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1.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(5): 870-874, 2020 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-33047721

RESUMO

OBJECTIVE: To investigate the clinical effect of a modified arthroscopic outside-in suture technique in the treatment of meniscus tear using a spinal needle. METHODS: From January 2015 to October 2017, 95 patients treated with this method were followed-up. Among these cases, there were 36 males and 59 females. The age of the patients ranged from 16 to 77 years, (46.79±18.07) years in average. Among them, there were 28 patieats aged 16-35, 53 patients aged 36-65, and 14 patients aged over 65 years old. 28 cases were diagnosed with medial meniscus tear, 43 cases with lateral meniscus tear and 24 cases with both medial and lateral meniscus tear. Causes of the injury included sports, sprain, etc. According to Barrett standard, the clinical healing of meniscus tear was judged. Lysholm score, knee range of motion, visual simulation score (VAS) and magnetic resonance imaging (MRI) were used to evaluate the postoperative knee function and recovery of the patients. RESULTS: The 95 patients were followed up for 22 to 36 months, with an average of (28.32±3.98) months. According to Barrett standard, 90 patients (94.7%) obtained meniscus clinical healing. Meniscal healing rates were 96.43%, 96.23% and 85.71% in the three age groups, respectively. The meniscal healing rate was lower in the elderly group, but there was no significant difference in statistical results (P=0.262). Five patients had deep tenderness in the joint space of the injured side, and the overstretch test was positive. The preoperative and postoperative VAS scores, Lysholm scores and knee motion were compared in each group, and the differences were statistically significant (P < 0.01). At the end of the last follow-up, there were no cases of knee joint effusion, swelling and interlocking, and the joint function was effectively improved in most patients. No surgical site infection, periarticular vascular/nerve injury or knotting reaction was found during the follow-up. CONCLUSION: This modified arthroscopic outside-in suture technique using a spinal needle has the characteristics of simple operation, small trauma and rapid recovery, and the mid-term follow-up results were satisfactory. Therefore, we consider this method to be a safe and efficient method for the treatment of meniscus anterior horn and body tear.


Assuntos
Traumatismos do Joelho , Lesões do Menisco Tibial , Idoso , Artroscopia , Feminino , Seguimentos , Humanos , Traumatismos do Joelho/cirurgia , Masculino , Punções , Técnicas de Sutura , Lesões do Menisco Tibial/cirurgia
2.
Arthroscopy ; 36(9): 2498-2500, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32891250

RESUMO

No topic in meniscal surgery has generated as much interest over the past decade as meniscal root tears. These rather simple tears, if left untreated, act biomechanically equivalently to a complete meniscectomy. As a result, many investigators have championed the treatment of this injury through the innovation of various surgical techniques designed to restore the biomechanical function of the meniscus to prevent the long-term clinical effects of a complete meniscectomy. Most procedures to repair the posterior meniscal root to its tibial attachment can be broadly grouped into using either a suture anchor or a transtibial bone tunnel for tibial fixation. There are obvious pros and cons to both methods, and most surgeons become comfortable with one "go-to" technique depending on their level of experience with meniscal root repair and their comfort level with various arthroscopic techniques. Most surgeons prefer the transtibial technique in which the sutured meniscus is anchored to its anatomic tibial attachment via a tunnel through which the sutures pass before being secured with either a suture anchor or screw post to the anterior tibial cortex. This technique has considerable biomechanical and clinical evidence to support its use. Unfortunately, there are drawbacks to the transtibial method that must be considered, such as the technical difficulties of accurately and safely drilling the tibial tunnel, the risk of suture failure or attenuation through the tunnel, and the challenge associated with placement of the tunnel in the setting of a concurrent anterior cruciate ligament reconstruction. Therefore, further advances in meniscal root repair are always welcomed by the arthroscopic community. However, as with any surgical innovation, 3 factors must be considered before a new repair procedure can be widely recommended: (1) it must be technically "doable" by most surgeons treating the clinical problem; (2) it must have biomechanical evidence to support its use; and (3) it must result in clinical outcomes that are at least as good as, and preferably better than, current techniques.


