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PubMed1982

[Behavior of resorbable and nonresorbable suture material in lymph vessel suture].

After transverse division of the abdominal thoracic duct of the rat, 14 anastomoses were performed using synthetic absorbable (Polyglactin 910, Vicryl) and synthetic non-absorbable (Polyamid 6.6, Ethilon) suture material. The anastomoses were achieved by means of a tension-free technique using interrupted sutures. The follow-up period was from 28 to 133 days. Clinical observation showed that all anastomoses were patent. However, with the aid of staining methods only five out of seven anastomoses were shown to be patent. Using absorbable suture material, a lumen was demonstrable at all anastomoses, while using non-absorbable suture material this could be proved in only four out of seven anastomoses. The foreign body reaction diminished with time when absorbable material was employed, whereas it persisted with non-absorbable material.

Animals↗
PubMed1994

Basic suture materials and suturing techniques.

There is a need for surgeons to be able to make a logical decision regarding which suture materials to use in a given clinical situation because the choice of wound-closure materials may make a difference in wound healing and the ultimate functional and cosmetic result obtained. This article will review the basic physical, handling, and tissue-reaction characteristics of commonly used suture materials. Basic suturing techniques are also reviewed. Knowledge of multiple suturing techniques provides versatility, individuality, and optimal closure of surgical wounds.

Absorption↗
PubMed1990

Suture-wick endophthalmitis with sutured posterior chamber intraocular lenses.

A patient had a corneal transplant with removal of an anterior chamber lens. As part of the procedure, an exchange posterior chamber lens was inserted and sutured transsclerally into the ciliary sulcus with two subconjunctival 10-0 polypropylene (Prolene) sutures. One month later the patient experienced a sudden decrease in vision and severe eye pain. Streptococcus viridans was cultured from the vitreous tap and the eye eventually was lost from this endophthalmitis. The infecting organism appeared to gain access to the eye through one of the Prolene sutures that had eroded through the conjunctiva and become exteriorized. This report presents a case in which an eroding 10-0 Prolene suture used for transscleral posterior chamber lens fixation was the probable mechanism causing endophthalmitis. This complication represents an avoidable risk unique to this type of intraocular lens fixation.

Aged↗
PubMed2005

A three-armed randomized trial comparing open Burch colposuspension using sutures with laparoscopic colposuspension using sutures and laparoscopic colposuspension using mesh and staples in women with stress urinary incontinence.

OBJECTIVE: To compare open Burch colposuspension using sutures (OC) with laparoscopic colposuspension using sutures (LCS) and laparoscopic colposuspension using mesh and staples (LCM) in women with stress urinary incontinence. DESIGN: Prospective randomized trial. SETTING: Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Göteborg, Sweden. POPULATION: Women with genuine stress urinary incontinence or mixed incontinence with a predominantly stress component attending the Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Göteborg, Sweden. METHODS: The women were assessed objectively using a 48-h frequency-volume chart, a 48-h pad test and a standardized stress test. Subjectively, the women were assessed by a questionnaire including influence on quality of life. The women were randomized to OC using sutures (n = 79), LCS (n = 53) or LCM (n = 79). Anaesthesia/operation time, blood loss, complications and other related surgical parameters were compared. Main outcome measures. Objective and subjective cure rate. RESULTS: Objective cure rates 1 year after surgery were significantly higher in the OC and LCS groups compared to the LCM group analyzed by a standardized stress test. Subjective findings were in concordance with the objective results. Performing an OC was less time consuming than performing a LCS and resulted in more blood loss compared to the two laparoscopic techniques. Patients in the LCM group had a shorter duration of catheter use and hospital stay. CONCLUSION: The use of sutures, irrespective of whether the surgical approach was laparoscopic or open surgery, was superior to the laparoscopic mesh and staple technique.

Adult↗
PubMed1993

The running locked intradermal suture. A cosmetically elegant continuous suture for wounds under light tension.

