Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SUTURES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 649 records · Page 36Linked to original sources
PubMed2004

The tensile strength of Cooper's ligament suturing: comparison of abdominal and transvaginal techniques.

This study was designed to compare the strength and position of sutures anchored into Cooper's ligament utilizing a minimally invasive transvaginal suturing technique, versus the 'open' abdominal approach. In 12 fresh cadavers, Cooper's ligament was accessed via abdominal and vaginal incisions. After randomization, polytetrafluoroethylene (00) sutures were spaced along one ligament with the transvaginal device (n=36). Contralaterally, sutures were placed abdominally (n=36). Progressive load was applied until suture breakage or dislodgement, and tensile strength was measured using a digital tensiometer. Peak tension averaged 14.5 psi for abdominal and 12.96 psi for vaginal (p=0.28). Suture breakage rather than ligament 'pullout' was more likely for abdominal (95 vs. 56%, p=0.0001). Vaginal and abdominal sutures demonstrated nearly identical mean distances from mid-symphysis (4.62 vs. 4.24 cm, p=0.56). Peak tension was not correlated with suture location (r2=0.17, p=0.28). We conclude that transvaginal suturing, using the minimally invasive device, achieved similar tensile strength and position to the open technique. Transvaginal sutures were associated with greater likelihood of ligament 'pullout' before suture breakage under maximal load; however, the clinical implications of this finding are uncertain.

Abdomen↗
PubMed1998

Morphology of the development of the sagittal suture of mice.

Syndesmotic sutures of the skull are formed by dense connective tissue and called "open"; they are "closed" by formation of a synostosis between adjacent bones. Open sutures are considered as areas of growth and as hinges. The importance of open sutures during the period of skull growth is reflected by pathological situations in which premature closure of the sutures occurs. As alterations of the FGF receptor have been reported in genetical disorders accompanied by premature suture closure (Bellus et al. 1996), the role of fibroblasts and connective tissue in the development of the sagittal suture of mice has been investigated by light and electron microscopy. Morphological changes of the sagittal suture at the following stages are reported: at embryonic day 18, days 1, 5, 9, 14, 20, 26, 28 after birth and in adult mice. Two skulls per stage were investigated. Early osteogenesis appeared in a thin plate, followed by a second plate underneath the first one. Both were separated by blood vessels. In general, vascularization preceded desmoid mineralization; the space around blood vessels was occupied by non-bone-forming cells leaving cavities for the presumptive bone marrow. Mineralization of the collagen-rich osteoid at the mineralizing rim of the bone plates was accompanied by apoptoses and cell disintegration. Newly formed bone was immediately covered by osteoblasts forming a sheet of bone-lining cells. At day 9, the double-layered bone plates of both sides reached the median area of the skull but were separated by non-mineralizing, collagen-rich connective tissue. From day 14 onwards, the bone plates thickened. Bone apposition, recognizable by the formation of collagen-rich osteoid and proceeding from day 14 pp onwards, occurred mainly at the outer and inner surfaces of the calvariae, but neither at bone marrow surfaces nor at the medial edges of the parietal bones. These opposite bone faces showed fewer osteoblasts and bone-lining cells, but an increased number of fibroblasts. Tendon-like collagen bundles connected both bone plates of the open suture of day 26 pp as well as in the adult mice, whereby synostotically closed areas alternated. Formation of an open, syndesmotic suture can, therefore, be described as a transition of bone-forming tissue into a bone-tendon junction. The results indicate the importance of the replacement of osteoblasts by fibroblasts at the sutural front of the bone plates in order to prevent a premature suture closure.

Animals↗
PubMed2002

[Primary strength of conventional and alternative suture techniques of the rotator cuff. A biomechanical study].