Assuntos
Ligamento Cruzado Posterior , Lesões do Menisco Tibial/cirurgia , Humanos , Meniscos Tibiais/cirurgia , Técnicas de Sutura , Suturas
3.
Khirurgiia (Mosk) ; (8): 61-68, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32869617

RESUMO

OBJECTIVE: To analyze an opinion of surgeons on advisability, efficacy and choice of topical hemostatic agents. MATERIAL AND METHODS: The research was based on anonymous questioning of surgeons. The questionnaires were developed by using of interactive Google Forms tool (https://www.google.ru/forms). Distribution of questionnaires and invitation of respondents to participation in research were carried out through the Internet. RESULTS: The study enrolled 135 surgeons. Colleagues with considerable experience and length of surgical practice prevailed: 10-15 years - 16 people; 15-20 years - 22 people; over 20 years - 38 people. Opinion of less experienced surgeons was also considered: less than 5 years - 40 people; 5-10 years - 19 people. General surgeons prevailed (49%). Hemostatic sutures (30%) and application of topical hemostatic agents (27%) were the most common methods to stop parenchymal bleeding. Efficacy of local hemostatics is confirmed by small number of cases of recurrent intraoperative bleeding (n=24). Thirty-four respondents reported recurrent bleeding after hemostasis by conventional methods. Postoperative suppuration of hemostatic implant was noted by 9.5% of respondents. Most respondents (77%) prefer combination of hemostatic implants and other traditional methods of hemostasis. CONCLUSION: According to surgeons' opinion, local hemostatic agents are effective for parenchymal bleeding. This method may be used as basic (injury grade I by E. Moore classification) or additional method of hemostasis (grade I-III). Many respondents consider that application of topical hemostatic agent after imposing hemostatic sutures ensures the greatest efficiency of hemostasis. Moreover, placement of the agent over or under sutures seems to be the most advisable.


Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Hemostasia Cirúrgica/métodos , Hemostáticos/administração & dosagem , Técnicas de Sutura , Administração Tópica , Pesquisas sobre Serviços de Saúde , Humanos , Internet , Recidiva
4.
Middle East Afr J Ophthalmol ; 27(2): 110-116, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32874044

RESUMO

PURPOSE: The purpose is to compare the clinical results of using silk versus nylon sutures for conjunctival autograft suturing in pterygium surgery. METHODS: In this prospective, randomized, controlled, clinical trial 50 eyes from 50 patients with primary nasal pterygium were randomized to undergo pterygium surgery with the use of either nylon sutures or silk sutures for conjunctival autograft suturing. Patients were followed up for 6 months. Main outcome measures included recurrence, postoperative discomfort according to a visual analog scale (VAS), graft hyperemia, and graft edema. RESULTS: According to the results, there was no significant difference between groups regarding recurrence rate of pterygium (P = 0.72). A significant decrease in the mean VAS discomfort score from day 1 to day 14 was observed in both groups (P = 0.001); postoperative discomfort during the first 2 weeks, was not significantly different between the two groups. At 2 weeks' postoperatively, significantly greater number of nylon sutures remained on the autograft (P = 0.021), some of which were buried and could not be removed. CONCLUSION: Both silk and nylon are effective suture materials for autograft suturing in pterygium surgery with similar postoperative discomfort and recurrence rate. Significantly greater number of nylon sutures remains buried on the autograft and could not be removed easily.


