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Rev. bras. ortop ; 57(3): 524-528, May-June 2022. graf
Article in English | LILACS | ID: biblio-1388021


Abstract The first meniscal suture was performed in 1885 and took about a century to become popular. Currently, all-inside meniscal repair devices are widely used. However, this technique presents the disadvantage of being a method dependent on specific devices, presenting a higher cost than other techniques. This high cost limits the use of such a technique in many locations. The objective of the present technical note is to describe a microinvasive meniscal suture technique as a modification of the all-inside technique, using a disposable 40 x 12 mm procedure needle. The authors believe that the proposed modification to the technique can make it more popular, enabling the use of the microinvasive technique in places with limited resources.

Resumo A primeira sutura meniscal foi realizada em 1885 e levou cerca de um século para tornar-se popular. Atualmente, os dispositivos de reparo meniscal all-inside são amplamente utilizados. Contudo, esta técnica apresenta a desvantagem de ser um método dependente de dispositivos específicos, apresentando um custo superior aos de outras técnicas. Este valor elevado limita o uso de tal técnica em muitos locais. O objetivo da presente nota técnica é descrever uma técnica de sutura meniscal microinvasiva, como uma modificação da técnica all-inside, utilizando uma agulha descartável de procedimento de 40 x 12 mm. Os autores acreditam que a modificação proposta para a técnica pode torná-la mais popular, possibilitando o uso da técnica microinvasiva em locais com recursos limitados.

Humans , Arthroscopy , Suture Techniques , Minimally Invasive Surgical Procedures , Tibial Meniscus Injuries/surgery
Rev. chil. obstet. ginecol. (En línea) ; 87(3): 241-244, jun. 2022. ilus
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1388731


Resumen La gestación cornual, también conocida como intersticial, es una gestación ectópica infrecuente que ocurre en 1/2500 a 1/5000 de los embarazos cuando el embrión implanta en el trayecto intramiometrial de la porción proximal de la trompa. Puede debutar como shock hipovolémico en un 25% de los casos, conllevando una mortalidad de hasta un 2,5%. Mediante ecografía se encuentra un saco gestacional excéntrico y rodeado por una fina capa de miometrio. El tratamiento, en la mayoría de los casos, es quirúrgico, y el control de la hemostasia supone todo un reto. Se presentan dos casos clínicos de mujeres con diagnóstico de gestación intersticial en quienes se realizó exéresis por laparoscopia tras inyección de vasopresina, permitiendo así controlar el sangrado. En una de las pacientes se practicaron también puntos transfixivos transitorios en la arteria uterina y el ligamento útero-ovárico.

Abstract Cornual gestation, also known as interstitial, is a rare ectopic gestation that occurs in 1/2500 to 1/5000 of pregnancies when the embryo implants in the intramyometrial tract of the proximal tube. It can debut as hypovolemic shock in 25% of cases, leading to a mortality rate of up to 2.5%. Using ultrasound, we will find an eccentric gestational sac surrounded by a thin layer of myometrium. Treatment, in most cases, is surgical and control of hemostasis is a challenge. Two clinical cases are presented of women with a diagnosis of interstitial pregnancy in whom transient transfixive sutures were performed at the level of the uterine artery and uterine-ovarian ligament and injection of vasopressin prior to laparoscopic exeresis, thus allowing the bleeding to be controlled.

Humans , Female , Pregnancy , Adult , Vasopressins/administration & dosage , Hemostatics/administration & dosage , Laparoscopy/methods , Pregnancy, Cornual/surgery , Blood Loss, Surgical/prevention & control , Suture Techniques , Injections
Article in Chinese | WPRIM | ID: wpr-928311


OBJECTIVE@#To systematically evaluate the clinical efficacy of arthroscopy and traditional incision in the treatment of tibial avulsion fracture of anterior cruciate ligament (ACL).@*METHODS@#From July 2010 to July 2020, clinical comparative trial about arthroscopy and traditional incision in the treatment of ACL tibial avulsion fracture was conducted by using computer-based databases, including Embase, Pubmed, Central, Cinahl, PQDT, CNKI, Weipu, Wanfang, Cochrane Library, CBM. Literature screening and data extraction were carried out according to the inclusion and exclusion criteria, and the quality of the included literature was evaluated by improved Jadad score and Ottawa Newcastle scale (NOS). The operation time, hospital stay, fracture healing time, knee range of motion, postoperative excellent and good rate, complication rate, Lysholm score, International Knee Documentation Committee (IKDC) score and Tegner score were statistically analyzed by Review Manager 5.3 software.@*RESULTS@#Finally, 16 literatures were included, including 1 randomized controlled trial and 15 non randomized controlled trials, with a total of 822 patients (405 in arthroscopy group and 417 in traditional incision group). Meta analysis showed that the operation time [MD=-9.03, 95% CI(-14.36, -3.70), P<0.001], hospital stay [MD=-5.81, 95%CI(-9.32, -2.31), P=0.001] and fracture healing time [MD=-14.61, 95% CI(-17.93, -11.28), P<0.001] in the arthroscopy group were better than those in the traditional incision group. The incidence of complications in arthroscopy group was lower than that in traditional incision group[OR=0.15, 95%CI(0.07, 0.33), P<0.001]. The postoperative excellent and good rate[OR=4.39, 95%CI (1.96, 9.82), P<0.001], knee mobility[MD=6.78, 95%CI(2.79, 10.77), P<0.001], Lysholm score[MD=11.63, 95%CI(4.91, 18.36), P<0.001], IKDC score[MD=7.83, 95%CI(6.09, 9.57), P<0.001] and Tegner score[MD=0.60, 95%CI(0.31, 0.89), P<0.001] in the arthroscopic group were higher than those in the traditional incision group.@*CONCLUSION@#Compared with the traditional open reduction and internal fixation, arthroscopic surgery in patients with ACL tibial avulsion fracture can shorten the operation time, hospital stay and fracture healing time, reduce the incidence of postoperative complications, and obtain good postoperative knee function. It can be recommended as one of the first choice for patients with ACL tibial avulsion fracture.

