-side anastomosis to provide objective feedback to trainees in relation to likely physiological anastomotic outcome.

  12. Integrated Approaches for the Management of Staple Line Leaks following Sleeve Gastrectomy

    Directory of Open Access Journals (Sweden)

    Mauro Montuori

    2017-01-01

    Full Text Available Introduction. Aim of the study was trying to draw a final flow chart for the management of gastric leaks after laparoscopic sleeve gastrectomy, based on the review of our cases over 10 years’ experience. Material and Methods. We retrospectively reviewed all patients who underwent LSG as a primary operation at the Bariatric Unit of Tor Vergata University Hospital in Rome from 2007 to 2015. Results. Patients included in the study were 418. There were 6 staple line leaks (1.44%. All patients with diagnosis of a leak were initially discharged home in good clinical conditions and then returned to A&E because of the complication. The mean interval between surgery and readmission for leak was 13,4 days (range 6–34 days, SD ± 11.85. We recorded one death (16.67% due to sepsis. The remaining five cases were successfully treated with a mean healing time of the gastric leak of 55,5 days (range 26–83 days; SD ± 25.44. Conclusion. Choosing the proper treatment depends on clinical stability and on the presence or not of collected abscess. Our treatment protocol showed being associated with low complication rate and minor discomfort to the patients, reducing the need for more invasive procedures.

  13. Does hyaluronic acid-carboxymethylcellulose (HA-CMC) membrane interfere with the healing of intestinal suture lines and abdominal incisions?

    Science.gov (United States)

    Yamaner, Sümer; Kalayci, Murat; Barbaros, Umut; Balik, Emre; Bulut, Türker

    2005-03-01

    Although hyaluronic acid-carboxymethylcellulose (HA-CMC) membrane has the advantage of preventing intraabdominal adhesions, it has theoretical risk of negative effects on the healing of intestinal suture lines by forming a barrier between the suture lines and neighboring serosal surfaces. This study evaluated the effect of HA-CMC on bowel anastomoses, scar healing, and intraabdominal adhesion formation. Two groups of 10 male Sprague-Dawley rats were examined. In the first group, laparotomy was performed with a median incision. Colotomy on the cecum and a single-layer repair of the bowel wall was performed. HA-CMC membrane was placed on the cecal suture line and under the laparotomy incision before abdominal closure. The second group had the same procedure but no HA-CMC membrane was placed. The animals were killed on postoperative day 14. Intraabdominal adhesions, laparotomy suture line endurance, bursting pressure of the repaired cecal wall, and tissue hydroxyproline levels were determined. The repaired cecal wall was also examined histopathologically. The statistical analyses revealed that HA-CMC prevented intraabdominal adhesions significantly. No negative effects of this material on the healing of the bowel and laparotomy suture lines were observed. HA-CMC appears to be a safe material to prevent intraabdominal adhesions, without negative effects on the healing of abdominal incisions and bowel suture lines.

  14. Tension Regulation at the Suture Lines for Repair of Neglected Achilles Tendon Laceration.

    Science.gov (United States)

    Massoud, Elsayed Ibraheem Elsayed

    2017-03-01

    Operative intervention is the preferred option for management of the neglected laceration of the Achilles tendon. However, the commonly used techniques rarely follow the principles of the regenerative medicine for the restoration of the lost tissue. This study postulated that incorporation of the autogenous tendon graft would properly progress when the interplay between mechanical loading and healing phases was correctly applied. A prospective study included 15 patients who were treated for neglected Achilles tendon laceration using the technique of lengthening of the proximal tendon stump. An absorbable reinforcement suture was used for control of the mechanical environment at the suture lines. By an average 5 years of the prospective follow-up, all the repaired tendons had restored continuity and length. The calf circumference equalized to the uninjured side in 12 patients. However, 3 patients had calf atrophy but they improved compared to the preoperative measurements. Sonogram confirmed the restoration of the normal thickness and the gliding characteristics of the repaired tendon. The technique restored continuity and tension of the repaired tendon, preserved the calf circumference, and prevented peritendinous adhesions. The absorbable reinforcement suture spontaneously allowed for the mechanical loading of the grafted tendon. Level IV, case series.

  15. Impact of process parameters and design options on heat leaks of straight cryogenic distribution lines

    Directory of Open Access Journals (Sweden)

    P. Duda

    2017-03-01

    Full Text Available The Future Circular Collider (FCC accelerator will require a helium distribution system that will exceed the presently exploited transfer lines by almost 1 order of magnitude. The helium transfer line will contain five process pipes protected against heat leaks by a common thermal shield. The design pressure of the FCC process pipe with supercritical helium will be equal to 5.0 MPa, significantly exceeding the 2.0 MPa value in the present, state-of–art transfer lines. The increase of the design pressure requires construction changes to be introduced to the support system, the vacuum barriers and the compensation bellows. This will influence heat flows to the helium. The paper analyses the impact of the increased design pressure on the heat flow. The paper also offers a discussion of the design modifications to the compensation system, including the replacement of stainless steel with Invar®—aimed at mitigating the pressure increase.

  16. Impact of process parameters and design options on heat leaks of straight cryogenic distribution lines

    CERN Document Server

    Duda, Pawel; Chorowski, Maciej Pawel; Polinski, J

    2017-01-01

    The Future Circular Collider (FCC) accelerator will require a helium distribution system that will exceed the presently exploited transfer lines by almost 1 order of magnitude. The helium transfer line will contain five process pipes protected against heat leaks by a common thermal shield. The design pressure of the FCC process pipe with supercritical helium will be equal to 5.0 MPa, significantly exceeding the 2.0 MPa value in the present, state-of–art transfer lines. The increase of the design pressure requires construction changes to be introduced to the support system, the vacuum barriers and the compensation bellows. This will influence heat flows to the helium. The paper analyses the impact of the increased design pressure on the heat flow. The paper also offers a discussion of the design modifications to the compensation system, including the replacement of stainless steel with Invar—aimed at mitigating the pressure increase.

  17. Effect of Early Use of Covered Self-Expandable Endoscopic Stent on the Treatment of Postoperative Stapler Line Leaks.

    Science.gov (United States)

    Quezada, Nicolás; Maiz, Cristóbal; Daroch, David; Funke, Ricardo; Sharp, Allan; Boza, Camilo; Pimentel, Fernando

    2015-10-01

    Postoperative leaks are a dreaded complication after bariatric surgery (BS). Its treatment is based on nutritional support and sepsis control by antibiotics, collections drainage and/or prosthesis, and/or surgery. The aim of this study is to report our experience with coated self-expandable endoscopic stents (SEES) for leaks treatment. This study was performed in a University Hospital, (censored). We performed a retrospective analysis of our BS database from January 2007 to December 2013. All patients with leak after BS treated with SEES were included. We identified 29 patients; 17 (59%) were women, with median age of 37 (19-65) years, and preoperative body mass index of 40 (28.7-56-6) kg/m(2). Nineteen (65.5%) patients had a sleeve gastrectomy and 10 (34.5%) a Roux-en-Y gastric bypass. All patients had a leak in the stapler line. Median time from surgery to leak diagnosis was 7 (1-51) days, and SEES were installed 8 (0-104) days after diagnosis. Twenty-one (72%) patients also had abdominal exploration. Median length of SEES use was 60 (1-299) days. Patients who had SEES as primary treatment (with or without simultaneous reoperation) had a shorter leak closure time (50 [6-112] vs 109 [60-352] days; p = 0.008). Twenty-eight (96.5%) patients successfully achieved leak closure with SEES. There were 16 migrations in 10 (34%) patients, 1 (3%) stent fracture, 1 opening of the blind end of alimentary limb (3%), and 5 patients (17%) required a second stent due to leak persistence. SEES is a feasible, safe, and effective management of post BS leaks, although patients may also require prosthesis revision and abdominal exploration. Primary SEES placement is associated with a shorter leak resolution time.

  18. DISAIN SISTEM KENDALI MESIN AIR LEAK TEST MENGGUNAKAN SISTEM KENDALI PLC OMRON CJ2M DI HVAC (HEATING, VENTILATING, AND AIR CONDITIONING LINE 6

    Directory of Open Access Journals (Sweden)

    Syahril Ardi

    2015-03-01

    Full Text Available Pada proses produksi pembuatan komponen HVAC (Heating, Ventilating, and Air Conditioning dari perusahaan manufaktur di Indonesia, memerlukan proses pengecekan kebocoran pada bagian HVAC. Proses pengecekan ini dilakukan untuk memastikan tidak ada komponen HVAC yang bocor sebelum dikirim ke pihak pelanggan. Penelitian ini dilakukan untuk membuat system dan alat air leak test. Mesin air leak test ini menggunakan prinsip kerja differential pressure air leak test, yaitu metode yang membandingkan antara tekanan udara yang diberikan ke produk dan master produk. Pada penelitian ini, kami membuat disain mesin air leak test menggunakan sistem kendali berupa air leak tester, PLC, dan HMI. Berdasarkan kondisi dengan kapasitas produksi yang meningkat karena bertambahnya permintaan dari customer, dapat ditanggulangi dengan adanya share loading produksi dari HVAC line 4 ke line baru, yaitu HVAC line 6. Hasil yang didapat dari pengujian deteksi kebocoran produk,didapat nilai parameter kebocoran produk sebesar 2.23 ml/min.

  19. The "washing line" suture technique for securing the Subepithelial Connective Tissue Graft.

    Science.gov (United States)

    McCrea, Shane J J

    2014-07-01

    Following tooth extraction, resorption of the buccal wall of the socket will occur; this will be true for both the maxilla and the mandible. Where the extraction site is surrounded by natural dentition, the loss of the buccal alveolar plate can degrade the visual aesthetics of an implant-supported prosthetic rehabilitation. To aid the harmonization of the hard and soft tissue morphology, both hard and soft tissue augmentation can be carried out either consecutively with an extraction/immediate implant placement or prior to an implant placement in the delayed scenario. The contemporary method of increasing soft tissue volume is to use the Subepithelial Connective Tissue (auto) Graft (the SCTG). The graft requires fixation, otherwise it can be extruded from the recipient site. This article presents a novel suturing technique which can confidently secure the SCTG, thus resisting its dislodgement.

  20. Cerebrospinal fluid leaks following spinal or posterior fossa surgery: use of fat grafts for prevention and repair.

    Science.gov (United States)

    Black, P

    2000-01-01

    Cerebrospinal fluid (CSF) leaks are relatively common following spinal or posterior fossa surgery. A midline dural tear in the spine is readily repaired by direct application of a suture. However, far-lateral or ventral dural tears are problematic. Fat is an ideal sealant because it is impermeable to water. In this paper the author reports his experience with using fat grafts for the prevention or repair of CSF leaks and proposes a technique in which a large sheet of fat, harvested from the patient's subcutaneous layer, is used to cover not only the dural tear(s) but all of the exposed dura and is tucked into the lateral recess. This procedure prevents CSF from seeping around the fat, which may be tacked to the dura with a few sutures. Fibrin glue is spread on the surface of the fat and is further covered with Surgicel or Gelfoam. For ventral dural tears (associated with procedures in which disc material is excised), fat is packed into the disc space to seal off the ventral dural leak. Leaks in the posterior fossa are managed similarly to those in the spine. Dural suture lines, following suboccipital or spinal intradural exploration, are prophylactically protected from CSF leakage in the same manner. With one exception, 27 dural tears noted during 1650 spinal procedures were successfully repaired using this technique. There was one case of postoperative CSF leakage in 150 cases in which intradural exploration for tumor or other lesions was undertaken. Both postoperative CSF leaks were controlled by applying additional skin sutures. The use of a fat graft is recommended as a rapid, effective means of prevention and repair of CSF leaks following posterior fossa and spinal surgery.

  1. Analysis of suture anchor eyelet position on suture failure load.

    Science.gov (United States)

    Aktay, Sevima A; Kowaleski, Michael P

    2011-06-01

    To compare mechanical performance of 2 orientations of the 5 mm Corkscrew® suture anchor with #5 Fiberwire® . In vitro biomechanical study. Suture anchor-suture constructs (n=40). Acute and cyclic tensile loads were applied to suture threaded through eyelets of 40 anchors perpendicular to the long axis of the anchor. Eyelets were positioned so that the suture pull was in line with (anchor rotation angle of 0° [ARA 0]) or 90° (ARA 90) to the eyelet plane. Load at failure, stiffness, and cycles to failure were determined. All constructs failed by suture breakage at the eyelet. Mean load at failure was significantly higher in the ARA 90 group (634 ± 93 N) compared with the ARA 0 group (495 ± 52 N; P=.0015). No significant difference was found between groups for mean number of cycles to failure (270 ± 177 versus 178 ± 109; P=.2166) and stiffness (50 ± 4 versus 48 ± 5 N/mm; P=.3141). The Corkscrew® 5 mm suture anchor with Fiberwire® suture fails via suture breakage at the eyelet under higher acute loads if the suture is loaded at an angle of 90° compared with 0° with respect to the plane of the eyelet. © Copyright 2011 by The American College of Veterinary Surgeons.

  2. Leak Detection for Potable Water Lines at Fort Hood: Final Report on Project AR-F-313 for FY05

    Science.gov (United States)

    2007-06-01

    Conservation Systems Xmic, was used at Fort Hood. This instrument consists of a battery pow- ered control console, a “ground microphone” sensor, and headphones ...of magnification. In addition, borrowed pipe lo- cation equipment (see Figure 2) allowed a pipeline’s route to be traced by inducing an RF carrier ... headphones . This type of sensor can detect sounds coming through the ground and can be used to find the exact spot along the pipeline where the leak

  3. Evaluating the effect of operative technique on leaks after laparoscopic sleeve gastrectomy: a case-control study.

    Science.gov (United States)

    Varban, Oliver A; Sheetz, Kyle H; Cassidy, Ruth B; Stricklen, Amanda; Carlin, Arthur M; Dimick, Justin B; Finks, Jonathan F

    2017-04-01

    considerable variation in operative technique, leak rates with laparoscopic sleeve gastrectomy have decreased over time as operative volume has increased. Oversewing of the staple line was associated with fewer leaks, but specific suturing technique was not uniform and oversewing was performed routinely by more experienced surgeons with higher case volumes and less complication rates overall. Before standardizing surgical technique one must take into account variations in surgeon skill and experience. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  4. Characterization of Vadose Zone Sediments from C Waste Management Area: Investigation of the C-152 Transfer Line Leak

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Christopher F; Serne, R JEFFREY; Bjornstad, Bruce N; Valenta, Michelle M; Lanigan, David C; Vickerman, Tanya S; Clayton, Ray E; Geiszler, Keith N; Iovin, Cristian; Clayton, Eric T; Kutynakov, I V; Baum, Steven R; Lindberg, Michael J; Orr, Robert D

    2007-02-05

    A geologic/geochemical investigation in the vicinity of UPR-200-E-82 was performed using pairs of cone-penetrometer probe holes. A total of 41 direct-push cone-penetrometer borings (19 pairs to investigate different high moisture zones in the same sampling location and 3 individual) were advanced to characterize vadose zone moisture and the distribution of contaminants. A total of twenty sample sets, containing up to two split-spoon liners and one grab sample, were delivered to the laboratory for characterization and analysis. The samples were collected around the documented location of the C-152 pipeline leak, and created an approximately 120-ft diameter circle around the waste site. UPR-200-E-82 was a loss of approximately 2,600 gallons of Cs-137 Recovery Process feed solution containing an estimated 11,300 Ci of cesium-137 and 5 Ci of technetium-99. Several key parameters that are used to identify subsurface contamination were measured, including: water extract pH, electrical conductivity, nitrate, technetium-99, sodium, and uranium concentrations and technetium-99 and uranium concentrations in acid extracts. All of the parameters, with the exception of electrical conductivity, were elevated in at least some of the samples analyzed as part of this study. Specifically, soil pH was elevated (from 8.69 to 9.99) in five samples collected northeast and southwest of the C-152 pipeline leak. Similarly, samples collected from these same cone-pentrometer holes contained significantly more water-extractable sodium (more than 50 g/g of dry sediment), uranium (as much as 7.66E-01 g/g of dry sediment), nitrate (up to 30 g/g of dry sediment), and technetium-99 (up to 3.34 pCi/g of dry sediment). Most of the samples containing elevated concentrations of water-extractable sodium also had decreased levels of water extractable calcium and or magnesium, indicating that tank-related fluids that were high in sodium did seep into the vadose zone near these probe holes. Several of the

  5. Endoscopic Insertion Of A Self-Expandable Stent Combined With Laparoscopic Rinsing Of Peritoneal Cavity As A Method For Staple Line Leaks Treatment In Patients Post Laparoscopic Sleeve Gastrectomy.

    Science.gov (United States)

    Matłok, Maciej; Major, Piotr; Pędziwiatr, Michał; Winiarski, Marek; Budzyński, Piotr; Małczak, Piotr; Hynnekleiv, Leif; Budzyński, Andrzej

    2015-05-01

    Currently, laparoscopic sleeve gastrectomy is one of bariatric surgeries most commonly performed in the world. The most frequent complications of surgeries of this type, with the highest mortality rate, include bleeding into the GI tract and peritoneal cavity, and sleeve staple line leaks. These severe complications prolong the hospital stay, and often are a cause of patient's death. While in a case of bleeding the procedure appears to be obvious, so far no uniform and standard guidelines have been established for the group of patients with staple line leaks. The aim of the study was to report results of treatment for staple line leaks following laparoscopic sleeve gastrectomy with a laparoscopic procedure and simultaneous endoscopic insertion of a self-expandable stent. 152 laparoscopic sleeve gastrectomies were performed from April 2009 to December 2014. The BMI median was 46.9, and the age median was 42 years. Staple line leaks developed in 3 out of 152 people (1.97%). All patients who developed this complication were included in the study. The treatment involved laparoscopic revision surgery with simultaneous endoscopic insertion of a self-expandable stent (Boston Scientific, Wallflex Easophageal Stent, 150×23 mm) into the gastric stump during gastroscopy. Leaks following laparoscopic sleeve gastrectomy were diagnosed on day 5 after the procedure, on average. Intervention consisting of laparoscopy and endoscopic insertion of a self-expandable stent was initiated within 14 hours of diagnosing the leak, on average. The mean time for which the stent was kept was 5 weeks (4-6 weeks). Stenting proved to be fully effective in all patients, where after discharging home, a cutaneous fistula, periodically (every 2-3 weeks) discharging several millilitres of matter, persisted in one patient. The mean time for the leak healing in 2 patients, in whom the described method was successful in treatment of this complication, was 37 days. No patient died in the perioperative or

  6. A comparison of running suture versus figure-8 sutures as the initial step in achieving hemostasis during laparoscopic partial nephrectomy.

    Science.gov (United States)

    Rosenblatt, Gregory S; Fuchs, Gerhard J

    2010-03-01

    During laparoscopic partial nephrectomy, the importance of the initial suture placed under warm ischemic conditions cannot be underestimated. Inadequate hemostasis may lead to further surgical complications. Our goal was to determine which method of suture ligation (running vs figure-8 interrupted) provides better initial hemostasis when performing partial nephrectomy in an ex-vivo porcine model. Deep partial nephrectomy defects were cut in the lateral aspect of six porcine kidneys. The renal artery was cannulated, and the kidneys were perfused from a water reservoir. The level (cm H(2)O) at which parenchymal leakage occurred was measured and recorded in three situations: No parenchymal suture; running suture along the base of the defect; and interrupted figure-8 sutures placed in parallel along the base of the defect. Six kidneys were studied. Using interrupted figure-8 sutures, the mean leak pressure was 56.7 cm H(2)O (over baseline). Using a running suture, the mean leak pressure was 147.5 cm H(2)O (over baseline). Mean values were compared using two-tailed t test and found to be statistically significant (P = 0.05). In an ex-vivo porcine kidney model, use of a running suture along the base of a renal tumor defect (simulating that which is seen during partial nephrectomy) appears to allow for better initial hemostatic control, as compared with interrupted figure-8 sutures placed in parallel.

  7. Solving Leak Testing Challenges

    National Research Council Canada - National Science Library

    John Sprovieri

    2007-01-01

    .... InterTech provided two Model 1075 pressure-decay leak detectors to perform the three tests-a leak test at 220 inches of water column, a leak test at 5 inches of water column, and a forward direction...

  8. 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.

  9. Management of gastric leaks after laparoscopic sleeve gastrectomy for morbid obesity: A tertiary care experience and design of a management algorithm

    Directory of Open Access Journals (Sweden)

    Palanivelu Praveenraj

    2016-01-01

    Full Text Available Background: Laparoscopic sleeve gastrectomy (LSG is the most commonly performed 'standalone' bariatric procedure in India. Staple line gastric leaks occur infrequently but cause significant and prolonged morbidity. The aim of this retrospective study was to analyse the management of patients with a gastric leak after LSG for morbid obesity at our institution. Patients and Methods: From February 2008 to 2014, 650 patients with different degrees of morbid obesity underwent LSG. Among these, all those diagnosed with a gastric leak were included in the study. Patients referred to our institution with gastric leak after LSG were also included. The time of presentation, site of leak, investigations performed, treatment given and time of closure of all leaks were analysed. Results: Among the 650 patients who underwent LSG, 3 (0.46% developed a gastric leak. Two patients were referred after LSG was performed at another institution. The mean age was 45.60 ± 15.43 years. Mean body mass index (BMI was 44.79 ± 5.35. Gastric leak was diagnosed 24 h to 7 months after surgery. One was early, two were intermediate and two were late leaks. Two were type I and three were type II gastric leaks. Endoscopic oesophageal stenting was used variably before or after re-surgery. Re-surgery was performed in all and included stapled fistula excision (re-sleeve, suture repair only or with conversion to roux-en-Y gastric bypass or fistula jujenostomy. There was no mortality. Conclusion: Leakage closure time may be shorter with intervention than expectant management. Sequence and choice of endoscopic oesophageal stenting and/or surgical re-intervention should be individualized according to clinical presentation.

  10. A bidirectional interface growth model for cranial interosseous suture morphogenesis

    Science.gov (United States)

    Zollikofer, Christoph P E; Weissmann, John David

    2011-01-01

    Interosseous sutures exhibit highly variable patterns of interdigitation and corrugation. Recent research has identified fundamental molecular mechanisms of suture formation, and computer models have been used to simulate suture morphogenesis. However, the role of bone strain in the development of complex sutures is largely unknown, and measuring suture morphologies beyond the evaluation of fractal dimensions remains a challenge. Here we propose a morphogenetic model of suture formation, which is based on the paradigm of Laplacian interface growth. Computer simulations of suture morphogenesis under various boundary conditions generate a wide variety of synthetic sutural forms. Their morphologies are quantified with a combination of Fourier analysis and principal components analysis, and compared with natural morphological variation in an ontogenetic sample of human interparietal suture lines. Morphometric analyses indicate that natural sutural shapes exhibit a complex distribution in morphospace. The distribution of synthetic sutures closely matches the natural distribution. In both natural and synthetic systems, sutural complexity increases during morphogenesis. Exploration of the parameter space of the simulation system indicates that variation in strain and/or morphogen sensitivity and viscosity of sutural tissue may be key factors in generating the large variability of natural suture complexity. PMID:21539540

  11. Use of bioabsorbable staple reinforcement material in side-to-side anastomoses: Suture line reinforcement of the weak point of the anastomosis.

    Science.gov (United States)

    Kimura, Masahiro; Terashita, Yukio

    2016-03-01

    Few studies have been designed regarding optimal reinforcement of the crotch of a side-to-side anastomosis. The purpose of this study was to clarify the weak point of the side-to-side anastomosis and to evaluate the effect of bioabsorbable reinforcement material. Fresh pig small bowel was used for all experiments. A side-to-side anastomosis was performed using a linear stapler, and the burst pressure of the anastomosis was measured. Three separate experiments were done. In experiment 1, the weak point and the burst pressure of that point were defined. In experiment 2, the burst pressure of the side of the anastomosis was measured. In experiment 3, we evaluated the effect of Neoveil(®) to strengthen the weak point of the anastomosis. The weak point of the side-to side anastomosis was the crotch and the burst pressure was 39.8 ± 5.7 mmHg. The burst pressure of the side of the anastomosis was 109.9 ± 7.9 mmHg. This was significantly higher than the burst pressure of the crotch (P = 0.008). The burst pressure of the crotch in the group with Neoveil(®) was 83.3 ± 14.9 mmHg. This pressure was significantly higher than the group with no Neoveil(®) reinforcement (P = 0.001). These findings suggest that the use of Neoveil(®) as a buttressing material is associated with reinforced staple lines and increased crotch burst pressures compared to non-buttressed staple lines. Neoveil(®) was found to perform comparably to clinically available buttress materials in this ex vivo model. Reinforcement of the weak point of the side-to-side anastomosis with Neoveil(®)may lead to fewer anastomotic leaks.

  12. Sensors for Fluid Leak Detection

    Directory of Open Access Journals (Sweden)

    Gonzalo Pajares Martinsanz

    2015-02-01

    Full Text Available Fluid leak detection represents a problem that has attracted the interest of researchers, but not exclusively because in industries and services leaks are frequently common. Indeed, in water or gas supplies, chemical or thermal plants, sea-lines or cooling/heating systems leakage rates can cause important economic losses and sometimes, what it is more relevant, environmental pollution with human, animal or plant lives at risk. This last issue has led to increased national and international regulations with different degrees of severity regarding environmental conservation.[...

  13. 3-D glass fabric-AHC epoxy laminates: Reinforced double linings with leak detection for above and below ground storage tanks

    Energy Technology Data Exchange (ETDEWEB)

    O' Donoghue, M.; Garrett, R.; Datta, V.J. [ICI Devoe Coatings Company (United States); Swinkels, K. [Parabeam (Netherlands); Crevolin, P. [CSI Coating Systems Inc (Canada)

    1999-07-01

    A unique three dimensional E-Glass Fabric/Advanced Hybrid Cycloaliphatic solventless epoxy laminate (3-D Glass Fabric/AHC System), which represents an innovative and cost-effective approach to safeguarding against accidental leakage of cargo from above ground (AST) and underground ( UST) storage containers, is described. This composite laminate provides an internal double layer and a secondary containment leak detection system and forms a chemically and thermally resistant integrated sandwich structure that prevents the side leaking of petroleum products into the environment, even when side corrosion produces a hole through the bottom of an AST, or the shell of a UST. The paper provides details of the components of the 3-D Glass Fabric/AHC System, relevant installation, testing, repair and leak detection procedures, and evaluation from two installations. 13 refs., 6 tabs., 6 figs.

  14. 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

    pressure levels, varying from 10 cmH2O to 60 cmH2O. The presence of air leaks along the suture line was verified through the water seal maneuver. RESULTS: The mean intrabronchial pressure level needed to cause suture line air leaks for each type were: type 1 (n = 10: 29 cmH2O; type 2 (n = 10: 38.5 cmH2O; type 3 (n = 10: 44 cmH2O; and type 4 (n = 10: 51.4 cmH2O. The comparison between the mean intrabronchial pressure level of type 1 and of types 2 and 3 sutures was statistically significant, respectively: p = 0.04 and p = 0.01. However, the comparison between types 2, 3 and 4 did not show statistic significance (p > 0.05. CONCLUSIONS: The pulmonary suture covered by biologic glue demonstrated more resistance to incremental levels of intrabronchial pressure. Parenchymal pulmonary sutures using stapled suture exclusively or stapled with bovine pericardium or biologic glue demonstrated an increased ability to avoid air leaks if compared to absorbable sutures in a model of porcine lung with incremental levels of intrabronchial pressure. There were no differences between stapler exclusively or stapler and bovine pericardium or biologic glue.

  15. Chlorofluorocarbon leak detection technology

    Energy Technology Data Exchange (ETDEWEB)

    Munday, E.B.

    1990-12-01

    There are about 590 large coolant systems located at the Portsmouth Gaseous Diffusion Plant (PORTS) and the Paducah Gaseous Diffusion Plant (PGDP) leaking nearly 800,000 lb of R-114 refrigerant annually (1989 estimate). A program is now under way to reduce the leakage to 325,000 lb/year -- an average loss of 551 lb/year (0.063 lb/h) per coolant system, some of which are as large as 800 ft. This report investigates leak detection technologies that can be used to locate leaks in the coolant systems. Included are descriptions, minimum leak detection rate levels, advantages, disadvantages, and vendor information on the following technologies: bubbling solutions; colorimetric leak testing; dyes; halogen leak detectors (coronea discharge detectors; halide torch detectors, and heated anode detectors); laser imaging; mass spectroscopy; organic vapor analyzers; odorants; pressure decay methods; solid-state electrolytic-cell gas sensors; thermal conductivity leak detectors; and ultrasonic leak detectors.

  16. Endoscopic Management of Gastrointestinal Leaks and Fistulae.

    Science.gov (United States)

    Willingham, Field F; Buscaglia, Jonathan M

    2015-10-01

    Gastrointestinal leaks and fistulae can be serious acute complications or chronic morbid conditions resulting from inflammatory, malignant, or postsurgical states. Endoscopic closure of gastrointestinal leaks and fistulae represents major progress in the treatment of patients with these complex presentations. The main goal of endoscopic therapy is the interruption of the flow of luminal contents across a gastrointestinal defect. In consideration of the proper endoscopic approach to luminal closure, several basic principles must be considered. Undrained cavities and fluid collections must often first be drained percutaneously, and the percutaneous drain provides an important measure of safety for subsequent endoscopic luminal manipulations. The size and exact location of the leak/fistula, as well as the viability of the surrounding tissue, must be defined. Almost all complex leaks and fistulae must be approached in a multidisciplinary manner, collaborating with colleagues in nutrition, radiology, and surgery. Currently, gastrointestinal leaks and fistulae may be managed endoscopically by using 1 or more of the following modalities: stent placement, clip closure (including through-the-scope clips and over-the-scope devices), endoscopic suturing, and the injection of tissue sealants. In this article, we discuss these modalities and review the published outcomes data regarding each approach as well as practical considerations for successful closure of luminal defects. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  17. Hypersensitivity to Suture Anchors

    OpenAIRE

    Masafumi Goto; Masafumi Gotoh; Yasuhiro Mitsui; Ryo Tanesue; Takahiro Okawa; Fujio Higuchi; Naoto Shiba

    2013-01-01

    Hypersensitivity to suture anchor is extremely rare. Herein, we present a case in which hypersensitivity to suture anchor was strongly suspected. The right rotator cuff of a 50-year-old woman was repaired with a metal suture anchor. Three weeks after the surgery, she developed erythema around her face, trunk, and hands, accompanied by itching. Infection was unlikely because no abnormalities were detected by blood testing or by medical examination. Suspicious of a metallic allergy, a dermatolo...

  18. Leak detection/verification

    Energy Technology Data Exchange (ETDEWEB)

    Krhounek, V.; Zdarek, J.; Pecinka, L. [Nuclear Research Institute, Rez (Czech Republic)

    1997-04-01

    Loss of coolant accident (LOCA) experiments performed as part of a Leak Before Break (LBB) analysis are very briefly summarized. The aim of these experiments was to postulate the leak rates of the coolant. Through-wall cracks were introduced into pipes by fatigue cycling and hydraulically loaded in a test device. Measurements included coolant pressure and temperature, quantity of leaked coolant, displacement of a specimen, and acoustic emission. Small cracks were plugged with particles in the coolant during testing. It is believed that plugging will have no effect in cracks with leak rates above 35 liters per minute. The leak rate safety margin of 10 is sufficient for cracks in which the leak rate is more than 5 liters per minute.

  19. Sutures and suture anchors--update 2006.

    Science.gov (United States)

    Barber, F Alan; Herbert, Morley A; Coons, David A; Boothby, Michael H

    2006-10-01

    To evaluate recently introduced sutures and suture anchors for single pull load to failure strength and failure mode. Suture anchors were tested in fresh porcine metaphyseal cortex and cancellous troughs with the use of an established protocol. An Instron machine applied tensile loads parallel to the axis of insertion at a rate of 12.5 mm/sec until failure, and mean anchor failure strengths were calculated. The mode of failure (anchor pull-out, suture eyelet cut-out, or suture failure) was recorded. Anchors tested included the BioRaptor 2.9, BioZip, Super Revo, Impact, Allograft cortical anchor, SpiraLok, Herculon, AxyaLoop titanium anchors 3, 5, and 6.5 mm, AxyaLoop bioabsorbable anchors 3, 5, and 6.5, ParaFix titanium anchors 3, 5, and 6.5, ParaSorb BioAnchors 3, 5.5, and 6.5, and Bio-Corkscrew FT. Sutures were also tested through an established protocol for load to failure. Sutures tested consisted of Orthocord, Ultrabraid (White and CoBraid), ForceFiber, Hi-Fi, MagnumWire, and Maxbraid Polyethylene Plus. Mean failure loads were as follows: BioRaptor 238 N, BioZip 366 N, double-loaded Super Revo 486 N, triple-loaded Super Revo 362 N, Impact 202 N, Allograft cortical anchor 240 N, SpiraLok 289 N, Herculon 819 N, AxyaLoop titanium anchors 3.0 (335 N), 5.0 (485 N), and 6.5 mm (465 N), AxyaLoop bioabsorbable anchors 3 (143 N), 5 (395 N), and 6.5 (369 N), ParaFix titanium anchors 3 (335 N), 5 (485 N), and 6.5 (465 N), ParaSorb BioAnchors 3 (143 N), 5.5 (395 N), and 6.5 (369 N), and Bio-Corkscrew FT (260 N). The sutures all broke at the mid point of their tested strands away from the grips. Mean suture strength for No. 2 Orthocord was 92 N; for No. 2 Ultrabraid CoBraid and White, strengths were 265 N and 280 N, respectively; strength for No. 2 Force Fiber was 289 N, for No. 2 Hi-Fi 250 N, for No. 2 MagnumWire 303 N, and for No. 2 Maxbraid Polyethylene Plus 256 N. Newer suture products showed significant improvements in load to failure values when compared with braided

  20. Treatment of cerebrospinal fluid leak after spine surgery

    Directory of Open Access Journals (Sweden)

    Zhao Fang

    2017-04-01

    Full Text Available Owing to the complexity of spinal surgery, there is a great prevalence of dural tear causing cerebrospinal fluid (CSF leakage. Many studies focused on suture repair for dural tear to stop CSF leak. Now some new treatment strategies have shown a promising effect that is listed as follows: 1 creating watertight dural closure to stop CSF leak with the help of dural substitute material; and 2 retarding CSF leak by changing pressure difference, including reducing the subarachnoid fluid pressure, increasing the epidural space pressure and both. In fact several methods mentioned above are usually combined to treat CSF leak. However, no update review summarized the relevant studies implemented in recent years. In this review, the authors would compare the effects of different dural closure techniques, and introduce the latest treatment methods and mechanisms.

  1. Successful Endoscopic Therapy of Traumatic Bile Leaks

    Directory of Open Access Journals (Sweden)

    Matthew P. Spinn

    2013-02-01

    Full Text Available Traumatic bile leaks often result in high morbidity and prolonged hospital stay that requires multimodality management. Data on endoscopic management of traumatic bile leaks are scarce. Our study objective was to evaluate the efficacy of the endoscopic management of a traumatic bile leak. We performed a retrospective case review of patients who were referred for endoscopic retrograde cholangiopancreatography (ERCP after traumatic bile duct injury secondary to blunt (motor vehicle accident or penetrating (gunshot trauma for management of bile leaks at our tertiary academic referral center. Fourteen patients underwent ERCP for the management of a traumatic bile leak over a 5-year period. The etiology included blunt trauma from motor vehicle accident in 8 patients, motorcycle accident in 3 patients and penetrating injury from a gunshot wound in 3 patients. Liver injuries were grade III in 1 patient, grade IV in 10 patients, and grade V in 3 patients. All patients were treated by biliary stent placement, and the outcome was successful in 14 of 14 cases (100%. The mean duration of follow-up was 85.6 days (range 54-175 days. There were no ERCP-related complications. In our case review, endoscopic management with endobiliary stent placement was found to be successful and resulted in resolution of the bile leak in all 14 patients. Based on our study results, ERCP should be considered as first-line therapy in the management of traumatic bile leaks.

  2. The calculation of the highest leak level of water pipe lines region at PDAM Tirta Kahuripan using fuzzy C-means and ArcGIS method analysis

    Science.gov (United States)

    Parwatiningtyas, D.; Ambarsari, E. W.; Mariko, S.

    2017-07-01

    Water is a basic necessity for human's life. Water, which is distributed to the public, should in decent condition, healthy, and protected from metal pollutants. In Indonesia, it is handled by a government institution, commonly is PDAM (Indonesian regional water utility company). A PDAM Tirta Kahuripan handles water distribution in Bogor area and part of Depok cities. Based on data, PDAM Tirta Kahuripan had approximately more than 46 % water loss, due to geological factor, human activity, etc. Therefore in this paper, we try to make a decision system of water loss at PDAM pipelines, using cluster Fuzzy C - Means method analysis. Then, mapped into ArcGIS software. Based on this method, we can be determine the region which shows the most water loss and also identify the highest leaks level from water pipelines at PDAM Tirta Kahuripan.

  3. Leak detection aid

    Science.gov (United States)

    Steeper, Timothy J.

    1989-02-01

    A leak detection apparatus and method for detecting leaks across an O-ring sealing a flanged surface to a mating surface is an improvement in a flanged surface comprising a shallow groove following O-ring in communication with an entrance and exit port intersecting the shallow groove for injecting and withdrawing, respectively, a leak detection fluid, such as helium. A small quantity of helium injected into the entrance port will flow to the shallow groove, past the O-ring and to the exit port.

  4. Hypersensitivity to Suture Anchors

    Directory of Open Access Journals (Sweden)

    Masafumi Goto

    2013-01-01

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

  5. Knotless anchors with sutures external to the anchor body may be at risk for suture cutting through osteopenic bone.

    Science.gov (United States)

    Ono, Y; Woodmass, J M; Nelson, A A; Boorman, R S; Thornton, G M; Lo, I K Y

    2016-06-01

    This study evaluated the mechanical performance, under low-load cyclic loading, of two different knotless suture anchor designs: sutures completely internal to the anchor body (SpeedScrew) and sutures external to the anchor body and adjacent to bone (MultiFIX P). Using standard suture loops pulled in-line with the rotator cuff (approximately 60°), anchors were tested in cadaveric bone and foam blocks representing normal to osteopenic bone. Mechanical testing included preloading to 10 N and cyclic loading for 500 cycles from 10 N to 60 N at 60 mm/min. The parameters evaluated were initial displacement, cyclic displacement and number of cycles and load at 3 mm displacement relative to preload. Video recording throughout testing documented the predominant source of suture displacement and the distance of 'suture cutting through bone'. In cadaveric bone and foam blocks, MultiFIX P anchors had significantly greater initial displacement, and lower number of cycles and lower load at 3 mm displacement than SpeedScrew anchors. Video analysis revealed 'suture cutting through bone' as the predominant source of suture displacement in cadaveric bone (qualitative) and greater 'suture cutting through bone' comparing MultiFIX P with SpeedScrew anchors in foam blocks (quantitative). The greater suture displacement in MultiFIX P anchors was predominantly from suture cutting through bone, which was enhanced in an osteopenic bone model. Anchors with sutures external to the anchor body are at risk for suture cutting through bone since the suture eyelet is at the distal tip of the implant and the suture directly abrades against the bone edge during cyclic loading. Suture cutting through bone may be a significant source of fixation failure, particularly in osteopenic bone.Cite this article: Y. Ono, J. M. Woodmass, A. A. Nelson, R. S. Boorman, G. M. Thornton, I. K. Y. Lo. Knotless anchors with sutures external to the anchor body may be at risk for suture cutting through osteopenic bone

  6. Does Barbed Suture Lower Cost and Improve Outcome in Total Knee Arthroplasty? A Randomized Controlled Trial.

    Science.gov (United States)

    Chan, Vincent W K; Chan, Ping-Keung; Chiu, Kwong-Yuen; Yan, Chun-Hoi; Ng, Fu-Yuen

    2017-05-01

    Wound closure is key to prevent infection, facilitate immediate rehabilitation, and improve efficiency of total knee arthroplasty (TKA). Continuous knotless suturing with barbed suture can potentially save time and distribute tension more evenly. However, its role in TKA in terms of cost-effectiveness and wound complications is not clear. This study aims at comparing barbed and traditional sutures' wound closure time and cost in primary TKA. One hundred nine knees were randomized into either barbed or traditional group. Synthetic absorbable sutures (Vicryl, Ethicon Inc) and bidirectional barbed sutures (Stratafix, Ethicon Inc) were used. Arthrotomy and subcutaneous wound closure time, wound complications, and rehabilitation parameters in terms of range of motion and Knee Society Score were compared. Patients were followed up to 3 months. Traditional sutures had significantly more positive leak tests (10 vs 2, P value sutures (arthrotomy 325 seconds vs 491 seconds; subcutaneous 306 seconds vs 381 seconds, P value suture material and operation time, barbed suture on average saved USD 48.7 per TKA in our local institute. Bidirectional barbed suture improves the cost-effectiveness of TKA through reducing wound closure time and wound complications. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Leaks in pipe networks

    Science.gov (United States)

    Pudar, Ranko S.; Liggett, James A.

    1992-01-01

    Leak detection in water-distribution systems can be accomplished by solving an inverse problem using measurements of pressure and/or flow. The problem is formulated with equivalent orifice areas of possible leaks as the unknowns. Minimization of the difference between measured and calculated heads produces a solution for the areas. The quality of the result depends on number and location of the measurements. A sensitivity matrix is key to deciding where to make measurements. Both location and magnitude of leaks are sensitive to the quantity and quality of pressure measurements and to how well the pipe friction parameters are known. The overdetermined problem (more measurements than suspected leaks) gives the best results, but some information can be derived from the underdetermined problem. The variance of leak areas, based on the quality of system characteristics and pressure data, indicates the likely accuracy of the results. The method will not substitute for more traditional leak surveys but can serve as a guide and supplement.

  8. Hydrostatic comparison of nonpenetrating titanium clips versus conventional suture for repair of spinal durotomies.

    Science.gov (United States)

    Faulkner, Nathan D; Finn, Michael A; Anderson, Paul A

    2012-04-20

    Biomechanics. To compare the hydrostatic strength of suture and nonpenetrating titanium clip repairs of standard spinal durotomies. Dural tears are a frequent complication of spine surgery and can be associated with significant morbidity. Primary repair of durotomies with suture typically is attempted, but a true watertight closure can be difficult to obtain because of leakage through suture tracts. Nonpenetrating titanium clips have been developed for vascular anastomoses and provide a close apposition of the tissues without the creation of a suture tract. Twenty-four calf spines were prepared with laminectomies and the spinal cord was evacuated leaving an intact dura. After Foley catheters were inserted from each end and inflated adjacent to a planned dural defect, the basal flow rate was measured and a 1-cm longitudinal durotomy was made with a scalpel. Eight repairs were performed for each material, which included monofilament suture, braided suture, and nonpenetrating titanium clips. The flow rate at 30, 60, and 90 cm of water and the time needed for each closure were measured. There was no statistically significant difference in the baseline leak rate for all 3 groups. There was no difference in the leakage rate of durotomies repaired with clips and intact specimens at any pressure. Monofilament and braided suture repairs allowed significantly more leakage than both intact and clip-repaired specimens at all pressures. The difference in leak rate increased as the pressure increased. Closing the durotomy with clips took less than half the time of closure with suture. Nonpenetrating titanium clips provide a durotomy closure with immediate hydrostatic strength similar to intact dura whereas suture repair with either suture was significantly less robust. The use of titanium clips was more rapid than that of suture repair.

  9. New sutures and suture anchors in sports medicine.

    Science.gov (United States)

    Alan Barber, F; Boothby, Michael H; Richards, David P

    2006-09-01

    Arthroscopic surgery requires appropriate surgical implants for effective fixation of tendons and ligaments to bone. Biodegradable suture anchors are being used with increasing frequency for various procedures in sports medicine. As companions to these biodegradable suture anchors, new sutures have been developed which possess greater strength and different material properties from the conventional braided polyester suture. Biodegradable polymers currently found in sutures and suture anchors include poly-L-lactic acid, poly-D, L lactic acid, polydioxanone, polyglycolic acid and their copolymers. Suture anchors are now available preloaded with a choice of conventional braided polyester sutures or some version of ultrahigh molecular weight polyethylene ("super") sutures. Most new suture anchors come with 2 sutures. The manner in which these sutures are attached to the anchor varies and may consist of 2 separate eyelets or 2 slots either parallel to one another or at different angles to one another. Some anchors have a very large single eyelet that allows for 2 or more sutures.

  10. Adjustable suture strabismus surgery

    Science.gov (United States)

    Nihalani, B R; Hunter, D G

    2011-01-01

    Surgical management of strabismus remains a challenge because surgical success rates, short-term and long-term, are not ideal. Adjustable suture strabismus surgery has been available for decades as a tool to potentially enhance the surgical outcomes. Intellectually, it seems logical that having a second chance to improve the outcome of a strabismus procedure should increase the overall success rate and reduce the reoperation rate. Yet, adjustable suture surgery has not gained universal acceptance, partly because Level 1 evidence of its advantages is lacking, and partly because the learning curve for accurate decision making during suture adjustment may span a decade or more. In this review we describe the indications, techniques, and published results of adjustable suture surgery. We will discuss the option of ‘no adjustment' in cases with satisfactory alignment with emphasis on recent advances allowing for delayed adjustment. The use of adjustable sutures in special circumstances will also be reviewed. Consistently improved outcomes in the adjustable arm of nearly all retrospective studies support the advantage of the adjustable option, and strabismus surgeons are advised to become facile in the application of this approach. PMID:21760626

  11. SEALING SIMULATED LEAKS

    Energy Technology Data Exchange (ETDEWEB)

    Michael A. Romano

    2004-09-01

    This report details the testing equipment, procedures and results performed under Task 7.2 Sealing Simulated Leaks. In terms of our ability to seal leaks identified in the technical topical report, Analysis of Current Field Data, we were 100% successful. In regards to maintaining seal integrity after pigging operations we achieved varying degrees of success. Internal Corrosion defects proved to be the most resistant to the effects of pigging while External Corrosion proved to be the least resistant. Overall, with limitations, pressure activated sealant technology would be a viable option under the right circumstances.

  12. Suture contamination in strabismus surgery.

    Science.gov (United States)

    Eustis, H Sprague; Rhodes, Annette

    2012-01-01

    To document the contamination rate of sutures used in strabismus surgery and evaluate the reduction of contamination using antibiotic-coated and antiseptic/antibiotic-coated sutures. This was a prospective randomized analysis of suture contamination and potential prophylaxis measures after strabismus surgery. Muscle sutures (6-0 polyglactin) used in 302 consecutive cases of strabismus from October 2008 to May 2009 were collected and randomly assigned to three groups: (1) a control without pretreatment sutures (61); (2) antibiotic/steroid-coated sutures (200); and (3) antiseptic-soaked and antibiotic/steroid-coated sutures (141). The sutures were used under sterile conditions and then cut into pieces and transferred to blood agar plates, which were incubated for 48 hours and then checked for growth. Group 1 had bacterial growth in 17 of 61 (28%) sutures; group 2 had growth in 44 of 200 (22%) sutures; and group 3 had growth in 12 of 141 (9%) sutures. The reduction in bacterial growth using the antibiotic/antiseptic coating was significant (P = .006). One patient developed coagulase-negative Staphylococcus epidermidis endophthalmitis 1 week after surgery, which was promptly diagnosed and successfully treated. No complications from the antibiotic-coated or antiseptic-soaked sutures were noted. Although endophthalmitis after strabismus surgery is rare, estimated at 1 in 35,000 to 1 in 185,000, visual outcome is uniformly poor. The authors hypothesize that strabismus sutures can be contaminated via contact with the eyelashes and skin, providing a possible conduit for endophthalmitis. Bacterial contamination of strabismus sutures is high (28%) and can be reduced significantly if sutures are soaked in antiseptic before use. Copyright 2012, SLACK Incorporated.

  13. Holding Strength of a Hem-o-lok/Lapra-Ty Clip Combination on Sutures Used During Partial Nephrectomy.

    Science.gov (United States)

    Paka, Bikal; Bossemeyer, Robert; Tourojman, Mouafak; Gupta, Ruchir; Lane, Brian R

    2017-09-01

    To investigate the anti-slip strength of closing systems employing sutures terminated with a Hem-o-lok/Lapra-Ty clip combination to determine which sutures perform best for this application. Partial nephrectomy is the reference standard for treatment of small renal masses. The main disadvantage of partial nephrectomy is the risk of technical complications, including renorrhaphy site bleeding and urine leak. A materials testing system produced a constant velocity pull on the free end of an anchored suture. A Lapra-Ty clip was attached 1 cm from the end of each suture as a backstop for the Hem-o-lok. A digital force gauge measured the tension that was applied until the suture slipped in the closing system. Vicryl, Monocryl, Chromic, Stratafix, and V-Loc sutures of diameters 1 to 4-0 were tested (n = 7 for each suture type, 161 total experiments). The holding strength of a Lapra-Ty/Hem-o-lok clip combination is lowest for Vicryl 4-0 (4.3 ± 1.4N) and highest for Monocryl 0 (16.5 ± 1.6N) sutures. Larger sutures (1 and 0) hold at higher tensions than sutures with smaller dimensions (4-0 and 3-0). For 2-0 sutures, the holding strength was 5.7N with Vicryl, 13.8N with Stratafix, and 15.9N with V-Loc sutures. The mean values of holding tension of this anchoring system for all sutures tested was greater than the amount found to be sufficient for tissue closure in previous studies (3.2N). Barbed sutures (Stratafix, V-Loc) appeared to have superior holding strength when compared with most standard sutures; barb orientation does not influence holding tension. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. The Leaking-Toilet Challenge

    Science.gov (United States)

    Roman, Harry T.

    2008-01-01

    Leaking toilets can cost homeowners big dollars--often before it is even realized. Homeowners do not necessarily hear it leaking. It just does, and when the water bill comes due, it can be a most unpleasant surprise. This article presents a classroom challenge to try to develop leak-detection ideas that would be inexpensive and easily added to…

  15. Releasable suture technique for trabeculectomy

    Directory of Open Access Journals (Sweden)

    Jacob Pushpa

    1993-01-01

    Full Text Available We studied the effect of the releasable suture technique on immediate postoperative intraocular pressure (IOP. Nine eyes of nine patients with glaucoma had trabeculectomy with a releasable suture. In the six eyes that did not receive antimitotics, the suture was released by the fifth postoperative day; in the others suture release was delayed up to the fourteenth day. Of the nine patients, one had an acceptable postoperative IOP and did not need suture release; in another the suture broke and could not be released. In the remaining seven patients, the difference between the pre-release and post-release IOP was statistically significant (p < 0.001. The complications of this technique include failed suture release, subconjunctival hematoma and a distinctive "windshield wiper" keratopathy.

  16. Natural gas leak mapper

    Science.gov (United States)

    Reichardt, Thomas A [Livermore, CA; Luong, Amy Khai [Dublin, CA; Kulp, Thomas J [Livermore, CA; Devdas, Sanjay [Albany, CA

    2008-05-20

    A system is described that is suitable for use in determining the location of leaks of gases having a background concentration. The system is a point-wise backscatter absorption gas measurement system that measures absorption and distance to each point of an image. The absorption measurement provides an indication of the total amount of a gas of interest, and the distance provides an estimate of the background concentration of gas. The distance is measured from the time-of-flight of laser pulse that is generated along with the absorption measurement light. The measurements are formated into an image of the presence of gas in excess of the background. Alternatively, an image of the scene is superimosed on the image of the gas to aid in locating leaks. By further modeling excess gas as a plume having a known concentration profile, the present system provides an estimate of the maximum concentration of the gas of interest.

  17. Aspects of leak detection

    Energy Technology Data Exchange (ETDEWEB)

    Chivers, T.C. [Berkeley Technology Centre, Glos (United Kingdom)

    1997-04-01

    A requirement of a Leak before Break safety case is that the leakage from the through wall crack be detected prior to any growth leading to unacceptable failure. This paper sets out to review some recent developments in this field. It does not set out to be a comprehensive guide to all of the methods available. The discussion concentrates on acoustic emission and how the techniques can be qualified and deployed on operational plant.

  18. Suture locking of isolated internal locking knotless suture anchors is not affected by bone quality

    Directory of Open Access Journals (Sweden)

    Woodmass JM

    2015-06-01

    Full Text Available Jarret M Woodmass,1 Graeme Matthewson,1 Yohei Ono,1,2 Aaron J Bois,1 Richard S Boorman,1 Ian KY Lo,1 Gail M Thornton1,31Department of Surgery, Section of Orthopaedic Surgery, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada; 2Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan; 3Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada Purpose: The purpose of this study was to evaluate the mechanical performance of different suture locking mechanisms including: i interference fit between the anchor and the bone (eg, 4.5 mm PushLock, 5.5 mm SwiveLock, ii internal locking mechanism within the anchor itself (eg, 5.5 mm SpeedScrew, or iii a combination of interference fit and internal locking (eg, 4.5 mm MultiFIX P, 5.5 mm MultiFIX S. Methods: Anchors were tested in foam blocks representing normal (20/8 foam or osteopenic (8/8 foam bone, using standard suture loops pulled in-line with the anchor to isolate suture locking. Mechanical testing included cyclic testing for 500 cycles from 10 N to 60 N at 60 mm/min, followed by failure testing at 60 mm/min. Displacement after 500 cycles at 60 N, number of cycles at 3 mm displacement, load at 3 mm displacement, and maximum load were evaluated. Results: Comparing 8/8 foam to 20/8 foam, load at 3 mm displacement and maximum load were significantly decreased (P<0.05 with decreased bone quality for anchors that, even in part, relied on an interference fit suture locking mechanism (ie, 4.5 mm PushLock, 5.5 mm SwiveLock, 4.5 mm MultiFIX P, 5.5 mm MultiFIX S. Bone quality did not affect the mechanical performance of 5.5 mm SpeedScrew anchors which have an isolated internal locking mechanism. Conclusion: The mechanical performance of anchors that relied, even in part, on interference fit were affected by bone quality. Isolated internal locking knotless suture anchors functioned independently of bone quality

  19. Leak test fitting

    Science.gov (United States)

    Pickett, P.T.

    A hollow fitting for use in gas spectrometry leak testing of conduit joints is divided into two generally symmetrical halves along the axis of the conduit. A clip may quickly and easily fasten and unfasten the halves around the conduit joint under test. Each end of the fitting is sealable with a yieldable material, such as a piece of foam rubber. An orifice is provided in a wall of the fitting for the insertion or detection of helium during testing. One half of the fitting also may be employed to test joints mounted against a surface.

  20. Nasal tip sutures: Techniques and indications.

    Science.gov (United States)

    Cingi, Cemal; Muluk, Nuray Bayar; Ulusoy, Seçkin; Söken, Hakan; Altıntoprak, Niyazi; Şahin, Ethem; Ada, Servet

    2015-01-01

    The surgical anatomy of the nasal tip is determined by intrinsic factors, such as the nasal tip volume, shape, definition, and symmetry. These factors are intimately related to the morphology of the lower lateral cartilages. Tip sutures reduce the need for grafts and allow the surgeon to manipulate the tip with a high degree of precision and better long-term clinical outcomes. In this review, we evaluated common nasal tip suture techniques to clarify the similarities and differences among them. The following nasal tip suture techniques were investigated: medial crural fixation suture, middle crura suture, transdomal (dome creating, dome binding, domal definition) suture, interdomal suture, lateral crural mattress suture, columella septal suture, intercrural suture, tip rotation suture, craniocaudal transdomal suture, lateral crural spanning suture, suspension suture, tongue-in-groove technique, and lateral crural steal. Tip sutures increase tip projection, narrow the tip, provide stabilization, and provide tip rotation. The sutures may be used separately or together. Nasal tip sutures have long been used as noninvasive suture techniques. Each suture technique has unique benefits, and various key points must be considered when using these techniques.

  1. Deconstructing Gender Stereotypes in Leak

    Directory of Open Access Journals (Sweden)

    Nengah Bawa Atmadja

    2015-05-01

    Full Text Available The belief of Balinese people towards leak still survive. Leak is a magic based on durgaism that can transform a person from human to another form, such as apes, pigs, etc. People tend to regard leak as evil. In general, the evilness is constructed in gender stereotypes, so it is identified that leak are always women. This idea is a power game based on the ideology of patriarchy that provides legitimacy for men to dominate women with a plea for social harmony. As a result, women are marginalized in the Balinese society. Women should be aware of so it would provide encouragement for them to make emancipatory changes dialogically. Kepercayaan orang Bali terhadap leak tetap bertahan sampai saat ini. Leak adalah sihir yang berbasiskan durgaisme yang dapat mengakibatkan seseorang bisa merubah bentuk dari manusia ke wujud yang lain, misalnya kera, babi, dll. Leak termasuk magi hitam sehingga dinilai bersifat jelek. Pada umumnya perempuan diidentikkan dengan leak sehingga melahirkan asumsi yang bermuatan steriotip gender bahwa leak = perempuan. Gagasan ini merupakan permainan kekuasaan berbasis ideologi patriarkhi dan sekaligus memberikan legitimasi bagi laki-laki untuk menguasai perempuan dengan dalih demi keharmonisan sosial. Akibatnya, perempuan menjadi termarginalisasi pada masyarakat Bali.  Perempuan harus menyadarinya sehingga memberikan dorongan bagi mereka untuk melakukan perubahan secara dialogis emansipatoris.

  2. Force sensing in surgical sutures

    NARCIS (Netherlands)

    Horeman, T.; Meijer, E.J.; Harlaar, J.J.; Lange, J.F.; Van den Dobbelsteen, J.J.; Dankelman, J.