Assuntos
Túnica Conjuntiva/transplante , Nylons , Pterígio/cirurgia , Seda , Técnicas de Sutura , Suturas , Adulto , Idoso , Idoso de 80 Anos ou mais , Autoenxertos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Oftalmológicos/métodos , Período Pós-Operatório , Estudos Prospectivos , Recidiva , Transplante Autólogo , Resultado do Tratamento
5.
Medicine (Baltimore) ; 99(38): e21237, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957304

RESUMO

Arthroscopic techniques are considered the gold standard for treatment of displaced avulsion fractures of the anterior cruciate ligament. However, most arthroscopic surgical techniques and fixation methods are technically demanding and require removal of hard implant. This report describes a new, easy, safe, and all-arthroscopic method for reduction and fixation of displaced tibial intercondylar eminence fractures by using 1 anchor and 1 Pushlock.From January 2015 to June 2017, 8 adult patients with type II and III displaced tibial intercondylar eminence fractures were operated using this technique. Clinical assessment included patient demographics, cause of injury, delay before surgery, operation time, time to return to work and sport, International Knee Documentation Committee scores, and Lysholm knee scores.The average operation time was 48 minutes. The average follow-up period was 12.5 months. At the 6-month follow-up, all patients had acquired fracture union and complete functional recovery and were able to return to work. International Knee Documentation Committee objective scores and Lysholm knee scores were 92.4 (range 88-94) and 93.6 (range 90-96), respectively. At the last follow-up, anterior drawer, Lachman's test, and pivot shift tests were negative, and all patients had returned to their preinjury activity levels.Arthroscopic fixation by use of 1 anchor and 1 Pushlock is an easy, safe, and minimally invasive technique for treatment of displaced tibial intercondylar eminence fractures and does not require further surgery to remove fixation devices.Level of Evidence: Level IV, therapeutic case series.


Assuntos
Ligamento Cruzado Anterior/cirurgia , Artroscopia/métodos , Tíbia/cirurgia , Adulto , Feminino , Fixação Interna de Fraturas , Humanos , Masculino , Duração da Cirurgia , Amplitude de Movimento Articular , Retorno ao Trabalho , Fatores Socioeconômicos , Técnicas de Sutura , Tempo para o Tratamento
6.
J Craniomaxillofac Surg ; 48(10): 1004-1008, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32873466

RESUMO

AIM AND OBJECTIVE: This study was aimed to compare the effectiveness of 3-0 knotless barbed suture (polydioxanone) with 4-0 polyglactin 910 (vicryl) in achieving wound closure after impacted mandibular third molar surgery. MATERIALS AND METHODS: Patients with bilateral mandibular third molar impaction of similar difficulty index enrolled in the split mouth study. Wound closure was done using 3-0 knotless suture (30 × 30 cm) for the study group and 4-0 polyglactin 910 (vicryl) for the control group following extraction. Samples were allocated on the basis of simple randomization. The clinical outcome parameters that were measured were (1) time taken to achieve wound closure and hemostasis (2) postoperative mouth opening (3) swelling and (4) Pain. Data analysis involved descriptive statistics and paired t-tests (p < 0.05). IBM SPSS software (v.20.0) was used. RESULT: A total of 25 patients participated in the study (14 males and 11 females) with the mean age of 25.6 years. The mean time taken for wound approximation was 2.45 min and 4.1480 min (p-0.026) for the study and control groups respectively. The difference in mouth opening (p-0.015), VAS score(p-0.24), and swelling (p-0.041) were statistically significant on the first post-operative day in the study group than the control group indicating reduction in pain (p < 0.0001), swelling (p-0.033) and improvement in mouth opening (p < 0.0001) on seventh post-operative day in the study group compared to the control group. CONCLUSION: Knotless suture is an effective alternative to conventional sutures for intra oral wound closure as it reduces suturing time, facilitates effective wound closure and minimises knot related complications.


