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PubMed2005

Use of continuous horizontal mattress suture techniques in microsurgery: an experimental study in rats.

PURPOSE: The purpose of this study was to determine whether the continuous horizontal mattress suture technique can replace the continuous simple suture technique and to compare the results with other microvascular suture procedures. METHODS: Sixty-four femoral arteries of 32 Sprague-Dawley rats were used in this study. The animals were divided equally into 4 groups with 16 anastomoses in each group. The arteries (0.8-1.0 mm diameter) were anastomosed by using the continuous horizontal mattress suture technique in group I, interrupted horizontal mattress suture technique in group II, simple interrupted suture technique in group III, and simple continuous suture technique in group IV. At the end of the anastomosis time, leakage, and patency were assessed and graded in all groups. On the 14th day after surgery the rats were killed and 5 patent specimens from each group were examined under light microscopy for histology. One specimen from each group was prepared for scanning of the endothelial surface under electron scanning microscopy. RESULTS: Group I anastomoses were performed the most quickly. Groups I and III anastomoses had 100% patency rates. Under light microscopy the edge eversion was apparent consistently and under electron microscopy all endothelial surfaces were intact and no suture material was seen in groups I and II. In group III some suture material was covered by endothelial cells and lumen surfaces were torn; endothelization also was rough compared with groups I and II. In group IV suture material was seen in the lumen because of a loose suture knot. The endothelium also was not regular. CONCLUSIONS: The horizontal mattress suturing technique is the only technique in which the suture material never contacts the lumen. Continuous horizontal mattress suture technique is superior to the other microvascular procedures and is the safest and fastest procedure for microvascular anastomosis in rats.

Anastomosis, Surgical↗
PubMed1987

Considerations in the choice of sutures for wound closure of the genitourinary tract.

The ideal suture for use within the urinary tract should maintain its tensile strength until wound repair is satisfactory and then it should undergo rapid total absorption without promoting stone formation. The bladder has a great potential for repair, attaining 100 per cent of the strength of the unwounded tissue in 14 to 21 days. Braided synthetic absorbable sutures appear to be suited ideally for closure of incised wounds of a urinary conduit. They maintain their tensile strength for approximately 21 days, during which time the healing tissues regain strength rapidly. Because sutures are foreign bodies and have access to urine, they may serve as a nidus for stone formation. Several factors that have been identified as important determinants of foreign body urolithiasis include the presence of urine, urine volume and pH, infection, physical and chemical configuration of the foreign body, and animal species. The incidence of suture urolithiasis is related directly to the duration in which the sutures are present in the urinary tract. Consequently, absorbable sutures are preferred over nonabsorbable sutures for closure of wounds of the urinary conduit. In the absence of infection braided synthetic absorbable sutures have distinct advantages over gut sutures for closure of urinary tract wounds. They are absorbed by nonenzymatic hydrolysis in a predictable manner with limited inflammatory response. In contrast, gut sutures have an unpredictable absorption rate by enzymatic degradation and elicit an exaggerated inflammatory response. Because infected urine, especially Proteus species, accelerates the degradation of absorbable synthetic sutures to a greater degree than gut sutures, wound closure in the presence of infection should be accomplished with the absorbable natural fiber suture. Nonabsorbable sutures or staples should not be used in the urinary tract because they predictably promote urolithiasis.

Collagen↗
PubMed2003

The tensile strength of uterosacral ligament sutures: a comparison of vaginal and laparoscopic techniques.

OBJECTIVE: To compare the tensile strength of two approaches for uterosacral ligament suturing using a cadaver model. METHODS: In 12 unembalmed cadavers, four polytetrafluoroethylene sutures were placed through the uterosacral ligaments. In each cadaver, two sutures were placed laparoscopically, and two more were placed vaginally. A single, experienced surgeon placed all laparoscopic sutures (n = 23), and another experienced surgeon placed all vaginal sutures (n = 22). A blinded team of investigators measured the distance from each suture to the ipsilateral ischial spine; determined whether any sutures incorporated ureters, viscera, or large vessels; and then passed the sutures through an apical vaginal incision. Using a hand-held tensiometer, progressive tensile load was then applied to these sutures along the axis of the vagina until they either broke or were completely dislodged from the ligaments. RESULTS: The average peak tension required to break or dislodge the sutures was 26.2 +/- 8.8 psi (laparoscopic) and 22.5 +/- 7.4 psi (vaginal) (P =.14, 95% confidence interval [CI] -1.2, 8.6). The average force required for suture breakage (n = 28) was 28 +/- 7 psi, and the average force applied when ligament failure occurred (n = 17) was 18.5 +/- 6 psi (P <.001, 95% CI -13.8, -5.2). The average distance from a laparoscopic or vaginal suture to the ipsilateral ischial spine was 19.1 +/- 7 mm and 17.4 +/- 6 mm, respectively (P =.46, 95% CI -3.0, 6.4). None of the sutures from either technique were found to incorporate a visceral structure, ureter, or great vessel. CONCLUSION: These suturing techniques appear to be equal in tensile strength.

