• 제목/요약/키워드: Sutures

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관절경적 Inside-Out 반월상 연골 봉합술에서 비흡수성 봉합사의 운명 - 1예 보고 - (The Fate of Nonabsorbable Sutures in Arthroscopic Inside-Out Meniscus Repair - A Case Report -)

  • 안진환;이동훈;장문종;서희수
    • 대한관절경학회지
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    • 제11권1호
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    • pp.54-58
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    • 2007
  • 반월상 연골 봉합술 시 여러 종류의 흡수성 또는 비흡수성 봉합사들이 사용되고 있으며, 술자에 따라 비흡수성 봉합사가 흡수성 봉합사에 비해 안정된 고정력을 제공한다고 하여 비흡수성 봉합사를 선호하기도 한다. 그러나 봉합사가 봉합부위에 지속적으로 남아있을 경우 이로 인한 문제가 발생할 수 있으며, 저자들은 Inside-Out 반월상 연골 봉합술에서 비흡수성 봉합사가 반월상 연골 실질부를 관통하여 후내측 관절막 밖으로 밀려나온 증례를 경험하였기에 이를 보고하고자 한다.

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급속 구개 확장 장치 종류가 상악골 주변 봉합에 미치는 영향에 대한 유한요소해석 (The Effects of Type of Rapid Palatal Expansion Appliance on the Circummaxillary Sutures : A 3D FEA study)

  • 김유완;문윤식;성상진
    • 대한구순구개열학회지
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    • 제15권2호
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    • pp.51-60
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    • 2012
  • Craniofacial sutures absorb the stress transferred to skull. It was reported the cells of craniofacial sutures respond to exogenetic factors to be involved in growth control mechanism. In this study, we constructed a finite element model composed of cortical bone, cancellous bone, suture, PDL, and teeth by using CT images of a growing patient, simulating maxillary expansion to evaluate the effects of the thickness of sutures and type of maxillary expansion appliance on stress distribution in circummaxillary sutures.

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온도에 따른 PLLA 및 PCL 봉합사의 기계적 특성 (The Mechanical Characteristics of the PLLA and PCL Sutures According to the Temperature)

  • 시에위잉;강순국
    • 한국산학기술학회논문지
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    • 제19권12호
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    • pp.931-937
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    • 2018
  • 봉합사는 단순한 접합용로 뿐만 아니라 한방, 미용 심지어 성형 분야에도 사용하고 있다. 특히 미용 성형 분야에 인기를 끌고 있다. 본 논문에서는 기존에 많이 사용했던 PDO 봉합사보다 강도 더 좋은 PCL 및 PLLA 봉합사를 제조하였다. 이들의 수축 특성을 알기 위해 PCL 및 PLLA 봉합사의 수축률, 인장강도 및 연신율을 측정하였다. 또한 직경 및 표면을 보기 위해 SEM을 분석하였다. 수축률은 온도 상관없이 일정기간 지나면 안정화 되다. 또한 온도 높을수록 수축 증가율이 높아진다는 것을 확인할 수 있다. 그리고 유리온도의 전후 온도에 따른 기계적 특성의 변화율이 다르게 나타나는 것을 확인할 수 있다. 또한 온도 높을수록 분자운동 더 빨라지고 인장강도 낮아진다. PCL 및 PLLA 봉합사의 직경은 봉합사의 수축률과 상반관계로 나타나는 것을 확인할 수 있다. 그리고 PLLA 봉합사의 멸균온도는 $45^{\circ}C$로 설정하고 PCL 봉합사의 멸균온도는 $35^{\circ}C$로 설정하는 것이 가장 적절하다고 사료된다.

Comparing intra-oral wound healing after alveoloplasty using silk sutures and n-butyl-2-cyanoacrylate

  • Suthar, Pratik;Shah, Sonal;Waknis, Pushkar;Limaye, Gandhali;Saha, Aditi;Sathe, Pranav
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제46권1호
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    • pp.28-35
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    • 2020
  • Objectives: The need for proper wound closure is of paramount importance after any intra-oral surgery. Various wound closure techniques have been described in literature using traditional non-absorbable suture materials. These include like synthetic absorbable sutures, surgical staples and tissue adhesives. Cyanoacrylates are among the most commonly used biocompatible tissue adhesives. To evaluate and compare intraoral wound healing using 3-0 silk sutures and n-butyl-2-cyanoacrylate after alveoloplasty. Materials and Methods: A total of 20 patients requiring bilateral alveoloplasty in the same arch (upper or lower) were included in this study. Patients with any pre-existing pathology or systemic disease were excluded. After alveoloplasty was performed, the wound was closed using 3-0 braided silk sutures on one side, and using n-butyl-2-cyanoacrylate bio adhesive on the other side. Patients were evaluated based on the following parameters: time required to achieve wound closure; the incidence of immediate and postoperative hemostasis; the time to the use of the first rescue medication; the side where pain first arises; and the side where wound healing begins first. Results: Compared to 3-0 silk sutures, cyanoacrylate demonstrated better hemostatic properties, reduced operative time, reduced postoperative pain and better wound healing. Conclusion: These data suggest that cyanoacrylate glue is an adequate alternative to conventional sutures to close the surgical wound after alveoloplasty, and better than are 3-0 silk sutures.