Assuntos
Dente Serotino/cirurgia , Dente Impactado/cirurgia , Adulto , Edema/etiologia , Edema/prevenção & controle , Feminino , Humanos , Masculino , Boca , Técnicas de Sutura , Suturas
7.
Tokai J Exp Clin Med ; 45(3): 131-135, 2020 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-32901901

RESUMO

Retained products of conception (RPOC) refer to the persistence of placental or fetal tissue in the uterus following delivery or miscarriage. RPOC may cause massive postpartum or post-abortion hemorrhage. Arterial embolization (AE) is an effective choice of management for postpartum hemorrhage including RPOC. We report a case of hemorrhagic RPOC, in which uterine artery embolization with transcervical resection did not achieve hemostasis, and laparotomy with uterine compression sutures was subsequently required. The RPOC was apparently fed by an aberrant branch derived from the inferior mesenteric artery (IMA). AE of IMA was not performed because of possible necrosis of the descending colon and rectum. A physician should be aware that AE is not an all-encompassing hemostatic technique for postpartum bleeding, such as with RPOC, and should keep alternatives in mind.


Assuntos
Hemostasia Cirúrgica/métodos , Laparotomia/métodos , Artéria Mesentérica Inferior , Complicações do Trabalho de Parto/etiologia , Complicações do Trabalho de Parto/cirurgia , Placenta Retida/cirurgia , Hemorragia Pós-Parto/etiologia , Hemorragia Pós-Parto/cirurgia , Técnicas de Sutura , Útero/cirurgia , Adulto , Colo/patologia , Contraindicações , Feminino , Humanos , Angiografia por Ressonância Magnética , Necrose , Complicações do Trabalho de Parto/diagnóstico por imagem , Placenta Retida/diagnóstico por imagem , Hemorragia Pós-Parto/diagnóstico por imagem , Gravidez , Reto/patologia , Tomografia Computadorizada por Raios X , Embolização da Artéria Uterina/efeitos adversos
8.
Am J Vet Res ; 81(10): 821-826, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32969726

RESUMO

OBJECTIVE: To evaluate holding security of 4 friction knots created with various monofilament and multifilament sutures in a vascular ligation model. SAMPLE: 280 friction knot constructs. PROCEDURES: 10 friction knots of 4 types (surgeon's throw, Miller knot, Ashley modification of the Miller knot, and strangle knot) created with 2-0 monofilament (polyglyconate, polydioxanone, poliglecaprone-25, and glycomer-631) and braided multifilament (silk, lactomer, and polyglactin-910) sutures were separately tied on a mock pedicle and pressure tested to the point of leakage. Linear regression analysis was performed to compare leakage pressures among suture materials (within friction knot type) and among knot types (within suture material). RESULTS: Mean leakage pressure of surgeon's throws was significantly lower than that of all other knots tested, regardless of the suture material used. All the other knots had mean leakage pressures considered supraphysiological. Significant differences in mean leakage pressure were detected between various friction knots tied with the same type of suture and various suture types used to create a given knot. Variability in leakage pressure among knots other than the surgeon's throw was greatest for poliglecaprone-25 and lowest for polydioxanone. CONCLUSIONS AND CLINICAL RELEVANCE: Most differences in knot security, although statistically significant, may not have been clinically relevant. However, results of these in vitro tests suggested the surgeon's throw should be avoided as a first throw for pedicle ligation and that poliglecaprone-25 may be more prone to friction knot slippage than the other suture materials evaluated.


Assuntos
Técnicas de Sutura/veterinária , Suturas/veterinária , Animais , Fricção , Polidioxanona , Poliglactina 910 , Resistência à Tração
9.
Am J Vet Res ; 81(10): 827-831, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32969730