    2013-01-01

    The tension in a suture is an important factor in the process of wound healing. If there is too much tension in the suture, the blood flow is restricted and necrosis can occur. If the tension is too low, the incision opens up and cannot heal properly. The purpose of this paper is to describe the

  3. Force sensing in surgical sutures

    NARCIS (Netherlands)

    T. Horeman (Tim); E.-J. Meijer (Evert-Jan); J.J. Harlaar (Joris Jan); J.F. Lange (Johan); J.J. van den Dobbelsteen (John); J. Dankelman (Jenny)

    2013-01-01

    textabstractThe tension in a suture is an important factor in the process of wound healing. If there is too much tension in the suture, the blood flow is restricted and necrosis can occur. If the tension is too low, the incision opens up and cannot heal properly. The purpose of this paper is to

  4. Bioactive Sutures: A Review of Advances in Surgical Suture Functionalisation.

    Science.gov (United States)

    Alshomer, Feras; Madhavan, Arul; Pathan, Omar; Song, Wenhui

    2017-01-01

    Sutures have been at the forefront of surgical medicine throughout time. With recent advances in suture technology, it is possible to incorporate biologically active substances to enhance suture function and capability. Bioactive sutures represent a modality interest in controlled drug and cell delivery to traumatic sites. In this article, a comprehensive literature search of key bibliographic databases focusing on suture material fabrication and advanced modification was performed. The history, manufacturing process and cost-effectiveness of bioactive sutures are presented. Several novel modifications to enhance function in drug and growth factor delivery and cell therapy are also reviewed. Different antimicrobial drugs and anaesthetics have been shown to be effective in reducing inflammation and bacterial infection. Cellular therapy represents a unique modality augmenting the surgical repair of various soft tissue injuries. We propose a definition of bio-active sutures as biomaterials that are engineered to have controlled tissue interaction to optimise wound/defect healing, in addition to their essential function in tissue approximation. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  5. Hermetic Seal Leak Detection Apparatus

    Science.gov (United States)

    Kelley, Anthony R. (Inventor)

    2013-01-01

    The present invention is a hermetic seal leak detection apparatus, which can be used to test for hermetic seal leaks in instruments and containers. A vacuum tight chamber is created around the unit being tested to minimize gas space outside of the hermetic seal. A vacuum inducing device is then used to increase the gas chamber volume inside the device, so that a slight vacuum is pulled on the unit being tested. The pressure in the unit being tested will stabilize. If the stabilized pressure reads close to a known good seal calibration, there is not a leak in the seal. If the stabilized pressure reads closer to a known bad seal calibration value, there is a leak in the seal. The speed of the plunger can be varied and by evaluating the resulting pressure change rates and final values, the leak rate/size can be accurately calculated.

  6. [A case of intractable fistula after low anterior resection repaired by transsacral direct suture].

    Science.gov (United States)

    Yamada, Takanobu; Kodato, Takashi; Shirai, Junya; Kamiya, Mariko; Sujishi, Ken; Kumazu, Yuta; Sugano, Nobuhiro; Hatori, Shinsuke; Osaragi, Tomohiko; Yoneyama, Katsuya; Kasahara, Akio; Rino, Yasushi; Masuda, Munetaka; Yamamoto, Yuji

    2014-11-01

    We report a case of an intractable fistula repaired by transsacral direct suture. A 65-year-old man underwent low anterior resection for rectal cancer. He subsequently underwent ileostomy due to anastomosis leakage. The fistula of the anastomosis persisted 3 months after surgery. He underwent surgery to repair the fistula using a transsacral approach. After removing the coccyx, the fistula in the postrectal space was exposed directly. The presence of the fistula was confirmed by an air leak test and was closed by direct suture. After 33 days, the patient underwent ileostomy closure.

  7. Fabrication and feasibility study of an absorbable diacetyl chitin surgical suture for wound healing.

    Science.gov (United States)

    Shao, Kai; Han, Baoqin; Gao, Jinning; Jiang, Zhiwen; Liu, Weizhi; Liu, Wanshun; Liang, Ye

    2016-01-01

    Diacetyl chitin (DAC) is an acidylated chitin obtained using acetic anhydride mixed perchloric acid system. By wet spinning and weaving technique, DAC has been successfully developed into a novel absorbable surgical suture. Thanks to the unique properties of chitins, the potential application of this novel monocomponent multifilament DAC suture may break the monopoly of synthetic polymer sutures in wound closure area. In this study, DAC was synthesized and characterized by multiple approaches including elemental analysis, Fourier transform infrared spectrometry (FTIR), and X-ray diffraction (XRD). In addition, we performed the feasibility assessment of DAC suture (USP 2-0) as absorbable suture for wound healing. Several lines of evidences suggested that DAC suture had comparable mechanical properties as synthetic polymer sutures. Moreover, DAC suture retained approximately 63% of the original strength at 14 days and completely absorbed in 42 days with no remarkable tissue reaction in vivo. Most important of all, DAC suture significantly promoted skin regeneration with faster tissue reconstruction and higher wound breaking strength on a linear incisional wound model. All these results demonstrated the potential use of DAC suture in short- or middle-term wound healing, such as epithelial and connective tissue. © 2015 Wiley Periodicals, Inc.

  8. Biomechanical analysis of suture anchors and suture materials in the canine femur.

    Science.gov (United States)

    Giles, James T; Coker, Demir; Rochat, Mark C; Payton, Mark E; Subramarian, Vijay; Bartels, Kenneth E

    2008-01-01

    Biomechanical analysis of acute load to failure (ALF) of 3 veterinary and 1 human suture anchor and cyclic load to failure with two suture material/suture anchor constructs in canine femoral condyles. Biomechanical in vitro study. Cadaveric femora from 20-30 kg dogs. Three veterinary and 1 human suture anchor were placed in the cranial and caudal aspects of the femoral condyle and subjected to 0 degrees ALF. Anchors were loaded with 5 USP Fiberwire or 27 kg test nylon leader line (NLL) and subjected to 90 degrees cyclic testing for 10,000 cycles followed by ALF at 90 degrees. No significant difference in ALF for any anchor type was detected in the cranial aspect of the femoral condyle; however all veterinary anchors had higher ALF in the caudal aspect of the femoral condyle. In cyclic testing, the constructs in descending order (most cycles to least) were: (1) FlexiTwist/NLL, (2) Securos/Fiberwire, Securos/NLL, (3) IMEX/Fiberwire, IMEX/NLL, and (4) FlexiTwist/Fiberwire, Fastin/Fiberwire. Fiberwire was significantly stronger than NLL in post-cycling ALF testing. Veterinary anchors had higher ALF in the caudal versus cranial aspect of the femoral condyle. Except for the FlexiTwist in which NLL performed better, Fiberwire and NLL both had similar cyclic performance with each veterinary anchor type. The veterinary anchors exceeded the human anchor in ALF and cycles to failure. The tested veterinary suture anchors with Fiberwire or NLL may be used in the femoral condyle, preferably in the caudal aspect, and should withstand estimated loading conditions in appropriately confined postoperative canine patients.

  9. Suture locking of isolated internal locking knotless suture anchors is not affected by bone quality

    Science.gov (United States)

    Woodmass, Jarret M; Matthewson, Graeme; Ono, Yohei; Bois, Aaron J; Boorman, Richard S; Lo, Ian KY; Thornton, Gail M

    2015-01-01

    Purpose The purpose of this study was to evaluate the mechanical performance of different suture locking mechanisms including: i) interference fit between the anchor and the bone (eg, 4.5 mm PushLock, 5.5 mm SwiveLock), ii) internal locking mechanism within the anchor itself (eg, 5.5 mm SpeedScrew), or iii) a combination of interference fit and internal locking (eg, 4.5 mm MultiFIX P, 5.5 mm MultiFIX S). Methods Anchors were tested in foam blocks representing normal (20/8 foam) or osteopenic (8/8 foam) bone, using standard suture loops pulled in-line with the anchor to isolate suture locking. Mechanical testing included cyclic testing for 500 cycles from 10 N to 60 N at 60 mm/min, followed by failure testing at 60 mm/min. Displacement after 500 cycles at 60 N, number of cycles at 3 mm displacement, load at 3 mm displacement, and maximum load were evaluated. Results Comparing 8/8 foam to 20/8 foam, load at 3 mm displacement and maximum load were significantly decreased (Panchors that, even in part, relied on an interference fit suture locking mechanism (ie, 4.5 mm PushLock, 5.5 mm SwiveLock, 4.5 mm MultiFIX P, 5.5 mm MultiFIX S). Bone quality did not affect the mechanical performance of 5.5 mm SpeedScrew anchors which have an isolated internal locking mechanism. Conclusion The mechanical performance of anchors that relied, even in part, on interference fit were affected by bone quality. Isolated internal locking knotless suture anchors functioned independently of bone quality. Anchors with a combined type (interference fit and internal locking) suture locking mechanism demonstrated similar mechanical performance to isolated internal locking anchors in osteopenic foam comparing similar sized anchors. Clinical relevance In osteopenic bone, knotless suture anchors that have an internal locking mechanism (isolated or combined type) may be advantageous for secure tendon fixation to bone. PMID:26124683

  10. Color Changing Material for Hydrogen Leak Detection

    Science.gov (United States)

    Victor, Megan E.

    2014-01-01

    Kennedy Space Center scientists developed a hydrogen leak sensor utilizing a combination of chemochromic pigment and polymer that can be molded or fiber spun into rigid or flexible shapes such as tape. The sensor turns a dark color when exposed to hydrogen gas. This sensor has proven to be very effective for pinpointing the exact location of leaks in hydrogen gas lines and fittings at launch pads. Kennedy Space Center exclusively licensed this technology to the University of Central Florida (UCF), who also holds patents that are complimentary to KSC's. UCF has bundled the patents and exclusively licensed the portfolio to HySense Technology LLC, a startup company founded by a UCF professor who supports the UCF Florida Solar Energy Center (FSEC). HySense has fully developed its product (known as Intellipigment"TM"), and currently has five commercial customers. The company recently won the $100,000 first-place award at the CAT5 innovation competition at the Innovation Concourse of the Southeast: Safety & Manufacturing event in Orlando, FL. Commercial production and sales of this technology by HySense Technology will make this leak sensor widely available for use by NASA, DoD, and industries that utilize hydrogen gas.

  11. Sterilization effects on tensile strength of non-conventional suture ...

    African Journals Online (AJOL)

    An experiment was carried out to determine the tensile strength of embroidery, braiding, cobbler's thread and nylon mono-filament fishing line (NMFL) use as non-conventional suture material. Their tensile strength were determined pre- sterilization using various calibrated weights (50gm, 100gm, 500gm).

  12. Leak Propagation Dynamics for the HIE-ISOLDE Superconducting Linac

    CERN Document Server

    Ady, M; Kersevan, R; Vandoni, G; Ziemianski, D

    2014-01-01

    In order to cope with space limitations of existing infrastructure, the cryomodules of the HIE-ISOLDE superconducting linac feature a common insulation and beam vacuum, imposing the severe cleanliness standard of RF cavities to the whole cryostat. Protection of the linac vacuum against air-inrush from the three experimental stations through the HEBT (High Energy Beam Transport) lines relies on fast valves, triggered by fast cold cathode gauges. To evaluate the leak propagation velocity as a function of leak size and geometry of the lines, a computational and experimental investigation is being carried out at CERN. A 28 m long tube is equipped with cold-cathode gauges. A leak is opened by the effect of a cutting pendulum, equipped with an accelerometer for data acquisition triggering, on a thin aluminium window. The air inrush dynamics is simulated by Finite Elements fluid dynamics in the viscous regime.

  13. Effect of configuration on the biomechanical performance of three suture materials used in combination with a metallic bone anchor.

    Science.gov (United States)

    Wasik, Sonya M; Cross, Rod C; Voss, Katja

    2013-12-01

    To determine whether different suture configurations could improve the biomechanical performance of 3 suture materials used with bone anchors. 3 suture materials (60-lb test nylon leader line, size 2 polyblend polyethylene composite suture, and 150-lb test ultrahigh-molecular weight spun polyethylene). PROCEDURES-Each suture material was looped through the eyelet of a metallic bone anchor and constructs were evaluated by use of an acute uniaxial load. Three configurations were tested for each suture material: single stranded (SS), double stranded (DS), and single stranded plus plastic insert (SSP). Force at failure, extension at failure, force at 3 mm of extension, stiffness, and site of failure of the suture were recorded for each test. For all sutures, the DS configuration was the stiffest and yielded significantly higher forces at failure and forces at 3 mm of extension. The SS configuration had the lowest forces at failure. The SSP configuration yielded greater forces at failure for all suture materials, compared with the SS configuration, with a comparable stiffness. All sutures failed at the eyelet in the SS and DS configurations. In the SSP configuration, 60-lb test nylon leader line and 150-lb test ultrahigh-molecular weight spun polyethylene failed at the eyelet less frequently than did the polyblend composite suture. Among the tested constructs, a DS suture configuration used in combination with the metallic bone anchor gave the best biomechanical results for all suture materials. Considering that the SSP configuration yielded greater forces at failure, compared with the SS configuration, covering metallic edges in bone anchors with softer materials might protect sutures and result in increased forces at failure.

  14. 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.

  15. Mesh Sutured Repairs of Abdominal Wall Defects

    National Research Council Canada - National Science Library

    Lanier, Steven T; Dumanian, Gregory A; Jordan, Sumanas W; Miller, Kyle R; Ali, Nada A; Stock, Stuart R

    2016-01-01

    BACKGROUND:A new closure technique is introduced, which uses strips of macroporous polypropylene mesh as a suture for closure of abdominal wall defects due to failures of standard sutures and difficulties with planar meshes...

  16. Suture materials and suture techniques used in tendon repair.

    Science.gov (United States)

    Ketchum, L D

    1985-02-01

    Immediately after a tendon repair, the tendon contributes nothing to the strength of repair. During that time, the suture itself and suture technique are the sole contributors to the strength of repair. Although stainless steel is the strongest material that can be used at the time of repair, it has serious disadvantages. It is difficult to work with and makes a bulky knot. Conversely, all absorbable sutures become too weak too soon to be of value. At this time, nonabsorbable, synthetic fibers that are relatively strong, such as Supramid or prolene, are the most desirable materials available. Regarding suture techniques, the lateral trap and end-weave techniques produce the strongest repairs; however, the end-weave technique can only be used with tendon grafts and the lateral trap, though it can be used for end-to-end primary repairs. It is too bulky for use in the fingers and hand but is ideal for the forearm and wrist. In the hand and fingers, the strongest repair techniques available are the Bunnell, Kessler, and Mason-Allen; however, the Bunnell stitch is more strangulating to the microcirculation of the tendon than the latter two stitches; thus, it contributes to tendomalacia and gap formation. The simplest and least traumatic suture technique, though weakest at first, will allow tendon healing to proceed more rapidly. If such a repair is protected from tension by splinting the wrist and metacarpophalangeal joints in flexion during healing (while allowing controlled passive motion of the finger joints), there will be a rapid increase in tensile strength of the tendon juncture with minimal gap formation, as the repaired hand is progressively stressed up until about 90 days postrepair. At that point, strength plateaus and maximum stress can be applied to the repaired tendon. Somewhere between three and six weeks post-tendon repair, the suture material and technique become secondary to tendon healing as the primary provider of tensile strength to the tendon wound

  17. Comparison of elastic versus rigid suture material for peripheral sutures in tendon repair.

    Science.gov (United States)

    Nozaki, Kenji; Mori, Ryuji; Ryoke, Koji; Uchio, Yuji

    2012-06-01

    For secure tendon repair, while core suture materials have been previously investigated, the optimum material for peripheral sutures remains unclear. Transected bovine gastrocnemius tendons were repaired by 2-strand side-locking loop technique using no.2 braided polyblend polyethylene thread for the core suture. Then, 8-strand peripheral cross-stitches were added using either 2-0 rigid sutures (braided polyblend polyethylene) or USP 2-0-sized elastic sutures (nylon). The holding area of each peripheral suture was set at either 3 × 1 mm (shallow holding) or 6 × 2 mm (deep holding). Therefore, 4 groups were compared (the shallow-rigid, deep-rigid, shallow-elastic, and deep-elastic groups). The gap formation, ultimate tensile strength, and suture migration state were measured after 500 cyclic loadings (from 10 to 200 N). The shallow-rigid group had inferior outcomes compared to the other groups. Although the deep-rigid group had the smallest gap and highest ultimate strength, all peripheral sutures had failure prior to core suture rupture. The two elastic groups showed no significant differences, irrespective of the size of the holding area. Suture migration did not occur in the two elastic groups until the ultimate strength was reached and the core suture ruptured. Depending on the suturing method, rigid suture material may not be appropriate for peripheral sutures, when accompanying rigid core suture material. If peripheral sutures can be made with accurate deep holding, rigid suture material will provide favorable outcome. However, in other cases, elastic suture material is considered best for supporting a rigid core suture, as elasticity is another important factor for peripheral sutures. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. The influence of suture material on the strength of horizontal mattress suture configuration for meniscus repair.

    Science.gov (United States)

    Hapa, Onur; Akşahin, Ertuğrul; Erduran, Mehmet; Davul, Serkan; Havitçioğlu, Hasan; LaPrade, Robert F; Bozdağ, Ergun; Sünbüloğlu, Emin

    2013-12-01

    Comparison of the mechanical characteristics of meniscal repair fixation using horizontal sutures and six different sutures under submaximal cyclic and load to failure test conditions may aid physicians in selecting a suture type. A 2-cm long anteroposterior vertical longitudinal incision was created in six groups of bovine medial menisci. Lesions were repaired using a No. 2 suture either composed of polyester or polyester and ultra high-molecular weight polyethylene (UHMWPE), or UHMWPE and polydioxanone or pure UHMWPE. Endpoints included ultimate failure load (N), pull-out stiffness (N/mm), pull-out displacement (mm), cyclic displacement (mm) after 100cycles, after 500cycles, and mode of failure. Polyester suture had lower ultimate load than all groups except the suture composed of polyester and UHMWPE (Psuture had higher ultimate failure load than sutures composed of either polyester or polyester plus UHMWPE (Psuture cutting through the meniscus for the groups except for polyester suture which failed by suture rupture. Under cyclic loading conditions in bovine meniscus, braided polyester suture fixation provided lower initial fixation strength than fixation with various high strength sutures composed of pure UHMWPE or a combination of absorbable monofilament polydioxanone and UHMWPE, except for combination of polyester and UHMWPE sutures. Present study does not support the usage of the braided polyester sutures instead of high strength sutures composed either partially or totally of ultra-high molecular weight polyethylene for the horizontal suture configuration of meniscus repair. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Stochastic Consequence Analysis for Waste Leaks

    Energy Technology Data Exchange (ETDEWEB)

    HEY, B.E.

    2000-05-31

    This analysis evaluates the radiological consequences of potential Hanford Tank Farm waste transfer leaks. These include ex-tank leaks into structures, underneath the soil, and exposed to the atmosphere. It also includes potential misroutes, tank overflow

  20. Anaerobic polymers as high vacuum leak sealants

    Science.gov (United States)

    Kendall, B. R. F.

    1982-01-01

    Anaerobic polymers are useful as solventless leak sealants with good vacuum properties at moderate temperatures. Loctite 290 can seal leaks in a range generally encountered in carefully constructed ultrahigh vacuum and high vacuum systems. It was found that small leaks are sealed best under vacuum, whereas large leaks should be sealed at atmospheric pressure. The high-temperature behavior of Loctite 290 is limited by its fast cure, which prevents deep penetration into small leaks; cracking eventually occurs at the entrance to the leak. Repeated thermal cycling to about 300 C is possible, however, provided viscosity, curing time, and leak size are properly matched to ensure penetration into the body of the leak. This may require special formulations for high temperature vacuum applications.

  1. Presidential Leaks: Rhetoric and Mediated Political Knowledge.

    Science.gov (United States)

    Erickson, Keith V.

    1989-01-01

    Argues that presidential leaks constitute rhetorical acts, enabling administrations to exercise a variety of rhetorically potent options not afforded by the public forum. Proposes a typology of presidential leaks and analyzes their rhetorical functions, benefits, and liabilities. (MM)

  2. Suture materials - Current and emerging trends.

    Science.gov (United States)

    Dennis, Christopher; Sethu, Swaminathan; Nayak, Sunita; Mohan, Loganathan; Morsi, Yosry Yos; Manivasagam, Geetha

    2016-06-01

    Surgical sutures are used to facilitate closure and healing of surgical- or trauma-induced wounds by upholding tissues together to facilitate healing process. There is a wide range of suture materials for medical purpose and the main types include absorbable and nonabsorbable. Recently, there is a growth in the development of classes of suture materials based on their properties and capabilities to improve tissue approximation and wound closure. This review outlines and discusses the current and emerging trends in suture technology including knotless barbed sutures, antimicrobial sutures, bio-active sutures such as drug-eluting and stem cells seeded sutures, and smart sutures including elastic, and electronic sutures. These newer strategies expand the versatility of sutures from being used as just a physical entity approximating opposing tissues to a more biologically active component enabling delivery of drugs and cells to the desired site with immense application potential in both therapeutics and diagnostics. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 1544-1559, 2016. © 2016 Wiley Periodicals, Inc.

  3. End-on extramucosal single layer suture with double anchoring in the submucosa on rabbits

    Directory of Open Access Journals (Sweden)

    Nascimento Luiz Roberto do

    1999-01-01

    Full Text Available The techniques of gastrointestinal surgical sutures have been frequently focused in controversial publications. These ones concern not only anastomosis? types but also about thread types and how to apply them. The values of the submucosa as layer of greatest resistence of the digestive tube was already known since the past century. The aim of this study is to avaluate the suture in an extramucosal single-layer suture with double anchoring of the submucosa, a technical detail not found in the searched literature. This experiment was carried out using 36 white,male adults New Zealand, rabbits divided into three groups which differed only regarding day of re-operation and euthanasia, as followed: group I ( 4 days, group II (7 days and group III ( 15 days. Two transversal and parallel gastrotomies were perfomed in the same animal, one distal and other proximal, of with 4 cm extension each. In these gastrotomies two types of sutures were alternated : 1- End-on extramucosal single-layer suture and 2- End-on extramucosal single-layer suture, with double anchoring in the submucosa. Macroscopic and microscopic studies were perfomed on the suture line in both gastrotomies and in each period of euthanasia. Except for the serosa item whose results were similar for both sutures, statiscally, the extramucosal single-layer suture, with double anchoring of submucosa layer showed better macro and microscopic results than the extramucosal single-layer suture in group I (4 days. In the others periods of euthanasia (groups II and III, the statistical results were similar.

  4. LINES

    Directory of Open Access Journals (Sweden)

    Minas Bakalchev

    2015-10-01

    Full Text Available The perception of elements in a system often creates their interdependence, interconditionality, and suppression. The lines from a basic geometrical element have become the model of a reductive world based on isolation according to certain criteria such as function, structure, and social organization. Their traces are experienced in the contemporary world as fragments or ruins of a system of domination of an assumed hierarchical unity. How can one release oneself from such dependence or determinism? How can the lines become less “systematic” and forms more autonomous, and less reductive? How is a form released from modernistic determinism on the new controversial ground? How can these elements or forms of representation become forms of action in the present complex world? In this paper, the meaning of lines through the ideas of Le Corbusier, Leonidov, Picasso, and Hitchcock is presented. Spatial research was made through a series of examples arising from the projects of the architectural studio “Residential Transformations”, which was a backbone for mapping the possibilities ranging from playfulness to exactness, as tactics of transformation in the different contexts of the contemporary world.

  5. Hydrogen Leak Detection Sensor Database

    Science.gov (United States)

    Baker, Barton D.

    2010-01-01

    This slide presentation reviews the characteristics of the Hydrogen Sensor database. The database is the result of NASA's continuing interest in and improvement of its ability to detect and assess gas leaks in space applications. The database specifics and a snapshot of an entry in the database are reviewed. Attempts were made to determine the applicability of each of the 65 sensors for ground and/or vehicle use.

  6. High Altitude Aerial Natural Gas Leak Detection System

    Energy Technology Data Exchange (ETDEWEB)

    Richard T. Wainner; Mickey B. Frish; B. David Green; Matthew C. Laderer; Mark G. Allen; Joseph R. Morency

    2006-12-31

    The objective of this program was to develop and demonstrate a cost-effective and power-efficient advanced standoff sensing technology able to detect and quantify, from a high-altitude (> 10,000 ft) aircraft, natural gas leaking from a high-pressure pipeline. The advanced technology is based on an enhanced version of the Remote Methane Leak Detector (RMLD) platform developed previously by Physical Sciences Inc. (PSI). The RMLD combines a telecommunications-style diode laser, fiber-optic components, and low-cost DSP electronics with the well-understood principles of Wavelength Modulation Spectroscopy (WMS), to indicate the presence of natural gas located between the operator and a topographic target. The transceiver transmits a laser beam onto a topographic target and receives some of the laser light reflected by the target. The controller processes the received light signal to deduce the amount of methane in the laser's path. For use in the airborne platform, we modified three aspects of the RMLD, by: (1) inserting an Erbium-doped optical fiber laser amplifier to increase the transmitted laser power from 10 mW to 5W; (2) increasing the optical receiver diameter from 10 cm to 25 cm; and (3) altering the laser wavelength from 1653 nm to 1618 nm. The modified RMLD system provides a path-integrated methane concentration sensitivity {approx}5000 ppm-m, sufficient to detect the presence of a leak from a high capacity transmission line while discriminating against attenuation by ambient methane. In ground-based simulations of the aerial leak detection scenario, we demonstrated the ability to measure methane leaks within the laser beam path when it illuminates a topographic target 2000 m away. We also demonstrated simulated leak detection from ranges of 200 m using the 25 cm optical receiver without the fiber amplifier.

  7. Autologous conjunctival resurfacing of leaking filtering blebs.

    Science.gov (United States)

    Harris, L D; Yang, G; Feldman, R M; Fellman, R L; Starita, R J; Lynn, J; Chuang, A Z

    2000-09-01

    To present a case series of a new technique to repair late bleb leaks. Retrospective, noncomparative, consecutive case series. Forty-seven autologous conjunctival resurfacings of late bleb leaks were performed by four surgeons at two institutions. Autologous conjunctival grafts were placed over existing de-epithelialized leaking blebs. Leak-free, Seidel-negative blebs and controlled glaucoma. After a mean follow-up of 14 +/- 12 months, one patient continued to have bleb leak at the last follow-up, and one frank leak resolved with aqueous suppression. Intraocular pressure increased from 6.6 +/- 4.4 mmHg (0.13 glaucoma medications) to 11.9 +/- 4.1 mmHg (0.41 glaucoma medications). Conjunctival resurfacing with autologous tissue is an effective technique to repair late bleb leaks.

  8. Gastric leaks post sleeve gastrectomy: Review of its prevention and management

    Science.gov (United States)

    Abou Rached, Antoine; Basile, Melkart; El Masri, Hicham

    2014-01-01

    Gastric sleeve gastrectomy has become a frequent bariatric procedure. Its apparent simplicity hides a number of serious, sometimes fatal, complications. This is more important in the absence of an internationally adopted algorithm for the management of the leaks complicating this operation. The debates exist even regarding the definition of a leak, with several classification systems that can be used to predict the cause of the leak, and also to determine the treatment plan. Causes of leak are classified as mechanical, technical and ischemic causes. After defining the possible causes, authors went into suggesting a number of preventive measures to decrease the leak rate, including gentle handling of tissues, staple line reinforcement, larger bougie size and routine use of methylene blue test per operatively. In our review, we noticed that the most important clinical sign or symptom in patients with gastric leaks are fever and tachycardia, which mandate the use of an abdominal computed tomography, associated with an upper gastrointrstinal series and/or gastroscopy if no leak was detected. After diagnosis, the management of leak depends mainly on the clinical condition of the patient and the onset time of leak. It varies between prompt surgical intervention in unstable patients and conservative management in stable ones in whom leaks present lately. The management options include also endoscopic interventions with closure techniques or more commonly exclusion techniques with an endoprosthesis. The aim of this review was to highlight the causes and thus the prevention modalities and find a standardized algorithm to deal with gastric leaks post sleeve gastrectomy. PMID:25320526

  9. Technical Details of Laparoscopic Sleeve Gastrectomy Leading to Lowered Leak Rate: Discussion of 1070 Consecutive Cases

    Science.gov (United States)

    Sasse, Kent C.

    2017-01-01

    Introduction Laparoscopic sleeve gastrectomy is a widely utilized and effective surgical procedure for dramatic weight loss in obese patients. Leak at the sleeve staple line is the most serious complication of this procedure, occurring in 1–3% of cases. Techniques to minimize the risk of sleeve gastrectomy leaks have been published although no universally agreed upon set of techniques exists. This report describes a single-surgeon experience with an approach to sleeve leak prevention resulting in a progressive decrease in leak rate over 5 years. Methods 1070 consecutive sleeve gastrectomy cases between 2012 and 2016 were reviewed retrospectively. Patient characteristics, sleeve leaks, and percent body weight loss at 6 months were reported for each year. Conceptual and technical changes aimed towards leak reduction are presented. Results With the implementation of the described techniques of the sleeve gastrectomy, the rate of sleeve leaks fell from 4% in 2012 to 0% in 2015 and 2016 without a significant change in weight loss, as depicted by 6-month change in body weight and percent excess BMI lost. Conclusion In this single-surgeon experience, sleeve gastrectomy leak rate has fallen to 0% since the implementation of specific technical modifications in the procedure. PMID:28761766

  10. Technical Details of Laparoscopic Sleeve Gastrectomy Leading to Lowered Leak Rate: Discussion of 1070 Consecutive Cases

    Directory of Open Access Journals (Sweden)

    David L. Warner

    2017-01-01

    Full Text Available Introduction. Laparoscopic sleeve gastrectomy is a widely utilized and effective surgical procedure for dramatic weight loss in obese patients. Leak at the sleeve staple line is the most serious complication of this procedure, occurring in 1–3% of cases. Techniques to minimize the risk of sleeve gastrectomy leaks have been published although no universally agreed upon set of techniques exists. This report describes a single-surgeon experience with an approach to sleeve leak prevention resulting in a progressive decrease in leak rate over 5 years. Methods. 1070 consecutive sleeve gastrectomy cases between 2012 and 2016 were reviewed retrospectively. Patient characteristics, sleeve leaks, and percent body weight loss at 6 months were reported for each year. Conceptual and technical changes aimed towards leak reduction are presented. Results. With the implementation of the described techniques of the sleeve gastrectomy, the rate of sleeve leaks fell from 4% in 2012 to 0% in 2015 and 2016 without a significant change in weight loss, as depicted by 6-month change in body weight and percent excess BMI lost. Conclusion. In this single-surgeon experience, sleeve gastrectomy leak rate has fallen to 0% since the implementation of specific technical modifications in the procedure.

  11. Intermediate-Scale Laboratory Experiments of Subsurface Flow and Transport Resulting from Tank Leaks

    Energy Technology Data Exchange (ETDEWEB)

    Oostrom, Martinus; Wietsma, Thomas W.

    2014-09-30

    Washington River Protection Solutions contracted with Pacific Northwest National Laboratory to conduct laboratory experiments and supporting numerical simulations to improve the understanding of water flow and contaminant transport in the subsurface between waste tanks and ancillary facilities at Waste Management Area C. The work scope included two separate sets of experiments: •Small flow cell experiments to investigate the occurrence of potential unstable fingering resulting from leaks and the limitations of the STOMP (Subsurface Transport Over Multiple Phases) simulator to predict flow patterns and solute transport behavior under these conditions. Unstable infiltration may, under certain conditions, create vertically elongated fingers potentially transporting contaminants rapidly through the unsaturated zone to groundwater. The types of leak that may create deeply penetrating fingers include slow release, long duration leaks in relatively permeable porous media. Such leaks may have occurred below waste tanks at the Hanford Site. •Large flow experiments to investigate the behavior of two types of tank leaks in a simple layered system mimicking the Waste Management Area C. The investigated leaks include a relatively large leak with a short duration from a tank and a long duration leak with a relatively small leakage rate from a cascade line.

  12. Analysis of the strength of the abdominal fascia in different sutures used in abdominoplasties.

    Science.gov (United States)

    Ishida, Luis Henrique; Gemperli, Rolf; Longo, Marco Vinicius Losso; Alves, Helio Ricardo Nogueira; da Silva, Pedro Henrique Quintino; Ishida, Luis Carlos; Ferreira, Marcus Castro

    2011-08-01

    Protrusion of the abdominal wall secondary to abdominoplasty may occur in patients with weakness of the aponeurotic structures. The anterior layer of the rectus abdominis muscle consists of fibers that are transverse rather than vertical. Based on this anatomical feature, vertical sutures are suggested for the correction of diastasis recti, since they include a greater amount of fascial fibers and thus would be more resistant to tensile strength than horizontal ones. The anterior layers of the rectus abdominis muscles of 15 fresh cadavers were dissected. Two vertical lines were marked on each side of the linea alba, corresponding to the site where plication is usually performed in abdominoplasties. Three abdominal levels were evaluated: the supraumbilical, umbilical, and infraumbilical levels. A simple suture was placed in the vertical direction in one group and in the horizontal direction in the other group, at each of the three levels previously described. These sutures were connected to a dynamometer, which was pulled medially toward the linea alba until rupture of the aponeurosis occurred. The mean strength required to rupture the aponeurotic structures in which the vertical sutures had been placed was greater than for the horizontal ones (p < 0.0001). The vertical suture of the rectus abdominis sheaths was stronger than the horizontal suture because of the more transversal arrangement of its aponeurotic fibers. Thus, routine use of the vertical suture in plications of the aponeurosis of the rectus abdominis muscles is suggested.

  13. Functional implications of dicynodont cranial suture morphology.

    Science.gov (United States)

    Jasinoski, Sandra C; Rayfield, Emily J; Chinsamy, Anusuya

    2010-06-01

    Cranial suture morphology of Lystrosaurus and the generalized dicynodont Oudenodon was investigated to determine the strain environment during mastication, which in turn may indicate a difference in cranial function between the two taxa. Finite element (FE) analysis indicated that less strain accumulated in the cranium of Lystrosaurus during orthal bite simulations than in Oudenodon. Despite the overall difference in strain magnitude, moderate to high FE-predicted strain accumulated in similar areas of the cranium of both taxa. The suture morphology in these cranial regions of Lystrosaurus and Oudenodon was investigated further by examination of histological sections and supplemented by observations of serial sections and computed tomography (CT) scans. The predominant type of strain from selected blocks of finite elements that contain sutures was determined, enabling comparison of suture morphology to strain type. Drawing from strain-suture correlations established in extant taxa, the observed patterns of sutural morphology for both dicynodonts were used to deduce cranial function. The moderate to high compressive and tensile strain experienced by the infraorbital bar, zygomatic arch, and postorbital bar of Oudenodon and Lystrosaurus may have been decreased by small adjustive movements at the scarf sutures in those regions. Disparities in cranial suture morphology between the two taxa may reflect differences in cranial function. For instance, the tongue and groove morphology of the postorbital-parietal suture in Oudenodon could have withstood the higher FE-predicted tensile strain in the posterior skull roof. The scarf premaxilla-nasal suture of Lystrosaurus provided an additional region of sutural mobility in the anterior surface of the snout, suggesting that Lystrosaurus may have employed a different biting regime than Oudenodon. The morphology of several sutures sampled in this study correlated with the FE-predicted strain, although other cranial functional

  14. A randomized study comparing traditional monofilament knotted sutures with barbed knotless sutures for donor leg wound closure in coronary artery bypass surgery.

    Science.gov (United States)

    Krishnamoorthy, Bhuvaneswari; Shepherd, Niamh; Critchley, William R; Nair, Janesh; Devan, Nehru; Nasir, Abdul; Barnard, James B; Venkateswaran, Rajamiyer V; Waterworth, Paul D; Fildes, James E; Yonan, Nizar

    2016-02-01

    Surgical knots on the suture line provide an anchoring function, but also represent a potential source of infection and irritation on the donor leg after coronary artery bypass surgery. Knotless barbed sutures were designed to prevent knot-related complications. This study compared knot-related wound complication rates between patients receiving traditional monofilament sutures and those receiving barbed knotless sutures for closure of the donor leg. One hundred and forty-two patients were randomized into two groups. Group 1 (n = 70) received traditional monofilament sutures and Group 2 (n = 72) received barbed knotless sutures. All wounds were assessed on postoperative days 3 and 5 and weeks 2, 4 and 6 using a validated wound scoring system. Antibiotics usage and general practitioner and district nurse visits were recorded. No demographic differences were observed between groups. Leg wound skin closure times were significantly shorter in Group 2 compared with Group 1 (P adverse skin tissue reactions (P adverse skin tissue reactions that may delay postoperative wound healing. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  15. Assessment of midpalatal suture ossification using cone-beam computed tomography.

    Science.gov (United States)

    Haghanifar, Sina; Mahmoudi, Sadaf; Foroughi, Ramin; Mir, Arash Poorsattar Bejeh; Mesgarani, Abas; Bijani, Ali

    2017-03-01

    The degree of ossification of the midpalatal suture is an important factor in the selection of treatment procedure, especially in young individuals. Considering the discrepancies in the results of studies on the exact time of the closure of this suture, the present study was undertaken to evaluate ossification and morphology of the suture with the use of CBCT. In the present cross-sectional study, the CBCT images of the maxilla in 144 Iranian subjects (72 males, 72 females) with an age range of 10 to 70 years, referring to a private radiology center in Sari, Iran, were evaluated. The CBCT images were evaluated in the axial cross-sectional slice at 1 mm intervals to determine morphology and the maturation stage of the suture and its degree of ossification. The six developmental stages that were observed were as follows: stage A, a direct line without disturbances; stage B, a scalloped appearance in the suture; stage C, two parallel lines with a scalloped appearance that were connected at some points; stage CD, the anterior portion was similar to stage C, and the posterior region was similar to stage D; stage D, ossification only in the palatine bone; stage E, complete ossification of the suture. The degree of ossification of the suture was calculated with the use of the ratio of the length of the ossified segment to the entire length of the suture. Data were analyzed with Spearman's correlation test, Chi-squared test, t-test, ANOVA, Mann-Whitney U, and Kruskal-Wallis test. Intra-observer agreement was calculated with the use of weighted kappa coefficient. Data were analyzed with SPSS 17. There was a strong correlation between the age groups and the developmental stages of the midpalatal suture in both genders (r=0.681, ptwo genders (p=0.193). Although the rate of suture closure increased with aging, age was not a reliable factor alone to determine the developmental stage of the suture. Use of CBCT is necessary in all the patients to determine the degree of

  16. Suture slippage in knotless suture anchors as a potential failure mechanism in rotator cuff repair.

    Science.gov (United States)

    Wieser, Karl; Farshad, Mazda; Vlachopoulos, Lazaros; Ruffieux, Kurt; Gerber, Christian; Meyer, Dominik C

    2012-11-01

    To quantify the strength of suture fixation of knotless suture anchors in relation to the anchors' pullout strength and to compare these results with the static friction between different sutures and anchor materials. Suture slippage within the anchor and pullout strength of 4 different knotless suture anchor models were assessed in a bovine bone model. Furthermore, the peak force before onset of slippage of different sutures trapped between increasingly loaded 4-mm rods made of commonly used anchor material (polyetheretherketone, poly-L-lactide acid, metal) was assessed. In all but 1 of the tested anchors, there was a relevantly lower load needed for slippage of the sutures than to pull out the anchor from bone. The mean load to anchor pullout ranged between 156 and 269 N. The load to suture slippage ranged between 66 and 109 N. All sutures were better held between the metal rods (mean, 21; 95% confidence interval [CI], 19.2 to 23.3) than with polyetheretherketone rods (mean, 17; 95% CI, 15.7 to 18.1) or poly-L-lactide acid rods (mean, 18; 95% CI, 17.6 to 18.4). In the case of suture anchors that hold the sutures by clamping, the hold of the suture in the anchor may be far lower than the pullout strength of the anchor from bone, because the sutures just slip out from the anchor through the clamping mechanism. This is well explained by the low static friction achieved between the tested sutures and the test rods made of anchor materials. The use of knotless suture anchors appears quick and easy to perform; however, most of the anchor systems could not even reach half of the anchor pullout strength from bone before suture slippage occurred. Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  17. Recycling Suture Limbs from Knotless Suture Anchors for Arthroscopic Shoulder Stabilization

    OpenAIRE

    Johnson, Timothy S.; DiPompeo, Christine M.; Ismaeli, Zahra C.; Porter, Polly A.; Nicholson, Shannon L.; Johnson, David C.

    2014-01-01

    Recurrent shoulder instability often leads to labral abnormality that requires surgical intervention that may require fixation with suture anchors. The proposed surgical technique allows the surgeon to achieve 2 points of fixation around the labrum and/or capsule with a single suture secured to the glenoid with a knotless anchor. Instead of cutting and discarding the residual suture limbs after anchor insertion, this technique uses the residual suture limbs of the knotless anchor for a second...

  18. Clamp fixation to prevent unfolding of a suture knot decreases tensile strength of polypropylene sutures.

    Science.gov (United States)

    Türker, Mehmet; Yalçinozan, Mehmet; Çirpar, Meriç; Çetik, Özgür; Kalaycioğlu, Barış

    2012-12-01

    Although sutures evolved in last decade and the product spectrum broadened largely, they can be still classified into two: monofilament and multifilament. Sutures are the mainstay of orthopedic procedures like fascial closures, tendon repairs or tenodesis. In every repair, a suture loop is created. This suture loop is prone to failure due to suture elongation, knot slip and suture breakage. As the knot is the stress riser in a suture loop, the majority of acute loop failure occurs just adjacent to the knot. Monofilament sutures have higher bending stiffness and tendency to untie than multifilament sutures. The first throw of monofilament sutures have tendency to untie, which decrease loop tension and result in loss of achieved tissue approximation. Although a common practice is to fix the first throw via a clamp before the locking one is tied, it can be hypothesized that a potential deforming effect can lead to a decrease in ultimate failure load of a monofilament suture loop. Fixing the first throw significantly reduced the ultimate failure load of monofilament nonabsorbable polypropylene sutures (Prolene) (62.2 ± 8 N vs. 72.7 ± 9 N, p = 0.019). The ultimate failure load achieved by monofilament sutures Polyglyconate (Maxon) and Nylon (Ethilon) and braided absorbable Polyglactin (Vicryl) were not affected by fixing the first throw. Under microscopic examination, polypropylene sutures were found to be deformed by clamp fixation, while the others were not. Polypropylene sutures can be easily damaged when it is fixed by a clamp during knot tying. Presented data demonstrated that in real surgical situations clamp fixation of polypropylene knots can damage the suture loop and carry the risk of acute failure of repair site during early rehabilitation.

  19. Suture complications in a teaching institution among patients undergoing uterosacral ligament suspension with permanent braided suture

    OpenAIRE

    Yazdany, Tajnoos; Yip, Sallis; Bhatia, Narender N.; Nguyen, John N.

    2010-01-01

    Introduction and hypothesis Our study aimed to identify the rate of suture complications over a 5-year period using braided permanent suture for uterosacral ligament suspension (USLS) surgery. Methods We reviewed the medical records of patients who underwent vaginal uterosacral ligament suspensions using braided polyester suture. Outcome measures included rate and timing of suture complications, patient symptoms post-operatively, efficacy of treatment modalities and surgical success. Results ...

  20. Should nylon corneal sutures be routinely removed?

    Science.gov (United States)

    Jackson, H.; Bosanquet, R.

    1991-01-01

    Three groups of patients who had undergone cataract extraction through a corneal incision closed with 10/0 nylon sutures one, two, and three years previously were recalled to determine the incidence of suture related complications. Broken corneal sutures were found in 87.5% of patients after two years and 90% after three years and were causing symptoms in over half the patients. It is recommended that 10/0 nylon corneal sutures be routinely removed no later than one year after surgery. Images PMID:1751460

  1. Management of the late leaking filtration blebs. A report of seven cases and a selective review of the literature.

    Directory of Open Access Journals (Sweden)

    Mandal A

    2001-01-01

    Full Text Available PURPOSE: To describe the outcome of various treatment modalities in the management of late bleb leaks after glaucoma filtering surgery (GFS. MATERIALS AND METHODS: Seven consecutive patients treated for late bleb leaks (Seidel′s positive between July 1990 and June 1999 were were enrolled in the study. The management strategy consisted of initial conservative therapy, and tailored surgery, if necessary. The surgical technique employed was either conjunctival-Tenon′s advancement flap, hinged scleral flap, or fistulectomy with direct suturing. The main outcome measures were bleb characteristics and postoperative intraocular pressure (IOP. The secondary outcome measure was visual acuity. RESULTS: One patient responded to conservative therapy (aqueous suppressants, bandage contact lens and six patients needed surgery. The successful surgical technique was conjunctivo-Tenon′s advancement flap in three, hinged scleral flap in two, and fistulectomy-direct suturing to the wound (combined with cataract surgery and intraocular lens implantation in one patient. The bleb leak stopped in all cases and 5 of the 6 surgical patients sustained functioning filtering blebs. Follow-up ranged from 8 to 56 months (mean = 20.4 +/- 16.2 months. Visual acuity improved to 6/12 or better in 4 cases, 6/36 in 2 cases and it remained at light perception in one case. None of the patients had any intraoperative or postoperative complications. CONCLUSIONS: Late leaking blebs after GFS can be treated successfully. The management decision and selection of surgical technique should be based on the clinical condition.

  2. A novel method for endoscopic perforation management by using abdominal exploration and full-thickness sutured closure.

    Science.gov (United States)

    Kumar, Nitin; Thompson, Christopher C

    2014-07-01

    Perforation of the GI tract during endoscopy can result in significant morbidity and mortality. Early recognition and immediate management of endoscopic perforation are essential to optimize outcome. Larger perforations, defects with complex geometry, and those complicated by leakage of luminal contents have traditionally required surgical management. To assess the feasibility of a new method for managing complex perforations that incorporates abdominal exploration and endoscopic sutured closure. Case series. Tertiary care center. Two patients with large, complicated perforations and peritoneal contamination. Endoscopic exploration of abdomen with angiocatheter placement under direct visualization, management of leaked luminal contents, and full-thickness sutured defect closure. Endoscopic abdominal exploration through the perforation site allowed safe placement of an angiocatheter for management of pneumoperitoneum, inspection for injury that may warrant surgical management, and removal of leaked luminal contents. Endoscopic sutured closure allowed safe and robust perforation management. Repair of gastrojejunal anastomotic perforation required 2 sutures and 63 minutes. Repair of gastric perforation required 4 sutures and 48 minutes. Patients had successful endoscopic defect closure confirmed by an upper GI series and were discharged 1 day later. Report of a new method in 2 patients performed at tertiary care center. We demonstrate successful management of complex perforations with peritoneal contamination by incorporating endoscopic exploration and sutured closure with standard treatment measures. Traditional practice would have directed these patients to surgical management, which introduces additional morbidity and cost. A means for safe and broad implementation of these techniques should be evaluated. Copyright © 2014 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  3. Endoscopic suture fixation is associated with reduced migration of esophageal fully covered self-expandable metal stents (FCSEMS).

    Science.gov (United States)

    Wright, Andrew; Chang, Andrew; Bedi, Aarti Oza; Wamsteker, Erik-Jan; Elta, Grace; Kwon, Richard S; Carrott, Phillip; Elmunzer, B Joseph; Law, Ryan

    2017-09-01

    Esophageal fully covered self-expandable metal stents (FCSEMS) are indicated for the management of benign and malignant conditions of the esophagus including perforations, leaks, and strictures. FCSEMS are resistant to tissue ingrowth and are removable; however, stent migration occurs in 30-55% of cases. Endoscopic suture fixation of FCSEMS has been utilized to decrease the risk of stent migration though data supporting this practice remain limited. The primary aim of this study was to compare clinical outcomes and migration rate of patients who underwent placement of esophageal FCSEMS with and without endoscopic suture fixation. Our single-center, retrospective, cohort study includes patients who underwent esophageal FCSEMS placement with and without endoscopic suture fixation between January 1, 2012, and November 11, 2015. Baseline patient characteristics, procedural details, and clinical outcomes were abstracted. Logistic regression was performed to identify clinical and technical factors associated with outcomes and stent migration. A total of 51 patients underwent 62 FCSEMS placements, including 21 procedures with endoscopic suture fixation and 41 without. Suture fixation was associated with reduced risk of stent migration (OR 0.13, 95% CI 0.03-0.47). Prior stent migration was associated with significantly higher risk of subsequent migration (OR 6.4, 95% CI 1.6-26.0). Stent migration was associated with lower likelihood of clinical success (OR 0.21, 95% CI 0.06-0.69). There was a trend toward higher clinical success among patients undergoing suture fixation (85.7 vs. 60.9%, p = 0.07). Endoscopic suture fixation of FCSEMS was associated with a reduced stent migration rate. Appropriate patient selection for suture fixation of FCSEMS may lead to reduced migration in high-risk patients.

  4. 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.

  5. Suture strength and angle of load application in a suture anchor eyelet.

    Science.gov (United States)

    Deakin, Mark; Stubbs, David; Bruce, Warwick; Goldberg, Jerome; Gillies, Ronald M; Walsh, William R

    2005-12-01

    To assess the effect of suture material, anchor orientation, and anchor eyelet design on the static loading properties of suture anchors. Biomechanical bench study. Two metallic suture anchors, Mitek GII (Mitek, Westwood, MA) and Corkscrew (Arthrex, Naples, FL) and a bioabsorbable anchor (Biocorkscrew; Arthrex) were tested with single strand of No. 2 Ethibond (Ethicon, Norderstedt, Germany) or No. 2 FiberWire (Arthrex) suture. Suture pull angle was varied through 0 degrees, 45 degrees, and 90 degrees with the anchor rotation angle in either a sagittal or coronal plane. Constructs were tested to failure using an MTS 858 Bionix testing machine (Material Testing Systems, Eden Prairie, MN). Peak loads, stiffness, energy to peak load, and failure modes were determined for all samples. FiberWire showed superior static mechanical properties when compared with single-strand Ethibond over all testing conditions (P Suture pull angle had a significant effect on load to failure with both metallic anchors but not on the bioabsorbable anchor (P Suture pull angle and anchor rotation angle play an important role in the failure load of suture when placed in an eyelet. The polyaxial nature of the Biocorkscrew eyelet allows for increased degrees of freedom but introduces failure of the suture eyelet as a new failure mode. The loading direction and placement of the suture anchor plays a role in the performance of the suture anchor-suture complex.

  6. Transoral Mucosal Excision Sutured Gastroplasty

    Science.gov (United States)

    Legner, Andras; Altorjay, Aron; Juhasz, Arpad; Stadlhuber, Rudolph; Reich, Viktor; Hunt, Brandon; Rothstein, Richard

    2014-01-01

    Introduction. An outpatient transoral endoscopic procedure for gastroesophageal reflux disease (GERD) and obesity would be appealing if safe, effective, and durable. We present the first in human experience with a new system. Methods. Eight patients with GERD (3) and obesity (5) were selected according to a preapproved study protocol. All GERD patients had preprocedure manometry and pH monitoring to document GERD as well as quality of life and symptom questionnaires. Obese patients (body mass index >35) underwent a psychological evaluation and tests for comorbidities. Under general anesthesia, a procedure was performed at the gastroesophageal junction including mucosal excision, suturing of the excision beds for apposition, and suture knotting. Results. One patient with micrognathia could not undergo the required preprocedural passage of a 60 F dilator and was excluded. The first 2 GERD patients had incomplete procedures due to instrument malfunction. The subsequent 5 subjects had a successfully completed procedure. Four patients were treated for obesity and had an average excess weight loss of 30.3% at 2-year follow-up. Of these patients, one had an 8-mm outlet at the end of the procedure recognized on video review—a correctable error—and another vomited multiple times postoperatively and loosened the gastroplasty sutures. The treated GERD patient had resolution of reflux-related symptoms and is off all antisecretory medications at 2-year follow-up. Her DeMeester score was 8.9 at 24 months. Conclusion. The initial human clinical experience showed promising results for effective and safe GERD and obesity therapy. PMID:24623807

  7. 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.

  8. Leak detection capability in CANDU reactors

    Energy Technology Data Exchange (ETDEWEB)

    Azer, N.; Barber, D.H.; Boucher, P.J. [and others

    1997-04-01

    This paper addresses the moisture leak detection capability of Ontario Hydro CANDU reactors which has been demonstrated by performing tests on the reactor. The tests confirmed the response of the annulus gas system (AGS) to the presence of moisture injected to simulate a pressure tube leak and also confirmed the dew point response assumed in leak before break assessments. The tests were performed on Bruce A Unit 4 by injecting known and controlled rates of heavy water vapor. To avoid condensation during test conditions, the amount of moisture which could be injected was small (2-3.5 g/hr). The test response demonstrated that the AGS is capable of detecting and annunciating small leaks. Thus confidence is provided that it would alarm for a growing pressure tube leak where the leak rate is expected to increase to kg/hr rapidly. The measured dew point response was close to that predicted by analysis.

  9. Something of the nature of gross sutural growth.

    Science.gov (United States)

    Sarnat, B G

    1986-10-01

    A series of experiments was performed on monkeys, rabbits, and turtles to study gross sutural growth of bones. Radiopaque implants in conjunction with serial gross and radiographic measurements were employed. Differences in growth were observed between 5 facial sutures and also the same suture at different times. Growth was greatest at the zygomaticotemporal suture and least at the premaxillomaxillary suture. The nasal bone side of the frontonasal suture grew about twice as fact as the frontal bone side. In the turtle shell the midsagittal suture grew faster than a transverse suture. In all of the animals the rate of sutural growth decreased with increase in age. No gross regional growth disturbance was noted after resection of the frontonasal, midpalatine, or transpalatine sutures. After extirpation of the median palatine suture, it re-formed, in an eccentric position, in a number of instances. We concluded that bone growth that occurred at sutures was secondary or compensatory to some other factor.

  10. Warming barium sulfate improves esophageal leak detection in pig model.

    Science.gov (United States)

    Raman, Vignesh; MacGlaflin, Caitlyn E; Moodie, Karen L; Kaiser, Larry R; Erkmen, Cherie P

    2015-12-01

    Barium esophagograms have poor sensitivity in detecting leaks. We hypothesized that heating barium would decrease viscosity, facilitate extravasation, and enhance its sensitivity in detecting esophageal leaks. We characterized the viscosity of barium at increasing temperatures. We measured the radiopacity of barium at 25°C and 50°C. We determined the smallest diameter defect in esophagus that barium can detect by perforating a porcine esophageal segment with angiocatheters of various diameters, injecting barium at 25°C, and observing extravasation of contrast. We repeated this with barium heated to 30°C, 40°C, 50°C, and 70°C. To determine the ability of barium to detect a staple line leak, we perforated a stapled esophageal segment by air insufflation, injected barium at different temperatures, and monitored extravasation. We used Visipaque, a water-soluble contrast agent, for comparison in all experiments. The viscosity of barium decreased with increasing temperature. The radiopacity of barium did not change with increasing temperature and was higher than that of Visipaque (P barium at 25°C to 1.3 mm at 40°C and 1.1 mm with Visipaque (P barium at 25°C to 80% (P = 0.02) with barium at 40°C. There was no significant difference in sensitivity between barium at 40°C and Visipaque. Barium warmed to 40°C offers the best sensitivity of esophageal leak detection without compromising radiopacity. Barium at 40°C may be the optimum choice for swallow study to detect esophageal leaks. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Modified suturing contact lens for penetrating keratoplasty.

    Science.gov (United States)

    Kramer, S G; Stewart, H L

    1978-11-01

    The authors have previously described a suturing contact lens that protects the corneal endothelium by aiding in the maintenance of the anterior chamber during penetrating keratoplasty. This report describes structural modifications of the suturing contact lens, which improve its stability and effectiveness. An additional configuration for use in corneal lacerations is presented.

  12. Mesh Sutured Repairs of Abdominal Wall Defects

    Science.gov (United States)

    Lanier, Steven T.; Jordan, Sumanas W.; Miller, Kyle R.; Ali, Nada A.; Stock, Stuart R.

    2016-01-01

    Background: A new closure technique is introduced, which uses strips of macroporous polypropylene mesh as a suture for closure of abdominal wall defects due to failures of standard sutures and difficulties with planar meshes. Methods: Strips of macroporous polypropylene mesh of 2 cm width were passed through the abdominal wall and tied as simple interrupted sutures. The surgical technique and surgical outcomes are presented. Results: One hundred and seven patients underwent a mesh sutured abdominal wall closure. Seventy-six patients had preoperative hernias, and the mean hernia width by CT scan for those with scans was 9.1 cm. Forty-nine surgical fields were clean-contaminated, contaminated, or dirty. Five patients had infections within the first 30 days. Only one knot was removed as an office procedure. Mean follow-up at 234 days revealed 4 recurrent hernias. Conclusions: Mesh sutured repairs reliably appose tissue under tension using concepts of force distribution and resistance to suture pull-through. The technique reduces the amount of foreign material required in comparison to sheet meshes, and avoids the shortcomings of monofilament sutures. Mesh sutured closures seem to be tolerant of bacterial contamination with low hernia recurrence rates and have replaced our routine use of mesh sheets and bioprosthetic grafts. PMID:27757361

  13. Association between Triclosan-Coated Sutures for Abdominal Wall Closure and Incisional Surgical Site Infection after Open Surgery in Patients Presenting with Fecal Peritonitis: A Randomized Clinical Trial.

    Science.gov (United States)

    Ruiz-Tovar, Jaime; Alonso, Natalia; Morales, Vicente; Llavero, Carolina

    2015-10-01

    A factor that may influence the incidence of surgical site infections (SSIs) is the suture used for closure of the abdominal wall because bacteria may adhere to the suture material. Sutures can be coated with antibacterial substances that may reduce the bacterial load in the incision. The aim of this study was to evaluate the effect of triclosan-coated sutures used in abdominal wall closure in patients with fecal peritonitis. A randomized study was performed. Inclusion criteria were intra-operative diagnosis of fecal peritonitis secondary to acute diverticulitis perforation, neoplastic tumor perforation, or colorectal anastomotic leak of previous elective colorectal resection. The patients were randomly assigned to either abdominal wall closure with triclosan-coated sutures (group 1) or sutures without triclosan (group 2). Fifty patients were included in group 1 and 51 in group 2. The incisional SSI rate was 10% in group 1 and 35.3% in group 2 (p=0.004; odds ratio [OR]=0.204; 95% confidence interval [CI] 0.069-0.605). A significant reduction in SSIs caused by Escherichia coli and Enterococcus faecalis was observed in group 2. The use of triclosan-coated sutures in fecal peritonitis surgery reduces the incidence of incisional SSI.

  14. Endoscopic suturing versus endoscopic clip closure of the mucosotomy during a per-oral endoscopic myotomy (POEM): a case-control study.