The aim of this biomechanical study was to evaluate rotator cuff repair strength using different suture anchor techniques compared to conventional repair, taking into consideration the native strength of the supraspinatus tendon. Therefore, a defined defect of the supraspinatus was created in 50 freshly frozen cadaver specimen (group size n = 10; median age at death: 56 years). Five methods were employed for cuff repair: standard transosseous suture, modified transosseous suture with patch augmentation and three suture anchors (Acufex Wedge TAG, Acufex Rod TAG und Mitek GII). The maximum tensile load of the five techniques was: standard transosseous suture, 410 N; modified transosseous suture, 552 N; Wedge TAG, 207 N; Rod TAG, 217 N; Mitek GII, 186 N. The difference between the suture anchor and standard techniques were highly significant (P < 0.001). In this series, the Mitek Gll anchor showed the lowest anchor dislocation rate at 3% (n = 1). The Wedge TAG system had a dislocation rate of 27% (n = 8) and the Rod TAG system 43% (n = 13). Suture anchor techniques revealed about 20%, the standard technique 34% and its modification 60% of the hypothetically calculated native tendon strength. Compared to conventional transosseous suture techniques, the use of the suture anchors tested in this series does not significantly increase the primary fixation strength of rotator cuff repair. The metallic implant with two barbs (Mitek GII) seems to be superior to the polyacetal anchors when inserted into the spongiform bone of the greater tubercle. The considerably weaker repair strength needs to be taken into consideration in postoperative patient rehabilitation, especially after the use of suture anchors.

Adult↗
PubMed1987

Effect of force on anastomotic suture line disruption after carotid arteriotomy.

Static and dynamic forces exerted on 6-0 polypropylene suture material after carotid arteriotomy were measured in 22 adult mongrel dogs. Force was measured in 11 normotensive animals (Group I) before and 6 weeks after carotid artery repair. Force was measured in the remaining animals during normotension and induced hypertension before and 6 weeks after operation. The tensile strength of each suture used in the study was measured by the manufacturer. The mean force required to break a 6-0 polypropylene suture measured 436.9 +/- 2 g, whereas knotting of the suture decreased the tensile strength to 316.9 +/- 3.9 g (p less than 0.001). The static and dynamic axial forces exerted on the suture after carotid arteriotomy in Group I was in the range of 26 g and decreased to 18 g at 6 weeks, whereas the 45 degree force exerted during the static dynamic phase measured in the range of 23 g and decreased to 16 g at 6 weeks (not statistically significant). The axial and 45 degree forces exerted on 6-0 polypropylene suture material in Group II under normotensive conditions were in the range of 14 g after carotid arteriotomy and ranged between 12 to 14 g at 6 weeks. Systolic hypertension did not result in a significant increase in axial or 45 degree forces during static or dynamic measurements, both in the range of 15 g after carotid arteriotomy. Measurements were similar at 6 weeks and ranged between 14 and 16 g. Our data indicate that 6-0 polypropylene suture material is an appropriate choice for repair of the carotid artery and that the suture material has sufficient inherent tensile strength to withstand forces generated in the neck region. Furthermore, our data indicate that spontaneous carotid artery suture line disruption is most likely related to damage to the suture strand during carotid artery repair rather than an inherent weakness in the suture material.

Animals↗
PubMed1996

Improved growth with bioabsorbable sutures in both high- and low-pressure zones.

BACKGROUND: Compromised growth after operation remains a significant problem in the cardiovascular field. Some benefit of absorbable suture materials has been demonstrated for arterial anastomoses. However, for the low-pressure zone, few data are available. METHODS: To assess growth in high- versus low-pressure zones we transected the abdominal aorta (high-pressure zone) as well as the inferior vena cava (low-pressure zone) in 10 young mongrel dogs using for reanastomosis 7-0 nonabsorbable versus absorbable running sutures in random order. RESULTS: All animals survived and were evaluated over 12 months including body weight (gain, 212% +/- 45% for nonabsorbable versus 218% +/- 8% for absorbable; not significant), angiography, and, after elective sacrifice, detailed studies of aorta and vena cava. Systematic complication of angiographic data at 12 months showed at the suture level an area of 13.8 mm2 for nonabsorbable versus 24.3 +/- 14.4 mm2 for absorbable sutures in the high-pressure zone as compared with 12.9 +/- 4.9 mm2 for nonabsorbable versus 25.3 +/- 15.4 mm2 for absorbable sutures in the low-pressure zone. Residual lumen, calculated as a function of the area above and below the suture, accounted for 35% +/- 10% for nonabsorbable versus 92% +/- 12% for absorbable sutures (p < 0.001) in the high-pressure zone as compared with 37% +/- 13% for nonabsorbable versus 75% +/- 15% for absorbable sutures (p < 0.003) in the low-pressure zone (high versus low, not significant). Poststenotic dilatation accounted for 199% +/- 22% for nonabsorbable versus 126% +/- 43% for absorbable sutures (p < 0.01) in the high-pressure zone. In the low-pressure zone, poststenotic dilatation remained below the inflow area, and the residual poststenotic lumen accounted for 52% +/- 14% for nonabsorbable versus 77% +/- 16% for absorbable sutures (p < 0.004). Macroscopic, light, and scanning electron microscopic studies confirmed different growth patterns in high- versus low-pressure zones. CONCLUSIONS: Aortic narrowing resulted in poststenotic dilatation and unrestricted outflow path (hourglass-type stenosis). Caval narrowing was followed by restriction of poststenotic outflow path (funnel-type stenosis). Absorbable suture material allows for superior growth in both high- and low-pressure zones.