Anterior Cruciate Ligament/surgery , Anterior Cruciate Ligament Injuries/surgery , Arthroscopy , Fractures, Avulsion/surgery , Humans , Randomized Controlled Trials as Topic , Suture Techniques
Article in Chinese | WPRIM | ID: wpr-928257


OBJECTIVE@#To investigate the morphological, histological and ultrastructural changes of acute closed rupture of Achilles tendon, in order to clarify the pathological basis of the injury and to explore the significance.@*METHODS@#From January 2015 to January 2019, 35 patients with acute Achilles tendon rupture who underwent the minimally invasive Achilles tendon suture technique were retrospectively analyzed. Among these patients, 12 cases in acute open Achilles tendon rupture group included 10 males and 2 females, with an average age of (35.1±9.7) years old ranging from 19 to 50, and the time from injury to operation was 2 to 8 hours with an average of(5.6±1.8);23 cases in acute closed Achilles tendon rupture group included 21 males and 2 females, with an average age of (35.5±6.6) years old ranging from 18 to 50, and the time from injury to operation was 3 to 15 hours with an average of (7.5±3.1). The gross appearance and imaging findings of the broken end of Achilles tendon tissue in the two groups were compared by naked eye observation and foot and ankle MRI at 4 to 6 hours before operation. HE staining, scanning and fluoroscopic electron microscopy, immunohistochemistry(Sirius red staining) were performed on the intraoperative Achilles tendon tissue specimens at 1 to 2 days after operation, the collagen fiber degeneration and local fat infiltration, collagen fiber shape, cell morphology and function, and the distribution of typeⅠand type Ⅲ collagen fibers in Achilles tendon were compared between the two groups.@*RESULTS@#Compared with the acute open Achilles tendon rupture group, the acute closed Achilles tendon rupture group had poor elasticity, hard texture, moderate edema, irregular shape of Achilles tendon broken end, horsetail shape, and more calcification around the broken end. HE staining results:the collagen fibers in the Achilles tendon of the acute open Achilles tendon rupture group were arranged irregularly, with hyaline degeneration and fat infiltration;The results of electron microscopy showed that collagen arranged disorderly and fibroblasts atrophied in the acute closed Achilles tendon rupture group. Immunohistochemical(Sirius staining) results:the proportion of collagenⅠin the acute open Achilles tendon rupture group and the acute closed Achilles tendon rupture group was(91.12±4.34)% and(54.71±17.78)% respectively, and the proportion of collagen Ⅲ was (8.88±4.34)% and (45.29±17.78)% respectively. The content of collagenⅠin the acute closed Achilles tendon rupture group was lower than that in the acute open Achilles tendon rupture group, and the content of collagen Ⅲ in the acute closed Achilles tendon rupture group was higher than that in the acute open Achilles tendon rupture group(P<0.05).@*CONCLUSION@#The morphology, histology and ultrastructure of the acute closed ruptured Achilles tendon are significantly altered compared with the normal Achilles tendon. The original fine and orderly spatial structure cannot be maintained, part of collagen Ⅰ is replaced by collagen Ⅲ, and the toughness and strength of the tendon tissue decreased, which may be the feature of degeneration of the Achilles tendon and an important pathological basis for closed Achilles tendon rupture.

Achilles Tendon/surgery , Adult , Female , Humans , Male , Retrospective Studies , Rupture/surgery , Suture Techniques , Tendon Injuries/surgery , Treatment Outcome
Artrosc. (B. Aires) ; 29(1): 39-41, 2022.
Article in Spanish | LILACS, BINACIS | ID: biblio-1369639


La fijación de luxaciones acromioclaviculares de alto grado con métodos de cerclaje coracoclavicular exige una manipulación cuidadosa del instrumental y de los dispositivos de fijación como suturas o injertos a nivel subcoracoideo. La estrecha relación de la apófisis coracoides con el plexo braquial y la arteria axilar hace que esta sea una zona riesgosa y técnicamente demandante durante la cirugía. Para esta instancia, se han desarrollado dispositivos específicos, pero pueden ser costosos y poco disponibles. Se presenta una técnica manual, reproducible, segura y sencilla, que evita el uso de dispositivos adicionales para realizar cerclaje coracoclavicular en fijación o reconstrucción acromioclavicular.

Stabilization of high-grade acromioclavicular dislocations with coracoclavicular cerclage methods requires careful manipulation of instruments and fixation devices when approaching the coracoid process. This is risky and technically challenging surgical area due to the close relationship with the brachial plexus and the axillary artery. Specific devices have been developed for this instance, but they can be expensive and rarely available. A reproducible, safe and simple manual technique is presented, which avoids the use of additional devices to perform coracoclavicular cerclage in acromioclavicular fixation or reconstruction.

