			Home About us Contact

Absorbable Sutures (absorbable + suture)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Equal Cosmetic Outcomes with 5-0 Poliglecaprone-25 Versus 6-0 Polypropylene for Superficial Closures

DERMATOLOGIC SURGERY, Issue 7 2010
LAURA B. ROSENZWEIG MD
BACKGROUND Cutaneous sutures should provide an aesthetically pleasing result. After placing subcutaneous sutures, enough absorbable suture often remains for the superficial closure. Mohs surgeons often use a nonabsorbable suture to close the superficial layer to obtain cosmetically elegant results, but using this additional suture is less cost effective than using the remaining absorbable suture. OBJECTIVES To compare the cosmetic results of simple running sutures using an absorbable suture material (5-0 poliglecaprone-25) with those of a nonabsorbable suture (6-0 polypropylene) in primary closures of suitable facial Mohs defects. MATERIALS AND METHODS Fifty-two patients with 57 facial Mohs surgery defects appropriate for multilayer primary repair had the defects prospectively randomized into a side-by-side comparison. After closure of the deep layers with 5-0 poliglecaprone-25 sutures, half of the wound was closed with a 5-0 poliglecaprone-25 simple running suture, and the other half of the wound was closed with a 6-0 polypropylene simple running suture. The investigators blindly determined the cosmetically superior side of the closure at 1 week and 4 months after suture removal. RESULTS Forty-four patients (48 total defects) completed the study. At the 4-month follow-up, 85% (41/48) did not show any difference between poliglecaprone-25 and polypropylene, 4% (2/48) had better outcomes with poliglecaprone-25, and 10% (5/48) had better outcomes with polypropylene. There was no statistically significant cosmetic difference between the two closure types. Wound complications such as infection, hematoma, and dehiscence did not occur in any of the patients. CONCLUSION In primary closures of facial defects, using 5-0 poliglecaprone-25 or 6-0 polypropylene for the superficial closure did not affect the cosmetic result. Therefore, 5-0 poliglecaprone-25 provides a comparable and cost-effective alternative to nonabsorbable sutures for epidermal approximation in layered closures. The authors have indicated no significant interest with commercial supporters. [source]

Frequency of Use of Suturing and Repair Techniques Preferred by Dermatologic Surgeons

DERMATOLOGIC SURGERY, Issue 5 2006
BETH ADAMS MD
BACKGROUND There are many closure techniques and suture types available to cutaneous surgeons. Evidence-based data are not available regarding the frequency of use of these techniques by experienced practitioners. OBJECTIVE To quantify, by anatomic site, the frequency of use of common closure techniques and suture types by cutaneous surgeons. METHOD A prospective survey of the members of the Association of Academic Dermatologic Surgeons that used length-calibrated visual-analog scales to elicit the frequency of use of specific suture techniques. RESULTS A response rate of 60% (61/101) indicated reliability of the received data. Epidermal layers were closed most often, in descending order, by simple interrupted sutures (38,50%), simple running sutures (37,42%), and vertical mattress sutures (3,8%), with subcuticular sutures used more often on the trunk and extremities (28%). The most commonly used superficial sutures were nylon (51%) and polypropylene (44%), and the most common absorbable suture was polyglactin 910 (73%). Bilayered closures, undermining, and electrocoagulation were used, on average, in 90% or more sutured repairs. The median diameters (defined as longest extent along any axis) of most final wound defects were 1.1 to 2.0 cm (56%) or 2.1 to 3.0 cm (37%). Fifty-four percent of wounds were repaired by primary closure, 20% with local flaps, and 10% with skin grafting, with the remaining 15% left to heal by second intent (10%) or referred for repair (5%). Experience-related differences were detected in defect size and closure technique: defects less than 2 cm in diameter were seen by less experienced surgeons, and defects greater than 2 cm by more experienced surgeons (Wilcoxon's rank-sum test: p=.02). But more experienced surgeons were less likely to use bilayered closures (r=,0.28, p=.036) and undermining (r=,0.28, p=.035). CONCLUSIONS There is widespread consensus among cutaneous surgeons regarding optimal suture selection and closure technique by anatomic location. More experienced surgeons tend to repair larger defects but, possibly because of their increased confidence and skill, rely on less complicated repairs. [source]