RESUMO

OBJECTIVE: To compare initial leak pressure (ILP) between cadaveric canine and synthetic small intestinal segments that did and did not undergo enterotomy. SAMPLE: Eight 8-cm grossly normal jejunal segments from 1 canine cadaver and eight 8-cm synthetic small intestinal segments. PROCEDURES: Intestinal segments were randomly assigned to undergo enterotomy (6 cadaveric and 6 synthetic segments) or serve as untreated controls (2 cadaveric and 2 synthetic segments). For segments designated for enterotomy, a 2-cm full-thickness incision was created along the antimesenteric border. The incision was closed in a single layer with 4-0 suture in a simple continuous pattern. Leak testing was performed with intestinal segments occluded at both ends and infused with dilute dye solution (999 mL/h) until the solution was observed leaking from the suture line or serosal tearing occurred. Intraluminal pressure was continuously monitored. The ILP at construct failure was compared between cadaveric and synthetic control segments and between cadaveric and synthetic enterotomy segments. RESULTS: Mean ± SD ILP did not differ significantly between cadaveric (345.11 ± 2.15 mm Hg) and synthetic (329.04 ± 24.69 mm Hg) control segments but was significantly greater for cadaveric enterotomy segments (60.77 ± 15.81 mm Hg), compared with synthetic enterotomy segments (15.03 ± 6.41 mm Hg). CONCLUSIONS AND CLINICAL RELEVANCE: Leak testing should not be used to assess the accuracy or security of enterotomy suture lines in synthetic intestinal tissue. Synthetic intestinal tissue is best used for students to gain confidence and proficiency in performing enterotomies before performing the procedure on live animals.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/veterinária , Doenças do Cão , Anastomose Cirúrgica/veterinária , Animais , Cadáver , Cães , Pressão , Técnicas de Sutura/veterinária , Suturas
10.
Klin Monbl Augenheilkd ; 237(9): 1079-1086, 2020 Sep.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-32967032

RESUMO

Iris and lens injuries entail a large spectrum and occur in closed and open globe injuries. Depending on accompanying ocular trauma (e.g. corneal involvement) as well as on the extend of the injuries several different surgical options are available ranging from suturing techniques to special individualized implants. The aim of this article is to present and discuss current treatment options for lens and iris trauma in regards to typical cases.


Assuntos
Traumatismos Oculares/cirurgia , Cristalino/cirurgia , Humanos , Iris/cirurgia , Implante de Lente Intraocular , Técnicas de Sutura
11.
Mymensingh Med J ; 29(3): 652-658, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32844808

RESUMO

This prospective comparative study was done to compare the outcome of stapled closure of the duodenal stump with hand-sewn closure during gastric resection in terms of total operating time, postoperative duodenal stump leakage, postoperative hospital stay, and surgical cost. This study was conducted from January 2013 to August 2014. Patients who were admitted to the Department of Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh with the indication of distal or total gastrectomy were included in the study. A total of 32 patients were enrolled in this study with 16 in each group, they were divided either into Group I (Hand Sewn) or Group II (stapling). Mean±SD age of Group I was 53.38±8.69 and Group II was 50.88±9.56 (p=0.445). Male patients were predominant than the female with a male: female ratio being 3.57:1. Mean±SD total operating time was 154.38±16.32 minutes and 136.88±17.40 minutes in Group I and Group II respectively (p=0.001). In Group I, 2(12.5%) patients and in Group II, 1(6.3%) patient had duodenal stump leakage which showed no statistically significant difference (p=0.999). Postoperative hospital stay had no statistically significant difference (p=0.923). The surgical cost had a significant difference (p=0.001) which is more in Group II. This study showed there was a significant reduction in total operating time but there was no significant difference in occurring of duodenal stump leakage or postoperative hospital stay. However, use of stapler hastens the surgeon's job and it relieves extra pressure of them.


Assuntos
Duodeno , Gastrectomia , Anastomose Cirúrgica , Bangladesh , Feminino , Humanos , Masculino , Complicações Pós-Operatórias , Estudos Prospectivos , Estudos Retrospectivos , Grampeamento Cirúrgico , Técnicas de Sutura
12.
J Craniomaxillofac Surg ; 48(9): 832-838, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32736835