Suture Techniques , Clavicle/injuries , Shoulder Injuries/surgery
Rev. bras. oftalmol ; 81: e0040, 2022. graf
Article in English | LILACS | ID: biblio-1376790


ABSTRACT Purpose: To describe a new accessible model of ophthalmological training using chicken eggs. Methods: With the aid of a spherical drill, the external calcified layer and the cuticle of the chicken eggshell were removed in a 2cm diameter circle. Using a video-magnification system, the film was dissected and cut to approximately 1.5 cm diameters. The film was removed and repositioned to make interrupted 12-0 nylon microsutures. The parameters analyzed were: cost, facility of acquisition and handling, time for making the model and the microsutures and number of possible uses. Results: In all simulators, it was possible to carry out separated and equidistant micro-sutures in the egg membrane, without the need for reintervention. Conclusion: The new chicken-egg model for ophthalmic surgery training is low-cost, easy to acquire and handle, and viable for the development of basic microsurgery skills.

RESUMO Objetivo: Descrever um novo modelo acessível de treinamento oftalmológico com ovo de galinha. Métodos: Com o auxílio de uma broca esférica, a camada calcificada externa e a cutícula da casca do ovo de galinha foram retiradas em um círculo 2 cm de diâmetro. Mediante um sistema de videomagnificação, a película foi dissecada e cortada em formato aproximado de 1,5 cm de diâmetro. A película foi removida e reposicionada para a confecção de microssuturas interrompidas com nylon 12-0. Os parâmetros analisados foram: custo, facilidade de aquisição e manuseio, tempo para confecção do modelo e para a confecção das microssuturas e número de utilizações possíveis. Resultados: Em todos os simuladores foi possível realizar microssuturas separadas e equidistantes na membrana do ovo, sem necessidade de reintervenção. Conclusão: O novo modelo com ovo de galinha para o treinamento de cirurgia oftalmológica é de baixo custo, fácil aquisição e manuseio, além de ser viável no desenvolvimento de habilidades básicas em microcirurgia.

Animals , Ophthalmologic Surgical Procedures/education , Egg Shell , Simulation Training/methods , Microsurgery/education , Models, Anatomic , Ophthalmology/education , Chickens , Suture Techniques/education , Eggs
Rev. bras. oftalmol ; 81: e0005, 2022. graf
Article in English | LILACS | ID: biblio-1360915


ABSTRACT Objective: To describe the upper and lower blepharoplasty technique associated with canthopexy with double pre septal orbicularis muscle elevation with a single suture in order to evaluate the efficacy of the technique. Methods: This is a retrospective study in which the medical records of 5,882 patients who underwent this technique between January 1999 and July 2015 were evaluated. The frequency and main causes of clinical complications and surgical reoperation were analyzed. Results: The incidence of complications found was 12.7% (n=750), being 0.8% (n=47) due to persistent chemosis, 3% (n=176) due to poor lower eyelid positioning, 4.17% (n=245) due to mild eyelid retraction and 4.8% (n=282) because of mild to moderate chemosis. Conclusion: The technique appears to be effective as it is simple and practical, and capable of resulting in positive functional and aesthetic outcomes with low rates of complications.

RESUMO Objetivo: Descrever a técnica de blefaroplastia superior e inferior associada à cantopexia associada à dupla elevação do músculo orbicular pré-septal em uma única sutura e avaliar sua eficácia. Métodos: Trata-se de estudo retrospectivo, no qual foram avaliados 5.882 prontuários de pacientes submetidos à blefaroplastia superior e inferior com a utilização da cantopexia, entre janeiro de 1999 e julho de 2015. Taxas e principais causas de complicações clínicas e reintervenção cirúrgica foram analisadas. Resultados: A incidência de complicações encontradas foi de 12,7% (n=750), sendo 0,8% (n=47) de caso de quemose persistente, 3% (n=176) de mau posicionamento palpebral inferior (ectrópio), 4,17% (n=245) de leve retração pálpebra e 4,8% (n=282) de quemose leve a moderada. Conclusão: A técnica mostra-se eficaz por ser simples e prática, podendo ter resultados funcionais e estéticos positivos e com baixo índice de complicações.

Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Blepharoptosis/surgery , Suture Techniques , Blepharoplasty/adverse effects , Blepharoplasty/methods , Eyelid Diseases/surgery , Postoperative Complications/etiology , Skin Aging , Medical Records , Retrospective Studies , Conjunctival Diseases/etiology , Edema/etiology , Eyelids/surgery , Facial Muscles/surgery
Rev. bras. oftalmol ; 81: e0045, 2022. graf
Article in English | LILACS | ID: biblio-1387976


ABSTRACT Objective: To describe a new surgical maneuver to position the graft in a Descemet Stripping with Automated Endothelial Keratoplasty (DSAEK) surgery. Methods: Case series. Results: This technique allows a correct repositioning of the graft in a minimally invasive way. Conclusion: This new surgical maneuver was successful in manipulating the graft in DSAEK surgery and therefore might be effective and safe.

