[SUTURE TECHNICS IN PERFORATING ULCERS OF THE STOMACH AND DUODENUM].
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UNLABELLED: The safety and efficacy of a suture-based closure device designed to achieve hemostasis at the femoral access site post catheterization procedures was compared to manual compression in a 600 patients randomized trial (data available for 590 patients). The patients were randomized to percutaneous vascular surgery (PVS) or manual compression after diagnostic (401 patients) and interventional (189 patients) procedures. Two types of PVS devices were used delivering 1 or 2 sutures at the arterial access site. The overall results as well as the results by procedure type demonstrated a significant reduction in time of hemostasis (7.8 +/- 4.8 min vs 19.6 +/- 13.2 min, p < 0.01) and time to ambulation (4.5 +/- 6.5 hours vs 17.8 +/- 5.0 hours, p < 0.01) with the use of the PVS device. The safety results showed no significant differences in the incidence of vascular complications (5.7% for PVS vs 11.3% for compression) in the overall population or in the interventional patients subset (8.4% for PVS vs 9.6% for compression). However, the PVS device demonstrated a significant reduction in the incidence of vascular complications post diagnostic catheterization procedures (4.4 for PVS vs 12.1% for compression, p < 0.05). The incidence of vascular complications and the time of hemostasis was similar in an American multicenter study (STAND II). CONCLUSION: Percutaneous vascular surgery is a safe and effective method to achieve hemostasis post catheterization procedure providing faster hemostasis and ambulation without increasing the rate of complication.
Suture techniques are a fundamental aspect of surgical practice in terms of the successful outcome of the operation. Even in dentistry it is important to have a clear idea of the method and the type of thread used. This paper lists the types of suture threads most commonly available today, the main techniques used and, on the basis of the authors' personal experience, explains a method used for oral surgery.
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A modification of the conventional tubal anastomosis technique bearing on the suture of the musculo-muscular layer is described. The extra-mucosal suture suggested is the most important point of the operation. The new technique applies to isthmo-isthmic, isthmo-interstitial and isthmo-uterine anastomoses but also to ampullo-isthmic, interstitial or uterine anastomoses. Two separate continuous sutures with a non-absorbent 8/0 or 9/0 thread are performed, one at 4, 6 and 8 hours, the other at 10, 12 and 2 hours, then ligated together. The advantages of this technique is that it is more rapid and less traumatic than others and gives very good anatomical and functional results.
It could be shown that beside the non-absorbable synthetic suture material (Polypropylene) for the subcuticular continuous skin suture absorbable synthetic suture material (Polyglactin 910) is suitable for the buried subcuticular skin suture to obtain good esthetic scars in plastic surgery. Experiences with Polyglactin 910 in over 300 patients are presented. In no case wound healing was disturbed as a result of the suture material. Further application will give more information about the usefulness of the absorbable synthetic suture material Polyglactin 910 for the buried subcuticular skin suture.
An altered suture technique for rectum anastomosis is elucidated. This single row of wide reaching sutures allows for a principally one-stage anterior rectum resection on the basis of intact microcirculation in the anastomosis region. The operative tactical procedure is explained in detail.
A surgical technic for liver wedge biopsy is described. Vertical mattress sutures are placed to outline a triangular mass of liver with its apes 2 to 3 cm from the liver edge and its based formed by the edge. The suture is tied tightly until the mass blanches, and the biopsy is made within the mass. No additional suturing or hemostatic agents are needed.
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The scar is the surgeon's best advertisement. Atraumatic operative technique including correct suturing is the best prophylaxis of bad scar formation.
The outcomes of traditional epineural, microsurgical epineural and interfascicular sutures of the median and ulnar nerves in the lower third of the forearm were compared in children. Evidence is provided for the differential approach to applying an interfascicular and microsurgical epineural suture, as well as for limitations in the use of an interfascicular suture. The authors show it necessary to make investigations to clarify whether the fascicles on the ends of a diseased nerve may be more validly identified and whether the studies into connective and nerve tissue relationships in the suture line.