Flexor tendon repair: a comparative study between a knotless barbed suture repair and a traditional four-strand monofilament suture repair.

We compared the tensile strength of a novel knotless barbed suture method with a traditional four-strand Adelaide technique for flexor tendon repairs. Forty fresh porcine flexor tendons were transected and randomly assigned to one of the repair groups before repair. Biomechanical testing demonstrated that the tensile strengths between both tendon groups were very similar. However, less force was required to create a 2 mm gap in the four-strand repair method compared with the knotless barbed technique. There was a significant reduction in the cross-sectional area in the barbed suture group after repair compared with the Adelaide group. This would create better gliding within the pulley system in vivo and could decrease gapping and tendon rupture.

Unnecessary inter-hospital referral of minor hand injuries: a continuing problem.

BACKGROUND: Trauma patients are a burden on resources in terms of personnel, operating time and bed occupancy. The plastic surgery trauma clinic was established in January 1999 and has been running Monday to Friday mornings from 9 am to 1 pm since its establishment. AIM: To analyse and compare referral patterns to the Plastic Surgery trauma clinic over three time periods. METHOD: Three time groups were analysed and compared: data from this initial study (2000-2001), a retrospective chart review (2002-2003), as well as a prospective study (2006-2007). RESULTS: Numbers of attendances at the Trauma Clinic seem to be increasing every year despite encouragement by letter after the initial study for local centres to treat many of the minor injuries not requiring plastic surgical skills. CONCLUSION: Admission rates have remained below 50% of the patients seen in the clinic; however 50% of patients required only local anaesthetic procedures performed in the clinic, or no treatment at all (27.6% of patients in 2003, 35.3% in 2006).