[Primary correction of orbital fractures using PDS-foil].
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Two new absorbable monofilament suture materials polydioxanone and Maxon are being employed increasingly in abdominal surgery because of increased strength retention and decreased tissue reactivity compared with previously available materials. As part of our investigation of the behaviour of suture materials, 3-0 sutures of polydioxanone and Maxon were enclosed in nylon pouches, a technique developed for in vivo experiments to prevent cellular interaction with implanted devices. The pouched sutures were gas sterilized, then implanted in either the extrafascial space or peritoneal cavity for periods of 1-5 wk. Sterilized sutures were also incubated in Ringer's lactate at 37 degrees C. Tensile strength of the exposed sutures was measured. For a given suture material and duration of incubation, there was no significant difference in tensile strength degradation among the three test environments. Although the strength of unexposed Maxon is greater than that of polydioxanone, the residual strength of Maxon decreases more rapidly in use, so that, after 2 wk, the strength of polydioxanone is greater. Scanning electron microscope examination of the suture surfaces reveals that polydioxanone develops surface crazing with time, whereas the surface morphology of Maxon remains relatively unaltered.
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Patients' postoperative pain experience during 5 days after hernia repairs or upper abdominal procedures was compared when skin closure was achieved by either full thickness interrupted sutures or subcuticular interrupted inversion sutures. Quantitative pain assessments were made using linear analogue charts and standardised analgesic requirements. Clinical advantage for the subcuticular technique was confirmed for the hernia group and possible advantage in the upper abdominal closure, suggested by lesser analgesic requirement. Statistical analysis has lent support to the hernia group findings but is less clear in the upper abdominal group. A comparison of wound healing, sepsis and cosmetic outcome showed no apparent advantage to either method. Economies and patient preference favoured the subcuticular method.
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Polydioxanon-splints have been used instead of Kirschner-wires in 13 cases for the treatment of fractures of the base or head of phalanges and metacarpals and also, in conjunction with intraosseous suture wires, to stabilize the bones in replantation surgery.
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