• Title/Summary/Keyword: Suture technique

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Biomechanical Test for Repair Technique of Full-thickness Rotator Cuff Tear

  • Lim, Chae-Ouk;Park, Kyoung-Jin
    • Clinics in Shoulder and Elbow
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    • v.19 no.1
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    • pp.51-58
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    • 2016
  • The arthroscopic rotator cuff repair is now considered a mainstream technique with highly satisfactory clinical results. However, concerns remain regarding healing failures for large and massive tears and high revision rate. In recent decades, various repair strategies and construct configurations have been developed for rotator cuff repair with the understanding that many factors contribute to the structural integrity of the repaired construct. The focus of biomechanical test in arthroscopic repair has been on increasing fixation strength and restoration of the footprint contact characteristics to provide early rehabilitation and improve healing. These include repaired rotator cuff tendon-footprint motion, increased tendon-footprint contact area and pressure, and tissue quality of tendon and bone. Recent studies have shown that a transosseous tunnel technique provides improved contact area and pressure between rotator cuff tendon and insertion footprint, and the technique of using double rows of suture anchors to recreate the native footprint attachment has been recently described. The transosseous equivalent suture bridge technique has the highest contact pressure and fixation force. In this review, the biomechanical tests about repair techniques of rotator cuff tear will be reviewed and discussed.

The treatment of lower extremity defects with severe proliferative tissue using an adjustable horizontal mattress suture in a Tosa dog

  • Heo, Suyoung;Kim, Namsoo
    • Korean Journal of Veterinary Research
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    • v.54 no.2
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    • pp.121-122
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    • 2014
  • A 2-year-old male Tosa was admitted for treatment of a non-healing wound on the right forelimb. Skin tests were unremarkable; however, the lesion contained severe proliferative tissue. Surgical treatment was conducted due to the extensive skin defect and granulation tissue present. Following removal of the proliferative tissue, the wound was closed using the adjustable horizontal mattress suture method with multiple punctate relaxing incisions. The proliferative tissue healed completely after the surgical treatment. This technique can be considered an alternative treatment for the proliferative tissue when conditions require a skin graft or flap after surgical treatment.

New Retear Pattern after Rotator Cuff Repair at Previous Intact Portion of Rotator Cuff

  • Choi, Chang-Hyuck;Kim, Sung-Guk;Nam, Jun-Ho
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.237-240
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    • 2016
  • Retear patterns after arthroscopic rotator cuff repair are classified into two patterns according to retear location. Type 1 is when the retear pattern occurs directly on the tendon at the bone repair site using the suture anchor repair method. Type 2 is when the retear pattern occurs at the musculocutaneous junction with a healed footprint in patients who undergo the suture bridge method. Here, the authors report another retear pattern, which was identified as a type 2 retear on magnetic resonance imaging in patients who had undergone arthroscopic rotator cuff repair by the suture-bridge technique. This pattern was different from the type 2 retear and occurred at the portion of the cuff away from the healed rotator cuff under the view of the arthroscope.

Pain and quality of life related to suture removal after 3 or 7 days at the extraction sites of impacted lower third molars

  • Rodanant, Pirasut;Wattanajitseree, Kannika;Shrestha, Binit;Wongsirichat, Natthamet
    • 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.

Effectiveness of Vicryl $plus^{(R)}$ (Ethicon, USA) in Nosocomial Bacteria (실제 병원성 균주에서 Vicryl $plus^{(R)}$ (Ethicon, USA)의 효용성)