A new suture technique, the running locked intradermal suture, is introduced. The suture is continuous and buried, and is designed for closing simple elliptical wounds under light tension in which a good cosmetic result is desired. It is used in conjunction with a topical antibiotic and a transparent dressing. This technique reduces the dermal dead space, achieves close approximation of the epidermal wound edges, has a good cosmetic appearance soon after surgery, reduces necessary postoperative wound care, reduces the risk of wound infection in clean surgical wounds, and obviates suture removal. Three examples of its application on the face are presented. It is compared with frequently used standard wound closure methods are discussed.

Aged↗
PubMed1997

Physical, biological and handling characteristics of surgical suture material: a comparison of four different multifilament absorbable sutures.

OBJECTIVE: Four different braided absorbable surgical materials (Dexon, Dexon II Bicolor, Vicryl and Polysorb) 2/0 USP, which basically share the same indications, were studied in vitro and in vivo with regard to their physical properties as well as tissue compatibility and surgical handling. Analyzing the results the authors tried to determine the most useful suture in surgical practice. METHOD: Physical tests to determine tensile strength, knot-breaking strength and knot security were carried out. Additionally an in vivo model (Wistar rat) was used to compare histocompatibility and loss of function due to hydrolytic resorption. Furthermore, a handling test was carried out by trained surgeons. RESULTS: Polysorb had the highest linear tensile strength but also the fastest loss of function following tissue implantation, whereas Vicryl showed the slowest loss of function. Similar results were obtained with regard to the knot-breaking strength. After pulsatile stressing Dexon II Bicolor and Dexon showed the highest irreversible elongation followed by Vicryl and Polysorb. Polysorb had the best knotting characteristics, scoring highest also in the handling study. CONCLUSIONS: The authors conclude that with Polysorb all features and properties of braided suture material have reached a high level of quality. This suture combines the positive characteristics of monofilament with those of multifilament materials, thus coming closest to being the 'optimal suture'.

Animals↗
PubMed1981

PDS (polydioxanone suture): a new synthetic absorbable suture in cataract surgery. A preliminary study.

PDS (polydioxanone suture), a new synthetic absorbable suture, was used in 21 patients undergoing cataract surgery. It still retains 25% of its tensile strength at 42 days but absorption takes 130-180 days. 1 braided coated and 1 monofilament PDS were adequate as conjunctival sutures but offered no advantage over available materials. 0.5 monofilament PDS was superior in handling qualities to 0.4 virgin silk. It does not need to be removed but retains tensile strength for longer than other absorbable sutures.

Aged↗
PubMed2002

NextStitch: double-stranded suture chain, a tool to optimize approximation of sutures in valve surgery with echocardiographic correlation.

Suture technique for valve replacement surgery has often focused on decreasing the soft tissue injury that leads to pseudoaneurysm formation and associated latent infection. There is universal recognition that precise suture placement is essential for avoiding adverse sequelae while allowing flexibility during the implantation of the prosthesis. The use of a continuous chain of linked horizontal mattress sutures (NextStitch) has allowed maximal precision in the approximation of sutures within the valve annulus. The product was used in a series of consecutive mitral and aortic valve replacements, and typical echocardiographic images from each type of implantation are presented. Postoperative echocardiography images revealed that no perivalvular leaks occurred and that NextStitch did not obscure detailed interrogation or assessment of the valve prosthesis.

Adult↗
PubMedDate not supplied

[One layer sutures of digestive tract knotted in the lumen, in dogs: perforating stitch versus serosubmucosal suture].

