• Title/Summary/Keyword: Suture technique

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Locking horizontal mattress suture as the alternative closure method for scalp lacerations difficult to suture with staple (두피 봉합기로 봉합하기 어려운 두피 열상에 시행한 잠금 수평 매트리스 봉합법의 유용성 관찰 연구)

  • Sah, Seung Woo;Seol, Seunghwan;Lee, Woon Jeong;Woo, Seon Hee;Kim, Dae Hee;Lee, June Young;In, Sangkook;Kim, Bonggyeom
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.6
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    • pp.649-655
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    • 2018
  • Objective: This paper reports the possibility of using of a locking horizontal mattress suture technique in repairing lacerations that are difficult to suture with staples. Methods: Data were collected retrospectively over a 6-month period regarding the routine repair of scalp lacerations: those in areas injured by a high energy blunt mechanism, continued to bleed after pressure, nonlinear or damaged skin repaired with a locking horizontal mattress technique, and simple interrupted technique. The effects of the two techniques used to repair scalp lacerations on wound healing, complication rate, and patient satisfaction were examined. The categorical variables are expressed as the number and percent. A Mann-Whitney-Wilcoxon test was used for statistical analysis. A P-value less than 0.05 was considered significant. Results: Thirty-seven consecutive patients with scalp lacerations presented for care. Wound closure was accomplished with the locking horizontal mattress sutures in 40.5% (n=15) (median length, 5.0 cm; interquartile range [IQR], 4.0-7.0 cm). Simple interrupted sutures (median length, 4 cm; IQR, 3.0-5.0 cm) were used in 59.5% (n=22) (P=0.015). The frequency of additional bandage compression (P=0.008), frequency of exudative hemorrhage (P=0.018), and suture mark frequency at suture removal (P=0.047) were significantly lower in the locking horizontal mattress group. Conclusion: The locking horizontal mattress suture, which has the advantage of a horizontal mattress suture, may be one of the ways that can be used alternatively to treat scalp lacerations that difficult to suture with staples.

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

  • Park, Jung-Chul;Koo, Ki-Tae;Lim, Hyun-Chang
    • Journal of Periodontal and Implant Science
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    • v.46 no.6
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    • pp.415-425
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    • 2016
  • Purpose: The present study investigated the impact of 2 different suture techniques, the conventional crossed mattress suture (X suture) and the novel hidden X suture, for alveolar ridge preservation (ARP) with an open healing approach. Methods: This study was a prospective randomized controlled clinical trial. Fourteen patients requiring extraction of the maxillary or mandibular posterior teeth were enrolled and allocated into 2 groups. After extraction, demineralized bovine bone matrix mixed with 10% collagen (DBBM-C) was grafted and the socket was covered by porcine collagen membrane in a double-layer fashion. No attempt to obtain primary closure was made. The hidden X suture and conventional X suture techniques were performed in the test and control groups, respectively. Cone-beam computed tomographic (CBCT) images were taken immediately after the graft procedure and before implant surgery 4 months later. Additionally, the change in the mucogingival junction (MGJ) position was measured and was compared after extraction, after suturing, and 4 months after the operation. Results: All sites healed without any complications. Clinical evaluations showed that the MGJ line shifted to the lingual side immediately after the application of the X suture by $1.56{\pm}0.90mm$ in the control group, while the application of the hidden X suture rather pushed the MGJ line slightly to the buccal side by $0.25{\pm}0.66mm$. It was demonstrated that the amount of keratinized tissue (KT) preserved on the buccal side was significantly greater in the hidden X suture group 4 months after the procedure (P<0.05). Radiographic analysis showed that the hidden X suture had a significant effect in preserving horizontal width and minimizing vertical reduction in comparison to X suture (P<0.05). Conclusions: Our study provided clinical and radiographic verification of the efficacy of the hidden X suture in preserving the width of KT and the dimensions of the alveolar ridge after ARP.