Feasibility of Use of a Barbed Suture (V-Loc 180) for Quilting the Donor Site in Latissimus Dorsi Myocutaneous Flap Breast Reconstruction

  • Thekkinkattil, Dinesh Kumar;Hussain, Tasadooq;Mahapatra, Tapan Kumar;McManus, Penelope Louise;Kneeshaw, Peter John
    • Archives of Plastic Surgery
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    • 제40권2호
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    • pp.117-122
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    • 2013
  • Background Latissimus dorsi (LD) myocutaneous flap is a popular method of breast reconstruction which can be associated with high incidence of seroma formation. Quilting sutures at the harvest site are used to reduce this. Barbed sutures are self anchoring sutures which avoid multiple knotting and can be useful in quilting. Methods A retrospective analysis of prospectively maintained database of patients who underwent LD flap breast reconstruction between January 2009 and January 2011 was carried out. Seroma formation at the harvest site, wound related complications, inpatient stay and duration of surgery were analysed and a comparison was made between two groups where quilting was done with barbed (V-Loc) suture and conventional polydioxanone (PDS) II sutures. Results Fifty-seven patients were included of which 33 had quilting by V-Loc sutures and in 24 patients PDS II suture was used. Median age in the PDS group was 55 years (interquartile range [IQR)], 45 to 61 years) which was comparable to the V-Loc group (53 years [IQR, 48 to 59 years]; P-value 0.948). Sixteen patients (28%) had significant seroma formation and 5 (9%) patients developed superficial wound dehiscence. Incidences of seroma or wound complications were comparable (P-value 0.378 and 1.00, respectively). Secondary outcomes such as total duration of surgery, total inpatient stay, total amount of drain at the donor site were also similar in two groups. Conclusions Use of barbed sutures for quilting the donor site in LD flap reconstruction is a feasible option and the associated seroma formation and wound complications are comparable with conventional sutures.

Absorbable versus Nonabsorbable Sutures for Facial Skin Closure: A Systematic Review and Meta-analysis of Clinical and Aesthetic Outcomes

  • Kashish Malhotra;Sophie Bondje;Alexandros Sklavounos;Hatan Mortada;Ankur Khajuria
    • Archives of Plastic Surgery
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    • 제51권4호
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    • pp.386-396
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    • 2024
  • When repairing facial wounds, it is crucial to possess a thorough understanding of suitable suture materials and their evidence base. The absence of high-quality and comprehensive systematic reviews poses challenges in making informed decisions. In this study, we conducted a review of the existing literature and assessed the quality of the current evidence pertaining to the clinical, aesthetic, and patient-reported outcomes associated with absorbable and nonabsorbable sutures for facial skin closure. The study was registered on Prospective Register of Systematic Reviews. We conducted searches on Embase, Ovid, and PubMed/MEDLINE databases. Only randomized controlled trials (RCTs) were eligible for inclusion in this study. Additionally, the risk of bias in the randomized studies was assessed using Cochrane's Risk of Bias Tool. The study included a total of nine RCTs involving 804 participants with facial injuries. Among these injuries, absorbable sutures were utilized in 50.2% (403 injuries), while nonabsorbable sutures were employed in 49.8% (401 injuries). The analysis of cosmesis scales revealed no statistically significant difference between absorbable and nonabsorbable sutures regarding infections (p = 0.72), visual analog scale (p = 0.69), wound dehiscence (p = 0.08), and scarring (p = 0.46). The quality of the included studies was determined to have a low risk of bias. Absorbable sutures can be considered a suitable alternative to nonabsorbable sutures, as they demonstrate comparable aesthetic and clinical outcomes. Future high-quality studies with a level I evidence design and cost-effectiveness analysis are necessary to enhance clinician–patient shared decision-making and optimize the selection of suture materials. Level of evidence is I, risk/prognostic study.

Tranilast-delivery surgical sutures to ameliorate wound healing by reducing scar formation through regulation of TGF-β expression and fibroblast recruitment

  • Choi, Sung Yoon;Kim, Byung Hwi;Huh, Beom Kang;Jeong, Woong;Park, Min;Park, Hyo Jin;Park, Ji-Ho;Heo, Chan Yeong;Choy, Young Bin
    • Journal of Industrial and Engineering Chemistry
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    • 제67권
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    • pp.469-477
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    • 2018
  • We describe surgical sutures enabled with the local, sustained delivery of a TGF-${\beta}$ inhibitory drug, tranilast. To fabricate drug-delivery sutures, we separately prepared a tranilast-loaded strand using poly (lactic-co-glycolic acid), which was then physically braided with a surgical suture already in clinical use. By this method, the drug-delivery sutures maintained the mechanical strength and allowed the modulation of drug release profiles by simply altering the tranilast-loaded strand. The drug-delivery sutures herein released tranilast for up to 14 days. When applied to animal models, scarring was indeed reduced with diminished TGF-${\beta}$ expression and fibroblast numbers during the entire 21 day testing period.

