• Title/Summary/Keyword: Suture technique

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Arthroscopic Vertical Enclosing Meniscus Suture -Technical Note- (관절경하 반월상연골의 수직 포위 봉합술 - 수술 수기 -)

  • Kim Jung-Man;Jahng Yoon-Jong
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.230-232
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    • 2003
  • To avoid incomplete coaptation of the peripheral tear of the meniscus an arthroscopic vertical enclosing meniscus suture technique was developed. In this technique the meniscus was not penetrated with any instruments or suture materials. This technique seems to be simple and easy to learn and to practice.

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Pull-in Suture Technique for the Disinsertion of the Phalangeal Tendon Distal Insertion (Pull-in 봉합술을 이용한 수지건 원위 부착부 파열의 치료)

  • Kim, Jae Won;Chung, Sung Mo
    • Archives of Plastic Surgery
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    • v.35 no.6
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    • pp.723-728
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    • 2008
  • Purpose: The disinsertion of the phalangeal tendon distal insertion has difficulties in ordinary tenorrhaphy operation for the anatomical features, and still has controversy between non-surgical and surgical management. The purpose of this study is to select treatment for the injury of the phalangeal tendon distal insertion, as we've had a good results from operation treatment with Pull-in suture technique. Methods: We reviewed the hospital records of 12 patients treated with Pull-in suture technique with disinsertion of the phalangeal extensor or flexor tendon distal insertion from June 2006 to June 2007. Eight patients were involved with the tendon disinsertion without bone fracture, and 4 patients were involved with the fracture of the phalangeal tendon distal insertion site. After removal of the K-wire in week 6, active physical exercises were commenced immediately. The mean follow-up period was 12.4 months. Results: All the patients who had tendon disinsertion with bone fracture had IIB, by Wehbe and Schneider's classification 2, and we evaluated the results comparing the same finger of the other hand according to Crawford's evaluation criteria 5. The nine excellent and three good results were obtained and there were no limitation of motor for the patient who had operation for the rupture of flexor tendon as well. There were no particular complications during the follow-up period. Conclusion: The most important thing for the disinsertion of the phalangeal tendon distal insertion is to maintain an accurate and durable reduction state keeping the tension of tendon. At this point, after removal of the K-wire, the Pull-in suture technique allows accurate realignment of the tendon-bone unit without any specific instrumentation under the more stable state. The Pull-in suture technique seems to be a strong alternative for the treatment of disinsertion of the phalangeal tendon distal insertion, with successful treatment outcome(rapid functional recovery and high patient satisfaction).

Clinical Study of 156 Cases of Secundum Atrial Septal Defect closed by Direct Suture (직접봉합으로 치료한 단독 이차공 심방중격결손증 156례 보고)

  • 송정근
    • Journal of Chest Surgery
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    • v.28 no.4
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    • pp.335-339
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    • 1995
  • Secundum atrial septal defect occupies about 10 to 15% of congenital heart diseases, and the surgical accomplishment is outstanding, so that the operative mortality is getting near to zero percent. But, the methods of correction, direct closure versus patch closure are still controversial and there is no absolute method about it. Some surgeons prefer direct closure technique for its simplicity and lesser thrombogenicity but others, afraid of arrhythmia and suture detachment after closure of large defect, prefer patch closure. Usually most surgeons use direct suture technique in small and moderate sized defects and patch closure in large defects. In our hospital, 156 cases of isolated secundum atrial septal defect were closed directly by double continuous over and over suture using 5-0 polypropylene[prolene , regardless their sizes and the amounts of shunt flow. There were no operative mortality and no serious complications such as heart block, suture detachment and embolism.

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Comparison of Tracheal Anastomosis by Interrupted and Continuous Technique of Absorbable polydioxanone (PDS) Suture Material in Rabbit (가토에서 흡수성 PDS 봉합사의 단속봉합술식과 연속봉합술식에 따른 기관문합의 비교)

  • 이석열;양성린;이길노
    • Korean Journal of Bronchoesophagology
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    • v.7 no.1
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    • pp.9-13
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    • 2001
  • Background: Tracheal resection and end-to-end anastomosis are the preferred treatment for tracheal tumor or tracheal stenosis. Absorbable suture material has been commonly used in case of tracheal anastomosis. But anastomosis technique is controversial. This experimental study compared between interrupted suture and continuous suture using Polydioxanone (PDS) absorbable suture material after tracheal resection and end-to-end anastomosis in rabbits. Methods : Twenty-four rabbits were used, divided into two groups of 12 animals each. The trachea was resected and then anastomosed with continuous 6-0 polydioxanone (PDS) (group 1), and intermittent 6-0 polydioxanone (PDS) (group 2). The animals were followed up for 6 months. Stenosis of the trachea was assessed at the time of death. Results : In two groups, anteroposterior diameter, transverse diameter, cross sectional area, and perimeter were greater in group 2 than in group 1 but, not significantly different. In addition, histologic findings were not different in two groups. Conclusions : This study suggest that stenosis after tracheal resection and end-to-end anastomosis using absorbable polydioxanone (PDS) suture material be not significantly different in both groups.