    Science.gov (United States)

    Pescarus, Radu; Shlomovitz, Eran; Sharata, Ahmed M; Cassera, Maria A; Reavis, Kevin M; Dunst, Christy M; Swanström, Lee L

    2016-05-01

    Obtaining an adequate mucosal closure is one of the crucial steps in per-oral endoscopic myotomy (POEM). Thus far, there have been no objective data comparing the various available closure techniques. This case-controlled study attempts to compare the application of endoscopic clips versus endoscopic suturing for mucosotomy closure during POEM cases. A retrospective review of our prospective POEM database was performed. All cases in which endoscopic suturing was used to close the mucosotomy were matched to cases in which standard endoclips were used. Overall complication rate, closure time and mucosal closure costs between the two groups were compared. Both techniques offer good clinical results with good mucosal closure and the absence of postoperative leak. Closure time was significantly shorter (p = 0.044) with endoscopic clips (16 ± 12 min) when compared to endoscopic suturing (33 ± 11 min). Overall, the total closure cost analysis showed a trend toward lower cost with clips (1502 ± 849 USD) versus endoscopic suturing (2521 ± 575 USD) without reaching statistical significance (p = 0.073). The use of endoscopic suturing seems to be a safe method for mucosal closure in POEM cases. Closure time is longer with suturing than conventional closure with clips, and there is a trend toward higher overall cost. Endoscopic suturing is likely most cost-effective for difficult cases where conventional closure methods fail.

  15. Biomechanical comparison of screw-in suture anchor-suture combinations used for Bankart repair.

    Science.gov (United States)

    Sparks, Brad S; Nyland, John; Nawab, Akbar; Blackburn, Ethan; Krupp, Ryan; Caborn, David N M

    2010-03-01

    Bankart repair laxity may contribute to pathologic joint instability. This biomechanical study compared two screw-in suture anchor-suture combinations under tensile loads. Twelve pairs of scapulae were implanted with either a 3 mm diameter, 14 mm long poly-L/D-lactide suture anchor with a suture eyelet (Group 1) or a 3.1 mm diameter, 11 mm long polylactide suture anchor with a molded eyelet (Group 2). Constructs were cyclically loaded between 25 and 50 N with a 25 N load increase every 25 cycles. Group 2 displayed greater displacement at failure, had more specimens with > or =2 mm displacement by the 50 N interval (P = 0.014), and had displaced more by 100 N (P suture anchor-suture loops, the rehabilitation timetable, and the timing of return to unrestricted activities.

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

    National Research Council Canada - National Science Library

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

    2013-01-01

    ...) on learning suturing skills. Participants watched an instructional video for simple interrupted, vertical mattress and horizontal mattress suturing then completed a pretest to assess baseline skills...

  17. [Suture of lingual nerve: Technical note].

    Science.gov (United States)

    Garconnet, J; Foletti, J-M; Guyot, L; Chossegros, C

    2015-06-01

    Because of its anatomical position, the lingual nerve may be severed during oral surgical procedures, such as third molar removal. Early suturing of the nerve promotes better recovery. We describe the end-to-end suture of this nerve. The suture is carried-out under general anesthesia. The approach is made in the mouth floor, in the same way as for submandibular gland lithiasis transoral removal. This approach allows good exposure and some laxity to displace the nerve stumps. The latter can then be sutured under microscope assistance before closing the mucosa. Lingual nerve suture is a simple, quick and inexpensive procedure. Unlike other procedures, it cannot be used in case of large loss of substance because of the small amount of laxity of the nerve. Nerve function recovery is better if performed before the 6th post-traumatic month, and in young patients. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  18. Flexor tendons repair: effect of core sutures caliber with increased number of suture strands and peripheral sutures. A sheep model.

    Science.gov (United States)

    Uslu, M; Isik, C; Ozsahin, M; Ozkan, A; Yasar, M; Orhan, Z; Erkan Inanmaz, M; Sarman, H

    2014-10-01

    Surgeons have aimed to achieve strong repair so as to begin early active rehabilitation programs for flexor tendon injury. Multi-strand suture techniques were developed to gain improved gap resistance and ultimate force compared with the respective two-strand techniques. In vivo studies indicate that multiple strands may cause ischemia during the intrinsic healing process by decreasing the total cross-sectional area of the injured site, unless the total cross-sectional area of the sutures is not decreased. The hypothesis was to design an in vitro study to understand the biomechanical relationship between suture calibers of core sutures with increased number of suture strands and peripheral suture on final repair strength. Sixty fresh sheep forelimb flexor digitorum profundus tendons were randomly placed into three groups (A, B, and C), each containing 20 specimens, for tendon repair. Two-, four-, and eight-strand suture techniques were respectively used in Groups A, B, and C. A simple running peripheral suture technique was used in Subgroups A2, B2, and C2. For each repaired tendon, the 2-mm gap-formation force, 2-mm gap-formation strength, maximum breaking force and maximum breaking strength were determined. Differences in 2-mm gap-formation force and 2-mm gap-formation strength were found between Subgroups A1 and A2, B1 and B2, and C1 and C2. Between Groups A and B, A and C, and B and C, there was no difference as well. Both the number of strands and the ratio between the total suture volume and tendon volume at the repair site are important for ideal repair. If the total cross-sectional area of the sutures is equal in 2-strand, 4-strand, and 8-strand procedure, there is no difference in the strength of the repair. A decrease in caliber size suture requires more passes to achieve the same strength. Instead, it is much better to use peripheral suture techniques to improve the strength of the repair with larger diameter 2-strand core sutures. Copyright © 2014

  19. Comparison of Knotless Barbed Suture Versus Monofilament Suture in the Oral Cavity of Cats.

    Science.gov (United States)

    Durand, Corinne L

    2017-09-01

    The present study compares a knotless, barbed, absorbable suture material against a conventional monofilament absorbable suture material in oral mucosal wound closure. The parameters measured include time of closure and differences in healing at 2 and 4 weeks postoperatively. A prospective study comparing a knotless, barbed suture system with conventional absorbable sutures was undertaken in 19 cats. Nineteen cats had full mouth extractions performed. Following the extraction procedures, the incisions in the arcades (maxillary and mandibular) were apposed with the barbed, knotless suture system in a continuous pattern on one side and with a conventional smooth suture in an interrupted pattern on the other. Suturing times for each arcade were recorded. The material used to close the first side of each cat varied. Healing, dehiscence, and other complications were assessed at 2 and 4 weeks postoperatively. The average closure time (± standard deviation) per quadrant with conventional monofilament suture was 8.7 (±1.3) minutes, while barbed suture required an average of 5.1 (±1.1) minutes per quadrant to complete the suture. This difference (95% confidence interval) of 3.6 (±3.2-4.1) minutes per quadrant was statistically significant ( P < .001). Dehiscence and ranula-like swelling formation were noted as uncommon postoperative complications, but the differences were not significant between the groups. Barbed, knotless sutures resulted in faster closure times than conventional, simple interrupted, monofilament sutures with similar healing and complication rates. To the author's knowledge, there is no current literature comparing conventional absorbable monofilament sutures to a knotless, barbed, absorbable suture system for closure of oral mucosal incisions in cats.

  20. Leaking Photons from the HII Region NGC 7538

    Science.gov (United States)

    Luisi, Matteo; Anderson, Loren D.; Balser, Dana S.; Bania, Thomas M.; Wenger, Trey

    2016-01-01

    Using data from the NRAO Green Bank Telescope and the INT Photometric H-Alpha Survey of the Northern Galactic Plane (IPHAS), we analyze the ionizing radiation that is escaping the photo-dissociation region (PDR) boundary of the HII region NGC 7538. We find extended radio continuum and radio recombination line (RRL) emission outside the PDR toward the north and east of the region. This suggests that a non-uniform PDR morphology is affecting the amount of radiation "leaking" through the PDR. We quantify the leaking photon fraction along the line of sight, and use a numerical model to estimate the leaking photon fraction in three dimensions of both radio continuum and H-alpha emission. We detect carbon RRL emission near the PDR and find a decrease in the helium-to-hydrogen ionic abundance ratio with increasing distance from the central position. This indicates a softening of the radiation field within the PDR. Using Herschel Space Observatory data, we create a dust temperature map of the region and show that small dust temperature enhancements to the north and east of NGC 7538 coincide with extended radio emission. We discuss implications for maintaining the ionization of the warm interstellar medium by HII regions.

  1. New adjustable suture technique for trabeculectomy

    Directory of Open Access Journals (Sweden)

    Vespasiano Rebouças-Santos

    2013-06-01

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

  2. Leak-Tight Welding Experience from the Industrial Assembly of the LHC Cryostats at CERN

    CERN Document Server

    Bourcey, N; Chiggiato, P; Limon, P; Mongelluzzo, A; Musso, G; Poncet, A; Parma, V

    2008-01-01

    The assembly of the approximately 1700 LHC main ring cryostats at CERN involved extensive welding of cryogenic lines and vacuum vessels. More than 6 km of welding requiring leak tightness to a rate better than 1.10-9 mbar.l.s-1 on stainless steel and aluminium piping and envelopes was made, essentially by manual welding but also making use of orbital welding machines. In order to fulfil the safety regulations related to pressure vessels and to comply with the leak-tightness requirements of the vacuum systems of the machine, welds were executed according to high qualification standards and following a severe quality assurance plan. Leak detection by He mass spectrometry was extensively used. Neon leak detection was used successfully to locate leaks in the presence of helium backgrounds. This paper presents the quality assurance strategy adopted for welds and leak detection. It presents the statistics of non-conformities on welds and leaks detected throughout the entire production and the advances in the use...

  3. Leak detection systems for uranium mill tailings impoundments with synthetic liners

    Energy Technology Data Exchange (ETDEWEB)

    Myers, D.A.; Tyler, S.W.; Gutknecht, P.J.; Mitchell, D.H.

    1983-09-01

    This study evaluated the performance of existing and alternative leak detection systems for lined uranium mill tailings ponds. Existing systems for detecting leaks at uranium mill tailings ponds investigated in this study included groundwater monitoring wells, subliner drains, and lysimeters. Three alternative systems which demonstrated the ability to locate leaks in bench-scale tests included moisture blocks, soil moisture probes, and a soil resistivity system. Several other systems in a developmental stage are described. For proper performance of leak detection systems (other than groundwater wells and lysimeters), a subgrade is required which assures lateral dispersion of a leak. Methods to enhance dispersion are discussed. Cost estimates were prepared for groundwater monitoring wells, subliner drain systems, and the three experimental systems. Based on the results of this report, it is suggested that groundwater monitoring systems be used as the primary means of leak detection. However, if a more responsive system is required due to site characteristics and groundwater quality criteria, subliner drains are applicable for ponds with uncovered liners. Leak-locating systems for ponds with covered liners require further development. Other recommendations are discussed in the report.

  4. A Systematic Review of Systematic Reviews and Panoramic Meta-Analysis: Staples versus Sutures for Surgical Procedures

    Science.gov (United States)

    Hemming, Karla; Pinkney, Thomas; Futaba, Kay; Pennant, Mary; Morton, Dion G.; Lilford, Richard J.

    2013-01-01

    Objective To systematically evaluate the evidence across surgical specialties as to whether staples or sutures better improve patient and provider level outcomes. Design A systematic review of systematic reviews and panoramic meta-analysis of pooled estimates. Results Eleven systematic reviews, including 13,661 observations, met the inclusion criteria. In orthopaedic surgery sutures were found to be preferable, and for appendicial stump sutures were protective against both surgical site infection and post surgical complications. However, staples were protective against leak in ilecolic anastomosis. For all other surgery types the evidence was inconclusive with wider confidence intervals including the possibly of preferential outcomes for surgical site infection or post surgical complication for either staples or sutures. Whilst reviews showed substantial variation in mean differences in operating time (I2 94%) there was clear evidence of a reduction in average operating time across all surgery types. Few reviews reported on length of stay, but the three reviews that did (I2 0%, including 950 observations) showed a non significant reduction in length of stay, but showed evidence of publication bias (P-value for Egger test 0.05). Conclusions Evidence across surgical specialties indicates that wound closure with staples reduces the mean operating time. Despite including several thousand observations, no clear evidence of superiority emerged for either staples or sutures with respect to surgical site infection, post surgical complications, or length of stay. PMID:24116028

  5. Fighting the Epidemic of Nuclear Plant Leaks.

    Science.gov (United States)

    Udell, Richard A.

    1983-01-01

    The current epidemic of steam generator tube leaks alone should put to rest the rosy future once envisioned for nuclear power. It is impossible to regulate quality into a nuclear plant; it must be built and designed that way. The economic impact of the leaks is discussed. (RM)

  6. Uncommon leaks revealed by low flow anaesthesia

    African Journals Online (AJOL)

    Adele

    TRAVEL FELLOWSHIP. Low flow techniques provide a long duration of reliable anaesthesia at minimal cost. The use of low flows requires a leak free circuit and anaesthetic machine. Should leaks occur during low flow anaesthesia, these will be immediately obvious and rapidly rectified. Anaesthetic machines have been ...

  7. Protecting brazing furnaces from air leaks

    Science.gov (United States)

    Armenoff, C. T.; Mckown, R. D.

    1980-01-01

    Inexpensive inert-atmosphere shielding protects vacuum brazing-furnace components that are likely to spring leak. Pipefittings, gages, and valves are encased in transparent plastic shroud inflated with argon. If leak develops, harmless argon will enter vacuum chamber, making it possible to finish ongoing brazing or heat treatment before shutting down for repair.

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

    Science.gov (United States)

    Hennessey, D B; Carey, E; Simms, C K; Hanly, A; Winter, D C

    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. To determine the effect of axial torsional forces on sutures used in abdominal closure. The effect of axial twisting on polydioxanone (PDS*II), polyglactin (Vicryl), polypropylene (Prolene) and nylon (Ethilon) sutures was investigated using a uniaxial testing device. The maximum tensile force withstood for untwisted sutures was determined: polydioxanone failed at a tensile force of 116.4±0.84 N, polyglactin failed at 113.9±2.4 N, polypropylene failed at 71.1±1.5 N and nylon failed at 61.8±0.5 N. Twisting decreased the maximum tensile force of all sutures; one complete twist per 10 mm (i.e., 15 twists) decreased the tensile strength of polydioxanone by 21%, polyglactin by 23%, polypropylene by 16% and nylon by 13%, psuture strength, with one twist per 75 mm (i.e., 20 twists) of polydioxanone decreasing strength by 39%, Psutures is a previously unrecognised phenomenon. Surgeons should be aware that this can result in a decrease in suture strength and reduce the elasticity of the material, and therefore need to adapt their practice to reduce the torsional force placed on sutures. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Development of a Free-Swimming Acoustic Tool for Liquid Pipeline Leak Detection Including Evaluation for Natural Gas Pipeline Applications

    Science.gov (United States)

    2010-08-01

    Significant financial and environmental consequences often result from line leakage of oil product pipelines. Product can escape into the surrounding soil as even the smallest leak can lead to rupture of the pipeline. From a health perspective, water...

  10. Leak Tightness of LHC Cold Vacuum Systems

    CERN Document Server

    Cruikshank, P; Maan, M; Mourier, L; Perrier-Cornet, A; Provot, N

    2011-01-01

    The cold vacuum systems of the LHC machine have been in operation since 2008. While a number of acceptable helium leaks were known to exist prior to cool down and have not significantly evolved over the last years, several new leaks have occurred which required immediate repair activities or mitigating solutions to permit operation of the LHC. The LHC vacuum system is described together with a summary and timetable of known air and helium leaks and their impact on the functioning of the cryogenic and vacuum systems. Where leaks have been investigated and repaired, the cause and failure mechanism is described. We elaborate the mitigating solutions that have been implemented to avoid degradation of known leaks and minimize their impact on cryogenic operation and LHC availability, and finally a recall of the consolidation program to be implemented in the next LHC shutdown.

  11. Postoperative washing of sutured wounds

    Directory of Open Access Journals (Sweden)

    Conrad Harrison

    2016-11-01

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

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

    Science.gov (United States)

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

    2017-05-01

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

  13. Barbed suture vs traditional suture in single-port total laparoscopic hysterectomy.

    Science.gov (United States)

    Song, Taejong; Lee, San-Hui

    2014-01-01

    To compare surgical outcomes between barbed suture and traditional suture used in repair of the vaginal vault during single-port total laparoscopic hysterectomy (TLH). Case-control study (Canadian Task Force classification II-2). Two institutions. One hundred two patients with benign uterine disease. Single-port TLH using barbed suture (n = 43) or traditional suture (n = 59). Patient characteristics (age, body mass index, demographic data), procedures performed, uterine weight, and uterine disease were similar between the 2 study groups. There were also no differences in operative complications, conversion to other surgical approaches, operative blood loss, postoperative pain, and duration of hospital stay between the 2 groups. Use of barbed suture significantly reduced the time required for vaginal cuff suturing (11.4 vs 22.5 minutes; p suture is less technically demanding than traditional suture (p suture in single-port TLH may aid surgeons by reducing operative time, suturing time, and surgical difficulty. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

  14. Stent migration following endoscopic suture fixation of esophageal self-expandable metal stents: a systematic review and meta-analysis.

    Science.gov (United States)

    Law, Ryan; Prabhu, Anoop; Fujii-Lau, Larissa; Shannon, Carol; Singh, Siddharth

    2018-02-01

    Covered self-expandable metal stents (SEMS) are utilized for the management of benign and malignant esophageal conditions; however, covered SEMS are prone to migration. Endoscopic suture fixation may mitigate the migration risk of covered esophageal SEMS. Hence, we conducted a systematic review and meta-analysis to evaluate the effectiveness and safety of endoscopic suture fixation for covered esophageal SEMS. Following PRISMA guidelines, we performed a systematic review from 2011 to 2016 to identify studies (case control/case series) reporting the technical success and migration rate of covered esophageal SEMS following endoscopic suture fixation. We searched multiple electronic databases and conference proceedings. We calculated pooled rates (and 95% confidence intervals [CI]) of technical success and stent migration using a random effects model. We identified 14 studies (212 patients) describing covered esophageal SEMS placement with endoscopic suture fixation. When reported, SEMS indications included leak/fistula (n = 75), stricture (n = 65), perforation (n = 10), and achalasia (n = 4). The pooled technical success rate was 96.7% (95% CI 92.3-98.6), without heterogeneity (I 2  = 0%). We identified 29 SEMS migrations at rate of 15.9% (95% CI 11.4-21.6), without heterogeneity (I 2  = 0%). Publication bias was observed, and using the trim-and-fill method, a more conservative estimate for stent migration was 17.0%. Suture-related adverse events were estimated to occur in 3.7% (95% CI 1.6-8.2) of cases. Endoscopic suture fixation of covered esophageal SEMS appears to reduce stent migration when compared to published rates of non-anchored SEMS. However, SEMS migration still occurs in approximately 1 out of 6 cases despite excellent immediate technical success and low risk of suture-related adverse events.

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

    Science.gov (United States)

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

    2015-01-01

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

  16. 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

  17. Real-time electronic monitoring of a pitted and leaking gas gathering pipeline

    Energy Technology Data Exchange (ETDEWEB)

    Asperger, R.G.; Hewitt, P.G.

    1986-08-01

    Hydrogen patch, flush electrical resistance, and flush linear polarization proves wre used with flush coupons to monitor corrosion rates in a pitted and leaking sour gas gathering line. Four inhibitors were evaluated in stopping the leaks. Inhibitor residuals and the amount and ratio of water and condensate in the lines were measured at five locations along the line. The best inhibitor reduced reduced the pit-leak frequency by over a factor of 10. Inhibitor usage rate was optimized using the hydrogen patch current as a measure of the instantaneous corrosion rate. Improper pigging was identified as a cause of corrosion transients. This problem is discussed in relation to the pigging of pipelines in stratified flow where moving fluids are the carriers for continuously injected corrosion inhibitors.

  18. 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.

  19. Corrosion Evaluation of Tank 40 Leak Detection Box

    Energy Technology Data Exchange (ETDEWEB)

    Mickalonis, J.I.

    1999-07-29

    'Leak detection from the transfer lines in the tank farm has been a concern for many years because of the need to minimize exposure of personnel and contamination of the environment. The leak detection box (LDB) is one line of defense, which must be maintained to meet this objective. The evaluation of a failed LDB was one item from an action plan aimed at minimizing the degradation of LDBs. The Tank 40 LDB, which failed in service, was dug up and shipped to SRTC for evaluation. During a video inspection while in service, this LDB was found to have black tubercles on the interior, which suggested possible microbial involvement. The failure point, however, was believed to have occurred in the drain line from the transfer line jacket. Visual, metallurgical, and biological analyses were performed on the LDB. The analysis results showed that there was not any adverse microbiological growth or significant localized corrosion. The corrosion of the LDB was caused by exposure to aqueous environments and was typical of carbon steel pipes in soil environments.'

  20. 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... surgical gut suture. (a) Identification. An absorbable surgical gut suture, both plain and chromic, is an... “Class II Special Controls Guidance Document: Surgical Sutures; Guidance for Industry and FDA.” See § 878...

  1. 21 CFR 878.4840 - Absorbable polydioxanone surgical suture.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Absorbable polydioxanone surgical suture. 878.4840... polydioxanone surgical suture. (a) Identification. An absorbable polydioxanone surgical suture is an absorbable... for the device is FDA's “Class II Special Controls Guidance Document: Surgical Sutures; Guidance for...

  2. 21 CFR 878.5020 - Nonabsorbable polyamide surgical suture.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nonabsorbable polyamide surgical suture. 878.5020... polyamide surgical suture. (a) Identification. Nonabsorbable polyamide surgical suture is a nonabsorbable... indicated for use in soft tissue approximation. The polyamide surgical suture meets United States...

  3. 21 CFR 882.4650 - Neurosurgical suture needle.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Neurosurgical suture needle. 882.4650 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4650 Neurosurgical suture needle. (a) Identification. A neurosurgical suture needle is a needle used in suturing during neurosurgical...

  4. 21 CFR 878.4495 - Stainless steel suture.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Stainless steel suture. 878.4495 Section 878.4495...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4495 Stainless steel suture. (a) Identification. A stainless steel suture is a needled or unneedled nonabsorbable surgical suture composed of 316L...

  5. 21 CFR 878.5010 - Nonabsorbable polypropylene surgical suture.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nonabsorbable polypropylene surgical suture. 878... Nonabsorbable polypropylene surgical suture. (a) Identification. Nonabsorbable polypropylene surgical suture is... suture meets United States Pharmacopeia (U.S.P.) requirements as described in the U.S.P. Monograph for...

  6. 21 CFR 878.5030 - Natural nonabsorbable silk surgical suture.

    Science.gov (United States)

    2010-04-01

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

  7. Suture anchor repair yields better biomechanical properties than transosseous sutures in ruptured quadriceps tendons.

    Science.gov (United States)

    Petri, M; Dratzidis, A; Brand, S; Calliess, T; Hurschler, C; Krettek, C; Jagodzinski, M; Ettinger, M

    2015-04-01

    This human cadaveric study compares the biomechanical properties of quadriceps tendon repair with suture anchors and the commonly applied transosseous sutures. The hypothesis was that suture anchors provide at least equal results concerning gap formation and ultimate failure load compared with transosseous suture repair. Thirty human cadaveric knees underwent tenotomy followed by repair with either 5.5-mm-double-loaded suture anchors [titanium (TA) vs. resorbable hydroxyapatite (HA)] or transpatellar suture tunnels using No. 2 Ultrabraid™ and the Krackow whipstitch. Biomechanical analysis included pretensioning the constructs with 20 N for 30 s and then cyclic loading of 250 cycles between 20 and 100 N at 1 Hz in a servohydraulic testing machine with measurement of elongation. Ultimate failure load analysis and failure mode analysis were performed subsequently. Tendon repairs with suture anchors yielded significantly less gap formation during cyclic loading (20th-250th cycle: TA 1.9 ± 0.1, HA 1.5 ± 0.5, TS 33.3 ± 1.9 mm, p sutures. Common failure mode was pull-out of the eyelet within the suture anchor in the HA group and rupture of the suture in the TA and TS group. Quadriceps tendon repair with suture anchors yields significantly better biomechanical results than the commonly applied transosseous sutures in this human cadaveric study. These biomechanical findings may change the future clinical treatment for quadriceps tendon ruptures. Randomised controlled clinical trials are desirable for the future. Not applicable, controlled laboratory human cadaveric study.

  8. Running sutures anchored with square knots are unreliable.

    Science.gov (United States)

    Aanning, H L; Van Osdol, Andrew; Allamargot, Chantal; Becker, Brandt E; Howard, Thomas C; Likness, Micah L; Merkwan, Courtney E; Tarver, Dan D

    2012-09-01

    A previous study showed that running polypropylene sutures anchored with square knots retain only 75% of their strength compared with half hitches. The aim of this study was to investigate whether anchor knot geometry similarly affects the tensile strength of other types of sutures used in continuous closures. Monofilament and multifilament sutures (all 3-0) were anchored with either square knots or half hitches to 1 tensionometer post, and the running ends were secured to the other. The force required to break the running suture and the site of suture failure were recorded. The running sutures anchored with square knots retained only 50% to 84% of the strength of the identical sutures secured with half hitches (P suture anchored with half hitches is stronger and safer in comparison with the same suture anchored with square knots. This study provokes a fundamental reconsideration of the use of square knots to anchor running sutures. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Multichannel leak detection system for electrochemical etching

    Energy Technology Data Exchange (ETDEWEB)

    Muhammed, R.; Abu-Jarad, F.; Al-Jarallah, M.I. (King Fahd Univ. for Petroleum and Minerals, Dhahran (Saudi Arabia))

    1988-01-01

    A multichannel leak detection system has been developed to detect any chemical leak during the electrochemical etching process. It gives an audible and a visible warning when there is a leak at any part of the system. This greatly helps in isolating the defective sample quickly. It can be removed during operation, while the etching process continues on other samples. The circuit is built from standard integrated circuits and has its own power supply. Provisions have been made to connect this system to the computer for recording date, time and location of the leaky unetched samples. (author).

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

    Science.gov (United States)

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

    2015-06-01

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

  11. Facial thread lifting with suture suspension

    National Research Council Canada - National Science Library

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

    ...: To analyze data published in the literature on the durability of results, their effectiveness, safety, and risk of serious adverse events associated with procedures using several types of threading sutures. Methods...

  12. Biomechanical properties of suture anchor repair compared with transosseous sutures in patellar tendon ruptures: a cadaveric study.

    Science.gov (United States)

    Ettinger, Max; Dratzidis, Antonios; Hurschler, Christof; Brand, Stephan; Calliess, Tilman; Krettek, Christian; Jagodzinski, Michael; Petri, Maximilian

    2013-11-01

    Ruptures of the patellar tendon are debilitating injuries requiring surgical repair. Reliable data about the most appropriate suture technique and suture material are missing. The standard procedure consists of refixing the tendon with sutures in transpatellar tunnels, sometimes combined with augmentation. Suture anchors provide at least equal results concerning gap formation during cyclic loading and ultimate failure load compared with transosseous suture repair. Controlled laboratory study. A total of 30 human cadaveric patellar tendons underwent tenotomy followed by repair with 5.5-mm titanium suture anchors, 5.5-mm resorbable hydroxyapatite suture anchors, or transpatellar suture tunnels with No. 2 Ultrabraid and the Krackow whipstitch technique. Biomechanical analysis included pretensioning the constructs at 20 N for 30 seconds and then cyclic loading of 250 cycles between 20 and 100 N at 1 Hz in a servohydraulic testing machine with measurement of elongation. After this, ultimate failure load and failure mode analysis was performed. Compared with transosseous sutures, tendon repairs with suture anchors yielded significantly less gap formation during cyclic loading (P suture anchor in the hydroxyapatite anchor group and rupture of the suture in the titanium anchor group and-at lower load to failure-in the transosseous group. Patellar tendon repair with suture anchors yields significantly better biomechanical results than repair with the commonly applied transosseous sutures. These findings may be of relevance for future clinical treatment of patellar tendon ruptures. Randomized controlled clinical trials comparing suture anchors to transosseous suture repair are desirable.

  13. 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; Psutures. 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.

  14. Comparison of All-Inside Suture Technique with Traditional Pull-out Suture and Suture Anchor Repair Techniques for Flexor Digitorum Profundus Attachment to Bone

    Science.gov (United States)

    Chu, Jennifer Y; Chen, Tony; Awad, Hani A.; Elfar, John; Hammert, Warren C.

    2015-01-01

    Purpose One goal in repairing Zone 1 flexor digitorum profundus (FDP) injuries is to create a tendon-bone construct strong enough to allow early rehabilitation while minimizing morbidity. This study introduces an alternative all-inside suture repair technique and compares it biomechanically with pull-out suture and double suture anchor repairs. Methods Repairs were performed on thirty cadaver fingers. In all-inside suture repairs (n=8), the FDP tendon was attached to bone with two 3-0 Ethibond sutures and tied over the dorsal aspect of distal phalanx. Pull-out suture repairs (n=8) were performed with 2-0 Prolene suture and tied over a dorsal button. There were two suture anchor repair groups: Arthrex Micro Corkscrew anchors preloaded with 2-0 FiberWire suture (n=7) and Depuy Micro Mitek anchors preloaded with 3-0 Orthocord suture (n=7). Repair constructs were tested using a servohydraulic materials testing system and loaded until the repair lost 75% of its strength. Results There were no statistically significant differences in tensile stiffness, ultimate load, or work to failure between the repairs. Failure mode was suture stretch and gap formation >2mm at the repair site for all pull-out suture repairs and 7 of 8 all-inside suture repairs. Two of the Arthrex Micro Corkscrew repairs and five of the Depuy Micro Mitek repairs failed by anchor pull out. Conclusions This cadaveric biomechanical study showed no difference in tensile stiffness, ultimate load, and work to failures between an all-inside suture repair technique for zone 1 FDP repairs and previously described pull-out suture and suture anchor repair techniques. The all-inside suture technique also has the advantages of avoiding an external button and the cost of anchors. Therefore, it should be considered as an alternative to other techniques. Clinical Relevance This study introduces a new FDP reattachment technique that avoids some of the complications of current techniques. PMID:23578439

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

    Directory of Open Access Journals (Sweden)

    Marc Manganiello

    2012-02-01

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

  16. Leaking Underground Storage Tank (LUST) Trust Fund

    Science.gov (United States)

    In 1986, Congress created the Leaking Underground Storage Tank (LUST) Trust Fund to address releases from federally regulated underground storage tanks (USTs) by amending Subtitle I of the Solid Waste Disposal Act.

  17. Pullout strength of suture anchors in comparison with transosseous sutures for rotator cuff repair.

    Science.gov (United States)

    Pietschmann, Matthias F; Fröhlich, Valerie; Ficklscherer, Andreas; Hausdorf, Jörg; Utzschneider, Sandra; Jansson, Volkmar; Müller, Peter E

    2008-05-01

    Suture anchors are increasingly gaining importance in rotator cuff surgery. This means they will be gradually replacing transosseous sutures. The purpose of this study was to compare the stability of transosseous sutures with different suture anchors with regard to their pullout strength depending on bone density. By means of bone densitometry (CT scans), two groups of human humeral head specimens were determined: a healthy and a osteopenic bone group. Following anchor systems were being tested: SPIRALOK 5.0 mm (resorbable, DePuy Mitek), Super Revo 5 mm (titanium, Linvatec), UltraSorb (resorbable, Linvatec) and the double U-sutures with Orthocord USP 2 (partly resorbable, DePuy Mitek) and Ethibond Excel 2 (non-resorbable, Ethicon). The suture anchors/double U-sutures were inserted in the greater tuberosity 12 times. An electromechanical testing machine was used for cyclic loading with power increasing in stages. We recorded the ultimate failure loads, the system displacements and the modes of failure. The suture anchors tended to bring about higher ultimate failure loads than the transosseous double U-sutures. This difference was significant in the comparison of the Ethibond suture and the SPIRALOK 5.0 mm-both in healthy and osteopenic bone. Both the suture materials and the SPIRALOK 5.0 mm showed a significant difference in pullout strength on either healthy or osteopenic bone; the titanium anchor SuperRevo 5 mm and the tilting anchor UltraSorb did not show any significant difference in healthy or osteopenic bone. There was no significant difference concerning system displacement (healthy and osteopenic bone) between the five anchor systems tested. The pullout strength of transosseous sutures is neither on healthy nor on osteopenic bone higher than that of suture anchors. Therefore, even osteopenic bone does not constitute a valid reason for the surgeon to perform open surgery by means of transosseous sutures. The choice of sutures in osteopenic bone is of little

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

    Science.gov (United States)

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

    2015-09-01

    Suture materials and surgical knot tying techniques have improved dramatically since their first use over five millennia ago. However, the approach remains limited by the ability of the suture to transfer load to tissue at suture anchor points. Here, we predict that adhesive-coated sutures can improve mechanical load transfer beyond the range of performance of existing suture methods, thereby strengthening repairs and decreasing the risk of failure. The mechanical properties of suitable adhesives were identified using a shear lag model. Examination of the design space for an optimal adhesive demonstrated requirements for strong adhesion and low stiffness to maximize the strength of the adhesive-coated suture repair construct. To experimentally assess the model, we evaluated single strands of sutures coated with highly flexible cyanoacrylates (Loctite 4903 and 4902), cyanoacrylate (Loctite QuickTite Instant Adhesive Gel), rubber cement, rubber/gasket adhesive (1300 Scotch-Weld Neoprene High Performance Rubber & Gasket Adhesive), an albumin-glutaraldehyde adhesive (BioGlue), or poly(dopamine). As a clinically relevant proof-of-concept, cyanoacrylate-coated sutures were then used to perform a clinically relevant flexor digitorum tendon repair in cadaver tissue. The repair performed with adhesive-coated suture had significantly higher strength compared to the standard repair without adhesive. Notably, cyanoacrylate provides strong adhesion with high stiffness and brittle behavior, and is therefore not an ideal adhesive for enhancing suture repair. Nevertheless, the improvement in repair properties in a clinically relevant setting, even using a non-ideal adhesive, demonstrates the potential for the proposed approach to improve outcomes for treatments requiring suture fixation. Further study is necessary to develop a strongly adherent, compliant adhesive within the optimal design space described by the model. Copyright © 2015 Acta Materialia Inc. Published by Elsevier

  19. Barbed sutures versus conventional sutures for uterine closure at cesarean section; a randomized controlled trial.

    Science.gov (United States)

    Zayed, Mohamed A; Fouda, Usama M; Elsetohy, Khaled A; Zayed, Shereef M; Hashem, Ahmed T; Youssef, Mohamed A

    2017-10-29

    The aim of this randomized control trial was to compare the operative data and the early postoperative outcomes of cesarean sections in which the uterine incision was closed with a barbed suture (STRATAFIX™ Spiral PDO Knotless Tissue Control Device, SXPD2B405, Ethicon Inc.) with those of cesarean sections in which the uterine incision was closed with a conventional smooth suture (VICRYL™; Ethicon Inc.). One hundred pregnant patients were randomized in a 1:1 ratio to the Stratafix group or the Vicryl group. The uterine incision was closed by two layers of sutures in both groups. In the Vicryl group, the first layer was continuous and the second layer was interrupted. In the Stratafix group, both layers were continuous. The uterine closure time was significantly lower in the Stratafix group (224 ± 46 versus 343 ± 75 s, p Stratafix group required additional sutures to achieve hemostasis (p value = .009). The mean blood loss during closure of uterine incision and mean hospital stay were lower in the Stratafix group but these differences failed to reach statistical significance. The use of barbed suture for uterine incision closure at cesarean section is associated with shorter uterine closure time and similar early perioperative complications compared with conventional smooth suture. The difference between both groups in the technique of suturing the second layer of the uterine incision may be the cause of the reduction in the uterine closure time and the need for additional sutures to achieve hemostasis during suturing the uterine incision with a barbed suture. Further, well designed randomized controlled trials should be conducted to investigate the association between the type of suture (barbed or conventional smooth) and remote complications of cesarean section (infertility, pelvic pain, abnormal placentation and rupture uterus).

  20. Experimental study of the characteristics of a novel mesh suture.

    Science.gov (United States)

    Dumanian, G A; Tulaimat, A; Dumanian, Z P

    2015-09-01

    The failure of sutures to maintain tissue in apposition is well characterized in hernia repairs. A mesh suture designed to facilitate tissue integration into and around the filaments may improve tissue hold and decrease suture pull-through. In vitro, the sutures were compared for resistance to pull-through in ballistics gel. In vivo, closure of midline laparotomy incisions was done with both sutures in 11 female pigs. Tissue segments were subsequently subjected to mechanical and histological testing. The mesh suture had tensile characteristics nearly identical to those of 0-polypropylene suture. Mesh suture demonstrated greater resistance to pull-through than standard suture (mean(s.d.) 4.27(0.42) versus 2.23(0.48) N; P suture (320(57) versus 160(56) N; P suture. Histological examination at 8 and 90 days showed complete tissue integration of the mesh suture. The novel mesh suture structure increased the strength of early wound healing in an experimental model. Surgical relevance Traditional sutures have the significant drawback of cutting and pulling through tissues in high-tension closures. A new mesh suture design with a flexible macroporous outer wall and a hollow core allows the tissues to grow into the suture, improving early wound strength and decreasing suture pull-through. This technology may dramatically increase the reliability of high-tension closures, thereby preventing incisional hernia after laparotomy. As suture pull-through is a problem relevant to all surgical disciplines, numerous additional indications are envisioned with mesh suture formulations of different physical properties and materials. © 2015 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.

  1. Utility of removable esophageal covered self-expanding metal stents for leak and fistula management.

    Science.gov (United States)

    Blackmon, Shanda H; Santora, Rachel; Schwarz, Peter; Barroso, Alberto; Dunkin, Brian J

    2010-03-01

    Esophageal or gastric leakage from anastomotic wound dehiscence, perforation, staple line dehiscence, or trauma can be a devastating event. Traditional therapy has often consisted of either surgical repair for rapidly diagnosed leaks or diversion for more complicated cases, commonly associated with a delayed diagnosis. This study summarizes our experience treating leaks or fistulas with novel, covered self-expanding metal stents (cSEMS). The primary objective of this study was to determine the efficacy and safety of covered self-expanding metal stents when used to treat complicated leaks and fistulas. Over 15 months, 25 patients with esophageal or gastric leaks were evaluated for stenting as primary treatment. A prospective database was used to collect data. Stents were placed endoscopically, with contrast evaluation used for leak evaluation. Patients who did not improve clinically after stenting or whose leak could not be sealed underwent operative management. During a mean follow-up of 15 months, 23 of the 25 patients with esophageal or gastric leaks during a 15-month period were managed with endoscopic stenting as primary treatment. Healing occurred in patients who were stented for anastomotic leakage after gastric bypass or sleeve gastrectomy (n = 10). One patient with three esophageal iatrogenic perforations healed with stenting. Eight patients successfully avoided esophageal diversion and healed with stenting and adjunctive therapy. Two of the 4 patients with tracheoesophageal fistulas sealed with the assistance of a new pexy technique to prevent stent migration; 1 additional patient had this same technique used to successfully heal an upper esophageal perforation. Esophageal leaks and fistulas can be effectively managed with cSEMS as a primary modality. The potential benefits of esophageal stenting are healing without diversion or reconstruction and early return to an oral diet. 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights

  2. The history and evolution of sutures in pelvic surgery

    Science.gov (United States)

    Muffly, Tyler M; Tizzano, Anthony P; Walters, Mark D

    2011-01-01

    Summary The purpose of the study is to review the history and innovations of sutures used in pelvic surgery. Based on a review of the literature using electronic- and hand-searched databases we identified appropriate articles and gynaecology surgical textbooks regarding suture for wound closure. The first documented uses of suture are explored and then the article focuses on the use of knotted materials in pelvic surgery. The development of suture of natural materials is followed chronologically until the present time where synthetic suture is implanted during countless surgeries every day. This millennial history of suture contains an appreciation of the early work of Susruta, Celsus, Paré and Lister, including a survey of some significant developments of suture methods over the last 100 years. Most surgeons know little about the history and science of sutures. A retrospective view of suture is critical to the appreciation of the current work and development of this common tool. PMID:21357979

  3. Arthroscopic Fixation of Tibial Eminence Fractures: A Biomechanical Comparative Study of Screw, Suture, and Suture Anchor.

    Science.gov (United States)

    Li, Ji; Yu, Yang; Liu, Chunhui; Su, Xiangzheng; Liao, Weixiong; Li, Zhongli

    2018-01-31

    To compare biomechanical outcomes of 4 different arthroscopic techniques for fixation of tibial eminence fractures. Twenty-four skeletally mature, fresh-frozen cadaveric knees were divided into 4 comparison groups based on the fixation method: screw fixation (group A), traditional sutures fixation with 2 FiberWire sutures (group B), a modified suture technique with 2 FiberWire sutures that created neckwear knots to firmly trap the fracture fragment (group C), or suture anchors which was based on the suture bridge technique primarily used in the shoulder for repair of rotator cuff tears and greater tuberosity fractures (group D). A tibial eminence fracture was created in each knee for subsequent fixation. After fixation, each knee underwent cyclic loading of 100 N to assess the displacement change after 500 cycles of the fixation construct. Afterward, a single tensile failure test load was performed to assess the ultimate failure load, stiffness, and failure mode for each specimen. All specimens survived cyclic testing and were subsequently loaded to failure. Group C had the highest ultimate failure load (P Suture fixation using the neckwear knots technique provides superior fixation with regard to higher ultimate failure load, and absorbable suture anchor fixation with the suture bridge technique provides less displacement under cyclic loading conditions. Both techniques exhibited superior biomechanical properties compared with traditional screw and suture fixation. The new techniques showed satisfactory biomechanical properties and provided more choice for surgeons in the treatment of tibial eminence fractures. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  4. Suture-related complications after congenital cataract surgery: Vicryl versus Mersilene sutures.

    Science.gov (United States)

    Bar-Sela, Shai M; Spierer, Oriel; Spierer, Abraham

    2007-02-01

    To evaluate 10-0 polyester sutures (Mersilene) and 10-0 absorbable polyglactin sutures (Vicryl) for small-incision congenital cataract surgery. Goldschleger Eye Institute, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel. A retrospective review comprised 51 patients (70 eyes) who had small-incision congenital cataract extraction and intraocular lens implantation between 1999 and 2005. Surgery was done using Mersilene sutures or Vicryl sutures. Retinoscopy and a careful examination for suture-related complications were done 1 week after surgery and then every month for 6 months. The sutures were removed in cases of local tissue reaction but not for high postoperative astigmatism. The t test was used to evaluate postoperative astigmatism and the Fisher exact test, to evaluate the difference in the incidence of suture-related complications. The patients' age ranged from 2 months to 15 years. Ten cases (18%) of corneal vascularization occurred in the Mersilene group during the 6-month follow-up period. This necessitated suture removal, after which 1 incident of endophthalmitis occurred. In contrast, no suture-related complications were noted in the Vicryl group during that time. The difference in the incidence of complications between the 2 groups approached statistical significance (P = .07). Mean astigmatism 1 week postoperatively was 2.3 diopters (D) +/- 2.1 (SD) in the Mersilene group, which was significantly higher than in the Vicryl group (mean 1.4 +/- 1.1 D) (P = .038). However, the mean astigmatism decreased to less than 1.0 D in both groups during the 6-month follow-up period. Vicryl sutures are recommended for small-incision congenital cataract surgery.

  5. Remote leak localization approach for fusion machines

    Energy Technology Data Exchange (ETDEWEB)

    Durocher, Au., E-mail: aurelien.durocher@cea.fr [CEA-IRFM, F-13108 Saint Paul-Lez-Durance (France); Bruno, V.; Chantant, M.; Gargiulo, L. [CEA-IRFM, F-13108 Saint Paul-Lez-Durance (France); Gherman, T. [Floralis UJF Filiale, F-38610 Gières (France); Hatchressian, J.-C.; Houry, M.; Le, R.; Mouyon, D. [CEA-IRFM, F-13108 Saint Paul-Lez-Durance (France)

    2013-10-15

    Highlights: ► Description of leaks issue. ► Selection of leak localization concepts. ► Qualification of leak localization concepts. -- Abstract: Fusion machine operation requires high-vacuum conditions and does not tolerate water or gas leak in the vacuum vessels, even if they are micrometric. Tore Supra, as a fully actively cooled tokamak, has got a large leak management experience; 34 water leaks occurred since the beginning of its operation in 1988. To handle this issue, after preliminary machine protection phases, the current process for leak localization is based on water or helium pressurization network by network. It generally allows the identification of a set of components where the leakage element is located. However, the unique background of CEA-IRFM laboratory points needs of accuracy and promptness out in the leak localization process. Moreover, in-vessel interventions have to be performed trying to minimize time and risks for the persons. They are linked to access conditions, radioactivity, tracer gas high pressure and vessel conditioning. Remote operation will be one of the ways to improve these points on future fusion machines. In this case, leak sensors would have to be light weight devices in order to be integrated on a carrier or to be located outside with a sniffing process set up. A leak localization program is on-going at CEA-IRFM Laboratory with the first goal of identifying and characterizing relevant concepts to localize helium or water leaks on ITER. In the same time, CEA has developed robotic carrier for effective in-vessel intervention in a hostile environment. Three major tests campaigns with the goal to identify leak sensors have been achieved on several CEA test-beds since 2010. Very promising results have been obtained: relevant scenario of leak localization performed, concepts tested in a high volume test-bed called TITAN, and, in several conditions of pressure and temperature (ultrahigh vacuum to atmospheric pressure and 20

  6. SINGLE-SHELL TANKS LEAK INTEGRITY ELEMENTS/SX FARM LEAK CAUSES AND LOCATIONS - 12127

    Energy Technology Data Exchange (ETDEWEB)

    VENETZ TJ; WASHENFELDER D; JOHNSON J; GIRARDOT C

    2012-01-25

    Washington River Protection Solutions, LLC (WRPS) developed an enhanced single-shell tank (SST) integrity project in 2009. An expert panel on SST integrity was created to provide recommendations supporting the development of the project. One primary recommendation was to expand the leak assessment reports (substitute report or LD-1) to include leak causes and locations. The recommendation has been included in the M-045-9IF Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) as one of four targets relating to SST leak integrity. The 241-SX Farm (SX Farm) tanks with leak losses were addressed on an individual tank basis as part of LD-1. Currently, 8 out of 23 SSTs that have been reported to having a liner leak are located in SX Farm. This percentage was the highest compared to other tank farms which is why SX Farm was analyzed first. The SX Farm is comprised of fifteen SSTs built 1953-1954. The tanks are arranged in rows of three tanks each, forming a cascade. Each of the SX Farm tanks has a nominal I-million-gal storage capacity. Of the fifteen tanks in SX Farm, an assessment reported leak losses for the following tanks: 241-SX-107, 241-SX-108, 241-SX-109, 241-SX-111, 241-SX-112, 241-SX-113, 241-SX-114 and 241-SX-115. The method used to identify leak location consisted of reviewing in-tank and ex-tank leak detection information. This provided the basic data identifying where and when the first leaks were detected. In-tank leak detection consisted of liquid level measurement that can be augmented with photographs which can provide an indication of the vertical leak location on the sidewall. Ex-tank leak detection for the leaking tanks consisted of soil radiation data from laterals and drywells near the tank. The in-tank and ex-tank leak detection can provide an indication of the possible leak location radially around and under the tank. Potential leak causes were determined using in-tank and ex-tank information that is not directly related to

  7. [Microsurgical blood vessel sutures using the so-called fibrin adhesive].

    Science.gov (United States)

    Meyermann, R; Ahyai, A; Pini, C

    1982-01-01

    Since the development of microvascular surgery by Jacobson and Suarez, adaptation of vessel ends of less than 1 mm diameter has been performed by means of 8-10 interrupted sutures. Even the finest suture material, however, produces a foreign body reaction. In addition, necrosis of the media can be seen after insertion of interrupted sutures. After the initial demonstration in 1940 that divided nerves could be successfully rejoined by means of factors from the blood coagulation system, this technique was introduced to microsurgery in 1977. The present investigation was carried out on 50 end-to-end anastomoses in rat common carotid arteries. Subsequently, the healing process was studied by light and electron microscopy. The adhesive used was fibrinogen cryoprecipitate (Fibrinkleber-Human-Immuno), which polymerises after simultaneous application of thrombin. Electron microscopy shows no basic difference between the healing after this technique and the healing process after trauma to the vessel wall. This method, however, prevents regional necrosis of the vessel wall and reduces intimal thickening. The condition of the intimal lining appears better than in sutured anastomoses. The question, whether this change is due only to the absence of sutures or due also to application of fibrinogen, cannot be answered, however.

  8. Influence of suturing on wound healing.

    Science.gov (United States)

    Burkhardt, Rino; Lang, Niklaus P

    2015-06-01

    The present article describes the significance of suturing and appropriate suture materials in current periodontal and implant surgery. Synthetic, nonresorbable, monofilament threads appear to be advantageous. The physical and biological properties of such threads remain unchanged with use and, when used in small diameters (i.e. with lower breaking resistance), seem to promote passive wound closure. Wound healing at hard, nonshedding surfaces is conceptually a more complex process than is wound healing in most other sites of the oral cavity. Firm adaptation and stabilization of the flaps by optimal suturing ensures adhesion of the delicate fibrin clot to the nonshedding surface. The early formation and mechanical stability of the blood clot between the mucosal or mucoperiosteal flap and the wound bed are of paramount importance and hence suturing techniques must be considered as a key prerequisite to ensure optimal surgical outcomes. With the sophisticated surgical procedures now applied, there is a greater need for knowledge with regard to the various types of suturing techniques and materials available in order to achieve the above-mentioned goals. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Facial thread lifting with suture suspension

    Directory of Open Access Journals (Sweden)

    Joana de Pinho Tavares

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

  10. Facial thread lifting with suture suspension.

    Science.gov (United States)

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

    2017-05-09

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

  11. Evaluation of methodologies for the calculation of leak rates for pressure retaining components with crack-like leaks; Bewertung von Methoden zur Berechnung von Leckraten fuer druckfuehrende Komponenten mit rissartigen Lecks

    Energy Technology Data Exchange (ETDEWEB)

    Sievers, Juergen; Heckmann, Klaus; Blaesius, Christoph

    2015-06-15

    . There are still open issues, especially with respect to the detailed simulation of flow processes in crack-like leaks in connection with adequately instrumented leak rate experiments, and in particular the quantification of the entrance losses. In order to simulate a leak accident thermohydraulic and structural-mechanical analyses for postulated leak positions in the surge line of a Konvoi-type PWR were performed. The size of these leaks was determined within the scope of FE-calculations. With these leak sizes ATHLET-calculations on thermohydraulics in the reactor circuit and on leak rates were made during which particularly the impact of the consideration of a variable leak size was analyzed as well. The effects of a leak size which is decreasing due to the loss of pressure and mechanical strains accompanied with a correspondingly smaller leak rate on the time dependent course of the accident and e.g. also on the pressure flow in the reactor circuit are significant. The consideration of these effects can increase the accuracy of analyses of accidents and severe accidents.

  12. 75 FR 4134 - Pipeline Safety: Leak Detection on Hazardous Liquid Pipelines

    Science.gov (United States)

    2010-01-26

    ... safety study on pipeline Supervisory Control and Data Acquisition (SCADA) systems (NTSB/SS-05/02). The... indications of a leak on the SCADA interface was the impetus for this study. The NTSB examined 13 hazardous... large pipeline breaks. The line balance processes incorporating SCADA or other technology are geared to...

  13. Operational Philosophy Concerning Manned Spacecraft Cabin Leaks

    Science.gov (United States)

    DeSimpelaere, Edward

    2011-01-01

    The last thirty years have seen the Space Shuttle as the prime United States spacecraft for manned spaceflight missions. Many lessons have been learned about spacecraft design and operation throughout these years. Over the next few decades, a large increase of manned spaceflight in the commercial sector is expected. This will result in the exposure of commercial crews and passengers to many of the same risks crews of the Space Shuttle have encountered. One of the more dire situations that can be encountered is the loss of pressure in the habitable volume of the spacecraft during on orbit operations. This is referred to as a cabin leak. This paper seeks to establish a general cabin leak response philosophy with the intent of educating future spacecraft designers and operators. After establishing a relative definition for a cabin leak, the paper covers general descriptions of detection equipment, detection methods, and general operational methods for management of a cabin leak. Subsequently, all these items are addressed from the perspective of the Space Shuttle Program, as this will be of the most value to future spacecraft due to similar operating profiles. Emphasis here is placed upon why and how these methods and philosophies have evolved to meet the Space Shuttle s needs. This includes the core ideas of: considerations of maintaining higher cabin pressures vs. lower cabin pressures, the pros and cons of a system designed to feed the leak with gas from pressurized tanks vs. using pressure suits to protect against lower cabin pressures, timeline and consumables constraints, re-entry considerations with leaks of unknown origin, and the impact the International Space Station (ISS) has had to the standard Space Shuttle cabin leak response philosophy. This last item in itself includes: procedural management differences, hardware considerations, additional capabilities due to the presence of the ISS and its resource, and ISS docking/undocking considerations with a

  14. Suture With Resorbable Cones: Histology and Physico-Mechanical Features

    Science.gov (United States)

    Consiglio, Fabio; Pizzamiglio, Roberto; Parodi, Pier Camillo; De Biasio, Fabrizio; Machin, Pier Nicola; Di Loreto, Carla; Gamboa, Mabel

    2016-01-01

    Background Silhouette Sutures (Kolster Methods, Inc., Corona, CA) exhibit different biological characteristics at various time points after their placement. Objectives The goals of this study were to understand the biological reactions of Silhouette Sutures in human tissues at different time intervals and to determine the index of resistance of the sutures in subcutaneous tissue. Methods Histologic examination was performed on section soft tissue containing the sutures at 1 month, 3 months, 6 months, and 1 year after suture placement. The study comprised 8 patients, each of whom received 4 sutures in the lower abdomen under local anesthesia. The sutures were placed exactly 1 month, 3 months, 6 months, and 1 year before planned post-bariatric abdominal surgery. Dynamometric evaluation was performed on a never-used suture and on sutures removed from 1 year after placement. The scar process around the threads was also examined. Results A progressive increase in scar tissue around the sutures was observed. One year after placement, there was a reduction of 16.7% in yield and tensile strength and a reduction of 14.29% in elongation at break, relative to the never-used suture. By 1 year, the cones in polylactic and glycolic acids had been replaced by scar tissue. Conclusions Fibrous tissue around the sutures increased progressively over time, and was most prominent at the level of the nodes. Cones were completely resorbed within 6 months. A reduction in the index of resistance of the suspension sutures occurred over 1 year. PMID:26879301

  15. Posterior fixation keratoprostheses and mechanical biocompatibility: determination of critical intraocular pressure causing aqueous humor leak and/or keratoprosthesis extrusion

    Science.gov (United States)

    Tahi, Hassan; Duchesne, Bernard; Parel, Jean-Marie A.; Nose, Izuru; Denham, David B.; Villain, Franck L.; Lacombe, Emmanuel

    1997-05-01

    The effect of increased intraocular pressure (IOP) in human cadaver eyes implanted with posterior fixation keratoprosthesis was evaluated. Experiments were carried out with six fresh pairs of human cadaver eyes. One eye of each pair was implanted with a PCL-5 keratoprosthesis (8.60 mm diameter with an optic of 5.60 nm diameter) and the contralateral eye was used as a control. The keratoprosthesis was inserted through a 6 mm diameter opening trephined in the cornea. The resistance of the implanted eye to pressure on `aqueous humor' leak and/or keratoprosthesis extrusion was tested by infusing water at a constant flow of 60 mmHg/second into the anterior chamber. IOP variations were recorded with a transducer connected to a computer. IOP could be increased up to 1520 to 2324 mmHg before aqueous humor leaks occurred. Leaks were always located at the keratoprosthesis-cornea interface. No prosthesis extrusion was observed. Implanted eyes that did not leak aqueous and control eyes tore at the sclera. All posterior fixation keratoprostheses implanted eyes resisted more than 100 times the normal physiological intraocular pressure and on this standpoint is safe. Additional experiments were needed to assess the influence of suture fixation and wound healing in an animal model.

  16. [Predictable tip suture techniques in rhinoplasty].

    Science.gov (United States)

    Papel, I D

    2010-09-01

    Recontouring the nasal tip in rhinoplastic procedures has generated a wide range of surgical techniques. These range from aggressive cartilage resection, division, grafting, or suture methods. Each of these categories contains many variations described in hundreds of publications. The goal of this communication is to describe a predictable, reproducible technique that can be used in a wide variety of rhinoplasty operations. Based on pre-existing anatomy variations of this technique can be adopted. The author described the basic technique in 2004 [1].The cornerstone of the technique is a predictable method of narrowing the interdomal space utilizing a suture technique. This procedure employs a pair of permanent sutures designed to minimize distortion, valve impingement and overcorrection. It can be performed through intranasal or external approaches. This paper will define the wide interdomal space, describe the technique, and demonstrate the efficacy of the technique in 250 rhinoplasty procedures. In addition, variations of the technique for specific goals will be shown.

  17. Optimal Suturing Technique and Number of Sutures for Surgical Implantation of Acoustic Transmitters in Juvenile Salmonids

    Energy Technology Data Exchange (ETDEWEB)

    Deters, Katherine A.; Brown, Richard S.; Boyd, James W.; Eppard, M. B.; Seaburg, Adam

    2012-01-02

    The size reduction of acoustic transmitters has led to a reduction in the length of incision needed to implant a transmitter. Smaller suture knot profiles and fewer sutures may be adequate for closing an incision used to surgically implant an acoustic microtransmitter. As a result, faster surgery times and reduced tissue trauma could lead to increased survival and decreased infection for implanted fish. The objective of this study was to assess the effects of five suturing techniques on mortality, tag and suture retention, incision openness, ulceration, and redness in juvenile Chinook salmon Oncorhynchus tshawytscha implanted with acoustic microtransmitters. Suturing was performed by three surgeons, and study fish were held at two water temperatures (12°C and 17°C). Mortality was low and tag retention was high for all treatments on all examination days (7, 14, 21, and 28 days post-surgery). Because there was surgeon variation in suture retention among treatments, further analyses included only the one surgeon who received feedback training in all suturing techniques. Incision openness and tissue redness did not differ among treatments. The only difference observed among treatments was in tissue ulceration. Incisions closed with a horizontal mattress pattern had more ulceration than other treatments among fish held for 28 days at 17°C. Results from this study suggest that one simple interrupted 1 × 1 × 1 × 1 suture is adequate for closing incisions on fish under most circumstances. However, in dynamic environments, two simple interrupted 1 × 1 × 1 × 1 sutures should provide adequate incision closure. Reducing bias in survival and behavior tagging studies is important when making comparisons to the migrating salmon population. Therefore, by minimizing the effects of tagging on juvenile salmon (reduced tissue trauma and reduced surgery time), researchers can more accurately estimate survival and behavior.

  18. [Suture techniques and material in surgery of flexor tendons].

