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At least 469 records · Page 26Linked to original sources
PubMed1989

Autogenous lamellar corneal grafting in dogs.

Lamellar, autogenous, corneal grafts were performed on 9 clinically normal dogs (1 eye in each of 2 dogs and both eyes in each of 7 dogs) and 7 dogs with corneal disease (1 eye in each dog). Nylon, polyglycolic acid, polyglactin 910, and polydioxanone suture materials were used in 8-0 to 10-0 sizes. The eyes of the normal dogs were examined weekly for up to 16 weeks; corneal endothelium was reestablished in all eyes by 6 weeks after surgery. The eyes of the dogs with corneal disease were reexamined periodically for up to 9 months. Twenty-two of 23 (95.7%) grafts were considered successful in that they were translucent, and the dogs were able to see after surgery. The suture materials that caused the least tissue reaction were nylon and polyglactin 910. This procedure is indicated for chronic descemetoceles and other perforating corneal disease. It has the advantage of rapidly resolving severe corneal disease, with a high degree of success.

Animals↗
PubMed1989

Reinforced staple line in severely emphysematous lungs.

In severely emphysematous or otherwise destroyed lung parenchyma, staples often cut through, which causes prolonged postoperative air leakage. A mechanical suture line reinforced by a polydioxanone ribbon is a simple, safe, and effective method for closure of air leaks, resection, or biopsy in such cases.

Humans↗
PubMed1989

Quantitative evaluation of stiffness of commercial suture materials.

The bending stiffness of 22 commercial suture materials of varying size, chemical structure and physical form was quantitatively evaluated using a stiffness tester (Taber V-5, model 150B, Teledyne). The commercial sutures were Chromic catgut; Dexon (polyglycolic acid); Vicryl (polyglactin 910); PDS (polydioxanone); Maxon (polyglycolide-trimethylene carbonate); Silk (coated with silicone); Mersilene (polyester fiber); Tycron (polyester fiber); Ethibond (polyethylene terephthalate coated with polybutylene); Nurolon (nylon 66); Surgilon (nylon 66 coated with silicone); Ethilon (coated nylon 66), Prolene (polypropylene); Dermalene (polyethylene), and Gore-tex (polytetraflouroethylene). These are both natural and synthetic, absorbable and nonabsorbable and monofilament and multifilament sutures. All of these sutures were size 2-0, but Prolene sutures with sizes ranging from 1-0 to 9-0 were also tested to determine the effect of suture size on stiffness. The bending stiffness data obtained showed that a wide range of bending stiffness was observed among the 22 commercial sutures. The most flexible 2-0 suture was Gore-tex, followed by Dexon, Silk, Surgilon, Vicryl (uncoated), Tycron, Nurolon, Mersilene, Ethibond, Maxon, PDS, Ethilon, Prolene, Chromic catgut, coated Vicryl, and lastly, Dermalene. The large porous volume inherent in Gore-tex monofilament suture was the reason for its lowest flexural stiffness. Sutures with a braided structure were generally more flexible than those of a monofilament structure, irrespective of the chemical constituents. Coated sutures had significantly higher stiffness than the corresponding uncoated ones. This is particularly true when polymers rather than wax were used as the coating material. This increase in stiffness is attributable to the loss of mobility under bending force in the fibers and yarns that make up the sutures. An increase in the size of the suture significantly increased the stiffness, and the magnitude of increase depended on the chemical constituent of the suture. The flexural stiffness of sutures was also found to depend on the duration of bending in the test for stiffness. In general, monofilament sutures exhibited the largest time-dependent stiffness. This was most pronounced with the Gore-tex suture. Most braided sutures also showed less time-dependence in stiffness. Nylon sutures did not exhibit this time-dependent phenomenon regardless of physical form.

Elasticity↗
PubMed1986

Dacron inhibition of arterial regenerative activities.

