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At least 307 records · Page 17Linked to original sources
PubMed1992

The vanishing tricuspid annuloplasty. A new concept.

A tricuspid De Vega annuloplasty with absorbable 2-0 polydioxanone sutures was performed on 16 sheep supported by cardiopulmonary bypass. The anulus diameter was reduced by 2 to 6 mm. Four sheep died perioperatively. The 12 survivors were electively killed at 2-week intervals during a period of 6 months. Infective endocarditis was not observed. At the time of death no gradient was found on simultaneous pressure measurements of the right atrium and ventricle. Epicardial echocardiography did not reveal tricuspid stenosis or regurgitation. Macroscopically there was no thrombus and the tricuspid leaflets were of a normal appearance. A thin white cord was observed at the anulus in all animals killed after 12 weeks. The annular size remained as surgically induced until the fourth month, but it reverted to its preoperative size after 5 months. Histologically there was granulation tissue initially only around the foreign material, but then progressively it appeared also between the foreign filaments, with the development of multinucleated foreign body giant cells. At approximately 5 months most of the foreign material had been disrupted or absorbed, leaving a tenuous ring of granulation tissue, which allowed expansion of the tricuspid ring to its original circumference. By 6 months most of the foreign material had disappeared and was replaced by loose collagenous tissue. The concept of a "vanishing annuloplasty" is advanced, with particular application in children and in patients with functional tricuspid insufficiency.

Animals↗
PubMed2005

[Bladder stone at an ureterovesical anastomotic site after renal transplantation: a report of three cases].

Three cases of bladder stones at the ureterovesical anastomotic site after renal transplantation (RT) are reported. The three patients were successfully treated with kidney grafts. The method used for the ureter bladder anastomosis in all patients was the extravesical technique with polyglyconate (Maxon) for case 1 and a polydioxanone suture (PDSII) for cases 2 and 3. Calculi formation was found between 3 to 15 months after RT. Endoscopic vesicolithotripsy was performed and the stones adherent to the ureterovesical anastomotic site were removed successfully in all cases. Stone analysis revealed uric acid (case 1), CaOx and CaP (case 2). Stone analysis was not done in case 3. The patients' symptoms improved and no bladder stones could be discerned postoperatively.

Adult↗
PubMed1992

[The pulmonary venous obstruction following repair with absorbable sutures in total anomalous pulmonary venous drainage--a case report].

A 4-month-old boy with infracardiac type of total anomalous pulmonary venous drainage (TAPVD) who underwent anastomosis between left atrium and common pulmonary vein at age of one month with absorbable suture of polydioxanone (PDS), was suffered from pulmonary venous obstruction (PVO). The ostia of pulmonary veins were stenosed severely. The histological findings showed that there were inflammatory changes and fibrosis around PDS suture. These findings suggested that PDS would cause inflammatory change of tissues around, which might be occurred following repair of TAPVD.

Anastomosis, Surgical↗
PubMed1992

[Mechanical properties of PDS-augmented patellar tendon transplants in reconstruction of the anterior cruciate ligament].

In 25 sheep the anterior cruciate ligament (ACL) was reconstructed after resection. Twelve modified "Jones procedures" were performed (transplantation of the central third of the patellar tendon with an initial load of 50 N) and 13 polydioxanone (PDS) augmentations. In 15 cases the ACL was resected from the right knee. Twenty-one sheep survived for 1 year and were then evaluated. Loss of the ACL leads to instable joints in this experiment. Within the first 6 months anterior translation occurs; after 1 year subluxations can be seen on the X-ray films. Macroscopical signs of extensive arthrosis were seen in the femorotibial and femoropatellar joints; the menisci were totally destroyed. Macroscopically strong ligaments were seen 1 year after PDS-augmented reconstruction as well as after transplantation of the patellar tendon with an initial load of 50 N. There was no difference between the two groups. The mechanical strength reached 54% of the maximum load of a control group in the Jones reconstructions and 61% after additional augmentation with a 2-mm biodegradable PDS cord. There was no statistically significant difference. Both methods are suitable for reconstruction of the ACL; the patellar tendon replaces the ACL very well.

Animals↗
PubMed1991

[Are patellar tension band reconstructions with absorbable materials possible? An animal experiment].

