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At least 163 records · Page 9Linked to original sources

Tissue reaction to suture material in the feline linea alba. A retrospective, prospective, and histologic study.

Swelling and inflammation along the incision line were observed after elective ovariohysterectomy in 22 of 66 cats in a retrospective study. In a prospective study of 99 feline abdominal incisions closed with surgical gut, polyglactin 910, or polydioxanone, with and without subcutaneous closure, the least inflammation occurred when the linea alba was sutured with polyglactin 910 and the subcutaneous tissues were not sutured. Histologically, reactions in the linea alba of 12 other cats progressed from purulent to fibromononuclear to fibrous within 14 days after closure with gut, polyglactin 910, and polydioxanone. Microscopic evidence of seroma formation in 9 of 12 animals in which the subcutaneous tissue was not sutured suggested that surgical closure of subcutaneous dead space was indicated. The inflammatory reaction did not appear to be related to any one suture material as reactions were seen with all of them.

Abdominal Muscles↗

[Polydioxanon (PDS)--a new monofilar synthetic, absorbable suture material. Tensile strength studies in a controlled clinical trial on the large intestine of humans and physical parameters in in vitro tests].

We investigated the properties of tensile strength for the following suture materials: Polyglycolic acid (2. and 3.generation), Polyglactin 910 (3.generation) and Polydioxanon. They were situated within human large bowels for 10 to 12 days and investigated in a controlled experimental procedure. The decrease of the tensile strength in the human large bowel is significantly slower for polydioxanon suture (PDS) than for PGA (2. and 3.generation) and Polyglactin 910 (3.generation) suture. As PDS-suture are primarily less tractable than the others, there is no significant difference of tractability between all sutures after 11 days of implantation within the human colon. For PGA (3.generation) and Polyglactin 910 we found a strong loss of tractability after 10 to 12 days. In a second experimental series tensile strength, knot breaking security and knot holding capacity were tested in a tensiometer for absorbable suture materials with 3 and 6 parallel knots. The tensile strength was higher than the knot security for all sutures. Coated suture material (PGA and Polyglactin 910, both 3.generation) as well as the new monofile polydioxanon must be knotted manyfold for a secure knot position.

Adult↗

[Abdominal wall prostheses. Biomechanic and histological study].

The best prosthetic material is one which provides the best mechanical resistance with the best biological tolerance. In order to assess the mechanical and histological properties of abdominal wall prostheses, we performed experimental tests in animal models comparing four materials: polypropylene, dacron, polyglactine 910 and a dacron-polyglactine 910 composite. One hundred thirty rabbits were used including 10 controls and 120 test animals. A medial laparotomy was closed with an antemuscular aponevrotic prosthesis in the test animals. Animals were sacrificed at one, two and three months after the operation. Abdominal wall and prosthesis samples were tested to determine resistance to pressure and extension, deformability and elasticity. Histology tests were also done to determine resistance quality and biological tolerance. Dacron was tolerated best and was less resistant than polypropylene, though resistance was satisfactory. There was no advantage with polyglactine compared with non-resorbable prostheses; its only indication would be a septic site. The composite material tested had a resistance comparable with that of dacron but was less well tolerated.

Abdominal Muscles↗

Biology of polypropylene/polyglactin 910 grafts.

The biological evaluation of polypropylene (PP)/polyglactin 910 grafts was reviewed including regulatory considerations, biocompatibility assessment, tissue reaction and integration, and infection potentiation of these synthetic materials used in urogynecological surgical procedures. The physical characteristics of the grafts including base composition, monofilament vs multifilament, and non-absorbable vs absorbable materials were compared. Grafts were implanted in rats to evaluate the tissue reaction and integration characteristics of the materials over time. Grafts were also implanted in mice and inoculated with Staphylococcus aureus to assess the potential for bacterial attachment and growth. The tissue reaction to PP/polyglactin 910 grafts was characterized by minimal to mild inflammation with some qualitative differences related to the physical construction of the different grafts. The tissue reaction to polyglactin 910 mesh was also mild but resolved after the material was absorbed 70 days post-implantation. The integration of PP/polyglactin 910 grafts by fibrosis with surrounding tissue was initially mild for all materials but decreased over time for the lightweight and multifilament PP-based grafts, including a graft with an absorbable polyglactin 910 component. Residual fibrosis was not observed for the graft constructed from polyglactin 910 alone. Grafts constructed from PP did not potentiate infection after inoculation with S. aureus whereas the number of bacteria recovered from naturally derived collagen-based materials increased by three to four logs. The biological performance of PP/polyglactin 910 grafts is dependent on multiple factors including the composition and physical construction of the base materials, the overall biocompatibility of the materials, particularly tissue reaction and integration of the grafts, and the resistance of the grafts to bacterial attachment and growth.