OBJECTIVE: To compare hand sewn digestive tract single layer anastomosis with knots tied in the lumen: total stitches versus serosubmucosal. METHODS: Six mongrel dogs were submitted to laparotomy, each one with two transversal jejunum sections, 30 and 70 cm far from Treizt angle and suture, serosubmucosal and total stitches, both with knots tied in the lumen, over the mucosa, at the posterior wall. After slaughter (7th post-operative day) was evaluated the peritoneal adhesions at posterior wall. The macro and microscopic features was observed. Wilcox on rank sum test was applied for the histhometry. RESULTS: More profuse adhesions with the serosubmucosal stitches tied in the lumen with adherence tissue over the suture line, avoiding the serosa, within or without healing deformation of the suture lines, doing an anastomosis angle. There was good serosa reconstitution with total stitches. The epithelium was perfectly reconstituted at serosubmucosa, but not at total stitches, where was residual focus of acute inflammation. The reline and regeneration of wall components (except the serosa, whose regeneration was impaired by peritoneal adherences) were better with serosubmucosal then total stitches. The muscularis never regeneration in anyone suture. The polimorphonuclear cells, macrophages, fibroblasts, and collagen fibers was more numerous (statistical significance) at total stitches. CONCLUSION: Total stitches with knots tied in the lumen, at posterior wall, over the mucosa are safe full, despite of major inflammation. Serosubmucosal with knots tied in the lumen, at posterior wall, over the mucosa, allows peritoneal adherences formation, and should be avoided.

Animals↗
PubMed1994

Comparative study of microepineural suture, microepineural suture-aided CO2 laser, and laser only anastomoses in rat sciatic nerves.

The cut sciatic nerves of 33 rats were anastomosed by three different methods under the operation microscope; microepineural suture technique, CO2 laser technique, and laser-aided microepineural suture technique. On histologic examination at the end of 3 months postoperatively, in the CO2 laser and suture-aided CO2 laser groups, the degrees of inflammation, fibrosis, and Schwann cell vacuolar degeneration were significantly higher than in the microepineural suture anastomosis group. At the end of 3 months sciatic nerve function was absent in 3 of 11 rats anastomosed by only CO2 laser, however, sciatic nerve functions were found to be normal in the other two groups.

Anastomosis, Surgical↗
PubMed2003

[An experimental study of 3-dimension zygomatic suture extension for suture osteogenesis].

OBJECTIVE: To explore a methods of 3-Dimension expansion of zygomatic suture in a goat model. METHODS: Seven goats were used in this study. The 3-D extensive applicator was designed and used to extend the zygomatic suture of the goats by placing it in the zygomatic bone through an infraorbital incision. Ten days after the first operation, it was gradually extended on a speed of 0.09 cm/d for 7 days. The zygomatic movement and the osteogenesis of the suture was evaluated in two weeks. RESULTS: The zygomatic bone was extended for 0.6 cm long in average, and the osteogenesis was also shown significantly in the suture. CONCLUSION: The above mentioned technique could be a safe and effect method to be applied for the zygomatic extension.

Animals↗
PubMed1991

[Intra-pulmonary suture abscess with hemoptysis after partial resection--concerning to the pathogenesis of the suture abscess].

A 53-year-old male with a intra-pulmonary suture abscess was admitted with recurrent hemoptysis. Five year before this admission, he had undergone a partial resection of the left upper lobe for pneumothorax using unabsorbable sutures (braided polyester). Chest CT showed tumor shadow in the left S1(+2) a on admission. Because of recurrent hemoptysis, left upper lobectomy was performed. Hemoptysis was due to the presence of a suture abscess. Pathological and clinical analysis of the intra-pulmonary suture abscess showed that it was caused not only by foreign body reaction but also transbronchial infection.

Hemoptysis↗
PubMedDate not supplied

Skin closure of laparotomy wounds: absorbable subcuticular sutures vs. non-absorbable interrupted sutures.