RESUMO Objetivo: Descrever uma nova manobra cirúrgica para posicionar o enxerto em uma cirurgia de ceratoplastia endotelial automatizada com desnudamento da Descemet. Métodos: Série de casos. Resultados: A técnica permitiu o correto reposicionamento do enxerto de forma minimamente invasiva. Conclusão: Esta nova manobra cirúrgica foi bem-sucedida para manipular o enxerto na cirurgia ceratoplastia endotelial automatizada com desnudamento da Descemet e, portanto, pode ser eficaz e segura.

Humans , Endothelium, Corneal/transplantation , Descemet Stripping Endothelial Keratoplasty/instrumentation , Descemet Stripping Endothelial Keratoplasty/methods , Needles , Surgical Flaps , Suture Techniques , Minimally Invasive Surgical Procedures , Cornea/surgery , Corneal Diseases/surgery , Descemet Membrane/surgery , Corneal Endothelial Cell Loss/prevention & control , Graft Rejection/prevention & control
Rev. bras. ortop ; 56(6): 726-732, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1357144


Abstract Objectives To evaluate the clinical results of patients submitted to arthroscopic treatment of partial lesion of the articular part of the rotator cuff by transtendon suture techniques and after completing the lesion and to compare the postoperative recovery time of the two techniques. Method Retrospective study based on the identification of all cases with partial lesion of the articular part of the rotator cuff submitted to arthroscopic treatment from October 1999 to December 2016 at the Shoulder and Elbow Group of our institution. Thirty-nine patients were included and divided intotwo groups: those who underwent the transtendon technique and those in whom the lesion was completed. The two groups were statistically similar. The respective medical records were analyzed as well as the identification of the applied technique, the postoperative results, and the related complications. The functional evaluation was performed using the score of the University of California at Los Angeles (UCLA). Results There was no statistically relevant difference between the groups, with a mean UCLA score of 32, and no difference in the time required for rehabilitation. Conclusion There was no difference between the clinical outcome of the patients, regardless of the technique used to repair the partial lesions of the articular part of the rotator cuff, with satisfactory results in 93% of the cases.

Resumo Objetivos Avaliar os resultados clínicos dos pacientes submetidos ao tratamento artroscópico da lesão parcial da porção articular do manguito rotador pelas técnicas de sutura transtendão e após completada a lesão e comparar o tempo de recuperação pósoperatório das duas técnicas. Método Estudo retrospectivo baseado na identificação de todos os casos com lesão parcial da porção articular do manguito rotador submetidos a tratamento artroscópico no período de outubro de 1999 a dezembro de 2016 pelo Grupo de Ombro e Cotovelo da nossa instituição. Foram incluídos 39 pacientes divididos em 2 grupos: os que foram submetidos à técnica transtendínea e os outros em que a lesão foi completada. Os dois grupos foram estatisticamente semelhantes. Foi realizada a análise dos respectivos prontuários, da identificação da técnica aplicada, dos resultados pós-operatórios e das complicações relacionadas. A avaliação funcional foi realizada através do escore da University of California at Los Angeles (UCLA). Resultados Não houve diferença estatisticamente relevante entre os grupos, com escore UCLA médio de 32, não havendo diferença também no tempo necessário para reabilitação. Conclusão Não houve diferença entre o resultado clínico dos pacientes, independente da técnica empregada para o reparo das lesões parciais da porção articular do manguito rotador com resultados satisfatórios em 93% dos casos.

Humans , Male , Female , Adult , Middle Aged , Aged , Medical Records , Retrospective Studies , Suture Techniques , Rotator Cuff Injuries
Rev. bras. ginecol. obstet ; 43(9): 655-661, Sept. 2021. tab
Article in English | LILACS | ID: biblio-1351776


Abstract Objective To describe the clinical experience with the B-Lynch technique in the management of postpartum hemorrhage as well as the factors related to the indication of the technique and to present the success rates of the application of the B-Lynch technique. Methods Observational, retrospective, cross-sectional, and analytical study. Patient data was obtained through the study of medical records. The study population comprised of patients who underwent hemostatic suture using the B-Lynch technique, including 104 patients within the period from January 1, 2005, to December 31, 2019. Results Of the total of 104 patients, 82.7% did not present any complications. Blood transfusion and intensive care unit admission were the most prevalent complications, with 13.5% and 15.4%, respectively. Only 1% of the patients had puerperal and surgical site infections. The factors most related to the application of the technique were the presence of previous cesarean section (30.8%), use of oxytocin (16.3%), and pre-eclampsia (11.6%). Puerperal hysterectomy was performed in 4.8% of the patients due to failure of the method. Conclusion The clinical experience with the B-Lynch technique was satisfactory since it presented few complications, with excellent results in hemorrhagic control. Previous cesarean section, the use of oxytocin, and preeclampsia stood out as factors related to the indication of the application of the technique, and the success rate in controlling postpartum hemorrhage was 95.2%.