Aged↗
PubMed2000

Comparison of biomechanical properties of periosteal suture fixation and bone anchor fixation to the pubic bone.

OBJECTIVES: To compare the relative strength of fixation using bone anchors (BAs) compared with direct suture placement into the periosteum. METHODS: The anterior bony pelvis was harvested from 21 female cadavers. In each pelvis, BA suture fixation was performed using Cinch anchors on one side of the pubic bone and direct periosteal suture fixation (PSF) on the contralateral side of the same pelvis. We used No. 1 polyproprolene suture for all cases. Using a hydraulic mechanical testing machine, all specimens were loaded in uniaxial tension until failure. RESULTS: Failure modes for BA-fixed pelves were as follows: 11 BA pull-out, 1 midsuture failure, and 9 suture cut by BA. Failure modes for the PSF pelves were as follows: 6 suture pull-outs through the bone, 14 midsuture failures, and 1 suture cut at the bone. PSF pelves required significantly higher loads to induce failure compared with BA pelves (PSF 92.63 +/- 22.62 N, BA 71.32 +/- 19.76 N, P <0.0002). In many cases, both PSF and BA were adequate points of fixation, and the major mechanism of failure was suture rupture. In pelves with suture failure, the load to induce failure was significantly higher in the PSF group (PSF 105.06 +/- 12.55 N, BA 86.06 +/- 7.78 N, P <0.0025). When the suture failed, PSF was better because BA fixation actually broke some sutures. The load required to induce failure was higher in the PSF groups in 19 (90.5%) of 21 pelves. CONCLUSIONS: Biomechanical testing using permanent monofilament suture did not demonstrate a superiority of BA suture fixation to PSF fixation. PSF appears superior, since BAs induced suture failure in many cases.

Biomechanical Phenomena↗
PubMed1998

Refractive and keratometric results after the triple procedure: experience with early and late suture removal.

OBJECTIVE: The objective of this study was to determine the outcome of early and late suture removal after the triple procedure (i.e., penetrating keratoplasty, cataract extraction, lens implant). DESIGN AND PARTICIPANTS: The refractive and keratometric results of 106 eyes undergoing the triple procedure were reviewed. The target postoperative refractive error was -1 diopter (D). RESULTS: Average length of follow-up was 40.3 months. Twenty eyes had sutures removed early (<18 months after surgery), 39 had sutures removed late (> or = 18 months after surgery), and 47 had sutures still intact at last follow-up. A best spectacle-corrected visual acuity of 20/40 or better was achieved in 90% of eyes with sutures removed early, 82.1% with sutures removed late, and 70.2% with sutures in place. For all eyes, the mean spherical equivalent at last follow-up was -2.50 D, with 75% of eyes falling between -4 and +2 D. The mean final refractive error was -3.40 +/- 3.53 D for eyes with sutures removed early and -1.79 +/- 3.99 D for eyes with sutures removed late. Eyes with sutures remaining had a mean final refractive error of -0.33 +/- 2.25 D. There was an overall decrease in refractive and keratometric astigmatism after both early and late suture removal with no significant difference between groups. However, there was a wide range of change with some eyes experiencing a decrease and others an increase in astigmatism. Mean postoperative K readings increased significantly for both groups after suture removal (final mean K, 47.00 D) but remained stable for eyes with sutures in. CONCLUSION: The authors data suggest that the final refractive error and net change in refractive and keratometric astigmatism after the triple procedure are not dependent on the timing of suture removal.

