• Archives of Plastic Surgery
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• v.36 no.3
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• pp.322-326
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• 2009

Purpose: Severe type of inverted nipple (cannot be pulled out above the areola plane by manipulation, grade III) usually cannot be corrected by a relatively simple purse - string suture technique. Most patients want to avoid visible scars. To treat the severe case and avoid visible stigma, we introduce this invisible dermal flap method. Methods: This new surgical procedure makes bilateral incisions on the sidewall of nipple and dissections vertically to free the ducts from the contracted tissues. After dissection, the tunnel is formed. We insert "dermal flaps" into the tunnel underneath nipple base. Then through - and - through sutures are performed vertically (6 o'clock and 12 o'clock positions) and the purse - string suture is added with 4 - 0 nylon. Results: We had treated 35 primary inverted nipples (grade III) in 27 patients and 13 recurrent nipples in 7 cases. The results were excellent in 45 nipples (93.7%). All but 3 recurred cases was fully or very satisfied with the results. Conclusion: This technique is effective for the correction of severe inverted nipples and recurrent cases. We can avoid the visible scars on the areola surface.

• Archives of Craniofacial Surgery
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• v.18 no.4
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• pp.277-281
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• 2017

Traumatic cleft earlobes are a common problem encountered by plastic and reconstructive surgeons. Various techniques have been reported for the repair of traumatic cleft earlobes. Usually, the techniques of split earlobe repair are divided into two categories, namely straight- and broken-line repairs. Straight-line repair is simple and easy, but scar contracture frequently results in notching of the inferior border of the lobule. It can be avoided by the broken-line repair such as Z-plasty, L-plasty, or a V-shaped flap. Between April 2016 and February 2017, six patients who presented with traumatic cleft earlobe underwent surgical correction using a combination of the inverted V-shaped excision technique and vertical mattress suture method. All the patients were female and had a unilateral complete cleft earlobe. No postoperative notching of the inferior border the lobule occurred during 6-16 months of follow-up. Without the use of a broken-line repair, both the patients and the operators attained aesthetically satisfactory results. Therefore, the combination of the inverted V-shaped excision technique and vertical mattress suture method is considered useful in the treatment of traumatic cleft earlobes.

• Journal of Veterinary Clinics
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• v.39 no.6
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• pp.378-383
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• 2022

A 3-year-old, 24-kg intact female Border Collie was referred for a toe-touch weight-bearing stance, intermittent weight-bearing lameness, and moderate pain reaction of the right forelimb on physical examination and right humerus olecranon avulsion fracture on diagnostic imaging examination. Surgical repair was performed using tension band wiring to re-attach the triceps tendon and distal olecranon. Migration of the distal olecranon fragment was observed due to comminuted fracture of the fragment 5-days after surgery, and revision surgery was performed. The tension-relieving sutures were passed through the pre-drilled hole in the olecranon, and the polyester mesh was augmented to the suture region, covering the triceps tendon and olecranon drilling hole using the Krackow suture pattern. The elbow joint was immobilized using a type IA transarticular external fixator, which was removed 8 weeks after surgery. Fourteen weeks after surgery, no lameness was observed on gait evaluation. At follow-up after 7 months, the distal olecranon fragment had stabilized, and no lameness was observed.

• Journal of Chest Surgery
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• v.57 no.1
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• pp.92-95
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• 2024

Complete resection of an apicoposterior mediastinal mass is essential due to the mass effect, which exerts pressure on adjacent organs. Recently, the use of minimally invasive surgery has had many advantages. In this report, we describe a case in which a large apicoposterior mediastinal hypervascular mass was managed using a purse-string suture technique during robotic-assisted thoracoscopic surgery (RATS). The patient, a 77-year-old woman, was diagnosed with a 6.2-cm apicoposterior mediastinal hypervascular solid mass originating from the branches of the right subclavian artery. The patient underwent RATS for treatment. To obtain an adequate view of the apex of the thoracic cavity, a needle aspiration was performed, followed by the application of a purse-string suture technique. This was done to reduce the size of the tumor and to prevent catastrophic events such as seeding or spillage of the cystic mass. The mass was histopathologically diagnosed as a schwannoma. The patient was discharged on the first postoperative day without experiencing any complications.