In a five year period (1984-1988) in the department of obstetrics and gynaecology of the University of Ilorin Teaching Hospital, Ilorin, 304 laparotomy patients whose skin incisions were closed with the traditional method of interrupted non-absorbable sutures or with absorbable subcuticular sutures were analysed. Out of these 304 patients, 164 had non-absorbable skin sutures while 140 had absorbable subcuticular sutures. The results of the two methods of skin closure were compared immediately on discharge, at 6 weeks and at 6 months after the operation. The appearance of the wounds and scar were better in the absorbable subcuticular group than in the non-absorbable interrupted group. The differences between the two groups were statistically significant in the cross-scar formation, Keloid/hypertrophic scar formation, period of hospitalisation and the acceptance rate. Subcuticular skin closure had the advantages of short stay in hospital, non stitch removal, better scar formation and being more acceptable to patients. There was no significant difference in the age between the two groups. All the patients were Africans.

Cicatrix↗
PubMed1987

Non-sutured fibrin adhesive vs. sutured anastomosis. A comparative intra-individual study in dog colon.

In each of ten dogs the colon was subjected to a two-layered sutured anastomosis and a non-sutured fibrin adhesive anastomosis. Intra-individual comparisons showed no significant difference of in vivo bursting strength after 7 days between the colon segments with sutured and those with non-sutured anastomoses. Under experimental conditions it was thus possible to achieve a safe, sutureless anastomosis in the colon using only fibrin adhesive.

Anastomosis, Surgical↗
PubMed1989

[Experimental studies on the development of peritoneal adhesions in cases of suturing and non-suturing of the parietal peritoneum in rabbits].

The author performed (in general ether anaesthesia) median upper and lower right oblique laparotomy in 50 rabbits (two incisions in each). In 25 rabbits from group I the author closed the wound without suturing the parietal peritoneum whereas in the remaining 25 rabbits from group II they closed the wound suturing the parietal peritoneum. On 1st, 3rd, 7th, 14th and 21st days following the procedure, 5 rabbits from each group were killed. The author evaluated the wounds of the parietal peritoneum by macro- and microscopy, and also the number of peritoneal adhesions in each group. It was found that in group I adhesions appeared only in 3 out of 50 incisions whereas in group II--17 adhesions out of 50 wounds (p less than 0.005). The author believes that parietal peritoneum that has not been sutured heals better and with a smaller number of adhesions than sutured parietal peritoneum.

Abdominal Muscles↗
PubMed1988

Comparison of Maxon suture with Vicryl, chromic catgut, and PDS sutures in fascial closure in rats.

Two hundred ten rats were randomized into one of five study groups to compare standard absorbable sutures with a new synthetic absorbable suture. We evaluated Maxon (polyglyconate), Vicryl (polyglactin), chromic catgut (catgut), and PDS (polydioxanone) with respect to tissue inflammatory reaction, knot security, suture tensile strength, and suture absorption. The results indicate that Maxon and PDS elicited a lower degree of chronic inflammation when compared with Vicryl and chromic catgut. The tensile strengths of Maxon and Vicryl significantly exceeded those of PDS and chromic catgut during the critical period of wound healing. Maxon and PDS retained a larger percentage of tensile strength during the long postoperative period, whereas Vicryl and chromic catgut were mostly absorbed. Maxon is an excellent addition to the armamentarium of the gynecologic surgeon.

Absorption↗
PubMed1985

The incidence of wound infection after stapled or sutured bowel anastomosis and stapled or sutured skin closure in humans and guinea pigs.

In a study of antimicrobial prophylaxis in colorectal surgery, a higher incidence of wound sepsis was noted in patients who underwent stapled rather than sutured anastomoses and skin closures. There were six wound infections in 69 patients (8.7%) who underwent nonstapled anastomoses compared with seven in 28 (25%) in whom GIA or EEA staplers were used (p = 0.003). Excluding the EEA-stapled cases, the infection rate was 29% (p = 0.022). In patients who underwent sutured anastomoses, there were no wound infections in 21 whose skin was closed with sutures compared with five in 38 patients (13%) with stapled skin closure (p = 0.082). In an experimental guinea pig model dual incisions were infected with Bacteroides fragilis and Escherichia coli. One incision was then closed with staples, the other with sutures. There was a statistically significant (p = 0.016) advantage to the use of staplers. The possible significance of these results is discussed.

Animals↗