    Science.gov (United States)

    Pillukat, T; Fuhrmann, R; Windolf, J; van Schoonhoven, J

    2017-03-01

    Adhesions and scar formation between flexor tendons and the surrounding tissue are only contemporarily avoidable by movement of flexor tendons. Concepts with active follow-up protocols are more favorable than passive mobilization. The main risks of flexor tendon repair are rupture of the tendon suture, insidious gap formation and resistance to tendon gliding within the tendon sheath. Currently, there is no consensus with respect to the optimal suture technique or suture material. Nevertheless, there are some principles worth paying attention to, such as using stronger suture material, blocking stitches, suture techniques with four or more strands as well as circular running sutures. A technically acceptable compromise, even for the less experienced, is currently the four-strand suture combined with a circular running suture. It maintains sufficient stability for active motion follow-up protocols without resistance.

  19. Clinical and histological comparison of polyglycolic acid suture with black silk suture after minor oral surgical procedure.

    Science.gov (United States)

    Balamurugan, R; Mohamed, Masroor; Pandey, Vijayendra; Katikaneni, Hari Krishna Rao; Kumar, K R Ashok

    2012-07-01

    Any suture material, absorbable or nonabsorbable, elicits a kind of inflammatory reaction within the tissue. Nonabsorbable black silk suture and absorbable polyglycolic acid suture were compared clinically and histologically on various parameters. This study consisted of 50 patients requiring minor surgical procedure, who were referred to the Department of Oral and Maxillofacial Surgery. Patients were selected randomly and sutures were placed in the oral cavity 7 days preoperatively. Polyglycolic acid was placed on one side and black silk suture material on the other. Seven days later, prior to surgical procedure the sutures will be assessed. After the surgical procedure the sutures will be placed postoperatively in the same way for 7 days, after which the sutures will be assessed clinically and histologically. The results of this study showed that all the sutures were retained in case of polyglycolic acid suture whereas four cases were not retained in case of black silk suture. As far as polyglycolic acid suture is concerned 25 cases were mild, 18 cases moderate and seven cases were severe. Black silk showed 20 mild cases, 21 moderate cases and six severe cases. The histological results showed that 33 cases showed mild, 14 cases moderate and three cases severe in case of polyglycolic acid suture. Whereas in case of black silk suture 41 cases were mild. Seven cases were moderate and two cases were severe. Black silk showed milder response than polyglycolic acid suture histologically. The polyglycolic acid suture was more superior because in all 50 patients the suture was retained. It had less tissue reaction, better handling characteristics and knotting capacity.

  20. A Biomechanical Analysis of the Interlock Suture and a Modified Kessler-Loop Lock Flexor Tendon Suture

    Directory of Open Access Journals (Sweden)

    Wenfeng Yang

    Full Text Available OBJECTIVE: In this work, we attempted to develop a modified single-knot Kessler-loop lock suture technique and compare the biomechanical properties associated with this single-knot suture technique with those associated with the conventional modified Kessler and interlock suture techniques. METHODS: In this experiment, a total of 18 porcine flexor digitorum profundus tendons were harvested and randomly divided into three groups. The tendons were transected and then repaired using three different techniques, including modified Kessler suture with peritendinous suture, interlock suture with peritendinous suture, and modified Kessler-loop lock suture with peritendinous suture. Times required for suturing were recorded and compared among groups. The groups were also compared with respect to 2-mm gap load, ultimate failure load, and gap at failure. RESULTS: For tendon repair, compared with the conventional modified Kessler suture technique, the interlock and modified Kessler-loop lock suture techniques resulted in significantly improved biomechanical properties. However, there were no significant differences between the interlock and modified Kessler-loop lock techniques with respect to biomechanical properties, gap at failure, and time required. CONCLUSIONS: The interlock and modified Kessler-loop lock techniques for flexor tendon sutures produce similar mechanical characteristics in vitro.

  1. CT assessment of anastomotic bowel leak

    Energy Technology Data Exchange (ETDEWEB)

    Power, N. [Department of Radiology, Sunnybrook Hospital, Toronto, Ontario M4N 3M5 (Canada); Atri, M. [Department of Radiology, Sunnybrook Hospital, Toronto, Ontario M4N 3M5 (Canada)]. E-mail: mostafa.atri@sw.ca; Ryan, S. [Department of Radiology, Sunnybrook Hospital, Toronto, Ontario M4N 3M5 (Canada); Haddad, R. [Department of Surgery, Sunnybrook Hospital, Toronto, Ontario M4N 3M5 (Canada); Smith, A. [Department of Surgery, Sunnybrook Hospital, Toronto, Ontario M4N 3M5 (Canada)

    2007-01-15

    Aim: To evaluate the predictors of clinically important gastrointestinal anastomotic leaks using multidetector computed tomography (CT). Subjects and methods: Ninety-nine patients, 73 with clinical suspicion of anastomotic bowel leak and 26 non-bowel surgery controls underwent CT to investigate postoperative sepsis. Fifty patients had undergone large bowel and 23 small bowel anastomoses. The time interval from surgery was 3-30 days (mean 10 {+-} 5.9 SD) for the anastomotic group and 3-40 days (mean 14 {+-} 11 SD) for the control group (p = 0.3). Two radiologists blinded to the final results reviewed the CT examinations in consensus and recorded the presence of peri-anastomotic air, fluid or combination of the two; distant loculated fluid or combination of fluid and air; free air or fluid; and intestinal contrast leak. Final diagnosis of clinically important anastomotic leak (CIAL) was confirmed at surgery or by chart review of predetermined clinical and laboratory criteria. Results: The prevalence of CIAL in the group undergoing CT was 31.5% (23/73). The CT examinations with documented leak were performed 5-28 (mean; 11.4 {+-} 6 SD) days after surgery. Nine patients required repeat operation, 10 percutaneous abscess drainage, two percutaneous drainage followed by surgery, and two prolonged antibiotic treatment and total parenteral nutrition (TPN). Of the CT features examined, only peri-anastomotic loculated fluid containing air was more frequently seen in the CIAL group as opposed to the no leak group (p = 0.04). There was no intestinal contrast leakage in this cohort. Free air was present up to 9 days and loculated air up to 26 days without CIAL. Conclusion: Most postoperative CT features overlap between patients with and without CIAL. The only feature seen statistically more frequently with CIAL is peri-anastomotic loculated fluid containing air.

  2. CT assessment of anastomotic bowel leak.

    Science.gov (United States)

    Power, N; Atri, M; Ryan, S; Haddad, R; Smith, A

    2007-01-01

    To evaluate the predictors of clinically important gastrointestinal anastomotic leaks using multidetector computed tomography (CT). Ninety-nine patients, 73 with clinical suspicion of anastomotic bowel leak and 26 non-bowel surgery controls underwent CT to investigate postoperative sepsis. Fifty patients had undergone large bowel and 23 small bowel anastomoses. The time interval from surgery was 3-30 days (mean 10+/-5.9 SD) for the anastomotic group and 3-40 days (mean 14+/-11 SD) for the control group (p=0.3). Two radiologists blinded to the final results reviewed the CT examinations in consensus and recorded the presence of peri-anastomotic air, fluid or combination of the two; distant loculated fluid or combination of fluid and air; free air or fluid; and intestinal contrast leak. Final diagnosis of clinically important anastomotic leak (CIAL) was confirmed at surgery or by chart review of predetermined clinical and laboratory criteria. The prevalence of CIAL in the group undergoing CT was 31.5% (23/73). The CT examinations with documented leak were performed 5-28 (mean; 11.4+/-6 SD) days after surgery. Nine patients required repeat operation, 10 percutaneous abscess drainage, two percutaneous drainage followed by surgery, and two prolonged antibiotic treatment and total parenteral nutrition (TPN). Of the CT features examined, only peri-anastomotic loculated fluid containing air was more frequently seen in the CIAL group as opposed to the no leak group (p=0.04). There was no intestinal contrast leakage in this cohort. Free air was present up to 9 days and loculated air up to 26 days without CIAL. Most postoperative CT features overlap between patients with and without CIAL. The only feature seen statistically more frequently with CIAL is peri-anastomotic loculated fluid containing air.

  3. Scanning, standoff TDLAS leak imaging and quantification

    Science.gov (United States)

    Wainner, Richard T.; Aubut, Nicholas F.; Laderer, Matthew C.; Frish, Michael B.

    2017-05-01

    This paper reports a novel quantitative gas plume imaging tool, based on active near-infrared Backscatter Tunable Diode Laser Absorption Spectroscopy (b-TDLAS) technology, designed for upstream natural gas leak applications. The new tool integrates low-cost laser sensors with video cameras to create a highly sensitive gas plume imager that also quantifies emission rate, all in a lightweight handheld ergonomic package. It is intended to serve as a lower-cost, higherperformance, enhanced functionality replacement for traditional passive non-quantitative mid-infrared Optical Gas Imagers (OGI) which are utilized by industry to comply with natural gas infrastructure Leak Detection and Repair (LDAR) requirements. It addresses the need for reliable, robust, low-cost sensors to detect and image methane leaks, and to quantify leak emission rates, focusing on inspections of upstream oil and gas operations, such as well pads, compressors, and gas plants. It provides: 1) Colorized quantified images of path-integrated methane concentration. The images depict methane plumes (otherwise invisible to the eye) actively interrogated by the laser beam overlaid on a visible camera image of the background. The detection sensitivity exceeds passive OGI, thus simplifying the manual task of leak detection and location; and 2) Data and algorithms for using the quantitative information gathered by the active detection technique to deduce plume flux (i.e. methane emission rate). This key capability will enable operators to prioritize leak repairs and thereby minimize the value of lost product, as well as to quantify and minimize greenhouse gas emissions, using a tool that meets EPA LDAR imaging equipment requirements.

  4. Laser Schlieren System Detects Sounds Of Leaks

    Science.gov (United States)

    Shakkottai, Parthasarathy P.; Alwar, A. Vijayaragavan

    1990-01-01

    Hostile environments monitored safely and noninvasively. Modified laser schlieren system acts as microphone to detect sounds of leaks remotely. Sensitive to acoustical frequencies above audible range and especially suited for monitoring leaks of high-pressure steam from boilers or chemical vapors from processing equipment. Does not require placement of delicate equipment in harsh environment monitored, and no contact needed with boiler or other unit being monitored. Detects sound waves via variation of index of refraction of air at acoustical frequencies. Used to monitor sound frequencies beyond range of human hearing.

  5. Single-Shell Tank Leak Integrity Summary

    Energy Technology Data Exchange (ETDEWEB)

    Harlow, D. G. [Washington River Protection Solutions LLC, Richland, WA (United States); Girardot, C. L. [Washington River Protection Solutions LLC, Richland, WA (United States); Venetz, T. J. [Washington River Protection Solutions LLC, Richland, WA (United States)

    2015-03-26

    This document summarizes and evaluates the information in the Hanford Tri-Party Agreement Interim Milestone M-045-91F Targets completed between 2010 and 2015. 1) Common factors of SST liner failures (M-045-91F-T02), 2) the feasibility of testing for ionic conductivity between the inside and outside of SSTs (M-045-91F-T03, and 3) the causes, locations, and rates of leaks from leaking SSTs (M-045-91F-T04).

  6. [A pancreas suture-less type II binding pancreaticogastrostomy].

    Science.gov (United States)

    Peng, Shu-you; Hong, De-fei; Liu, Ying-bin; Li, Jiang-tao; Tao, Feng; Tan, Zhi-jian

    2009-12-01

    To explore the feasibility and safety of type II binding pancreaticogastrostomy (BPG) in pancreaticoduodenectomy and mid-segmentectomy of pancreas. From November 2008 to May 2009, 26 patients underwent pancreaticoduodenectomy and mid-segmentectomy of pancreas with type II BPG reconstruction, including 13 cases of pancreatic head cancer, 3 cases of duodenal adenocarcinoma, 2 cases of ampullary carcinoma, 4 cases of cholangiocarcinoma, 1 case of bile duct cell severe atypical hyperplasia, and 1 case of stomach cancer. The process of type II BPG was described as the following: after pancreas remnant was mobilized for 2-3 cm, a piece of sero-muscular layer at the posterior gastric wall was excised and then a sero-muscular depth purse-suturing with 3-0 prolene was pre-placed (outer purse-string). Incising anterior gastric wall or opening part of the closed distal gastric stump, the mucosa layer at the sero-muscular defect was incised and then purse-suture at the mucosal tube was pre-placed (inner purse-string). Through the two pre-placed purse-strings, the pancreas remnant was pulled into the gastric lumen and then posterior gastric wall was pushed backward to keep it closely in contact with the retro-peritoneal wall. Thereafter, the outer purse-string was tied (outer binding) and then the inner purse-string was tied (inner binding). All cases underwent BPG of type II. The operative time ranged from 3 to 5.5 hours. The postoperative hospital stay ranged from 6 to 48 days. Postoperative complications included 1 case of ascites, 2 cases of delayed gastric emptying and 1 case of intra-abdominal bleeding. All cases with complications were cured after nonsurgical treatment. No mortality or pancreatic leakage occurred. Pancreaticogastrostomy is good for accommodating a large pancreas stump. Binding technique is very helpful in minimizing the leak rate of pancreaticogastrostomy. While type I BPG is safe and easy to perform, type II is even safer and easier to be done.

  7. 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.

  8. Intrastromal corneal suture for small incision cataract surgery.

    Science.gov (United States)

    Chipont Benabent, E; Artola Roig, A; Martínez Toldos, J J

    1996-01-01

    Proper wound closure is important in preventing postoperative endophthalmitis. We developed an intrastromal corneal suture technique that uses some principles of the running, locked, intradermal suture for light-tension skin wounds. It achieves close approximation of the wound edges, reduces postoperative wound care and the risk of wound infection in clean surgical wounds, and obviates suture removal. It may also help prevent endophthalmitis and early against-the-rule astigmatism without the complications associated with external suture exposure.

  9. Comparison of surgically induced astigmatism between horizontal and X-pattern sutures in the scleral tunnel incisions for manual small incision cataract surgery.

    Science.gov (United States)

    Eslami, Yadollah; Mirmohammadsadeghi, Arash

    2015-07-01

    Two types of popular scleral tunnel sutures in the manual small incision cataract surgery (MSICS) are horizontal and X-pattern sutures. Surgically induced corneal astigmatism (SIA) is a useful indicator of the suturing effect. To compare SIA between horizontal and X-pattern sutures in the scleral tunnel incisions for MSICS. Prospective, nonrandomized comparative trial. After superior scleral tunnel incision and capsulorhexis, the nucleus was prolapsed into the anterior chamber and delivered. The wound was sutured with either horizontal or X-pattern suture. The simulated keratometry values were derived from the corneal topography preoperatively and 1.5 and 3 months postoperatively. The SIA was calculated by Cartesian coordinates based analysis. Sixty-four patients (32 patients in each group) were included in the study. In the horizontal suture group, the SIA centroid values at 1.5 and 3 months after the surgery were 0.87 × 1° and 1.11 × 180°, respectively, showing induction of against-the-rule astigmatism. In the X-pattern suture group, the SIA centroid values at 1.5 and 3 months after the surgery were 0.61 × 97° and 0.66 × 92°, respectively, showing induction of mild with-the-rule astigmatism. The difference between the amount of SIA at 1.5 and 3 months after surgery was small. In the MSICS, the X-pattern sutures were preferred to the horizontal sutures in the patients without significant preoperative steepening in line with the central meridian of the incision. In the cases with significant preoperative steepening, sutureless surgery or horizontal sutures were preferred. Corneal astigmatism in the patients undergoing MSICS was stable at 1.5 months after the surgery.

  10. Comparison of surgically induced astigmatism between horizontal and X-pattern sutures in the scleral tunnel incisions for manual small incision cataract surgery

    Directory of Open Access Journals (Sweden)

    Yadollah Eslami

    2015-01-01

    Full Text Available Background: Two types of popular scleral tunnel sutures in the manual small incision cataract surgery (MSICS are horizontal and X-pattern sutures. Surgically induced corneal astigmatism (SIA is a useful indicator of the suturing effect. Aims: To compare SIA between horizontal and X-pattern sutures in the scleral tunnel incisions for MSICS. Design: Prospective, nonrandomized comparative trial. Materials and Methods: After superior scleral tunnel incision and capsulorhexis, the nucleus was prolapsed into the anterior chamber and delivered. The wound was sutured with either horizontal or X-pattern suture. The simulated keratometry values were derived from the corneal topography preoperatively and 1.5 and 3 months postoperatively. Statistical Analysis: The SIA was calculated by Cartesian coordinates based analysis. Results: Sixty-four patients (32 patients in each group were included in the study. In the horizontal suture group, the SIA centroid values at 1.5 and 3 months after the surgery were 0.87 × 1° and 1.11 × 180°, respectively, showing induction of against-the-rule astigmatism. In the X-pattern suture group, the SIA centroid values at 1.5 and 3 months after the surgery were 0.61 × 97° and 0.66 × 92°, respectively, showing induction of mild with-the-rule astigmatism. The difference between the amount of SIA at 1.5 and 3 months after surgery was small. Conclusion: In the MSICS, the X-pattern sutures were preferred to the horizontal sutures in the patients without significant preoperative steepening in line with the central meridian of the incision. In the cases with significant preoperative steepening, sutureless surgery or horizontal sutures were preferred. Corneal astigmatism in the patients undergoing MSICS was stable at 1.5 months after the surgery.

  11. 21 CFR 878.5035 - Nonabsorbable expanded polytetrafluoroethylene surgical suture.

    Science.gov (United States)

    2010-04-01

    ... surgical suture. 878.5035 Section 878.5035 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Devices § 878.5035 Nonabsorbable expanded polytetrafluoroethylene surgical suture. (a) Identification. Nonabsorbable expanded polytetrafluoroethylene (ePTFE) surgical suture is a monofilament, nonabsorbable, sterile...

  12. 21 CFR 878.4930 - Suture retention device.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Suture retention device. 878.4930 Section 878.4930...) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4930 Suture retention device. (a) Identification. A suture retention device is a device, such as a retention bridge, a surgical...

  13. Transpupillary thermotherapy for central serous chorioretinopathy with parafoveal leaks

    Directory of Open Access Journals (Sweden)

    Qing Xiao

    2014-04-01

    Full Text Available AIM:To explore the clinical effect of transpupillary thermotherapy(TTTfor the treatment of central serous chorioretinopathy(CSCwith parafoveal leaks.METHODS: Twenty-three eyes from nineteen patients with long-standing CSC and parafoveal leaks(50-200μm around the foveawho opted for TTT and observation were enrolled in this study. Eighteen of nineteen patients(23 eyeswere male, fourteen of twenty-three eyes were right eyes. The patients' mean age was 44.00±4.973 years(range from 32-52 years. TTT was performed using 810nm infrared diode laser. All patients underwent Snellen visual acuity measurement(converted to LogMAR for analysisfundus examination, fluorescein angiography(FFAand optical coherence tomography(OCT. Follow-up was scheduled at 1, 2, 6mo. RESULTS:Following treatment of TTT, complete resolution of neurosensory detachment on OCT and disappearance of leakage on FFA was seen in fourteen eyes(61%, twenty-one eyes(91%at the 2mo and twenty-three eyes(100%at the 6mo respectively. A total of 74% had ≥3 lines of improvement after 6mo. Success was defined as resolution of neurosensory on OCT and disappearance of leakage on FFA at the 2mo. Failure was defined as no change at the 6mo and no improvement of visual acuity.CONCLUSION:TTT is safe and effective therapeutic option in patients with CSC and parafoveal leaks. It may improve the visual acuity by shortening the persistent serous elevation of the macula.

  14. Simple suture and anchor in rabbit hips

    Science.gov (United States)

    Garcia Filho, Fernando Cal; Guarniero, Roberto; de Godoy Júnior, Rui Maciel; Pereira, César Augusto Martins; Matos, Marcos Almeida; Garcia, Lucas Cortizo

    2012-01-01

    Objective Using biomechanical studies, this research aims to compare hip capsulorrhaphy in rabbits, carried out with two different techniques: capsulorrhaphy with simple sutures and with anchors. Method Thirteen New Zealand Albino (Oryctolaguscuniculus) male rabbits, twenty-six hip joints, were used. First, a pilot project was performed with three rabbits (six hip joints). This experiment consisted of ten rabbits divided into two groups: group 1 underwent capsulorrhaphy on both right and left hips with simple suture using polyglycolic acid absorbable thread, and group 2 underwent capsulorrhaphy with titanium anchors. After a four-week postoperative period, the animals were euthanized and the hip joints were frozen. On the same day of the biomechanical studies, after the hip joints were previously unfrozen, the following parameters were evaluated: rigidity, maximum force, maximum deformity and energy. Results There was no relevant statistical difference in rigidity, maximum force, maximum deformity and energy between the simple suture and anchor groups. Conclusion Through biomechanical analyses, using parameters of rigidity, maximum force, maximum deformity and energy, it has been shown that capsulorrhaphy with simple suture and with anchors has similar results in rabbit hip joints. Level of Evidence II, Prospective Comparative Study. PMID:24453618

  15. Frontoorbital advancement in coronal suture craniosynostosis: a ...

    African Journals Online (AJOL)

    The frontal bone was then removed as indicated. The most lateral aspect of the coronal suture was radically removed with rongeurs, including a part of the greater and lesser wings of the sphenoid bone. The frontal and temporal lobes of the brain were gently repositioned to allow for safe upper orbital osteotomies through ...

  16. Non-suture methods of vascular anastomosis

    NARCIS (Netherlands)

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

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

  17. Suture needles in oral surgery: alterations depending on the type and number of sutures.

    Science.gov (United States)

    Torres-Lagares, Daniel; Barranco-Piedra, Sebastian; Rodríguez-Caballero, Angela; Serrera-Figallo, María-Angeles; Segura-Egea, Juan-José; Gutiérrez-Pérez, José-Luis

    2012-01-01

    This study examined whether the number and type of sutures used in oral surgery influence two ad hoc variables (incision plane and displaced area), which are two variables related to whether the suture needle is suitable for the task. Seventy-five TB-15 needles were studied, which were used to suture between zero and three mucosa and/subperiosteal sutures, producing 15 groups with 5 needles in each one. The incision plane and displaced area were measured for each group, which are two variables related to how the needle has worn and altered. Statistical treatment was conducted using the Kruskal-Wallis H test to compare multiple values and the Mann-Whitney U test to compare pairs. A multi-stage regression model was applied with the aim of predicting the changes in the dependent variables based on the number and type of sutures performed. The incision plane ranged from 126.67 to 346.24 µm among the different groups. The displaced area was measured as being between 14 524.83 µm² and 128 311.91 µm². The best predictive model for the incision plane obtained a coefficient of determination (R2) of 0.149, while it reached 0.249 for the displaced area. Subperiosteal sutures held more weighting among the variables studied. Mucosal sutures did not seem to greatly affect needle wear. Observations reported in this paper indicate that the needle should be changed after having performed two subperiosteal sutures, given the wear and change to the incision plane that is produced, which causes the needle's cutting ability to reduce.

  18. Leak before break evaluation for main steam piping system made of SA106 Gr.C

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Kyoung Mo; Jee, Kye Kwang; Pyo, Chang Ryul; Ra, In Sik [Korea Power Engineering Company, Seoul (Korea, Republic of)

    1997-04-01

    The basis of the leak before break (LBB) concept is to demonstrate that piping will leak significantly before a double ended guillotine break (DEGB) occurs. This is demonstrated by quantifying and evaluating the leak process and prescribing safe shutdown of the plant on the basis of the monitored leak rate. The application of LBB for power plant design has reduced plant cost while improving plant integrity. Several evaluations employing LBB analysis on system piping based on DEGB design have been completed. However, the application of LBB on main steam (MS) piping, which is LBB applicable piping, has not been performed due to several uncertainties associated with occurrence of steam hammer and dynamic strain aging (DSA). The objective of this paper is to demonstrate the applicability of the LBB design concept to main steam lines manufactured with SA106 Gr.C carbon steel. Based on the material properties, including fracture toughness and tensile properties obtained from the comprehensive material tests for base and weld metals, a parametric study was performed as described in this paper. The PICEP code was used to determine leak size crack (LSC) and the FLET code was used to perform the stability assessment of MS piping. The effects of material properties obtained from tests were evaluated to determine the LBB applicability for the MS piping. It can be shown from this parametric study that the MS piping has a high possibility of design using LBB analysis.

  19. Endoscopic management of bile leaks after laparoscopic ...

    African Journals Online (AJOL)

    2013-11-04

    Nov 4, 2013 ... abscesses, interloop and intra-abdominal sepsis and cholangitis, or the later secondary sequelae of biliary cirrhosis, portal hypertension and end-stage liver disease. There is consensus that optimal management of a bile duct injury requires multidisciplinary. Endoscopic management of bile leaks after.

  20. Detecting gas leaks by ultrasonic emission

    DEFF Research Database (Denmark)

    Rasmussen, Karsten Bo; Henriksen, Eigil

    1997-01-01

    The emission of noise in the frequency range 10 kHz to 25.6 kHz from an experimental gas leak in a flanged joint has been experimentally investigated. The overall conclusion is that the emitted noise is almost frequency independent in level within the considered frequency range.A small PC program...

  1. The Morphogenesis of Cranial Sutures in Zebrafish.

    Directory of Open Access Journals (Sweden)

    Jolanta M Topczewska

    Full Text Available Using morphological, histological, and TEM analyses of the cranium, we provide a detailed description of bone and suture growth in zebrafish. Based on expression patterns and localization, we identified osteoblasts at different degrees of maturation. Our data confirm that, unlike in humans, zebrafish cranial sutures maintain lifelong patency to sustain skull growth. The cranial vault develops in a coordinated manner resulting in a structure that protects the brain. The zebrafish cranial roof parallels that of higher vertebrates and contains five major bones: one pair of frontal bones, one pair of parietal bones, and the supraoccipital bone. Parietal and frontal bones are formed by intramembranous ossification within a layer of mesenchyme positioned between the dermal mesenchyme and meninges surrounding the brain. The supraoccipital bone has an endochondral origin. Cranial bones are separated by connective tissue with a distinctive architecture of osteogenic cells and collagen fibrils. Here we show RNA in situ hybridization for col1a1a, col2a1a, col10a1, bglap/osteocalcin, fgfr1a, fgfr1b, fgfr2, fgfr3, foxq1, twist2, twist3, runx2a, runx2b, sp7/osterix, and spp1/ osteopontin, indicating that the expression of genes involved in suture development in mammals is preserved in zebrafish. We also present methods for examining the cranium and its sutures, which permit the study of the mechanisms involved in suture patency as well as their pathological obliteration. The model we develop has implications for the study of human disorders, including craniosynostosis, which affects 1 in 2,500 live births.

  2. A Comparison of Barbed Sutures and Standard Sutures with regard to Wound Cosmesis in Panniculectomy and Reduction Mammoplasty Patients

    Directory of Open Access Journals (Sweden)

    Kristen Aliano

    2016-01-01

    Full Text Available Cosmesis is a vital concern for patients undergoing plastic and reconstructive surgery. Many variations in wound closure are employed when attempting to minimize a surgical scar’s appearance. Barbed sutures are one potential method of achieving improved wound cosmesis and are more common in recent years. To determine if barbed sutures differ from nonbarbed in wound cosmesis, we conducted a single-blinded, randomized, controlled trial of 18 patients undergoing bilateral reduction mammoplasty or panniculectomy. Patients were their own controls, receiving barbed sutures on one side and standard sutures on the contralateral side. Surgical scars were evaluated postoperatively by patient preference self-assessment and an observer. Ten patients were evaluated at 3 months postoperatively, yielding a mean Stony Brook Scar Evaluation Scale (SBSES rating of 4.4 for barbed suture and 3.5 for regular suture (p=0.15. At 6 months, 8 patients performed self-assessment to determine their preference; 4 preferred the barbed sutures, 1 preferred the regular sutures, and 3 had no preference. Further research with larger sample sizes is needed to determine if barbed sutures convey any advantage over standard sutures in wound healing. However, our results suggest that barbed sutures are a reasonable alternative to standard sutures particularly with regard to wound cosmesis.

  3. The suture pullout characteristics of human and porcine linea alba.

    Science.gov (United States)

    Cooney, Gerard M; Lake, Spencer P; Thompson, Dominic M; Castile, Ryan M; Winter, Des C; Simms, Ciaran K

    2017-04-01

    There is a substantial prevalence of post-operative incisional hernia for both laparoscopic and laparotomy procedures, but there have been few attempts at quantifying abdominal wound closure methodology in the literature. One method to ascertain a more robust method of wound closure is the identification of the influence of suture placement parameters on suture pullout force. Current surgical practice involves a recommended bite depth and bite separation of 10mm, but the evidence base for this is not clear. In this paper, the suture pullout characteristics of both porcine and human linea alba were investigated to ascertain a suture placement protocol for surgical wound closure. Uniaxial suture pullout force testing on fresh frozen porcine and human linea alba samples was performed using standard materials testing machines. The influence of the number of suture loops, the bite depth and the bite separation of the sutures and the orientation of the sutures with respect to the principal fibre direction in the linea alba were assessed. Results showed a clearly identifiable relationship between pullout force of the suture, bite separation and bite depth, with low suture separation and high suture depth as optimal parameters for increasing pullout force. Resistance to pullout could be improved by as much as 290% when optimizing test conditions. Both human and porcine tissue were observed to exhibit very similar pullout force characteristics, corroborating the use of a porcine model for investigations into wound closure methodology. Orientation of suture application was also found to significantly affect the magnitude of suture pullout, with suturing applied longitudinally across a transverse defect resulting in higher pullout forces for small suture bite separations. Although further assessment in an environment more representative of in vivo conditions is required, these findings indicate that increasing the bite depth and reducing the bite separation with respect to

  4. Comparison of an all-inside suture technique with traditional pull-out suture and suture anchor repair techniques for flexor digitorum profundus attachment to bone.

    Science.gov (United States)

    Chu, Jennifer Y; Chen, Tony; Awad, Hani A; Elfar, John; Hammert, Warren C

    2013-06-01

    One goal in repairing zone 1 flexor digitorum profundus (FDP) injuries is to create a tendon-bone construct strong enough to allow early rehabilitation while minimizing morbidity. This study compares an all-inside suture repair technique biomechanically with pull-out suture and double-suture anchor repairs. Repairs were performed on 30 cadaver fingers. In all-inside suture repairs (n = 8), the FDP tendon was attached to bone with two 3-0 Ethibond sutures and tied over the dorsal aspect of distal phalanx. Pull-out suture repairs (n = 8) were performed with 2-0 Prolene suture and tied over a dorsal button. There were 2 suture anchor repair groups: Arthrex Micro Corkscrew anchors preloaded with 2-0 FiberWire suture (n = 7) and Depuy Micro Mitek anchors preloaded with 3-0 Orthocord suture (n = 7). Repair constructs were tested using a servohydraulic materials testing system and loaded until the repair lost 75% of its strength. There were no statistically significant differences in tensile stiffness, ultimate load, or work to failure between the repairs. Failure mode was suture stretch and gap formation greater than 2 mm at the repair site for all pull-out suture repairs and for 7 of 8 all-inside suture repairs. Two of the Arthrex Micro Corkscrew repairs and 5 of the Depuy Micro Mitek repairs failed by anchor pull-out. This cadaveric biomechanical study showed no difference in tensile stiffness, ultimate load, and work to failures between an all-inside suture repair technique for zone 1 FDP repairs and previously described pull-out suture and suture anchor repair techniques. The all-inside suture technique also has the advantages of avoiding an external button and the cost of anchors. Therefore, it should be considered as an alternative to other techniques. This study introduces a new FDP reattachment technique that avoids some of the shortcomings of current techniques. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights

  5. REFLEAK: NIST Leak/Recharge Simulation Program for Refrigerant Mixtures

    Science.gov (United States)

    SRD 73 NIST REFLEAK: NIST Leak/Recharge Simulation Program for Refrigerant Mixtures (PC database for purchase)   REFLEAK estimates composition changes of zeotropic mixtures in leak and recharge processes.

  6. The leak location package for assessment of the time-frequency correlation method for leak location

    Science.gov (United States)

    Faerman, V. A.; Cheremnov, A. G.; Avramchuk, V. S.; Shepetovsky, D. V.

    2017-01-01

    The paper describes the simplest implementation of a software and hardware package for acoustic correlation leak location and results of its performance assessment for location of water leaks from a metallic pipe in laboratory conditions. A distinctive feature of this leak locator is the use of the software based on the time-frequency correlation analysis of signals, which was proposed in our previous papers. Comparative analysis results are given for the information content of classical and time-frequency cross-correlation functions as obtained during processing of experimental data. The results obtained justify comparatively higher efficiency of a time-frequency cross correlation method to solve the leak location task. Improved efficiency is determined by bandpass filtration embedded into the time-frequency cross-correlation function calculation.

  7. Experiences with leak rate calculations methods for LBB application

    Energy Technology Data Exchange (ETDEWEB)

    Grebner, H.; Kastner, W.; Hoefler, A.; Maussner, G. [and others

    1997-04-01

    In this paper, three leak rate computer programs for the application of leak before break analysis are described and compared. The programs are compared to each other and to results of an HDR Reactor experiment and two real crack cases. The programs analyzed are PIPELEAK, FLORA, and PICEP. Generally, the different leak rate models are in agreement. To obtain reasonable agreement between measured and calculated leak rates, it was necessary to also use data from detailed crack investigations.

  8. 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.

  9. Horizontal running mattress suture modified with intermittent simple loops.

    Science.gov (United States)

    Chacon, Anna H; Shiman, Michael I; Strozier, Narissa; Zaiac, Martin N

    2013-01-01

    Using the combination of a horizontal running mattress suture with intermittent loops achieves both good eversion with the horizontal running mattress plus the ease of removal of the simple loops. This combination technique also avoids the characteristic railroad track marks that result from prolonged non-absorbable suture retention. The unique feature of our technique is the incorporation of one simple running suture after every two runs of the horizontal running mattress suture. To demonstrate its utility, we used the suturing technique on several patients and analyzed the cosmetic outcome with post-operative photographs in comparison to other suturing techniques. In summary, the combination of running horizontal mattress suture with simple intermittent loops demonstrates functional and cosmetic benefits that can be readily taught, comprehended, and employed, leading to desirable aesthetic results and wound edge eversion.

  10. Double Shell Tank AY-102 Radioactive Waste Leak Investigation

    Energy Technology Data Exchange (ETDEWEB)

    Washenfelder, Dennis J.

    2014-04-10

    PowerPoint. The objectives of this presentation are to: Describe Effort to Determine Whether Tank AY-102 Leaked; Review Probable Causes of the Tank AY-102 Leak; and, Discuss Influence of Leak on Hanford’s Double-Shell Tank Integrity Program.

  11. 49 CFR 230.64 - Leaks under lagging.

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF TRANSPORTATION STEAM LOCOMOTIVE INSPECTION AND MAINTENANCE STANDARDS Boilers and Appurtenances Steam Leaks § 230.64 Leaks under lagging. The steam locomotive owner and/or operator shall take out of service at once any boiler that has developed a leak under the lagging due to a crack in the shell, or to...

  12. 49 CFR 174.50 - Nonconforming or leaking packages.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Nonconforming or leaking packages. 174.50 Section 174.50 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS... General Operating Requirements § 174.50 Nonconforming or leaking packages. A leaking non-bulk package may...

  13. 1999 Leak Detection and Monitoring and Mitigation Strategy Update

    Energy Technology Data Exchange (ETDEWEB)

    OHL, P.C.

    1999-09-23

    This document is a complete revision of WHC-SD-WM-ES-378, Rev 1. This update includes recent developments in Leak Detection, Leak Monitoring, and Leak Mitigation technologies, as well as, recent developments in single-shell tank retrieval technologies. In addition, a single-shell tank retrieval release protection strategy is presented.

  14. Atraumatic intracutaneous skin closure with self-made fishing line ...

    African Journals Online (AJOL)

    Objective: The aim of this study was to prove, whether the intracutaneous skin closure with self made fishing line suture is equivalent to commercial sutures. Design: It was a randomised blinded animal study. Setting: The study was performed in December 2002 at the Muhimbili University College of Health Sciences in ...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-05-01

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

  16. Economic evaluation of different suture closure methods: barbed versus traditional interrupted sutures.

    Science.gov (United States)

    Elmallah, Randa K; Khlopas, Anton; Faour, Mhamad; Chughtai, Morad; Malkani, Arthur L; Bonutti, Peter M; Roche, Martin; Harwin, Steven F; Mont, Michael A

    2017-12-01

    Healthcare systems are receiving increasing pressures from payers, such as the Centers for Medicare and Medicaid (CMS), to reduce the costs associated with procedures, and with the implementation of the Affordable Care Act, high costs are addressed through pay-for-performance programs. Thus, multiple areas of total knee arthroplasty (TKA) surgery are under scrutiny, including surgical times, material costs, and the costs of associated complications and readmissions. Suture type has been determined to be a factor that may influence closure times, as well as direct material costs. Therefore, the purpose of this review was to compare: (I) the cost of using barbed vs. conventional interrupted sutures; (II) the additional cost of differences in complications, if any; (III) to extrapolate cost savings on a hospital and national level; and (IV) to discuss the role of these findings on hospital savings and the effect on bundled payments. It was found that the main factors affecting differences in overall costs between barbed and standard interrupted suture were material cost and closure time. Many studies have demonstrated greater cost savings with the barbed suture due to shorter operative times, despite the higher material costs. The majority of studies also demonstrated similar complication rates between the suture types, and thus these are unlikely to affect the cost difference. However, to the best of our knowledge, there are no TKA studies in the literature evaluating the effect of suture type and associated complications on lengths of stay and readmission rates. Thus, it is unclear how these cost savings will translate to reimbursements rates and the role that they might play in bundled payments. Several studies in other specialties demonstrate decreased infection rates with the use of barbed sutures, which, if found to be true for TKA can be extrapolated to 3 million dollars of savings in revision TKA costs. Further studies on this topic are needed to define these

  17. Sandwich wound closure reduces the risk of cerebrospinal fluid leaks in posterior fossa surgery

    Directory of Open Access Journals (Sweden)

    Verena Heymanns

    2016-07-01

    Full Text Available Posterior fossa surgery is demanding and hides a significant number of obstacles starting from the approach to the wound closure. The risk of cerebrospinal fluid (CSF leakage in posterior fossa surgery given in the literature is around 8%. The present study aims to introduce a sandwich closure of the dura in posterior fossa surgery, which reduces significantly the number of CSF leaks (3.8% in the patients treated in our department. Three hundred and ten patients treated in our hospital in the years 2009-2013 for posterior fossa pathologies were retrospectively evaluated. The dura closure method was as following: lyophilized dura put under the dura and sealed with fibrin glue and sutures, dura adapting stitches, TachoSil® (Takeda Pharma A/S, Roskilde, Denmark, Gelfoam® (Pfizer Inc., New York, NY, USA and polymethylmethacrylate (osteoclastic craniotomy. The incidence of postsurgical complications associated with the dural closure like CSF leakage, infections, bleeding is evaluated. Only 3.8% of patients developed CSF leakage and only 0.5% needed a second surgery for CSF leakage closure. Two percent had a cerebellar bleeding with no need for re-operation and 3% had a wound infection treated with antibiotics. The sandwich wound closure we are applying for posterior fossa surgery in our patients correlates with a significant reduction of CSF leaks compared to the literature.

  18. Optimal suture materials for contaminated gastrointestinal surgery: does infection influence the decrease of the tensile strength of sutures?

    Science.gov (United States)

    Tanaka, Yoichi; Sadahiro, Sotaro; Ishikawa, Kenji; Suzuki, Toshiyuki; Kamijo, Akemi; Tazume, Seiki; Yasuda, Masanori

    2012-12-01

    Suture materials are selected based on the following factors: absorbable/non-absorbable, monofilament/multifilament, duration with sufficiently high tensile strength, and the tissue to be sutured. Absorbable sutures are hydrolyzed in tissues. However, little is known about the influence of infection on the hydrolysis and decrease in the tensile strength. Four kinds of sutures, i.e., non-absorbable multifilament silk, non-absorbable monofilament polypropylene (Prolene(®)), absorbable multifilament polyglactin 910 (Vicryl(®)), and absorbable monofilament polydioxanone (PDS(®)) were implanted in the back of rats. A suspension of Escherichia coli + Bacteroides fragilis or saline was injected subcutaneously into the contaminated and clean condition groups, respectively. The sutures were removed 1, 2, 4 or 8 weeks after the implantation. There was significantly more severe inflammation macroscopically for the silk sutures under the contaminated conditions (p = 0.03), however, no significant differences were observed among the other three sutures. All 4 kinds of sutures showed a reduction of the tensile strength over time. There were no significant differences in the magnitude of reduction between both the clean and contaminated conditions for any of the sutures. The reduction of the tensile strength with time did not differ significantly between sutures exposed to contaminated and clean conditions, even for the absorbable sutures.

  19. Validation of sleeve of straight union type B for leaks

    Energy Technology Data Exchange (ETDEWEB)

    Teutonico, Mauricio; Fazzini, Pablo [Gie S.A., Buenos Aires (Argentina)

    2009-07-01

    Analytic study and experimental validation of type B sleeve with overlapping, were done in order to determine whether they are suitable for used as permanent leaks repair in hydrocarbons transport lines. All relevant background of this type of repair was analyzed, following the guidelines defined by applicable regulations (ASME B31.8 and ASME B31.4) and modeled by finite elements methods. Solicitations under internal pressure of each one of the reinforcement parts were analyzed. All solicitations involved in welded unions were studied, so as the reinforcement effectiveness when it is filled with internal gap filler. Experimental tests were developed, consisted on the reinforcement installation upon damaged pipes and the following hydrostatic test. These tests were assisted by a digitalized measurement, to determine the solicitations at different parts of the reinforcement; strain gauges were used for this task. (author)

  20. Management of dislocated intraocular lenses with iris suture.

    Science.gov (United States)

    Faria, Mun Y; Ferreira, Nuno P; Canastro, Mario

    2017-01-19

    MAR units. The mean visual acuity improvement was 4.08 ± 5.33 lines on the logMAR scale. In this study, every IOL was stable at the last follow-up. As late complications, macular edema occurred in 1 patient and retinal detachment occurred in 2 patients. There were no cases of endophthalmitis. Iris suture fixation of subluxated IOL is a good treatment option for eyes with dislocated IOLs, leading to long-term stability of the IOL. The advantage of this procedure is using the same IOL in a closed eye surgery. No astigmatic difference is expected as no large corneal incision is needed.

  1. Fluid pipeline leak detection and location with miniature RF tags

    Energy Technology Data Exchange (ETDEWEB)

    McIntyre, Timothy J.

    2017-05-16

    Sensors locate troublesome leaks in pipes or conduits that carry a flowing medium. These sensors, through tailored physical and geometric properties, preferentially seek conduit leaks or breaches due to flow streaming. The sensors can be queried via transceivers outside the conduit or located and interrogated inside by submersible unmanned vehicle to identify and characterize the nature of a leak. The sensors can be functionalized with other capabilities for additional leak and pipeline characterization if needed. Sensors can be recovered from a conduit flow stream and reused for future leak detection activities.

  2. Skin tension related to tension reduction sutures.

    Science.gov (United States)

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

    2015-01-01

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

  3. 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.

  4. Knotless Suture Anchor With Suture Tape Quadriceps Tendon Repair Is Biomechanically Superior to Transosseous and Traditional Suture Anchor-Based Repairs in a Cadaveric Model.

    Science.gov (United States)

    Kindya, Michael C; Konicek, John; Rizzi, Angelo; Komatsu, David E; Paci, James M

    2017-01-01

    To compare the biomechanical properties of a knotless suture anchor with suture tape quadriceps tendon repair technique with transosseous and suture anchor repair techniques. Twenty matched pairs of cadaveric knees underwent a quadriceps tendon avulsion followed by repair via the use of transosseous tunnels with #2 high-strength sutures, 5.5-mm biocomposite fully threaded suture anchors with #2 high-strength sutures, or 4.75-mm biocomposite knotless suture anchors with suture tape. Ten knees were repaired via transosseous repair and 10 via fully threaded suture anchor repair, and their matched specimens were repaired with suture tape and knotless anchors. Biomechanical analysis included displacement during cyclic loading over 250 cycles, construct stiffness, ultimate load to failure, and failure mode analysis. Compared with transosseous repairs, quadriceps tendons repaired with knotless suture tape demonstrated significantly less displacement during cyclic loading (cycles 1-20 3.6 ± 1.3 vs 6.3 ± 1.9 mm, P = .003; cycles 20-250 2.0 ± 0.4 vs 3.1 ± 0.9 mm, P = .011), improved construct stiffness (67 ± 25 vs 26 ± 12 N/mm, P = .001), and greater ultimate load to failure (616 ± 149 vs 413 ± 107 N, P = .004). Our repair technique also demonstrated improved biomechanical parameters compared with fully threaded suture anchor repair in initial displacement during cyclic loading (cycles 1-20 3.0 ± 0.8 vs 5.1 ± 0.9 mm, P suture anchor with suture tape repair technique is biomechanically superior in cyclic displacement, construct stiffness, and ultimate load to failure compared with transosseous and fully threaded suture anchor techniques in cadaveric specimens. The demonstration that our repair technique is biomechanically superior to previously described techniques in a cadaveric setting suggests that consideration should be given to this technique. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  5. Method for mapping a natural gas leak

    Science.gov (United States)

    Reichardt, Thomas A [Livermore, CA; Luong, Amy Khai [Dublin, CA; Kulp, Thomas J [Livermore, CA; Devdas, Sanjay [Albany, CA

    2009-02-03

    A system is described that is suitable for use in determining the location of leaks of gases having a background concentration. The system is a point-wise backscatter absorption gas measurement system that measures absorption and distance to each point of an image. The absorption measurement provides an indication of the total amount of a gas of interest, and the distance provides an estimate of the background concentration of gas. The distance is measured from the time-of-flight of laser pulse that is generated along with the absorption measurement light. The measurements are formatted into an image of the presence of gas in excess of the background. Alternatively, an image of the scene is superimposed on the image of the gas to aid in locating leaks. By further modeling excess gas as a plume having a known concentration profile, the present system provides an estimate of the maximum concentration of the gas of interest.

  6. [Suture tip plasty using an endonasal approach].

    Science.gov (United States)

    Tasman, A-J; Palma, P

    2010-09-01

    Over the last two decades, the use of the external approach for primary and secondary rhinoplasties has become increasingly popular. This article illustrates the versatility of endonasal techniques for the correction of nasal tip deformities on the basis of four cases. The approach to the nasal tip and the chosen technique as used in 100 consecutive rhinoplasties were reviewed. For primary and revision tip plasty, endonasal approaches were used in 81% of cases. Preferred incisions were the infracartilaginous approach and the transfixion incision. Using these approaches, correction of the tip was achieved by using sutures to reposition and reshape the alar cartilages and the columella without grafts to the nasal tip in most cases. Nasal tip plasty via endonasal approaches using sutures is technically more challenging compared to the external approach with its superior exposure. This drawback is outweighed by less operating time and faster patient recovery. Contrary to the general trend, the authors believe that endonasal tip plasty techniques using sutures can obviate the external approach and grafts in many cases and should form an integral part of the rhino-surgeon's repertoire.

  7. Natural gas pipeline leaks across Washington, DC.

    Science.gov (United States)

    Jackson, Robert B; Down, Adrian; Phillips, Nathan G; Ackley, Robert C; Cook, Charles W; Plata, Desiree L; Zhao, Kaiguang

    2014-01-01

    Pipeline safety in the United States has increased in recent decades, but incidents involving natural gas pipelines still cause an average of 17 fatalities and $133 M in property damage annually. Natural gas leaks are also the largest anthropogenic source of the greenhouse gas methane (CH4) in the U.S. To reduce pipeline leakage and increase consumer safety, we deployed a Picarro G2301 Cavity Ring-Down Spectrometer in a car, mapping 5893 natural gas leaks (2.5 to 88.6 ppm CH4) across 1500 road miles of Washington, DC. The δ(13)C-isotopic signatures of the methane (-38.2‰ ± 3.9‰ s.d.) and ethane (-36.5 ± 1.1 s.d.) and the CH4:C2H6 ratios (25.5 ± 8.9 s.d.) closely matched the pipeline gas (-39.0‰ and -36.2‰ for methane and ethane; 19.0 for CH4/C2H6). Emissions from four street leaks ranged from 9200 to 38,200 L CH4 day(-1) each, comparable to natural gas used by 1.7 to 7.0 homes, respectively. At 19 tested locations, 12 potentially explosive (Grade 1) methane concentrations of 50,000 to 500,000 ppm were detected in manholes. Financial incentives and targeted programs among companies, public utility commissions, and scientists to reduce leaks and replace old cast-iron pipes will improve consumer safety and air quality, save money, and lower greenhouse gas emissions.

  8. An AEM survey of a leaking landfill

    OpenAIRE

    Beamish, D

    2005-01-01

    This study presents results obtained from a remarkably small-scale helicopter airborne electromagnetic (AEM) survey of a closed landfill. The landfill, occupying a former quarry, is situated among shallow, worked-out coal seams (pillar and stall workings) and was located over at least two mineshafts that occupied the quarry floor. The landfill was known to be leaking from an extensive borehole investigation that took place in the 1970’s, when the landfill was active. Redevelopment issues and ...

  9. Regular Versus Releasable Sutures in Surgery for Primary Congenital Glaucoma.

    Science.gov (United States)

    Bayoumi, Nader H

    2017-09-01

    To compare releasable and regular sutures in combined angle and filtering surgery for primary congenital glaucoma. A prospective study was conducted on 39 eyes (26 right eyes) of 39 children (20 boys; 19 girls) who had primary congenital glaucoma treated with combined trabeculotomy-trabeculectomy with mitomycin C and scleral flap closure with regular or releasable sutures. Follow-up was 24 months. Success rates (defined as an intraocular pressure [IOP] suture group (20 eyes) and 5.3 ± 2.8 months (range: 1 to 13 months; median: 5 months) in the releasable suture group (19 eyes). The initial glaucoma surgery was successful in 13 (65%) and 13 (68.4%) eyes in the regular suture and releasable suture groups, respectively. The mean IOP was 17.4 ± 7.3 and 16.0 ± 5.4 mm Hg (P = .84) preoperatively and 8.0 ± 9.7 and 5.8 ± 3.6 mm Hg (P = .40) at the end of follow-up in the regular suture and releasable suture groups, respectively. There was no statistically significant difference in the clinical parameters between the two groups. Complications included rhegmatogenous retinal detachment, cataract, and superior lens subluxation, with each complication developing in one eye. Releasable sutures were not more advantageous than regular sutures in combined trabeculotomy-trabeculectomy with mitomycin C surgery for primary congenital glaucoma. [J Pediatr Ophthalmol Strabismus. 2017;54(5):295-301.]. Copyright 2017, SLACK Incorporated.

  10. Probabilistic pipe fracture evaluations for leak-rate-detection applications

    Energy Technology Data Exchange (ETDEWEB)

    Rahman, S.; Ghadiali, N.; Paul, D.; Wilkowski, G. [Battelle, Columbus, OH (United States)

    1995-04-01

    Regulatory Guide 1.45, {open_quotes}Reactor Coolant Pressure Boundary Leakage Detection Systems,{close_quotes} was published by the U.S. Nuclear Regulatory Commission (NRC) in May 1973, and provides guidance on leak detection methods and system requirements for Light Water Reactors. Additionally, leak detection limits are specified in plant Technical Specifications and are different for Boiling Water Reactors (BWRs) and Pressurized Water Reactors (PWRs). These leak detection limits are also used in leak-before-break evaluations performed in accordance with Draft Standard Review Plan, Section 3.6.3, {open_quotes}Leak Before Break Evaluation Procedures{close_quotes} where a margin of 10 on the leak detection limit is used in determining the crack size considered in subsequent fracture analyses. This study was requested by the NRC to: (1) evaluate the conditional failure probability for BWR and PWR piping for pipes that were leaking at the allowable leak detection limit, and (2) evaluate the margin of 10 to determine if it was unnecessarily large. A probabilistic approach was undertaken to conduct fracture evaluations of circumferentially cracked pipes for leak-rate-detection applications. Sixteen nuclear piping systems in BWR and PWR plants were analyzed to evaluate conditional failure probability and effects of crack-morphology variability on the current margins used in leak rate detection for leak-before-break.

  11. Leak detection technologies for oil and gas pipelines; Tecnologias para deteccao e localizacao de vazamento em dutos de oleo e ou gas

    Energy Technology Data Exchange (ETDEWEB)

    Alonso, Julio R. [MTT Aselco Automacao Ltda., Sao Paulo, SP (Brazil)

    2005-07-01

    Two concepts are available for leak detection in oil and/or gas pipelines: On-line leak detection system and off-line leak detection technique. The off-line leak detection technique is, usually, portable and does net configure a 'system'. This technique includes hydro-test, acoustic emission of high frequency, tracer of chemical substances, ultrasonic flow meter (UT), thermographic infra-red mapping, electromagnetic offset registration, etc. Since most of those methods requests stop of the system or depend on direct and detailed inspection of the whole monitored piping they are limited to the off-line inspection. In the current days there are only two technologies applied to detect and locate leaks on-line: The acoustic Leak Detection System and the modeling of computerized simulation also called as RTM (Real Time Modeling), RTTM or Mass Balance. There are still other techniques in the market, as acoustic emission, pressure analysis (PPA) beyond other rough techniques, without good results. Even some of these techniques are working without success, they are still used to accomplish with government standards. (author)

  12. Insertion force in manual and robotic corneal suturing.

    Science.gov (United States)

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

    2012-03-01

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

  13. Suture With Resorbable Cones: Histology and Physico-Mechanical Features.

    Science.gov (United States)

    Consiglio, Fabio; Pizzamiglio, Roberto; Parodi, Pier Camillo; De Biasio, Fabrizio; Machin, Pier Nicola; Di Loreto, Carla; Gamboa, Mabel

    2016-03-01

    Silhouette Sutures (Kolster Methods, Inc., Corona, CA) exhibit different biological characteristics at various time points after their placement. The goals of this study were to understand the biological reactions of Silhouette Sutures in human tissues at different time intervals and to determine the index of resistance of the sutures in subcutaneous tissue. Histologic examination was performed on section soft tissue containing the sutures at 1 month, 3 months, 6 months, and 1 year after suture placement. The study comprised 8 patients, each of whom received 4 sutures in the lower abdomen under local anesthesia. The sutures were placed exactly 1 month, 3 months, 6 months, and 1 year before planned post-bariatric abdominal surgery. Dynamometric evaluation was performed on a never-used suture and on sutures removed from 1 year after placement. The scar process around the threads was also examined. A progressive increase in scar tissue around the sutures was observed. One year after placement, there was a reduction of 16.7% in yield and tensile strength and a reduction of 14.29% in elongation at break, relative to the never-used suture. By 1 year, the cones in polylactic and glycolic acids had been replaced by scar tissue. Fibrous tissue around the sutures increased progressively over time, and was most prominent at the level of the nodes. Cones were completely resorbed within 6 months. A reduction in the index of resistance of the suspension sutures occurred over 1 year. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

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

    Science.gov (United States)

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

    2016-05-01

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

  15. Effect of the number of suture throws on the biomechanical characteristics of the suture-tendon construct.

    Science.gov (United States)

    Hong, Chih-Kai; Lin, Cheng-Li; Chang, Chih-Hsun; Jou, I-Ming; Su, Wei-Ren

    2014-12-01

    We aimed to investigate the effect of the number of suture throws on biomechanical characteristics of the suture-tendon construct for 3 currently used suture configurations in this ex vivo biomechanical study. Three stitch configurations-the Krackow stitch, the locking SpeedWhip (LSW) stitch, and the modified finger trap (MFT) suture-were assessed with 3, 5, and 7 throws using porcine flexor profundus tendons randomly divided into 9 groups of 11 specimens. The Krackow stitch and MFT suture were completed with nonabsorbable No. 2 braided sutures, whereas the LSW stitch was completed with loops of nonabsorbable No. 2 braided sutures. Each tendon was pretensioned to 100 N for 3 cycles and then cyclically loaded to 200 N for 200 cycles. Finally, each tendon was loaded to failure. Percent elongation, load to failure, and mode of failure for each suture-tendon construct were measured. After being pretensioned, there were no significant differences in the elongation between different suture throws in the LSW and MFT suture groups (P = .38 and P = .34, respectively). The elongation of the Krackow 7-throw suture group was significantly greater than that of the 5-throw (P = .01) and 3-throw groups (P = .03). After cyclic loading, there was no significant difference in the elongation of each suture technique with respect to different suture throws. The elongation after 200 loading cycles of the MFT sutures was significantly less than that of the Krackow and LSW sutures for all throws. The load to failure and cross-sectional area (43.1 ± 4.6 mm(2); P = .398) were not significantly different across all groups. This ex vivo biomechanical study showed that there are no significant differences in elongation after cyclic loading and load to failure among the various suture throws for the 3 types of sutures investigated. CLINICAL  The 3-suture throw configuration may provide sufficient fixation of the tendon graft regarding biomechanical characteristics of elongation

  16. Diagonal tarsal suture technique sine marginal sutures for closure of full-thickness eyelid defects.

    Science.gov (United States)

    Willey, Andrea; Caesar, Richard H

    2013-01-01

    Precise apposition of the tarsal plates and meticulous alignment of the eyelid margins are essential to ensure a seamless repair and avoid notching of the eyelid margin. The authors present a simple and reliable technique that firmly apposes and precisely aligns the eyelid margin in the x, y, and z axes, obviating the need for marginal sutures. A retrospective audit of electronic medical records was performed for all patients who underwent reconstructive procedures that included the repair of a full-thickness defect in the eyelid margin using the diagonal suture technique from 2003 to 2012. Of the 652 surgeries performed in the past 9 years, 9 incidences of notching occurred, all of which were associated with infections. The diagonal tarsal suture technique is a simple and effective method for the repair of full-thickness defects with a high degree of patient satisfaction.

  17. Ex vivo biomechanical comparison of barbed suture and standard polypropylene suture for acute tendon laceration in a canine model.

    Science.gov (United States)

    Duffy, D J; Main, R P; Moore, G E; Breur, G J; Millard, R P

    2015-01-01

    Evaluate performance and resistance to gap formation of a non-absorbable, barbed, monofilament suture, in comparison with a non-absorbable, smooth, monofilament polypropylene suture, in two different suture patterns: three-loop pulley (3LP) and modified Bunnell-Mayer (BM). Seventy-two medium-sized cadaveric superficial digital flexor muscle tendon units. After manual transection and suture repair, individual specimens were placed in an electromechanical tensile testing machine and tested to monotonic failure using tensile ramp loading. Video data acquisition allowed evaluation of failure mode and quantification of gap formation. Incidence of gap formation between tendon ends was significantly greater in tenorrhaphies repaired with barbed suture compared to those repaired with smooth polypropylene. Use of a 3LP suture pattern caused significantly less gapping between tendon ends when compared to the BM pattern. Smooth polypropylene suture was consistently superior in load performance than a unidirectional barbed suture. The 3LP pattern was more resistant than a BM pattern at preventing gap formation. Smooth polypropylene should be recommended over barbed unidirectional suture for use in canine tendinous repair to provide increased resistance to gap formation. The 3LP is superior to the BM suture pattern, requiring significantly more force to cause tenorrhaphy gap formation and failure, which may translate to increased accrual of repair site strength and tendinous healing in clinical situations.