Absorption↗
PubMed1987

Growth promotion by silk sutures in the urinary bladder of rat.

A silk suture in the urinary bladder of rats induces tumorous growths of urothelia. Whether these tumorous growths are due to initiation or due to promotion by the suture remains unknown. A 3-O silk suture was therefore placed in the bladders of rats for 4 or 8 weeks. After removal of the suture and a period of recovery, the bladders of these and sham-operated control rats were exposed to N-methyl-N-nitrosourea (MNU) in order to examine whether the effects of the suture were reversible following its removal from the bladder. In addition, the bladder mucosa was exposed to either MNU or Ringer's solution followed by placement of the silk suture in the bladder wall in order to examine promotor activity of the suture. The tumor incidence induced by MNU was little influenced by the prior temporary placement of the suture in the bladder wall, thus indicating a reversibility of the effects of the suture. The placement of the silk suture in the bladder wall that had a prior exposure to MNU resulted in a significant incidence of invasive tumors. All these results are consistent with the fact that a silk suture in the bladder acts as a promoter but not as an initiator.

Animals↗
PubMed1990

Mechanical properties of cranial sutures.

Many bones in mammalian skulls are linked together by cranial sutures, connective tissue joints that are morphologically variable and show different levels of interdigitation among and within species. The goal of this investigation was to determine whether sections of skull with cranial sutures have different mechanical properties than adjacent sections without sutures, and if these properties are enhanced with increased interdigitation. To test these hypotheses, bending strength and impact energy absorption were measured for samples of goat (Capra hircus) cranial bone without sutures and with sutures of different degrees of interdigitation. Bending strength was measured under both dynamic (9.7 mm displacement s-1) and relatively static (0.8 mm s-1) conditions, and at either speed, increased sutural interdigitation provided increased strength during three-point bending. However, except for very highly interdigitated sutures loaded slowly, sutures were not as strong in bending as bone. In contrast, sutures absorbed from 16% to 100% more energy per unit volume during impact loading than did bone. This five-fold increase in energy absorption by the sutures was significantly correlated with increased sutural interdigitation.

Animals↗
PubMed2004

Arthroscopic all-inside suture repair of medial meniscus lesion in anterior cruciate ligament--deficient knees: results of second-look arthroscopies in 39 cases.