Resumo Objetivo Descrever a experiência clínica com a técnica de B-Lynch no manejo da hemorragia pós-parto e os fatores relacionados à indicação da técnica bem como apresentar as taxas de sucesso da aplicação da técnica de B-lynch. Métodos Estudo observacional, retrospectivo, de corte transversal e analítico. Os dados foram obtidos por estudo de prontuário. A população do estudo foi constituída de pacientes submetidas à sutura hemostática com a técnica de B-Lynch, sendo incluídas 104 pacientes dentro do período de 01 de janeiro de 2005 a 31 de dezembro de 2019. Resultados Do total de 104 pacientes, 82,7% não apresentaram qualquer complicação. A transfusão de sangue e a internação na UTI foram as complicações mais prevalentes, com 13,5% e 15,4%, respectivamente. Apenas 1% teve infecção puerperal e do sítio cirúrgico. Os fatores mais relacionados com a aplicação da técnica foram a presença de cesárea anterior (30,8%), uso de ocitocina (16,3%) e pré-eclâmpsia (11,6%). A histerectomia puerperal foi realizada em 4,8% das pacientes por falha do método. Conclusão A experiência clínica com a técnica de B-Lynch foi satisfatória, pois apresentou poucas complicações, com excelentes resultados no controle hemorrágico. A cesárea anterior, o uso de ocitocina e a pré-eclâmpsia se destacaram como fatores relacionados à indicação da aplicação da técnica. A taxa de sucesso avaliada foi de 95,2%.

Humans , Female , Pregnancy , Postpartum Hemorrhage/surgery , Cesarean Section/adverse effects , Cross-Sectional Studies , Retrospective Studies , Suture Techniques
Rev. cuba. cir ; 60(2): e1075, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1280217


Introducción: La dehiscencia de la línea de sutura es una de las complicaciones más frecuentes en la cirugía intestinal. Objetivo: Diseñar una escala predictiva para estimar de forma individual la probabilidad de dehiscencia de la línea de sutura intestinal. Métodos: Se realizó un estudio, analítico, de cohorte con recogida retrospectiva de datos en el sexenio 2014-2019 en el hospital "Celia Sánchez Manduley". La muestra fue de 437 pacientes y se usó la variable dependiente: dehiscencia de la línea de sutura intestinal y variables independientes: edad, sexo, comorbilidad, hemoglobina, hipoalbuminemia, neoplasia de colon, riesgo anestésico, entre otras. Resultados: En el análisis multivariado se obtuvo un modelo ajustado con las variables: edad mayor de 70 años (p = 0,002), hipoalbuminemia (p = 0,014), anastomosis enterocólica (p = 0,018), cirugía urgente (p = 0,001) e íleo paralítico prolongado (p < 0,001). La escala predictiva fue derivada del modelo estadístico ajustado y clasificado en 3 grupos de riesgo la probabilidad de dehiscencia de la línea de sutura intestinal: bajo (menor de 2 puntos), moderado (entre 3 y 5 puntos) y elevado (mayor de 6 puntos). Presentó una sensibilidad de 89,6 por ciento, especificidad de 89,1 por ciento, porciento predictivo global de 89,2 por ciento, valor predictivo positivo de 66,1 por ciento y valor predictivo negativo de 97,2 por ciento. Tuvo una excelente calibración y un elevado poder discriminativo. Conclusión: Se obtuvo una escala predictiva para estimar de forma individual la probabilidad de dehiscencia de la línea de sutura intestinal(AU)

ABSTRACT Introduction: The suture line dehiscence is one of the most frequent complications in intestinal surgery. Objective: To design a predictive scale for estimating individual probability of suture line dehiscence. Methods: An analytical cohort study, which involved retrospective data collection, was carried out, in the six-year period of 2014-2019, at Celia Sánchez Manduley Hospital. The sample consisted of 437 patients. Dehiscence of the intestinal suture line was used as a dependent variable, while age, sex, comorbidity, hemoglobin, hypoalbuminemia, colon neoplasia, anesthetic risk, among others, were used as independent variables. Results: Through multivariate analysis, an adjusted model was obtained, with the following results for the variables: age over 70 years (P=0.002), hypoalbuminemia (P=0.014), enterocolic anastomosis (P=0.018), urgent surgery (P=0.001), and ileus prolonged paralytic (P < 0.001). The predictive scale was derived from the adjusted statistical model and, based on the probability of dehiscence of the intestinal suture line, classified into three risk groups: low (less than two points), moderate (between 3-5 points) and high (more than six points). It presented a sensitivity of 89.6 percent, a specificity of 89.1 percent, a global predictive percentage of 89.2 percent, a positive predictive value of 66.1 percent, and a negative predictive value of 97.2 percent. It had an excellent calibration and a high discriminative power. Conclusion: A predictive scale was obtained for estimating the individual probability of dehiscence of the intestinal suture line(AU)

Humans , Surgical Wound Dehiscence/complications , Intestinal Pseudo-Obstruction/therapy , Predictive Value of Tests , Suture Techniques/adverse effects , Data Collection , Retrospective Studies , Cohort Studies
Rev. bras. ciênc. vet ; 28(2): 81-85, abr./jun. 2021. il.
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1367208


Relata-se o caso de uma felina, sem raça definida, de oito meses de idade e 3,6 kg, com queixa de impotência funcional completa do membro pélvico esquerdo após trauma. A paciente apresentava aumento de volume em região do joelho, dor à palpação e instabilidade patelar. O diagnóstico de ruptura do ligamento patelar foi realizado com base nos resultados do exame ortopédico, juntamente com exame radiográfico e ultrassonográfico do joelho. O método utilizado para reparo da lesão foi a sutura em oito com fio de tetrafluorcabono associado à sutura interrompida simples para aproximação das bordas do ligamento. Durante a reavaliação de trinta dias pós-operatório, a paciente já apresentava melhora significativa, com atividade funcional completa do membro e ausência de dor.