  18. Comparison of a new multifilament stainless steel suture with frequently used sutures for flexor tendon repair.

    Science.gov (United States)

    McDonald, Erik; Gordon, Joshua A; Buckley, Jenni M; Gordon, Leonard

    2011-06-01

    To investigate the mechanical properties of some common suture materials currently in use and compare them with a new multifilament stainless steel suture. We investigated the mechanical properties of 3-0 and 4-0 Fiberwire, 3-0 Supramid, 3-0 Ethibond, and a new 3-0 and 4-0 multifilament stainless steel suture. All suture material was tested in a knotted configuration and all but the Supramid was tested in an unknotted configuration. We measured the load, elongation at failure, and stiffness during both tests. The 4-0 multifilament stainless steel showed the least elongation, whereas the 3-0 multifilament stainless steel withstood the highest load of any material in both the knotted and unknotted tests. There was no difference in stiffness between the 3-0 and 4-0 multifilament stainless steel when untied; however, the 3-0 multifilament stainless steel was stiffer when tied. Soaking in a saline solution had no significant effect on the ultimate load, elongation at failure, or stiffness of any of the sutures. The 3-0 Fiberwire and 3-0 Ethibond required at least 5 throws to resist untying. Multifilament stainless steel exhibited promising mechanical advantages over the other sutures tested. More research is needed to determine how this material will affect the clinical outcomes of primary flexor tendon repair. With a secure attachment to the tendon, the multifilament stainless steel's lower elongation and better knot-holding ability may result in a higher force to produce a 2-mm gap and a higher ultimate tensile strength in a tendon repair. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  19. BMP9 induces osteogenesis and adipogenesis in the immortalized human cranial suture progenitors from the patent sutures of craniosynostosis patients.

    Science.gov (United States)

    Song, Dongzhe; Zhang, Fugui; Reid, Russell R; Ye, Jixing; Wei, Qiang; Liao, Junyi; Zou, Yulong; Fan, Jiaming; Ma, Chao; Hu, Xue; Qu, Xiangyang; Chen, Liqun; Li, Li; Yu, Yichun; Yu, Xinyi; Zhang, Zhicai; Zhao, Chen; Zeng, Zongyue; Zhang, Ruyi; Yan, Shujuan; Wu, Tingting; Wu, Xingye; Shu, Yi; Lei, Jiayan; Li, Yasha; Zhang, Wenwen; Wang, Jia; Lee, Michael J; Wolf, Jennifer Moriatis; Huang, Dingming; He, Tong-Chuan

    2017-11-01

    The cranial suture complex is a heterogeneous tissue consisting of osteogenic progenitor cells and mesenchymal stem cells (MSCs) from bone marrow and suture mesenchyme. The fusion of cranial sutures is a highly coordinated and tightly regulated process during development. Craniosynostosis is a congenital malformation caused by premature fusion of cranial sutures. While the progenitor cells derived from the cranial suture complex should prove valuable for studying the molecular mechanisms underlying suture development and pathogenic premature suture fusion, primary human cranial suture progenitors (SuPs) have limited life span and gradually lose osteoblastic ability over passages. To overcome technical challenges in maintaining sufficient and long-term culture of SuPs for suture biology studies, we establish and characterize the reversibly immortalized human cranial suture progenitors (iSuPs). Using a reversible immortalization system expressing SV40 T flanked with FRT sites, we demonstrate that primary human suture progenitor cells derived from the patent sutures of craniosynostosis patients can be efficiently immortalized. The iSuPs maintain long-term proliferative activity, express most of the consensus MSC markers and can differentiate into osteogenic and adipogenic lineages upon BMP9 stimulation in vitro and in vivo. The removal of SV40 T antigen by FLP recombinase results in a decrease in cell proliferation and an increase in the endogenous osteogenic and adipogenic capability in the iSuPs. Therefore, the iSuPs should be a valuable resource to study suture development, intramembranous ossification and the pathogenesis of craniosynostosis, as well as to explore cranial bone tissue engineering. © 2017 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

  20. 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.

  1. 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.)

  2. Viability and proliferation of pluripotential cells delivered to tendon repair sites using bioactive sutures--an in vitro study.

    Science.gov (United States)

    Yao, Jeffrey; Korotkova, Tatiana; Smith, R Lane

    2011-02-01

    We evaluated the fate of pluripotential stem cells adherent to a suture carrier after being passed through tendon tissue in vitro. FiberWire suture segments were coated with poly-L-lysine (PLL) and a 2 × 10(6) C3H10T1/2 (a mouse embryo pluripotential cell line) cell suspension. The sutures were incubated for 7 days, passed through two 1-cm segments of acellularized rabbit Achilles tendons and tied (horizontal mattress). The repairs were frozen and sectioned (6 μm). The sections were stained with 4',6-diamidino-2-phenylindole and a live/dead viability/cytotoxicity (calcein/ethidium homodimer) kit and examined with fluorescent microscopy to evaluate cell presence and viability. Alamar Blue was used in parallel to assess metabolic activity. PLL-coated sutures showed a 3-fold increase in fluorescence when compared with the phosphate-buffered saline-coated controls. At day 3, fluorescence was 2.2 times greater. At day 5, a 2-fold increase was found, and at day 8 there was no significant difference in values. Furthermore, after delivery of the cells into tendon, fluorescence readings for the samples (n = 19) showed 9450 compared with the positive control at 21,218. At 96 hours the mean was 27,609 compared with 34,850 for the positive control. The difference in fluorescence means at 48 hours and 96 hours were significant (p cells at the tendon repair site. Sutures seeded with pluripotential embryonic cells deliver cells to a tendon repair site. The cells deposited at the repair site survive the trauma of passage and remain metabolically active, as seen in staining and metabolic assay studies. Use of bioactive sutures leads to repopulation of the acellular zone surrounding sutures within the tendon. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  3. Strabismus Surgery Reoperation Rates With Adjustable and Conventional Sutures.

    Science.gov (United States)

    Leffler, Christopher T; Vaziri, Kamyar; Cavuoto, Kara M; McKeown, Craig A; Schwartz, Stephen G; Kishor, Krishna S; Pariyadath, Allison

    2015-08-01

    To determine the association of strabismus surgery reoperation rates with adjustable or conventional sutures. Retrospective cross-sectional study. setting: Review of a large national private insurance database. Adults aged 18-89 having strabismus surgery between 2007 and 2011. Adjustable vs conventional suture strabismus surgery. Reoperation rate in the first postoperative year. Overall, 526 of 6178 surgical patients had a reoperation (8.5%). Reoperations were performed after 8.1% of adjustable suture surgeries and after 8.6% of conventional suture surgeries (P = .57). Of the 4357 horizontal muscle surgeries, reoperations were performed after 5.8% of adjustable suture surgeries, and after 7.8% of conventional suture surgeries (P = .02). Of the 1072 vertical muscle surgeries, reoperations were performed after 15.2% of adjustable suture surgeries and after 10.4% of conventional suture surgeries (P = .05). Younger age (18-39 years) was associated with a lower reoperation rate (P ≤ .02). The significant multivariable predictors of reoperation for horizontal surgery were adjustable sutures (odds ratio [OR] 0.69, 95% confidence interval 0.52-0.91), monocular deviation (OR 0.64), complex surgery (OR 1.63), and unilateral surgery on 2 horizontal muscles (OR 0.70, all P ≤ .01). Adjustable sutures were not significantly associated with reoperation rates after vertical muscle surgery (multivariable OR 1.45, P = .07). Adjustable sutures were associated with significantly fewer reoperations for horizontal muscle surgery. Adjustable sutures tended to be associated with more reoperations for vertical muscle surgery, but this observation was not statistically significant in the primary analysis after controlling for age. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Understanding the logic of common suturing techniques in dermatologic surgery

    OpenAIRE

    Yazdani Abyaneh, Mohammad-Ali; Levitt, Jacob O

    2015-01-01

    Although most trainees in dermatology learn that different suturing techniques are designated for a specific purpose (i.e., certain functional and cosmetic outcomes), students often have a difficult time visualizing how a given suture functions in its designated capacity. In this article, we address the logic behind the most common suturing techniques in dermatologic surgery, including the direction and magnitude of their pulling force with respect to the wound edges and the ensuing displacem...

  5. New "loop" suture for FDP zone I injuries.

    Science.gov (United States)

    Kapickis, Martins

    2009-09-01

    There are many methods describing distal juncture fixation techniques of the injured flexor digitorum profundus (FDP) or flexor tendon graft. We have noted a tendency in the surgical repair of tissues toward the more expensive and technology-dependent methods. New suture type was developed to find better FDP distal juncture suture not indulging into expensive technology-dependent techniques. The positive aspect of the most popular Bunnell pullout technique is eventual removal of the suture. The negative aspect is necessity to use tie over button to secure the end of the tendon in the bone canal and thus externalizing suture. This can be complicated with maceration, decubitus, and infection. In addition, any device secured to the finger nail can be caught by external objects. We propose buttonless method of the tendon-to-bone fixation. The only negative aspect is retaining suture. Suture is easy to perform and cheaper than any of the anchor sutures. Twelve patients were included in this preliminary study. Seven patients had acute FDP tendon zone I bone juncture injuries. Five patients had second stage flexor tendon reconstruction with tendon grafts. No infections, ruptures of the FDP or nail growth disturbances were noted. Three patients presented with slight DIP joint flexion contracture. One patient had "mallet" deformity. Our tendon-to-bone fixation is easy to perform. It is as cheap as standard Bunnell fixation and excludes complications encountered in standard pullout sutures. Although bone suture anchors with modified Becker core suture are superior in tensile strength to 2-stranded sutures, many hand surgeons are limited by the price of the bone anchors and can find our suture more affordable.

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

    Science.gov (United States)

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

    1986-03-01

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

  7. LEAK: A source term generator for evaluating release rates from leaking vessels

    Energy Technology Data Exchange (ETDEWEB)

    Clinton, J.H.

    1994-09-01

    An interactive computer code for estimating the rate of release of any one of several materials from a leaking tank or broken pipe leading from a tank is presented. It is generally assumed that the material in the tank is liquid. Materials included in the data base are acetonitrile, ammonia, carbon tetrachloride, chlorine, chlorine trifluoride, fluorine, hydrogen fluoride, nitric acid, nitrogen tetroxide, sodium hydroxide, sulfur hexafluoride, sulfuric acid, and uranium hexafluoride. Materials that exist only as liquid and/or vapor over expected ranges of temperature and pressure can easily be added to the data base file. The Fortran source code for LEAK and the data file are included with this report.

  8. 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.

  9. Visual measurement of suture strain for robotic surgery.

    Science.gov (United States)

    Martell, John; Elmer, Thomas; Gopalsami, Nachappa; Park, Young Soo

    2011-01-01

    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.

  10. Clinical Applications of Barbed Suture in Aesthetic Breast Surgery.

    Science.gov (United States)

    Mitchell, Ryan T M; Bengtson, Bradley P

    2015-10-01

    The breadth of literature regarding barbed suture applications in plastic surgical procedures and of importance to this article, barbed suture applications in breast surgery, is growing dramatically as surgical practitioners are becoming more familiar with the advantages of this new suture technology. Barbed suture devices were first implemented by plastic surgeons for the use in various minimally invasive techniques for facial rejuvenation, but have now surpassed these applications and are now much more commonly used in Breast and Body closures. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Comparison of Barbed Sutures in Porcine Flexor Tenorrhaphy

    OpenAIRE

    Sull, Alan; Inceoglu, Serkan; August, Alicia; Gregorius, Stephen; Wongworawat, Montri D.

    2016-01-01

    Background: Barbed suture use has become more popular as technology and materials have advanced. Minimal data exist regarding performance of the 2 commercially available products, V-LocTM and StratafixTM in tendon repairs. The purpose of this study was to compare gap resistance and ultimate tensile strength of both suture materials and nonbarbed suture in a porcine ex vivo model. Methods: Porcine flexor tendons were harvested and divided into 3 groups of 10 of varying suture material (3-0 PDS...

  12. Cyclic loading comparison of Bio-SutureTak-#2 FiberWire and Bio Mini-Revo-#2 Hi-Fi suture anchor-sutures in cadaveric scapulae.

    Science.gov (United States)

    Sparks, Brad S; Nyland, John; Nawab, Akbar; Blackburn, Ethan; Krupp, Ryan; Burden, Robert

    2008-03-01

    This study compared tap-in Bio-SutureTak suture anchor-#2 FiberWire suture (Group 1) and screw-in Bio Mini-Revo suture anchor-#2 Hi-Fi suture (Group 2) fixation in the glenoid region of interest for Bankart repair, in addition to evaluation of isolated suture loop biomechanical properties under progressive incremental cyclic loads. With knowledge of glenoid apparent bone mineral density (BMD), implant preparation and fit characteristics, and following application of a light manual tensile load, the primary investigator scored each specimen for perceived within group biomechanical test performance using a 0-10 point modified visual analog scale. After scoring, 12 paired constructs were placed in a servo hydraulic device clamp, preloaded to 25 N, and cycled between 25 and 50 Hz with a 25 N load increase every 25 cycles. Group 2 withstood greater load (104.1 +/- 56 vs. 70 +/- 36.9 N, P = 0.04) and displaced more at failure (13 +/- 4.5 vs. 8.6 +/- 3.3 mm, P = 0.04). All Group 1 specimens failed prior to reaching 150 N, whereas 25% of Group 2 specimens (n = 3) failed at 200 N. All specimens failed by anchor pullout except for three Group 2 specimens that failed by eyelet breakage at 200 N. Isolated suture testing revealed that Group 1 sutures displaced less at each cyclic load (P = 0.028) and withstood greater failure loads (P = 0.028) than that of Group 2 sutures. Group 2 constructs displayed moderately strong relationships between perceived within group biomechanical test performance and ultimate load (r (2) = 0.55) and displacement at failure (r (2) = 0.67). Group 1 did not display significant relationships. Similar biomechanical performance between 50 and 125 N, greater load at failure, and superior biomechanical test prediction accuracy suggest that the screw-in type Bio Mini-Revo suture anchor-#2 Hi-Fi suture combination may be preferred for Bankart lesion repair in low apparent BMD glenoid processes. The #2 Hi-Fi suture, however, allowed significantly greater

  13. The Hand-sewn Anastomosis with an Absorbable Bidirectional Monofilament Barbed Suture Stratafix® During Laparoscopic One Anastomosis Loop Gastric Bypass. Retrospective Study in 50 Patients.

    Science.gov (United States)

    Blanc, Pierre; Lointier, Patrice; Breton, Christophe; Debs, Tarek; Kassir, Radwan

    2015-12-01

    Laparoscopic One Anastomosis Gastric Bypass (LOAGB) is one of the main bariatric procedures that require a safe and reproducible gastrojejunal anastomosis. Barbed suture has been widely used for surgery in recent years; however, few studies have reported their use for gastro-intestinal anastomosis. We proposed their use for totally hand-sewn anastomosis during LOAGB. The objective of this study is to evaluate the risk of leaks and stenosis after a hand-sewn anastomosis using an absorbable bidirectional monofilament barbed suture: Stratafix®. The study was done in a private practice setting. Between April and November 2014, 50 consecutive patients undergoing a hand-sewn antecolic, antegastric gastrojejunal anastomosis (GJA) using Stratafix®. Pre, intra, and postoperative parameters were assessed for these patients. No fistulas or anastomotic stenosis had occurred up to 6 months after surgery. All procedures were completed laparoscopically, and no intraoperative complications occurred. The mean length of hospital stay was 3 days. The use of an absorbable bidirectional monofilament barbed suture for the GJA was safe. Further prospective studies with a higher number of patients are needed to address the safety and efficacy of the absorbable bidirectional monofilament barbed suture in bariatric surgery.

  14. Oesophageal elongation with traction sutures (FOKER procedure in a newborn baby with long-gap oesophageal atresia (LGEA: Maybe too early, maybe too dangerous?

    Directory of Open Access Journals (Sweden)

    Holger Till

    2013-01-01

    Full Text Available In children with long gap oesophageal atresia (LGEA, the FOKER technique (oesophageal elongation with traction sutures has been criticized for its high complication rate. We advocate analysing such problems to increase the safety in the future. The present case report will focus on timing. A female newborn (3000 g with LGEA (gap of 5 cm was delivered in an outward hospital. On day two of life, she received traction sutures on both pouches. By day five, all sutures had torn out, and a primary anastomosis was attempted. However, it leaked severely. Thus, on day ten, the oesophagus was approached from the neck converting the proximal end into a spit fistula and closing the distal end blindly. Furthermore, the gastro-oesophageal (GE- junction was wrapped with a Teflon sling. When the baby arrived in our institution, she suffered from cavernous oesophageal masses extending from the thoracic inlet down to the diaphragm and fistulas draining them into the neck as well as into the right lung. Moreover, the Teflon sling had dislodged allowing for GE-reflux. In several stages, the oesophageal remnants were resected without any complications. Finally, Prof. Alaa Hamza performed a colonic interposition, which is working well today. In conclusion, the present case aims to caution paediatric surgeons to apply traction sutures for oesophageal elongation in newborns with LGEA.

  15. Suture-Only Repair Versus Suture Anchor–Augmented Repair for Achilles Tendon Ruptures With a Short Distal Stump

    Science.gov (United States)

    Boin, Michael A.; Dorweiler, Matthew A.; McMellen, Christopher J.; Gould, Gregory C.; Laughlin, Richard T.

    2017-01-01

    Background: Chronic noninsertional Achilles tendinosis can result in an acute Achilles tendon rupture with a short distal stump. In such tendon ruptures, there is a limited amount of adequate tissue that can hold suture, thus presenting a challenge for surgeons who elect to treat the rupture operatively. Hypothesis: Adding suture anchors to the repair construct may result in biomechanically stronger repairs compared with a suture-only technique. Study Design: Controlled laboratory study. Methods: Nine paired Achilles-calcaneus complexes were harvested from cadavers. An artificial Achilles rupture was created 2 cm proximal to the insertion on the calcaneus. One specimen from each cadaver was assigned to a suture-only or a suture anchor–augmented repair. The contralateral specimen of the same cadaver received the opposing repair. Cyclic testing was then performed at 10 to 100 N for 2000 cycles, and load-to-failure testing was performed at 0.2 mm/s. This was followed by analysis of repair displacement, gapping at repair site, peak load to failure, and failure mode. Results: The suture anchor–augmented repair exhibited a 116% lower displacement compared with the suture-only repair (mean ± SD, 1.54 ± 1.13 vs 3.33 ± 1.47 mm, respectively; P suture anchor–augmented repair also exhibited a 45% greater load to failure compared with the suture-only repair (303.50 ± 102.81 vs 209.09 ± 48.12 N, respectively; P Suture anchor–augmented repairs performed on acute Achilles tendon ruptures with a short distal stump are biomechanically stronger than suture-only repairs. Clinical Relevance: Our results support the use of suture anchor–augmented repairs for a biomechanically stronger construct in Achilles tendon ruptures with a short distal stump. Biomechanically stronger repairs may lead to less tendon repair gapping and failure, increasing the ability to start early active rehabilitation protocols and thus improving patient outcomes. PMID:28203592

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

    OpenAIRE

    Sei Haga; Shinji Nagata

    2014-01-01

    Background: When microvascular anastomosis is performed in a deep, narrow operating field, securing space to throw knots is difficult. To simplify the procedure and avoid obstruction of the anastomosis, we use a continuous suturing with short-thread double-armed micro-suture. Methods: Sixty-four patients (38 cerebral revasculazation, 16 moyamoya disease, and 10 aneurysm surgery) undergoing microvaucular anastomosis were included. During anastomosis, a continuous suture was placed with sho...

  17. atraumatic intracutaneous skin closure with self-made fishing line ...

    African Journals Online (AJOL)

    hi-tech

    MADE FISHING LINE SUTURE COMPARED TO COMMERCIAL THREAD. S. Freudenberg .... software). RESULTS. Observation of the surgeons: The time needed from the first stitch to the last exit of the needle ranged from. 120 sec to 360 sec.

  18. Arthroscopic suture anchor capsulorrhaphy versus labral-based suture capsulorrhaphy in a cadaveric model.

    Science.gov (United States)

    Gillis, Robert C; Donaldson, Christopher T; Kim, Hyunchul; Love, James M; Dreese, James C

    2012-11-01

    The purpose of this study was to establish whether suture anchor capsulorrhaphy (SAC) is biomechanically superior to suture capsulorrhaphy (SC) in the management of recurrent anterior shoulder instability without a labral avulsion. Twelve matched pairs of shoulders were randomized to either SC or SAC. Specimens were mounted in 60° of abduction and 90° of external rotation. Testing was conducted on an MTS servohydraulic load testing device (MTS, Eden Prairie, MN). A compressive load of 22 N was applied, followed by a 2-N anterior and posterior force to establish a 0 point. Translation with 10-N anterior and posterior loads was recorded for baseline laxity measurement. Arthroscopic capsulorrhaphy was performed with either 3 solitary sutures or 3 suture anchors. Specimens were remounted and returned to the 0 point. Translation was measured with 10-N anterior and posterior loads to determine reduction in translation. Specimens were then loaded to failure to the 0 point at a rate of 0.1 mm/s. Load to failure was significantly greater (P = .02) in the SC group (13.6 ± 1.0 N) versus the SAC group (20.5 ± 2.8 N). No differences were found between SC (2.7 ± 0.7 mm) and SAC (2.3 ± 0.6 mm) when we compared reduction of anterior translation with a 10-N load. The percent reduction of anterior displacement with a 10-N load was similar for the SC (49.9%) and SAC (49.6%) groups. The dominant mode of failure in the study was suture pull-through of the capsular tissue. Our study indicates that labral-based SC and SAC similarly reduce anterior glenohumeral translation at low loading conditions. Load-to-failure studies indicate that SAC exhibits significantly greater resistance to translation at higher loading conditions. Our study suggests that the use of a suture anchor when one is performing a capsulorrhaphy may provide biomechanical advantage at high loading conditions. Our study suggests that when one is performing capsulorrhaphy, the use of a suture anchor may provide

  19. Leak Detection of High Pressure Feedwater Heater Using Empirical Models

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Song Kyu; Kim, Eun Kee [Korea Power Engineering Company, Daejeon (Korea, Republic of); Heo, Gyun Young [Kyung Hee University, Yongin (Korea, Republic of); An, Sang Ha [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

    2009-10-15

    Even small leak from tube side or pass partition within the high pressure feedwater heater (HPFWH) causes a significant deficiency in its performance. Plant operation under the HPFWH leak condition for long time will result in cost increase. Tube side leak within HPFWH can produce the high velocity jet of water and it can cause neighboring tube failures. However, most of plants are being operated without any information for internal leaks of HPFWH, even though it is prone to be damaged under high temperature and high pressure operating conditions. Leaks from tubes and/or pass partition of HPFWH occurred in many nuclear power plants, for example, Mihama PS-2, Takahama PS-2 and Point Beach Nuclear Plant Unit 1. If the internal leaks of HPFWH are monitored, the cost can be reduced by inexpensive repairs relative to loss in performance and moreover plant shutdown as well as further tube damages can be prevented.

  20. A Hydrogen Leak Detection System for Aerospace and Commercial Applications

    Science.gov (United States)

    Hunter, Gary W.; Makel, D. B.; Jansa, E. D.; Patterson, G.; Cova, P. J.; Liu, C. C.; Wu, Q. H.; Powers, W. T.

    1995-01-01

    Leaks on the space shuttle while on the launch pad have generated interest in hydrogen leak monitoring technology. Microfabricated hydrogen sensors are being fabricated at Case Western Reserve University (CWRU) and tested at NASA Lewis Research Center (LeRC). These sensors have been integrated into hardware and software designed by Aerojet. This complete system allows for multipoint leak monitoring designed to provide leak source and magnitude information in real time. The monitoring system processes data from the hydrogen sensors and presents the operator with a visual indication of the leak location and magnitude. Although the leak monitoring system was designed for hydrogen propulsion systems, the possible applications of this monitoring system are wide ranged. This system is in operation in an automotive application which requires high sensitivity to hydrogen.

  1. Dog detectives : sniffer dogs proving indispensable in finding pipeline leaks

    Energy Technology Data Exchange (ETDEWEB)

    Lorenz, A.

    2004-09-06

    This article reports on the use of dogs to detect leaks in gas pipelines. A project was undertaken by Benoit Oilfield Construction in which dogs were trained to smell mercaptans, the odourant used by pipeline companies for safety and leak detection in natural gas. In the event of a leak, the odourant is released and migrates directly to the soil surface where it can be detected by the dogs. A leak can shut down several wells at once and can result in fines for regulatory non-compliance. If the cost of repair and cleanup is added, leaks can have a major negative financial effect on operations. The pinpointing ability of the dogs is good enough to determine if there is one large leak or several smaller ones. This helps determine if the problem resulted from a manufacturing defect or a bad welder, and thus determine who should pay the associated costs. A trained dog is worth about $11,000. 3 figs.

  2. Blends of Thermoplastic Polyurethane and Polydimethylsiloxane Rubber: Assessment of Biocompatibility and Suture Holding Strength of Membranes

    Directory of Open Access Journals (Sweden)

    Krishna Prasad Rajan

    2013-01-01

    Full Text Available In the present investigation, a compatibilized blend of thermoplastic polyurethane (TPU and polydimethylsiloxane (PDMS is prepared by using copolymer of ethylene and methyl acrylate (EMA as a reactive compatibilizer. Detailed in vitro biocompatibility studies were carried out for this compatibilized blend and the material was found noncytotoxic towards L929 mouse fibroblast subcutaneous connective tissue cell line. Microporosity was created on the surface of membranes prepared from the blend material by adopting the crazing mechanism. Cell proliferation and growth studies on the membranes surface showed that the microporous surface favoured ingrowth of the cells compared with a nonmicroporous surface. Suture holding strength studies indicate that the microporous membranes have enough strength to withstand the cutting and tearing forces through the suture hole. This blend material could be evaluated further to find its suitability in various implant applications.

  3. Double row of overlapping sutures for downsizing annuloplasty decreases the risk of residual regurgitation in ischaemic mitral valve repair.

    Science.gov (United States)

    Nappi, Francesco; Spadaccio, Cristiano; Chello, Massimo; Lusini, Mario; Acar, Christophe

    2016-04-01

    The aim of this study was to evaluate a novel insertion technique of the prosthetic ring that would further magnify the degree of annulus narrowing, thereby reducing the potential for a residual leak in ischaemic mitral valve repair. Thirty-six patients with ischaemic mitral regurgitation (MR) were randomly assigned into two groups. In 18 patients, the prosthetic ring was inserted in the conventional manner with a single row of sutures (control group). In the remaining 18 patients, the ring was attached using a double row of sutures tied both on the inner and on the outer part of the sewing cuff. Both groups had similar preoperative clinical and echocardiographic characteristics with severe leaflet tethering: mean tenting area >2.5 cm(2), mean anterior leaflet angle >25° and posterior leaflet angle >45°. The mean prosthetic ring sizes inserted in both groups were identical (mean: 27.3 mm). At 12 months, there was no clinical event except for 1 rehospitalization in the control group. The mean mitral regurgitation grade was higher in the control group than in the group with the double row of sutures at 1.6 ± 0.9 vs 0.7 ± 0.3 (P = 0.0003). Annulus diameter reduction was less pronounced in the control group when compared with the group with the double row of sutures, both in the parasternal long-axis: 29.3 ± 3 vs 26.3 ± 3 mm (P = 0.0003) and in apical four-chamber views: 31 ± 3 vs 28 ± 2 mm (P = 0.003). Leaflet tethering indices were greater in the control group than in the group with the double row of sutures: tenting area: 1.42 ± 0.3 vs 1.1 ± 0.5 cm(2) (P = 0.002), anterior leaflet angle: 33 ± 3° vs 28 ± 5° (P = 0.0009) and posterior leaflet angle: 110 ± 13° vs 80 ± 11° (P = 0.0001). Left ventricular function parameters were not statistically different among the two groups. A double row of overlapping sutures for attaching the prosthetic ring in downsizing annuloplasty is more efficient in narrowing the mitral annulus than the conventional technique

  4. New suture materials for midline laparotomy closure: an experimental study

    Science.gov (United States)

    2014-01-01

    Background Midline laparotomy closure carries a significant risk of incisional hernia. This study examines the behavior of two new suture materials, an elastic material, polyurethane (PUe), and a barbed polydioxanone (PDXb) suture thread in a rabbit model of midline incision closure. Methods Three 2-cm midline incisions were made in 68 New Zealand White rabbits. The incisions were closed by running suture using four 3/0 threads: polypropylene (PP) (Surgipro®, Covidien), PUe (Assuplus®, Assut Europe), PDX (Assufil®, Assut Europe) or PDXb (Filbloc®, Assut Europe). Animals in each suture group were euthanized 3 weeks and 6 months after surgery. Histological sections of the tissue-embedded sutures were subjected to morphological, collagen expression, macrophage response and uniaxial tensiometry studies. Results No signs of wound dehiscence or complications were observed. At 3 weeks, all sutures were surrounded by connective tissue composed mainly of collagen III. PUe showed greater collagen I expression than the other sutures. All sutures elicited a macrophage response that diminished from 3 weeks to 6 months (p sutures (PP and PUe) yet PDXb showed a significantly greater response than the other reabsorbable suture (PDX) at 3 weeks (p  0.05). Conclusion Three weeks after surgery, PUe revealed more collagen I deposition than the remaining materials and this translated to a similar biomechanical behavior to linea alba, that could avoid the appearance of short term dehiscences and thus reduce the incidence of incisional hernia. PDXb provides no additional advantages in their behavior regarding PDX suture. PMID:25231161

  5. Proceedings of the first international summit on intestinal anastomotic leak, Chicago, Illinois, October 4-5, 2012

    NARCIS (Netherlands)

    Shogan, B.D.; An, G.C.; Schardey, H.M.; Matthews, J.B.; Umanskiy, K.; Fleshman, J.W.; Hoeppner, J.; Fry, D.E.; Garcia-Granereo, E.; Jeekel, H.; Goor, H. van; Dellinger, E.P.; Konda, V.; Gilbert, J.A.; Auner, G.W.; Alverdy, J.C.

    2014-01-01

    OBJECTIVE: The first international summit on anastomotic leak was held in Chicago in October, 2012 to assess current knowledge in the field and develop novel lines of inquiry. The following report is a summary of the proceedings with commentaries and future prospects for clinical trials and

  6. Margins in high temperature leak-before-break assessments

    Energy Technology Data Exchange (ETDEWEB)

    Budden, P.J.; Hooton, D.G.

    1997-04-01

    Developments in the defect assessment procedure R6 to include high-temperature mechanisms in Leak-before-Break arguments are described. In particular, the effect of creep on the time available to detect a leak and on the crack opening area, and hence leak rate, is discussed. The competing influence of these two effects is emphasized by an example. The application to Leak-before-Break of the time-dependent failure assessment diagram approach for high temperature defect assessment is then outlined. The approach is shown to be of use in assessing the erosion of margins by creep.

  7. Surgical device for supporting corneal suturing

    Science.gov (United States)

    Ventura, Liliane; Oliveira, Gunter C. D.; De Groote, Jean-Jacques; Sousa, Sidney J. F.; Saia, Paula

    2009-02-01

    A system for ophthalmic surgery support has been developed in order to minimize the residual astigmatism due to the induced irregular shape of the cornea by corneal suture. The system projects 36 light spots, from LEDs, displayed in a precise circle at the lachrymal film of the examined cornea. The displacement, the size and deformation of the reflected image of these light spots are analyzed providing the keratometry and the circularity of the suture. Measurements in the range of 32D - 55D (up to 23D of astigmatism are possible to be obtained) and a self-calibration system has been designed in order to keep the system calibrated. Steel precision spheres have been submitted to the system and the results show 99% of correlation with the fabricant's nominal values. The system has been tested in 13 persons in order to evaluate its clinical applicability and has been compared to a commercial keratometer Topcon OM-4. The correlation factors are 0,92 for the astigmatism and 0.99 for the associated axis. The system indicates that the surgeon should achieve circularity >=98% in order to do not induce astigmatisms over 3D.

  8. Biomechanical comparison of tibial eminence fracture fixation with high-strength suture, EndoButton, and suture anchor.

    Science.gov (United States)

    Hapa, Onur; Barber, F Alan; Süner, Ganim; Özden, Raif; Davul, Serkan; Bozdağ, Ergun; Sünbüloğlu, Emin

    2012-05-01

    To biomechanically compare anterior cruciate ligament (ACL) tibial bony avulsion fixation by suture anchors, EndoButtons (Smith & Nephew, Andover, MA), and high-strength sutures subjected to cyclic loading. Type III tibial eminence fractures were created in 49 ovine knees, and 7 different types of repairs were performed. Each repair group contained 7 specimens. The repair groups were as follows: No. 2 FiberWire (Arthrex, Naples, FL); No. 2 UltraBraid (Smith & Nephew); No. 2 MaxBraid (Arthrotek, Warsaw, IN); No. 2 Hi-Fi (ConMed Linvatec, Largo, FL); No. 2 OrthoCord (DePuy Mitek, Raynham, MA); Ti-Screw suture anchor (Arthrotek); and titanium EndoButton. These constructs were cyclically loaded (500 cycles, 0 to 100 N, 1 Hz) in the direction of the native ACL and loaded to failure (100 mm/min). Endpoints included ultimate failure load (in Newtons); pullout stiffness (in Newtons per millimeter); cyclic displacement (in millimeters) after 100 cycles, between 100 and 500 cycles, and after 500 cycles; and mode of failure. Bone density testing was performed in all knees. Bone density was not different among the groups. The EndoButton group had a higher ultimate failure load than the FiberWire, UltraBraid, Hi-Fi, and suture anchor groups (P suture anchor group (P suture anchor group had less displacement than the Hi-Fi and FiberWire groups (P suture rupture. Under cyclic loading conditions in an ovine model, EndoButton fixation of tibial eminence fractures provided greater initial fixation strength than suture anchor fixation or fixation with various high-strength sutures except for OrthoCord. During initial cyclic loading of ACL tibial eminence fractures, the strength of the repair construct should be taken into consideration because conventional suture repair even with ultrahigh-molecular-weight polyethylene sutures may not provide enough strength. Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  9. RESEARCH A randomised controlled trial of suture materials used ...

    African Journals Online (AJOL)

    A variety of suture materials and skin staples (SS) are used for skin closure after caesarean section (CS). Some of these suture materials have been associated with lower wound infection rates, reduced pain, improved cosmetic outcomes and cost-effectiveness.1 On the other hand, SS are easier to use and are associated ...

  10. Effect of nylon suture diameter on induced astigmatism after phacoemulsification.

    Science.gov (United States)

    Mendívil, A

    1997-10-01

    To prospectively compare the clinical results of 10-0 and 9-0 monofilament nylon sutures after phacoemulsification with poly(methyl methacrylate) intraocular lens implantation through a 4.0 mm cruciate incision. Department of Ophthalmology, Ramón y Cajal Hospital, Madrid, Spain. One hundred eyes with cataract were randomly assigned to have surgery using a 10-0 or a 9-0 nylon suture. Except for suture diameter, identical surgical methods were used in every case. Data on uncorrected visual acuity, keratometry and postoperative astigmatism were analyzed up to 12 months after surgery. Both groups had similar uncorrected visual acuity. Mean postoperative corneal astigmatism was against the rule in the 10-0 nylon suture group and with the rule in the 9-0 nylon suture group. Significant differences were found between groups (P suture diameters offered satisfactory clinical results. Patients with preoperative with-the-rule astigmatism might benefit from 10-0 nylon sutures and those with preoperative against-the-rule astigmatism, from 9-0 nylon sutures.

  11. 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.

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

    Science.gov (United States)

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

    2015-02-01

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

  13. Suture granuloma after orchiectomy: sonography, doppler and elastography features

    Directory of Open Access Journals (Sweden)

    Mustafa Secil

    2015-08-01

    Full Text Available ABSTRACTSuture granuloma is a mass forming benign lesion that develops at the site of surgery as a foreign body reaction to non-absorbable suture material. We present a case of suture granuloma that developed at the inguinal region after orchiectomy, and define the sonography, color Doppler sonography and real-time ultrasound elastography findings in correlation with the histopathological findings.

  14. Nose tip refinement using interdomal suture in caucasian nose

    Directory of Open Access Journals (Sweden)

    Pasinato, Rogério

    2012-01-01

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

  15. Punctal occlusion with Prolene suture material in the patients with ...

    African Journals Online (AJOL)

    Aim: To analyze the efficacy and outcomes of punctal occlusion with 5-0 Prolene suture material for the treatment of dry eye. Materials and. Methods: A total of 20 patients with moderate and severe dry eyes, recalcitrant to maximal medical therapy, underwent temporary punctal occlusion with 5-0 Prolene suture material.

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

    African Journals Online (AJOL)

    We describe a case of corneal abscess presenting three years after uneventful cataract extraction with posterior chamber lens implantation through a limbal incision secured with threesutures placed in the clear cornea. After removing the abscess, a loose10/0 nylon suture was found at the base of an ulcer. The suture was ...

  17. Astigmatism induced by intrastromal corneal suture after small incision phacoemulsification.

    Science.gov (United States)

    Chipont-Benabent, E; Artola Roig, A; Pérez-Santonja, J J; Guisbert Medel, M; Alió Sanz, J L

    1998-04-01

    To evaluate the course of astigmatic evolution and complications after clear corneal incisions using an intrastromal corneal suture. Instituto Oftalmologico de Alicante, University of Alicante, Spain. Eighty eyes of 62 patients had endocapsular phacoemulsification. A foldable intraocular lens was implanted through a 4.0 mm clear corneal incision. A 10-0 nylon intrastromal corneal suture was used in all eyes. Change sin corneal astigmatism were calculated by vector analysis; follow-up was 6 months. Early and late suture-related complications were also evaluated. Mean induced cylinder was 1.25 diopters (D) +/- 1.24 (SD) with the wound 1 day postoperatively and 0.19 +/- 0.81 D against the wound at 6 months. There were no incision- or suture-related complications postoperatively. Use of the intrastromal corneal suture led to astigmatically neutral closure of multiplanar corneal incisions.

  18. A new mathematical model for pattern formation by cranial sutures.

    Science.gov (United States)

    Yoshimura, Kenji; Kobayashi, Ryo; Ohmura, Tomohisa; Kajimoto, Yoshinaga; Miura, Takashi

    2016-11-07

    Cranial sutures are narrow mesenchymal tissues that connect skull bones to each other. Given that they serve as growth centers in the skull, these undifferentiated tissues play crucial roles in skull development. Cranial sutures are also of clinical importance, because the premature fusion of skull bones results in a pathological condition called craniosynostosis. In newborns, skull sutures are wide and straight; during adolescence, they become thinner and start winding to form an interdigitating pattern. From a functional aspect, as the degree of interdigitation becomes larger, the strength of the connection between bones increases. However, the mechanisms underlying the maintenance of mesenchymal narrow bands or formation of interdigitation remain poorly understood. In the present study, we presented a new mathematical model that can reproduce the suture width maintenance and interdigitation formation. We can predict the width of the mesenchyme bands and wavelengths of suture interdigitations from the model. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Signaling mechanisms implicated in cranial sutures pathophysiology: Craniosynostosis

    Directory of Open Access Journals (Sweden)

    Maria A. Katsianou

    2016-12-01

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

  20. A new uterine compression suture for postpartum haemorrhage with atony.

    Science.gov (United States)

    Zheng, J; Xiong, X; Ma, Q; Zhang, X; Li, M

    2011-02-01

    Postpartum haemorrhage (PPH) is a major cause of worldwide maternal mortality and is still associated with significant morbidity. After the B-Lynch suture was reported in 1997, several different uterine compression sutures were found to be successful in controlling PPH. In this paper, we describe another simple variation of the uterine compression suture technique, which was performed without an incision in the uterine wall, without entering the uterine cavity and without suturing the anterior and posterior walls of the uterus together, so minimising the trauma to the uterus. This new uterine compression suture is an effective and safe surgical treatment for PPH caused by atony. It has the potential to apply to intractable PPH after vaginal delivery.

  1. Microbial keratitis after penetrating keratoplasty: impact of sutures.

    Science.gov (United States)

    Moorthy, Sonia; Graue, Enrique; Jhanji, Vishal; Constantinou, Marios; Vajpayee, Rasik B

    2011-08-01

    To determine the impact of presence or absence of sutures in cases with post-penetrating keratoplasty (PKP) microbial keratitis. A 10-year retrospective chart review of post-PKP patients admitted with microbial keratitis at the Royal Victorian Eye and Ear Hospital, Melbourne, between January 1998 and December 2008 was undertaken. Patients were categorized in 2 groups, "sutures present" and "sutures absent." Main parameters evaluated were clinical and microbiological profile and treatment outcome. One hundred and twenty-two episodes of microbial keratitis were noted in 101 patients: 71 (58.2%) with sutures present and 51 (41.8%) with sutures absent. Overall, pseudophakic bullous keratopathy was the most common indication for keratoplasty (P=.92). Ocular surface disorder was the commonest risk factor associated with the occurrence of infection in both groups (P=.17). Infections caused by Moraxella sp. (P=.001) were significantly more common in the "sutures absent" group. Surgical interventions were required for 47 episodes (39%), with corneal gluing performed in significantly higher number of cases in the "sutures absent" group (40% vs 15%; P=.05). Multivariate analyses did not reveal any significant associations. Final mean visual acuity outcome was poorer in the "sutures absent" group (logMAR 2.10 ± 0.92 vs 1.76 ± 0.96; P=.04). Corneal graft infections, in the presence and absence of sutures, share similar indications and risk factors. However, infections caused by indolent microorganisms were more prevalent in grafts without sutures. This group of patients required a higher number of surgical interventions in the form of corneal gluing and the overall visual outcome was poor. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Bacterial Contamination of Surgical Suture Resembles a Biofilm

    Science.gov (United States)

    Henry-Stanley, Michelle J.; Hess, Donavon J.; Barnes, Aaron M.T.; Dunny, Gary M.

    2010-01-01

    Abstract Background Although much attention is currently directed to studying microbial biofilms on a variety of surfaces, few studies are designed to study bacterial growth on surgical suture. The purpose of this study was to compare the kinetic development of Staphylococcus aureus and Enterococcus faecalis on five surgical suture materials and to clarify factors that might influence this growth. Methods Pure cultures of S. aureus and E. faecalis were incubated with five types of suture for four days using either tissue culture medium or a bacterial growth medium. Suture-associated bacteria were quantified daily. In selected experiments, the bacterial growth medium was supplemented with heparin, a substance known to promote S. aureus biofilm formation. The ultrastructure of S. aureus biofilm developing on braided suture was studied with scanning electron microscopy. Results Staphylococcus aureus and E. faecalis were recovered in greater numbers (typically p suture, and the numbers of bacteria were greater (often p sutures incubated in bacterial growth medium rather than tissue culture medium. Addition of heparin 1,000 U/mL to silk or braided polyglactin 910 suture incubated three days with S. aureus resulted in greater numbers of bacteria on day one but not on subsequent days. Scanning electron microscopy showed a maturing S. aureus biofilm that developed from small clusters of cells among amorphous material and fibrillar elements to larger clusters of cells that appeared covered by more consolidated extracellular material. Conclusions Bacterial growth was favored on braided vs. monofilament suture, and heparin enhanced bacterial adherence after day one, but not at subsequent times. Staphylococcus aureus adhered to suture material and formed a structure consistent with a bacterial biofilm. PMID:20673144

  3. Prediction of Gas Leak Tightness of Superplastically Formed Products

    NARCIS (Netherlands)

    Snippe, Q.H.C.; Meinders, Vincent T.; Barlat, F; Moon, Y.H.; Lee, M.G.

    2010-01-01

    In some applications, in this case an aluminium box in a subatomic particle detector containing highly sensitive detecting devices, it is important that a formed sheet should show no gas leak from one side to the other. In order to prevent a trial-and-error procedure to make this leak tight box, a

  4. HIGH RESOLUTION RESISTIVITY LEAK DETECTION DATA PROCESSING & EVALUATION MEHTODS & REQUIREMENTS

    Energy Technology Data Exchange (ETDEWEB)

    SCHOFIELD JS

    2007-10-04

    This document has two purposes: {sm_bullet} Describe how data generated by High Resolution REsistivity (HRR) leak detection (LD) systems deployed during single-shell tank (SST) waste retrieval operations are processed and evaluated. {sm_bullet} Provide the basic review requirements for HRR data when Hrr is deployed as a leak detection method during SST waste retrievals.

  5. 40 CFR 63.1363 - Standards for equipment leaks.

    Science.gov (United States)

    2010-07-01

    ... definition. The instrument reading, as determined by the method as specified in § 63.180(b) of subpart H of... equipment leaks. (a) General equipment leak requirements. (1) The provisions of this section apply to... subpart applies to general alternative means of emission limitation. Section 63.179 of subpart H of this...

  6. Holding Strength of Suture: An Experimental Study Using Porcine Kidney

    Science.gov (United States)

    Akpinar, Haluk; Karadag, Mert Ali; Dönmez, Muhammet İrfan; Altunrende, Fatih

    2017-01-01

    Background and Objectives: The search for the perfect suture is going on and has resulted in the introduction of many different suture types into the market. The purpose of this study is to investigate the holding strength (HS) of different sutures in the renal parenchyma in an experimental study on pig kidneys. Methods: The HS that caused sliding of the suture was investigated in 5 adult porcine kidneys with 7 suture variants. HS-caused tearing of the kidney was investigated with 3 suture types on 5 kidneys. The third investigation, performed on 5 porcine kidneys, was a comparison between 2-0 Vicryl sutures with a Hem-o-lok clip and 2-0 V-Loc sutures with 1 knot. The Friedman test was used to compare the groups. Post hoc analysis was performed with the Wilcoxon signed ranks test (Bonferroni corrected). Results: For HS causing sliding of the suture, the mean HSs of the tested sutures were as follows: 2-0 Vicryl with 1 Hem-o-lok clip, 3.26 ± 0.55 N; 2-0 Vicryl with 2 Hem-o-lok clips, 4.1 ± 0.46 N; 2-0 V-Loc, 2.52 ± 0.63 N; 4-0 V-Loc, 1.62 ± 0.17 N; 0 Quill, 0.48 ± 0.16 N; 2-0 Vicryl with 1 Hem-o-lok clip (halfway), 3.62 ± 0.66 N; and 2-0 V-Loc (halfway), 1.02 ± 0.40 N. For HS causing tearing of the kidney, the mean value of 2-way 2-0 Vicryl (Hem-o-lok in the middle) was 13.28 ± 1.38 N, 2-0 2-way Vicryl (Hem-o-lok at the end) was 5.86 ± 0.75 N, and 2-way 2-0 V-Loc was 3.98 ± 1.60 N. For the third group, the difference between the 2 suture variants was not statistically significant. Conclusion: Our study revealed that 2-0 Vicryl (polyglactin 910) sutures with 2 Hem-o-lok clips had the maximum HS in renal parenchyma when compared with other sutures. PMID:28729782

  7. Holding Strength of Suture: An Experimental Study Using Porcine Kidney.

    Science.gov (United States)

    Özkuvanci, Ünsal; Akpinar, Haluk; Karadag, Mert Ali; Dönmez, Muhammet İrfan; Altunrende, Fatih

    2017-01-01

    The search for the perfect suture is going on and has resulted in the introduction of many different suture types into the market. The purpose of this study is to investigate the holding strength (HS) of different sutures in the renal parenchyma in an experimental study on pig kidneys. The HS that caused sliding of the suture was investigated in 5 adult porcine kidneys with 7 suture variants. HS-caused tearing of the kidney was investigated with 3 suture types on 5 kidneys. The third investigation, performed on 5 porcine kidneys, was a comparison between 2-0 Vicryl sutures with a Hem-o-lok clip and 2-0 V-Loc sutures with 1 knot. The Friedman test was used to compare the groups. Post hoc analysis was performed with the Wilcoxon signed ranks test (Bonferroni corrected). For HS causing sliding of the suture, the mean HSs of the tested sutures were as follows: 2-0 Vicryl with 1 Hem-o-lok clip, 3.26 ± 0.55 N; 2-0 Vicryl with 2 Hem-o-lok clips, 4.1 ± 0.46 N; 2-0 V-Loc, 2.52 ± 0.63 N; 4-0 V-Loc, 1.62 ± 0.17 N; 0 Quill, 0.48 ± 0.16 N; 2-0 Vicryl with 1 Hem-o-lok clip (halfway), 3.62 ± 0.66 N; and 2-0 V-Loc (halfway), 1.02 ± 0.40 N. For HS causing tearing of the kidney, the mean value of 2-way 2-0 Vicryl (Hem-o-lok in the middle) was 13.28 ± 1.38 N, 2-0 2-way Vicryl (Hem-o-lok at the end) was 5.86 ± 0.75 N, and 2-way 2-0 V-Loc was 3.98 ± 1.60 N. For the third group, the difference between the 2 suture variants was not statistically significant. Our study revealed that 2-0 Vicryl (polyglactin 910) sutures with 2 Hem-o-lok clips had the maximum HS in renal parenchyma when compared with other sutures.

  8. Objective classification system for sagittal craniosynostosis based on suture segmentation

    Science.gov (United States)

    Qian, Xiaohua; Tan, Hua; Zhang, Jian; Zhuang, Xiahai; Branch, Leslie; Sanger, Chaire; Thompson, Allison; Zhao, Weiling; Li, King Chuen; David, Lisa; Zhou, Xiaobo

    2015-01-01

    Purpose: Spring-assisted surgery is an effective and minimally invasive treatment for sagittal craniosynostosis (CSO). The principal barrier to the advancement of spring-assisted surgery is the patient-specific spring selection. The selection of spring force depends on the suture involved, subtypes of sagittal CSO, and age of the infant, among other factors. Clinically, physicians manually judge the subtype of sagittal CSO patients based on their CT image data, which may cause bias from different clinicians. An objective system would be helpful to stratify the sagittal CSO patients and make spring choice less subjective. Methods: The authors developed a novel informatics system to automatically segment and characterize sutures and classify sagittal CSO. The proposed system is composed of three phases: preprocessing, sutures segmentation, and classification. First, the three-dimensional (3D) skull was extracted from the CT images and aligned with the symmetry of the cranial vault. Second, a “hemispherical projection” algorithm was developed to transform 3D surface of the skull to a polar two-dimensional plane. Through the transformation, an “effective” projected region can be obtained to enable easy segmentation of sutures. Then, the different types of sutures, such as coronal sutures, lambdoid sutures, sagittal suture, and metopic suture, obtained from the segmented sutures were further identified by a dual-projection technique of the midline of the sutures. Finally, 108 quantified features of sutures were extracted and selected by a proposed multiclass feature scoring system. The sagittal CSO patients were classified into four subtypes: anterior, central, posterior, and complex with the support vector machine approach. Fivefold cross validation (CV) was employed to evaluate the capability of selected features in discriminating the four subtypes in 33 sagittal CSO patients. Receiver operating characteristics (ROC) curves were used to assess the robustness

  9. New leak assembly based on fluidic nanochannels

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Aiqing; Zhao, Yongheng; Wang, Xudi, E-mail: wxudi@hfut.edu.cn [School of Mechanical and Automobile Engineering, Hefei University of Technology, Hefei 230031 (China); Wang, Yu; Wei, Wei; Qiu, Keqiang [National Synchrotron Radiation Laboratory, University of Science and Technology of China, Hefei 230029 (China); Dong, Dong [Shanghai Institute of Spacecraft Equipment, Shanghai 201100 (China)

    2016-09-15

    Fluidic nanochannels with a characteristic dimension of ∼280 nm were fabricated and designed as a leak assembly, where the nanochannels were formed on silicon wafers and enclosed with Pyrex{sup ®} glass. The geometric dimensions were characterized by scanning electron microscopy, and the gas flow conductance of He and other heavy gases (N{sub 2}, O{sub 2}, and Ar) was measured, and its uncertainty estimated, by the difference method. The results indicated that the measured flow conductance values were 45% less than the calculated flow conductance values. For helium, molecular flow was shown to occur at pressures ranging from vacuum to atmospheric pressure. As a consequence of the well-defined geometry, the prediction of flow conductance could be achieved for various gas species.

  10. Confidence leak in perceptual decision-making

    Science.gov (United States)

    Rahnev, Dobromir; Koizumi, Ai; McCurdy, Li Yan; D’Esposito, Mark; Lau, Hakwan

    2015-01-01

    We live in a continuous environment in which the visual scene changes on a slow timescale. It has been shown that, to exploit such environmental stability, the brain creates a “continuity field” such that objects seen seconds ago influence the perception of current objects. What is unknown is whether a similar mechanism exists at the level of our metacognitive representations. In three experiments we demonstrate a robust inter-task “confidence leak” that cannot be explained by response priming or attentional fluctuations. Observers’ ability to modulate this confidence leak predicted higher capacity for metacognition as well as greater gray matter volume in the prefrontal cortex. A model based on normative principles from Bayesian inference explained the results by postulating that observers subjectively estimate the perceptual signal strength in a stable environment. These results point to the existence of a novel metacognitive mechanism mediated by regions in prefrontal cortex. PMID:26408037

  11. Pressure Change Measurement Leak Testing Errors

    Energy Technology Data Exchange (ETDEWEB)

    Pryor, Jeff M [ORNL; Walker, William C [ORNL

    2014-01-01

    A pressure change test is a common leak testing method used in construction and Non-Destructive Examination (NDE). The test is known as being a fast, simple, and easy to apply evaluation method. While this method may be fairly quick to conduct and require simple instrumentation, the engineering behind this type of test is more complex than is apparent on the surface. This paper intends to discuss some of the more common errors made during the application of a pressure change test and give the test engineer insight into how to correctly compensate for these factors. The principals discussed here apply to ideal gases such as air or other monoatomic or diatomic gasses; however these same principals can be applied to polyatomic gasses or liquid flow rate with altered formula specific to those types of tests using the same methodology.

  12. Arthroscopic Fixation of Tibial Eminence Fractures: A Clinical Comparative Study of Nonabsorbable Sutures Versus Absorbable Suture Anchors.

    Science.gov (United States)

    Liao, Weixiong; Li, Zhongli; Zhang, Hao; Li, Ji; Wang, Ketao; Yang, Yimeng

    2016-08-01

    To compare clinical outcomes of arthroscopic therapy for tibial eminence fracture with nonabsorbable suture and absorbable suture anchor. Between February 2010 and September 2012, a total of 60 tibial eminence fracture patients were treated with nonabsorbable suture fixation or absorbable suture anchor fixation under arthroscopy. Patients with tibial plateau fractures and other significant injuries, including osteochondral lesions, meniscal tear, and anterior cruciate ligament (ACL) or mutiligament injuries, were excluded from the study. Radiographs, anterior drawer test (ADT), Lachman test, Lysholm score, and International Knee Documentation Committee (IKDC) 2000 subjective score were employed to evaluate clinical outcomes in follow-up. A total of 41 patients were analyzed. Among these patients, 22 were treated with nonabsorbable suture fixation and 19 with absorbable suture anchor fixation. According to the modified Meyers-McKeever classification, 15 cases were categorized as type II, 21 as type III, and 5 as type IV fractures. The mean time from injury to surgery was 7.1 days (range, 3 to 12 days). All patients were followed up for a median period of 33.7 months (range, 24 to 45 months). Radiographic evaluation showed optimal reduction immediately after operation and bone union within 3 months in all patients. At the final follow-up, there was no limitation of knee motion range in any patient. Grade II laxity was found in 2 cases from suture group and 1 from suture anchor group, showing no significant difference based on ADT (χ(2) = 0.538, P = .764) and Lachman test (χ(2) = 0.550, P = .760). Lysholm and IKDC 2000 subjective scores were significantly improved (P suture fixation and absorbable suture anchor fixation are equivalent techniques in terms of the clinical efficacy of arthroscopic tibial eminence fracture treatment. Level III, retrospective comparative study. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc

  13. Biomechanical evaluation of double Krackow sutures versus the three-loop pulley suture in a canine gastrocnemius tendon avulsion model.

    Science.gov (United States)

    Wilson, L; Banks, Ta; Luckman, P; Smith, B

    2014-11-01

    To compare two Krackow sutures with a three-loop pulley suture for the reattachment of canine gastrocnemius tendons, using a tendon avulsion model. In vitro biomechanical study. Ten paired gastrocnemius tendons were severed at their insertions on the calcaneal tuberosity and repaired with either two modified Krackow sutures or a modified three-loop pulley suture. Sutures were placed in the tendon ends and through diverging bone tunnels in the medial and lateral processes of the calcaneal tuberosity. Tensile loads required to (a) create a 3-mm gap and (b) induce construct failure were measured. The mean load to achieve a 3-mm gap was 77.22 ± 9.72 and 55.85 ± 9.91 N, and to result in construct failure was 106.88 ± 12.74 and 80.86 ± 12.23 N for the Krackow and three-loop pulley suture patterns, respectively. These differences were statistically significant (P sutures were superior to the three-loop pulley pattern in both resistance to 3-mm gap formation and load to failure in a canine gastrocnemius avulsion model. The prevention of gap formation is critical for the success of tenorrhaphy. These results indicate that a suture pattern using two Krackow sutures may be clinically superior to the three-loop pulley suture pattern in the repair of canine gastrocnemius avulsion. Further work is required to determine if this superiority is mirrored in the repair of other tendon avulsion or laceration scenarios. © 2014 Australian Veterinary Association.