GS27P TECHNIQUES FOR CLOSURE OF MIDLINE ABDOMINAL INCISIONS

ANZ JOURNAL OF SURGERY, Issue 2007
A. Ali
Background A recent meta-analysis of randomised controlled trials of abdominal fascial closures concluded that in order to reduce incisional hernia rates without increasing wound pain, or the rate of dehiscence slowly absorbable continuous sutures appear to achieve the best results in abdominal fascial closures. We surveyed the techniques for abdominal fascial closure among general surgeons in Canberra, Australia. Methodology 49 out of 80 surgeons responded to the survey by form. The information collected included the seniority of the surgeon, the frequency of laparotomy closure, surgical technique and suture material utilised in abdominal fascial closure. Results 34 (69%) of the surgeons surveyed preferred a non-absorbable monofilament suture material for abdominal fascial closure with nylon being the most popular. Most (38, 78%) also preferred a non-absorbable monofilament suture in emergency surgery. 12 (24%) surgeons preferred to use slowly absorbable suture. The majority of surgeons (37, 76%) preferred continuous suture technique, whilst only 2 (4%) used continuous followed by interrupted suture closures. Only 5 (10%) complied with the dual recommendation of continuous suture technique and slowly absorbable suture. Conclusion The majority of surgeons preferred non-absorbable monofilament suture rather than slowly absorbable suture. Only 1 in 10 surgeons complied with both components of evidence base, which supports the use of slowly absorbable suture material and a continuous technique in abdominal fascial closure. A definitive RCT would confirm this observation. [source]

Influence of suture material and surgical technique on risk of reoperation after non-mesh open hernia repair

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 8 2003
P. Nordin
Background: Although mesh techniques are used with increasing frequency, sutured repair still has a place in groin hernia surgery. Studies relating suture material to recurrence rate have yielded conflicting results. The aim of the present study was to analyse the influence of suture material and sutured non-mesh technique on the risk of reoperation in open groin hernia repair using data from the Swedish Hernia Register. Methods: The relative risk of reoperation after sutured repair using non-absorbable, late absorbable and early absorbable sutures was compared in multivariate analyses, taking into account known confounding factors. Results: Between 1992 and 2000, 46 745 hernia repairs were recorded in the Swedish Hernia Register. Of these, 18 057 repairs were performed with open non-mesh methods and were included in the analysis. Using non-absorbable suture as reference, the relative risk of reoperation after repair with early absorbable suture and late absorbable suture was 1·50 (95 per cent confidence interval (c.i.) 1·22 to 1·83) and 1·03 (95 per cent c.i. 0·83 to 1·28) respectively. Using the Shouldice repair as reference, other sutured repairs were associated with a significantly higher relative risk of reoperation (1·22, 95 per cent c.i. 1·03 to 1·44). Conclusion: A non-absorbable or a late absorbable suture is recommended for open non-mesh groin hernia repair. The Shouldice technique was found to be superior to other open methods. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Old habits tie hard: an in vitro comparison of first-throw tension holding in Polyglycolic acid (Dexon S) and Polyglactin 910 (Coated Vicryl)

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 2 2006
Thomas L Kersey MB BS
Abstract Purpose:, To compare the first-throw tension holding property of two braided absorbable sutures commonly used in oculoplastic surgery. Methods:, The study was an in vitro experimental model. 6/0 Polyglycolic acid (Dexon S) and 6/0 Polyglactin 910 (Coated Vicryl) were compared using an experimental model to determine first-throw knot security. A polypropylene suture (Surgipro 2) was included as a benchmark to judge the apparatus by, ensuring that our experiment could be designed independently of the test suture materials. Increasing metric loads were applied to the first double throw of a surgical knot. Each suture was tested to the point of knot slipping and the critical tension recorded. All the sutures were kept wet during use. Three variations of the experiment were undertaken: experiment 1 , two metal loops brought together by the test suture; experiment 2 , two strips of tissue brought together by the test suture; and experiment 3 , a knot tied over a metal bar coated in tissue. The tissue used was processed cross-linked porcine dermal collagen (Permacol). Each experiment was repeated three times for each suture type and the mean value taken. Results:, Experiment 1: Dexon S 12.2 g (11, 12, 13.5), Coated Vicryl 2.5 g (2.5, 2.5, 2.5) and Surgipro 2 2.3 g (2, 2, 3); experiment 2: Dexon S 33.33 g (30, 35, 35), Coated Vicryl 25 g (25, 25, 25) and Surgipro 2 5 g (5, 5, 5); experiment 3: Dexon S 100 g (100, 100, 100), Coated Vicryl 56.667 g (60, 55, 55) and Surgipro 2 5 g (5, 5, 5). Conclusions:, Dexon S-braided absorbable suture has significantly better first-throw knot security when compared with Coated Vicryl. This is an important property when suturing tissues under tension as it minimizes slippage before the locking throw is tied. [source]

