Skin dressings in the treatment of contaminated wounds.
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Animals↗
Biomedical subjects
G T Rodeheaver
Publications and source records attributed to G T Rodeheaver.
Physical and chemical configuration of sutures in the development of surgical infection.
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Animals↗
Tensiometric testing of absorbable and nonabsorbable sutures.
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Absorption↗
Performance of new wound closure tapes.
The purpose of this study was to determine the performance of six different wound closure tapes using a battery of standardized tests that included breaking strength, elongation, air porosity, and shear adhesion. The results of these tests were incorporated into a ranking system that provided an index of the overall performance of each tape. Because Nichi-Strip, Curi-Strip and Steri-Strip wound closure tapes achieved the highest rankings, we recommend their use in the emergency department.
Adhesiveness↗
Anesthetic properties and toxicity of bupivacaine and lidocaine for infiltration anesthesia.
The purpose of this study was to measure the toxicity and anesthetic properties of two anesthetic agents, bupivacaine and lidocaine. These anesthetic agents did not damage tissue defenses or invite infection in experimental animals. In addition, the pain of subdermal injection, the onset of anesthesia, and the frequency of satisfactory anesthesia in human volunteers were remarkably similar. Because the duration of anesthesia induced by bupivacaine was nearly four times longer than that by lidocaine, bupivacaine is recommended for infiltration anesthesia of lacerations treated in the emergency department.
Anesthesia↗
Influence of cutting edge configuration on surgical needle penetration forces.
A standardized test for measuring the needle penetration forces has been developed that can be easily replicated in any laboratory. Using this test, conventional cutting edge needles utilized in the test produced lower penetration forces than reverse cutting edge needles. The lower penetration forces encountered by the conventional cutting edge needles imply that the physician should be able to handle these needles with more dexterity and precision than the reverse cutting edge needle.
Membranes, Artificial↗
Ease of continuous dermal suture removal.
The purpose of this investigation is to identify the synthetic nonabsorbable monofilament suture that requires the lowest forces for removal of continuous dermal sutures. Immediately after wound closure, continuous dermal polypropylene sutures require the lowest suture removal forces. The ease of polypropylene suture removal from continuous dermal skin closure is related to the suture's low surface coefficient of friction.
Animals↗
Biomechanics of a new atraumatic surgical needle holder.
It is the purpose of this report to design, develop, and evaluate a needle holder whose jaws improve needle-holding security without altering the geometry of the curved surgical needle. The configuration of the jaws of this new needle holder is curved, conforming to the curvature of the surgical needle. A biomechanical study of this curved surgical needle holder demonstrates that it holds the curved needle securely without needle deformation.
Biomechanical Phenomena↗
Influence of knot configuration and tying technique on the mechanical performance of sutures.
The purpose of this investigation was to determine the influence of knot configuration and tying technique on the mechanical performance of surgical sutures. Multifilament and monofilament nylon sutures were selected for this evaluation because they are commonly used in wound closure. The mechanical performance of these sutures was judged by the following parameters: knot breakage force, configuration of secure knots, and knot run down force. During each test, tension was applied at either rapid or slow rates, which correlates with the physician's speed of tying knots. On the basis of these mechanical performance tests, four throw square (1 = 1 = 1 =1) knots and five throw square (1 = 1 = 1 = 1 = 1) knots are recommended for monofilament nylon and multifilament nylon sutures, respectively, in which the speed of application of forces to the knots is relatively slow. Because these tests can easily be replicated in any laboratory, manufacturers now have a scientific basis for recommending specific tying techniques for their surgical sutures.
Physical Phenomena↗
Damage to tissue defenses by EMLA cream.
EMLA is a new topical agent that safely anesthetizes intact skin. The purpose of this study was to determine if this cream could be safely used for anesthetizing wounds. This investigation evaluated the potential toxicity of EMLA cream in wounds by measuring its effect on host defenses and on the biology of wound repair. In contaminated wounds, EMLA cream elicited an exaggerated inflammatory response that damaged host defenses, inviting the development of infection. As a result of these investigations, we do not recommend the use of EMLA cream in wounds.
Anesthetics, Local↗
Mechanical performance of disposable surgical needle holders.