Arthroscopic Footprint Reconstruction of Bursal-side Delaminated Rotator Cuff Tears using the Suture-bridge Technique

  • Kim, Kyung-Cheon;Rhee, Kwang-Jin;Shin, Hyun-Dae;Byun, Ki-Yong;Yang, Jae-Hoon;Kim, Dong-Kyu;Kim, Pil-Sung
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2009.03a
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    • pp.210-210
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    • 2009
  • For a bursal-side retracted laminated rotator cuff tear, simple repair of the retracted bursal-side rotator cuff might be insufficient because the repaired tendon could remain as an intratendinous tear of the rotator cuff. We present a repair method for intratendinous rotator cuff tears using the suture-bridge technique. We believe that this method helps to preserve the remnant rotator cuff tendon without tissue damage and restores the normal rotator cuff footprint in bursal-side delaminated rotator cuff tears.

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Outcomes of Nonpledgeted Horizontal Mattress Suture Technique for Mitral Valve Replacement

  • Kim, Gun Jik;Lee, Jong Tae;Lee, Young Ok;Cho, Joon Young;Oh, Tak-Hyuk
    • Journal of Chest Surgery
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    • v.47 no.6
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    • pp.504-509
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    • 2014
  • Background: Most surgeons favor the pledgeted suture technique for heart valve replacements because they believe it decreases the risk of paravalvular leak (PVL). We hypothesized that the use of nonpledgeted rather than pledgeted sutures during mitral valve replacement (MVR) may decrease the incidence of prosthetic valve endocarditis (PVE) and risk of a major PVL. Methods: We analyzed 263 patients, divided into 175 patients who underwent MVR with nonpledgeted sutures from January 2003 to December 2013 and 88 patients who underwent MVR with pledgeted sutures from January 1995 to December 2001. We compared the occurrence of PVL and PVE between these groups. Results: In patients who underwent MVR with or without tricuspid valve surgery and/or a Maze operation, PVL occurred in 1.1% of the pledgeted group and 2.9% of the nonpledgeted group. The incidence of PVE was 2.9% in the nonpledgeted group and 1.1% in the pledgeted group. No differences were statistically significant. Conclusion: We suggest that a nonpledgeted suture technique can be an alternative to the traditional use of pledgeted sutures in most patients who undergo MVR, with no significant difference in the incidence of PVL.

Open Intramedullary Nail with Tension Band Sutures on Proximal Humeral Fracture (상완골 근위부 골절에 시행한 긴장 대 봉합을 동반한 관혈적 골수강내 고정술)

  • Park, Jin-Young;An, Jin-Woo;Lee, Sung-Churl
    • Clinics in Shoulder and Elbow
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    • v.6 no.2
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    • pp.149-160
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    • 2003
  • Purpose: to determine the results after open intramedullary nailing and tension band suture technique in proximal humerus fracture for improving the stability and decreasing the complications. Materials and Method: Authors reviewed 27 patients treated by open intramedullary nailing and tension band suture technique. Mean follow-up period was 39 months (24-59months). Surgical neck fracture were 6 cases, surgical neck fracture with shaft fracture were 3 cases, three part fracture with greater tuberosity fracture were 17 cases, four part fracture was 1 case and fracture and dislocation were 2 cases Results: We got the bony union in 26 cases. Average pain scale was 1 point (0-6), Neer score was 86 point(45-99) and ASES score was 85 point(40-100). We separate all cases in two groups based on age (65 years), L-spine t-score (-2.5) and Neer classification (2 and 3 part). There is no significance in pain scale, Neer score and ASES score between each group. Conclusion: As a method of surgical treatment on severe proximal humeral fractures, we recommend intramedullary nailing and tension band suture technique and it may have particular advantages in early exercise and satisfactory functional outcome.