These biocompatibility studies evaluate the effects of Dacron, absorbable polymeric, and compound prostheses containing both elements in various constructions on the migration, proliferation, and functional characteristics of regenerating endothelial and smooth muscle-like cells in the rabbit aorta model. Prosthesis/tissue complexes explanted after 2 weeks to 9 months were studied grossly, photographed, sectioned for light microscopy and scanning and transmission electron microscopy, and assayed for 6-keto-PGE1 alpha contents in inner capsular tissues. Polyglycolic acid, polyglactin 910, or polydioxanone prostheses elicited a transinterstitial migration and proliferation of primitive mesenchymal cells that differentiated into smooth muscle-like myofibroblasts and a surface repopulation of confluent endothelial-like cells paralleling the time course of macrophage-mediated prosthetic dissolution. Even small Dacron components (20%) woven into or surrounding the absorbable polymer significantly inhibited these processes, yielding significantly thinner, less cellular inner capsules with lower 6-keto-PGF1 alpha contents. These studies show the augmentation of clinically efficacious arterial regenerative activities by polymers phagocytosed by macrophages and the inhibition of these activities by Dacron.

6-Ketoprostaglandin F1 alpha↗
PubMed1988

Infant orthotopic cardiac transplantation.

Infant orthotopic cardiac transplantation has been recently applied to various forms of congenital heart disease with encouraging short-term results. Between June 1986 and September 1987 we evaluated 16 infants for orthotopic cardiac transplantation. Fourteen had hypoplastic left heart syndrome, one had endocardial fibroelastosis with aortic atresia, and one had anomalous pulmonary arterial origin of the left main coronary. Eight families accepted the treatment program and eight families refused (two because of associated anomalies and six on philosophical grounds). Of the eight patients who were candidates for orthotopic cardiac transplantation, one died 6 hours after diagnosis, one was allowed to die after 60 days because of acquired neurologic complications, and another had congenital cytomegalic virus infection. The remaining five patients (four with hypoplastic left heart syndrome, one with anomalous pulmonary arterial origin of the left main coronary) had orthotopic cardiac transplantation. The operation was performed with absorbable polydioxanone suture with deep hypothermia and circulatory arrest in four neonates for hypoplastic left heart syndrome (average time 47 minutes) and bicaval cannulation and continuous bypass in one 11-month-old infant for anomalous origin of the left main coronary. In-house retrieval was used in all. One neonate died of complications as a result of pretransplant donor heart dysfunction and size discrepancy, whereas the remaining three neonates and one infant survived and are home 23 months, 12 months, and 8 months (the patients with hypoplastic left heart syndrome) and 17 months (the patient with anomalous origin of the left main coronary) postoperatively. Triple-drug immunosuppression included cyclosporine, azathioprine, and prednisone. Rejection was diagnosed by clinical evaluation of child activity and monocyte cell cycle analysis from peripheral blood samples without myocardial biopsies. Routine echocardiograms, electrocardiograms, and chest x-ray films were not helpful. Six episodes of rejection were successfully treated in four patients. Twelve-month postoperative catherization in one patient (hypoplastic left heart syndrome) showed appropriate graft growth, no aortic or pulmonary anastomotic strictures, normal right and left ventricular function, and no coronary artery disease. We conclude that infant orthotopic cardiac transplantation is an acceptable procedure for severe forms of untreatable congenital heart disease. The excellent short-term results warrant continued application of orthotopic cardiac transplantation.

Acute Kidney Injury↗
PubMed1988

Evaluation of three techniques for end-to end anastomosis of the small colon in horses.

In an attempt to determine the best method for surgical removal of devitalized small colon lesions, 12 horses underwent a double small colon resection and end-to-end anastomosis. In 4 horses (study 1), an appositional single-layer (APP-1) suture pattern was compared with an inverting 2-layer (INV-2) suture pattern. In 8 horses (study 2), an appositional 2-layer (APP-2) suture pattern was compared with the INV-2 suture technique. Polydioxanone suture (size 1-0), was used. Horses were evaluated at necropsy 3, 10, 14, 28, or 56 days after surgery. Postoperative complications (peritonitis, impaction, or excessive adhesions) were encountered in 100, 42, and 13% of the APP-1, INV-2, and APP-2 anastomoses, respectively. Postmortem evaluation of the small colon revealed dehiscence of the anastomotic site, diffuse peritonitis, and adhesion formation in 3 of the 4 horses in which the resection line was closed with the APP-1 pattern. With the INV-2 and APP-2 techniques, more intestinal inversion was present in the nontaenial than in the taenial portion of the small colon. More postoperative impactions were found with the INV-2 (n = 5) anastomoses than with the APP-2 (n = 1) technique; this appeared to be the result of excessive tissue inversion. There was no difference in lumen diameter between the INV-2 and the APP-2 techniques (P greater than or equal to 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomosis, Surgical↗
PubMed1985

[Suture technics for the abdominal wall after midline laparotomy].