PURPOSE: To evaluate by second-look arthroscopy the clinical results of arthroscopic all-inside sutures with hook using 2 posteromedial portals for medial meniscus posterior horn (MMPH) tears in patients who underwent concurrent anterior cruciate ligament (ACL) reconstruction. TYPE OF STUDY: Case series. METHODS: From May 1997 to June 2001, 78 knees underwent surgery for MMPH tears with arthroscopic all-inside sutures with hook and concurrent ACL reconstruction. Among them, 39 patients were evaluated with follow-up second-look arthroscopy. All MMPH tears were repaired by arthroscopic all-inside suture technique using 2 posteromedial portals. The second-look arthroscopy was performed, on average, 19 months (range, 6 to 40 months) after the ACL reconstruction and meniscal repair. They were divided into complete healing, incomplete healing, and failure groups. Tear size, type, and location were analyzed. We determined clinical criteria for success in meniscal status as (1) not positive for 4 clinical objective parameters--joint line pain and tenderness, locking or catching, recurrent effusions, and McMurray test; and (2) complete healing of all-inside sutured meniscus during second-look arthroscopy. RESULTS: Among 39 knees assessed by second-look arthroscopy, 32 (82.1%) knees showed complete healing and 6 (15.4%) showed incomplete healing without any positive findings of the clinical symptoms. Furthermore, all cases in the incompletely healed group had complete healing of the posterior horn, which was sutured by an all-inside suture; the incomplete healing was observed between the junction areas of all-inside to inside-out sutures, which was mainly at the posteromedial corner. The success rate was 97.4% (38 of 39 patients) overall for all-inside suture healing. The 1 patient (2.6%) with clinical failure had a retear of the repaired site. The average knee scores improved and all showed less than 2-mm side-to-side difference on KT-2000 testing. CONCLUSIONS: Arthroscopic all-inside vertical suture using a suture hook resulted in a high rate of healing even in large and complex vertical tears. This suturing can be one of the optimal treatments for MMPH tears greater than 1 cm during concurrent ACL reconstruction. LEVEL OF EVIDENCE: Level IV, Therapeutic Study, Cases Series (no, or historical, control group).

Adolescent↗
PubMed2006

Geometry and cell density of rat craniofacial sutures during early postnatal development and upon in vivo cyclic loading.

Cranial sutures are unique to skull bones and consist of multiple connective tissue cell lineages such as mesenchymal cells, fibroblast-like cells, and osteogenic cells, in addition to osteoclasts. Mechanical modulation of intramembranous bone growth in the craniofacial suture is not well understood, especially during postnatal development. This study investigated whether in vivo mechanical forces regulate sutural growth responses in postnatal rats. Cyclic compressive forces with a peak-to-peak magnitude of 300 mN and 4 Hz were applied to the maxilla in each of 17-, 23-and 32-day-old rats for 20 min/day over 5 consecutive days. Computerized histomorphometric analysis revealed that cyclic loading significantly increased the average geometric widths of the premaxillomaxillary suture (PMS) to 86 +/- 7 microm, 99 +/- 12 microm, and 149 +/- 30 microm, representing 32%, 50%, and 39% increases for P17, P23, and P32 in comparison with age-matched sham controls. For the nasofrontal suture (NFS), cyclic loading significantly increased the average sutural widths to 88 +/- 15 microm, 92 +/- 10 microm, and 100 +/- 14 microm, representing 33%, 24%, and 32% increases for P17, P23, and P32 relative to age-matched controls. The average PMS cell density upon cyclic loading was 10182 +/- 132 cells/mm(2), 9752 +/- 661 cells/mm(2), and 9521 +/- 628 cells/mm(2), representing 62%, 35%, and 30% increases for P17, P23, and P32 in comparison with age-matched controls. For the NFS, cyclic loading increased the average cell density to 9884 +/- 893 cells/mm(2), 9818 +/- 1091 cells/mm(2), 9355 +/- 661 cells/mm(2), representing 44%, 46% and 40% increases at P17, P23, and P32 respectively. Osteoblast-occupied sutural bone surface was significantly greater in cyclically loaded sutures for P17, P23, and P32 than corresponding controls for both the PMS and NFS. On the other hand, cyclic loading elicited significantly higher sutural bone surface populated by osteoclast-like cells by P17 and P23 days, but not P32 days, for the PMS. For the NFS, sutural osteoclast surface was significantly higher upon cyclic loading for P23 and P32 days, but not P17. The present data demonstrate that cyclic forces are potent stimuli for modulating postnatal sutural development, potentially by stimulating both osteogenesis and osteoclastogenesis. Cyclic loading may have clinical implications as novel mechanical stimuli for modulating craniofacial growth in patients suffering from craniofacial anomalies and dentofacial deformities.

Animals↗
PubMed2004

An evaluation of the semiadjustable suture strabismus surgical procedure.