Application of Hand Towel Drape over Dingman Mouth Gag

  • Choi, Kyeong Beom;Park, Myong Chul
    • Archives of Craniofacial Surgery
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    • v.16 no.1
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    • pp.29-30
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    • 2015
  • In cleft palate surgery, the environment is especially critical when suturing. Encum-bered, obstructive space in the environment can hinder a suture while using the Dingman mouth gag. We introduced a novel but simple draping technique. A simple hand towel is placed over the gag. A hole is cut out in the middle according to each patient's mouth. After making the hole, the hand towel is soaked in water and gently squeezed. Then the towel is properly placed over the Dingman mouth gag. Dripping water on the hand towel during the suture helps keep it in place. Using this draping technique, we cut 14 minutes of operation time compared to the average operation time of the past 2 years. There were several disadvantages in previous draping method. First, long suture material may easily get caught. Second, the operation field can easily be contaminated. Third, focusing on the operation becomes difficult due to the obstruction. This draping technique can compensate for the disadvantages of the previous Dingman mouth gag.

Management of a Large Hypervascular Apicoposterior Mediastinal Mass Using the Purse-String Suture Technique in Robotic-Assisted Thoracoscopic Surgery: A Case Report

  • Juan Kim;Jonggeun Lee;Hyo Yeong Ahn
    • 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.

Bar Suture for the Treatment of Bovine Abomasal Displacement (소의 제4위전위증 교정을 위한 봉봉합법)

  • Cho Myoung-Rae
    • Journal of Veterinary Clinics
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    • v.9 no.1
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    • pp.261-266
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    • 1992
  • Surgical treatment was performed in 507 heads out of 1078 dairly cows which were diagnosed as abomasal displacement. Out of 507 heads. bar suture was performed in 280 heads. Twelve heads out of 280 heads(4.9%) recurred. Incorrective suture of the reticulum or pylorus instead of abomasum occurred in 3 cows. The cows in which abdominal wall was sutured but the suture was not inserted into the abomasum were 4 heads. The cows in which bar was broken are 4 heads. A cow suffered peritonitis after bar suture. Bar suture technique is thought to be a good method as a first choice for the correction of abomasal displacement.

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Subclavian Portal Approach for Isolated Subscapularis Tendon Tear - Technical Note - (견갑하 건 단독 파열에 대한 쇄골하 삽입구를 이용한 봉합술 - 술기보고 -)

  • Choi, Chang-Hyuk;Kim, Shin-Kun;Chang, Il-Woong;Kim, Se-Sik
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.221-225
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    • 2009
  • Purpose: For an isolated tear of the subscapularis tendon, the presented technique using a subclavian portal provides both a good angle for anchor placement and sufficient space for managing the upper portion of a subscapularis tendon tear. Materials and Methods: The conventional method needs 2 additional portals for traction, debriding the footprint and anchor fixation for repair. The presented technique requires only an anterior portal for suture management and a subclavian portal without cannula for suture anchoring and placement of suture hooks. Results: The two suture limbs of the anchor can be placed on the subscapularis tendon by the switching technique and these limbs are repaired sequentially. Conclusion: This technique is simple and reproducible and it can be applied to partial tears and minimally retracted subscapularis tears.

Arthroscopic Capsular Repair without Relaying Sutures: 'Simple Sewing Technique'

  • Kim, Hyungsuk;Song, Hyun Seok;Kang, Seung Gu;Han, Sung Bin
    • Clinics in Shoulder and Elbow
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    • v.22 no.3
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    • pp.146-148
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    • 2019
  • We report a simple technique for repairing capsular tear, using only a hook-like, cannulated instrument and braided sutures without relaying steps. A No. 2 braided suture is passed through the lumen of the instrument. Under direct arthroscopic view, the tip of the instrument is passed through the side of the capsule that has previously been separated with the probe. One end of the suture is retrieved with a grasper through a separate portal. The tip is moved back without withdrawing through the skin, and reinserted into the other side of the capsule. Holding the end retrieved earlier, the other end of the suture is retrieved with a suture retriever. After complete removal of the instrument, the suture is tied through a cannula using the standard knot tying techniques. The same procedures are repeated for other required knots.