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Arthroscopic transosseous anchorless rotator cuff repair reduces bone defects related to peri-implant cyst formation: a comparison with conventional suture anchors using propensity score matching

  • Hyeon Jang Jeong;Ji Soo Lee;Young Kyu Kim;Sung-Min Rhee;Joo Han Oh
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.276-286
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    • 2023
  • Background: The transosseous anchorless repair (ToR) technique was recently introduced to avoid suture anchor-related problems. While favorable outcomes of the ToR technique have been reported, no previous studies on peri-implant cyst formation with the ToR technique exist. Therefore, this study compared the clinical outcomes and prevalence of peri-implant cyst formation between the ToR technique and the conventional transosseous equivalent technique using suture anchors (SA). Methods: Cases with arthroscopic rotator cuff repair (ARCR) between 2016 and 2018 treated with the double-row suture bridge technique were retrospectively reviewed. Patients were divided into ToR and SA groups. To compare clinical outcomes, 19 ToR and 57 SA cases without intraoperative implant failure were selected using propensity score matching (PSM). While intraoperative implant failure rate was analyzed before PSM, retear rate, peri-implant cyst formation rate, and functional outcomes were compared after PSM. Results: The intraoperative implant failure rate (ToR, 8% vs. SA, 15.3%) and retear rate (ToR, 5.3% vs. SA, 19.3%) did not differ between the two groups (all P>0.05). However, peri-implant cysts were not observed in the ToR group, while they were observed in 16.7% of the SA group (P=0.008). Postoperative functional outcomes were not significantly different between the two groups (all P>0.05). Conclusions: The ToR technique produced comparable clinical outcomes to conventional techniques. Considering the prospect of potential additional surgeries, the absence of peri-implant cyst formation might be an advantage of ToR. Furthermore, ToR might reduce the medical costs related to suture anchors and, thereby, could be a useful option for ARCR. Level of evidence: III.

Evaluation of the Educational Efficacy of a Cadaver-based Model for Teaching a Simple Suture Technique to Medical Students (임상실습과정 의과대학생을 대상으로 카데바 모델을 이용한 단순 봉합술 교육의 효율성)

  • Do, Hyun Soo;Min, Jin Hong;Hong, Seung Woo;Han, Sang Kyoon;Kim, In Soo;Ryu, Seung;Lee, Jin Woong;Kim, Seung Whan;Yoo, In Sool
    • Journal of Trauma and Injury
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    • v.19 no.2
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    • pp.121-125
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    • 2006
  • Purpose: There is ongoing demand to deliver better procedural training to medical students in the emergency department. Thus, we studied the efficacy of a cadaver-based training model for teaching simple suture techniques to medical students. Methods: We investigated ten fourth-year medical students, who were rounding and being trained in the Emergency Department of Chungnam National University Hospital. They were educated with slides about a simple suture technique for 30 minutes to evaluate the efficacy of the cadaver-based training model. We prospectively measured their skill by administering a test on the cadaver-based simple suture technique in 3cm sized linar wound separately to each of them. Results: A total of ten fourth-year medical students completed the investigation. The tension, the direction of suture, the degree of cleanness, the number of sutures, the adequacy of the cutting thread length, and the suturing time in the first attempt were compared with those in the second one. The second results were compared with those in the third one, and the third results were compared with those in the fourth one. All the results had statistical significance. Conclusion: These findings support the value of the cadaver-based simple suture technique training model as a medical student teaching model. The cadaver-based simple suture technique teaching model is a good way of teaching several medical skills to medical students.