BACKGROUND: Muscle slippage is an adverse outcome of strabismus surgery. Its incidence is increased if adjustable sutures are used or if surgery is performed on the inferior or medial rectus muscles. Although there are no firm numbers for this complication, studies have suggested incidence rates between 7% and 41% when adjustable suture surgery is performed on the inferior rectus muscle. In theory, the semiadjustable suture procedure should decrease this adverse outcome. This procedure involves suturing the corners of the muscle firmly to the sclera and placing the center of the muscle on an adjustable suture. This study evaluates semiadjustable suture surgery with respect to muscle slippage. METHODS: The primary treatment group consisted of 57 patients who underwent semiadjustable suture surgery on a total of 61 muscles that either had never previously undergone surgery or had undergone surgery and had not previously slipped postoperatively. Fifty-five were inferior rectus muscles and 6 were medial rectus muscles. An additional 7 patients had semiadjustable suture surgery on muscles that had slipped after prior surgery and were analyzed separately. The outcome evaluation was at least 6 months after surgery. RESULTS: None of the 57 patients in the primary treatment group demonstrated muscle slippage after semiadjustable suture surgery. One of the 7 patients who had history of prior muscle slippage also had slippage after semiadjustable suture surgery. CONCLUSION: The semiadjustable suture procedure appears to decrease the incidence of muscle slippage.

Adolescent↗
PubMed2004

A comparative analysis of the biomechanical behaviour of five flexor tendon core sutures.

Five core suture techniques were compared by static tensile testing in vitro. Fifty porcine tendons were used. The core sutures were performed with 3-0 or 4-0 braided polyester suture (Ticron) and the over-and-over running peripheral sutures with 6-0 monofilament polypropylene (Prolene). The core sutures were: (1) Pennington modified Kessler (3-0), (2) Double Pennington modified Kessler (3-0), (3) 4-strand Savage (3-0), (4) 4-strand Savage (4-0), and (5) 6-strand Savage (4-0). Repairs were compared as paired in regard to one variable: the number of core suture strands, the suture calibre, or the suture configuration. Biomechanical differences between the repair groups started during the linear region, with the yield force and stiffness increasing along with the number of core suture strands. All three variables influenced the strain at the yield point. Thus, the strength of the intact repair can be improved by modifying the core suture. In all repairs gap formation started near the yield point after failure of the peripheral suture. The yield force represents the strength of the intact repair composite and should be considered the strength of the tendon repair.

Animals↗
PubMed1998

Different suturing techniques variously affect the regularity of postkeratoplasty astigmatism.

OBJECTIVE: This study aimed to determine the effect of various suturing techniques on the regularity of postkeratoplasty astigmatism. DESIGN: A prospective clinical trial. PARTICIPANTS: Sixty-two consecutive patients undergoing penetrating keratoplasty by the same surgeon (MB) participated. INTERVENTION: Each patient was assigned to one of four groups according to the suturing technique used (a = 16 interrupted 10-0 nylon sutures; b = 2 running 10-0 nylon sutures, each with 8 bites; c = 2 running 10-0 nylon sutures, each with 12 bites; d = 2 running 10-0 nylon sutures, each with 16 bites). This was the only parameter permitted to be changed in the standard keratoplasty procedure used for all cases. Corneal topography was performed 1, 3, and 6 months after surgery. The astigmatic patterns seen on the corneal maps then were classified into regular (symmetric or asymmetric bowtie patterns) or irregular (distorted bowtie, multiaxial, or other patterns). MAIN OUTCOME MEASURES: Regularity of postkeratoplasty corneal astigmatism was measured. RESULTS: At all postoperative examination times, the percentage of irregular astigmatic patterns was highest in group a and lowest in group d (chi-square test: P < 0.005). Groups b and c showed intermediate values. The entity of the astigmatic error as measured by the simulated K-readings of the topographic maps did not differ significantly in the four groups. CONCLUSIONS: A suturing technique using 2 running sutures with 16 bites each can minimize irregular postkeratoplasty astigmatism as long as sutures are in place, when compared with interrupted sutures or double-running sutures of less than 16 bites.

Adolescent↗
PubMed1997

Placement of the tension-bearing suture in repairing the alar facial junction.