  14. Wet-aerosol leakage through simulated containment leak paths

    Energy Technology Data Exchange (ETDEWEB)

    Sutradhar, S.C. [Atomic Energy of Canada Limited, Chalk River, Ontario (Canada)

    2007-07-01

    Some types of postulated accidents in a nuclear reactor can result in the formation of radioactive wet aerosols in containment and their subsequent release into the environment. Wet-aerosol leakage was investigated using simulated leak paths for isolation damper valves and airlock door seals. Leakage was calculated from measured uranine concentrations deposited on high-quality filters positioned downstream of the simulated leak paths. Test results indicated that a small fraction of wet aerosols leaked through the simulated isolation damper valves, whereas a large fraction leaked through the simulated airlock door seals. Data on wet-aerosol leakage through containment leak paths are needed to develop and validate models in safety analysis codes. (author)

  15. Early results of all-inside meniscal repairs using a pre-loaded suture anchor.

    Science.gov (United States)

    Fok, August W M; Yau, W P

    2013-04-01

    To report the clinical and radiological results of all-inside meniscal repairs using a pre-loaded suture anchor. Case series. Regional hospital, Hong Kong. From January 2008 to June 2010, 51 patients with a mean age of 26 (range, 15-48) years with 57 meniscal tears underwent meniscal repair utilising the all-inside meniscal repair technique entailing a pre-loaded suture anchor. All tears were located at red-red or red-white zones. Concurrent anterior cruciate ligament reconstruction was performed in 37 (73%) of the patients. Patients were evaluated postoperatively based on the International Knee Documentation Committee score, clinical examination, and magnetic resonance imaging. Presence of locking, joint-line tenderness, effusion, and positive McMurray test were considered to indicate clinical failure. The mean follow-up was 19 (range, 12-39) months. An average of 2 (range, 1 to 4) suture devices was used per patient. The mean tear size was 20 (range, 10-40) mm. In all, 10 (18%) of the tears had failed clinically and 11 (19%) appeared unhealed on postoperative imaging. The mean International Knee Documentation Committee score improved significantly from 62 preoperatively to 81 postoperatively (Psuture anchor is safe and effective, and yielded an 83% clinical and 81% radiological success rate.

  16. Vacuum-assisted early transanal closure of leaking low colorectal anastomoses: the CLEAN study.

    Science.gov (United States)

    Borstlap, W A A; Musters, G D; Stassen, L P S; van Westreenen, H L; Hess, D; van Dieren, S; Festen, S; van der Zaag, E J; Tanis, P J; Bemelman, W A

    2017-06-29

    Non-healing of anastomotic leakage can be observed in up to 50% after total mesorectal excision for rectal cancer. This study investigates the efficacy of early transanal closure of anastomotic leakage after pre-treatment with the Endosponge(®) therapy. In this prospective, multicentre, feasibility study, transanal suturing of the anastomotic defect was performed after vacuum-assisted cleaning of the presacral cavity. Primary outcome was the proportion of patients with a healed anastomosis at 6 months after transanal closure. Secondary, healing at last follow-up, continuity, direct medical costs, functionality and quality of life were analysed. Between July 2013 and July 2015, 30 rectal cancer patients with a leaking low colorectal anastomosis were included, of whom 22 underwent neoadjuvant radiotherapy. Median follow-up was 14 (7-29) months. At 6 months, the anastomosis had healed in 16 (53%) patients. At last follow-up, anastomotic integrity was found in 21 (70%) and continuity was restored in 20 (67%) patients. Non-healing at 12 months was observed in 10/29 (34%) patients overall, and in 3/14 (21%) when therapy started within three weeks following the index operation. Major LARS was reported in 12/15 (80%) patients. The direct medical costs were €8933 (95% CI 7268-10,707) per patient. Vacuum-assisted early transanal closure of a leaking anastomosis after total mesorectal excision with 73% preoperative radiotherapy showed that acceptable anastomotic healing rates and stoma reversal rates can be achieved. Early diagnosis and start of treatment seems crucial.

  17. Calculation note for an underground leak which remains underground

    Energy Technology Data Exchange (ETDEWEB)

    Goldberg, H.J.

    1997-05-20

    This calculation note supports the subsurface leak accident scenario which remains subsurface. It is assumed that a single walled pipe carrying waste from tank 106-C ruptures, releasing the liquid waste into the soil. In this scenario, the waste does not form a surface pool, but remains subsurface. However, above the pipe is a berm, 0.762 m (2.5 ft) high and 2.44 m (8 ft) wide, and the liquid released from the leak rises into the berm. The slurry line, which transports a source term of higher activity than the sluice line, leaks into the soil at a rate of 5% of the maximum flow rate of 28.4 L/s (450 gpm) for twelve hours. The dose recipient was placed a perpendicular distance of 100 m from the pipe. Two source terms were considered, mitigated and unmitigated release as described in section 3.4.1 of UANF-SD-WM-BIO-001, Addendum 1. The unmitigated consisted of two parts of AWF liquid and one part AWF solid. The mitigated release consisted of two parts SST liquid, eighteen parts AWF liquid, nine parts SST solid, and one part AWF solid. The isotopic breakdown of the release in these cases is presented. Two geometries were considered in preliminary investigations, disk source, and rectangular source. Since the rectangular source results from the assumption that the contamination is wicked up into the berm, only six inches of shielding from uncontaminated earth is present, while the disk source, which remains six inches below the level of the surface of the land is often shielded by a thick shield due to the slant path to the dose point. For this reason, only the rectangular source was considered in the final analysis. The source model was a rectangle 2.134 m (7 ft) thick, 0.6096 m (2 ft) high, and 130.899 m (131 ft) long. The top and sides of this rectangular source was covered with earth of density 1.6 g/cm{sup 3} to a thickness of 15.24 cm (6 in). This soil is modeled as 40% void space. The source consisted of earth of the same density with the void spaces filled with

  18. The Strength of Transosseous Medial Meniscal Root Repair Using a Simple Suture Technique Is Dependent on Suture Material and Position.

    Science.gov (United States)

    Robinson, James R; Frank, Evelyn G; Hunter, Alan J; Jermin, Paul J; Gill, Harinderjit S

    2018-01-01

    A simple suture technique in transosseous meniscal root repair can provide equivalent resistance to cyclic load and is less technically demanding to perform compared with more complex suture configurations, yet maximum yield loads are lower. Various suture materials have been investigated for repair, but it is currently not clear which material is optimal in terms of repair strength. Meniscal root anatomy is also complex; consisting of the ligamentous mid-substance (root ligament), the transition zone between the meniscal body and root ligament; the relationship between suture location and maximum failure load has not been investigated in a simulated surgical repair. (A) Using a knottable, 2-mm-wide, ultra-high-molecular-weight polyethylene (UHMWPE) braided tape for transosseous meniscal root repair with a simple suture technique will give rise to a higher maximum failure load than a repair made using No. 2 UHMWPE standard suture material for simple suture repair. (B) Suture position is an important factor in determining the maximum failure load. Controlled laboratory study. In part A, the posterior root attachment of the medial meniscus was divided in 19 porcine knees. The tibias were potted, and repair of the medial meniscus posterior root was performed. A suture-passing device was used to place 2 simple sutures into the posterior root of the medial meniscus during a repair procedure that closely replicated single-tunnel, transosseous surgical repair commonly used in clinical practice. Ten tibias were randomized to repair with No. 2 suture (Suture group) and 9 tibias to repair with 2-mm-wide knottable braided tape (Tape group). The repair strength was assessed by maximum failure load measured by use of a materials testing machine. Micro-computed tomography (CT) scans were obtained to assess suture positions within the meniscus. The wide range of maximum failure load appeared related to suture position. In part B, 10 additional porcine knees were prepared. Five

  19. Aqua splint suture technique in isolated zygomatic arch fractures.

    Science.gov (United States)

    Kim, Dong-Kyu; Kim, Seung Kyun; Lee, Jun Ho; Park, Chan Hum

    2014-04-01

    Various methods have been used to treat zygomatic arch fractures, but no optimal modality exists for reducing these fractures and supporting the depressed bone fragments without causing esthetic problems and discomfort for life. We developed a novel aqua splint and suture technique for stabilizing isolated zygomatic arch fractures. The objective of this study is to evaluate the effect of novel aqua splint and suture technique in isolated zygomatic arch fractures. Patients with isolated zygomatic arch fractures were treated by a single surgeon in a single center from January 2000 through December 2012. Classic Gillies approach without external fixation was performed from January 2000 to December 2003, while the novel technique has been performed since 2004. 67 consecutive patients were included (Classic method, n = 32 and Novel method, n = 35). An informed consent was obtained from all patients. The novel aqua splint and suture technique was performed by the following fashion: first, we evaluated intraoperatively the bony alignment by ultrasonography and then, reduced the depressed fracture surgically using the Gillies approach. Thereafter, to stabilize the fracture and obtain the smooth facial figure, we made an aqua splint that fit the facial contour and placed monofilament nonabsorbable sutures around the fractured zygomatic arch. The novel aqua splint and suture technique showed significantly correlated with better cosmetic and functional results. In conclusion, the aqua splint suture technique is very simple, quick, safe, and effective for stabilizing repositioned zygomatic arch fractures. The aqua splint suture technique can be a good alternative procedure in isolated zygomatic arch fractures.

  20. Infected shoulder joint with loose Suture Anchor in the joint after Bankart's Repair- A Case Report.

    Science.gov (United States)

    Kumar, Mukesh; Thilak, Jai

    2016-01-01

    The glenoid labrum is frequently torn in traumatic glenohumeral dislocation; arthroscopic repair is the standard method of treatment. The complications associated with this repair are pulling out of metal suture anchors, chondrolysis and joint infection. The infection of joint after arthroscopy is less than 1%. Staphylococcus is most common organism and rarely followed by Pseudomonas aeruginosa. We report a case of infected shoulder with chondrolysis of the joint and pulled out metal suture anchor lying inside the joint after Bankart's repair. A 22-year-old gentleman came to us with complaints of shoulder joint pain & gross restriction of movements for one year, with history of intermittent fever and treatment in nearby hospital. He also gives past history of recurrent dislocation of shoulder with last episode 18 months back, which was diagnosed as Bankart's lesion and arthroscopic Bankart's repair was done 15 months back. He was evaluated at our institute and suspected to have infection of shoulder joint with pulled out metal suture anchor inside the joint. Arthroscopic removal of suture anchor and debridement of shoulder joint was done, Culture was obtained and culture specific antibiotics were given for six weeks, and significant improvement was observed with this line of treatment. At lyear follow up, the patient was able to perform his daily activities with terminal restriction of range of motion. Shoulder joint infection is rare after Bankart's repair and required a high degree of suspicion. Any foreign materials inside the joint should be taken out & followed with aggressive treatment by debridement, irrigation and culture specific antibiotics. Suppression of joint infection with antibiotics should be avoided specially when there is foreign body inside the joint.

  1. Sutural strain in orthopedic headgear therapy: a finite element analysis.

    Science.gov (United States)

    Holberg, Christof; Holberg, Nikola; Rudzki-Janson, Ingrid

    2008-07-01

    The goal of this study was to analyze the strains induced in the sutures of the midface and the cranial base by headgear therapy involving orthopedic forces. Does the mechanical signal induced in the sutures sufficiently account for a growth-influencing effect? A finite element model of the viscerocranium and the neurocranium was used. It consisted of 53,555 tetrahedral elements and 97,550 nodes. The strain induced in the sutures of the cranial base and the midface when applying orthopedic headgear forces of 5 and 10 N was computed and recorded with an interactive measurement tool. The magnitude and the distribution of the measured strains depended on the level and the direction of the acting force. Overall, the strain values measured at the sutures of the midface and the cranial base were moderate. The measured peak values at a load of 5 N per side were usually just below 20 microstrain irrespective of the force direction. A characteristic distribution of strain values appeared on the anatomical structures of the midface and the cranial base for each vector direction. The measurements based on the finite element method provided a good overview of the approximate magnitudes of sutural strains with orthopedic headgear therapy. The signal arriving in the sutures is apparently well below threshold, since the maximum measured strains in most sutures were about 100 fold lower than the minimal effective strain. A skeletal effect of the orthopedic headgear due to a mechanical effect on sutural growth cannot be confirmed from these results. The good clinical efficacy of headgear therapy with orthopedic forces is apparently based mainly on dentoalveolar effects, whereas the skeletal effect due to inhibition of sutural growth is somewhat questionable.

  2. Perioperative modulating factors on astigmatism in sutured cataract surgery.

    Science.gov (United States)

    Cho, Yang Kyeung; Kim, Man Soo

    2009-12-01

    To evaluate the factors that affect postoperative astigmatism and post-suture removal astigmatism, and to evaluate the risk factors associated with astigmatism axis shift. We performed a retrospective chart review of 130 eyes that had undergone uneventful phacoemulsification cataract surgery. Preoperative astigmatism was divided into four groups (Groups I, II, III, and IV) according to the differences between the axis of preoperative astigmatism (flattest axis) and the incision axis (105 degrees). We analyzed the magnitude and axis of the induced astigmatism after the operation and after suture removal in each group. We also analyzed the factors which affected the postoperative astigmatism and post-suture removal astigmatism in each sub-group of Groups I, II, III, and IV, excluding postoperative or post-suture removal axis shift (specifically, Group I(WAS), II(WAS), III(WAS), and IV(WAS)). We identified the variables associated with the prevalence of postoperative astigmatism axis shift and those associated with the prevalence of post-suture removal axis shift. An increase in the magnitude of postoperative astigmatism was associated with an increase in the preoperative magnitude of astigmatism in Groups I(WAS), II(WAS), and III(WAS) (pastigmatism was associated with an increase in the corneal tunnel length in Groups III(WAS) and IV(WAS) (psuture removal astigmatism was associated with an increase in the magnitude of postoperative astigmatism in Groups I(WAS) and IV(WAS) (psuture removal in Group IV(WAS) (psuture removal astigmatism was associated with late suture removal in Groups I(WAS) and II(WAS). A logistic regression analysis showed that the prevalence of post-suture removal astigmatism axis shift was associated with increased corneal tunnel length, decreased magnitude of postoperative astigmatism, and early suture removal. In order to reduce postoperative and post-suture removal astigmatism, we recommend a short corneal tunnel length and late suture removal

  3. Midwives conducting perineal repair: The Danish Suture Trial

    DEFF Research Database (Denmark)

    Kindberg, Sara

    2007-01-01

    haemorrhage >1000 ml, Diabetes, mental disorders. Both suture techniques were 2-layered using a polyglactin 910 multifilament suture (Vicryl Rapid or Vicryl). Treatment A was a continuous suture technique and treatment B was interrupted, inverted stitches. Primary outcomes: Perineal pain and wound healing...... assessed day 1-2 and 10 post partum. Secondary outcomes: patient satisfaction with wound healing, need for secondary repair, superficial pain during intercourse.   Data management: Double entry of all data and intention-to-treat analysis.   Results The follow up rate was 97%. Baseline data were evenly...

  4. 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 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Strength of suture anchor versus transosseous tunnel in anatomic reconstruction of the ankle lateral ligaments: a biomechanical study.

    Science.gov (United States)

    Li, Hong-Yun; Hua, Ying-Hui; Wu, Zi-Ying; Chen, Bo; Chen, Shi-Yi

    2013-11-01

    The purpose of this study was to compare the biomechanical characteristics of fixation with 2-suture anchors versus transosseous tunnel fixation in anatomic reconstruction of the ankle lateral ligaments. Six matched pairs of human cadaveric ankles underwent anatomic lateral ankle reconstruction, and fixation of the graft on the talus was achieved with 2 suture anchors or a transosseous tunnel. Ankles for the transosseous tunnel group were chosen at random, with the paired contralateral ankles used for the 2-suture anchor group. Half of the peroneus brevis tendon was harvested as a graft. For each technique, one end of the tendon was secured to the original insertion point of the anterior talofibular ligament (ATFL) at the talus, whereas the other end was armed with 2 No. 5 nonabsorbable sutures (Ethicon, Somerville, NJ) and passed through the bone tunnel in the fibula. Biomechanical testing was performed by applying the force in line with the graft. Load to failure was determined at a displacement rate of 50 mm/min. The load-displacement curve, maximum load at failure (N), and stiffness (N/mm) were recorded and compared between the 2 techniques. There was no difference between constructs in the 2-suture anchor group and the transosseous tunnel group in terms of the ultimate load and stiffness (161.8 ± 47.6 N v 171.9 ± 76.0 N; P = .92; 4.59 ± 1.85 N/mm v 5.77 ± 1.98 N/mm; P = .35). Most constructs failed because of anchor pullout in the 2-suture anchor group (5 of 6) and fracture of the bony bridge in the transosseous tunnel group (6 of 6). The strength of fixation with suture anchors in anatomic reconstruction of the ankle lateral ligaments was equivalent to transosseous tunnel fixation as determined with biomechanical testing. However, this study did not prove that one is advantageous over the other. Both techniques showed excellent biomechanical results. Therefore, the 2-suture anchor fixation approach can be safely used in anatomic reconstruction of the

  7. In vivo evaluation of a novel mesh suture design for abdominal wall closure.

    Science.gov (United States)

    Souza, Jason M; Dumanian, Zari P; Gurjala, Anandev N; Dumanian, Gregory A

    2015-02-01

    The authors present a novel mesh suture design aimed at minimizing the early laparotomy dehiscence that drives ventral hernia formation. The authors hypothesized that modulation of the suture-tissue interface through use of a macroporous structure and increased aspect ratio (width-to-height ratio) would decrease the suture pull-through that leads to laparotomy dehiscence. Incisional hernias were produced in 30 rats according to an established hernia model. The rat hernias were randomized to repair with either two 5-0 polypropylene sutures or two midweight polypropylene mesh sutures. Standardized photographs were taken before repair and 1 month after repair. Edge-detection software was used to define the border of the hernia defect and calculate the defect area. Histologic analysis was performed on all mesh suture specimens. Seventeen hernias were repaired with mesh sutures and 13 were repaired with conventional sutures. The mean area of the recurrent defects following repair with mesh suture was 177.8 ± 27.1 mm2, compared with 267.3 ± 34.1 mm2 following conventional suture repair. This correlated to a 57.4 percent reduction in defect area after mesh suture repair, compared with a 10.1 percent increase in defect area following conventional suture repair (p sutures pulled through the surrounding tissue, whereas 65 percent (17 of 26) of the conventional sutures demonstrated complete pull-through. Excellent fibrocollagenous ingrowth was observed in 13 of 17 mesh suture specimens. Mesh sutures better resisted suture pull-through than conventional polypropylene sutures. The design elements of mesh sutures may prevent early laparotomy dehiscence by more evenly distributing distracting forces at the suture-tissue interface and permitting tissue incorporation of the suture itself.

  8. 21 CFR 878.4493 - Absorbable poly(glycolide/l-lactide) surgical suture.

    Science.gov (United States)

    2010-04-01

    ... suture. 878.4493 Section 878.4493 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND....4493 Absorbable poly(glycolide/l-lactide) surgical suture. (a) Identification. An absorbable poly(glycolide/l-lactide) surgical suture (PGL suture) is an absorbable sterile, flexible strand as prepared and...

  9. Air-leak effects on ear-canal acoustic absorbance.

    Science.gov (United States)

    Groon, Katherine A; Rasetshwane, Daniel M; Kopun, Judy G; Gorga, Michael P; Neely, Stephen T

    2015-01-01

    Accurate ear-canal acoustic measurements, such as wideband acoustic admittance, absorbance, and otoacoustic emissions, require that the measurement probe be tightly sealed in the ear canal. Air leaks can compromise the validity of the measurements, interfere with calibrations, and increase variability. There are no established procedures for determining the presence of air leaks or criteria for what size leak would affect the accuracy of ear-canal acoustic measurements. The purpose of this study was to determine ways to quantify the effects of air leaks and to develop objective criteria to detect their presence. Air leaks were simulated by modifying the foam tips that are used with the measurement probe through insertion of thin plastic tubing. To analyze the effect of air leaks, acoustic measurements were taken with both modified and unmodified foam tips in brass-tube cavities and human ear canals. Measurements were initially made in cavities to determine the range of critical leaks. Subsequently, data were collected in ears of 21 adults with normal hearing and normal middle-ear function. Four acoustic metrics were used for predicting the presence of air leaks and for quantifying these leaks: (1) low-frequency admittance phase (averaged over 0.1-0.2 kHz), (2) low-frequency absorbance, (3) the ratio of compliance volume to physical volume (CV/PV), and (4) the air-leak resonance frequency. The outcome variable in this analysis was the absorbance change (Δabsorbance), which was calculated in eight frequency bands. The trends were similar for both the brass cavities and the ear canals. ΔAbsorbance generally increased with air-leak size and was largest for the lower frequency bands (0.1-0.2 and 0.2-0.5 kHz). Air-leak effects were observed in frequencies up to 10 kHz, but their effects above 1 kHz were unpredictable. These high-frequency air leaks were larger in brass cavities than in ear canals. Each of the four predictor variables exhibited consistent dependence on

  10. Resilience to leaking--dynamic systems modeling of information security.

    Science.gov (United States)

    Hamacher, Kay

    2012-01-01

    Leaking of confidential material is a major threat to information security within organizations and to society as a whole. This insight has gained traction in the political realm since the activities of Wikileaks, which hopes to attack 'unjust' systems or 'conspiracies'. Eventually, such threats to information security rely on a biologistic argument on the benefits and drawbacks that uncontrolled leaking might pose for 'just' and 'unjust' entities. Such biological metaphors are almost exclusively based on the economic advantage of participants. Here, I introduce a mathematical model of the complex dynamics implied by leaking. The complex interactions of adversaries are modeled by coupled logistic equations including network effects of econo-communication networks. The modeling shows, that there might arise situations where the leaking envisioned and encouraged by Wikileaks and the like can strengthen the defending entity (the 'conspiracy'). In particular, the only severe impact leaking can have on an organization seems to originate in the exploitation of leaks by another entity the organization competes with. Therefore, the model suggests that leaks can be used as a `tactical mean' in direct adversary relations, but do not necessarily increase public benefit and societal immunization to 'conspiracies'. Furthermore, within the model the exploitation of the (open) competition between entities seems to be a more promising approach to control malicious organizations : divide-et-impera policies triumph here.

  11. Resilience to leaking--dynamic systems modeling of information security.

    Directory of Open Access Journals (Sweden)

    Kay Hamacher

    Full Text Available Leaking of confidential material is a major threat to information security within organizations and to society as a whole. This insight has gained traction in the political realm since the activities of Wikileaks, which hopes to attack 'unjust' systems or 'conspiracies'. Eventually, such threats to information security rely on a biologistic argument on the benefits and drawbacks that uncontrolled leaking might pose for 'just' and 'unjust' entities. Such biological metaphors are almost exclusively based on the economic advantage of participants. Here, I introduce a mathematical model of the complex dynamics implied by leaking. The complex interactions of adversaries are modeled by coupled logistic equations including network effects of econo-communication networks. The modeling shows, that there might arise situations where the leaking envisioned and encouraged by Wikileaks and the like can strengthen the defending entity (the 'conspiracy'. In particular, the only severe impact leaking can have on an organization seems to originate in the exploitation of leaks by another entity the organization competes with. Therefore, the model suggests that leaks can be used as a `tactical mean' in direct adversary relations, but do not necessarily increase public benefit and societal immunization to 'conspiracies'. Furthermore, within the model the exploitation of the (open competition between entities seems to be a more promising approach to control malicious organizations : divide-et-impera policies triumph here.

  12. Resilience to Leaking — Dynamic Systems Modeling of Information Security

    Science.gov (United States)

    Hamacher, Kay

    2012-01-01

    Leaking of confidential material is a major threat to information security within organizations and to society as a whole. This insight has gained traction in the political realm since the activities of Wikileaks, which hopes to attack ‘unjust’ systems or ‘conspiracies’. Eventually, such threats to information security rely on a biologistic argument on the benefits and drawbacks that uncontrolled leaking might pose for ‘just’ and ‘unjust’ entities. Such biological metaphors are almost exclusively based on the economic advantage of participants. Here, I introduce a mathematical model of the complex dynamics implied by leaking. The complex interactions of adversaries are modeled by coupled logistic equations including network effects of econo-communication networks. The modeling shows, that there might arise situations where the leaking envisioned and encouraged by Wikileaks and the like can strengthen the defending entity (the ‘conspiracy’). In particular, the only severe impact leaking can have on an organization seems to originate in the exploitation of leaks by another entity the organization competes with. Therefore, the model suggests that leaks can be used as a `tactical mean’ in direct adversary relations, but do not necessarily increase public benefit and societal immunization to ‘conspiracies’. Furthermore, within the model the exploitation of the (open) competition between entities seems to be a more promising approach to control malicious organizations : divide-et-impera policies triumph here. PMID:23227151

  13. Autogenous Metallic Pipe Leak Repair in Potable Water Systems.

    Science.gov (United States)

    Tang, Min; Triantafyllidou, Simoni; Edwards, Marc A

    2015-07-21

    Copper and iron pipes have a remarkable capability for autogenous repair (self-repair) of leaks in potable water systems. Field studies revealed exemplars that metallic pipe leaks caused by nails, rocks, and erosion corrosion autogenously repaired, as confirmed in the laboratory experiments. This work demonstrated that 100% (N = 26) of 150 μm leaks contacting representative bulk potable water in copper pipes sealed autogenously via formation of corrosion precipitates at 20-40 psi, pH 3.0-11.0, and with upward and downward leak orientations. Similar leaks in carbon steel pipes at 20 psi self-repaired at pH 5.5 and 8.5, but two leaks did not self-repair permanently at pH 11.0 suggesting that water chemistry may control the durability of materials that seal the leaks and therefore the permanence of repair. Larger 400 μm holes in copper pipes had much lower (0-33%) success of self-repair at pH 3.0-11.0, whereas all 400 μm holes in carbon steel pipes at 20 psi self-repaired at pH 4.0-11.0. Pressure tests indicated that some of the repairs created at 20-40 psi ambient pressure could withstand more than 100 psi without failure. Autogenous repair has implications for understanding patterns of pipe failures, extending the lifetime of decaying infrastructure, and developing new plumbing materials.

  14. Leak Path Development in CO2 Wells

    Science.gov (United States)

    Torsater, M.; Todorovic, J.; Opedal, N.; Lavrov, A.

    2014-12-01

    Wells have in numerous scientific works been denoted the "weak link" of safe and cost-efficient CO2 Capture and Storage (CCS). Whether they are active or abandoned, all wells are man-made intrusions into the storage reservoir with sealing abilities depending on degradable materials like steel and cement. If dense CO2 is allowed to expand (e.g. due to leakage) it will cool down its surroundings and cause strong thermal and mechanical loading on the wellbore. In addition, CO2 reacts chemically with rock, cement and steel. To ensure long-term underground containment, it is therefore necessary to study how, why, where and when leakage occurs along CO2wells. If cement bonding to rock or casing is poor, leak paths can form already during drilling and completion of the well. In the present work, we have mapped the bonding quality of cement-rock and cement-steel interfaces - and measured their resistance towards CO2 flow. This involved a large experimental matrix including different rocks, steels, cement types and well fluids. The bonding qualities were measured on composite cores using micro computed tomography (µ-CT), and CO2 was flooded through the samples to determine leakage rates. These were further compared to numerical simulations of leakage through the digitalized µ-CT core data, and CO2chemical interactions with the materials were mapped using electron microscopy. We also present a new laboratory set-up for measuring how well integrity is affected by downhole temperature variations - and we showcase some initial results. Our work concludes that leak path development in CO2 wells depends critically on the drilling fluids and presflushes/spacers chosen already during drilling and completion of a well. Fluid films residing on rock and casing surfaces strongly degrade the quality of cement bonding. The operation of the well is also important, as even slight thermal cycling (between 10°C and 95°C on casing) leads to significant de-bonding of the annular cement.

  15. Automatic Detection of Wild-type Mouse Cranial Sutures

    DEFF Research Database (Denmark)

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

    In the study of craniofacial malformations, the cranial sutures are often of interest. The premature fusion of sutures occurring in e.g. Crouzon and Apert syndrome can lead to asymmetric head shape, enlarged intracranial pressure and blindness. In large population studies of such syndromes......, 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...... these transformations, any annotation on the atlas can automatically be transformed back to all cases. For this study, two rounds of tracing seven of the cranial sutures, were performed on the atlas by one observer. The average of the two rounds was automatically propagated to all the cases. For validation...

  16. Quartz enhanced photoacoustic leak sensor for mechatronic components

    Science.gov (United States)

    Sampaolo, A.; Patimisco, P.; Giglio, M.; Calabrese, P. P.; Chieco, L.; Scamarcio, G.; Tittel, F. K.; Spagnolo, V.

    2016-02-01

    We report the first demonstration of a leak sensor based on a mid-IR quartz-enhanced photoacoustic (QEPAS) spectroscopic technique. A QEPAS sensor was integrated in a vacuum seal test station for mechatronic components. The laser source is a quantum cascade laser emitting at 10.56 μm, resonant with a strong absorption band of sulfur hexafluoride (SF6), which was selected as target gas for leak detection. The minimum detectable concentration of the QEPAS sensor is 6.9 ppb with an integration time of 1 s. This detection sensitivity allowed to measure SF6 leak flows as low as 3x10-5 standard cm3.

  17. Constraining the location of the Archean--Proterozoic suture in the Great Basin based on magnetotelluric soundings

    Science.gov (United States)

    Rodriguez, Brian D.; Sampson, Jay A.

    2012-01-01

    It is important to understand whether major mining districts in north-central Nevada are underlain by Archean crust, known to contain major orogenic gold deposits, or, alternatively, by accreted crust of the Paleoproterozoic Mojave province. Determining the location and orientation of the Archean-Proterozoic suture zone between the Archean crust and Mojave province is also critical because it may influence subsequent patterns of sedimentation, deformation, magmatism, and hydrothermal activity. In the Great Basin, the attitude of the suture zone is unknown because it is concealed below cover. A regional magnetotelluric sounding profile along the Utah-Nevada State line reveals a deeply penetrating, broad electrical conductor that may be the Archean-Proterozoic suture zone in the northwest corner of Utah. This major crustal conductor's strike direction is northwest, where it broadens to about 80 km wide below about 3-km depth. These results suggest that the southwestern limit of intact Archean crust in this part of the Great Basin is farther north than previously reported. These results also suggest that the major gold belts in north-central Nevada are located over the Paleoproterozoic Mojave province, and the Archean terrain lies northeast in the northwest corner of Utah. Rifted Archean crust segments south and west of the suture suggest that future mineral exploration northeast of current mineral trends may yield additional gold deposits.

  18. Influence of suture regularity on corneal astigmatism after penetrating keratoplasty.

    Science.gov (United States)

    Hjortdal, Jesper; Søndergaard, Anders; Fledelius, Walther; Ehlers, Niels

    2011-08-01

    To investigate whether suture regularity affects corneal astigmatism after keratoplasty. Twenty-one patients undergoing penetrating keratoplasty for various corneal diseases were included in the study. The grafts were sutured in place using a single-running Nylon 10-0 suture, taking 24 bites. Immediately after surgery, standard calibrated images of the grafted eye were captured and stored. Using a dedicated image analysis programme, stitches and needle points were identified, and a number of suture regularity variables were calculated. Corneal topographic images were obtained before suture removal (12 months after surgery) and 3 months after suture removal (18 months after surgery). Topographic measures of astigmatism [surface regularity (SRI), surface asymmetry index (SAI) and simulated keratometric astigmatism] were calculated and correlated with the computed suture regularity variables. The average stitch length was 3.04 ± 0.28 mm and the distance between the outer needle points was 2.53 ± 0.09 mm. The SRI was 1.26 ± 0.36 and the SAI was 1.59 ± 0.67 after 12 months; these decreased to 1.03 ± 0.48 and 0.92 ± 0.46 after 18 months, respectively. Corneal astigmatism was 6.38 ± 2.99 and 5.87 ± 3.13 dioptres after 12 and 18 months, respectively. Suture regularity did not affect SAI, SRI or corneal astigmatism significantly 12 months after surgery. Eighteen months after surgery (3 months after suture removal), the standard deviation on the original stitch length was found to significantly increase corneal astigmatism. In addition, the size of the counter-clockwise angle between stitch and graft radian was correlated significantly with a lower SRI. The origin of corneal astigmatism after penetrating keratoplasty is multifaceted. Regular stitch length and stitch advancement on the surface appears to improve the optical quality of the graft after suture removal. Factors such as stitch depth, suture tension and variations in wound construction might also be

  19. Determination of crack morphology parameters from service failures for leak-rate analyses

    Energy Technology Data Exchange (ETDEWEB)

    Wilkowski, G.; Ghadiali, N.; Paul, D. [Battelle Memorial Institute, Columbus, OH (United States)] [and others

    1997-04-01

    In leak-rate analyses described in the literature, the crack morphology parameters are typically not well agreed upon by different investigators. This paper presents results on a review of crack morphology parameters determined from examination of service induced cracks. Service induced cracks were found to have a much more tortuous flow path than laboratory induced cracks due to crack branching associated with the service induced cracks. Several new parameters such as local and global surface roughnesses, as well as local and global number of turns were identified. The effect of each of these parameters are dependent on the crack-opening displacement. Additionally, the crack path is typically assumed to be straight through the pipe thickness, but the service data show that the flow path can be longer due to the crack following a fusion line, and/or the number of turns, where the number of turns in the past were included as a pressure drop term due to the turns, but not the longer flow path length. These parameters were statistically evaluated for fatigue cracks in air, corrosion-fatigue, IGSCC, and thermal fatigue cracks. A refined version of the SQUIRT leak-rate code was developed to account for these variables. Sample calculations are provided in this paper that show how the crack size can vary for a given leak rate and the statistical variation of the crack morphology parameters.

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

    Directory of Open Access Journals (Sweden)

    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. Recurrent vitreous hemorrhage after sutured posterior chamber intraocular lenses.

    Science.gov (United States)

    Fu, Arthur D; McDonald, H Richard; Jumper, J Michael; Aaberg, Thomas M; Smiddy, William E; Robertson, Joseph E; Johnson, Robert N; Ai, Everett

    2004-04-01

    To describe the clinical course and management of patients with late vitreous hemorrhage after scleral suturing of posterior chamber intraocular lenses (PCIOL). The authors reviewed patient demographics, ocular findings, and clinical course of six patients with late (>3 weeks) vitreous hemorrhage after sclera-sutured PCIOL. Intraoperative endoscopy was performed on two patients to better assess the haptic sulcus interaction. Patient age ranged from 39 to 84 years (median 77 years). The interval between scleral suturing of the PCIOL and vitreous hemorrhage ranged from 3 weeks to 68 months (median 5 months). The number of hemorrhages ranged from one to four. The hemorrhage cleared spontaneously in three eyes. Three patients underwent surgery after the hemorrhages including sutured PCIOL removal with concurrent placement of an anterior chamber IOL (ACIOL) (two patients) and resuturing of a PCIOL in a different meridian (one patient). Follow-up ranged from 4 to 36 months, median 19.5 months, starting from the time of the initial postsuturing vitreous hemorrhage. Final vision ranged from 20/20 to hand motions, with four eyes having 20/40 or better vision. Endoscopy revealed a haptic embedded into the pars plicata in one eye but no evidence of neovascularization. Recurrent vitreous hemorrhage may occur as a complication of scleral suturing of PCIOL. The etiology of these hemorrhages does not appear to be related to neovascular proliferation at the haptic suture site, but may be secondary to erosion of the haptic into uveal structures. Not all eyes require reoperation after these hemorrhages; however, good visual results may be achieved by replacing the sutured PCIOL with an ACIOL or by suturing the PCIOL in a different meridian.

  2. 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) (psuture breaking for all PushLocks while the Morphix failed equally by anchor 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.

  3. A New Coating for Non-resorbable Surgical Suture

    Directory of Open Access Journals (Sweden)

    Ahmed Salah Hameed

    2017-12-01

    Full Text Available Suture is a biomaterial used to approximate wound edges to facilitate the healing process. This task could be compromised as a result of wound infection. Zinc is an element that has antibacterial action and can be a member of silicate glasses. The zinc-silicate glasses can be used as a coating for surgical suture to combat wound infection. However, zinc has a negative effect on glass degradation and its  antibacterial action is a pH sensitive. In this work, silicate glasseswith ZnO at 14 and 17 mole% were used as a coating for non-resorbable Mersilk suture using a slurry-dipping technique. The coating morphology was studied using SEM and itsanti-bacterial action was investigated in vitroagainstgram positive and negative bacteria at neutral and acidic conditions.The effect of the coating on tensile strength of the sutures wasstudied as well.The results revealed that the coatingwas well-adhered to the suture and had anti-bacterial action atacidic condition.The coating had no effect on the tensile strength of the surgical suture

  4. [Hermetic sealing of the cataract incision with intracorneal mattress sutures].

    Science.gov (United States)

    Alekseev, B N; Voronin, G V

    1998-01-01

    Main factors of hermetic closure of an operative wound in cataract extraction with intracapsular implantation of intraocular lens are discussed. A new method for closure of operation wound in this operation is proposed. Opposition intracorneal mattress sutures are made over the incision plane. Their principal feature is that the thread is not thrown over the external edge of corneal incision, as in traditional non-opposition sutures, and during pulling and suture the thread does not deform the external surface of the cornea in the central zone and hence, causes no postoperative corneal astigmatism. A method combining opposition and interrupted non-opposition sutures is proposed, and various combinations of these sutures are compared. Forty-five patients (45 eyes) were operated on using the proposed technique. Opposition sutures made in accordance with the methods proposed by the authors do not cause high postoperative corneal astigmatism, or it approximates the normal values of corneal astigmatism. A special marker is proposed for preliminary marking of sites for nonperforating incisions on the cornea and the site of cataract incision.

  5. Development of braided drug-loaded nanofiber sutures

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-08-06

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

  6. Polyethylene glycol hydrogel spinal sealant (DuraSeal Spinal Sealant) as an adjunct to sutured dural repair in the spine: results of a prospective, multicenter, randomized controlled study.

    Science.gov (United States)

    Kim, Kee D; Wright, Neill M

    2011-11-01

    A prospective, multicenter, randomized, two-arm, single-blind, investigational device exemption pivotal study. To assess the efficacy and the safety of a polyethylene glycol (PEG) hydrogel spinal sealant (DuraSeal Spinal Sealant) as an adjunct to sutured dural repair compared with standard of care methods (control) to obtain a watertight dural closure in patients undergoing an intentional durotomy during spinal surgery. If a watertight dural closure is not achieved, cerebrospinal fluid leak with associated complications may occur. The PEG hydrogel spinal sealant is an Food and Drug Administration (FDA)-approved adjunct to sutured dural repair in spine surgery. This synthetic, absorbable hydrogel sealant works in the presence of fluid, conforms to irregular surfaces, and demonstrates strong adherence and compliance to tissue, without interfering with underlying tissue visibility. A total of 158 patients were treated at 24 centers after they were randomized on the basis of an approximately 2:1 ratio (sealant:control); 102 received the PEG hydrogel spinal sealant and 56 received standard care. The primary end point was intraoperative watertight closure. Secondary end points included evaluations of postoperative cerebrospinal fluid leak, infection, and wound healing. Patients treated with the PEG hydrogel spinal sealant had a significantly higher rate of watertight closure than the control (100% vs. 64.3%, P hydrogel spinal sealant evaluated in this study is safe and effective for providing watertight closure when used as an adjunct to sutured dural repair during spinal surgery. This readily available tool is superior to other standard of care technologies commonly used to achieve intraoperative watertight dural closure.

  7. Outcomes of conjunctival compression sutures for hypotony after glaucoma filtering surgery.

    Science.gov (United States)

    Quaranta, Luciano; Riva, Ivano; Floriani, Irene C

    2013-01-01

    To evaluate the outcomes of conjunctival compression sutures (CCS) for enlarged overfiltering blebs associated with ocular hypotony after uncomplicated trabeculectomy with mitomycin C (TM). A retrospective analysis of consecutively recruited patients with enlarged conjunctival bleb associated with hypotony who had undergone CCS was performed. Patients were considered for CCS if they had enlarged overfiltering bleb for at least 4 weeks, following an uncomplicated TM, with no sign of resolution. Only patients with hypotony, defined as intraocular pressure (IOP) 6 mm Hg 6 months after surgery. A total of 45 eligible patients were identified. In 29 eyes of 45 patients (64.4%), success in providing resolution of the preexisting hypotony (postoperative IOP mean ± standard deviation 13.4 ± 1.8 mm Hg, range 10-16 mm Hg) was obtained. Out of these 29 eyes, 9 eyes had a conjunctival bleb diffusion over 180 degrees, 19 eyes overfiltering bleb over 270 degrees, and 1 eye over 360 degrees. Complications from CCS included a transient spike of IOP in the first postoperative week (8 patients); a bleb rupture associated with conjunctival leaks and hypotony was observed in one eye. The placement of CCS is a safe and effective technique for managing overfiltering blebs associated with hypotony. The present study suggests that CCS are not effective for dealing with circumferential blebs extending over 360 degrees.

  8. Standard Test Procedures for Evaluating Various Leak Detection Methods

    Science.gov (United States)

    Learn about protocols that testers could use to demonstrate that an individual release detection equipment type could meet the performance requirements noted in the federal UST requirements for detecting leaks.

  9. Distributed Leak Detection System Using Structure-Borne Noise Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Manned spacecraft are vulnerable to air leaks caused by micrometeorite and space debris impact. The ability to detect and quickly locate and mitigate a pressure...

  10. Distributed Leak Detection System Using Structure-Borne Noise Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Manned spacecraft are vulnerable to air leaks caused by micrometeoroid and space debris impact. The ability to detect and quickly locate and mitigate a pressure...

  11. Leaking Underground Tanks in Rhode Island; LUSTs12

    Data.gov (United States)

    University of Rhode Island Geospatial Extension Program — This dataset shows the location of storage tanks and associated piping used for petroleum and certain hazardous substances that have experienced leaks as determined...

  12. In-Space Distributed Fiber Optic Hydrogen Leak Sensor Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Broadband Photonics Inc. proposes development of a patent-pending distributed fiber optic sensor for in-space hydrogen leak detection. Reliable and fast detection of...

  13. The world is polluted with leaked cyber data

    CSIR Research Space (South Africa)

    Burke, Ivan D

    2017-10-01

    Full Text Available Data breaches are becoming more common and numerous every day, where huge amount of data (corporate and personal) are leaked more frequently than ever. Corporate responses to data breaches are insufficient, when commonly remediation is minimal...

  14. Anastomotic leak after oesophagectomy and stent implantation: a systematic review

    Directory of Open Access Journals (Sweden)

    A.N. Kanatas

    2011-12-01

    Full Text Available Anastomotic leaks following oesophageal cancer resection have a high mortality. Stents have an established position in the palliation of dysphagia due to malignancy and in treating malignant perforation or fistula. They are increasingly used for benign conditions such as spontaneous oesophageal perforation with encouraging results. In this systematic review we examine the available evidence and attempt to define the role of stents in the management of oesophageal anastomotic leaks after resection for cancer. It is evident from the review that plastic- and metal-covered stents are an effective strategy for the treatment of anastomotic leaks. Vigilance is required as complications such as stent migration and incomplete sealing are not uncommon. Further clinical studies with greater methodological rigor in terms of sample size and study design may confirm that stents have an important contribution to make in the management of oesophageal anastomotic leak.

  15. Duodenal stump leak following a duodenal switch: A case report

    Directory of Open Access Journals (Sweden)

    Lars Nelson

    2015-01-01

    Conclusion: Duodenal stump leaks must be diagnosed as early as possible, and treated appropriately with operative intervention. Regardless of the operative technique the key to appropriate treatment is stabilize the patient, repair the duodenal stump, and adequate drainage.

  16. An ultrasonic array sensor for spacecraft leak direction finding.

    Science.gov (United States)

    Holland, Stephen D; Roberts, Ron; Chimenti, D E; Song, Jun Ho

    2006-12-01

    We have developed an ultrasonic array sensor useable for locating air leaks in manned spacecraft and have found that this sensor locates leaks in a 1-m(2) plate to within 2 cm. The sensor consists of a 63-element multiplexed array plus a reference element, all constructed from a single PZT disc and a printed circuit board. Cross-correlations of signals from the array elements with signals from the single reference element provide a measurement of the leak noise passing through the spacecraft skin under the array. A spatial Fourier transform reveals the dominant direction of propagation. Triangulation from multiple sensor locations can be used to find the source of the leak.

  17. Leak in spiral weld in a 16 inches gas pipeline

    Energy Technology Data Exchange (ETDEWEB)

    Fazzini, Pablo G.; Bona, Jeremias de [GIE S.A., Mar del Plata (Argentina); Otegui, Jose L. [University of Mar del Plata (Argentina)

    2009-07-01

    This paper discusses a failure analysis after a leak in the spiral weld of a 16 inches natural gas pipeline, in service since 1974. The leak was the result of the coalescence of two different defects, on each surface of the pipe wall, located in the center of the inner cord of the helical DSAW weld. Fractographic and metallographic studies revealed that the leak was a combination of three conditions. During fabrication of the pipe, segregation in grain boundary grouped in mid weld. During service, these segregations underwent a process of selective galvanic corrosion. One of these volumetric defects coincided with a tubular pore in the outer weld. Pigging of the pipeline in 2005 for cleaning likely contributed to the increase of the leak flow, when eliminating corrosion product plugs. Although these defects are likely to repeat, fracture mechanics shows that a defect of this type is unlikely to cause a blowout. (author)

  18. Locating Leaks with TrustRank Algorithm Support

    National Research Council Canada - National Science Library

    Luísa Ribeiro; Joaquim Sousa; Alfeu Sa Marques; Nuno E Simões

    2015-01-01

      This paper presents a methodology to quantify and to locate leaks. The original contribution is the use of a tool based on the TrustRank algorithm for the selection of nodes for pressure monitoring...

  19. Robust sensor placement for leak location: analysis and design

    OpenAIRE

    Blesa, Joaquim; Nejjari, Fatiha; Sarrate, Ramon

    2015-01-01

    In this paper, a nominal sensor placement methodology for leak location in water distribution networks is presented. To reduce the size and the complexity of the optimization problem a clustering technique is combined with the nominal sensor placement methodology. Some of the pressure sensor placement methods for leak detection and location in water distribution networks are based on the pressure sensitivity matrix analysis. This matrix depends on the network demands, which are nondeterminist...

  20. 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.

  1. Tank 241-A-105 leak assessment

    Energy Technology Data Exchange (ETDEWEB)

    1991-06-01

    Tank 241-A-105 is one of 149 single shell tanks constructed at Hanford to contain and store highly radioactive wastes originating from the processing of spent nuclear reactor fuel. Radiation detection and temperature monitoring devices installed beneath the tank indicate that several episodes of leakage of waste from the tank have occurred. The aim of this study was to evaluate the previous estimates and reanalyze the data to provide a more accurate estimate of leakage from the tank. The principal conclusions of this study are as follows: Earlier investigators estimated leakage prior to August 1968 at 5,000 to 15,000 gallons. Their estimate appears reasonable. Leakage while the tank was being sluiced (8/68--11/70) probably exceeded 5,000 gallons, but probably did not exceed 30,000 gallons. Insufficient data are available to be more precise. Cooling water added to the tank during the sprinkling phase (11/70 -- 12/78) was approximately 610,000 gallons. Sufficient heat was generated in the tank to evaporate most, and perhaps nearly all, of this water. Radionuclides escaping into the soil under the tank cannot be estimated directly because of many uncertainties. Based on a range of leakage from 10,000 to 45,000 gallons, assumed compositions, and decayed to 1/1/91, radioactivity under the tank is expected to be in the range of 85,000--760,000 curies. Measured radiation peaks were nearly all located directly below the perimeter of the tank and, except in rare cases, they showed no tendency to spread horizontally. Moreover, the maximum radiation readings detected are a very small fraction of the radiation reading in the tank. This is the basis for the conclusion that the rate of leakage and, most likely, the quantity leaked, was small. 51 refs., 5 figs., 3 tabs.

  2. FUZZY INFERENCE BASED LEAK ESTIMATION IN WATER PIPELINES SYSTEM

    Directory of Open Access Journals (Sweden)

    N. Lavanya

    2015-01-01

    Full Text Available Pipeline networks are the most widely used mode for transporting fluids and gases around the world. Leakage in this pipeline causes harmful effects when the flowing fluid/gas is hazardous. Hence the detection of leak becomes essential to avoid/minimize such undesirable effects. This paper presents the leak detection by spectral analysis methods in a laboratory pipeline system. Transient in the pressure signal in the pipeline is created by opening and closing the exit valve. These pressure variations are captured and power spectrum is obtained by using Fast Fourier Transform (FFT method and Filter Diagonalization Method (FDM. The leaks at various positions are simulated and located using these methods and the results are compared. In order to determine the quantity of leak a 2 × 1 fuzzy inference system is created using the upstream and downstream pressure as input and the leak size as the output. Thus a complete leak detection, localization and quantification are done by using only the pressure variations in the pipeline.

  3. Influence of Crack Morphology on Leak Before Break Margins

    Energy Technology Data Exchange (ETDEWEB)

    Weilin Zang (Inspecta Technology AB, Stockholm (SE))

    2007-11-15

    The purpose of the project is to evaluate the deterministic LBB-margins for different pipe systems in a Swedish PWR-plant and using different crack morphology parameters. Results: - The influence of crack morphology on Leak Before Break (LBB) margins is studied. The subject of the report is a number of LBB-submittals to SKI where deterministic LBB-margins are reported. These submittals typically uses a surface roughness of 0.0762 mm (300 microinch) and number of turns equal to zero and an in-house code for the leak rate evaluations. The present report has shown that these conditions give the largest LBB-margins both in terms of the quotient between the critical crack length and the leakage crack size and for the leak rate margin. - Crack morphology parameters have a strong influence on the leak rate evaluations. Using the SQUIRT code and more recent recommendations for crack morphology parameters, it is shown that in many cases the evaluated margins, using 1 gpm as the reference leak rate detection limit, are below the safety factor of 2 on crack size and 10 on leak rate, which is generally required for LBB approval. - The effect of including weld residual stresses on the LBB margins is also investigated. It is shown that for the two examples studied, weld residual stresses were important for the small diameter thin wall pipe whereas it was negligible for the large diameter thick wall pipe which had a self-balanced weld residual stress distribution

  4. Measurement of Submerged Oil/Gas Leaks using ROV Video

    Science.gov (United States)

    Shaffer, Franklin; de Vera, Giorgio; Lee, Kenneth; Savas, Ömer

    2013-11-01

    Drilling for oil or gas in the Gulf of Mexico is increasing rapidly at depths up to three miles. The National Commission on the Deepwater Horizon Oil Leak concluded that inaccurate estimates of the leak rate from the Deepwater Horizon caused an inadequate response and attempts to cap the leak to fail. The first response to a submerged oil/gas leak will be to send a Remotely Operated Vehicle (ROV) down to view the leak. During the response to the Deepwater Horizon crisis, the authors Savas and Shaffer were members of the Flow Rate Technical Group's Plume Team who used ROV video to develop the FRTG's first official estimates of the oil leak rate. Savas and Shaffer developed an approach using the larger, faster jet features (e.g., turbulent eddies, vortices, entrained particles) in the near-field developing zone to measure discharge rates. The authors have since used the Berkeley Tow Tank to test this approach on submerged dye-colored water jets and compressed air jets. Image Correlation Velocimetry has been applied to measure the velocity of visible features. Results from tests in the Berkeley Tow Tank and submerged oil jets in the OHMSETT facility will be presented.

  5. Methane Leaks from Natural Gas Systems Follow Extreme Distributions.

    Science.gov (United States)

    Brandt, Adam R; Heath, Garvin A; Cooley, Daniel

    2016-11-15

    Future energy systems may rely on natural gas as a low-cost fuel to support variable renewable power. However, leaking natural gas causes climate damage because methane (CH 4 ) has a high global warming potential. In this study, we use extreme-value theory to explore the distribution of natural gas leak sizes. By analyzing ∼15 000 measurements from 18 prior studies, we show that all available natural gas leakage data sets are statistically heavy-tailed, and that gas leaks are more extremely distributed than other natural and social phenomena. A unifying result is that the largest 5% of leaks typically contribute over 50% of the total leakage volume. While prior studies used log-normal model distributions, we show that log-normal functions poorly represent tail behavior. Our results suggest that published uncertainty ranges of CH 4 emissions are too narrow, and that larger sample sizes are required in future studies to achieve targeted confidence intervals. Additionally, we find that cross-study aggregation of data sets to increase sample size is not recommended due to apparent deviation between sampled populations. Understanding the nature of leak distributions can improve emission estimates, better illustrate their uncertainty, allow prioritization of source categories, and improve sampling design. Also, these data can be used for more effective design of leak detection technologies.

  6. Operational tank leak detection and minimization during retrieval

    Energy Technology Data Exchange (ETDEWEB)

    Hertzel, J.S.

    1996-03-01

    This report evaluates the activities associated with the retrieval of wastes from the single-shell tanks proposed under the initial Single-Shell Tank Retrieval System. This report focuses on minimizing leakage during retrieval by using effective leak detection and mitigating actions. After reviewing the historical data available on single-shell leakage, and evaluating current leak detection technology, this report concludes that the only currently available leak detection method which can function within the most probable leakage range is the mass balance system. If utilized after each sluicing campaign, this method should allow detection at a leakage value well below the leakage value where significant health effects occur which is calculated for each tank. Furthermore, this report concludes that the planned sequence or sluicing activities will serve to further minimize the probability and volume of leaks by keeping liquid away from areas with the greatest potential for leaking. Finally, this report identifies a series of operational responses which when used in conjunction with the recommended sluicing sequence and leak detection methods will minimize worker exposure and environmental safety health risks.

  7. Standard practice for leaks using the mass spectrometer leak detector in the detector probe mode

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2011-01-01

    1.1 This practice covers procedures for testing and locating the sources of gas leaking at the rate of 1 × 10−7 Pa m3/s (1 × 10−8 Std cm3/s) or greater. The test may be conducted on any device or component across which a pressure differential of helium or other suitable tracer gas may be created, and on which the effluent side of the leak to be tested is accessible for probing with the mass spectrometer sampling probe. 1.2 Two test methods are described: 1.2.1 Test Method A—Direct probing, and 1.2.2 Test Method B—Accumulation. 1.3 Units—The values stated in either SI or std-cc/sec units are to be regarded separately as standard. The values stated in each system may not be exact equivalents: therefore, each system shall be used independently of the other. Combining values from the two systems may result in non-conformance with the standard. 1.4 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this sta...

  8. Conceptual design report for the project to install leak detection in FAST-FT-534/548/549

    Energy Technology Data Exchange (ETDEWEB)

    Galloway, K.J.

    1992-07-01

    This report provides conceptual designs and design recommendations for installing secondary containment and leak detection systems for three sumps at the Fluorinel and Storage Facility (FAST), CPP-666. The FAST facility is located at the Idaho Chemical Processing Plant (ICPP) at the Idaho National Engineering Laboratory (INEL). The three sumps receive various materials from the FAST water treatment process. This project involves sump upgrades to meet appropriate environmental requirements. The steps include: providing sump modifications or designs for the installation of leak chases and/or leakage accumulation, coating the sump concrete with a chemical resistant sealant (except for sump VES-FT-534 which is already lined with stainless steel) to act as secondary containment, lining the sumps with a primary containment system, and providing a means to detect and remove primary containment leakage that may occur.

  9. Comparison of Barbed Sutures in Porcine Flexor Tenorrhaphy

    Science.gov (United States)

    Sull, Alan; Inceoglu, Serkan; August, Alicia; Gregorius, Stephen; Wongworawat, Montri D.

    2016-01-01

    Background: Barbed suture use has become more popular as technology and materials have advanced. Minimal data exist regarding performance of the 2 commercially available products, V-LocTM and StratafixTM in tendon repairs. The purpose of this study was to compare gap resistance and ultimate tensile strength of both suture materials and nonbarbed suture in a porcine ex vivo model. Methods: Porcine flexor tendons were harvested and divided into 3 groups of 10 of varying suture material (3-0 PDS™, 3-0 V- V-Loc 180™, or 3-0 Stratafix™). A modified 4-strand cruciate technique was used to repair each tendon. Knotless repair was performed using barbed suture, whereas a buried 6-throw square knot was done using conventional suture. A servohydrolic tester was used for biomechanical testing of linear 2-mm gap resistance and maximum tensile strength. Results: No difference was found in 2-mm gap resistance among the 3 groups. No difference was found in ultimate tensile strength between V-Loc™ (76.0 ± 9.4 N) and Stratafix™ (68.1 ± 8.4 N) repairs, but the ultimate strength of the PDS™ control group (83.4 ± 10.0 N) was significantly higher than that of Stratafix™. Conclusions: Barbed (knotless) and nonbarbed suture repairs demonstrate equivalent 2-mm gap resistance. Stratafix™ repairs show slightly inferior performance to nonbarbed repairs in ultimate tensile strength, although this occurred at gap distances far beyond the 2-mm threshold for normal tendon gliding. Both barbed and nonbarbed 4-strand cruciate flexor tendon repairs may require peripheral repair to withstand physiologic loads. PMID:28149217

  10. Effects of wound architecture and suture technique on postoperative astigmatism.

    Science.gov (United States)

    Gimbel, H V; Sun, R; DeBroff, B M

    1995-01-01

    A prospective randomized investigation was performed to evaluate the effects of wound architecture and suture techniques on postoperative astigmatism after phacoemulsification and intraocular lens implantation. Two hundred eyes with preexisting with-the-rule astigmatism were randomized into four groups: (1) sutureless scleral tunnel frown incision, (2) scleral tunnel frown incision with a horizontal suture, (3) scleral tunnel frown incision with both a horizontal and a running suture, and (4) posterior limbal acute beveled cataract incision with a running suture. All the incisions were placed in the vertical steep meridian. Data were analyzed from 128 cases with 1-year follow-up. The results revealed that at the 2-month postoperative visit, preexisting astigmatism was significantly reduced in group 1 (P = .029) and significantly increased in groups 3 (P = .020) and 4 (P = .005). There was no significant change in group 2 (P = .06). By the 1-year postoperative visit, there was no significant difference in astigmatism from preoperative levels for all four groups. Vector analysis revealed no significant difference in the mean surgically induced cylinder at 1 year in all four groups. The number of eyes with induced against-the-rule astigmatism, however, was significantly higher than the number of eyes with induced with-the-rule astigmatism in all four groups (P sutured wounds placed in the vertical steep meridian may initially increase with-the-rule astigmatism, whereas nonsutured wounds placed in the vertical steep meridian may initially reduce with-the-rule astigmatism. By 1 year, however, a mean flattening of the vertical steep meridian was observed in the three groups with sutures as well as in the group without sutures.