We report the case of an eight-month-old, 3.6 kg, crossbred feline, complaining of complete functional impotence of the left pelvic limb after trauma. The patient presented swelling in the knee region, pain on palpation and patellar instability. The diagnosis of patellar ligament rupture was based on the results of the orthopedic examination, together with radiographic and ultrasound examinations of the knee. The method used to repair the lesion was eight-point suture with tetrafluorocabono thread associated with simple interrupted suture for approximation of the ligament edges. During the thirty-day postoperative reassessment, the patient already presented significant improvement, with complete functional activity of the limb. and absence of pain.

Animals , Cats , Rupture/veterinary , Cats/surgery , Patellar Ligament/surgery , Surgery, Veterinary/methods , Suture Techniques/veterinary , Knee/surgery
Rev. chil. ortop. traumatol ; 62(1): 19-26, mar. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1342598


OBJETIVO:Comparar el promedio de curva de presión de contacto y el porcentaje de presión de contacto residual final en la interfase tendón-huella de una reparación transósea (TO) realizada con nudos cruzados y una configuración Mason-Allen modificada (MAM). MÉTODOS: Se utilizaron ocho hombros de cordero para simular una rotura de manguito rotador. Se midió la presión con un sensor digital. Se registró la presión basal durante la aplicación de carga cíclica y al final de la intervención. Se compararon dos reparaciones: dos túneles TOs con nudos cruzados (TOCs) (n » 4) y dos puntos MAMs (n » 4) utilizando suturas MaxBraid #2 (Zimmer Biomet, Warsaw, IN, EEUU). Se realizaron 1.000 ciclos, con una frecuencia de 2 Hz y una carga de 30 N. Se utilizó el test de t de Student, y se consideraron significativos valores de p < 0,05. RESULTADOS: El promedio de curva de presión de contacto en las piezas que fueron reparadas con suturas TOCs fue de 86,01 8,43%, mientras que con MAM fue de 73,28 12,01% (p < 0,0004). El promedio del porcentaje residual al final del ciclado fue de 71,57% para suturas TOCs y de 51,19% para MAM (p < 0,05). CONCLUSION: La reparación TOC presenta mayor promedio de curva de presión de contacto y mayor porcentaje de presión de contacto residual final en la interfase tendón-huella que la reparación con sutura MAM luego de carga cíclica estandarizada, lo que podría traducirse en una mejor cicatrización del tendón. NIVEL DE EVIDENCIA: Estudio de ciencia básica.

OBJECTIVE: To compare the average contact pressure curve and the percentage of final residual contact pressure at the tendon-footprint interphase of a transosseous (TO) repair performed with crossover sutures or a modified Mason-Allen (MMA) configuration. METHODS: Eight lamb shoulders were used to simulate a rotator cuff tear. The pressure was measured with a digital sensor. The baseline pressure was recorded during the application of the cyclic load and at the end of the intervention. Two repairs were compared: 2 crossover TO (CTO) sutures (n » 4) and 2 MMA sutures MMA (n » 4), using MaxBraid #2 (Zimmer Biomet, Warsaw, IN, US) sutures. A thousand cycles were performed, with a frequency of 2 Hz and a 30-N load. The Student t-test was used, and significance was set at p < 0.05. RESULTS: The average contact pressure curve was of 86.01 8.43% for parts repaired with CTO sutures, and of 73.28 12.01% for those repaired with MMA sutures (p < 0.0004). The mean residual percentage at the end of cycling was of 71.57% for CTO sutures, and of 51.19% for MMA sutures (p < 0.05). CONCLUSION: The CTO repair shows a higher average contact pressure curve and a higher percentage of final residual contact pressure at the tendon-footprint interphase than the MMA suture repair after standardized cyclic loading, potentially resulting in improved tendon healing. LEVEL OF EVIDENCE: Basic Science Study.

Animals , Pressure , Suture Techniques , Rotator Cuff Injuries/surgery , Arthroscopy , Tendon Injuries/surgery , Sheep , Shoulder Injuries/surgery
Article in Chinese | WPRIM | ID: wpr-879459


OBJECTIVE@#To compare biomechanical characteristic of different high-strength sutures and suture sites for repairing posterior root tear of the medial meniscus with modified Mason-Allen technique.@*METHODS@#Forty-eight specimen of medial meniscus of knee joint from fresh porcine (female, aged from 5 to 9 months with an average of 7 months) were chosen and established experimental model. The samples were divided into red zone fixation group and red-white zone fixation group according to suture sites, 24 in each group; and then were randomly divided into 3 subgroups which 8 in each group, and fixed with Ethibond suture, Ultrabraid suture and FiberWire suture, respectively. Biomechanical tests were performedon universal electromagnetic and mechanical testing machine. Each specimen was underwent 1 000 cyclic tests on the first time, then pull out test until failure. The maximum failure load, yield load, stiffness and displacement were analyzed.@*RESULTS@#All specimen were successfully completed biomechanical tests. The failure mode of Ethibond group was caused by suture fracture; 6 cases of Ultrabraid suture group was caused by suture fracture which belong to red zone fixation group, 10 cases were caused by suture pull out, which 2 cases belong to red zone fixation group, 8 cases belong to red-white zone fixation group;8 cases of FiberWire group was caused by suture pull-out. Biomechanical test showed that:(1)In terms of suture strength, comparison of the maximum failure load, yield load and stiffness showed that Ethibond suture group