REPAIR OF THE PERFORATED SINUS MEMBRANE WITH A MICRO-SUTURE TECHNIQUE : REPORT OF CASES (상악동점막 천공의 미세봉합술을 이용한 처치)

  • Im, Dae-Ho;Jang, So-Jeong;Kim, Kyoung-A;Baek, Jin-A;Ko, Seong-O;Shin, Hyo-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.3
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    • pp.241-249
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    • 2007
  • An augmentation of the maxillary sinus floor facilitates placement of dental implants in the posterior atrophic maxilla. However, a maxillary sinus augmentation has potential complications that can lead to early failure and loss of the bone graft. One specific complication is sinus membrane perforation. Especially, large perforations may cause loss of the graft materials into the sinus and infection, so, early failure of the sinus lift. Attempts at managing sinus membrane perforations are difficult because of the limited access to them and friability of the thin Schneiderian membrane. Repair of sinus membrane perforations intraoperatively may be performed using a variety of techniques and materials, including sutures, collagen membranes, fibrin glue. Inspite of various repair technique, as has been reported extensively in the literature, large perforations represent an absolute contraindication to the continuation of surgery. But, we obtained clinically favorable results in cases that show repair of the perforated sinus membrane with a micro-suture technique by 4X Loupe ($Surgitel^{(R)}$ Loupe, General Scientific Corporation) in large perforation. The objective of this presentation is to report of several cases of repair of the perforated sinus membrane with micro-suture technique using 7.0 or 8.0 suture materials, to make a brief review of the literature about various technique managing perforated sinus membrane.

Aortic Valve Replacement Using Continuous Suture Technique in Patients with Aortic Valve Disease

  • Choi, Jong Bum;Kim, Jong Hun;Park, Hyun Kyu;Kim, Kyung Hwa;Kim, Min Ho;Kuh, Ja Hong;Jo, Jung Ku
    • Journal of Chest Surgery
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    • v.46 no.4
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    • pp.249-255
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    • 2013
  • Background: The continuous suture (CS) technique has several advantages as a method for simple, fast, and secure aortic valve replacement (AVR). We used a simple CS technique without the use of a pledget for AVR and evaluated the surgical outcomes. Materials and Methods: Between October 2007 and 2012, 123 patients with aortic valve disease underwent AVR alone (n=28) or with other concomitant cardiac procedures (n=95), such as mitral, tricuspid, or aortic surgery. The patients were divided into two groups: the interrupted suture (IS) group (n=47), in which the conventional IS technique was used, and the CS group (n=76), in which the simple CS technique was used. Results: There were two hospital deaths (1.6%), which were not related to the suture technique. There were no significant differences in cardiopulmonary bypass time or aortic cross-clamp time between the two groups for AVR alone or AVR with concomitant cardiac procedures. In the IS group, two patients had prosthetic endocarditis and one patient experienced significant perivalvular leak. These patients underwent reoperations. In the CS group, there were no complications related to the surgery. Postoperatively, the two groups had similar aortic valve gradients. Conclusion: The simple CS method is useful and secure for AVR in patients with aortic valve disease, and it may minimize surgical complications, as neither pledgets nor braided sutures are used.

Modified Suturing Techniques in Carotid Endarterectomy for Reducing the Cerebral Ischemic Time

  • Joo, Sung-Pil;Cho, Yong-Hwan;Lee, Yong-Jun;Kim, You-Sub;Kim, Tae-Sun
    • 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.

Treatment of Acute Achilles Tendon Rupture Using Krackow Suture Technique (Krackow 봉합술을 이용한 아킬레스 건 급성 파열의 치료)

  • Kim, Hyong-Nyun;Park, Ki-Hoon;Park, Yong-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.34-39
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    • 2009
  • Purpose: We try to evaluate the clinical results of the acute Achilles tendon rupture treated with Krackow suture technique. Materials and Methods: We reviewed 27 patients with acute Achilles tendon rupture treated between October 2005 and September 2007. There were 26 complete ruptures and 1 incomplete rupture. All were ruptured at tendinous area. There were 21 men and 6 women, and mean age was 38 years. We repaired ruptured Achilles tendon with Krackow suture technique. The results were evaluated with Arner-Lindholm scale for patients' satisfaction, strength of calf muscle power, calf circumference, and ankle motion. The average follow-up was 29 months. Results: The patients' subjective clinical results was excellent in 25 cases and good in 2 cases. There were 15 cases of less than 1 cm, 6 cases of 1${\sim}$3 cm, and 1 case of more than 3 cm in the calf circumference difference between the normal and affected leg. There were 20 cases of less than 5 degrees, and 2 cases of more 5 degrees in the difference of range of motion between the normal and affected ankle. We had an experience of postoperative deep infection in one diabetic patient. Conclusion: We had a good clinical result for acute Achilles tendon rupture treated with Krackow suture method. So we recommand Krackow suture technique for acute Achilles tendon rupture.

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