During the last 10 years 268 laparotomies by a midline incision were performed. A high incidence of seromas, fistulas caused by suturing material and wound ruptures were observed. After finding only a small number of publications in the veterinary medicine about wound healing disturbances an analysis of the human medical literature was done. This induced the change of our surgical procedure and suturing technique: The midline incision and surgical management during the laparotomies in 14 horses suffering from colic were performed by a minimized trauma. The abdominal wall was closed layer by layer in the following manner: peritoneum by a running suture of catgut metric 5, linea alba by Sultan single sutures of polyglycolic acid material metric 5 (12 cases) or of polydioxanone metric 4 (2 cases), subcutaneous layer by a running suture of polyglycolic acid material metric 4, skin by single sutures of monofilamentous synthetic material metric 2. Thus, no complications in wound healing were observed in these 14 horses. Therefore, we recommend to prove the described surgical and suturing procedure by a larger number of horses undergoing a laparotomy by a midline incision.

Animals↗
PubMed1983

[Pathophysiologic aspects, progressive and new developments in absorbable fully synthetic suture materials].

Polyglycolic acid (PGA) sutures and Polyglactin-910 sutures show only minimal tissue reaction, nearly no scar formation and no immunological reactions. PGA sutures of the third generation have the same advantages, but surgical handling is to much improved that they may be technically employed in unfavourable locations, e.g. gastrointestinal tract and respiratory organs. PGA sutures of the third generation and the new monofil Polydioxanon suture need special knot techniques.

Absorption↗
PubMed1984

Surgical implantation of radiotelemetry devices in American river otters.

The Oklahoma Department of Wildlife Conservation elected to investigate the feasibility of reintroducing American river otters (Lutra canadensis) into Oklahoma waterways. Intra-abdominal radiotelemetry devices were selected to monitor otter movements following release. For implantation of those devices, the anesthetic regimen included a mixture of ketamine HCl, xylazine, and acepromazine maleate given intramuscularly followed by delivery of isoflurane through precision vaporizers. A ventral midline approach and adherent surgical barrier drapes facilitated aseptic placement of the devices, with minimal tissue damage and loss of insulating pelage. Absorbable monofilament suture (polydioxanone) was used in a buried 3-layer closure of surgical incisions. The incisions healed rapidly and without complications.

Anesthesia↗
PubMedDate not supplied

Risk of complications of first metatarsal head osteotomies with biodegradable pin fixation: Biofix versus Orthosorb.

Bioabsorbable materials for fracture repair have recently become available in the United States. These products have been especially attractive to surgeons that perform elective foot surgeries because an additional surgery is not required to remove internal fixation, and exposed pins and their complications can be avoided. The aim of this study was to compare complications in distal first metatarsal head osteotomies fixed with Biofix, polyglycolide pins and Orthosorb, polydioxanon pins. The authors identified nine patients with 11 distal first metatarsal osteotomies repaired with Biofix and 28 patients with 34 osteotomies repaired with Orthosorb from surgery logs for a 2-year period. The authors abstracted medical records and radiographs to identify sterile sinus formation, non-unions, malunions, and osteolytic lesions. The age and gender of patients in the Orthosorb and Biofix groups were similar. Six osteotomies in five patients in the Biofix group demonstrated bone resorption and osteolytic changes involving the osteotomy. Two of these patients also had a dorsally subluxed malunion of the first metatarsal head. There was one dorsally subluxed malunion in the Orthosorb group. No sterile sinus tracts were identified in either group. Complications were more common in distal first metatarsal osteotomies fixed with Biofix compared with Orthosorb (Biofix 55%, Orthosorb 3%, p < 0.001, odds ratio: 39.6, confidence interval (CI) = 3.9-401.6). Complications in the Biofix group were significantly more common in patients 50 years of age and older (p < 0.05).

Adult↗
PubMed1994

[Rupture of the Achilles tendon--case report of a rare form of Achilles tendon damage].

