• Title/Summary/Keyword: suture

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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
    • Journal of Veterinary Clinics
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    • v.39 no.6
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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.

The Mechanical Appearances and Microscopic Tissue Reactions of the Suture Materials in vivo (생체내 이식된 흡수성 봉합사들의 물리적 성질 변화와 조직 소견에 관한 연구)

  • 김남중;김명철
    • Journal of Veterinary Clinics
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    • v.13 no.2
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    • pp.184-194
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    • 1996
  • A comparative study of three absorbable suture materials of chromic catgut, Dexon II (a polyglycolic acid suture with a polycaprolate coating system) and Coated Vicryl (a polyglactin 910 suture with a glycolide-lactide-calcium stearate coating system) was undertaken in terms of tensile strength, breaking elongation, appearances of the suture materials in the subcutaneous layer of rats and of tissue reaction in the intramuscular layer of rats. The initial tensile strength of chromic catgut and the tensile strength after 21 days were about 1.55 kg and 0.19 kg, respectively. Those of Dexon II were about 2.01 kg and 0. 20 kg, respectively. Those of Coated Vicryl were about 2.39 kg and 0.48 kg, respectively. Coated Vicryl showed the highest tensile strength among the three materials during the whole period. On the other hand, Dexon II showed the highest breaking elongation among the three materials during the first week. But the breaking elongation of Dexon II rapidly continuously decreased during the whole period. The appearances of the suture materials in the subcutaneous layer of rats showed that chromic catgut was the fastest among the three materials, whereas it formed comparatively much connective tissue. The intramuscular absorption rate and tissue reaction of Dexon II were similar to those of Coated Vicryl. The intramuscular absorption rate of these was fairly late when compared with chromic catgut. And the tissue reaction appearance of these showed the formation of a granuloma with foreign body giant cells, macrothages and epitheloid cells by the 28th day in the experimental period.

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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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Enhancing Venous Anastomosis Visualization in Murine Kidney Transplants: The Two Stay Suture Technique

  • Jong-Min Kim
    • Journal of Veterinary Clinics
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    • v.40 no.6
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    • pp.423-428
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    • 2023
  • The mouse kidney transplantation model serves as an invaluable tool for exploring various aspects of the transplant process, including acute rejection, cellular and humoral rejection, ischemia-reperfusion injury, and the evaluation of novel therapeutic strategies. However, conducting venous anastomosis in this model poses a significant challenge due to the thin and pliable characteristics of the renal vein, which often obstruct clear visualization of the resected vein's edge. This study proposes the adoption of a two stay suture technique to enhance the visualization of the renal vein's edge, thereby facilitating efficient and successful venous anastomosis. A total of 22 mice served as kidney donors in this study. The conventional anchoring suture technique was employed for venous anastomosis in 11 of these mice, while the remaining 11 underwent the two stay suture technique. The anastomosis duration and completion rates were then compared between these two groups. The conventional anchoring suture technique yielded an average anastomosis time of 29 minutes and a completion rate of 64%. In contrast, the two stay suture technique demonstrated a substantial improvement, with an average anastomosis time of 14 minutes and a completion rate of 100%. The two stay suture technique offers a promising solution to enhance visualization during venous anastomosis in murine kidney transplantation. This technique may particularly benefit novices by enabling them to perform venous anastomosis more easily, swiftly, and successfully.

