• Title/Summary/Keyword: suture

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Barbed sutures versus conventional tenorrhaphy in flexor tendon repair: An ex vivo biomechanical analysis

  • Colak, Ozlem;Kankaya, Yuksel;Sungur, Nezih;Ozer, Kadri;Gursoy, Koray;Serbetci, Kemal;Kocer, Ugur
    • Archives of Plastic Surgery
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    • v.46 no.3
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    • pp.228-234
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    • 2019
  • Background The management of flexor tendon injuries has evolved in recent years through industrial improvements in suture materials, refinements of repair methods, and early rehabilitation protocols. However, there is no consensus on the ideal suture material and technique. This study was conducted to compare the tensile strength, repair time, and characteristics of 4-strand cruciate, modified Kessler, and 4-strand horizontal intrafiber barbed sutures for flexor tenorrhaphy with a 12-mm suture purchase length in an animal model. Methods The right third deep flexors of 60 adult Leghorn chicken feet were isolated and repaired with a 12-mm suture purchase length. The tendons were randomly assigned to three groups of equal number (n=20 each). Groups 1 and 2 received 4-strand cruciate and modified Kessler repair with conventional suture materials, respectively. A 4-strand horizontal intrafiber barbed suture technique was used in group 3. The repaired tendons were biomechanically tested for tensile strength, 2-mm gap resistance, and mode of failure. Repair times were also recorded. Results The maximum tensile strength until failure was $44.6{\pm}4.3N$ in group 1, $35.7{\pm}5.2N$ in group 2, and $56.7{\pm}17.3N$ in group 3. The barbed sutures were superior to the other sutures in terms of the load needed for 2-mm gap formation (P<0.05). Furthermore, the barbed sutures showed the shortest repair time (P<0.05). Conclusions This study found that 4-strand horizontal intrafiber barbed suture repair with a 12-mm purchase length in a chicken flexor tendon injury model showed promising biomechanical properties and took less time to perform than other options.

CLINICAL CASES OF NON-SURGICAL PALATAL EXPANSION ON ADULT PATIENTS

  • Kim, Kyung-Ho;Hong, Hee-Sook;Park, Jun-Ho
    • The korean journal of orthodontics
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    • v.25 no.6 s.53
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    • pp.733-746
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    • 1995
  • In narrow maxillary arch, midpalatal suture can be readily opened in growing children with maxillary palatal expansion. In adult patients, narrow maxilla is generally treated surgically because their growth are deemed completed due to their age. However, in patients under 25, midpalatal suture may not be closed. In addition, maxillary expansion may depend upon the closure of other maxillary sutures, which generally remain open at this stage. The present study attempted suture openings with palatal expansion on 5 female patients in their early 20's. The opening was successful in 4 patients, while only one patient showed no suture opening. In all 4 subjects, no discomfort or pain was present during s\expansion, and the successful suture opening was confirmed on occlusal x-rays. Therefore, for those patients with narrow maxilla in their early 20's, rapid palatal expansion or slow palatal expansion may offer a simple and less complicated option which, if successful, may preclude the need for surgery and thereby circumvent the psychological and financial burdens for the patients.

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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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Tissue Reaction to Chromic catgut, Polyglycolic acid and Nylon Sutures in the Rumen Wall of Goats (염소의 제 1위벽에 있어서 Chromic catgut, Polyglycolic acid 및 Nylon 봉합사에 대한 조직반응)

  • Ahn Keun-Seung;Nam Tchi-Chou;Cheong Chang-Kook
    • Journal of Veterinary Clinics
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    • v.3 no.2
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    • pp.299-307
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    • 1986
  • The each rumen of six goats was incised and sutured with chromic catgut, polyglycolic acid and nylon. Tissue reaction to each suture materials was observed and comared at the 7th, 14th and 21st post-operative days. The predominent inflammatory cells around suture materials are macrophages, fibroblast and neutrophils. A few lymphocytes was infiltrated around suture materials. Infiltration of neutrophils was rapidly diminished but infiltration of macrophages, fibroblasts and lymphocytes were persisted. The overall grade of tissue reaction varid by suture materials. At the 7th post-operative days, tissue reaction to chromic catgut was most prominant and that of polyglycolic acid and nylon was moderate. At the 14th and 21st postoperative days, tissue reaction to each suture materials was not greatly different.