The mechanical performance of disposable Webster surgical needle holders supplied by three different surgical instrument companies was determined by recording the forces (clamping moment) applied by the different needle holder jaws to curved surgical needles. This investigation demonstrated that there was a large variability in the mechanical performance of the disposable needle holders supplied by each surgical instrument company. In addition, the mechanical performance of the disposable needle holder of each surgical instrument company was distinctly different.
Disposable Equipment↗
Technical considerations in manual and instrument tying techniques.
The purpose of this study was to relate the two-hand (manual) and instrument tie techniques with the ultimate security of granny and square knots constructed in multifilament and monofilament nylon sutures. Instrument-tie technique constructed secure granny and square knots, which failed by breakage rather than slippage. Similarly, two-hand (manual) tie techniques constructed square knots, which achieved knot security, failing only by breakage. In contrast, knot security was not reliably achieved with granny knots constructed by the two-hand (manual) tie techniques, with the knots frequently failing by slippage.
Nylons↗
Influence of emergency physician's tying technique on knot security.
The purpose of this study was to determine the influence of emergency physician's tying technique on knot security using 2-0 and 4-0 monofilament and multifilament nylon sutures. Using an Instron Tensile Tester and a portable tensiometer, knot security was achieved with these sutures using four-throw square knots (1 = 1 = 1 = 1). After didactic and psychomotor skill training, medical students were taught to construct the four-throw square knot using either a two-hand tie or an instrument tie. Using the portable tensiometer, their knot tying techniques were judged to be superior to those used by emergency physicians. The emergency physician's faulty technique can easily be corrected by didactic information and psychomotor skill training.
Emergency Medicine↗
New, innovative packaging system for surgical sutures and needles.
A new, innovative packaging system for surgical needles and sutures has been developed that meets the special needs of emergency physicians, surgeons, and operating personnel. This packaging system consists of an overwrap, or breather pouch, as well as an innerwrap containing the needle swaged to a surgical suture. The flaps of the overwrap are offset and serrated to facilitate the opening and sterile transfer of the inner packet to the sterile field. The inner packet contains either a plastic labyrinth or craft board that maintains the suture as straight as possible until knot construction. The needle swaged to a suture is parked in foam to protect its sharp cutting edges and point.
Emergency Service, Hospital↗
A new hazard of cornstarch, an absorbable dusting powder.
Cornstarch is currently the only powder used in the manufacture of surgical and examination gloves. The purpose of this study was to determine if cornstarch damages local tissue defenses in contaminated wounds. It was found that in contaminated wounds, cornstarch enhanced the growth of bacteria and elicited exaggerated inflammatory responses as measured by wound induration. As a result of this investigation, we do not recommend the use of gloves with cornstarch powders.
Animals↗
Tissue adhesive wound repair revisited.
The purpose of this experimental study was to compare the effect of a tissue adhesive, N-butyl-2-cyanoacrylate, on the wound's ability to resist infection and gain strength to the effect of percutaneous polypropylene suture. Percutaneous sutures damaged host defenses, inviting the growth of bacteria to a level that was significantly greater than that encountered with the tissue adhesive. Immediately after wound closure, percutaneous sutures provided a more secure closure, as measured by breaking strength, than did tissue adhesives. Seven days later, the breaking strengths of wounds closed by tissue adhesives did not differ significantly from those repaired with percutaneous sutures. Tissue adhesive closure requires less psychomotor skills than suture closure and is accomplished more rapidly than suture closure.
Animals↗
Considerations in the selection of surgical gloves for tape wound closure.
One of the reasons that tape closure of wounds is rarely used in the emergency department is that it is difficult for the emergency physician wearing powdered, latex gloves to handle skin closure tapes. Because the skin closure tapes adhere aggressively to powdered latex gloves, it is difficult for the emergency physician to separate the tape from his glove and apply the tape to the skin. The advent of a new powder free glove allows the emergency physician to handle the tapes and accomplish tape wound closure.
Adhesiveness↗
Enhancing needle durability by silicone coating of surgical needles.
The purpose of this study was to assess the effect of coating surgical needles with silicone on their durability. Needle durability is a measure of needle sharpness after repeated passage through tissue. Needle sharpness was determined by quantitating the energy required to pass a designated needle repeatedly (20 times) through porcine skin, linea alba, colon, and aorta. The results demonstrate that the durability and sharpness of silicone-coated needles were significantly greater than those of comparable uncoated needles in linea alba, colon, and aorta, but not in skin.
Animals↗