  11. Mesh fixation with a barbed anchor suture results in significantly less strangulation of the abdominal wall.

    Science.gov (United States)

    Lyons, Calvin; Joseph, Rohan; Salas, Nilson; Reardon, Patrick R; Bass, Barbara L; Dunkin, Brian J

    2012-05-01

    Laparoscopic ventral hernia repair using an underlay mesh frequently requires suture fixation across the abdominal wall, which results in significant postoperative pain. This study investigates the utility of a novel mesh fixation technique to reduce the strangulation force on the abdominal wall. Multiple 2-cm(2) pieces of polyester mesh (Parietex Composite, Covidien) were placed as an underlay against a porcine abdominal wall. Fixation was accomplished using either the standard 0-polyglyconate or the 0-polyglyconate barbed anchor suture designed to hold in tissue without the need to tie a knot (V-Loc 180; Covidien). Suture fixation began with a stab wound incision in the skin. A suture-passing device then was used to pass the suture across the abdominal wall and through the mesh. The suture passer was removed and reintroduced through the same stab wound incision but at a different fascial entry point 1.5 cm away. The tail of the suture was grasped and pulled up through both the mesh and the abdominal wall, creating a full-thickness U-stitch. One tail of the suture was attached to a tensiometer, and the strangulation force on the abdominal wall was measured while the suture was tied (standard) or looped (barbed). To compare pullout force, the tensiometer was attached to either the mesh or the suture, and traction was applied until material failure or suture pull through. Results are expressed as mean ± standard deviation. Comparisons were performed using Student's t-test. Eight pieces of mesh were placed for each suture. The average force required to secure the barbed suture (0.59 ± 0.08 kg) was significantly less than the force needed to secure the standard suture (2.17 ± 0.58 kg) (P suture pullout forces with the mesh failure forces. Although the pullout force for the standard suture is significantly greater than for the barbed suture, both sutures have a pullout strength significantly greater than the mesh failure force. Table 1 Suture fixation forces for

  12. The effect of different suturing techniques on astigmatism after penetrating keratoplasty.

    Science.gov (United States)

    Kim, Sang Jin; Wee, Won Ryang; Lee, Jin Hak; Kim, Mee Kum

    2008-12-01

    The purpose of this study was to compare the effects on astigmatism after penetrating keratoplasty with three different suture techniques. In this prospective study, 38 eyes of 38 patients underwent penetrating keratoplasty with three suturing techniques: interrupted, single running, and double running. Topographic astigmatism was measured at 2, 6, 12, and 18 months after keratoplasty. During 18 months after surgery, the interrupted suture group had higher astigmatism than the double running suture group. There was no significant difference in the amounts of astigmatism during the first year after keratoplasty between the single running and the double running suture group. However, at 18 months after surgery, when all sutures were out, the double running suture group (3.60+/-1.58 diopters) showed significantly less astigmatism than the single running group (5.65+/-1.61 diopters). In conclusion, post-keratoplasty astigmatism was the least in the double running suture group of the three suturing techniques at 18 months after penetrating keratoplasty.

  13. Intelligence Leaks: What Is the Role of the Leak and the Leaker in U.S. Democracy?

    Science.gov (United States)

    2014-03-01

    repository of leaked documents and other artifacts of the millennial cyber-punk set. The obscure website gained global notoriety for the massive...The Christian Science Monitor, July 25, 2013, sec. NEWS. 90 Joe Wiesenthal, “WikiLeaks Blows the Lid off the Sex Parties and Drug Usage Among...the Saudi Royals,” Business Insider, March 7, 2011, http://www.businessinsider.com/wikileaks-blows-the-lid-off- the-sex-parties-and- drug -usage-among

  14. Positioning of the cross-stitch on the modified Kessler core tendon suture.

    Science.gov (United States)

    Gil-Santos, L; Monleón-Pradas, M; Gomar-Sancho, F; Más-Estellés, J

    2018-01-26

    Cryopreserved human tendons were sutured with different variations of a modified Kessler-type grasping suture in a series of different designs in order to assess the influence of the distance between the cross-stitch on the core suture (5 and 10 mm from the cut tendon edge) on the peripheral suture. An original mathematical model was employed to explain the mechanical behavior (strength, deformation, and distribution of load) of the different suture designs. The effect of the peripheral epitendinous suture, combined with the distance of the core suture, was evaluated. The variation of core suture distance had no relevant consequences on the overall resilience of the design. However, increasing the distance between the cross-stitches of the core suture reduces the deformation that is absorbed not only by the core suture itself but also by the peripheral suture. Adding a peripheral epitendinous suture to a 10-mm design almost doubles the breaking load in absolute values. The mathematical model predicts that the peripheral suture will support a greater load when the distance of the core suture cross-stitches is increased. The evidence level is II. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Comparison of two surgical suture techniques in uvulopalatopharyngoplasty and expansion sphincter pharyngoplasty.

    Science.gov (United States)

    Steinbichler, Teresa B; Bender, Birte; Giotakis, Aristeidis I; Dejaco, Daniel; Url, Christoph; Riechelmann, Herbert

    2018-02-01

    Uvulopalatopharyngoplasty (UPPP) and expansion sphincter pharyngoplasty (ESP) are two standard surgical procedures for treatment of snoring and sleep apnea. In a prospective clinical trial, we compared a standard simple interrupted suture technique for closure of the tonsillar pillars with a running locked suture. Each suture technique was randomly assigned either to the left or the right tonsillar pillars in 28 patients. During the first week, patients were daily checked for suture dehiscence and again on days 10 and 21, the end of followup. Time to perform the sutures was measured intraoperative and surgical complications were recorded. During followup, suture dehiscence was observed in 15/28 interrupted and 16/28 running sutures (p > 0.5). If a dehiscence occurred during the observation period, the median day of dehiscence was 10 (1 and 3 quartile: 5.75 and 17) days for the interrupted suture and 10 (5-11) days for the running locked suture technique (p > 0.05). The mean (± SD) surgical time for the interrupted suture was 5.2 ± 1.9 and 3.5 ± 1.8 min for the running locked suture (p sutures and 2/28 interrupted sutures. The running locked suture technique is an equally safe and time saving way of wound closure in UPPP and ESP.

  16. Location estimation method of steam leak in pipeline using leakage area analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Se Oh; Jeon, Hyeong Seop; Son, Ki Sung [Sae An Engineering Corp., Seoul (Korea, Republic of); Park, Jong Won [Dept. of Information Communications Engineering, Chungnam National University, Daejeon (Korea, Republic of)

    2016-10-15

    It is important to have a pipeline leak-detection system that determines the presence of a leak and quickly identifies its location. Current leak detection methods use a acoustic emission sensors, microphone arrays, and camera images. Recently, many researchers have been focusing on using cameras for detecting leaks. The advantage of this method is that it can survey a wide area and monitor a pipeline over a long distance. However, conventional methods using camera monitoring are unable to target an exact leak location. In this paper, we propose a method of detecting leak locations using leak-detection results combined with multi-frame analysis. The proposed method is verified by experiment.

  17. Effect of Additional Sutures per Suture Anchor in Arthroscopic Bankart Repair: A Review of Single-loaded Versus Double-loaded Suture Anchors.

    Science.gov (United States)

    Chen, Jeffrey S; Novikov, David; Kaplan, Daniel J; Meislin, Robert J

    2016-07-01

    To directly compare single-loaded suture anchors (SSA) with double-loaded suture anchors (DSA) to help surgeons optimize the operative technique, time, and cost of Bankart repairs. A literature review was performed using the PubMed and SCOPUS databases. Studies that directly compared SSA and DSA for Bankart repairs, or indirectly compared them by collecting relevant data despite a different objective, were included. A total of two studies were included, both of which were cadaveric laboratory studies. A total of 28 shoulders were tested. Tests conducted include loading to failure and cyclic loading. One study found SSA to be biomechanically equivalent to DSA, and one found DSA to be superior. Based on limited cadaveric study, DSA are at least equivalent biomechanically to SSA, and may be superior. By using DSA, surgeons create repair constructs that are as strong as, or stronger than, those made with SSA, but with fewer anchors. This reduces the amount of holes drilled and implants placed in the glenoid, while also minimizing cost. Quantifying the benefit of additional sutures in a suture anchor can help optimize the quality of repair, time, and cost in arthroscopic shoulder repair. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  18. Evaluation of Postoperative Povidone-Iodine in Adjustable Suture Strabismus Surgery to Reduce Suture Colonization: A Randomized Clinical Trial.

    Science.gov (United States)

    Rossetto, Julia D; Suwannaraj, Sirinya; Cavuoto, Kara M; Spierer, Oriel; Miller, Darlene; McKeown, Craig A; Capo, Hilda

    2016-10-01

    Although the association between suture colonization and postoperative infections remains hypothetical, measures to reduce perioperative suture colonization may minimize postoperative infections. The suture colonization rate in adjustable suture strabismus surgery is not well defined, and the effect of povidone-iodine use on suture colonization is unknown. To assess whether povidone-iodine application at the end of adjustable suture strabismus surgery decreases the suture colonization rate. In this randomized clinical trial designed in 2015 and performed from June 1 through October 31, 2015, a total of 65 adjustable and 43 control suture specimens from 65 demographically similar adults undergoing adjustable suture strabismus surgery were studied. A random sampling assigned participants into group 1 (with povidone-iodine) or group 2 (without povidone-iodine) at the end of surgery. A control suture specimen was obtained if ipsilateral nonadjustable surgery was performed. Both groups received antibiotic ointment at the end of the procedure. No patients refused participation or withdrew. Data analysis was performed from October 1 to December 31, 2015. Observers were unaware of patient grouping. One drop of 5% povidone-iodine directly over the sliding noose of the adjustable suture at the end of surgery. The suture colonization rate after adjustment in group 1, group 2, and the control group. Of 65 adults undergoing surgery, there were 17 men (49%) and 18 women (51%) in group 1 and 10 men (33%) and 20 women (67%) in group 2, as well as 20 men (47%) and 23 women (53%) in the control group. The mean (SD) age of the patients was 48.5 (16.8) years in group 1, 46.6 (18.1) years in group 2, and 47.7 (17.0) years in the control group. There was no difference in the colonization rate between group 1 (57%) and group 2 (47%) (relative risk [RR], 1.1; 95% CI, 0.6-1.7; P = .80), group 1 and the control group (44%) (RR, 1.0; 95% CI, 0.5-1.8; P > .99), or group 2 and

  19. Infrared Camera System for Visualization of IR-Absorbing Gas Leaks

    Science.gov (United States)

    Youngquist, Robert; Immer, Christopher; Cox, Robert

    2010-01-01

    Leak detection and location remain a common problem in NASA and industry, where gas leaks can create hazardous conditions if not quickly detected and corrected. In order to help rectify this problem, this design equips an infrared (IR) camera with the means to make gas leaks of IR-absorbing gases more visible for leak detection and location. By comparing the output of two IR cameras (or two pictures from the same camera under essentially identical conditions and very closely spaced in time) on a pixel-by-pixel basis, one can cancel out all but the desired variations that correspond to the IR absorption of the gas of interest. This can be simply done by absorbing the IR lines that correspond to the gas of interest from the radiation received by one of the cameras by the intervention of a filter that removes the particular wavelength of interest from the "reference" picture. This can be done most sensitively with a gas filter (filled with the gas of interest) placed in front of the IR detector array, or (less sensitively) by use of a suitable line filter in the same location. This arrangement would then be balanced against the unfiltered "measurement" picture, which will have variations from IR absorption from the gas of interest. By suitable processing of the signals from each pixel in the two IR pictures, the user can display only the differences in the signals. Either a difference or a ratio output of the two signals is feasible. From a gas concentration viewpoint, the ratio could be processed to show the column depth of the gas leak. If a variation in the background IR light intensity is present in the field of view, then large changes in the difference signal will occur for the same gas column concentration between the background and the camera. By ratioing the outputs, the same signal ratio is obtained for both high- and low-background signals, even though the low-signal areas may have greater noise content due to their smaller signal strength. Thus, one

  20. Suture anchor materials, eyelets, and designs: update 2008.

    Science.gov (United States)

    Barber, F Alan; Herbert, Morley A; Beavis, R Cole; Barrera Oro, Fernando

    2008-08-01

    Our purpose was to evaluate recently introduced sutures and suture anchors for single pull load to failure strength and failure mode. Suture anchors were tested in fresh porcine metaphyseal cortex and cancellous troughs using an established protocol. An Instron machine applied tensile loads parallel to the axis of insertion at a rate of 12.5 mm per second until failure and mean anchor failure strengths were calculated. The mode of failure was recorded (anchor pullout, suture eyelet cut out, or suture failure). Anchors tested included the Kinsa, Kinsa RC, BioRaptor 2.3 PK, TwinFix PK FT 5.5 and 6.5, BioCleat, Healix Peek, VersaLok, BioKnotless, BioKnotless BR, Corkscrew FT III, SwiveLock C, and PEEK SutureTak. The mean cortical failure loads were as follows: Kinsa (219 N), Kinsa RC (222 N), BioRaptor 2.3 PK (172 N), TwinFix PK FT 5.5 (491 N) and 6.5 (503 N), BioCleat (218 N), Healix Peek (407 N), VersaLok (376 N), BioKnotless (249 N), BioKnotless BR (265 N), Corkscrew FT III (386 N), SwiveLock C (712 N), and PEEK SutureTak (168 N). Pullout was the predominant failure mode for the VersaLok, BioKnotless, BioKnotless BR, and BioRaptor 2.3PK anchors. Eyelet failure was the predominant failure mode for the Kinsa, Kinsa RC, BioCleat, Healix Peek, Corkscrew FT III, SwiveLock C, and PEEK SutureTak. The newer anchors showed markedly increased load to failure strengths. Two or more high-strength sutures are commonly used as well as new anchor materials (PEEK and Biocryl Rapide), new eyelet designs, and the increased use of a "knotless" concept. An anchor which fails principally by pull out at a low load to failure is at risk for creating an intra-articular loose body.

  1. Correction of astigmatism after penetrating keratoplasty by relaxing incision with compression suture: a comparison between the guiding effect of photokeratoscope and of computer-assisted videokeratography.

    Science.gov (United States)

    Chang, Sheng-Ming; Su, Chuan-Yi; Lin, Chang-Ping

    2003-07-01

    To report the results of astigmatism correction after penetrating keratoplasty by relaxing incision with compression suture and to compare the guiding ability of a photokeratoscope with that of computer-assisted videokeratography. In the two independent retrospective series, 11 eyes received a relaxing incision with compression suture guided by photokeratoscope or computer-assisted videokeratography. In 22 eyes, the relaxing incision with compression suture showed a mean 56% reduction in astigmatism and 78% reduction in vector-calculated astigmatism. The mean postoperative visual acuity was improved 2.92 Landolt lines. The 11 eyes in which treatment was guided by photokeratoscope demonstrated a mean reduction of 50% and 71% in astigmatism and vector-calculated astigmatism, respectively, and visual acuity increased 2.44 Landolt lines. Another 11 eyes in which treatment was guided by computer-assisted videokeratography achieved a mean reduction of 67% and 90% in astigmatism and vector-calculated astigmatism, respectively, together with 3.41 Landolt lines improvement in visual acuity. There were no significant differences in astigmatism correction and visual acuity improvement between the two groups. The results demonstrate that the relaxing incision with compression suture is an effective and safe procedure for correcting high astigmatism after penetrating keratoplasty. The two instruments have no significant difference in their guiding capacities for this procedure.

  2. Arthroscopic Transtendinous Biceps Tenodesis With All-Suture Anchor.

    Science.gov (United States)

    Shih, Chien-An; Chiang, Florence L; Hong, Chih-Kai; Lin, Cheng-Wei; Wang, Ping-Hui; Jou, I-Ming; Su, Wei-Ren

    2017-06-01

    There are several methods for long head of the biceps (LHB) tenodesis, yet the optimal option is still debatable. Here we introduce a technique for arthroscopic suprapectoral biceps tenodesis with an all-suture anchor, the transtendinous biceps tenodesis technique. The LHB tenodesis is performed by using the Y-Knot anchor (1.3-mm). A standard suprapectoral approach is used for the tenodesis. A 1.3-mm drill bit is used to drill through the midportion of the biceps tendon and underlying bone to make a pilot hole. Next, the Y-Knot anchor is passed through the tendon and anchored on the underlying bone. A wrapping suture technique is then used to wrap around, tension, and secure the LHB tendon with the aid of a shuttling polydioxanone suture. The construct is fixed by tying down both suture limbs in a nonsliding fashion. This Technical Note describes an alternative method for all-arthroscopic suprapectoral biceps tenodesis using an all-suture anchor with a small diameter to minimize trauma to the tendon.

  3. EFFECTS OF DIFFERENT SUTURE MATERIALS ON TISSUE HEALING

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

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

    2014-03-01

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

  5. 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.

  6. 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.

  7. The pump and leak steady-state concept with a variety of regulated leak pathways

    DEFF Research Database (Denmark)

    Hoffmann, E K

    2001-01-01

    The paper will reflect on how Ussing has affected my own scientific work and how he created much of the framework within which I have been working. I have used five examples: (i) The first description of a 1:1 exchange diffusion was introduced by Ussing in 1947 and has been found to be of great....... This had a major influence on my later description of a swelling-activated Cl- conductance. (ii) The pump-leak steady-state concept for cell volume control was introduced by Krogh in 1946, but it was developed in detail by Leaf and Ussing in 1959. This concept was the basis for me and others, when we later...... to study ion transport across epithelia. A few results on Cl- transport across the operculum epithelium of the small eurohaline fish Fundulus heteroclitus mounted in small Ussing chambers are presented. (v) Shrinkage-activated Na+ conductance and its possible role in isotonic secretion in frog skin glands...

  8. 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.

  9. The Stress Relaxation Process in Sutures Tied with a Surgeon's Knot in a Simulated Biological Environment.

    Science.gov (United States)

    Liber-Kneć, Aneta; Łagan, Sylwia

    2016-01-01

    The exact characteristics of sutures are not only the basis for selecting from among different types of suture, but also provide the necessary information for the design of new surgical sutures. Apart from information relating to the breaking load of a suture reported in pharmacopoeias, the viscoelastic properties of sutures can be an additional selection criterium - one that influences stitching quality, especially when there is a risk of wound dehiscence. The aim of the study was to assess the stress relaxation process for 3 polymeric sutures in an environment simulating the conditions in a living organism and (for comparison) in room conditions. Stress relaxation testing was carried out on 3 polymeric sutures: polypropylene (PP), polydioxanone (PDS) and polyglycolic acid (PGA). To identify the mechanical properties of the sutures, uniaxial tensile tests were conducted according to the Polish Pharmacopoeia. The relaxation test was carried out in room conditions and in the bath simulating a biological environment. The sutures being tested were tied with a surgeon's knot. The PP suture exhibited the greatest stress relaxation (18% of the initial stress in room conditions and 21% of the initial stress in the bath). The PGA suture exhibited the least stress relaxation (approximately 60% of the initial stress in room conditions and 59% of the initial stress in the bath). The PDS suture was tested at a lower strain level and showed stress relaxation similar to the PGA suture (approximately 63% of the initial stress in room conditions and 55% in the bath). Multifilament braided absorbable (PGA) sutures and monofilament absorbable (PDS) sutures had a higher stress relaxation ratio over time than monofilament non-absorbable (PP) sutures. These findings may indicate higher stress maintained over time in PDS and PGA sutures, and thus higher tension at wound edges, sufficient to resist wound dehiscence.

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

    Science.gov (United States)

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

    2017-01-01

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

  11. 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.

  12. Do galaxies that leak ionizing photons have extreme outflows?

    Science.gov (United States)

    Chisholm, J.; Orlitová, I.; Schaerer, D.; Verhamme, A.; Worseck, G.; Izotov, Y. I.; Thuan, T. X.; Guseva, N. G.

    2017-09-01

    Context. To reionize the early universe, high-energy photons must escape the galaxies that produce them. How these photons escape is debated because too many ionizing photons are absorbed even at small H i column densities. It has been suggested that stellar feedback drives galactic outflows out of star-forming regions, creating low density channels through which ionizing photons escape into the inter-galactic medium. Aims: We compare the galactic outflow properties of confirmed Lyman continuum (LyC) leaking galaxies to a control sample of nearby star-forming galaxies to explore whether the outflows from leakers are extreme as compared to the control sample. Methods: We use data from the Cosmic Origins Spectrograph on the Hubble Space Telescope to measure the equivalent widths and velocities of Si ii and Si iii absorption lines, tracing neutral and ionized galactic outflows. We explore whether the leakers have similar outflow properties to the control sample, and whether the outflows from the leakers follow similar scaling relations with host galaxy properties as the control sample. We rederive the escape fraction of ionizing photons for each leaker, and study whether the outflow properties influence the LyC escape fractions. Results: We find that the Si ii and Si iii equivalent widths of the LyC leakers reside on the low-end of the trend established by the control sample. The leakers' velocities are not statistically different than the control sample, but their absorption line profiles have a different asymmetry: their central velocities are closer to their maximum velocities. This possibly indicates a more rapidly accelerated outflow due to the compact size of the leakers. The outflow kinematics and equivalent widths are consistent with the scaling relations between outflow properties and host galaxy properties - most notably metallicity - defined by the control sample. Additionally, we use the Lyα profiles to show that the Si ii equivalent width scales with the

  13. Triangular mattress suture in abdominal diastasis to prevent epigastric bulging.

    Science.gov (United States)

    Ferreira, L M; Castilho, H T; Hochberg, J; Ardenghy, M; Toledo, S R; Cruz, R G; Tardelli, H

    2001-02-01

    In the classic abdominoplasty, the treatment of large diastasis recti with simple or vertical mattress sutures may result in a nonaesthetic bulge. The surgeon may produce a craniocaudal bulge deformity by treating the flaccidity in the horizontal plane only, although it occurs in all directions. The authors describe the triangular mattress suture for the treatment of large diastasis recti, and demonstrate the mechanism involved in producing an epigastric bulge. Also presented is their clinical experience with 56 patients, with a 3-year follow-up, using this new plication method. The triangular mattress suture is a simple, quick, and effective way to correct abdominal diastasis and to avoid the epigastric bulge deformity with no added morbidity.

  14. CT and MR image fusion for CSF leak diagnosis

    Science.gov (United States)

    Hu, Yangqiu; Haynor, David R.; Maravilla, Kenneth R.

    2008-03-01

    The diagnosis of CSF leak using MR images alone is difficult due to the inherently poor bony information on MR images. While CT images show bones exquisitely, they lack the soft tissue contrast that is important for detecting CSF leak. For these reasons, CT cisternography has been the preferred modality for CSF leak diagnosis despite its invasiveness. We propose a method to fuse the CT and MR images to combine the complementary information from each modality, which we believe will help with the diagnosis and surgical planning for patients with CSF leak, and potentially reduce/replace the use of CT cisternography. In the first step, the user identifies three roughly corresponding points on both the CT and MR images. A GUI was designed that allows the user to quickly navigate through the images by reslicing the volumes interactively. After finding the CT and MR slices at approximately the same anatomical position, the user places three markers to represent the same spatial location. In the second step, a generalized Procrustes transform is used to compute an initial transformation that aligns the CT and MR, which is then optimized using mutual information maximization. The CT is registered with the MR using the optimal transformation found, and the bony masks determined from thresholding CT intensity are blended with MR images. Initial results suggest that CT/MR fusion images are superior to unprocessed CT and MR images in diagnosing CSF leak, and a formal clinical evaluation is being planned to assess the efficacy of fusion images.

  15. Managing leaks following anterior resections: a new classification system.

    Science.gov (United States)

    Shukla, Parul J; Barreto, Savio George; Pandey, Durgatosh; Kanitkar, Gajanan A; Shrikhande, Shailesh V

    2011-01-01

    Anastomotic leak rates following rectal resections and anastomosis stand at 2.9-15.3%, with an attendant mortality rate of 6- 39.3%. The aim of our study was to identify those patients who had developed an anastomotic leak, and evaluate the indications for re-exploration as well as study the impact of covering colostomies on the subsequent outcome. We analyzed 266 consecutive anterior resections for rectal cancer performed at a single institution between 1st September 2002 and 31st December 2006. Twenty-one anastomotic leaks were encountered in 266 resections. Covering colostomies were performed in 56% (151/266) of the patients. Out of the 21 patients who developed a leak, 9 had a covering colostomy (42.8%). In this group, 3 of patients (33%) could be managed without surgical re-exploration, while all the 12 patients without a covering colostomy had to undergo a reexploration. With our new classification system for anastomotic dehiscence, the clinical decisions appear to follow a predictable pattern. There were 4 deaths (1.5%). However, the mortality rate in the patients undergoing surgical re-exploration for complications was 16.6% (3/18). This large study provides an insight into the potential advantages of covering colostomies wherever indicated following anterior resections. With our new and effective classification system for clinical leaks, the management road map can be simplified and standardized.

  16. Meaningful assessment method for laparoscopic suturing training in augmented reality.

    Science.gov (United States)

    Botden, Sanne M B I; de Hingh, I H J T; Jakimowicz, J J

    2009-10-01

    To be an effective training tool, a laparoscopic simulator has to provide metrics that are meaningful and informative to the trainee. Time, path length and smoothness are often used parameters, but are not very informative on the quality of the performance. This study aims to validate a newly developed assessment method for laparoscopic suturing on the ProMIS augmented reality simulator, and compares it with scores of objective observers. Twenty-four participants practised their suturing skills on the augmented reality suturing module: experienced participants (n = 10), >50 clinical laparoscopic suturing experience; and novice participants (n = 14), without laparoscopic experience. The performances were recorded and assessed by two unrelated observers and compared with the assessment scores. The assessment score was a calculation of time spent in the correct area and quality (strength) of the knot. To test the accuracy of the individual assessment parameters, we compared these with each other. The experienced participants had significantly higher performance scores than the novice participants in the beginner-level mode (mean 95.73 vs. 60.89, standard deviation 2.63 vs. 17.09, p < 0.001, independent t-test). The performance scores of the assessment method (n = 43) correlated significantly with the scorings of the objective observers (Spearman's rho 0.672; p < 0.001). The parameter time spent in correct area had a calculated significant correlation with the strength of the knot (n = 229, Spearman's rho 0.257, p < 0.001), but this was clinically irrelevant. This assessment method is a valid tool for objectively assessing laparoscopic suturing skills. Although assessment parameters can correlate, to provide informative feedback it is important to combine meaningful measurements in the assessment of suturing skills.

  17. Triclosan sutures for surgical site infection in colorectal cancer.

    Science.gov (United States)

    Yamashita, Kanefumi; Takeno, Shinsuke; Hoshino, Seiichiro; Shiwaku, Hironari; Aisu, Naoya; Yoshida, Yoichiro; Tanimura, Syu; Yamashita, Yuichi

    2016-11-01

    Among all procedures, surgical site infections (SSIs) in colorectal surgery continue to have the highest rate, accounting for 5%-45%. To prevent the bacterial colonization of suture material, which disables local mechanisms of wound decontamination, triclosan-coated sutures were developed. We assessed the effectiveness of triclosan-coated sutures used for skin closure on the rate of SSIs in colorectal cancer surgery. Until August 2012, we used conventional methods for skin closure in colorectal cancer surgery at the Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine. Therefore, for the control group, we retrospectively collected surveillance data over a 1.5-y period. From September 2012, we began using triclosan-coated polydioxanone antimicrobial sutures (PDS plus) for skin and fascia closure. Hence, we collected data for the study group from September 2012 to October 2013. Differences in baseline characteristics and selection bias were adjusted using the propensity score-matching method. A total of 399 patients who underwent colorectal surgery were included in this study. There were 214 patients in the control group and 185 patients in the study group. Baseline patient characteristics were similar between the propensity score-matched groups. The incidence of SSIs was less in the study group. Multivariate logistic regression analysis showed that the site of the procedure, laparoscopic surgery, and using triclosan-coated sutures remained the independent predictors of SSIs. The use of triclosan-coated sutures was advantageous for decreasing the risk of SSIs after colorectal surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Virtual interactive suturing for the Fundamentals of Laparoscopic Surgery (FLS).

    Science.gov (United States)

    Qi, Di; Panneerselvam, Karthikeyan; Ahn, Woojin; Arikatla, Venkata; Enquobahrie, Andinet; De, Suvranu

    2017-11-01

    Suturing with intracorporeal knot-tying is one of the five tasks of the Fundamentals of Laparoscopic Surgery (FLS), which is a pre-requisite for board certification in general surgery. This task involves placing a short suture through two marks in a penrose drain and then tying a double-throw knot followed by two single-throw knots using two needle graspers operated by both hands. A virtual basic laparoscopic skill trainer (VBLaST©) is being developed to represent the virtual versions of the FLS tasks, including automated, real time performance measurement and feedback. In this paper, we present the development of a VBLaST suturing simulator (VBLaST-SS©). Developing such a simulator involves solving multiple challenges associated with fast collision detection, response and force feedback. In this paper, we present a novel projection-intersection based knot detection method, which can identify the validity of different types of knots at haptic update rates. A simple and robust edge-edge based collision detection algorithm is introduced to support interactive knot tying and needle insertion operations. A bimanual hardware interface integrates actual surgical instruments with haptic devices enabling not only interactive rendering of force feedback but also realistic sensation of needle grasping, which realizes an immersive surgical suturing environment. Experiments on performing the FLS intracorporeal suturing task show that the simulator is able to run on a standard personal computer at interactive rates. VBLaST-SS© is a computer-based interactive virtual simulation system for FLS intracorporeal knot-tying suturing task that can provide real-time objective assessment for the user's performance. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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

  20. Retinal detachment caused by Arruga suture scleral intrusion. Treatment.

    Science.gov (United States)

    Sánchez-Vicente, J L; Rueda-Rueda, T; González-García, M L; López-Herrero, F; Sánchez-Vicente, P; Castilla-Lázpita, A

    2015-10-01

    We present the case of an 81-year-old man with retinal detachment caused by intrusion of an Arruga suture. The encircling buckle was located in the sub-retinal space and caused retinal breaks with retinal detachment A pars plana vitrectomy was performed along with intraocular cutting of the Arruga suture with retinal re-attachment. Copyright © 2014 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  1. Distal clavicular fracture treatment with suture anchor method

    OpenAIRE

    Mirbolook, Ahmadreza; Sadat, Mirmostafa; Golbakhsh, Mohammadreza; Mousavi, Mohammad Sadegh; Gholizadeh, Amirmohammad; Saghari, Sepehr

    2018-01-01

    Objective: The aim of this study was to evaluate the results of the suture anchor fixation in the treatment of distal clavicle fractures.Methods: This cross series study included 43 patients (27 males, 12 females; mean age: 40.1±10.18 years) with type II unstable distal clavicle fractures. The fractures were fixed by 2 pins and 1 suture anchor. All patients were followed at postoperative months 3, 6, and 12 and underwent clinical and radiographic evaluation after 1 year, ongoing at 6-month in...

  2. A biomechanical analysis of anterior Bankart repair using suture anchors.

    Science.gov (United States)

    Nho, Shane J; Frank, Rachel M; Van Thiel, Geoffrey S; Wang, Fan Chia; Wang, Vincent M; Provencher, Matthew T; Verma, Nikhil N

    2010-07-01

    Arthroscopic repair of anterior Bankart lesions is typically done with single-loaded suture anchors tied with simple stitch configuration. The knotless suture anchor will have similar biomechanical properties compared with two types of conventional suture anchors. Controlled laboratory study. Fresh-frozen shoulders were dissected and an anteroinferior Bankart lesion was created. For phase 1, specimens were randomized into either simple stitch (SSA) or knotless suture anchors (KSA) and loaded to failure. For phase 2, specimens were randomized into 1 of 4 repair techniques and cyclically loaded then loaded to failure: (1) SSA, (2) suture anchor with horizontal mattress configuration, (3) double-loaded suture anchor with simple stitch configuration, or (4) KSA. Data recorded included mode of failure, ultimate load to failure, load at 2 mm of displacement, as well as displacement during cyclical loading. For phase 1, the load required to 2 mm displacement of the repair construct was significantly greater in SSA (66.5 +/- 21.7 N) than KSA (35.0 +/- 12.5 N, P = .02). For phase 2, there was a statistically significant difference in ultimate load to failure among the 4groups, with both the single-loaded suture anchor with simple stitch (184.0 +/- 64.5 N), horizontal mattress stitch (189.0 +/- 65.3N), and double-loaded suture anchor with simple stitch (216.7 +/- 61.7 N) groups having significantly (P .05) among the 4 groups in displacement after cyclical loading or load at 2 mm of displacement. Both knotless and simple anchor configurations demonstrated similar single loads to failure (without cycling); however, the knotless device required less single load to displace 2 mm. All repair stitches, including simple, horizontal, and double-loaded performed similarly. The findings may suggest that with cyclical loading up to 25 N there is no difference in gapping greater than 2mm, but a macrotraumatic event may demonstrate a difference in fixation during the initial

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

    Science.gov (United States)

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

    2016-12-01

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

  4. 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.

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

    National Research Council Canada - National Science Library

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

    2013-01-01

    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...

  6. 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...... display an age-related development, but that it is impossible to arrive at any precise age determinations for older adults. It seems that for some individuals, suture obliteration simply does not take place, even at an advanced age, whereas for others, suture obliteration progresses rapidly. Until...... a better understanding of sutural biology is reached, this will render cranial sutures only marginally useful in age determination. This does not mean, however, that investigations should not be made to elucidate more unbiased methods of sutural morphology quantification....

  7. 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

  8. Hermetic Seal Leak Detection Apparatus with Variable Size Test Chamber

    Science.gov (United States)

    Kelley, Anthony R. (Inventor)

    2015-01-01

    The present invention is a versatile hermetic seal leak detection apparatus for testing hermetically sealed containers and devices for leaks without the need to create a custom or specially manufactured testing chamber conforming to the dimensions of the specific object under test. The size of the testing chamber may be mechanically adjusted by the novel use of bellows to reduce and optimize the amount of gas space in a test chamber which surrounds the hermetically sealed object under test. The present invention allows the size of the test chamber to be selectively adjusted during testing to provide an optimum test chamber gas space. The present invention may be further adapted to isolate and test specific portions of the hermetically sealed object under test for leaks.

  9. Systemic Capillary Leak Syndrome: Is Methylene Blue the Silver Bullet?

    Directory of Open Access Journals (Sweden)

    Michele Umbrello

    2014-01-01

    Full Text Available Background. Systemic capillary leak syndrome (SCLS is a rare disorder characterized by unexplained, recurrent episodes of transient, abrupt increase in endothelial permeability, leading to severe hypotension, generalized edema, and hemoconcentration. Case Report. We report the case of a patient suffering from systemic capillary leak syndrome and present a possible interpretation of the pathophysiology of this condition. Besides the classical triad of hypotension, edema, and hemoconcentration, we recorded increased levels of methemoglobin, an index of NO overproduction. We present a possible interpretation of the pathophysiology of this condition based on the fast and complete reversal of symptoms after methylene blue administration (which opposes NO-induced effects and speculate that increased NO levels could be implicated in the pathophysiology of the capillary leak phase. Why should an emergency physician be aware of this? The safety of this treatment and its fluid- and cathecolamine-sparing effect deserve consideration and further research.

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

    LENUS (Irish Health Repository)

    Baig, M N

    2017-05-01

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

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

    Science.gov (United States)

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

    2014-05-01

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

  12. 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.

  13. How do absorbable sutures absorb? A prospective double-blind randomized clinical study of tissue reaction to polyglactin 910 sutures in human skin.

    Science.gov (United States)

    Cartmill, Barry T; Parham, David M; Strike, Paul W; Griffiths, Liz; Parkin, Ben

    2014-12-01

    To compare the tissue reaction produced by 2 gauges of implanted polyglactin 910(Vicryl) suture material in human skin. A prospective, double masked, parallel randomized IRB approved clinical trial. Consecutive patients with involutional entropion and horizontal eyelid laxity were randomly allocated to 5/0 or 7/0 gauge test suture groups. Symptoms were alleviated during the wait for definitive surgery by placement of eyelid everting sutures. After 28 days, surgical entropion correction including eyelid wedge excision was achieved. Histological analysis was carried out, masked to the suture gauge used, on the excised eyelid containing one of the temporary everting sutures. Both patient and analyst were masked to the suture group. The four primary outcome measurements were granuloma outer diameter, central cellular diameter, giant cell number and area of fibrous coat and a statistical comparison made between suture gauge groups. 21 patients were allocated to each group, and histological analysis was possible in 36 patients. Significant suture-related granulomatous inflammatory reactions were found in all specimens. Medians of the measurements for 5/0 and 7/0 gauge sutures, respectively, were 0.855 mm versus 0.387 mm granuloma outer diameter (p = 0.0001); 0.464 mm versus 0.250 mm central cellular element diameter (p = 0.0003); 0.194 mm(2) versus 0.053 mm(2) fibrous coat area (p = 0.0009) and 0.8 versus 1.2 giant cell number (p = 0.7511). Polyglycolic acid sutures elicit a significant foreign body inflammatory response proportional to suture gauge. This reaction may be minimized by early suture removal. The study validates a novel and ethical approach to the examination of human skin response to implanted suture material.

  14. A Pentagram Suture Technique for Closing Tumor Resection Sites in the Face

    OpenAIRE

    Matsumine, Hajime; Takeuchi, Masaki; Mori, Satoko; Sakurai, Hiroyuki

    2015-01-01

    Background: Resection of facial skin tumors aims to remove the tumors completely and make the surgical scar unnoticeable as much as possible. By improving the purse string suture method, we developed a new pentagram suture technique that enables simple and safe suturing of small to large defects with early satisfactory esthetic outcomes. The surgical outcomes of a case series were examined in this report. Methods: As in drawing a unicursal star, 5 suture sites were marked at specific interval...

  15. Use of tissue adhesives versus sutures on minor surgery for incision closure: randomized controlled trial

    OpenAIRE

    Barros da Silva Pinto de Oliveira, Diogo

    2016-01-01

    Sutures, staples and adhesive tapes have been used for many years as methods of wound closure, but tissue adhesives have entered clinical practice more recently Closure of wounds with sutures enables the closure to be meticulous, but the sutures may show tissue reactivity and can require removal. Tissue adhesives offer the advantages of an absence of risk of needlestick injury and no requirement to remove sutures later. Initially, tissue adhesives were used primarily in emergency room setting...

  16. WikiLeaks under fire: Is it electronic civil disobedience?

    Directory of Open Access Journals (Sweden)

    Miquel Comas Oliver

    2017-05-01

    Full Text Available This paper evaluates the usefulness of the civil disobedience theory to legitimate the e-leaking of secrets, i.e. ethical and electronic disclosure of confidential information. First, the main definitions of offline civil disobedience are reviewed. Liberalism established the dominant set of validity conditions: symbolic, peaceful, responsible, public, constitutionally loyal, etc. We criticize this standpoint thanks to the discursive approach, but also highlighting its prejudices. Second, we analyse whether WikiLeaks meets those classical requirements. Encrypted anonymity, partial decriminalization and limited irresponsibility become acceptable. Regarding publicity, the disobedient visualization of a political conflict can be satisfied without revealing the identity of its participants.

  17. Leak before break application in French PWR plants under operation

    Energy Technology Data Exchange (ETDEWEB)

    Faidy, C. [EDF SEPTEN, Villeurbanne (France)

    1997-04-01

    Practical applications of the leak-before break concept are presently limited in French Pressurized Water Reactors (PWR) compared to Fast Breeder Reactors. Neithertheless, different fracture mechanic demonstrations have been done on different primary, auxiliary and secondary PWR piping systems based on similar requirements that the American NUREG 1061 specifications. The consequences of the success in different demonstrations are still in discussion to be included in the global safety assessment of the plants, such as the consequences on in-service inspections, leak detection systems, support optimization,.... A large research and development program, realized in different co-operative agreements, completes the general approach.

  18. Strength and leak testing of plasma activated bonded interfaces

    DEFF Research Database (Denmark)

    Visser, M.M.; Weichel, Steen; Reus, Roger De

    2002-01-01

    on detection of changes in membrane deflections. The detection limit for leak was 8E-13 mbar l/s. For comparison, strength and leak tests were also performed with regular fusion bonded wafers annealed at 1100 degreesC. The PAB was found to withstand post-processing steps such as RCA cleaning, 24 h in de......Bond strength and hermeticity of plasma activated bonded (PAB) Si-Si interfaces are reported. Bonding of 100 mm Si(1 0 0) wafers was performed. An average bond strength of 9.0+/-3.9 MPa was achieved without performing any annealing steps. Cavities bonded in vacuum were found to be hermetic based...

  19. Ethical Risks, Informers, Whistleblowers, Leaks and Clamor for Transparency

    Directory of Open Access Journals (Sweden)

    Rogério Christofoletti

    2016-08-01

    Full Text Available Leaks and whistleblowers have been increasingly used for the production of large media coverage. Characters like Edward Snowden, Chelsea Manning, Julian Assange and informers of “Operation Car Wash” in Brazil have become not only useful for the process of transparency and accountability, but also signal traps to reporters and newsrooms. In this article, I present the concept of Ethical Risk and I list a number of its forms in contemporary journalistic production, driven by WikiLeaks, Panama Papers and transformations of democratic societies

  20. Esophagojejunal anastomotic leak managed with self expandable metallic stent

    Directory of Open Access Journals (Sweden)

    Arvind Madurandagam Annapillai

    2013-01-01

    Full Text Available Esophagealjejunal anastomotic leak after gastrectomy is a serious surgical emergency with high mortality. This report describes a 57-year-old male with esophagojejunal anastomotic leak following total gastrectomy for gastric cancer and was managed successfully with self-expandable metallic stent. To our knowledge this is the first such report from India. This case report highlights the need of interdisciplinary coordination in managing this difficult clinical situation. Endotherapy with self-expandable metallic stent (SEM provided twin benefits of improving respiratory embarrassment and the joy of eating. Therapy of such difficult cases must be individualized; however, and SEM stent usage is a viable option

  1. Suture Fixation Using Polyblend Polyethylene Sutures With Hydroxyapatite Block for an Intra-articular Depression Fracture of the Pisiform Bone.

    Science.gov (United States)

    Kataoka, Toshiyuki; Kuriyama, Kohji; Yasui, Yukihiko

    2018-01-19

    Few cases in which open reduction and internal fixation was performed for displaced pisiform fractures have been reported. We present a new surgical technique for the treatment of depressed intra-articular pisiform fractures. First, the depressed fragment was reduced by pushing the bone tamp. Then, the fracture void resulting from the reduction of the depressed fragment was filled with a shaped hydroxyapatite block. Finally, the fragments were sutured using braided polyblend polyethylene sutures. The postoperative radiography could achieve a well-reduced articular facet, and this procedure had a good clinical outcome.

  2. New otoplasty approach: a laterally based postauricular dermal flap as an addition to Mustarde and Furnas to prevent suture extrusion and recurrence.

    Science.gov (United States)

    Basat, Salih Onur; Askeroğlu, Ufuk; Aksan, Tolga; Alleyne, Brendan; Yazar, Memet; Orman, Çağdaş; Üsçetin, İlker; Akan, Mithat

    2014-02-01

    Prominent ear is the most common deformity of the external ear. The major causes can be an underdeveloped antithetical fold, concha hypertrophy, and prominence of the ear lobule. Since Ely's first aesthetic correction of the prominent ear in 1881, more than 200 different techniques have been described, but the choice of procedure still remains the surgeon's preference. This report presents the laterally based posterior auricular dermal flap technique as an adjunct to the conventional cartilage-sparing otoplasty. An elliptical skin incision was planned according to the classic prominent ear correction technique. Instead of the excision, skin was deepithelialized. From the inferior border of the incision, the dermal flap was incised and elevated in a medial-to-lateral direction. The posterior auricular dermal flap was used to support and cover the suture material. This method was used in the treatment of 17 consecutive patients. After a follow-up period of 6-32 months (mean 16 months), the patients were evaluated in terms of the recurrence and suture line problems. No suture line problems or recurrences were observed at the end of the follow-up period. Use of the posterior auricular dermal flap both prevents suture extrusion and decreases recurrences. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  3. 21 CFR 878.5000 - Nonabsorbable poly(ethylene terephthalate) surgical suture.

    Science.gov (United States)

    2010-04-01

    ...) surgical suture. 878.5000 Section 878.5000 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Devices § 878.5000 Nonabsorbable poly(ethylene terephthalate) surgical suture. (a) Identification. Nonabsorbable poly(ethylene terephthalate) surgical suture is a multifilament, nonabsorbable, sterile, flexible...

  4. 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

  5. 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.

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

    NARCIS (Netherlands)

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

    1990-01-01

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

  7. Advancement of Buried Muco- Subcutaneous Sutures for Ostomy Creation in Surgery for Ulcerative Colitis.

    Science.gov (United States)

    Uchino, Motoi; Ikeuchi, Hiroki; Matsuoka, Hiroki; Bando, Toshihiro; Okayamaz, Kanako; Takesue, Yoshio; Tomita, Naohiro

    2015-06-01

    Ostomy creation is a fundamental technique. However, little information is available concerning the procedure and the associated complications. We reviewed the relationship between the ostomy procedure and complications. The records of patients who were diagnosed with ulcerative colitis and underwent ostomy creation between January 2007 and July 2012 were reviewed. Stoma complications, including muco-cutaneous dehiscence, fistula and granulation were also reviewed. The study included 176 patients who received interrupted sutures with removal of the stitches and 202 patients who received subcutaneous sutures without removal of the stitches. Among the patients with buried sutures, 108 received braided absorbable sutures and 94 received with mono filament absorbable sutures. The incidence of dehiscence was significantly higher with the interrupted sutures (43.2%) than with the buried sutures (31.2%), although the granulation and fistula rates were not significantly different. Among the patients with buried sutures, fistula (6.4%) and granulation (21.3%) rates were slightly increased with the mono filament sutures compared with the braided sutures, although the differences were not significant. CONCLUSIONS. Suture removal appeared to be an unnecessary manipulation at ostomy creation. Further study for all colorectal surgery is needed to investigate whether the incidence of fistula increases with buried sutures.

  8. 21 CFR 878.4494 - Absorbable poly(hydroxybutyrate) surgical suture produced by recombinant DNA technology.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Absorbable poly(hydroxybutyrate) surgical suture... DEVICES Surgical Devices § 878.4494 Absorbable poly(hydroxybutyrate) surgical suture produced by recombinant DNA technology. (a) Identification. An absorbable poly(hydroxybutyrate) surgical suture is an...

  9. Omental pedicle transposition and suture repair of peripheral nerve ...

    African Journals Online (AJOL)

    In the primary epineural repair group or control group (CG), the left sciatic nerve was skeletonized from the sciatic notch till the point of bifurcation. The nerve was transected at the mid shaft of the femoral bone and repaired with six epineural sutures. In the treatment group (TG), the epineural repaired sciatic nerve was ...

  10. Suture Anchor Biomechanics After Rotator Cuff Footprint Decortication.

    Science.gov (United States)

    Hyatt, Adam E; Lavery, Kyle; Mino, Christopher; Dhawan, Aman

    2016-04-01

    To identify the biomechanical consequences of violating the cortical shelf when preparing the greater tuberosity for suture anchor repair. Demographic information and bone mineral density were obtained for 20 fresh-frozen human humeri (10 matched pairs). Suture anchors were placed at a predetermined location in decorticated and non-decorticated settings after randomization. Anchors were tested under cyclic loads followed by load-to-failure testing. The number of cycles, failure mode, stiffness, and final pullout strength were recorded. Nineteen specimens met the inclusion criteria for final testing. A significant difference in mean ultimate load to failure was seen between the non-decorticated specimens (244.04 ± 89.06 N/mm) and the decorticated humeri (62.84 ± 38.04 N/mm, P suture anchor. Gender and bone mineral density also play a significant role in bone-anchor biomechanics and should be considered during repair. Caution should be exercised when preparing the rotator cuff footprint before suture anchor placement because of the significant risk of early repair failure at the bone-anchor interface. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  11. 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.

  12. END-TO-SIDE NERVE SUTURE - A TECHNIQUE TO REPAIR ...

    African Journals Online (AJOL)

    End-to-side nerve suture (ETSNS) has until recently been extensively researched in the laboratory animal (rat and baboon). Lateral sprouting from an intact nerve into an attached nerve does occi.rr, and functional recovery (sensory and motor) has been demonstrated. We have demonstrated conclusively that ETSNS in the ...

  13. Bone Suture in Management of Mandibular Degloving Injury ...

    African Journals Online (AJOL)

    In this article, the author describes the mandibular degloving injury, characterized by the separation of periosteum and soft tissues of the anterior buccal side of the mandible, and the bone suture technique. This article outlines that a correct diagnostic assessment and appropriate treatment plan can reduce the complications ...

  14. The malament suture: any role in transvesical prostatectomy ...

    African Journals Online (AJOL)

    Background: We evaluated the role of the Malament suture in the development of bladder neck stenosis and in reducing transfusion requirements following transvesical prostatectomy for benign prostatic hyperplasia. Methodology: This was a retrospective study done at the Jos University Teaching Hospital, a tertiary health ...

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

    NARCIS (Netherlands)

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

    1992-01-01

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

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

    African Journals Online (AJOL)

    Objective: To describe the outcome and safety of surgical treatment of Saudi adult patients with strabismus by nonadjustable suture and to evaluate the prevalence of diplopia and binocularity after strabismus correction. Materials and Methods: Retrospective analysis of medical records of 96 patients above the age of ...

  17. The frictional behaviour of surgical suture interacting with skin substistute

    NARCIS (Netherlands)

    Zhang, Gangqiang

    2017-01-01

    Surgical sutures are essential for the re-approaching of divided tissues, for the ligation of the cut ends of vessels, and play a significant role in wound repair by providing support to healing tissues. Frictional behaviour is one important part of the physical and handling characteristics and knot

  18. 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.

  19. Penile torsion correction by diagonal corporal plication sutures

    Directory of Open Access Journals (Sweden)

    Brent W. Snow

    2009-02-01

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

  20. 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.

  1. 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…

  2. Late Cretaceous evolution of the northern Sistan suture zone ...

    Indian Academy of Sciences (India)

    and kinematic environments, particularly trans- pressive and extensional regime, such as in ..... pressional and dextral strike-slip movement at least in the later episodes of intrusion, when ... Possible kinematics at the eastern boundary of the Sistan suture zone; (c) for a slip vector perpendicular to the boundary and pure ...

  3. non absorbable sutures in the urinary bladder resulting in ...

    African Journals Online (AJOL)

    contain components such as calcium, ammonium, phosphate, oxalate, and uric acid. These components mostly exist as mixtures. The bladder stone in our patient was made of carbonate, i.e., apatite, which is not uncommon. We report a case of bladder calculi formed around suture material following colposuspension.

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

    African Journals Online (AJOL)

    Abstract. We describe a case of corneal abscess presenting three years after uneventful cataract extraction with posterior chamber lens implantation through a limbal incision secured with threesutures placed in the clear cornea. After removing the abscess, a loose10/0 nylon suture was found at the base of an ulcer.

  5. Modeling the Risk of Fire/Explosion Due to Oxidizer/Fuel Leaks in the Ares I Interstage

    Science.gov (United States)

    Ring, Robert W.; Stott, James E.; Hales, Christy

    2008-01-01

    A significant flight hazard associated with liquid propellants, such as those used in the upper stage of NASA's new Ares I launch vehicle, is the possibility of leakage of hazardous fluids resulting in a catastrophic fire/explosion. The enclosed and vented interstage of the Ares I contains numerous oxidizer and fuel supply lines as well as ignition sources. The potential for fire/explosion due to leaks during ascent depends on the relative concentrations of hazardous and inert fluids within the interstage along with other variables such as pressure, temperature, leak rates, and fluid outgasing rates. This analysis improves on previous NASA Probabilistic Risk Assessment (PRA) estimates of the probability of deflagration, in which many of the variables pertinent to the problem were not explicitly modeled as a function of time. This paper presents the modeling methodology developed to analyze these risks.

  6. [Induced astigmatism after corneal suture removal after cataract surgery].

    Science.gov (United States)

    Loriaut, P; Kaswin, G; Rousseau, A; Meziani, L; M'nafek, N; Pogorzalek, N; Labetoulle, M

    2014-03-01

    To evaluate the time until astigmatic stabilization after corneal suture removal after cataract surgery. A prospective study was performed on 13 patients who had undergone cataract surgery by phacoemulsification with 2.4mm incision, for whom it was felt necessary to remove a corneal suture. A specular corneal topography was performed by OPD Scan before removal, immediately after, then 10, 20, 30 minutes and 15 days later. For each acquisition, the keratometric readings at the steepest (Kmax) and the flattest (Kmin) meridians (central at 1.15 mm from corneal center, intermediate at 2.30 mm and peripheral at 3.30 mm) and the amount of corneal astigmatism were measured. Corneal topography of 13 patients was acquired. Mean age was 70 ± 12 years. Mean time after cataract surgery was 23 ± 14 days. The greatest change in Kmax occurred within the first minutes following suture removal for the central and intermediate cornea (mean variation of -4.38% and -4.59% of initial Kmax respectively, i.e. -2.04 D ± 3.14 D et -2.15 D ± 3.11 D) whereas it was observed between 0 and 10 minutes for the peripheral area (mean 1.57% of Kmax after suture removal i.e. 0.96 D ± 1.85 D). Mean change in corneal astigmatism between 30 minutes and day 15 was 0.08 D ± 0.31 D (3.6% of baseline). When suture removal was performed between 7 and 10 days postoperatively, mean change was 0.16 D ± 0.24 D, whereas it was 0.03 D ± 0.34 D when performed after four weeks. Keratometric readings vary only slightly beyond the first 30 minutes after suture removal. These results suggest that the refraction could be accurately measured the same day as suture removal, with no additional follow-up absolutely necessary in order to prescribe the final spectacles. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  7. Which uterine sparing technique should be used for uterine atony during cesarean section? The Bakri balloon or the B-Lynch suture?

    Science.gov (United States)

    Kaya, Baris; Guralp, Onur; Tuten, Abdullah; Unal, Orhan; Celik, Melih Ozgur; Dogan, Askın

    2016-09-01

    To evaluate various aspects of two popular uterine sparing techniques, the B-Lynch uterine compression suture and Bakri balloon tamponade, in severe postpartum hemorrhage (PPH). 21 women who underwent the Bakri balloon procedure and 24 women who underwent the B-Lynch suture as primary uterus-sparing methods, due to PPH not responding to medical treatment, were retrospectively evaluated. The success rates of the B-Lynch procedure and the Bakri balloon were 79.1 and 80 %, respectively. The success rates of the B-Lynch + IIAL and the Bakri balloon + IIAL were 91.6 and 95 %, respectively. There was no significant difference in success rates, mean duration of time to stop bleeding, estimated blood loss, transfused packed red blood cells or mean duration of hospital stay between the B-Lynch and the Bakri balloon groups. The duration of operation was significantly longer in the Bakri balloon compared to the B-Lynch group (p = 0.01). In our study, the Bakri balloon and the B-Lynch suture had similar success rates in uterine atony during CS. The advantages of the B-Lynch suture include rapid application with no need for lithotomy position or extra material; whereas the Bakri balloon is less invasive and easier to learn, but more time consuming and expensive compared to the B-Lynch suture. We suggest that the B-Lynch suture may be preferred in uterine atony during CS in low resource settings; however, the less invasive Bakri balloon should be the first line in full resource settings. Further studies are needed to evaluate the advantages and disadvantages of the two methods.

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

    Directory of Open Access Journals (Sweden)

    Abhishek Ghosh

    2015-01-01

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

  9. Standard practice for atmospheric leaks using a thermal conductivity leak detector

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2011-01-01

    1.1 This practice covers procedures for detecting the sources of gas leaking at the rate of 1 × 10–5 Pa m3/s (1 × 10–4 standard cm3/s) or greater. The tests may be conducted on any object that can be pressurized with a tracer gas that is detectable by a thermal conductivity detector. The test sensitivity will vary widely depending on the tracer gas used. 1.2 Units—The values stated in either SI or std-cc/sec units are to be regarded separately as standard. The values stated in each system may not be exact equivalents: therefore, each system shall be used independently of the other. Combining values from the two systems may result in non-conformance with the standard. 1.3 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.

  10. Novel Coating of Surgical Suture Confers Antimicrobial Activity Against Porphyromonas gingivalis and Enterococcus faecalis.

    Science.gov (United States)

    Meghil, Mohamed M; Rueggeberg, Frederick; El-Awady, Ahmed; Miles, Brodie; Tay, Franklin; Pashley, David; Cutler, Christopher W

    2015-06-01

    The oral cavity is colonized by >10(9) bacteria, many of which can increase heart disease risk when seeded into the bloodstream. Most dentoalveolar surgeries require the use of surgical sutures. Suture placement and removal can increase the risk of postoperative infection and bacteremia. The aim of this study is to evaluate the antimicrobial activity of a novel quaternary ammonium compound, K21, when coated on different suture materials. The periodontal pathogen Porphyromonas gingivalis and the endodontic species Enterococcus faecalis were grown to early log phase and inoculated on enriched Brucella blood agar, on which were placed identical lengths of surgical suture (chromic gut, polyester suture, silk, and nylon suture) and control unwaxed dental floss impregnated with K21 at 5%, 10%, 20%, and 25% volume/volume in ethanol vehicle. Controls included the following: 1) sutures treated with vehicle; 2) untreated sutures; and 3) unwaxed floss. Zones of inhibition in millimeters were measured at five randomized sites per suture/floss for each concentration and material used. Mean ± SD of zones of inhibition were calculated, and analysis of variance (P suture at concentrations ranging from 5% to 25%, depending on the type of suture, have antimicrobial activity for P. gingivalis and E. faecalis. Nylon suture coated with K21 at 5%, 10%, 20%, and 25% resulted in zones ranging from 3 to 11 mm. Polyester suture was more effective at lower K21 concentrations with 5% (P = 0.0031), 10% (P = 0.0011), and 20% (P = 0.0002), yielding 7.5, 8.3, and 10.5 mm zones of inhibition. K21-coated silk suture yielded significant zones of inhibition at 25% (P sutures have antimicrobial activity for bacterial species of direct relevance to postoperative infection and bacteremia.

  11. Suture-Only Repair Versus Suture Anchor-Augmented Repair for Achilles Tendon Ruptures With a Short Distal Stump: A Biomechanical Comparison.