The great increase in the number of persons engaged in sports in the 30-50 years age group has led to a marked increase in injuries of the tendon of Achilles. In this case there is tearing loose of the Achilles tendon; the bone and the tendon come apart, as in a rupture of Sharpey's fibres. The tack was made in webbing the tendon of Achilles with polydioxanone ligaments to the tuberosity of calcaneus. The question about prophylactic webbing of the degenerated tendon of Achilles on the other side has to be discussed. Assessment of this injury from the viewpoint of the accident insurance company is explained.

Achilles Tendon↗
PubMed1994

Mechanical strength of repairs of the rotator cuff.

We have studied the mechanical properties of several current techniques of tendon-to-bone suture employed in rotator-cuff repair. Non-absorbable braided polyester and absorbable polyglactin and polyglycolic acid sutures best combined ultimate tensile strength and stiffness. Polyglyconate and polydioxanone sutures failed only at high loads, but elongated considerably under moderate loads. We then compared the mechanical properties of nine different techniques of tendon grasping, using 159 normal infraspinatus tendons from sheep. The most commonly used simple stitch was mechanically poor: repairs with two or four such stitches failed at 184 N and 208 N respectively. A new modification of the Mason-Allen suture technique improved the ultimate tensile strength to 359 N for two stitches. Finally, we studied the mechanical properties of several methods of anchorage to bone using typically osteoporotic specimens. Single and even double transosseous sutures and suture anchor fixation both failed at low tensile loads (about 140 N). The use of a 2 mm thick, plate-like augmentation device improved the failure strength to 329 N. The mechanical properties of many current repair techniques are poor and can be greatly improved by using good materials, an improved tendon-grasping suture, and augmentation at the bone attachment.

Animals↗
PubMed1993

Vanishing De Vega annuloplasty for functional tricuspid regurgitation.

Annuloplasty is performed for significant functional tricuspid regurgitation even if it is presumed that in some cases the regurgitation will regress spontaneously after correction of the left-sided lesion. In an attempt to avoid the drawbacks of a permanent annuloplasty, we used a reabsorbable De Vega annuloplasty in a selected group of patients. Of 73 patients with functional tricuspid regurgitation operated on between May 1989 and May 1991, 25 with pulmonary arteriolar resistance below 400 dyne.sec.cm-5 underwent a De Vega annuloplasty with 2-0 polydioxanone suture. The diagnosis of significant functional tricuspid regurgitation (mean 2.74 +/- 1.05) was established by transthoracic color Doppler echocardiography in all patients. The degree of functional tricuspid regurgitation and pulmonary arteriolar resistance were measured with the patients anesthetized. In 16 patients the regurgitation remained severe (3+ to 4+) and in 9 it was moderate (2+). Twenty-three patients had mitral (12 repairs, 11 replacements) and 9 had aortic (4 repairs, 5 replacements) valve operations. The immediate postbypass residual functional tricuspid regurgitation was 0 to 1+ in 23 and 0 in 2. There was 1 (4%) operative death. The maximum follow-up period was 24 months (mean 13.9 months). There were 2 (8.3%) late deaths. Six patients underwent reoperation because of mitral dysfunction. Four of them who were reoperated on between 2 and 5 weeks after the initial procedure showed no recurrence of functional tricuspid regurgitation. The other 2, reoperated on at 5 and 10 months after the first operation, had recurrence of functional tricuspid regurgitation. Visual inspection of these two tricuspid valves showed a dilated anulus with otherwise normal valves. All surviving patients are in New York Heart Association functional class I or II without significant functional tricuspid regurgitation (mean 0.78 +/- 0.56). We concluded that functional tricuspid regurgitation in patients with low pulmonary arteriolar resistance can be adequately treated by a vanishing De Vega annuloplasty, which will stent the tricuspid anulus for about 4 months.

Adolescent↗
PubMed1996

Vaginal vault evisceration after total laparoscopic hysterectomy.