Different biodegradable tension band reconstructions of transverse osteotomies of sheep patella were tested in an experimental pilot study. Without postoperative immobilization, 4 metallic fixations in the control group dislocated secondarily 3 +/- 2 days after the operation. After tenotomy of the gastrocnemius muscle tendon, 6 other metallic fixations showed good bone healing after 12 weeks. Therefore all other fixations were immobilized postoperatively. In 5 of 6 tension band fixations with pure polydioxanone cords (PDS) ventral callus distraction started after 18 +/- 7 days, but total consolidation had taken place after 14 weeks. One PDS fixation failed for technical reasons. The combination of two axial polyglycolide rods (BIOFIX) with two ventral PDS cords showed different results: when rods 4.5 mm in diameter were used 1 fixation dislocated because the fragments were burst by the oversized rods. With rods 3.2 mm in diameter 3 other fixations were followed by complete consolidation with no dislocation after 12 weeks. Other tested combined fixation systems made up of polyglycolide and polylactide composites (cords, screws) failed secondarily, either because the fragments were burst by the oversized implants or because of the fragility of the polylactide cords. It was impossible to use polylactide screws as lag screws, because the screw heads gave way to torque. In an additional study we observed a decrease in tissue pH after implantation of polyglycolide rods in the medullary space of the tibia. Compared with the control medullary space without implants, the pH decreased from 7.38 to 6.92 at the point of greatest implant mass.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

[Biomechanical studies of various forms of symphysis banding].

The banding operation with polydioxanone cord for pelvis stabilization after accidental symphysis rupture is altogether reliable. Nevertheless in some cases we saw later on non satisfying reduction results in the "pelvis-half-joints"--especially in intense dislocation of the iliosacral amphiarthrosis. For improving the stability we investigated the stiffness character of some different methods with four PDS cords varied by four and six drilling holes. By increasing number of holes and short intentions direction knotted cords the stability is growing by 25%.

Biomechanical Phenomena↗
PubMed1991

[Experimental in vitro studies of the stability of tendon sutures].

In early mobilization tendon sutures must perform a sufficient stability. For the examination of a suture under tension tendons of cows with 4 to 6 mm diameter were taken as specimen. They were divided and then sutured with the techniques of Kirchmayr, of Lange and of Dychno-Bunnell. We used the resorbable Polydioxanon-Suture (PDS) and the non-resorbable Polypropylene-Suture (PPS) in 3-0, 4-0 and 5-0 of cross diameter (USP). Breaking-strength, elongation of the suture, the absorbed strength until a gap is developing and the extent of the gaps at their maximum were measured. The results recommend the suture techniques of Dychno-Bunnell and of Lange with 4-0 and 5-0 PDS as sufficient stable for early mobilization.

Animals↗
PubMed1991

[Results following the surgical treatment of acromioclavicular joint dislocations. A comparison of direct trans- and extra-articular fixation].

During the years 1985-1988, a total of 41 patients were treated for acromioclavicular dislocations. 25 (61%) were followed postoperatively for an average of 21 months. Two different methods of direct fixation of the AC-joint were compared: in 13 patients the transarticular fixation with two Kirschner wires and a 7.5 mm biodegradable Polydioxanon band (group I); in 12 patients an extraarticular fixation with PDS-band alone (group II). In both groups the ruptured ligament were sutured. In the first group physiotherapy was instituted immediately with limitation in abduction range to ninety degrees. After six weeks the Kirschner wires were removed under local anaesthesia and physiotherapy progressed to full range of motion. The shoulders of the second group patients were immobilized for 4 weeks. All of the patients were evaluated at follow-up on a subjective (pain, stiffness), objective (strength, range of motion, stability of the AC-joint) and roentgenographic (degree of displacement, posttraumatic arthritis, calcifications around the injured ligaments) basis. In both groups we saw good and satisfying results in more than 90%. A significant difference exists only as far as rehabilitation time is concerned. It was shorter in group I. In spite of the complications we observed with the metallic implants, which didn't have any negative influence on the results, we prefer the transarticular fixation method, because an immobilization postoperatively is not necessary and the time of rehabilitation is shortened.

Acromioclavicular Joint↗
PubMedDate not supplied

Kinetics of collagen deposition within bioresorbable and nonresorbable vascular prostheses.

This study compares the kinetics of collagen deposition within the prosthesis/tissue complexes formed following implantation of either polyglactin 910 (PG910), polydioxanone (PDS), or Dacron prostheses into rabbit infrarenal aortas. The grafts were explanted in triplicate at 1, 3, and 12 months, and then processed for spectrophotometric hydroxyproline quantitation. A 2 mm longitudinal strip from each sample was processed for histologic evaluation by light and electron microscopy. Results showed more extensive collagen deposition within the prosthesis/tissue complexes of both PG910 and PDS continuing throughout 3 months, as compared to less collagen deposition in Dacron grafts at all time points. Differences between PG910 and Dacron, and between PDS and Dacron at each time point were statistically significant. When correlated with previous related studies done in our laboratory, data showed that in resorbable grafts the rate of collagen deposition parallels the kinetics of cellular proliferation, tissue thickening, and graft resorption.