BACKGROUND: The cheek advancement flap was used to repair defects of the concave junctional zone of the nasal base, the medial aspect of the cheek, and the upper lip. Prior description of the sequence of suture placement depended on the concept of the initial suture or key suture. Splitting the functions of the initial suture into its functions of tension bearing or aligning aided the surgeon in determining the sequence and location of suture placement. OBJECTIVE: The purpose of the terminology change was to improve teaching concepts of tissue movement. METHODS: A series of 40 cases explored the use of a tension-bearing suture at the base of the cheek advancement flap, which was anchored to the fascia and periosteum at the nasal notch of the maxilla. In placement of this suture, the pyramid of the nose was elevated and the flap slid under the nose. RESULTS: Two complications occurred: one case of flap tip necrosis and one infection. There were no cases of bridging of the nasal cheek junction (sulcus) occurred. In all cases, the procedure restored the contours of the area. CONCLUSION: This redefinition of the key suture into tension-bearing and aligning suture helped the novice to place the tension-bearing suture first. In the example of the cheek advancement flap, careful placement of the tension-bearing suture promoted the restoration of the nasolabial fold.

Cheek↗
PubMedDate not supplied

The twist-lock concept of tissue transport and suture fixation without knots: observations along the Hong Kong skyline.

PURPOSE: To evaluate the load to failure and the mode of failure of a novel suture anchor construct that does not require knots (the "twist-lock" construct) and to compare it with a standard suture anchor construct (Corkscrew; Arthrex, Naples, FL). TYPE OF STUDY: Biomechanical single-pull load-to-failure study comparing the twist-lock construct to the Corkscrew suture anchor construct. METHODS: The twist-lock construct is a suture anchor system that does not use knots, instead using 3 consecutive twists between suture limbs to enhance internal interference between the suture limbs. This system maximizes internal interference by 2 mechanically verifiable friction-multiplier mechanisms: the cable friction effect and the wedge effect. After theoretically verifying the strength characteristics of the twist-lock system, the authors tested and compared its strength in vitro to that of a standard screw-type suture anchor system (Corkscrew). Unicellular polyurethane, which has been shown to accurately mimic the properties of cancellous bone, was used for implantation of suture anchors for the purpose of comparing the load to failure of 10 identical constructs in each of the 2 anchor systems. Axial single-pull loading to failure was performed with an Instron 5565 testing machine (Instron, Canton, MA). RESULTS: The average load to failure for the twist-lock group was 137.2 N, and the average for the Corkscrew group was 123.0 N, a difference of 14.2 N. This study shows that the twist-lock anchors failed at a load that was 12% higher than that of the Corkscrew group (P =.02). CONCLUSION: The twist-lock system is a suture anchor system that achieves suture fixation of soft tissue to bone without the need to tie knots. It shows single-pull loads to failure that are significantly higher than those of a standard suture anchor system.

Equipment Design↗
PubMed1997

Prospective, randomized vector analysis of astigmatism after three-, one-, and no-suture phacoemulsification.

PURPOSE: To compare surgically induced astigmatism and visual outcomes after three-, one-, and no-suture phacoemulsification. SETTING: Johns Hopkins Hospital, Baltimore, Maryland and Manhattan Eye, Ear, and Throat Hospital, New York, New York, USA. METHODS: This prospective, randomized study followed 131 patients treated with phacoemulsification with a 5.5 mm self-sealing scleral tunnel and implantation of a 5.5 mm poly(methyl methacrylate) posterior chamber lens. Radial 10-0 nylon sutures were used in the three- and one-suture groups. RESULTS: Mean astigmatism was greatest in the first postoperative week in all groups and stabilized after 8 weeks. The percentage of patients with with-the-rule (WTR) astigmatism increased from baseline in the one- and three-suture groups and decreased in the sutureless group. Mean uncorrected Snellen acuity was significantly better in the no- and one-suture groups than in the three-suture group at 1 week. There were no significant differences in uncorrected acuity at other times. No statistically significant differences in the surgically induced spherical equivalent were noted among the three groups during the 1 year follow-up. There was significantly less surgically induced keratometric astigmatism in the one-suture group at 4 (P = .03) and 8 (P = .007) weeks postoperatively. At all follow-ups, the sutureless group had the greatest proportion of patients, with significant ATR astigmatic shift (1 week, 17%; 4 weeks, 32%); and the lowest proportion of patients with significant WTR astigmatic shift (10% after 1 week). At 4 weeks, the percentage of patients with significant WTR shift in the one-suture group dropped to that in the sutureless group (10%); however, those in the one-suture group had less ATR astigmatic shift (16%). CONCLUSION: Sutureless and one-suture surgery resulted in a low percentage of WTR induced astigmatism 4 weeks postoperatively. Compared with sutureless surgery, the one-suture surgery resulted in less ATR shift.