RESUMO

The aim of this retrospective study was to evaluate the relationships between upper jaw movements and nasal soft-tissue changes in patients who have undergone subspinal Le Fort I osteotomy combined with alar cinch suture. Single and multivariate linear regression analyses were used to examine the relationships between greatest inter-alar width (GAW) and maxillary advancement, maxillary impaction, and rotational movements. The database of our referral hospital was searched for patients who had undergone upper jaw surgery with a subspinal LFI osteotomy to correct dentoskeletal deformities between April 2012 and June 2016. Thirty-eight of the patients (15 men and 23 women) who were identified were eligible for inclusion. The average change in inter-alar width (ΔGAW) was +1.7 ± 1.2 mm. GAW increased by 0.3 mm (p < 0.0001) for each millimetre of maxillary advancement, and increased by 0.5 mm (p < 0.0001) for each millimetre of maxillary impaction. GAW increased by 0.2 mm for each degree of counterclockwise rotation of the occlusal plane (p < 0.0001). An analysis of our data compared with the current literature confirmed that subspinal Le Fort I combined with alar cinch suture reduced alar base widening.


Assuntos
Cartilagens Nasais/cirurgia , Osteotomia de Le Fort , Cefalometria , Feminino , Humanos , Masculino , Maxila/cirurgia , Estudos Retrospectivos , Técnicas de Sutura , Suturas
13.
Medicine (Baltimore) ; 99(34): e21573, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846766

RESUMO

This study aimed to investigate the effectiveness of tendon suture fixation versus cortical screw fixation for the treatment of distal tibiofibular syndesmosis injury.This study recruited 42 patients with Danis-Weber type B, C1 and C2 fractures concomitant with lower tibiofibular syndesmosis injury, who were randomly assigned to 2 groups according to treatment with cortical screw fixation (n = 21) and tendon suture fixation (n = 21). Operation time, intraoperative blood loss, time to full weight-bearing activity, medical cost, ankle function, and ankle pain were compared between the 2 groups.The operation time was significantly less with cortical screw fixation (57.1 ±â€Š5.3 min) than with tendon suture fixation (63.3 ±â€Š6.3 min; p = 0.01), but there was no significant difference in intraoperative blood loss. The time until full weight-bearing was possible was significantly longer after cortical screw fixation (10.9 ±â€Š2.7 weeks) than after tendon suture fixation (7.1 ±â€Š1.9 weeks; P < .001). The medical cost was much greater for cortical screw fixation (1861.6 ±â€Š187.3 USD) than for tendon suture fixation (1209.6 ±â€Š97.6 USD; P < .01). The rate of excellent and good ankle function at 3 months after surgery was significantly higher with tendon suture fixation (71.4%) than with cortical screw fixation (33.3%; P = .03).Tendon suture fixation is associated with quicker recovery of ankle function, shorter time to full weight-bearing, and lower medical cost to the patient compared with screw fixation. Our findings suggest that tendon suture fixation is an effective method for the treatment of tibiofibular syndesmosis injury.


Assuntos
Traumatismos do Tornozelo/cirurgia , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Adulto , Parafusos Ósseos , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas de Sutura , Adulto Jovem
14.
Medicine (Baltimore) ; 99(34): e21867, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846841

RESUMO

BACKGROUND: Barbed suture is a novel type of suture introduced in different surgical specialties. Nevertheless, its effect in total knee replacement is still unclear in terms of wound complications and cost effectiveness. The purpose of the present work is to evaluate the safety and efficacy of bidirectional barbed suture in reducing postoperative wound complications in the patients undergoing total knee replacement. METHODS: This prospective, randomized, and controlled study was performed from January 2017 to December 2018. It was authorized via institutional review committee of Yuebei People's Hospital (GDYB1002189). Hundred participants were divided randomly into 2 groups, namely, control group (n = 50) and the study group (n = 50), respectively. All operations were performed using the Miller-Galante prosthesis (Zimmer; Warsaw, IN). For study groups, the joint capsule (Stratafix1-0) and subcutaneous (Stratafix2-0) and intracutaneous (Stratafix3-0) tissues were sutured by a bidirectional barbed suture. At the end, extra 4 to 5 stitches were made to avoid detachment and incision rupture. For control group: the joint capsule was sutured by a traditional absorbable suture (Ethicon VICRYL* Plus 1-0), and the subcutaneous tissue was sutured by an absorbable suture (Ethicon VICRYL* Plus 2-0). The skin was sutured by staples. Incision length, suture time, operation time, postoperative length of hospital stay, and incision complications (such as effusion, infection, hematoma, and skin necrosis) were recorded. All data analyses are implemented through utilizing SPSS for Windows Version 20.0. RESULTS: The results will be shown in Table 1. CONCLUSION: This study can reach a reliable evidence for utilizing bidirectional barbed suture in wound closure in total knee replacement. TRIAL REGISTRATION: This study protocol was registered in Research Registry (researchregistry5823).