Dorsal onlay augmentation urethroplasty with small intestinal submucosa: Modified Barbagli technique for strictures of the bulbar urethra

INTERNATIONAL JOURNAL OF UROLOGY, Issue 11 2006
IVO I DONKOV
Aim: To present the results from one clinic's experience of using small intestinal submucosa (SIS) in augmentation urethroplasty for management of strictures of the bulbar urethra. Methods: Urethral surgery was performed in nine men with strictures 4,6 cm. All of the patients were evaluated by history, physical examination, retrograde urethrogram, and uroflowmetry. Four layers of SIS were soaked in saline or Ringer's solution for 15 minutes at 37°C, and the inner surface of the patch was gently fenestrated with a thin scalpel. The patch was spread-fixed onto the tunica albuginea. The mucosa was sutured to the submucosal graft first at 2,3 mm inwards from the SIS margins, then the spongiosum tissue was attached to the margins with interrupted absorbable sutures. Results: Of the nine patients who underwent augmentation urethroplasty using SIS, only one had re-stricture at 6 months due to urethral infection. At 18 months after the surgery the uroflowmetry of the other eight patients was 20,21 mL/s. In terms of complications, six patients reported having post-micturition dribbling, and seven patients reported lack of morning erections for 35,69 days after surgery. Conclusions: Using SIS is a safe procedure; however, long-term follow-up is needed to substantiate the good short-term results. [source]

Facilitating the technique of laparoscopic running urethrovesical anastomosis using Lapra-ty absorbable suture clips

INTERNATIONAL JOURNAL OF UROLOGY, Issue 2 2006
YASUMASA SHICHIRI
Abstract, We herein describe a simplified technique for performing laparoscopic running urethrovesical anastomosis using Lapra-ty absorbable suture clips (Ethicon, Somerville, NJ, USA) during a laparoscopic radical prostatectomy (LRP). Using two 20 cm absorbable sutures tied together and locked with Lapra-ty at their tail ends, the initiating mattress sutures are placed in the 5:30,6:30-o'clock area between the urethra and the bladder neck. The left and right running sutures are then made clockwise from the 6:30,12-o'clock position and counterclockwise from the 5:30,12-o'clock position, respectively. Both sutures are locked with proper tension by Lapra-ty at the 3, 9 and 12-o'clock positions, and then they are intracorporeally tied together just at the 12-o'clock position. In the initial 20 cases, this anastomosis took 22.5 min on average to perform. We experienced no major urine extravasation and no anastomotic stricture to date. [source]

A Cosmetic Approach for Pectoral Pacemaker Implantation in Young Girls

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 9 2000
ERIC ROSENTHAL
Pectoral placement of pacemaker generators, combined with use of a redundant intravascular lead portion, reduces the need for endocardial lead advancement during growth in children. While the use of small generators and submuscular pockets has contributed to cosmetic acceptability, the conventional subclavicular incision may occasionally form a keloid scar that is unacceptable in young girls. A modified implantation technique was used in five girls (age 2.6,13.3 years) during implantation of VDD (n = 2), VVIR (n = 2), and DDDR (n = 1) pacemakers. A 5-cm incision was made in the axilla along the line of the pec-toralis major and dissection was continued below the muscle to create a pocket for the generator. Subclavian vein puncture was performed from the axillary incision and beneath the pectoralis major muscle using standard or extra long needles with a needle guard. Peel away sheaths were used for lead positioning. The generator was placed in the submuscular pocket and the wound closed with absorbable sutures. At follow-up, pacemaker function was excellent and neither the scars nor pacemakers were visible from the front. In conclusion, the axillary incision with direct subclavian vein puncture from below the pectoralis major muscle offers the advantages of pectoral pacemaker implantation through a single cosmetic incision. [source]