Aged↗
PubMed2002

A quantitative analysis of sutural contributions to variability in back vertex distance and transmittance in rabbit lenses as a function of development, growth, and age.

PURPOSE: To correlate specific parameters of lens structure (anterior and posterior suture branch length and planar area) with variability in back vertex distance (BVD) and scatter in rabbit lenses as a function of development, growth, and age. METHODS: Lenses from juvenile (n = 9), adult (n = 9), and aged (n = 10) New Zealand White rabbits were utilized in this study. After sacrifice, lens suture patterns were photographed using a stereo surgical dissecting microscope. Within 5 min of sacrifice, average BVD, variability in BVD, and scatter were assessed with a Scantox In Vitro Assay System. Laser beams were passed incrementally along anterior and posterior suture planes through right eye (oculus dexter, OD) lenses, and between suture planes through left eye (oculus sinister, OS) lenses. After fixation, lens axial dimensions and suture branch lengths were assessed and used to create scaled, 3-dimensional computer assisted drawings (3-D CADs) depicting gross lens shape and sutural changes throughout life. RESULTS: Whereas average BVD only increased significantly as a function of growth, variability in BVD only increased significantly as a function of aging. However, anterior sutures exerted a greater influence on variability of BVD than posterior sutures throughout growth and aging. This difference is consistent with anterior suture branches being longer, or extending farther peripherally, than posterior sutures. Scatter was essentially unchanged between juvenile and adult lenses but significantly increased in aged lenses. Notably, posterior sutures effected a greater age-related increase in scatter than anterior sutures. This difference was consistent with the formation of numerous small, posterior subbranches and subplanes later in life. Structural analysis also suggested that asymmetric age-related lens compaction had occurred, predominantly affecting posterior lens dimensions. CONCLUSIONS: Lens sutures significantly influence average BVD throughout development and growth, and variability in BVD throughout aging. In addition, even though the rabbit lenses appeared transparent throughout growth and aging, unequal length and area of anterior vs. posterior suture branches and planes respectively, as well as a greater degree of age-related posterior lens compaction, were factors contributing to increased scatter.

Aging↗
PubMed1997

Osteoblastic and osteoclastic activation in coronal sutures undergoing fusion ex vivo.

Numerous studies have demonstrated the importance of dura mater in the normal development and regeneration of the cranium and its sutures. The purpose of this study was to analyze the effect of dura mater on the metabolism of bone during the process of premature suture fusion. Previously, coronal sutures of fetal rats have been shown to fuse in serum-free culture after removal of their dura mater, whereas sutures of neonatal rats resist fusion even without their dura mater present. Sutures from these two distinct developmental stages were evaluated by assaying alkaline phosphatase and tartrate-resistant acid phosphatase (TRAP), marker enzymes of bone synthesis and catabolism, respectively. Coronal sutures with adjacent calvaria were dissected from fetal day 19.5 (F19) rats (n = 142) and neonatal day 1 (N1) rats (n = 42) and randomly divided into two groups each: F19 sutures with dura mater intact; F19 sutures with dura mater removed; N1 sutures with dura mater intact; and N1 sutures with dura mater removed. Calvaria were grown in serum-free medium for up to 21 days, and enzyme activities in suture regions were assayed by microanalytical techniques at different time intervals of culture. F19 sutures without dura mater exhibited significant increases in enzyme activities during days 7 to 21 of culture, whereas those without dura mater did not. N1 sutures with or without dura mater exhibited no significant changes in enzyme activities during the 14-day period of culture. The process of F19 suture fusion, occurring in the absence of dura mater, coincided with the increased activities of both alkaline phosphatase and TRAP. These cellular, enzymatic changes may have implications for the cellular events comprising craniosynostosis in vivo.

Acid Phosphatase↗
PubMed2001

The role of transforming growth factor-beta in the modulation of mouse cranial suture fusion.