Assuntos
Artroplastia do Joelho/métodos , Complicações Pós-Operatórias/prevenção & controle , Suturas/efeitos adversos , Cicatrização/fisiologia , Idoso , Idoso de 80 Anos ou mais , Artroplastia do Joelho/efeitos adversos , Análise Custo-Benefício , Humanos , Cápsula Articular/cirurgia , Tempo de Internação/estatística & dados numéricos , Pessoa de Meia-Idade , Duração da Cirurgia , Complicações Pós-Operatórias/patologia , Estudos Prospectivos , Segurança , Tela Subcutânea/cirurgia , Grampeamento Cirúrgico/efeitos adversos , Técnicas de Sutura/tendências , Suturas/tendências , Resultado do Tratamento
16.
Harefuah ; 159(8): 570-574, 2020 Aug.
Artigo em Hebraico | MEDLINE | ID: mdl-32852156

RESUMO

INTRODUCTION: The use of sutures is a common practice in plastic surgical procedures. The potential risk of developing an allergic reaction to suture materials exists. To the best of the authors' knowledge, this is the first case reported in the literature of such a reaction in aesthetic breast surgery. The aim of this review is to raise the awareness of possible allergic and infective or inflammatory reactions to the suture material and to expand the knowledge of the management and interventions which are critical for patient safety and satisfaction. More research is needed to study this challenging topic.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos , Cirurgia Plástica , Suturas , Humanos , Mastectomia , Técnicas de Sutura
17.
Kyobu Geka ; 73(7): 539-542, 2020 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-32641674

RESUMO

In this report, chest drain wound closure using barbed suture material in patients with thoracic disease is presented. From October to December 2019, 77 patients underwent thoracic surgery and closed chest drain wound using barbed suture material. Of them,( median age 67 years, range 16 to 89 years) 51 were men (66%) and 26 were women. Most was 50 cases of primary lung cancer (65%). Chest tube was inserted after continuous subcutaneous suture by barbed suture material. The mean chest tube duration was 2.3±0.6. No harmful events due to this procedure nor wound complication during the median follow-up period of 1 months after operation were noted.


Assuntos
Tubos Torácicos , Técnicas de Sutura , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Drenagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Suturas , Resultado do Tratamento , Adulto Jovem
19.
Zhonghua Wai Ke Za Zhi ; 58(8): 608-613, 2020 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-32727192

RESUMO

Objective: To compare the wound healing time, Surgical site infection (SSI) rate and other postoperative outcomes between the gunsight closure and purse-string closure technique in loop stoma closure. Methods: Between November 2013 and December 2017, a total of 143 patients who underwent gunsight stoma reversal were included in this multicenter prospective randomized controlled trial. The patients were randomized to undergo gunsight (gunsight group, n=72) or purse-string closure technique (purse-string group, n=71). The primary endpoint was wound healing time. The second endpoints were the incidence of SSI, morbidity, and patient satisfaction. Statistical analysis between groups was performed using the t-test, repeated measures analysis of variance, Mann-Whitney U test, χ(2) test or Fisher's exact test. Results: There were 45 males and 27 females with age of 67 (11) (M(Q(R))) years in gunsight group, 42 males and 29 females with age of 65 (20) years in purse-string group. The body mass index, American Society of Anesthesiologist classification, comorbidities, primary diagnosis, the type of ostomy, intraoperative blood loss, perioperative complications, postoperative hospital stay, hospitalization cost, SSI rate and incisional hernia (stoma site) between the 2 groups were not significantly different (P>0.05). Although had a statistically longer operating time (80(10) minutes vs. 70(10) minutes, Z=-2.381, P=0.017), patients who underwent gunsight procedure and a significantly shorter wound healing time (17(2) days vs. 25(4) days, Z=-10.199, P<0.01), higher patient satisfaction score with regards to wound healing time (3(1) vs. 3(1), Z=-4.526, P<0.01), and higher total patient satisfaction score (25(3) vs. 25(3), Z=-2.529, P=0.011) compared with those who underwent purse-string procedure. Conclusions: The gunsight and purse-string techniques are effective procedures for stoma reversal and both have low SSI rate. The gunsight technique is associated with shorter wound healing time, higher levels of patient satisfaction compared with purse-string technique, and is recommended as the closure technique of choice.