The technical pitfalls of duct-to-duct biliary reconstruction in pediatric living-donor left-lobe liver transplantation: The impact of stent placement

PEDIATRIC TRANSPLANTATION, Issue 6 2008
Seisuke Sakamoto
Abstract:, The feasibility of D-D biliary reconstruction in pediatric LDLT using a left-lobe graft is still controversial. The medical records of 19 pediatric patients (age: four months to 16 yr) were reviewed. The biliary reconstruction was performed in an end-to-end fashion using absorbable sutures. An external biliary tube was placed into the bile duct through the anastomotic site (n = 10) and not through the anastomotic site (n = 4). An external tube was not used in five patients. The median follow-up was 4.7 yr. Nine patients had 11 biliary complications (leakage, n = 2; stricture, n = 7; stricture with leakage, n = 2). Due to biliary complications, conversion to an R-Y was required in five patients, and four patients required radiological or endoscopic management. The patients younger than one yr of age required conversion to R-Y within one wk after LDLT. The analysis of factors related to biliary complications revealed that the use of a trans-anastomotic biliary tube was the only significant factor to avoid biliary complications. In conclusion, D-D biliary reconstruction in LDLT using a left-lobe graft is feasible in selected cases, though it remains challenging. The use of a trans-anastomotic biliary tube is important to avoid biliary complications. [source]

Maximizing Breast Projection with Combined Free Nipple Graft Reduction Mammaplasty and Back-folded Dermaglandular Inferior Pedicle

THE BREAST JOURNAL, Issue 3 2007
Metin Gorgu MD
Abstract:, Standard technique for free nipple reduction mammoplasty was described by Thorek in 1922 (1). In contrast to its effectiveness, late postoperative results included insufficient projection of the breast and the nipple,areola region. We describe a modification of this well recognized technique in order to increase central mound projection and improve nipple,areola projection by suturing the dermaglandular flap to the pectoralis major muscle by back-folding the pedicle. Twenty macromastia patients were subjected to free-nipple-graft reduction mammoplasty in combination with inferior pedicled dermaglandular reduction mammaplasty of a total of 40 breasts with this technique between years 2000 and 2004. Preoperative planning for inferior pedicled dermaglandular flap was made using the "Wise" pattern for large breasts. The variation of the technique comes from using the back-folded deepithelialized inferior pedicled dermaglandular flap for increasing the breast mound projection by fixating the demaglandular flap with absorbable sutures to the underlying pectoralis major muscle fascia and the costal cartilage pericondrium. By applying this technique, increased projection during the early preoperative and late postoperative periods are achieved, compared with patients who only underwent free-nipple- graft reduction mammoplasty. [source]

Influence of suture material and surgical technique on risk of reoperation after non-mesh open hernia repair

Sutureless encircling band , biomechanical calculations and clinical experience

ACTA OPHTHALMOLOGICA, Issue 2009
M MAIER
Purpose In cases with multiple retinal breaks and in combination with vitrectomy in eyes with Proliferative vitreoretinopathy (PVR) for retinal detachment surgery often an encircling band is used. Usually the encircling band is fixed with non absorbable sutures. Methods A fixation method for an encircling band in retinal detachment surgery with one scleral tunnel in every of the 4 quadrants is reported. We describe our experience and biomechanical calculations of this fixation technique. Results In comparison to conventional fixation technique we found the following advantages: No suture is necessary, this means no additional foreign body can produce irritations. The scleral tunnel is safe and the preparation under the microscope can be performed fast and well controlled. Sclera tunnel fixation is very comfortable in combination with a vitrectomy. Conclusion With a short learning curve the operating time is as short as with conventional suture fixation of the encircling band. There is less perforating risc, less irritation and less patient discomfort postoperatively. A sutureless encircling band with sclera tunnel fixation is a very usefull operation technique in clinical routine. [source]