Animals↗
PubMed1991

[Tension band osteosynthesis with absorbable cords in proximal comminuted fractures of the humerus].

We reviewed 25 cases of comminuted fractures of the proximal humerus that were operatively treated from December 1984 to December 1988. Ten patients were treated by a Magerl operation modified by Marti using a metallic wire as a tension band. Twelve patients were operated on using a resorbable PDS (Polydioxanon) thread in the same manner. In this paper the PDS thread technique is described. The two groups are clinically and radiologically comparable. Using a PDS thread as a tension band has evident advantages: the relatively simple technique and the absence of implant removal.

Adult↗
PubMed1991

[The management of complete shoulder joint dislocation without metallic implants].

In 14 patients reduction of the acromioclavicular joint was reinforced by completely absorbable polydioxanon cord. In 3 cases parts of the cord were rejected and a fistula formed through the scar without further impairment following as a result of healing local treatment. Altogether we had 12 good and 2 poor results with respect to function, X-ray appearance and pain. The complication rate and general outcome of the method described do not differ substantially from those of other commonly used procedures. However, no second operation for removal of the metal implants is necessary.

Acromioclavicular Joint↗
PubMed1990

[Reducing tension in sutures of peripheral nerves].

A method is presented to reinforce normal suturing techniques in median and ulnar nerve repairs at the level of the forearm or wrist. If the distance between the stumps does not exceed 20 to 30 mm the coaptation can be protected from tension by two ribbons of polydioxanone (PDS) which are sutured to the epineurium bridging the site of the suture of the nerve. PDS ribbons proved to give remarkable support to experimental nerve repairs using epineural, perineural or Tsuge suture techniques. In further experiments with tibial nerves of rats the PDS ribbon did not interfere with the nerve function or with axon sprouting. Follow-up investigations of thirty-two median and ulnar nerve injuries treated with primary or secondary interfascicular sutures using PDS ribbons of 20 mm length and 1 mm width to protect the suture line revealed satisfactory reinnervation. The late results with this method were superior to a comparable group treated with autografts.

Animals↗
PubMed1990

Growth of tracheal anastomoses in lambs. Comparison of PDS and Vicryl suture material and interrupted and continuous techniques.

Tracheal anastomoses were performed in 19 lambs (mean age 4 weeks, mean weight 9.8 kg) to compare polydioxanone (PDS) and polyglactin 910 (Vicryl) suture material (Ethicon, Inc., Somerville, N.J.) and simple continuous and simple interrupted suture technique. Each animal had two anastomoses with full-thickness bites for both suture techniques. Animals were killed at 4 months (n = 6) or 8 months (n = 5). Eight animals died before they were scheduled to be put to death (mean 6 weeks postoperatively). Transverse sections of the trachea were taken at the level of the anastomoses and three tracheal rings above and below each anastomosis. The cross-sectional area of the tracheal lumen of these transverse sections was measured with a computerized digitizing tablet. A percent luminal area for each anastomosis was calculated relative to the mean tracheal area three rings above and three rings below the anastomosis. There was little difference between interrupted and continuous technique with either suture material (p = 0.94). In 10 animals that each served as its own control for suture material, PDS anastomotic area was 55.0% +/- 4.1% of mean tracheal luminal area compared with 45.4% +/- 7.1% for Vicryl anastomoses (p = 0.06). Histologic analysis revealed a more intense inflammatory reaction surrounding multifilament Vicryl sutures with more rapid resorption and greater subsequent fibrosis relative to the reaction seen with PDS sutures. A small clinical experience with seven infants has confirmed short-term satisfactory clinical performance of continuous PDS suture for tracheal anastomosis.

Anastomosis, Surgical↗
PubMed1990

Absorbable rings for pediatric valvuloplasty. Preliminary study.

Secondary valvular stenosis is a significant risk of annular ring implantation during valvular repair in children. To avoid this problem, we have developed an absorbable prosthetic ring (APR), which induces the generation of a biologic fibroelastic ring with mitotic capability and thereby allows atrioventricular annulus growth with age. Twelve polydioxanone (PDS) biodegradable APRs were surgically implanted in immature goats. To avoid possible embolic complications from ring fragments during the absorption period, APRs were covered with an extensible sewing sheath of high-porosity polyester, allowing contact between the PDS, blood, and endocardium. Four APRs were implanted into the right atrial cavity, four in the tricuspid position, and four in the mitral position. Histological studies at 6 months showed a considerable amount of remaining PDS. At 1 year, only small residual fragments of PDS were present, surrounded by collagen and elastic fibers as well as fibroblasts with mitotic activity. This histological structure represents a new biologic fibroelastic ring, which has originated from PDS rings. Echocardiography at 12 months showed that the elasticity of APRs and fibrotic tissue allows normal systolic and diastolic valve motions. These findings, which demonstrate histological changes in native valve annuli as well as stable and elastic annuloplasty without secondary stenosis in growing animals, call for new studies involving hearts with valvular disease.