• Journal of Chest Surgery
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• v.28 no.7
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• pp.721-725
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• 1995

One case of surgical correction of a large aortopulmonary window in a 4 months old female is reported in detail. Clinical symptoms consisted of fatigue when feeding and recurrent upper respiratory tract infection. Under cardiopulmonary bypass with moderate hypothermia and cardioplegic arrest of the heart, the aortopulmonary window was approached through a vertical incision at the anterior wall of window itself. The defect was closed with pericardial patch using continuous suture posteriorly and sandwitch technique anteriorly. The patient was weaned from the cardiopulmoanry bypas without hemodynamic problem and postoperative course was uneventful. This surgical technique is recommandable as it provides good exposure of the defect and can be performed easily and safely.

• Journal of Korean Neurosurgical Society
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• v.63 no.6
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• pp.834-840
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• 2020

Objective : Carotid endarterectomy (CEA) is an effective surgical procedure for treating symptomatic or asymptomatic patients with carotid stenosis. Many neurosurgeons use a shunt to reduce perioperative ischemic complications. However, the use of shunting is still controversial, and the shunt procedure can cause several complications. In our institution, we used two types of modified arteriotomy suture techniques instead of using a shunt. Methods : In technique 1, to prevent ischemic complications, we sutured a third of the arteriotomy site from both ends after removing the plaque. Afterward, the unsutured middle third was isolated from the arterial lumen by placing a curved Satinsky clamp. And then, we opened all the clamped carotid arteries before finishing the suture. In technique 2, we sutured the arteriotomy site at the common carotid artery (CCA). We then placed a curved Satinsky clamp crossing from the sutured site to the carotid bifurcation, isolating the unsutured site at the internal carotid artery (ICA). After placing the Satinsky clamp, the CCA and external carotid artery (ECA) were opened to allow blood flow from CCA to ECA. By opening the ECA, ECA collateral flow via ECA-ICA anastomoses could help to reduce cerebral ischemia. Results : The modified suture methods can reduce the cerebral ischemia directly (technique 1) or via using collaterals (technique 2). The modified arteriotomy suture techniques are simple, safe, and applicable to almost all cases of CEA. Conclusion : Two modified arteriotomy suture techniques could reduce perioperative ischemic complications by reducing the cerebral ischemic time.

• Journal of the Korean Arthroscopy Society
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• v.16 no.1
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• pp.66-71
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• 2012

The posterior root of medial meniscus maintains normal meniscal function by circumferential hoop tension and prevents extrusion of meniscus and progression of osteoarthritis. A complete tear of posterior root of medial meniscus leads to loss of hoop tension, it is important to repair it and preserve the function of the medial meniscus. Recently, a variety of arthroscopic assisted reduction and repair techniques have been used. We create an arthroscopic all-inside suture technique using a 18 gauge spinal needle and suture anchor that is easier and more convenient compared with the previous techniques. So we report this technique with a review of current literatures.

• Journal of Korean Foot and Ankle Society
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• v.20 no.2
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• pp.73-77
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• 2016