BACKGROUND: Vaginal vault rupture with intestinal herniation, although rare, is a recognized postoperative complication of vaginal and abdominal hysterectomies. The incidence after laparoscopic hysterectomy is unknown. CASES: Three women, ages 40-43 years, presented to the emergency room with bleeding and pain 2-5 months after total laparoscopic hysterectomy. The small bowel was visible through the introitus or protruding into the vagina. Inspection of the bowel revealed no evidence of trauma. Two vaginal cuff repairs were completed transvaginally and one laparoscopically, all with interrupted sutures of no. 0 polydioxanone or polyglactin. In follow-up period of 12-17 months, the patients were doing well. CONCLUSION: Total laparoscopic hysterectomy may be associated with an increased risk of vaginal vault evisceration. Because laparoscopy increasingly is used to replace abdominal hysterectomy, it is important to be aware of this complication and its management.

Adult↗
PubMed1994

[Characteristics of surgical sutures in the duodenum and small intestine].

The particularities of the surgical suture of duodenum and small intestine are exposed. According to the recent experiences from the literature, the best material for the intestinal suture is monofilamentous, with delayed resorption rate, and characterized by the hardness appropriate to the tissue involved. The representatives of these are Polyglactin and Polydioxanon. In the technique of the duodenal suture, inversion of the tissue and placing the sutures in the healthy tissue are more important than mucosal inversion and multiple layers closure. The omental patch must be variable, and not involved directly in sutures. In the small intestinal surgery, one layer sero muscular-extramucosal, or two layers mucomucosal with inversion and seroserosal suture are to be used. For duodenojejunal transition, terminolateral anastomosis is recommendable. Upon lower parts of ileum oblique terminoterminal or latero-lateral anastomosis is to be used. In the cases of luminal disproportion between open ends, terminolateral anastomosis seems to be the best choice. The percentage of duodenal stump dehiscence in the period of 1986-1992. is 2.53% upon 356 emergencies of delayed operations, and the percentage of the intestinal anastomotic dehiscence upon 102 elective and emergency operations is 5.8%.

Anastomosis, Surgical↗
PubMed1996

[Indications for various reconstruction and osteosynthesis methods in surgical management of subcondylar fractures of the mandible].

We do not advocate routine open reduction in subcondylar fractures, but there are some indications for surgical treatments. If we have decided for open reduction, the risks must be weighed against the benefits. If we are not sure, that the condyle is in a correct position, we avoid rigid internal fixation and we prefer only a temporary stabilization with resorbable Polydioxanone, Polylactide or autologous bone-pins. In non oblique fractures, we recommend only open reduction without further internal fixation. The advantage is that the condyle has the ability to move into a physiologic position and there is no need to remove metal implants in a second operation, the disadvantage is that we cannot avoid MMF and functional therapy, but our experience shows that the functional therapy can be shortened. Resorbable- and bone-pins could not take place of miniplates or traction-screws, but in selected cases, they could enlarge the surgical treatment in subcondylar fractures.

Adolescent↗
PubMed1996

Laparoscopic management of intentional and unintentional cystotomy.

PURPOSE: We assessed the laparoscopic closure of intentional or unintentional bladder lacerations during operative laparoscopy. MATERIALS AND METHODS: Retrospective review of operative reports revealed 19 women who required bladder repair. The defect was repaired laparoscopically in 1 layer using interrupted absorbable polyglycolic suture (17 patients) or polydioxanone suture (2) and followed by 7 to 14 days of transurethral drainage. RESULTS: Complications were limited to 1 vesicovaginal fistula that required reoperation. After 6 to 48 months of followup all patients were well with a good outcome. CONCLUSIONS: In select cases the bladder can be repaired safely and effectively during operative laparoscopy by an experienced laparoscopic surgeon.

Adult↗
PubMed1997

Bioresorbable fracture fixation in orthopedics: a comprehensive review. Part I. Basic science and preclinical studies.

Metal alloys are currently the most popular materials for manufacture of fracture-fixation devices. Two major disadvantages of these materials are their extreme stiffness, which causes stress shielding of the underlying bone, and the necessity, in a significant number of cases, of removing metallic implants after fracture healing is complete. These shortcomings of metal alloys have led to the study of bioresorbable materials for use in fracture fixation. Currently, polylactic acid, polyglycolic acid, and polydioxanone implants are available to the orthopedic surgeon for the fixation of small cancellous bone fractures. Part I of this article provides an overview of the basic science of bioresorbable materials and presents a comprehensive review of preclinical studies reported in the orthopedic literature. Clinical studies will be reviewed in Part II.

Alloys↗