Animals↗

Use of the n-butyl cyanoacrylate adhesive and the polyglactine thread suture for corneal rhaphy in rabbit (Oryctolagus cunicullus).

The aim of this study was to evaluate the cicatricial repair of perforating cornea in rabbits, by using the N-butyl cyanoacrylate adhesive compared to the 910-polyglactine thread suture through macroscopic and histological assays. Corneas from 18 adult rabbits were perforated and subsequently occluded with N-butyl cyanoacrylate synthetic adhesive (right cornea) or by separated single points using the 910-polyglactine thread (left cornea). The rabbits were divided into groups containing three animals per group. Examination after 7, 15, and 30 days post-operative showed that both the synthetic adhesive and the suture were efficient in the occlusion of the surgical wounds, thus stabilizing the intra-ocular content. The N-butyl cyanoacrylate adhesive was shown to be superior to the 910-polyglactine suture thread with regards to the evolution and the organization of the healing process.

Animals↗

A temporary nontoxic lubricant for a synthetic absorbable suture.

Synthetic absorbable sutures have been coated with lubricants to improve their handling characteristics. A unique surfactant, poloxamer 188, has been used to coat the surface of the polyglycolic acid sutures. This lubricant was chosen because it does not damage the tissues defenses of the host and invite infection. Since poloxamer 188 is readily soluble in aqueous solutions, it is rapidly absorbed in the tissue environment resulting in an uncoated suture that displays increased knot security. The coating of polyglactin 910 is also minimally reactive in tissues and does not damage tissue defense. In contrast with the coated polyglycolic acid sutures, the knot security of the coated polyglactin 910 sutures is not altered by exposure to an aqueous environment or implantation. The increased knot security of the coated polyglycolic acid suture after implantation is considered to be a distinct clinical advantage over that of the coated polyglactin 910 sutures.

Animals↗

Unbiased stereological methods used for the quantitative evaluation of guided bone regeneration.

The present study describes the use of unbiased stereological methods for the quantitative evaluation of the amount of regenerated bone. Using the principle of guided bone regeneration the amount of regenerated bone after placement of degradable or non-degradable membranes covering defects in rabbit calvaria was compared. Forty rabbits were divided into 5 groups. A titanium microplate was placed over the defect to prevent collapse of the membrane. The non-degradable expanded polytetrafluoroethylene membrane and the degradable Polyglactin 910 material were both placed unicortically and bicortically. Undecalcified sections were prepared for stereologic evaluation after an observation period of 8 weeks. Complete bone healing of the defects was not observed in any of the specimens. Unbiased stereologic estimates revealed 48% bone regeneration in defects covered by 2 ePTFE membranes, and 12% in defects covered by 2 Polyglactin 910 membranes. Defects covered by 1 ePTFE or 1 Polyglactin 910 membranes revealed 10% or 18% bone regeneration, respectively. The control group regenerated 14%. The major difference of the estimates was caused by real difference between specimens, i.e. biologic variation, whereas only minimal variance was added by the stereologic estimation procedure.

Animals↗

Wound complications after closure of abdominal incisions with Dexon or Vicryl. A randomized double-blind study.

Polyglactin 910 and polyglycolic sutures were compared in layer closure of laparotomy wounds after 306 acute or elective operations. The total incidence of wound dehiscence and herniation was 0.65%, with no significant difference between polyglycolic acid (0.6%) and polyglactin 910 (0.7%). The incidence of abscess, granuloma or sinus formation was 6.5% for polyglycolic acid and 11.3% for polyglactin 910. The difference was not statistically significant.