Transforming growth factor-beta (TGF-beta) is actively expressed during mouse calvarial suture fusion. However, the role TGF-beta plays in this process remains unclear. The present study was performed to investigate whether modulation of suture fusion can be achieved by blocking the bioavailability of TGF-beta. Both in vitro and in vivo models were studied. For the in vitro model, the posterior frontal sutures from 24-day-old mice were harvested and cultured for 2, 3, or 4 weeks in the presence of 20 microg/ml of pan-specific TGF-beta polyclonal antibody or rabbit IgG as a control. Culture media were changed every 48 hours and fresh antibody or rabbit IgG was added during each media change. Suture fusion was evaluated by histometric analysis. For the in vivo model, TGF-beta antisense plasmid DNA complexed with lipofectamine was injected into the subgaleal layer along the frontal suture of 22-day-old mice under anesthesia. For control groups, empty vector plasmid DNA+ complexed with lipofectamine was used. The posterior frontal sutures were harvested at various time points and examined by histometric analysis and reverse transcription and polymerase chain reaction for the detection of messenger RNA. The in vitro studies demonstrated that the presence of TGF-beta antibody in culture media delayed posterior frontal suture fusion. By 3 weeks in culture, new bone area was only 20 percent of that in control groups as determined by histometric analysis. By the end of the fourth week, suture fusion was only 25 percent completed compared with controls. The in vivo studies demonstrated that, compared with the control, posterior frontal suture fusion was significantly delayed in the animals injected with antisense plasmid DNA. Suture fusion was complete in control animals by postnatal day 45. There was a 70 percent inhibition of suture fusion (new bone area) in antisense groups measured with histometric analysis. Four days after antisense plasmid DNA injection (age of 26 days), messenger RNA expression for TGF-beta 1 was 77 percent lower than in the control group. We have demonstrated that modulation of TGF-beta affects calvarial suture formation in vitro and in vivo with TGF-beta antibody and TGF-beta1 antisense plasmid DNA treatment, respectively. These data indicate that TGF-beta may play a causative role in mouse posterior frontal suture fusion. Modulation TGF-beta 1 gene expression in vivo can alter the natural history of cranial suture fusion.

Animals↗
PubMed2005

Functional significance of arytenoid adduction with the suture attaching to cricoid cartilage versus to thyroid cartilage for unilateral paralytic dysphonia.

OBJECTIVE: In the treatment of unilateral paralytic dysphonia, traditional arytenoid adduction is designed to place suture through the muscular process of the arytenoid attaching anteriorly to the thyroid ala. In contrast with the suture direction of this technique, a new paramedian approach to arytenoid adduction anchors anteroinferiorly to the cricoid cartilage, mimicking the force action of the lateral cricoarytenoid muscle (the major adductor of the larynx). This study investigated the influence of these changes in suture direction on the vocal fold level as well as the vocal outcomes in these two techniques of arytenoid adduction. STUDY DESIGN: A prospective clinical series. METHODS: Thirty patients with unilateral paralytic dysphonia underwent medialization laryngoplasty with arytenoid adduction and strap muscle transposition. Under local anesthesia, the thyroid lamina on the involved side was paramedially separated. The inner perichondrium was carefully elevated away from the overlying thyroid cartilage, carrying the dissection posteriorly to the level of the superior and inferior cornua. The lamina was retracted laterally, the inner perichondrium was opened near the midpoint, and the lateral cricoarytenoid muscle identified. Tracing the muscle fibers posterosuperiorly, the muscular process of the arytenoid was identified. A 2-0 Prolene suture was placed through the muscular process and temporarily tied to the anterolateral aspect of the thyroid ala (AA-thyroid suture). Intraoperative acoustic and perceptual assessments were performed. After releasing the tie, the suture was anchored to the cricoid cartilage at the origin of the lateral cricoarytenoid muscle (AA-cricoid suture). Voice assessments were repeated, and the outcomes of the two tests were compared. The choice of the type of arytenoid adduction suture was made intraoperatively according to which condition provided better vocal performance. After securing the suture, a bipedicled strap muscle flap was transposed into the space between the lamina and inner perichondrium and the thyroid cartilages sutured back into place. RESULTS: The intraoperative acoustic and perceptual assessments revealed the vocal performance was significantly better with AA-cricoid suture than the AA-thyroid suture in this series. No major complications occurred in the study. CONCLUSION: This study suggests that arytenoid adduction with suture attachment along the longitudinal axis of the lateral cricoarytenoid muscle to the cricoid cartilage is more physiologic and effective than that attaching the suture to the thyroid ala. A paramedian approach to arytenoid adduction with or without strap muscle transposition is a safe and effective method for treatment of unilateral paralytic dysphonia.