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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Arthroscopic Reduction of Subluxed Medial Meniscus using Suture Anchor for Restoration of Hoop Stress - Technical Note - (버팀테응력 회복을 위한 아탈구된 내측 반월상 연골의 Suture anchor를 이용한 정복술 - 술기 보고 -)

  • Kim, Jaw-Hwa;Lee, Yoon-Seok;Kim, Chul;Han, Seung-Chul
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.3
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    • pp.280-284
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    • 2009
  • Purpose: The authors introduce a new technique of arthroscopic reduction of subluxed medial meniscus using suture anchor for the restoration of hoop stress. Operative Technique: Anterolateral, anteromedial, and medial midpatellar arthroscopic portal are used. Arthroscope was inserted through anterolateral portal. Through the scope, we confirmed subluxation of medial meniscus. Transection of menisci including radial and root tear were excluded. We released the anterior horn of medial meniscus through anteromedial and burred the future insertion site of suture anchor. After inserting suture anchor through medial midpatellar portal, we used 90 degree suture hook and no.2 Nylon to retrieve the suture of inserted anchor. We tied the suture by sliding knot-tying method. Weight bearing was limited for 6 weeks postoperatively. Conclusion: Arthroscopic retightening of medial meniscus is less invasive, conserving and progressed method for subluxed meniscus.

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Anteroinferior Capsulolabral Complex Repair Using Antegrade Suture Passer - Technical Note - (Antegrade Suture Passer를 이용한 전하방 관절낭-관절와순 복합체의 복원술 - 수술 술기 -)

  • Seo, Hyuk-Jun;Cho, Chul-Hyun;Lee, Si-Wook
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.95-99
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    • 2013
  • We introduce arthroscopic Bankart repair technique using antegrade suture passer that can effectively restore detached anteroinferior capsulolabral complex for shoulder anterior instability. After diagnostic arthroscopy is performed using posterior, anteroinferior and anterosuperior portals, we confirm Bankart lesion and perform debridement and decortications of anteroinferior glenoid edge and neck. Suture anchor is inserted through anteroinferior portal at 2 mm medial side of glenoid edge (4:30 direction). Scorpion$^{TM}$ loaded suture is directly advanced to detached and retracted anteroinferior capsulolabral complex and the suture is passed at 10~15 mm medial side of detached anteroinferior capsulolabral complex (5:30 direction). The suture is retrieved by Scorpion's hook and then is tied using samsung medical center (SMC) sliding knot technique. Then suture anchors are serially inserted (2:30, 3:30) and capsulolabral complex repair is performed using suture hook and suttle-relay technique. This technique that can obtain anatomical restoration of anteroinferior glenohumeral ligament with proper tension is useful technique to reduce postoperative recurrence and makes it possible for less experienced surgeons.

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Assessment of Midpalatal Suture Maturation by Skeletal Maturity on Hand Wrist Radiographs (성장기 아동의 수완부 골 성숙도를 이용한 정중구개봉합 성숙도 평가)

  • Yu, Dayeol;Kim, Donghyun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.48 no.1
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    • pp.31-41
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    • 2021
  • The aim of this retrospective study was to evaluate the correlation between the midpalatal suture maturation and skeletal maturation in growing children aged 7 - 15 years and predict the maturational stages of the midpalatal suture corresponding to skeletal maturity assessed by the skeletal maturation indicators (SMI) and middle phalanx of the third finger (MP3) stages. The group of this retrospective study was consisted of randomly selected 132 male and 135 female in age from 7 - 15 years. The maturation of the midpalatal suture was evaluated by using images from cone-beam computed tomography (CBCT) while the skeletal age was assessed by hand-wrist radiography. CBCT images and hand-wrist radiographs used in this study were obtained from all subjects for orthodontic diagnosis before orthodontic treatment. The maturational stages of the midpalatal suture showed strong correlations with both SMI and MP3 stages. The correlation between the midpalatal suture maturation and SMI (Spearman's correlation coefficient, ϒS = 0.905, p < 0.05) was slightly greater than that of MP3 stages (ϒS = 0.830, p < 0.05). There was a positive significant correlation between the midpalatal suture maturation and chronological age (ϒS = 0.868,p < 0.05). CBCT for evaluation of the midpalatal suture maturational stages may be unnecessary in every pediatric patients because SMI and MP3 stages were both replaceable useful methods for assessing maturation of the midpalatal suture before orthopedic treatment. In this retrospective study, the diagnostic reliability of the SMI method for estimating midpalatal suture maturation showed better reliability than the MP3 method.