Purpose: The purpose of this study was to evaluate the clinical outcome of a modified Kidner procedure using a suture bridge technique in symptomatic type II accessory navicular. Materials and Methods: Between January 2013 and December 2014, a total of 35 cases with symptomatic type II accessory navicular were treated with a modified Kidner procedure using the suture bridge technique. The patients were evaluated preoperatively, 3 months after surgery, and at the latest follow-up (at least six months postoperatively) clinically via the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, visual analogue scale (VAS), and the self-subjective satisfaction score. Results: The mean AOFAS midfoot score demonstrated significant improvement from a mean of 45.3 preoperatively to a mean of 89.2 at 3 months after surgery. At the latest follow-up, the mean AOFAS midfoot score was 92.6 (p<0.001). The mean VAS also improved significantly, decreasing from 6.7 out of 10 preoperatively to 1.8 at 3 months after surgery. At the latest follow-up, the VAS was 1.2 (p<0.001). The mean time of a single-limb heel raise was 4.6 months postoperatively and the self-subjective satisfaction score was 1.4 out of 4 at the latest follow-up. Conclusion: The short-term surgical results of the modified Kidner procedure with a suture bridge technique for symptomatic type II accessory navicular were good to excellent in terms of pain, functional and clinical assessments. In conclusion, the modified Kidner procedure with the suture bridge technique is a reasonable treatment option for symptomatic type II accessory navicular.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.2
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• pp.131-136
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• 2016

Background: This study aimed to evaluate the patient's pain and quality of life after suture removal at either 3 or 7 days following the bilateral surgical extraction of impacted lower third molars. Methods: This study was a prospective, randomized controlled clinical trial carried out in 30 patients, who acted as their own control. Each patient required the bilaterally impacted mandibular third molars to be extracted. The impacted teeth were removed and the wound margins were approximated and sutured with black braided silk. The suture material was removed on day 3 on one side and on day 7 on the other. Each participant was asked to complete a questionnaire after the removal of the suture material on each designated day. Results: Regarding overall clinical symptoms, the mean VAS scores of male and female participants on day 3 were not significantly different from those on day 7. A significant difference was found in female participants, in that overall daily activity was better on day 7. There were significant differences in the ability to smile and laugh in both sexes and the ability to chew in the male participants was better on day 7. Conclusions: There were no significant differences in the patient's pain and quality of life between suture removal on day 3 or on day 7 following surgery to remove impacted lower third molars.

• Journal of Minimally Invasive Surgery
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• v.21 no.4
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• pp.160-167
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• 2018

Purpose: The aim of our study was to present an abdominal wall closure technique using barbed suture $V-Loc^{TM}$ 90 after single incision laparoscopic appendectomy (SILA) and to compare perioperative outcomes with conventional layer by layer abdominal wall closure after SILA. Methods: From March 2014 to July 2016, a retrospective case-control study was conducted for a total of 269 consecutive patients who underwent SILA. According to abdominal wall closure methods, 129 patients were classified into the V-Loc closure group and 140 patients were assigned into the conventional layer by layer closure group. In the V-Loc group, abdominal wall closure was performed from the fascia to the skin with a single thread of unidirectional absorbable barbed suture $V-Loc^{TM}$ 90 2-0 using continuous running suture and reverse overlapping reinforced running technique. Subcutaneous closure and subcuticular suture were performed with the remaining portion of V-Loc. Results: The V-Loc closure group showed shorter total operation time ($40.0{\pm}15.4min$ vs. $44.9{\pm}16.3min$, p=0.013) and abdominal wall cusing continuous running suture and reverse overlapping reinforced running technique. Subcutaneous closure and subcuticular suture were performed with the remaining portion of V-Loc. Results: The V-Loc closure group showed shorter total operation time losure time ($5.5{\pm}0.9min$ vs. $6.5{\pm}0.8min$, p<0.001). Postoperative incision length was significantly shorter in the V-Loc closure group ($1.1{\pm}0.3cm$ vs. $1.8{\pm}0.4cm$, p<0.001). Postoperative wound pain, time to resume diet, postoperative hospital stay, complications including surgical site infection, or mean patient satisfaction score at one month after hospital discharge was not significantly different between the two groups. Conclusion: In conclusion, unidirectional knotless barbed suture is a safe alternative method for abdominal wall closure after SILA. It can save time while providing comparable cosmesis.