Adult↗
PubMed2006

A reinvestigation of murine cranial suture biology: microcomputed tomography versus histologic technique.

BACKGROUND: Histology remains the standard form to analyze cranial suture in murine models, but this technique provides only limited "snapshots" of the entire suture and requires animal euthanasia with tissue destruction. Because of the bone complex microarchitecture, better methods are required to study the behavior of the cranial suture and its surrounding environment. The authors compared microcomputed tomography and histology as techniques to evaluate murine cranial sutures. METHODS: A total of 360 microcomputed tomography images and 160 to 170 histologic sections were processed from a mouse at postnatal days 22 and 45, respectively. After euthanasia, the posterior frontal and sagittal sutures were imaged with a microcomputed tomography system and subsequently processed for histologic analysis. Quantitative analysis of two-dimensional images was performed to determine the percentage of bone in a 1-mm sample. RESULTS: Quantitative analysis of the percentage of bone within the sutures showed identical patterns by microcomputed tomography and histology techniques. Both methods demonstrated the posterior frontal suture to have heavier fusion patterns in the anterior and endocranial portions, with variable skip areas of complete patency on the endocranial surface, ectocranial surface, or both at day 45. CONCLUSIONS: Cranial suture fusion in the murine model is not an "all-or-none" phenomenon. The posterior frontal suture, previously thought to be completely fused on day 45 by histological analysis, showed variable fusion along the length of the suture by both methods. Quantitative assessment of the percentage of bone within the posterior frontal and sagittal sutures and morphologic assessment of these sutures demonstrated similar findings by both methods. Whereas thorough histologic evaluation of an entire suture would be extremely labor intensive and impractical, these findings help to validate microcomputed tomography as a rapid and reliable method of examining the entire suture in murine models.

Animals↗
PubMedDate not supplied

Biomechanical analysis of the effect of varying suture pitch in tendon graft fixation.

The purpose of this study was to biomechanically assess the effect of varying suture pitch on the holding power of the Krackow suture technique for tendon graft fixation. Seven pairs of rabbit Achilles tendons were sutured with single No. 5 Ti-Cron suture using the Krackow technique. One tendon from each pair was sutured using a 0.5-cm suture pitch (half-pitch group) while the contralateral tendon from each pair was sutured with a 1.0-cm suture pitch (one-pitch group). The tendons were loaded to failure using a servohydraulic materials test system at a loading rate of 0.5 mm/sec. There were no statistically significant differences noted in suture slippage at failure (1.58 cm for half pitch versus 1.45 cm for one pitch) or maximal force to failure (158.5 N for half pitch versus 168.2 N one pitch) between the two treatment groups. However, the construct with the 1-cm suture pitch was significantly stiffer than the construct with the 0.5-cm suture pitch, with stiffness values of 106.2 N/cm and 91.4 N/cm, respectively. The most common mechanism of failure was slippage of the suture at the first suture throw and tearing of the first knot through the most distal portion of the tendon. Four constructs failed by suture rupture, two from each experimental group.

Achilles Tendon↗
PubMed1991

[Effects of sutures on rat corneas].

Cellular infiltration of the suture line was studied immunohistologically after rat corneas were sutured with various types of suture materials. The suture line was invaded by helper/inducer T lymphocytes, cytotoxic/suppressor T lymphocytes, and Ia-antigen-positive cells. Among the invading cells, Ia-antigen-positive cells were the most prominent over an extended period of time from immediately after suture placement. The helper/inducer T lymphocytes consisted predominantly of cytotoxic/suppressor T lymphocytes. The 9-0 silk suture produced a higher degree of cellular infiltration than the 10-0 nylon suture or the 10-0 prolene suture. There was no marked difference in the infiltration produced by the 10-0 nylon and 10-0 prolene sutures. After the sutures were removed, the cellular infiltration appreciably decreased. More marked invasion occurred with interrupted sutures than after the inter-lamellar insertion of suture material. These findings indicate that suture materials on the cornea promote infiltration of immunocompetent cells and that mechanical stimulation of the suture notch enhances such cellular response, which may be involved in graft rejection of the corneal transplantation.

Animals↗
PubMed1989

[Clinical and histopathological studies of the suture made of DCFF-treated natural collagen fiber].