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Delayed Lateral Row Anchor Failure in Suture Bridge Rotator Cuff Repair: A Report of 3 Cases

  • Jeong, Jae-Jung;Ji, Jong-Hun;Park, Seok-Jae
    • Clinics in Shoulder and Elbow
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    • v.21 no.4
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    • pp.246-251
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    • 2018
  • Compared to single row repair, use of lateral row anchors in suture bridge rotator cuff repair enhances repair strength and increases footprint contact area. If a lateral knotless anchor (push-in design) is inserted into osteoporotic bone, pull-out of the lateral row anchor can developed. However, failures of lateral row anchors have been reported at several months after surgery. In our cases, even though complete cuff healing occurred, delayed pull-out of the lateral row anchor in the suture bridge repair occurred. In comparison to a conventional medial anchor, further biomechanical evaluation of the pull-out force, design, and insertion angle of the lateral anchor is needed in future studies. We report three cases with delayed pull-out of lateral row anchor in suture bridge rotator cuff repair with a literature review.

The suture bridge transosseous equivalent technique for Bony Bankart lesion

  • Choe, Chang-Hyeok;Kim, Sin-Geun;Baek, Seung-Hun;Sin, Dong-Yeong
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2008.03a
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    • pp.178-178
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    • 2008
  • In order to improve static stability and healing of reattached labrum, we combined the advantages of suture bridge and transosseous technique. Using the conventional 3 portal for anterior instability, check stability of bony Bankart and preparation of glenoid bed in 3 way including removal, reshaping or mobilization of bony fragment. Two anchors were inserted to the superior and inferior portion and medial edge of bony Bankart lesion. It usually corresponded to the area of IGHL. Medial mattress sutures were applied around IGHL complex to get enough depth of glenoid coverage using suture hook. Make 3.5mm pushlock anchor hole to the articular edge of glenoid cartilage. Proximal suture bridge was applied at first and then distal suture bridge was inserted to mobilize the labrum in proximal direction. These construction can provide more stable labral repair with wide contact and compression in case of deficient bony stability. It not only avoids technical disadvantage of point contact with anchor fixation, but also decreasing gap formation through cross compression of labrum that couldn't gain even with the transosseous fixation which affords linear compression effect. Additional bony stability could be gained if the the bony fragment was mobilized to the glenoid margin with potential healing bed or reshaped for the good contact with reattached labrum.

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Changes of Tracheal Anastomosis Site in Growing Rats (흰쥐에서 기관절제 단단 문합부의 성장에 따른 변화)

  • 박희철
    • Journal of Chest Surgery
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    • v.26 no.5
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    • pp.343-348
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    • 1993
  • Growth of suture line and anastomosis is required for long-term success after the tracheal and bronchial surgery in infant and pediatric patient. We used various suture materials in these cases, but the results were differ. To select the adequate suture material in tracheal surgery, we tried next. Tracheal anastomoses were performed in 150 Sprague Dawley rats, aged 4 to 8 [mean 5.8] weeks and weight 62 to 106[mean 83.6] gram, to compare polydioxanone[PDS] 7-0, polyglactin 910[Vicryl]7-0, and polypropylene [prolene] 8-0 suture materials. In 150 rats, only 29[20%] were lived over 300 days, and the weight was 250 to 320[mean 289.5]gram. Cross sectional area of the anastomoses and two or three tracheal rings below anastomosis site were measured under microscope, and calculated and compared as Hsieh`s equition. Cross-sectional area,anastomosis site/normal site 100, were 89.4 $\pm$ 5.34% in PDS group[n=9], 75.7 $\pm$ 6.06% in Vicrylgroup [n = 10], and 80.8$\pm$ 4.06% in Prolene group[n = 10]. Histopathologic studies were done for all autopsies or put in death around 300 days postoperatively. PDS absorblion was not seen 16 weeks after suture but disappeared over 24 weeks slide. Vicryl absorbtion was noted postoperative 8 to 16 weeks, with marked tissue reaction. Prolene showed least tissue reaction, but the suture material was persisted with regional fibrotic capsule.Causes of death were respiratory failure in 76 cases, tracheal rupture in 22 cases, hemorrhage, biting, starvation and etc. in 23 cases. With the brief review of literatures, we report the results.