Inframammary Fold Creation in Breast Reconstruction (유방재건시 유방하 주름의 생성)

  • Lee, Hae Min;Ahn, Hee Chang;Choi, Seung Suk;Jo, Dong In;Byun, Tae Ho
    • Archives of Plastic Surgery
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    • v.32 no.2
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    • pp.231-236
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    • 2005
  • Nowadays breast reconstruction with autologous tissues after radical mastectomy is commonly performed, and a natural inframammary fold in the reconstructed breast is considered to be an essential aspect of symmetrical breast shape and location. Total of 104 patients underwent breast reconstruction with free TRAM flap and formation of inframammary fold with free TRAM breast reconstruction was done in 79 patients. No suture fixation for inframammary fold were done in 19 patients. 27 patients(24.0%) were made of inframammary fold with absorbable suture, 52 patients (50.0%) underwent inframammary fold creation with nonabsorbable suture. There were 4 cases(16.0%) of displacement of reconstructed breast and 2 cases(8.0%) of partial disruption of inframammary fold in the group of no suture. There were 2 cases(7.4%) of displacement of reconstructed breast and 3 cases(11.1%) of partial disruption of inframmamary fold in the fixed group with absorbable suture. There was only 1 case(1.9%) of partial disruption of inframammary fold fixed with nonabsorbable suture group. Therefore, we could speculate that the reinforcement of ligamentous structure for making the definite inframammary fold is necessary, and the area of the inframammary fold should not be undermined in immediate breast reconstruction as much as possible in order to preserve the zone of adherence. If the fold is disrupted during the mastectomy, it should be re-created with the non-absorbable sutures. Nonabsorbable suture fixation seemed to be more stable than absorbable suture. Preoperative marking and design are very important to make the symmetrical shape and location of inframammary fold in both of immediate and delayed reconstruction of breasts.

The effect of cetirizine, a histamine 1 receptor antagonist, on bone remodeling after calvarial suture expansion

  • Hwang, Soonshin;Chung, Chooryung J.;Choi, Yoon Jeong;Kim, Taeyeon;Kim, Kyung-Ho
    • The korean journal of orthodontics
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    • v.50 no.1
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    • pp.42-51
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    • 2020
  • Objective: The objective of this study was to evaluate the effects of cetirizine, a histamine 1 receptor antagonist, on bone remodeling after calvarial suture expansion. Methods: Sixty male Sprague-Dawley rats were divided into 4 groups; the phosphate-buffered saline (PBS)-injected no expansion group, cetirizine-injected no expansion group, PBS-injected expansion group, and cetirizine-injected expansion group, and were observed at 7, 14, and 28 days. Five rats per group were examined at each observation day. Daily injections of cetirizine or PBS were administered to the relevant groups starting 2 weeks prior to expander insertion. A rapid expander was inserted in the calvarial bone to deliver 100 cN of force to the parietal suture. The specimens were prepared for hematoxylin and eosin and tartrate-resistant acid phosphatase (TRAP) staining. Suture opening and bone regeneration were evaluated using microcomputed tomography and bone histomorphometric analysis. Serum blood levels of osteocalcin and carboxy-terminal collagen crosslinks (CTX) were also evaluated. Results: TRAP-positive cell counts and CTX levels decreased while osteocalcin levels increased in the cetirizine-injected expansion group at observation day 28. In the expansion groups, the mineralized area gradually increased throughout the observation period. At day 28, the cetirizine-injected expansion group showed greater bone volume density, greater mineralized area, and narrower average suture width than did the PBS-injected expansion group. Conclusions: Cetirizine injection facilitated bone formation after suture expansion, mostly by suppressing osteoclastic activity. Histamine 1 receptor antagonists may aid in bone formation after calvarial suture expansion in the rat model.