  • Jin, Young-Wan;Na, Young-Cheon
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.590-593
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    • 2011
  • Purpose: Surgical site infections (SSIs) are the third most frequently reported nosocomial infection. Of these SSIs, mostly were confined to the incision associated with underlying disease as diabetes, cigarette smoking, systemic steroid use, obesity, operating room environment, suture and surgical technique. This study has been planned to reduce the SSIs by using Vicryl $plus^{(R)}$ (Ethicon, USA) which contains triclosan, a broad-spectrum antibacterial agent, into the infected wound to evaluate whether or not Vicryl $plus^{(R)}$ (Ethicon, USA) is effective to nosocomial bacteria using a zone of inhibition assay. Methods: We did a comparison of Vicryl $plus^{(R)}$ suture (with triclosan) size 2-0, 5-0 with $Vicryl^{(R)}$ suture (without triclosan) size 4-0 each as treatment and control group, applied in Mueller-Hinton agar infected by following mircroorganisms: Methicillin-sensitive $Staphylococcus$ $aureus$ (MSSA), Methicillin-resistant $Staphylococcus$ $aureus$ (MRSA), Acinetobacter baumanii, $Escherichia$ $coli$, Enterobacter faecalis, Pseudomonas aeruginosa, Candida albicans. Cultures were made of the selected mircroorganisms, seeding the study strain in agar plates for 24 and 48-hour period in an oven at $37^{\circ}C$ followed by zone of inhibition assay. Results: Vicryl $plus^{(R)}$ group has demonstrated to create a zone of inhibition against MRSA, MSSA and $A.$ $baumanii$, but no effect on $E.$ $faecalis$, $P.$ $aeruginosa$, $C.$ $albicans$. Vicryl $plus^{(R)}$ suture size 2-0 also had antibactericidal effect while Vicryl $plus^{(R)}$ suture size 5-0 did not. $Vicryl^{(R)}$ group had no zones of inhibition showing colonization at all mircroorganisms. Conclusion: Our results seem to warrant the use of Vicryl $plus^{(R)}$ as absorbable buried suture when concerning SSIs as a prophylaxis against surgical nosocomial infection.

Limited Dissection Face Lift with PDS Quilting Suture (PDS 퀼팅봉합술을 이용한 안면거상술)

  • Kim, Seok-Kwun;Kim, Myung-Hoon;Kwon, Yong-Seok;Lee, Keun-Cheol
    • Archives of Plastic Surgery
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    • v.37 no.6
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    • pp.801-807
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    • 2010
  • Purpose: Facial rejuvenating surgery has become a challenge to most plastic surgeons. Patients are demanding fewer complications, a prompt recovery, and more natural results. Current trend of the face lift surgery has been developed into less invasive procedures. Every aging patient in Asia wants to look younger without obvious evidence of surgical correction. Methods: The authors performed the limited dissection face lift with PDS quilting suture on twenty five patients. These five quilting sutures consist of sutures at 1~2 cm posterior to the prominent point of zygoma to the periosteum of the zygomatic arch, at the lateral border of Bichat's fat pad area to the zygomatic arch, at the lateral border of the orbicularis oculi muscle to the deep temporal fascia, at the upper lateral border of the platysma to the periosteum of the mastoid, and at the anterior lower margin of the earlobe to the deep temporal fascia by quilting suture technique to achieve rejuvenation. Results: These procedures could produce a balanced volumetric rejuvenation. This method gave considerable benefit of stable and satisfactory results. It provides reduced operative time, well corrected nasolabial fold and neck wrinkle, and swift recovery with minimal complications. Conclusion: Although it could not replace the classic facelift, this technique can be recommended as an option for patients who do not present with advanced facial aging or not want a more extensive procedure.

Fracture of Proximal Humerus in the Lateral Anchor Site after Suture Bridge Repair - A Case Report

  • Park, Kyoung-Jin;Kim, Yong-Min;Kim, Dong-Soo;Choi, Eui-Sung;Keum, Sang-Wook;Kil, Kyoung-Min;Lim, Chae-Wook;Park, Sang-Jun
    • Clinics in Shoulder and Elbow
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    • v.17 no.3
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    • pp.134-137
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    • 2014
  • To report the fracture of proximal humerus in the lateral anchor site after suture bridge repair. A 57-year-old female patient with shoulder pain on the right-side was admitted through the emergency room following a car accident. Seven weeks before the accident, the patient had undergone surgery at a different hospital for the repair of supraspinatus tendon rupture on the right-side via suture bridge technique. Humerus surgical neck fracture was confirmed by X-ray, and proximal humerus fracture at the anchor site was confirmed by magnetic resonance imaging. Following 7 months of conservative treatment resulted in satisfactory bone union and motion of the shoulder joint. We report the need of close observation during and after the arthroscopic repair of the rotator cuff in patients with osteoporosis.