Animals , Biomechanical Phenomena , Female , Menisci, Tibial/surgery , Rupture/surgery , Suture Techniques , Sutures , Swine
Article in Chinese | WPRIM | ID: wpr-879390


Shoulder arthroscopic as a conventional method usually is applied to repair rotator cuff tears. In clinical, plenty single-row, double-row and transosseous tunnels suture technique are performed, but the ideal suture technique for rotator cuff repair is not found. Compared with single-row, double-row has better strength in biomechanics property. As the two best suture technique among the single-row, massive cuff stitch and modified Mason-Allen suture have the strongest biomechanics property. Clinical trials indicate that double-row could improve healing rates, but there are no significant difference in clinical outcome functional scores. Transosseous tunnel techniques possess a better bio-mechanic property, which could improve regional micro-environment and induce tendon-bone healing. Transosseous tunnel techniques are better for small to media size rotator cuff tears and osteoporosis patient. The author suggest that optimal rotator cuff repair technique should performed according to skill of performer and individual of patient by analysing bio-mechanic properties, clinical outcome, operative complexity and patient situation. The technique should follow simple opertaion, rapid, less trauma, stable fixation and utility to perform.

Arthroscopy , Humans , Rotator Cuff/surgery , Rotator Cuff Injuries/surgery , Suture Anchors , Suture Techniques , Sutures
Article in Chinese | WPRIM | ID: wpr-879381


OBJECTIVE@#To compare therapeutic efficacy of modified single-needle arthroscopic repair technique and Fast-Fix technique in repairing longitudinal meniscus injuries.@*METHODS@#From July 2016 to July 2017, patients with longitudinal meniscus injuries who underwent meniscal repair surgery were retrospectively analyzed. Ninety-one patients treated with modified single-needle technique and 77 patients were treated with Fast-Fix technique, the average age were (26.7±7.6) and (27.9±6.1) years old respectively, the average lengths of follow-up were (32.5±9.2) and (33.2±11.9) months, respectively. Operation cost, suture time, intraoperative failure rate and postoperative failure rate were used as clinical outcomes, MRI of knee joint was used as main diagnosis and evaluation basis; 2000 IKDC subjective score, Lysholm score and Tegner activity scale were compared between two groups preoperatively, 12 months after operation and at the latest follow-up. Intraoperative and postopertaive complications were observed.@*RESULTS@#Compared with Fast-Fix group, patients in modified single-needle technique group had lower operation costs [(645.7±133.1 vs.(12 184.8±4 709.8), @*CONCLUSION@#Modified single-needle arthrscopicrepair technique could achieve the similar therapeutic efficacy as Fast-Fix technique, and it has advantageds of simple opertion and more economical. This study recommends clinical application of modified single-needle arthrscopic repair technique in treating meniscus injuries.

Adult , Arthroscopy , Humans , Knee Injuries/surgery , Menisci, Tibial/surgery , Retrospective Studies , Suture Techniques , Tibial Meniscus Injuries/surgery , Treatment Outcome , Young Adult
Acta cir. bras ; 36(8): e360807, 2021. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1339012


ABSTRACT Purpose: To evaluate the impact of submersion of the microsurgical anastomosis suture area using saline (0.9% NaCl) in an experimental laboratory during the training of medical students and resident physicians. Methods: Wistar rats (n = 10) were selected to have the two femoral arteries sectioned and anastomosed end-to-end under optical magnification. They were randomly divided, so that on one side suturing was performed under submersion with saline, and the contralateral side was kept dry during the procedure. The surgical times, as well as the patency within 30 min and 72 h of the procedure, were evaluated. Results: Six male Wistar rats survived the surgical anesthetic procedure, with the average initial weight of 243.3 g and the average artery diameter of 0.86 mm, with average time of 15.67 min for the submerged technique and 20.50 min for the dry technique (p = 0.03). The failure rates were 17 and 50% for the submerged group and the dry one, respectively (p = 0.62). Conclusions: Submerged microvascular suture does not compromise the patency of the vessel or increase the time of anastomosis. Therefore, it is a strategy that can be applied by the surgeon according to his/her technical preferences.

Animals , Male , Female , Rats , Suture Techniques , Microsurgery , Surgical Procedures, Operative , Sutures , Vascular Patency , Anastomosis, Surgical , Rats, Wistar , Femoral Artery/surgery
Acta cir. bras ; 36(5): e360502, 2021. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1278107