Natural and synthetic fiber sutures used clinically, especially twist or braid type ones, will remain to the region after healing by the first intention and often cause inflammation by capillarity. It is necessary to remove those sutures from healing wounds. To obviate this necessity, we separated collagen fibers from a tendon of a rat's tail, gave them DCFF treatment for immunological tolerance, and made collagen sutures on an experimental basis. The discussion on the clinical, histopathological and physical properties of the collagen sutures proved their superiority over any other type of suture currently used. (DCFF treatment: decalcifying, defatting and freeze-drying a material previously fixed in formalin.) 1. Results of Clinical Application: Collagen sutures immersed in 70% ethanol, contacting saliva, were easily handled and fell off spontaneously in about 7 days after operation. Thus removing sutures aren't necessary. 2. Histopathological Characteristics: (1) Biopsy observations show that the collagen sutures disclosed outside of the tissues were gradually decomposed by the activity of microbes in the oral cavity, falling off spontaneously in 7-10 days by the time of healing by the first intention, whereas those inside the tissues were more slowly absorbed. (2) The major portion of the collagen sutures, implanted in the dermis of a rat's back, was decomposed and absorbed in one week or 3 months at latest, with some portion encapsulated. All nylon sutures remained without being decomposed; most silk sutures, neither easily decomposed nor encapsulated, remained and occasionally caused distinct inflammatory rejection. 3. Physical Characteristics (load and elongation test): A tensility comparison between silk sutures (4-0 U.S.P. standard) with the collagen sutures of the same thickness showed the collagen sutures were stronger than the silk ones when they are wet.

Animals↗
PubMed1993

Craniofacial growth following rigid fixation: suture excision, miniplating, and microplating.

The effects of plating the coronal and nasofrontal sutures on skull growth were studied in New Zealand white rabbits. Removal of the underlying coronal suture and reduction in the size of the plate were also studied with regard to their effect on growth. Three-dimensional coordinate landmarks located on the skulls were digitized and analyzed to determine the differences in form between operated and unoperated animals using Euclidian distance matrix analysis. Interlandmark distances in three dimensions were compared to demonstrate changes induced by plating. Coronal suture plating (n = 8) resulted in local decreases in dimensions of the plated bones and contralateral and adjacent skull size increases. Removal of the coronal suture without plating (n = 6) resulted in an increase in the size of the adjacent frontal bone and an increase in the width of the suture. Placement of a plate after removal of the underlying suture (n = 8) resulted in decreases in dimensions of the plated bones, with distant length and width increases in a pattern similar to that of the skulls that were simply plated. Plating across the nasofrontal suture (n = 6) resulted in decreases in dimensions in the plated bone, with some distant width increases at the midfrontal bone, the coronal suture, and the posterior parietal bone. In this group, no contralateral increase in dimensions was detected. This is unlike the pattern observed for the animals with a coronal suture plate only. Placing a microplate across the coronal suture (n = 6) resulted in morphologies similar to those with the use of miniplates across the coronal suture. We propose that the varying morphologies in these groups represent compensatory changes accompanying growth restriction induced by plating. We suggest that the lack of contralateral growth increases with nasofrontal suture plating results from lesser effects on the underlying growing cranial contents at this location, as compared with the coronal suture. We find consistent results despite suture removal, change in plate location, and change in plate size.

Animals↗
PubMed1997

Sutural bone frequency in synostotic rabbit crania.

This study tests the hypothesis that crania with synostosed sutures will have a significantly higher incidence of calvarial sutural bones than normal crania. Sutural bones were counted in seven calvarial sutures and compared among four groups of adult New Zealand white rabbit skulls: normal in-colony (NI) controls (N = 14), normal out-colony (NO) controls (N = 12), skulls with familial delayed onset (DO) coronal synostosis (N = 25), and skulls with experimentally immobilized coronal sutures (EI) (N = 20). Comparisons among groups were made with a Kruskal-Wallis one-way ANOVA and between groups with a Mann-Whitney U-test, using a Bonferroni correction for multiple comparisons. Significant differences (P < 0.05) were noted only in the coronal and sagittal sutures, with EI crania having the greatest number of coronal sutural bones; between group differences were undetectable for sagittal sutural bones. A post hoc two-sample binomial test for equal proportions showed that the distribution of coronal sutural bones among individuals across groups was even, while the distribution of sagittal sutural bones was significantly higher in EI crania. These results suggest that altered sutural forces of the calvaria contribute to an increased occurrence of sutural bones. However, the influence of inheritance on increased occurrence of sutural bones cannot be discounted, as reflected in the equivalent number of individuals across groups that possessed coronal sutural bones.