Adult↗

A randomized clinical trial of two surgical techniques for cesarean section.

The Joel-Cohen incision followed by nonclosure of pelvic and parietal peritoneum has been advocated as an alternative method to the Pfannenstiel incision with peritonealization at cesarean section. A randomized trial was designed to compare intra- and postoperative morbidity between the two techniques. Women to undergo a cesarean section were randomly allocated to have either the Joel-Cohen incision with the parietal and pelvic peritoneum left open (group 1) or to have the Pfannenstiel incision with both peritoneal layers sutured (group 2). The myometrium was closed with 1-0 polyglactin 910 suture using a continuous single-layer nonlocking technique. Patients in group 2 had the peritoneum approximated with 2-0 polyglactin 910 suture. The fascia was sutured with continuous 1-0 polyglactin 910 suture in all cases. Opening time was defined as the interval from skin incision to the opening of the uterine cavity. Febrile morbidity was defined as a temperature > or =38 degrees C on two occasions 4 hours (hr) apart excluding the first postoperative day. Endometritis was defined as postpartum temperature > or =38 degrees C on two occasions 4 hr apart, with uterine tenderness and/or foul-smelling lochia. One hundred forty-nine and 150 patients were allocated to group 1 and to group 2, respectively. A shorter median (range) opening time [4 min (2-21) vs. 6 min (2-19), respectively, p < 0.01] and a shorter median (range) operative time [30 min (10-65) vs. 40 min (20-110), respectively, p < 0.01] were observed in group 1. No difference was found in terms of intraoperative complications, proportion of patients who required transfusion, endometritis, sepsis, febrile morbidity, and urinary tract infections. A higher rate of wound infections was found in group 2 than in group 1 [14 of 150 (9.3%) vs. 2 of 149 (1.3%), respectively, p < 0.01]. The Joel-Cohen incision without peritonealization resulted in a shorter opening and total operative time than the Pfannenstiel laparotomy with peritonealization. This was accomplished with a reduction of wound infections.

Adult↗

Peritoneal adhesions to prosthetic materials: choice of mesh for incisional hernia repair.

BACKGROUND: In many cases, incisional hernia repair requires the use of prosthetic materials. The aim of this experimental study in a rat model was to assess the role of polyglactin 910 mesh and fluoropassivated polyester mesh in preventing the formation of adhesions. METHODS: In the first experiment, the formation of peritoneal adhesions was assessed after insertion of polypropylene, polypropylene combined with polyglactin 910, or no mesh. In the second experiment, adhesion formations were compared after insertion of fluoropassivated polyester, polypropylene, and no mesh. RESULTS: The first experiment showed no significant difference in adhesion formations between the polypropylene mesh and the combined mesh; however, when no mesh was used, there were significantly fewer adhesions in both experiments (p < 0.01). The second experiment showed a significantly lower degree of adhesions and a lower Adhesion Index after insertion of fluoropassivated polyester mesh than when polypropylene mesh was used (p = 0.04). CONCLUSIONS: Adding polyglactin 910 mesh to polypropylene mesh to prevent the formation of adhesions is not an effective measure. Fluoropassivated polyester meshes appear to provide a better alternative to the use of polypropylene meshes for incisional hernia repair in humans in terms of the formation of adhesions.

Animals↗

Knotting and handling characteristics of coated synthetic absorbable sutures.

The purpose of this study was to evaluate the knotting and handling characteristics of the new coated synthetic absorbable sutures. When compared to the coated polyglactin 910 sutures, the coated polyglycolic acid sutures displayed a lower coefficient of friction, encountered less tissue drag forces, and exhibited less flexural rigidity. In the case of sizes O, 2-O, and 3-O coated polyglycolic sutures, knot security was achieved with one less throw than with similar sizes of coated polyglactin 910 sutures. On the basis of these comprehensive mechanical performance tests, the knotting and handling characteristics of the coated polyglycolic acid sutures were judged to be superior to that of the coated polyglactin 910 sutures.

Absorption↗

[Prolene and vicryl as synthetic sutures for intradermal suture technics].