Evaluation of tensile strength of surgical synthetic absorbable suture materials: an in vitro study

  • Khiste, Sujeet Vinayak;Ranganath, V.;Nichani, Ashish Sham
    • Journal of Periodontal and Implant Science
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    • 제43권3호
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    • pp.130-135
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    • 2013
  • Purpose: The purpose of this study was to evaluate the tensile strength of surgical synthetic absorbable sutures over a period of 14 days under simulated oral conditions. Methods: Three suture materials (polyglycolic acid [PGA], polyglactin [PG] 910, and poly (glycolide-co-${\epsilon}$-caprolactone) [PGC]) were used in 4-0 and 5-0 gauges. 210 suture samples (35 of each material and gauge) were used. All of the samples were tested preimmersion and 1 hour and 1, 3, 7, 10, and 14 days postimmersion. The tensile strength of each suture material and gauge was assessed. The point of breakage and the resorption pattern of the sutures were also assessed. Results: During the first 24 hours of immersion, all 4-0 and 5-0 samples of PGA, PG 910, and PGC maintained their initial tensile strength. At baseline (preimmersion), there was a statistically significant (P<0.001) difference in the tensile strengths between the 4-0 and 5-0 gauge of PGA, PG 910, and PGC. PGA 4-0 showed the highest tensile strength until day 10. At 7 days, all the 4-0 sutures of the three materials had maintained their tensile strength with PGA 4-0 having significantly greater (P=0.003) tensile strength compared to PG. Conclusions: 4-0 sutures are stronger and have greater tensile strength than 5-0 sutures. The PGA 4-0 suture showed the highest tensile strength at the end of day 10.

Flexor Tenorrhaphy Using Absorbable Suture Materials

  • Kang, Hyung Joo;Lee, Dong Chul;Kim, Jin Soo;Ki, Sae Hwi;Roh, Si Young;Yang, Jae Won
    • Archives of Plastic Surgery
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    • 제39권4호
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    • pp.397-403
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    • 2012
  • Background Nonabsorbable sutures are favorable for repairing flexor tendons. However, absorbable sutures have performed favorably in an animal model. Methods Two-strand sutures using the interlocking modified Kessler method with polydioxanone absorbable sutures 4-0 were used to repair completely ruptured flexor tendons in 55 fingers from 41 consecutive patients. The medical records of average 42 follow up weeks were analyzed retrospectively. The data analyzed using the chi-squared test, and Fisher's exact test was used for postoperative complications. The results were compared with those of other studies. Results Among the index, middle, ring, and little fingers were injured in 9, 17, 16, and 13 fingers, respectively. The injury levels varied from zone 1 to 5. Of the 55 digits in our study, there were 26 (47%) isolated flexor digitorum profundus (FDP) injuries and 29 (53%) combined FDP and with flexor digitorum superficialis injuries. Pulley repair was also conducted. Concomitant injuries of blood vessels and nerves were found in 17 patients (23 fingers); nerve injuries occurred in 5 patients (10 fingers). Two patients had ruptures (3.6%), and one patient had two adhesions (3.6%). Using the original Strickland criteria, all the patients were assessed to be excellent or good. Also, fibrosis and long-term foreign body tissue reactions such as stitch granuloma were less likely occurred in our study. Compared to the Cullen's report that used nonabsorbable sutures, there was no significant difference in the rupture or adhesion rates. Conclusions Therefore, this study suggests that appropriate absorbable core sutures can be used safely for flexor tendon repairs.

Cadaveric Feasibility Study of Knotless Barbed Suture for Tracheal Anastomosis in Dogs

  • Hyeon-Ah Min;Chang-Hwan Moon;You-Jeong Jeong;Hae-Beom Lee;Dae-Hyun Kim;Seong Mok Jeong
    • 한국임상수의학회지
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    • 제39권6호
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    • pp.311-318
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    • 2022
  • Appropriate suture technique is crucial for successful tracheal anastomosis. However, standards for an ideal suture method have not yet been established. A previous study suggested tracheal anastomosis using barbed sutures that do not require knots; however, their use in small animals has not been reported. In this study, we aimed to compare knotless barbed sutures with conventional smooth sutures in terms of maximum tensile strength and suturing time in canine tracheal models to demonstrate the feasibility of using barbed sutures in tracheal anastomosis in dogs. Tracheal segments harvested from nine beagle dog cadavers were randomly assigned to three suture groups: barbed suture (B), smooth suture in simple interrupted pattern (SI), and smooth suture in simple continuous pattern (SC). The maximum tensile force and suturing time were compared according to the suturing method, and the mode of failure was evaluated. The average suturing time was 3.29 min in the B group; 4.41 min, SC group; and 8.99 min, SI group (p < 0.001). The average maximum tensile force in the SC group was 134.97 N, which was stronger than the SI (110.57 N) and B groups (103.10 N) (p < 0.05 and p < 0.01, respectively). The difference between the B and SI groups was not significant (p = 0.05). The B group demonstrated comparable mechanical strength and shorter suture time compared with the SI group. Therefore, tracheal anastomosis using barbed sutures could be an effective alternative to conventional smooth sutures in dogs.