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The Effect of Indwelling Silk Suture Following Aspiration in the Treatment of Chronic Lateral Malleolar Bursitis (흡입 후 견 봉합사 거치를 통한 만성 족관절 외과 점액낭염의 치료)

  • Lee, Bong-Jin;Lee, Sung-Rak;Kim, Seong-Tae
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.38-41
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    • 2005
  • Purpose: To evaluate the drainage effect of silk suture following aspiration of the bursa as an early treatment of chronic lateral malleolar bursitis. Materials and Methods: Thirteen cases, which have over two weeks of history and over one year of follow-up, were investigated. The average duration of follow-up was 16.4 months. The average symptom duration before introduction into this study was 7.8 weeks. With an aseptic technique, the aspiration of the bursa was done with 18G needle and syringe and then the insertion of silk suture through the aspiration needle was performed. The amount of drainage was identified two or three times in a week and stitch out was done at the cessation of drainage. Over one year follow-up, recurrence, infection, pain, and limitation of range of motion were investigated by telephone interview. Results: Redness around the insertion site of silk suture was found in all cases, but there was no development of active infection or recurrence. The average duration of treatment is 10.4 days. Conclusion: The drainage with silk suture following aspiration of the bursa is less invasive and very effective method in the early treatment of chronic lateral malleolar bursitis.

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A STUDY ON THE MAXILLARY INTERINCISAL DIASTEMA (상악중절치간(上顎中切齒間) 정중이개(正中離開)에 관(關)한 연구(硏究))

  • Kim, Yung Bolt
    • The korean journal of orthodontics
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    • v.8 no.1
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    • pp.7-17
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    • 1978
  • The purpose of this study was to investigate the interrelationship of the maxillary interincisal diastema, spacing and crowing to the type of superior labial frenum and the type of intermaxillary suture by analyzing histories, intraoral radiographs, orthopantomographs, intraoral slide films, and dental casts. The data for this study were compiled from 500 outpatients of the Department of Orthodontics, Infirmary of Dental College, Seoul National University. The following conculusions were obtained: 1. The occurrence of maxillary interincisal diastema in the permanent dentition decreased rapidly compared with that in the mixed dentition. And there was no sex difference in the occurrence of diastema in the both dentitions. 2. Frenum attachment remained relatively constant between the two dentitions but assumed a higher level in the permanent dentition than in the mixed dentition. 3. Except suture type D which was not yet fused completely, there was no significant difference in the distribution of suture type between the mixed dentition and the permanent dentition. 4. Frenum and suture type were highly related; frenum types 5 and 6 were associated with suture types III and V. 5. In the permanent dentition, frenum type 5 and 6 and suture types III and IV occurred more frequently in the spacing group than in the normal or crowding group. 6. The relationship between the diastema and frenum types 5 and 6 and sture types III and IV showed a strong correlation.

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Galeal Tack-Up Sutures to Prevent Subgaleal Cerebrospinal Fluid Collection

  • Choi, Won Ho;Moon, Chang Taek;Koh, Young-Cho;Chun, Young Il;Cho, Joon;Song, Sang Woo
    • Journal of Korean Neurosurgical Society
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    • v.54 no.4
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    • pp.336-339
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    • 2013
  • Objective : Postoperative subgaleal cerebrospinal fluid (CSF) collection is considered as one of the common minor surgical complication which can lead to prolonged hospitalization. We introduce "galeal tack-up suture" to prevent postoperative subgaleal CSF collection. Methods : Galeal tack-up suture consists of various surgical techniques which aim to fix galea to cranium in order to prevent CSF pooling in subgaleal space. A total of 87 patients who underwent craniotomy were divided into two groups while closing the wound : group A with galeal tack-up suture and group B with routine wound closure without galeal tack-up suture. The patients were observed for postoperative subgaleal CSF collection. Results : Among 87 cranitomy cases, galeal tack-up suture was performed in 32 cases and routine wound closure was done in 55 cases. Postoperative subgaleal CSF collection occurred in 13 cases (15%) in which 12 cases occurred in group B patients and 1 case occurred in group A patients (p=0.026). Conclusion : Galeal tack-up suture is an easy and effective technique in wound closure to prevent postoperative CSF collection.