Heterotopic Heart Transplantation in the Rat Model (쥐모델에서의 이소성의 심장이식)

  • Chung, Won-Sang;Jeon, Yang-Bin;Chun, Soon-Ho;Kim, Hyuk;Lee, Chul-Burm;Kim, Young-Hak;Jee, Heng-Ok;Seo, Jung-Kuk;Kong, Gu
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.531-535
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    • 1998
  • In 1964, Abbott and Colleagues published the world's first heterotopic heart transplantation technique in the rat. Their method established circulation by end-to-end anastomoses of the graft's aorta and pulmonary artery to the recipient's abdominal aorta and Inferior Vena Cava(IVC), respectively. In 1966, Tomita et al altered Abbott's technique by employing end-to-side rather than end-to-end anastomoses, thus eliminating the hind leg paralysis that sometimes resulted from Abbott's technique. In order to prevent postsuture hemorrhage (since 7-0 silk suture was the finest available at that time), Tomita's aortic anastomosis was done with double up-and-down continuous suture technique. A single layer continuous anstomosis effected the pulmonary artery-IVC anastomosis. The availability of Nylon monofilament suture made it possible for Ono and Lindsey to use a single layer suture technique for the aortic end-to-side anastomosis in their modified rat heart transplantation. We observed survival time between control group and Immunosuppression(Cyclosporine administration, 10mg/Kg${\times}$4 times postoperatively) group after heterotopic heart transplantation in the rat model. The cyclosporine adminstration group survived longer than the control group, thus we concluded that cyclosporine was based on Immunosuppressive drugs.

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A comparison between the modified Brostrom procedure using single and double suture anchor for chronic lateral ankle instability (발목관절 외측 불안정성에서 단일 봉합나사와 이중 봉합나사를 이용한 변형 Brostrom 술식간의 임상결과 비교)

  • Shon, Hyun-Chul;Cho, Byung-Ki;Kim, Yong-Min;Kim, Dong-Soo;Choi, Eui-Sung;Park, Kyoung-Jin;Park, Ji-Kang
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.69-77
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    • 2011
  • Purpose: This study was retrospectively performed to compare the clinical outcomes of modified Brostrom procedures using the single suture anchor and the double suture anchor for chronic lateral ankle instability. Materials and Methods: Thirty-seven patients were followed up for more than 1 year after the modified Brostrom procedures using suture anchor. Single surgeon treated seventeen cases with single suture anchor and 20 cases with double suture anchor. The clinical evaluation was performed according to the Karlsson scale and Sefton grading system. Radiologic measurement of the talar tilt and anterior talar translation was performed through anterior and varus stress radiographs using Telos device. Results: The Karlsson scale had improved significantly from preoperative average of 45.2 points to 89.4 points in single suture anchor group, and from 46.4 points to 90.5 points in double suture anchor group. According to the Sefton grading system, 15 cases (88.2%) in single suture anchor group and 18 cases (90%) in double suture anchor group achieved satisfactory results. The talar tilt angle and anterior talar translation had improved significantly from preoperative average of $13.6^{\circ}$ and 8.6 mm to $5.4^{\circ}$ and 4.1 mm in single suture anchor group, from $14.1^{\circ}$ and 8.4mm to $3.9^{\circ}$ and 4 mm in double suture anchor group. Double suture anchor technique was significantly superior in postoperative talar tilt. Conclusion: Single and double suture anchor techniques produced similar clinical and functional outcomes except for talar tilt, which was significantly superior in double suture anchor group. Both modified Brostrom procedures using the single and double suture anchor appear to be effective treatment methods for chronic lateral ankle instability. Further evaluation of clinical outcomes and biomechanical studies in athletes are needed.

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Iatrogenic Tracheal Posterior Wall Perforation Repaired with Bronchoscope-Guided Knotless Sutures Through Tracheostomy

  • Jung, Yong Chae;Sung, Kiick;Cho, Jong Ho
    • Journal of Chest Surgery
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    • v.51 no.4
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    • pp.277-279
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    • 2018
  • A 68-year-old man presented with a posterior tracheal wall injury caused by percutaneous dilatational tracheostomy. The wound was immediately covered with an absorbable polyglycolic acid sheet. Ten days after the injury, the perforation was closed with knotless sutures using a Castroviejo needle-holder through the tracheostomy. The successful repair in this case indicates the feasibility of the knotless suture technique for perforations. The technique is described in detail in this report. The patient was weaned from the mechanical ventilator on postoperative day 25. In cases of posterior tracheal posterior wall perforation, every effort should be made to repair the perforation through an existing opening.