It could be shown that beside the non-absorbable synthetic suture material (Polypropylene) for the subcuticular continuous skin suture absorbable synthetic suture material (Polyglactin 910) is suitable for the buried subcuticular skin suture to obtain good esthetic scars in plastic surgery. Experiences with Polyglactin 910 in over 300 patients are presented. In no case wound healing was disturbed as a result of the suture material. Further application will give more information about the usefulness of the absorbable synthetic suture material Polyglactin 910 for the buried subcuticular skin suture.

Breast↗

Early bacterial accumulation on guided tissue regeneration membrane materials. An in vivo study.

The aim of the study was to compare the in vivo early bacterial plaque colonization of 3 different guided tissue regeneration (GTR) membrane materials using a morphological (scanning electron microscope) method. Rectangular-shaped strips were cut from 3 periodontal membranes (expanded polytetrafluoroethylene, polyglactin 910, and polylactic acid) and glued to the buccal aspect of removable acrylic devices, which were applied to the molar-premolar region of the upper quadrants in 8 dental students. Each device held 3 strips: one ePTFE, one polyglactin 910, and one polylactic acid. The surface roughness of each membrane material was measured by means of a laser profilometer. During a 24-hour period, the students had to refrain from any oral hygiene procedures and did not use chlorhexidine mouthrinses. In each subject, one device was removed after 4 hours and the other after 24 hours. After removal, the devices were placed in a 2.5% gluteraldehyde solution to fix the membranes, which were then processed for SEM analysis. Fifty-four microscopic fields (at 200x magnification) were randomly selected and analyzed in each strip. Magnification was increased to determine the presence of bacterial morphotypes. The presence or absence of bacteria was assessed in a binomial fashion. In such a system, the field was bacteria-positive when bacteria constituted the deposits covering the surface of the membrane. The microscopic field was considered bacteria-negative when no bacteria were present. Bacteria-positive fields showing rods and filaments as prevalent bacterial morphotypes were recorded as rod-positive fields. A different pattern of plaque accumulation was demonstrated on different membrane materials. The 4-hour results indicated a statistically significant difference (P = 0.008, ANOVA) in the proportion of bacteria-positive fields among the 3 membranes; a greater amount of bacteria was demonstrated on the ePTFE membrane compared to the other 2 membranes. At 24 hours, the difference in the proportion of bacteria-positive fields was statistically significant (P = 0.002, ANOVA); a lesser amount of bacterial plaque was present on the polylactic acid membrane compared to the ePTFE and polyglactin 910 membranes. No difference in the proportion of rod/bacteria-positive fields was demonstrated among the 3 membranes at either 4 or 24 hours. It was concluded that quantitative differences in early plaque accumulation on various membranes seem to be related to the textural and structural characteristics of the surface, which is not adequately represented by the surface Ra value measured with a profilometric instrument.

Absorbable Implants↗

[Guided tissue regeneration around dental implants in immediate extraction sockets: comparison of resorbable and nonresorbable membranes].

OBJECTIVE: This study was performed to compare the efficacy of guided tissue regeneration (GTR) around dental implants immediately placed into extraction sockets by resorbable or nonresorbable membranes. METHODS: Mandibular P2, P3, and P4 of four adult beagle dogs were extracted bilaterally, and buccal standard defects were created and measured. Eighteen commercially pure titanium Steri-Oss implant fixtures were placed into the fresh extraction sockets. Four untreated implants were as controls, four implants received polytetrafluoroethylene (e-PTFE, Gore-Tex) membranes, five implants received collagen membranes, and five implants received polyglactin 910 mesh. After 14 weeks, clinical measurements were taken and the dogs were sacrificed and all specimens retrieved for histologic and histomophometric evaluation. RESULTS: The average gain in bone height was 2.1 mm for untreated control sites, 3.3 mm for Gore-Tex sites, 3.8 mm for collagen sites, and 1.3 mm for polyglactin 910 sites. CONCLUSION: The results of this study indicated that Gore-Tex and collagen membrane produced good results for GTR around implants. Collagen membrane can be a valid alternative to Gore-Tex membrane to improve bone regeneration around dental implants, while polyglactin 910 mesh seemed not suitable to be used as GTR membrane in immediate implantation for its high infection rate.