Analysis of Variance↗
PubMed1984

Sutures of the crystalline lens: a review.

The sutures of the crystalline lens have previously been studied by light microscopy (LM). While the gross suture patterns (umbilical, line, y-shaped and star) of lenses are readily visualized by LM, fiber cell shape, curvature, length and the morphology of fiber cell ends cannot be adequately resolved by this technique. We have used scanning electron microscopy (SEM) to examine the sutures of crystalline lenses. SEM has revealed that in lenses with line, y-shaped or umbilical sutures, the anterior and posterior ends of fiber cells curve away in opposite directions from the polar axis of the lens before interlocking at suture branches. The degree of curvature decreases as a function of the number of suture branches. This relationship was not resolved by LM. SEM has revealed that the relationship of fiber cell taper to suture type was underestimated by previous LM studies. The reduction in fiber cell width from the equator to the sutures is 3:1 and 2:1 respectively, in lenses with line and y-shaped sutures. Furthermore, in lenses with star sutures, fiber cells are flared (1:1.7) rather than tapered, a fact not reported by previous LM studies. SEM also revealed that the offsetting of anterior and posterior suture branches does not result in equal fiber cell length in any growth ring as reported by LM studies. Rather, fiber cell length in any one growth ring varies as a sine wave function according to fiber cell location at the equator. Furthermore, the range of fiber cell length decreases as a function of the number of suture branches. Finally, SEM has revealed that the distal ends of fiber cells are expanded in both width and thickness prior to interlocking at suture branches and that these ends overlap rather than simply abut end-to-end to form a three dimensional suture plane extending down from the lens surfaces to the primary fiber cell mass.

Animals↗
PubMed2001

Influence of suture technique on laparotomy wound healing: an experimental study in the rat.

A suture length to wound length ratio (SLWL ratio) of 4:1 for laparotomy closure has proven in clinical studies to reduce incisional hernia incidence. The effect of different SLWL ratios on the mechanical qualities of the healing incision has not been examined experimentally. In 50 rats, the musculo-fascial layer of median laparotomies was closed with polypropylene sutures using SLWL ratios of 8:1, 4:1, 2:1 and 1.7:1. Single and running sutures, different tissue bites and different suture tensions were applied. Five rats served as controls. After 14 days, the horizontal strength of the incision was tested in a digitised tensiometer. The SLWL ratio, suture tension and suture technique proved to have significant influences on the mechanical strength of the incision. Running sutures and especially closures with a ratio of between 4:1 and 8:1 proved significantly stronger than wounds closed with single sutures. When small tissue bites were applied, the positive influence of running sutures was equalised in the early phase of wound healing. High suture tension led to significantly weaker scars independent of the applied suture technique. In accordance with clinical data, it could be proven experimentally that running closure of midline laparotomies with a SLWL ratio above 4:1 avoiding high suture tension exerts a significantly positive effect on the mechanical strength of the incision. Further studies are needed to allow measurement and better control of suture tension.

Animals↗
PubMed2004

Half-stained thread in shoulder arthroscopy: an improved method of suture management.

Shoulder arthroscopy is used widely to treat a variety of shoulder pathologies. These include various diagnostic and stabilization procedures such as Bankart repair, treating SLAP lesions, capsular plication, and rotator cuff repair. Sutures are commonly used, particularly in stabilization procedures, with or without the use of suture anchors. Suture management is one of the prerequisites for a successful arthroscopic stabilization procedure. We describe a simple method of aiding suture management. In cases using the suture anchor, the preloaded suture is firstly removed from the anchor, and approximately half the length of the suture is stained with methylene blue. The suture is then reinserted into the same suture anchor. The suture anchor is used in the usual manner. During shoulder arthroscopy, one end of the suture is pulled, if necessary, to determine the direction of the thread, which is readily shown by the methylene blue. This simple maneuver helps the surgeon identify the desired direction of the thread and avoid the common problems of pulling out the suture and twisting the sutures.

Arthroscopy↗