ABSTRACT Purpose To evaluate the use of barbed sutures over the surgical time, the leukogram, the tissue thickness in which the sutures were employed (ultrasonography), the costs, and the possible complications in bitches with pyometra submitted to ovariohysterectomy (OH). Methods Convectional 2.0 polyglyconate suture was used in the control group (CG n = 10) and 2.0 barbed polyglyconate suture in the barbed group (BG n = 10) to perform celiorrhaphy (simple continuous pattern) and subcutaneous closure (continuous intradermal pattern). Data were assessed using paired (leukogram between 24 and 48 h within the same group) and unpaired (leukogram, surgical time, tissue thickness, and costs) Student's t-test. The Fisher exact test was used to assess the occurrence of seroma between groups (p < 0.05). Results are shown as mean ± standard error of mean. Results The time spent to perform the celiorrhaphy (195.30 ± 17.37 s vs. 204 ± 16.00 s), subcutaneous closure (174.0 ± 15.86 s vs. 198.0 ± 15.62 s), and the total surgical time (24.30 ± 1.44 min vs. 23.00 ± 1.30 min) did not differ between BG and CG, respectively (p > 0.05). Leukogram at 48 h post-surgery did not differ between groups (p = 0.20). No differences were observed in the subcutaneous and the abdominal wall thickness (cm) assessed by ultrasonography at 48 h in BG (0.31 ± 0.04, 0.80 ± 0.05) and CG (0.34 ± 0.03, 0.72 ± 0.06), respectively. Similarly, 15 days post-surgery the same structures did not differ between BG (0.26 ± 0.02, 0.74 ± 0.08) and CG (0.26 ± 0.03, 0.64 ± 0.05) (p > 0.05). In one bitch from each group, a mild seroma was observed on one side of the surgical wound 48 h after surgery (p = 1.00). The procedures in which barbed sutures were used had an average additional cost of R$ 200.00 ± 11.66 (p < 0.0001). Conclusions Barbed suture has proven to be efficient and safe for abdominal and subcutaneous closure. However, considering its current high cost in addition thatthe surgical time of bitches with pyometra undergone OH was not reduced, no advantages were observed with theuse of barbed sutures for this type of surgery.

Humans , Female , Abdominal Wall/surgery , Pyometra , Sutures , Suture Techniques , Operative Time
Article in Chinese | WPRIM | ID: wpr-921938


OBJECTIVE@#To investigate the clinical effect of arthroscopic fixation of tibial avulsion fracture of posterior cruciate ligament with a knot-free anchor and Endobuton titanium plate.@*METHODS@#From October 2019 to October 2020, 12 patients with tibial avulsion fracture of posterior cruciate ligament were treated with the arthroscopic knot-free anchor and Endobuton titanium plate, including 9 males and 3 females. The age ranged from 23 to 58 years old. The time from injury to operation ranged from 2 to 9 days. There were 2 cases of Meyers typeⅡand 10 cases of Meyers type Ⅲ. There were 2 cases of meniscus injury and 1 case of partial injury of medial collateral ligament. The fracture healing and knee range of motion were evaluated after operation, and the clinicalefficacy was evaluated by Lysholm function score.@*RESULTS@#All patients were followed up for 12 months. All patients healed within 6 months, and there were no complications such as incision infection, lower extremity deep venous thrombosis and internal fixation falling off. The knee flexion range of motion recovered from 50°-90° before operation to 115°-130° 6 months after operation, and no patient had straightening disorder. Lysholm functional score recovered from preoperative 29-54 scores to 86-100 scores 12 months after operation.@*CONCLUSION@#Arthroscopic reduction and fixation of tibial avulsion fracture of posterior cruciate ligament with the knot-free anchor and Endobuton titanium plate has less complications, high fracture healing rate, good extension and flexion angle and early function recovery of knee joint.

Adult , Arthroscopy , Female , Fractures, Avulsion/surgery , Humans , Knee Joint/surgery , Male , Middle Aged , Posterior Cruciate Ligament/surgery , Suture Techniques , Tibial Fractures/surgery , Titanium , Treatment Outcome , Young Adult
Article in Chinese | WPRIM | ID: wpr-921904


OBJECTIVE@#To explore clinical effect of arthroscopic meniscus tear strapping suture by rotator cuff suture threader.@*METHODS@#Forty patients with meniscus tear injury admitted from July 2015 to May 2019, including 27 males and 13 females, aged from 20 to 55 years old with an average of (36.0±1.4) years old. Menisci laceration was sutured with rotator cuff suture thread under arthroscopy. Postoperative complication was observed, Lysholm knee joint score before and after operation at 12 months were used to evaluate clinical effects, visual analogue scale (VAS) and range of knee flexion and extension were applied to evaluate recovery of pain and function.@*RESULTS@#All patients were followed up from 12 to 15 months with an average of (12.6±0.7) months.No complication such as joint effusion, suture failure occurred. Two patients occurred mild pain after activity without clinical physical abnormality, and 1 patient manifested moderate pain with joint space tenderness, the other rest without abnormal. Lysholm knee joint score was increased from (49.55±1.21) preoperatively to (98.95±0.42) at 12 months after operation, VAS score decreased from (5.18±0.78)preoperatively to (1.03±0.77) at 12 months after operation, and range of knee joint flexion and extension activity increased from (50.63±9.20)°preoperatively to (130.38±4.99)°after operation, and there were statistical differences in Lysholm knee joint score, VAS and range of knee joint flexion and extension activity (@*CONCLUSION@#Arthroscopic strapping suture by rotator cuff suture threading device applies to most meniscus injuries, including medial meniscus posterior horn tears, lateral meniscus body tears and lateral meniscus posterior horn tears. This technique meets the need of full-internal meniscus suture without specialmeniscus suture, and has advantages of convenient operation, less complications and good postoperative function.

Adult , Arthroscopy , Female , Humans , Male , Menisci, Tibial/surgery , Middle Aged , Rotator Cuff , Rotator Cuff Injuries/surgery , Suture Techniques , Sutures/adverse effects , Tibial Meniscus Injuries/surgery , Treatment Outcome , Young Adult