    Science.gov (United States)

    Boin, Michael A; Dorweiler, Matthew A; McMellen, Christopher J; Gould, Gregory C; Laughlin, Richard T

    2017-01-01

    Chronic noninsertional Achilles tendinosis can result in an acute Achilles tendon rupture with a short distal stump. In such tendon ruptures, there is a limited amount of adequate tissue that can hold suture, thus presenting a challenge for surgeons who elect to treat the rupture operatively. Adding suture anchors to the repair construct may result in biomechanically stronger repairs compared with a suture-only technique. Controlled laboratory study. Nine paired Achilles-calcaneus complexes were harvested from cadavers. An artificial Achilles rupture was created 2 cm proximal to the insertion on the calcaneus. One specimen from each cadaver was assigned to a suture-only or a suture anchor-augmented repair. The contralateral specimen of the same cadaver received the opposing repair. Cyclic testing was then performed at 10 to 100 N for 2000 cycles, and load-to-failure testing was performed at 0.2 mm/s. This was followed by analysis of repair displacement, gapping at repair site, peak load to failure, and failure mode. The suture anchor-augmented repair exhibited a 116% lower displacement compared with the suture-only repair (mean ± SD, 1.54 ± 1.13 vs 3.33 ± 1.47 mm, respectively; P suture anchor-augmented repair also exhibited a 45% greater load to failure compared with the suture-only repair (303.50 ± 102.81 vs 209.09 ± 48.12 N, respectively; P Suture anchor-augmented repairs performed on acute Achilles tendon ruptures with a short distal stump are biomechanically stronger than suture-only repairs. Our results support the use of suture anchor-augmented repairs for a biomechanically stronger construct in Achilles tendon ruptures with a short distal stump. Biomechanically stronger repairs may lead to less tendon repair gapping and failure, increasing the ability to start early active rehabilitation protocols and thus improving patient outcomes.

  12. Laboratory modelling of geoelectric response of a leaking ...

    African Journals Online (AJOL)

    Laboratory modelling of geoelectric response of a leaking underground petroleum storage tank in sand formation. ... Journal Home > Vol 2, No 2 (2004) > ... A crude oil filled metallic cylindrical tank (simulating a typical crude / refined hydrocarbon storage tank) was buried in the sand and pre-impact resistivity measurements ...

  13. Incidence and management of postoperative bile leaks: A ...

    African Journals Online (AJOL)

    Background: Bile leaks from the parenchymal transection margin are a major cause of morbidity following major liver resections. The aim of this study was to benchmark the incidence and identify the risk factors for postoperative bile leakage after hepatic resection. Patients and methods: A prospective database of 467 ...

  14. Portable Rapid Test Fuel Tank Leak Detection System

    Science.gov (United States)

    2010-04-01

    the site-specific test parameters and selects the “Start Test” icon . Leak test final results can be obtained in less than 5 hours. 3.0 PROTOTYPE...the reference tube into section lengths of less than 7 feet for shipping, and 3) downsizing the reference tube diameter to reduce weight and for

  15. Analyzing User Awareness of Privacy Data Leak in Mobile Applications

    Directory of Open Access Journals (Sweden)

    Youngho Kim

    2015-01-01

    Full Text Available To overcome the resource and computing power limitation of mobile devices in Internet of Things (IoT era, a cloud computing provides an effective platform without human intervention to build a resource-oriented security solution. However, existing malware detection methods are constrained by a vague situation of information leaks. The main goal of this paper is to measure a degree of hiding intention for the mobile application (app to keep its leaking activity invisible to the user. For real-world application test, we target Android applications, which unleash user privacy data. With the TaintDroid-ported emulator, we make experiments about the timing distance between user events and privacy leaks. Our experiments with Android apps downloaded from the Google Play show that most of leak cases are driven by user explicit events or implicit user involvement which make the user aware of the leakage. Those findings can assist a malware detection system in reducing the rate of false positive by considering malicious intentions. From the experiment, we understand better about app’s internal operations as well. As a case study, we also presents a cloud-based dynamic analysis framework to perform a traffic monitor.

  16. Dural diverticulum with a symptomatic cerebrospinal fluid leak

    Directory of Open Access Journals (Sweden)

    Nicholas Armstrong, MD

    2016-03-01

    Full Text Available A case report of a 63-year-old female patient with a cervical spinal dural diverticulum and intracranial hypotension secondary to a symptomatic CSF leak after minor trauma. The patient responded well after the cervical approach epidural blood patch procedure.

  17. The minimal leak test technique for endotracheal cuff maintenance.

    Science.gov (United States)

    Harvie, D A; Darvall, J N; Dodd, M; De La Cruz, A; Tacey, M; D'Costa, R L; Ward, D

    2016-09-01

    Endotracheal tube (ETT) cuff pressure management is an essential part of airway management in intubated and mechanically ventilated patients. Both under- and over-inflation of the ETT cuff can lead to patient complications, with an ideal pressure range of 20-30 cmH2O defined. A range of techniques are employed to ensure adequate ETT cuff inflation, with little comparative data. We performed an observational cross-sectional study in a tertiary metropolitan ICU, assessing the relationship between the minimal leak test and cuff manometry. Forty-five mechanically ventilated patients, over a three-month period, had ETT cuff manometry performed at the same time as their routine cuff maintenance (minimal leak test). Bedside nurse measurements were compared with investigator measurements. At the endpoint of cuff inflation, 20 of 45 patients (44%) had cuff pressures between 20 and 30 cmH2O; 11 of 45 patients (24%) had cuff pressures analysis demonstrated an association between both patient obesity and female gender requiring less ETT cuff volume (P=0.008 and P analysis. No association was demonstrated between any measured variables and cuff pressures. Inter-operator reliability in performing the minimal leak test showed no evidence of bias between nurse and investigators (Pearson coefficient = 0.897). We conclude the minimal leak test for maintenance of ETT cuffs leads to both over- and under-inflation, and alternative techniques, such as cuff manometry, should be employed.

  18. 40 CFR 63.1255 - Standards: Equipment leaks.

    Science.gov (United States)

    2010-07-01

    ... Periodic Report following the end of the monitoring period for that component, whichever is later. (8... tasks (e.g., weekly, monthly, quarterly, annual) refer to the standard calendar periods unless specified... paragraphs (c)(5) through (9) of this section. (ii) Leak definition. The instrument reading, as determined by...

  19. A statistical analysis on the leak detection performance of ...

    Indian Academy of Sciences (India)

    This paper attempts to provide a statistical insight on the concepts of leak detection performance of WSNs when deployed on overground and underground pipelines.The approach in the study employs the hypothesis testing problem to formulate a solution on the detection plan.Through the hypothesis test, the maximum ...

  20. Recurrent Transvaginal Leak of Dialysate as a Complication of ...

    African Journals Online (AJOL)

    Recurrent Transvaginal Leak of Dialysate as a Complication of Peritoneal Dialysis Catheter Tip Capture by Fallopian Tube after Tubal Occlusion. ... Mini laparotomy and tubal ligation with catheter removal were done and the patient was maintained on hemodialysis until she received a kidney transplant four months later.

  1. Patients with and without Posttransplant Capillary Leak Syndrome

    Directory of Open Access Journals (Sweden)

    Håkon Reikvam

    2015-01-01

    Full Text Available Allogeneic stem cell transplantation is commonly used in the treatment of younger patients with severe hematological diseases, and endothelial cells seem to be important for the development of several posttransplant complications. Capillary leak syndrome is a common early posttransplant complication where endothelial cell dysfunction probably contributes to the pathogenesis. In the present study we investigated whether the pretreatment serum metabolic profile reflects a risk of posttransplant capillary leak syndrome. We investigated the pretransplant serum levels of 766 metabolites for 80 consecutive allotransplant recipients. Patients with later capillary leak syndrome showed increased pretherapy levels of metabolites associated with endothelial dysfunction (homocitrulline, adenosine altered renal regulation of fluid and/or electrolyte balance (betaine, methoxytyramine, and taurine and altered vascular function (cytidine, adenosine, and methoxytyramine. Additional bioinformatical analyses showed that capillary leak syndrome was also associated with altered purine/pyrimidine metabolism (i.e., metabolites involved in vascular regulation and endothelial functions, aminoglycosylation (possibly important for endothelial cell functions, and eicosanoid metabolism (also involved in vascular regulation. Our observations are consistent with the hypothesis that the pretransplant metabolic status can be a marker for posttransplant abnormal fluid and/or electrolyte balance.

  2. Scrape on Endeavour's robotic arm during oxygen leak repairs

    Science.gov (United States)

    2002-01-01

    KENNEDY SPACE CENTER, FLA. -- A piece of the honeycomb shell around Endeavour's robotic arm has been cut to inspect the arm. A scrape of the shell occurred while work platforms were being installed to gain access to repair the oxygen leak in the Shuttle's mid-body. Launch of Endeavour on mission STS-113 has been postponed until no earlier than Nov. 22.

  3. 40 CFR 63.424 - Standards: Equipment leaks.

    Science.gov (United States)

    2010-07-01

    ... implement an instrument leak monitoring program that has been demonstrated to the Administrator as at least equivalent. (g) Owners and operators shall not allow gasoline to be handled in a manner that would result in... recycling devices, such as oil/water separators. ...

  4. Unravelling the molecular control of calvarial suture fusion in children with craniosynostosis

    Directory of Open Access Journals (Sweden)

    Morris C Phillip

    2007-12-01

    Full Text Available Abstract Background Craniosynostosis, the premature fusion of calvarial sutures, is a common craniofacial abnormality. Causative mutations in more than 10 genes have been identified, involving fibroblast growth factor, transforming growth factor beta, and Eph/ephrin signalling pathways. Mutations affect each human calvarial suture (coronal, sagittal, metopic, and lambdoid differently, suggesting different gene expression patterns exist in each human suture. To better understand the molecular control of human suture morphogenesis we used microarray analysis to identify genes differentially expressed during suture fusion in children with craniosynostosis. Expression differences were also analysed between each unfused suture type, between sutures from syndromic and non-syndromic craniosynostosis patients, and between unfused sutures from individuals with and without craniosynostosis. Results We identified genes with increased expression in unfused sutures compared to fusing/fused sutures that may be pivotal to the maintenance of suture patency or in controlling early osteoblast differentiation (i.e. RBP4, GPC3, C1QTNF3, IL11RA, PTN, POSTN. In addition, we have identified genes with increased expression in fusing/fused suture tissue that we suggest could have a role in premature suture fusion (i.e. WIF1, ANXA3, CYFIP2. Proteins of two of these genes, glypican 3 and retinol binding protein 4, were investigated by immunohistochemistry and localised to the suture mesenchyme and osteogenic fronts of developing human calvaria, respectively, suggesting novel roles for these proteins in the maintenance of suture patency or in controlling early osteoblast differentiation. We show that there is limited difference in whole genome expression between sutures isolated from patients with syndromic and non-syndromic craniosynostosis and confirmed this by quantitative RT-PCR. Furthermore, distinct expression profiles for each unfused suture type were noted, with

  5. Leak detection and localization system through acoustics; Sistema de deteccao e localizacao de vazamentos por acustica

    Energy Technology Data Exchange (ETDEWEB)

    Alonso, Julio [Aselco Automacao, Sao Paulo, SP (Brazil)

    2003-07-01

    Acoustic Leak Detection Systems (ALDS) are used on both liquid and gas pipelines as well as multi-phase flow pipelines to detect leaks quickly and provide a means of limiting product loss. The real-time acoustic signal is continuously compared against signature leak profiles for the particular operating and geometric conditions. These profiles were developed from a database established from over 20 years of experimental and field leak tests. This technique not only drastically reduces the false alarm rate, but also significantly improves the sensitivity and leak location accuracy. This system will also detect leaks with shut-in flow (zero flow rate in the pipeline). With the use of GPS (Global Positioning System) it not only improves leak location accuracy, but also allows for continuous leak detection during the loss of communications. (author)

  6. CSNI specialist meeting on leak-before-break in nuclear reactor piping: proceedings

    Energy Technology Data Exchange (ETDEWEB)

    1984-08-01

    On September 1 and 2, 1983, the CSNI subcommittee on primary system integrity held a special meeting in Monterey, California, on the subject of leak-before-break in nuclear reactor piping systems. The purpose of the meeting was to provide an international forum for the exchange of ideas, positions, and research results; to identify areas requiring additional research and development; and to determine the general attitude toward acceptance of the leak-before-break concept. The importance of the leak-before-break issue was evidenced by excellent attendance at the meeting and through active participation by the meeting attendees. Approximately 125 people representing fifteen different nations attended the meeting. The meeting was divided into four technical sessions addressing the following areas: Application of Piping Fracture Mechanics to Leak-Before Break, Leak Rate and Leak Detection, Leak-Before-Break Studies, Methods and Results, Current and Proposed Positions on Leak-Before-Break.

  7. Leaks in nuclear grade high efficiency aerosol filters

    Energy Technology Data Exchange (ETDEWEB)

    Scripsick, Ronald Clyde [Univ. of California, Davis, CA (United States)

    1994-07-01

    Nuclear grade high efficiency aerosol filters, also known as high efficiency particulate air (HEPA) filters, are commonly used in air cleaning systems for removal of hazardous aerosols. Performance of the filter units is important in assuring health and environmental protection. The filter units are constructed from pleated packs of fiberglass filter media sealed into rigid frames. Results of previous studies on such filter units indicate that their performance may not be completely predicted by ideal performance of the fibrous filter media. In this study, departure from ideal performance is linked to leaks existing in filter units and overall filter unit performance is derived from independent performance of the individual filter unit components. The performance of 14 nuclear grade HEPA filter units (size 1, 25 cfm) with plywood frames was evaluated with a test system that permitted independent determination of penetration as a function of particle size for the whole filter unit, the filter unit frame, and the filter media pack. Tests were performed using a polydisperse aerosol of di-2-ethylhexyl phthalate with a count median diameter of 0.2 {mu}m and geometric standard deviation of 1.6. Flow rate and differential pressure were controlled from 1% to 100% of design values. Particle counts were made upstream and downstream of the filter unit with an optical particle counter (OPC). The OPC provided count information in 28 size channels over the particle diameter range from 0.1 to 0.7 μm. Results provide evidence for a two component leak model of filler unit performance with: (1) external leaks through filter unit frames, and (2) internal leaks through defects in the media and through the seal between the media pack and frame. For the filter units evaluated, these leaks dominate overall filter unit performance over much of the flow rate and particle size ranges tested.

  8. Real-time imaging of methane gas leaks using a single-pixel camera.

    Science.gov (United States)

    Gibson, Graham M; Sun, Baoqing; Edgar, Matthew P; Phillips, David B; Hempler, Nils; Maker, Gareth T; Malcolm, Graeme P A; Padgett, Miles J

    2017-02-20

    We demonstrate a camera which can image methane gas at video rates, using only a single-pixel detector and structured illumination. The light source is an infrared laser diode operating at 1.651μm tuned to an absorption line of methane gas. The light is structured using an addressable micromirror array to pattern the laser output with a sequence of Hadamard masks. The resulting backscattered light is recorded using a single-pixel InGaAs detector which provides a measure of the correlation between the projected patterns and the gas distribution in the scene. Knowledge of this correlation and the patterns allows an image to be reconstructed of the gas in the scene. For the application of locating gas leaks the frame rate of the camera is of primary importance, which in this case is inversely proportional to the square of the linear resolution. Here we demonstrate gas imaging at ~25 fps while using 256 mask patterns (corresponding to an image resolution of 16×16). To aid the task of locating the source of the gas emission, we overlay an upsampled and smoothed image of the low-resolution gas image onto a high-resolution color image of the scene, recorded using a standard CMOS camera. We demonstrate for an illumination of only 5mW across the field-of-view imaging of a methane gas leak of ~0.2 litres/minute from a distance of ~1 metre.

  9. Cadaveric Nerve and Artery Proximity to Sacrospinous Ligament Fixation Sutures Placed by a Suture-Capturing Device.

    Science.gov (United States)

    Katrikh, Aaron Z; Ettarh, Rajuno; Kahn, Margie A

    2017-11-01

    To simulate sacrospinous ligament fixation on cadaveric specimens, describe the surrounding retroperitoneal anatomy, and estimate the risk to nerves and arteries for the purposes of optimizing safe suture placement. Sacrospinous ligament fixation was performed on eight fresh-tissue female cadavers using a Capio ligature capture device. Distances from placed sutures to the following structures were measured: ischial spine; fourth sacral root; pudendal nerve; the nerve to coccygeus muscle; the nerve to levator ani muscle; inferior gluteal artery; and internal pudendal artery. Periligamentous anatomy was examined in an additional 17 embalmed cadaver dissections. Sacrospinous ligament length was not seen to differ significantly between sides. The fourth sacral spinal nerve was seen most commonly associated with the medial third of the ligament, whereas the pudendal nerve and the nerves to coccygeus and levator ani muscles were associated with the lateral third. The inferior gluteal artery was seen leaving the greater sciatic foramen a median 15.8 mm (range 1.8-48.0, CI 14.9-22.3) above the ligament, whereas the internal pudendal artery exited just above the ischial spine. The two sets of sutures were placed 20.5 mm (range 9.2-34.4, CI 19.7-24.7) and 24.8 mm (range 12.4-46.2, CI 24.0-30.0) medial to the ischial spine, respectively. No structures were directly damaged by placed sutures. The nerves to coccygeus and levator ani were closest and arteries farthest from the placed sutures. The middle segment of the sacrospinous ligament has the lowest incidence of nerves and arteries associated with it. This study confirms that the nerves supplying the pelvic floor muscles are at a higher risk from entrapment than the pudendal nerve.

  10. 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.

  11. Surgical suture assembled with polymeric drug-delivery sheet for sustained, local pain relief.

    Science.gov (United States)

    Lee, Ji Eun; Park, Subin; Park, Min; Kim, Myung Hun; Park, Chun Gwon; Lee, Seung Ho; Choi, Sung Yoon; Kim, Byung Hwi; Park, Hyo Jin; Park, Ji-Ho; Heo, Chan Yeong; Choy, Young Bin

    2013-09-01

    Surgical suture is a strand of biocompatible material designed for wound closure, and therefore can be a medical device potentially suitable for local drug delivery to treat pain at the surgical site. However, the preparation methods previously introduced for drug-delivery sutures adversely influenced the mechanical strength of the suture itself - strength that is essential for successful wound closure. Thus, it is not easy to control drug delivery with sutures, and the drug-delivery surgical sutures available for clinical use are now limited to anti-infection roles. Here, we demonstrate a surgical suture enabled to provide controlled delivery of a pain-relief drug and, more importantly, we demonstrate how it can be fabricated to maintain the mechanical strength of the suture itself. For this purpose, we separately prepare a drug-delivery sheet composed of a biocompatible polymer and a pain-relief drug, which is then physically assembled with a type of surgical suture that is already in clinical use. In this way, the drug release profiles can be tailored for the period of therapeutic need by modifying only the drug-loaded polymer sheet without adversely influencing the mechanical strength of the suture. The drug-delivery sutures in this work can effectively relieve the pain at the surgical site in a sustained manner during the period of wound healing, while showing biocompatibility and mechanical properties comparable to those of the original surgical suture in clinical use. Copyright © 2013 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  12. Suture choice matters in rabbit model of laparoscopic, preperitoneal, inguinal hernia repair.

    Science.gov (United States)

    Kelly, Katherine B; Krpata, David M; Blatnik, Jeffrey A; Ponsky, Todd A

    2014-06-01

    We evaluated the effect of different suture materials in a laparoscopic preperitoneal ligation of the patent processus vaginalis in a rabbit survival model. New Zealand White rabbits underwent laparoscopic assisted preperitoneal ligation of the patent processus vaginalis. The processus vaginalis was closed with silk (n=10), polyglactin 910 (Vicryl(®); Ethicon, a Johnson & Johnson Company, Somerville, NJ) (n=10), or polypropylene (Prolene(®); Ethicon) (n=10). At necropsy, the suture was removed, and repair integrity was evaluated. All rabbits survived to necropsy without complications. No suture material was identified during necropsy of the Vicryl group. Eight (80%) of the Vicryl closures failed, with six (60%) failing at initial inspection. Following removal of suture material, nine (90%) of the Prolene closures failed, and only one (10%) of the silk closures failed (P=.009). The silk suture resulted in an improved closure rate. Ligation with silk suture probably incited an increased inflammatory response that likely created a scar while persisting long enough for the scar to become established. In contrast, the Vicryl sutures probably failed because the sutures dissolved before a scar was able to fully develop. Finally, the Prolene closures were suture dependent as evidenced by failure when the suture was removed. Nonabsorbable braided suture may improve closure of pediatric indirect inguinal hernias during laparoscopic-assisted preperitoneal ligation.

  13. Effect of re-sterilization of surgical sutures by ethylene oxide.

    Science.gov (United States)

    Nagaraja, Prem Anand; Shetty, Devi

    2007-01-01

    Surgical suture packs are opened (and external packaging removed) on the operating table prior to surgery. Some of these suture packs may not be used in the surgery for reasons of inappropriateness or change in the surgical technique or following accidental contact with a non-sterile surface. These unused sutures with their foil packs still unopened are sometimes re-sterilized using ethylene oxide to allow for reuse. This re-sterilization of unopened suture packs can be contentious, due to legislation and health regulations in developed countries. The purpose of the present paper was to measure the effect of such repeated gas sterilization on sutures. The knot tensile strength was measured for new sterile sutures and ethylene oxide re-sterilized sutures. The tests were conducted on two available brands of sutures, including both absorbable and non-absorbable synthetic sutures. No statistically significant difference was observed in the tensile strengths between the two sets of sutures, before and after re-sterilization. Some foil packs showed slight crimping after re-sterilization, but remained intact. No humidity was observed inside the foil packs. Re-sterilization of unused suture foil packs can be carried out without loss of tensile strength.

  14. Novel insights into the composition and function of the Toxoplasma IMC sutures.

    Science.gov (United States)

    Chen, Allan L; Moon, Andy S; Bell, Hannah N; Huang, Amy S; Vashisht, Ajay A; Toh, Justin Y; Lin, Andrew H; Nadipuram, Santhosh M; Kim, Elliot W; Choi, Charles P; Wohlschlegel, James A; Bradley, Peter J

    2017-04-01

    The Toxoplasma inner membrane complex (IMC) is a specialized organelle underlying the parasite's plasma membrane that consists of flattened rectangular membrane sacs that are sutured together and positioned atop a supportive cytoskeleton. We have previously identified a novel class of proteins localizing to the transverse and longitudinal sutures of the IMC, which we named IMC sutures components (ISCs). Here, we have used proximity-dependent biotin identification at the sutures to better define the composition of this IMC subcompartment. Using ISC4 as bait, we demonstrate biotin-dependent labeling of the sutures and have uncovered two new ISCs. We also identified five new proteins that exclusively localize to the transverse sutures that we named transverse sutures components (TSCs), demonstrating that components of the IMC sutures consist of two groups: those that localize to the transverse and longitudinal sutures (ISCs) and those residing only in the transverse sutures (TSCs). In addition, we functionally analyze the ISC protein ISC3 and demonstrate that ISC3-null parasites have morphological defects and reduced fitness in vitro. Most importantly, Δisc3 parasites exhibit a complete loss of virulence in vivo. These studies expand the known composition of the IMC sutures and highlight the contribution of ISCs to the ability of the parasite to proliferate and cause disease. © 2016 John Wiley & Sons Ltd.

  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. Summary of QRL 7-8 Repair and Re-installation Leak Test Results

    CERN Document Server

    Kos, N; CERN. Geneva. TE Department

    2009-01-01

    This note describes the leak tests that have been performed during the repair and re-installation of QRL sector 7-8 during 2005 and 2006. The leak tests were performed in UX65, where the pipe elements were refurbished before re-installation, and in the tunnel. A variety of leaks have been detected, localised and repaired in the tunnel, including weld defects, accidentally drilled holes and imported leaks in previously tested components.

  17. Assessment of historical leak model methodology as applied to the REDOX high-level waste tank SX-108

    Energy Technology Data Exchange (ETDEWEB)

    JONES, T.E.

    1999-09-22

    Using the Historical Leak Model approach, the estimated leak rate (and therefore, projected leak volume) for Tank 241-SX-108 could not be reproduced using the data included in the initial document describing the leak methodology. An analysis of parameters impacting tank heat load calculations strongly suggest that the historical tank operating data lack the precision and accuracy required to estimate tank leak volumes using the Historical Leak Model methodology.

  18. 49 CFR 192.705 - Transmission lines: Patrolling.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Transmission lines: Patrolling. 192.705 Section... NATURAL AND OTHER GAS BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Maintenance § 192.705 Transmission... adjacent to the transmission line right-of-way for indications of leaks, construction activity, and other...

  19. Arthroscopic rotator cuff repair using a triple-loaded suture anchor and a modified Mason-Allen technique (Alex stitch).

    Science.gov (United States)

    Castagna, Alessandro; Garofalo, Raffaele; Conti, Marco; Borroni, Mario; Snyder, Stephen J

    2007-04-01

    Surgical repair of the rotator cuff must have good resistance and should restore the tendon footprint. To attain this goal, a stitch with a strong biomechanical profile that avoids tissue strangulation should be used. We describe an arthroscopic suture technique undertaken to repair rotator cuff tears with a single triple-loaded suture anchor. The technique consists of a combination of a horizontal mattress and 2 vertical simple sutures that are positioned medial to the mattress suture. The suture anchor used is the 5-mm self-tapping ThRevo (Linvatec). This anchor is loaded with 3 sutures: 2 No. 2 nonabsorbable braided polyester sutures of different colors and a central high-strength No. 2 polyethylene suture. The shape of the anchor eyelet permits all 3 sutures to glide freely. A modified Mason-Allen technique (Alex stitch) that combines a horizontal side-to-side suture and 2 simples sutures as vertical loops is used. With use of the Spectrum suture passing device and shuttle relay system (Linvatec), both limbs of the centrally located polyethylene suture are passed through the cuff from bottom to top, approximately 1 cm from the tendon edge. This suture is not immediately tied. Next, with use of the same system, the other 2 sutures are placed medially and over the previous horizontal suture. Simple sutures are placed at an approximately 30 degrees angle from the center of the anchor; 1 is placed anterior and the other posterior. The sutures are tied through the lateral portal. The mattress horizontal central stitch is always tied first, followed by the 2 vertical sutures. The horizontal mattress suture serves as a "rip stop stitch" and theoretically reduces the possibility of cutting out of the simple sutures.

  20. Comparison of arthroscopic medial meniscal suture repair techniques: inside-out versus all-inside repair.

    Science.gov (United States)

    Choi, Nam-Hong; Kim, Tae-Hyung; Victoroff, Brian N

    2009-11-01

    There are no reports comparing meniscal healing between inside-out and all-inside repairs using sutures. No difference in healing rate exists between meniscal repairs with inside-out and all-inside suture repair in conjunction with anterior cruciate ligament reconstruction with hamstring tendon. Cohort study; Level of evidence, 2. Forty-eight consecutive patients underwent meniscal repairs of longitudinal tears of the posterior horn of the medial meniscus combined with anterior cruciate ligament reconstructions. All-inside repair was attempted when the tears were located in the red-red zone or the ramp area of the meniscus. If a tear that was in the ramp area or red-red zone extended to the midbody of the meniscus, or if there was a tear in red-white zone, the inside-out repair technique was used. Fourteen patients had all-inside meniscal repairs, and 34 patients had inside-out meniscal repairs with absorbable sutures. Identical postoperative rehabilitation protocols were used. Postoperative evaluations included Lysholm knee scoring scale, Tegner activity levels, Lachman and pivot-shift tests, and KT-1000 arthrometer. Assessment of meniscal status was performed using joint line tenderness, McMurray test, and range of motion. Follow-up magnetic resonance imaging scans were obtained on all patients. Mean follow-up was 35.7 months. No patient had joint line tenderness or reported pain or clicking on McMurray test. There was no significant difference in range of motion between groups. Follow-up magnetic resonance imaging scans demonstrated that 10 (71.4%) menisci were healed and 4 (28.6%) partially healed in the all-inside group; 24 (70.6%) menisci were healed and 10 (29.4%) partially healed in the inside-out group. There was no significant difference in meniscal healing between groups. There were no differences in Lachman test, KT-1000 arthrometer side-to-side differences measurements, Lysholm scores, and Tegner activity scales. There was a significant difference in

  1. PORTABLE IMAGING DEVICES FOR INDUSTRIAL LEAK DETECTION AT PETROLEUM REFINERIES AND CHEMICAL PLANTS

    Science.gov (United States)

    Undiscovered gas leaks, or fugitive emissions, in chemical plants and refinery operations can impact regional air quality as well as being a public health problem. Surveying a facility for potential gas leaks can be a daunting task. Industrial Leak Detection and Repair (LDAR) pro...

  2. 40 CFR 63.1004 - Instrument and sensory monitoring for leaks.

    Science.gov (United States)

    2010-07-01

    ... individual HAP, VOC or other regulated material individual chemical compound in the stream. For process...)(2) of this section, or monitoring at a different leak definition if the data would indicate the... applicable leak definition for the monitored equipment to determine whether there is a leak or to determine...

  3. Hanford Single-Shell Tank Leak Causes and Locations - 241-B Farm

    Energy Technology Data Exchange (ETDEWEB)

    Girardot, Crystal L. [Washington River Protection Systems, Richland, WA (United States); Harlow, Donald G. [Washington River Protection Systems, Richland, WA (United States)

    2013-07-11

    This document identifies 241-B Tank Farm (B Farm) leak cause and locations for the 100 series leaking tank (241-B-107) identified in RPP-RPT-49089, Hanford B-Farm Leak Inventory Assessments Report. This document satisfies the B Farm portion of the target (T04) in the Hanford Federal Facility Agreement and Consent Order milestone M-045-91F.

  4. Changes in biomechanical strain and morphology of rat calvarial sutures and bone after Tgf-β3 inhibition of posterior interfrontal suture fusion.

    Science.gov (United States)

    Shibazaki-Yorozuya, Reiko; Wang, Qian; Dechow, Paul C; Maki, Koutaro; Opperman, Lynne A

    2012-06-01

    Craniofacial sutures are bone growth fronts that respond and adapt to biomechanical environments. Little is known of the role sutures play in regulating the skull biomechanical environment during patency and fusion conditions, especially how delayed or premature suture fusion will impact skull biomechanics. Tgf-β3 has been shown to prevent or delay suture fusion over the short term in rat skulls, yet the long-term patency or its consequences in treated sutures is not known. It was therefore hypothesized that Tgf-β3 had a long-term impact to prevent suture fusion and thus alter the skull biomechanics. In this study, collagen gels containing 3 ng Tgf-β3 were surgically placed superficial to the posterior interfrontal suture (IFS) and deep to the periosteum in postnatal day 9 (P9) rats. At P9, P24, and P70, biting forces and strains over left parietal bone, posterior IFS, and sagittal suture were measured with masticatory muscles bilaterally stimulated, after which the rats were sacrificed and suture patency analyzed histologically. Results demonstrated that Tgf-β3 treated sutures showed less fusion over time than control groups, and strain patterns in the skulls of the Tgf-β3-treated group were different from that of the control group. Although bite force increased with age, no alterations in bite force were attributable to Tgf-β3 treatment. These findings suggest that the continued presence of patent sutures can affect strain patterns, perhaps when higher bite forces are present as in adult animals. Copyright © 2012 Wiley Periodicals, Inc.

  5. The effect of suture caliber and number of core suture strands on zone II flexor tendon repair: a study in human cadavers.

    Science.gov (United States)

    Osei, Daniel A; Stepan, Jeffrey G; Calfee, Ryan P; Thomopoulos, Stavros; Boyer, Martin I; Potter, Ryan; Gelberman, Richard H

    2014-02-01

    To compare the tensile properties of a 3-0, 4-strand flexor tendon repair with a 4-0, 4-strand repair and a 4-0, 8-strand repair. Following evaluation of the intrinsic material properties of the 2 core suture calibers most commonly used in tendon repair (3-0 and 4-0), we tested the mechanical properties of 40 cadaver flexor digitorum profundus tendons after zone II repair with 1 of 3 techniques: a 3-0, 4-strand core repair, a 4-0, 8-strand repair, or a 4-0, 4-strand repair. We compared results across suture caliber for the 2 sutures and across tendon repair methods. Maximum load to failure of 3-0 polyfilament caprolactam suture was 49% greater than that of 4-0 polyfilament caprolactam suture. The cross-sectional area of 3-0 polyfilament caprolactam was 42% greater than that of 4-0 polyfilament caprolactam. The 4-0, 8-strand repair produced greater maximum load to failure when compared with the 2 4-strand techniques. Load at 2-mm gap, stiffness, and work to yield were significantly greater in the 4-0, 8-strand repair than in the 3-0, 4-strand repair. In an ex vivo model, an 8-strand repair using 4-0 suture was 43% stronger than a 4-strand repair using 3-0 suture, despite the finding that 3-0 polyfilament caprolactam was 49% stronger than 4-0 polyfilament caprolactam. These results suggest that, although larger-caliber suture has superior tensile properties, the number of core suture strands across a repair site has an important effect on time zero, ex vivo flexor tendon repair strength. Surgeons should consider using techniques that prioritize multistrand core suture repair over an increase in suture caliber. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  6. The Effect of Suture Caliber and Number of Core Suture Strands on Zone II Flexor Tendon Repair; A Study in Human Cadavers

    Science.gov (United States)

    Osei, Daniel A.; Stepan, Jeffrey G.; Calfee, Ryan P.; Thomopoulos, Stavros; Boyer, Martin I.; Potter, Ryan; Gelberman, Richard H.

    2014-01-01

    Purpose To compare the tensile properties of a 3-0, 4-strand flexor tendon repair to a 4-0, 4 strand repair and a 4-0, 8-strand repair. Methods Following evaluation of the intrinsic material properties of the 2 core suture calibers most commonly used in tendon repair (3-0 and 4-0), we tested the mechanical properties of 40 cadaver flexor digitorum profundus tendons after zone II repair with one of 3 techniques: a 3-0, 4-strand core repair, a 4-0, 8-strand repair, or a 4-0, 4-strand repair. We compared results across suture caliber for the 2 sutures and across tendon repair methods. Results Maximum load to failure of 3-0 polyfilament caprolactam suture was 49% greater than that of 4-0 polyfilament caprolactam suture. The cross sectional area of 3-0 Supramid was 42% greater than that of 4-0 Supramid. The 4-0, 8 strand, repair produced greater maximum load to failure when compared to the 2 4-strand techniques. Load at 2 mm gap, stiffness, and work to yield were significantly greater in the 4-0, 8-strand repair when compared to the 3-0, 4-strand repair. Discussion In an ex vivo model, an 8-strand repair using 4-0 suture was 43% stronger than a 4-strand repair using 3-0 suture, despite the finding that 3-0 polyfilament caprolactam was 49% stronger than was 4-0 polyfilament caprolactam. These results suggest that, although larger caliber suture has superior tensile properties, the number of core suture strands across a repair site has an important effect on time zero, ex vivo flexor tendon repair strength. Clinical Relevance Surgeons should consider using techniques that prioritize multi-strand core suture repair over an increase in suture caliber. PMID:24342261

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

    Directory of Open Access Journals (Sweden)

    Fernandes MA

    2014-02-01

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

  8. Delayed Repair of Infected Ruptured Patellar Tendon using Suture Anchors

    Directory of Open Access Journals (Sweden)

    Himanshu Kataria

    2017-10-01

    Full Text Available Patellar tendon rupture are rare injuries that are easily missed in acute phases if careful clinical examination is not carried out. The delayed condition is further difficult to treat and augmentation of end to end repair is generally required. However, literature presents no such case of delayed presentation with presence of infection. We here present one such case of delayed presentation of patellar tendon rupture at three weeks in a 52-year-old male patient. Usual techniques were not sufficient to allow early rehabilitation. Technique of suture anchors was planned for repair after thorough debridement. After this intervention, patient was put on aggressive rehabilitation protocol and he gained excellent range of motion. Patient was followed for one year and he showed no loss of movement or signs of infection. We thus recommend using anchor suture repair of patellar tendon that provides a stable and rigid fixation with possibility of early active rehabilitation even in delayed setting.

  9. Bridging Suture Repair for Acetabular Chondral Carpet Delamination.

    Science.gov (United States)

    Kaya, Mitsunori; Hirose, Toshiaki; Yamashita, Toshihiko

    2015-08-01

    Acetabular chondral carpet delamination is a frequent finding at hip arthroscopy. The cartilage is macroscopically normal but deboned from the subchondral bone, without a disruption at the chondrolabral junction. Arthroscopic anatomic repair of delaminated cartilage is challenging. We propose that a combination of microfracture and use of stitches to press the delaminated cartilage against the subchondral bone using a suture limb offers an effective method to provide an environment for cartilage repair. This article describes the technique of bridging suture repair for carpet delamination in detail; the technique enables the surgeon to stabilize the delaminated acetabular cartilage. Intra-articular soft anchors and an acetabular rim knotless anchor footprint provide a stable repair for delaminated cartilage. This technique is especially helpful in cases with acetabular cartilage carpet delamination.

  10. Non phaco suture less cataract extraction through temporal approach.

    Science.gov (United States)

    Junejo, Sameen Afzal; Jatoi, Shafi Muhammad; Khan, Nisar Ahmed

    2009-01-01

    Non Phaco suture less cataract extraction through temporal approach retains most of the advantages of phacoemulsification but can be delivered at lower cost with better visual out come. Extra capsular cataract extraction followed by posterior chamber intraocular lens implantation was performed, on 300 eyes of 250 patients. The technique involved was posterior limbal corneal tunnel incision through temporal approach, followed by implantation of PMMA posterior chamber intraocular lens. Visual acuity at the time of discharge, third post operative week and sixth week was recorded. Surgically induced astigmatism was reported. The uncorrected visual acuity at discharge was 6/18 or better in 63.2% eyes. The best corrected visual acuity was 6/9 and better in 96.0% subjects at six weeks. Poor visual outcome (astigmatism, as the corneal incision was given through temporal approach. Suture less manual extra capsular cataract surgery through temporal approach ensures rapid visual recovery with minimum astigmatism against rule.

  11. Suture patterns and corneal graft rotation in the cadaver eye.

    Science.gov (United States)

    Au, Y K; Mahjoub, S B; Hart, J C

    1990-07-01

    Torque and antitorque running sutures as described by Eisner are commonly used in penetrating keratoplasty. We tested the rotational effect of three different 16-bite running suture patterns on eight cadaver eyes, with the following results: (1) the torque pattern rotates the corneal graft counterclockwise by 0.7 +/- 0.1 mm at the wound or 11 degrees; (2) the antitorque pattern rotates the corneal graft clockwise by 0.7 +/- 0.1 mm at the wound or 11 degrees; (3) an intermediate "no torque" pattern, the bites of which form an isosceles triangle, produces no rotational effect. We recommend the use of a "no torque" pattern to minimize corneal graft rotation.

  12. Numerical and experimental investigation of leaks in viscoelastic pressurized pipe flow

    Directory of Open Access Journals (Sweden)

    S. Meniconi

    2013-02-01

    Full Text Available This paper extends the analysis concerning the importance in numerical models of unsteady friction and viscoelasticity to transients in plastic pipes with an external flow due to a leak. In fact recently such a benchmarking analysis has been executed for the cases of a constant diameter pipe (Duan et al., 2010, a pipe with a partially closed in-line valve (Meniconi et al., 2012a, and a pipe with cross-section changes in series (Meniconi et al., 2012b. Tests are based on laboratory experiments carried out at the Water Engineering Laboratory (WEL of the University of Perugia, Italy, and the use of different numerical models. The results show that it is crucial to take into account the viscoelasticity to simulate the main characteristics of the examined transients.

  13. Arthroscopic Lateral Meniscus Root Repair With Soft Suture Anchor Technique

    OpenAIRE

    Prasathaporn, Niti; Kuptniratsaikul, Somsak; Kongrukgreatiyos, Kitiphong

    2013-01-01

    Meniscus root tear leads to circumferential hoop tension loss and increases femorotibial contact force, which causes irreversible cartilage degeneration. Biomechanical studies have shown that meniscus root repair provides better femorotibial contact force than meniscectomy. Many techniques for meniscus root repair have been published in recent years. The soft suture anchor is widely used in the glenoid labral repair. It is a small low-profile soft anchor. This article presents a new and simpl...

  14. Visual Measurement of Suture Strain for Robotic Surgery

    OpenAIRE

    Martell, John; Elmer, Thomas; Gopalsami, Nachappa; Park, Young Soo

    2011-01-01

    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 surr...

  15. [Suturing a child's wound, humanising care in the emergency department].

    Science.gov (United States)

    Potor, Margot; El Kaissi, Mohamed; Massart, Loïc; Alongi, Stephan; Hemelsoet, Nathalie; Thys, Frédéric

    The humanisation of the care pathway constitutes an objective for all caregivers. A visit to the emergency department by a child requiring a suture is a simple and frequent situation which highlights the different stages of the care. Several of these stages can be anticipated in the waiting room, in particular the exchanging of information with the patient and the family, which helps to improve the parent-child-professional relationship. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  16. Two different suturing techniques in distal hypospadias repair using ...

    African Journals Online (AJOL)

    follow-up were excluded from this study. The ages of the patients ranged from 8 to 48 months (mean 13.6±6.9 months). All patients underwent repair using the ... 8–42. 0.276. Mean ± SD. 14.4 ± 6.8. 12.8 ± 7.1. Hypospadias type. Distal penile. 26. 29. 0.315. Coronal. 14. 11. Hypoplastic urethra. 3. 7. 0.155. Suture size. 5/0.

  17. 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.

  18. The mechanical interaction between three geometric types of nylon core suture and a running epitenon suture in repair of porcine flexor tendons

    NARCIS (Netherlands)

    Wit, T.; Walbeehm, E.T.; Hovius, S.E.; McGrouther, D.A.

    2013-01-01

    The effect of core suture geometry on the mechanical interaction with the epitenon suture in terms of gap prevention, failure strength and mode of failure was investigated in a flexor tendon repair model. A total of 48 porcine flexor tendons were repaired using three techniques with distinct core

  19. Comparison of bidirectional barbed suture Stratafix and conventional suture with intracorporeal knots in laparoscopic myomectomy by office transvaginal hydrolaparoscopic follow-up: a preliminary report.

    Science.gov (United States)

    Giampaolino, Pierluigi; De Rosa, Nicoletta; Tommaselli, Giovanni Antonio; Santangelo, Fabrizia; Nappi, Carmine; Sansone, Anna; Bifulco, Giuseppe

    2015-12-01

    To compare surgical outcomes of different types of intracorporeal sutures for laparoscopic posterior myomectomy, by a prospective randomized study. Prospective randomized study on 47 patients with single posterior intramural myoma (4-7cm in diameter) undergoing laparoscopic myomectomy. The patients enrolled were divided into two groups, one operated using conventional suture in double strand, and the other with bidirectional barbed suture Stratafix. The main outcome measures were suturing time, peri-operative variables, and post-operative adhesions in both groups. The mean operative time was shorter with the Stratafix™ than with the conventional suture (66.3±8.2 vs. 73±8min; p=0.005). Suturing time was significantly shorter in the Stratafix™ than in the control group (8.8±2.4 vs. 15.5±2.8min; p=0.001). Intraoperative bleeding was significantly less in the Stratafix group (p=0.0012). Conversely, there was no statistically significant difference for postoperative adhesions between the two groups (26.7% vs. 21.4% p=0.5). The use of barbed suture may reduce operative time, suturing time, and blood loss. No difference in post operative adhesions was found. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2017-07-01

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

  1. 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.

  2. Sutured posterior chamber intraocular lenses for traumatic cataract in Africa.

    Science.gov (United States)

    Rogers, Graeme; Mustak, Hamzah; Hann, Mignon; Steven, David; Cook, Colin

    2014-07-01

    To determine the outcomes of sutured scleral fixation of posterior chamber intraocular lenses (PC IOLs) after trauma in an African population. State hospital and affiliated district hospital, Cape Town, South Africa. Case series. A retrospective review was performed of the medical records of patients in whom a sutured PC IOL had been implanted for traumatic aphakia in the preceding 5 years. Eighty-five percent of the 59 patients had a significant improvement in uncorrected distance visual acuity (UDVA) at the final visit. Two-thirds of patients achieved an UDVA of 6/18 or better. Those not improving had severe preexisting macular or corneal pathology. A significant number of patients (28%) with angle recession developed ocular hypertension during the postoperative period. After careful preoperative selection, sutured PC IOLs were effective in the visual rehabilitation of eyes with traumatic subluxated cataract in which the capsular bag could not be retained. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2013-12-01

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

  4. A novel postoperative immobilization model for murine Achilles tendon sutures.

    Science.gov (United States)

    Shibuya, Yoichiro; Takayama, Yuzo; Kushige, Hiroko; Jacinto, Sandra; Sekido, Mitsuru; Kida, Yasuyuki S

    2016-08-01

    The body's motion and function are all in part effected by a vital tissue, the tendon. Tendon injury often results in limited functioning after postoperative procedures and even for a long time after rehabilitation. Although numerous studies have reported surgical procedures using animal models which have contributed to both basic and clinical research, modeling of tendon sutures or postoperative immobilizations has not been performed on small experimental animals, such as mice. In this study we have developed an easy Achilles tendon suture and postoperative ankle fixation model in a mouse. Right Achilles tendons were incised and 10-0 nylons were passed through the proximal and distal ends using a modified Kessler method. Subsequently, the right ankle was immobilized in a plantarflexed position with novel splints, which were made from readily available extension tubes. Restriction of the tendon using handmade splints reduced swelling, as opposed to fixating with the usual plaster of Paris. Using this method, the usage of the right Achilles tendons began on postoperative days 13.5 ± 4.6, which indicated healing within two weeks. Therefore our simple short-term murine Achilles tendon suture procedure is useful for studying immediate tendon repair mechanisms in various models, including genetically-modified mice. © The Author(s) 2015.

  5. Massive Cerebrospinal Fluid Leak of the Temporal Bone

    Directory of Open Access Journals (Sweden)

    Giannicola Iannella

    2016-01-01

    Full Text Available Cerebrospinal fluid (CSF leakage of the temporal bone region is defined as abnormal communications between the subarachnoidal space and the air-containing spaces of the temporal bone. CSF leak remains one of the most frequent complications after VS surgery. Radiotherapy is considered a predisposing factor for development of temporal bone CSF leak because it may impair dural repair mechanisms, thus causing inadequate dural sealing. The authors describe the case of a 47-year-old man with a massive effusion of CSF which extended from the posterior and lateral skull base to the first cervical vertebrae; this complication appeared after a partial enucleation of a vestibular schwannoma (VS with subsequent radiation treatment and second operation with total VS resection.

  6. Coil embolization of an anastomotic leak after ascending aorta replacement

    DEFF Research Database (Denmark)

    Nørgaard, Anders; Andersen, Lars Ib; Haahr, P.E.

    2008-01-01

    treated aneurysm in the ascending thoracic aorta complicated with an anastomotic leak. If a short prosthesis (6 cm) had been available, the anastomotic leak would have been treated with endovascular repair. In lack of this prosthesis, we were forced to treat the patient with a method not generally......Surgical treatment of diseases of the thoracic aorta (aneurysms, dissections, and ruptures) may be associated with serious postoperative complications. Endovascular repair of thoracic aorta pathology is less invasive and offers a therapeutic alternative in high-surgical-risk patients, particularly...... in the presence of previous surgical repair of the thoracic aorta. The endovascular procedure, however, is almost only possible in the descending thoracic aorta, although advances have also been made in the aortic arch as well as in the ascending aorta with branched stent grafts. We report a case of a surgically...

  7. Propofol lipemia mimicking chyle leak during neck dissection.

    Science.gov (United States)

    Vokes, David E; Linskey, Mark E; Armstrong, William B

    2006-12-01

    Propofol is an intravenous agent used in anesthesia. Lipemia is an uncommon adverse effect of propofol infusion. A patient undergoing neck dissection for recurrent chordoma had intraoperative lipemia develop after prolonged propofol infusion. Lipemia gave blood in the surgical field a milky appearance resembling chyle, but no chyle leak was present. Lipemia was confirmed by drawing a sample of blood and leaving it to stand. Layering of the blood with a milky white upper layer was observed. Analysis of a second sample of blood revealed a high lipemic index. Lipemia is an uncommon adverse effect of propofol infusion, which may give blood a milky appearance and be confused for a chyle leak in a dissected neck. Identification of lipemia is also important because there is a risk of acute pancreatitis, and it may represent the early stage of propofol infusion syndrome.

  8. Method for HEPA filter leak scanning with differentiating aerosol detector

    Energy Technology Data Exchange (ETDEWEB)

    Kovach, B.J.; Banks, E.M.; Wikoff, W.O. [NUCON International, Inc., Columbus, OH (United States)

    1997-08-01

    While scanning HEPA filters for leaks with {open_quotes}Off the Shelf{close_quote} aerosol detection equipment, the operator`s scanning speed is limited by the time constant and threshold sensitivity of the detector. This is based on detection of the aerosol density, where the maximum signal is achieved when the scanning probe resides over the pinhole longer than several detector time-constants. Since the differential value of the changing signal can be determined by observing only the first small fraction of the rising signal, using a differentiating amplifier will speed up the locating process. The other advantage of differentiation is that slow signal drift or zero offset will not interfere with the process of locating the leak, since they are not detected. A scanning hand-probe attachable to any NUCON{reg_sign} Aerosol Detector displaying the combination of both aerosol density and differentiated signal was designed. 3 refs., 1 fig.

  9. Management of Leaks in Hydrogen Production, Delivery, and Storage Systems

    Energy Technology Data Exchange (ETDEWEB)

    Rawls, G

    2006-04-27

    A systematic approach to manage hydrogen leakage from components is presented. Methods to evaluate the quantity of hydrogen leakage and permeation from a system are provided by calculation and testing sensitivities. The following technology components of a leak management program are described: (1) Methods to evaluate hydrogen gas loss through leaks; (2) Methods to calculate opening areas of crack like defects; (3) Permeation of hydrogen through metallic piping; (4) Code requirements for acceptable flammability limits; (5) Methods to detect flammable gas; (6) Requirements for adequate ventilation in the vicinity of the hydrogen system; (7) Methods to calculate dilution air requirements for flammable gas mixtures; and (8) Concepts for reduced leakage component selection and permeation barriers.

  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 (Pkeratoplasty.

  11. Microbiology of Explanted Suture Segments from Infected and Noninfected Surgical Patients

    Science.gov (United States)

    Krepel, Candace J.; Marks, Richard M.; Rossi, Peter J.; Sanger, James; Goldblatt, Matthew; Graham, Mary Beth; Rothenburger, Stephen; Collier, John; Seabrook, Gary R.

    2013-01-01

    Sutures under selective host/environmental factors can potentiate postoperative surgical site infection (SSI). The present investigation characterized microbial recovery and biofilm formation from explanted absorbable (AB) and nonabsorbable (NAB) sutures from infected and noninfected sites. AB and NAB sutures were harvested from noninfected (70.9%) and infected (29.1%) sites in 158 patients. At explantation, devices were sonicated and processed for qualitative/quantitative bacteriology; selective sutures were processed for scanning electron microscopy (SEM). Bacteria were recovered from 85 (53.8%) explanted sites; 39 sites were noninfected, and 46 were infected. Suture recovery ranged from 11.1 to 574.6 days postinsertion. A significant difference in mean microbial recovery between noninfected (1.2 isolates) and infected (2.7 isolates) devices (P sutures was noted. Biofilm was present in 100% and 66.6% of infected and noninfected devices, respectively (P sutures provide a hospitable surface for microbial adherence: (i) a significant difference in microbial recovery from infected and noninfected sutures was noted, (ii) infected sutures harbored a mixed flora, including multidrug-resistant health care-associated pathogens, and (iii) a significant difference in the presence or absence of a biofilm in infected versus noninfected explanted devices was noted. Further studies to document the benefit of focused risk reduction strategies to minimize suture contamination and biofilm formation postimplantation are warranted. PMID:23175247

  12. [Influence of different types of surgical suture materials on mechanical damage of oral mucosa].

    Science.gov (United States)

    Mirković, Sinisa; Mirković, Tatjana Durdević

    2011-01-01

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

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

    Science.gov (United States)

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

    2005-12-01

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

  14. Absence of endochondral ossification and craniosynostosis in posterior frontal cranial sutures of Axin2(-/- mice.

    Directory of Open Access Journals (Sweden)

    Björn Behr

    Full Text Available During the first month of life, the murine posterior-frontal suture (PF of the cranial vault closes through endochondral ossification, while other sutures remain patent. These processes are tightly regulated by canonical Wnt signaling. Low levels of active canonical Wnt signaling enable endochondral ossification and therefore PF-suture closure, whereas constitutive activation of canonical Wnt causes PF-suture patency. We therefore sought to test this concept with a knockout mouse model. PF-sutures of Axin2(-/- mice, which resemble a state of constantly activated canonical Wnt signaling, were investigated during the physiological time course of PF-suture closure and compared in detail with wild type littermates. Histological analysis revealed that the architecture in Axin2(-/- PF-sutures was significantly altered in comparison to wild type. The distance between the endocranial layers was dramatically increased and suture closure was significantly delayed. Moreover, physiological endochondral ossification did not occur, rather an ectopic cartilage appeared between the endocranial and ectocranial bone layers at P7 which eventually involutes at P13. Quantitative PCR analysis showed the lack of Col10α1 upregulation in Axin2(-/- PF-suture. Immunohistochemistry and gene expression analysis also revealed high levels of type II collagen as compared to type I collagen and absence of Mmp-9 in the cartilage of Axin2(-/- PF-suture. Moreover, TUNEL staining showed a high percentage of apoptotic chondrocytes in Axin2(-/- PF-sutures at P9 and P11 as compared to wild type. These data indicated that Axin2(-/- PF-sutures lack physiological endochondral ossification, contain ectopic cartilage and display delayed suture closure.

  15. A prospective controlled study of a 10/0 absorbable polyglactin suture for corneal incision phacoemulsification.

    Science.gov (United States)

    Bainbridge, J W; Teimory, M; Kirwan, J F; Rostron, C K

    1998-01-01

    To evaluate the performance of a 10/0 monofilament absorbable polyglactin suture for temporal 5.2 mm corneal incision phacoemulsification. A prospective randomised controlled study of 49 patients undergoing phacoemulsification with a sutured temporal 5.2 mm corneal section was conducted to compare the refractive results and complications of a 10/0 monofilament absorbable polyglactin suture with 10/0 nylon. Thirty-eight patients completed the study. There was no significant difference in induced astigmatism between the two groups. All absorbable sutures were intact at 1 week. Six weeks post-operatively the absorbable suture was still intact in 1 (6%) patient, present but broken in 4 (24%) and completely absent in 12 (70%) patients. All polyglactin sutures had been completely absorbed by 12 weeks. Absorption of the polyglactin sutures was associated with mild localised corneal haze in 3(18%) cases (p = 0.055). One of the 18 patients (6%) in the polyglactin suture group presented with iris prolapse associated with knot failure 1 week post-operatively. There was no significant difference in foreign body symptoms between the two groups. 10/0 polyglactin sutures maintain adequate tensile strength during the immediate post-operative period for small incision surgery and are associated with minimal induction of astigmatism. Their subsequent absorption obviates the need for routine suture removal. Suture absorption is well tolerated although in some cases a mild degree of local tissue reaction raises concern about possible mechanisms of absorption. The risk of knot failure may be reduced by an alternative suture tying technique. 10/0 monofilament polyglactin is an attractive option when a suture is required during small incision cataract surgery.

  16. Assessing the Adequacy of Absorbable Braided Suture for Laparoscopic High Ligation in Rabbits.

    Science.gov (United States)

    Bruns, Nicholas E; Glenn, Ian C; Craner, Domenic R; McNinch, Neil L; Schomisch, Steve J; Ponsky, Todd A

    2017-07-01

    Our previous work demonstrated that intentional peritoneal injury reduces the incidence of recurrence of a patent processus vaginalis even after removal of the suture. Therefore, the necessity of permanent suture has been brought into question because of the risk of suture granuloma formation. The purpose of this study was to evaluate the efficacy of absorbable, braided versus permanent, braided suture in a rabbit survival model of laparoscopic percutaneous ligation of the processus vaginalis with intentional peritoneal injury. Eighteen New Zealand White rabbits underwent bilateral subcutaneous endoscopically assisted ligation (SEAL) of the internal ring. Before SEAL, peritoneal injury was caused with endoscopic shears. Each animal was randomized to receive absorbable braided suture on one side and permanent braided suture on the contralateral side. The rabbits were survived for 8 weeks to allow for complete hydrolysis of the absorbable suture. Necropsy was performed during which the integrity of the repair was assessed with insufflation of carbon dioxide up to 30 mm Hg. McNemar's test for paired data was performed for statistical analysis. Seventeen rabbits survived 8 weeks. One rabbit died in the early postoperative period because of urinary tract obstruction. After insufflation, four (24%) recurrences were present in the absorbable group and two (12%) recurrences were present in the permanent group. This difference was not statistically significant (P = .50). Both rabbits with a recurrence on the side with permanent suture also had a recurrence with absorbable suture on the contralateral side. In all rabbits, the permanent suture was identified, whereas there was no visual evidence of absorbable suture. A trend toward a higher recurrence rate with the use of absorbable braided suture was present, although, in this study, the finding was not statistically significant. Caution should be used when considering implementation of absorbable suture for

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

    Directory of Open Access Journals (Sweden)

    Kathleen Hennecke

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

  18. 105-KE Isolation Barrier Leak Rate Acceptance Test Report

    Energy Technology Data Exchange (ETDEWEB)

    McCracken, K.J.

    1995-06-14

    This Acceptance Test Report (ATR) contains the completed and signed Acceptance Procedure (ATP) for the 105-KE Isolations Barrier Leak Rate Test. The Test Engineer`s log, the completed sections of the ATP in the Appendix for Repeat Testing (Appendix K), the approved WHC J-7s (Appendix H), the data logger files (Appendices T and U), and the post test calibration checks (Appendix V) are included.

  19. Multiple-Feature Extracting Modules Based Leak Mining System Design

    Directory of Open Access Journals (Sweden)

    Ying-Chiang Cho

    2013-01-01

    mining system that is equipped with SQL injection vulnerability detection, by means of an algorithm developed for the web crawler. In addition, we analyze portal sites of the governments of various countries or regions in order to investigate the information leaking status of each site. Subsequently, we analyze the database structure and content of each site, using the data collected. Thus, we make use of practical verification in order to focus on information security and privacy through black-box testing.

  20. ACOUSTIC LOCATION OF LEAKS IN PRESSURIZED UNDER- GROUND PETROLEUM PIPELINES

    Science.gov (United States)

    Experiments were conducted at the Underground Storage Tank (UST) Test Apparatus Pipeline in which three acoustic sensors separated by a maximum distance of 38.1 m (125 ft) were used to monitor signals produced by 11.4-, 5.7-, and 3.8-L/h (3.0-, 1.5-, and 1.0-gal/h) leaks in th...