Assuntos
Técnicas de Fechamento de Ferimentos Abdominais , Enterostomia/efeitos adversos , Técnicas de Fechamento de Ferimentos Abdominais/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Enterostomia/métodos , Feminino , Humanos , Hérnia Incisional/etiologia , Hérnia Incisional/prevenção & controle , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Estudos Prospectivos , Estomas Cirúrgicos/efeitos adversos , Infecção da Ferida Cirúrgica/etiologia , Técnicas de Sutura , Fatores de Tempo , Cicatrização
20.
Zhonghua Wai Ke Za Zhi ; 58(8): 631-635, 2020 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-32727196

RESUMO

Objective: To examine the short-term outcomes of modified load-sharing rip-stop repair (mLSRS) and suture-bridge repair (SB) for large rotator cuff tear. Methods: The clinical data of patients who underwent shoulder arthroscopy for large rotator cuff repair at Department of Orthopedic, China Academy of Chinese Medical Sciences Wang Jing Hospital from January 2017 to December 2018 were collected. Totally 111 patients (39 in mLSRS group and 72 in SB group) were included in the study. There were 45 males and 66 females, aged (58.0±6.9)years (range: 40 to 72 years).A total of 39 pairs of patients were successfully matched by propensity score matching. The pain of shoulder joint was assessed by visual analogy score (VAS) , the shoulder function was assessed by Constant-Murley score, the abduction strength of bilateral shoulder joint was assessed by 90˚ force assessment method of upper limb on the plane of scapula, and the healing of rotator cuff on the operative side was assessed by sugaya ultrasonic classification standard. The difference of short-term outcome between the two groups were compared using t test, χ(2) test, Mann-Whitney U test, repeated measures design anova and multivariate analysis of variance. Results: At the 4th week after surgery, the VAS of mLSRS group was significantly lower than SB group(1 (2) vs. 2 (2) , F=5.32, P=0.02). One year after surgery, Constant-Murley score of two groups were significantly higher than those before surgery, but there was no significant difference between two groups(89.1±5.7 vs. 87.6±7.3, t=1.00, P=0.32). Abductor strength of affected limbs were lower than that of the opposite side, but there were no statistically significant differences between two groups(4.28±1.61 vs. 4.54±1.64, t=-0.70, P=0.49). According to the Sugaya classification, 32 cases in mLSRS group were healed while 7 cases were not healed,30 cases in SB group were healed while 9 cases were not healed(χ(2)=0.32, P=0.58). Conclusion: The use of mLSRS fixation construct on large rotator cuff tear can reduce pain and the short-term outcome is reliable.


Assuntos
Lesões do Manguito Rotador/cirurgia , Técnicas de Sutura , Adulto , Idoso , Artralgia/diagnóstico , Artralgia/etiologia , Artralgia/cirurgia , Artroscopia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Pontuação de Propensão , Amplitude de Movimento Articular , Manguito Rotador/cirurgia , Articulação do Ombro/cirurgia , Resultado do Tratamento
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