Adult↗
PubMed1995

Bacterial contamination of nylon corneal sutures.

We report the findings of a prospective study into the bacterial contamination of monofilament nylon sutures removed from corneal wounds following cataract surgery. Sutures were classified as tight, loose or broken at the time of removal. Loose and broken sutures showed significantly more bacterial contamination than tight sutures (p < 0.001, chi squared). Positive cultures were obtained from 2 (6.2%) of 32 tight sutures, 14 (38.9%) of 36 loose sutures and 11 (37.9%) of 29 broken sutures. Staphylococcus epidermidis was the most commonly isolated organism (isolated in pure growth from 22 (81.5%) of 27 positive cultures). These findings may explain the occasional association of biodegraded corneal monofilament nylon sutures and suppurative keratitis and highlight the potential risk of seeding a suture track infection at the time of suture removal. They also emphasise the need for prophylactic topical antibiotic when removing biodegraded sutures.

Bacteria↗
PubMed2001

A Knotless Suture Anchor: Technique for use in arthroscopic Bankart repair.

Arthroscopic Bankart repair performed using suture anchors most closely mimics open repair techniques. One of the challenges with the arthroscopic technique is tying consistent, good-quality arthroscopic knots. The unique Knotless Suture Anchor (Mitek Products, Westwood, MA) and method of use for arthroscopic Bankart repair is described. The Knotless Suture Anchor has a short loop of suture secured to the tail end of the anchor. A channel is located at the tip of the anchor that functions to capture the loop of suture after it has been passed through the ligament. The ligament is tensioned as the anchor is inserted into bone to the appropriate depth. The doubled suture configuration that is created with the loop increases the suture strength in the Knotless Suture Anchor compared with standard suture anchors with the same size suture. To my knowledge, this article describes the first knotless suture anchor. A secure, low-profile repair can be created without arthroscopic knot tying.

Acromion↗
PubMed1995

Crouzon's disease correlates with low fibroblastic growth factor receptor activity in stenosed cranial sutures.

Reports have demonstrated that Crouzon's disease is associated with a gene on chromosome 10 coding for the fibroblastic growth factor (FGF) receptor 2. The purpose of this investigation was to evaluate the FGF receptor 2 levels in cranial sutures of children with Crouzon's disease and nonsyndromic, isolated craniosynostosis. Twelve children between the ages of 6 and 24 months were studied. Four patients had Crouzon's disease with coronal suture stenosis. The 8 remaining had a nonsyndromic, isolated coronal stenosis. Stenosed and adjacent nonstenosed cranial sutures were removed at cranioplasty and promptly fixed, decalcified, and embedded in paraffin. Immunohistochemical analysis of cranial sutures was performed with labeled, specific anti-FGF receptor 2 antibodies. In children with Crouzon's disease, we found significantly lower levels of FGF receptor 2 staining in stenosed sutures compared with nonstenosed sutures. In addition, sutures from children with Crouzon's disease demonstrated lower levels of FGF receptor 2 activity in both stenosed and nonstenosed sutures compared with children with a nonsyndromic, isolated coronal stenosis. However, there were no significant differences in FGF receptor 2 staining between stenosed and nonstenosed sutures in children with a nonsyndromic, isolated coronal stenosis. These findings suggest that low FGF receptor 2 activity in cranial sutures correlates with Crouzon's disease. This work supports genetic studies and yet shows that patients with Crouzon's disease have low FGF receptor 2 activity in cranial sutures. The findings also suggest that there may be etiological differences between syndrome- and nonsyndrome-associated craniosynostoses in children.

Child, Preschool↗