Animals↗
PubMedDate not supplied

Prostacyclin production by blood-contacting surfaces of endothelialized vascular prostheses.

This study examines prostacyclin production by blood-contacting surfaces within woven vascular prostheses of polydioxanone (PDS), polyglactin 910 (PG910), or Dacron interposed into rabbit infrarenal aortas. Grafts and normal aortic segments were explanted after 1, 3, and 6 months for pulsatile perfusion with Medium-199 for 60 minutes. Aliquots were removed serially for 6-keto-PGF1 alpha assay. After 30 minutes sodium arachidonate (10 micrograms/ml) was added. Specimens were studied by light microscopy, SEM and TEM. Patency in all three groups exceeded 90%. All three showed re-endothelialization at one month. Normal aorta produced low basal 6-keto-PGF1 alpha with a marked evanescent post arachidonate increase. Dacron did not differ from normal aorta. PG910 and PDS both produced significantly less 6-keto-PGF1 alpha post arachidonate at one month but both increased to normal by three months.

6-Ketoprostaglandin F1 alpha↗
PubMed1989

Incisional closure in morbidly obese patients.

Wound complications cause significant morbidity in patients undergoing gastric restrictive procedures. Two randomized, prospective trials were done evaluating suture technique and material. A subcutaneous suction catheter was used for 48 hours in all patients. In Trial I a Polyglactin-910 (Vicryl) suture, #1 in size, was used. Patients were randomized between interrupted Smead-Jones far-far-near-near sutures and running sutures. Because hernia formation appeared excessive in both groups of patients, a second study was done comparing running #1 polydioxanone (PDS) and #1 polypropylene (Prolene) suture. Hernia formation was excessive in this group as well. The authors conclude running and interrupted closures are of equal reliability. Hernia formation was excessive in both groups. The type of suture material used in these studies was inconsequential. A better method of closure is needed in morbidly obese patients to achieve less postoperative hernia formation.

Adult↗
PubMed1989

[Growth of tracheal anastomoses in growing animals].

Growth of the trachea after complete transection and anastomoses was studied in four equal groups (N = 7) of young New Zealand white rabbits (mean weight 1.19 +/- 0.19 kg). The trachea was transected below the 5th cartilagenous ring and immediately anastomosed. Suture materials and sewing techniques used for comparison were continuous 6-0 polypropylene, interrupted 6-0 polypropylene, continuous 6-0 polydioxanone (PDS) or interrupted 6-0 PDS. The animals were electively sacrificed between 95 and 98 days after surgery. Mean body weight increased to 2.7 +/- 0.18 kg. Mean cross sectional area (CSA) of the trachea at sacrifice at the anastomosis (A) and an average of CSA 5 mm above and below the anastomosis (B) were compared. The ratios (A/B) of each groups were 0.52 (continuous polypropylene), 0.62 (interrupted polypropylene), 0.58 (continuous PDS) and 0.80 (interrupted PDS), respectively. One way of analysis of variance revealed that growth of the tracheal anastomoses in interrupted PDS was significantly better (p less than 0.005) than other combinations. It was concluded that growth of the trachea following complete transection and anastomosis in a growing animal was significantly better with absorbable suture material and interrupted suturing technique.

Anastomosis, Surgical↗
PubMedDate not supplied

The resistance of absorbable sutures in fetal tissue and fluids.

The resistance of three different types of absorbable suture materials was studied in three groups which simulated intrauterine conditions. In group I the sutures were incubated in the amnioallantoic cavity of chicken embryo (CE) and in group II in the fetal tissue of CE. For incubation of sutures in group III, human amniotic fluid collected during cesarean section operations in the thirty-eighth week of pregnancy was used. We discovered that chromic catgut had a lower resistance in fetal tissue than in fetal fluid (p less than 0.01), which could be an important point in the selection of fetal dermal sutures. In vitro incubation in human amniotic fluid did not effect the known rate of loss of chromic catgut, proglactin 910 and polydioxanone.

Amniotic Fluid↗