Animals↗

A comparison of TC7 and 32% dextran 70 for prevention of postoperative adhesions in hamsters.

Prevention of postoperative adhesion formation has received considerable attention by infertility specialists. Barrier methods and hydroflotation solutions are currently used for adhesion prevention. The present study compared the efficacy of TC7 and 32% dextran 70 in a hamster model. At laparotomy, 90 golden hamsters had a lesion created on the left uterine horn and repaired with absorbable suture. The first experiment used 3-0 chromic catgut suture in 43 hamsters; the second experiment used 5-0 polyglactin 910 suture in 47 hamsters. The animals were randomly divided into a control group (N = 25) which received no treatment, a TC7-treated group (N = 33), and a 32% dextran 70-treated group (N = 32). The animals were sacrificed between 10-14 days after laparotomy and adhesions were graded (0 = no adhesions; 3 = severe adhesions). TC7 had average adhesion scores of 1.91 for chromic catgut and 2.25 for polyglactin 910; 32% dextran 70 had average adhesion scores of 1.53 and 2.00, respectively. These scores were not different from the control average adhesion score of 1.80 for both chromic catgut and polyglactin 910. We conclude that TC7 and 32% dextran 70 do not appear to be effective agents for preventing postoperative adhesions in this animal model.

Animals↗

Guided tissue regeneration around dental implants in immediate extraction sockets: comparison of resorbable and nonresorbable membranes.

This study was performed to compare the efficacy of guided tissue regeneration (GTR) around dental implants immediately placed into extraction sockets by resorbable of nonresorbable membranes. Mandibular P2, P3, and P4 of four adult beagle dogs were extracted bilaterally, and buccal standard defects were created and measured. Eighteen commercially pure titanium Steri-Oss implant fixtures were placed into the fresh extraction sockets. Four implants were untreated controls, four implants received polytetrafluoroethylene (e-PTFE, Gore-Tex) membranes, five implants received collagen membranes (ParaGuide), and five implants received polyglactin 910 mesh (Vicryl). After 14 weeks, clinical measurements were taken and the dogs were sacrificed and all specimens retrieved for histologic and histomorphometric evaluation. The average gain in bone height was 2.1 mm for untreated control sites, 3.3 mm for Gore-Tex sites, 3.8 mm for collagen sites, and 1.3 mm for polyglactin 910 sites. The greatest gain in bone height and volume was seen for two sites that received Gore-Tex membranes and remained covered for the entire evaluation interval. The results of this study indicate that Gore-Tex and collagen membrane produced good results for GTR around implants immediately placed into extraction sockets. Since collagen membrane does not cause obvious infection and does not need the surgical reentry for membrane removal, it can be a valid alternative to Gore-Tex membrane to improve bone regeneration around dental implants, while polyglactin 910 mesh seems not suitable to be used as GTR membrane in immediate implantation for its high infection rate.

Animals↗

Some biomechanical considerations in microsutures.

The purpose of this study was to measure the biomechanical performance for commercially available microsutures, nylon polypropylene, polyester, and polyglactin 910. The biomechanical performance was determined by reproducible, biomechanical parameters that included stiffness, elasticity, resistance to creep, secure knot construction, and knot breaking strength. On the basis of these comprehensive studies, the handling characteristics of the nylon microsutures were judged to be superior over the other microsutures. Knot security was achieved with a three-throw square (1 = 1 = 1) knot that allowed a preview of the ultimate apposition of the divided tissue. In addition, nylon microsutures were more supple than the other microsutures. The breaking strength of the knotted nylon microsutures was comparable with those of the knotted polyglactin 910 and polyester microsutures, and significantly greater than that of the knotted polypropylene sutures. Its resistance to creep was significantly greater than that of the polypropylene microsutures but less than those of polyglactin 910 and polyester microsutures.

Biomechanical Phenomena↗

A randomized clinical trial comparing two methods of fascia closure following midline laparotomy.

Three hundred forty women undergoing midline laparotomy were randomized into an interrupted suture (polyglactin 910, size 1) or a continuous suture (polyglyconate, size 0) closure group. The two groups were well balanced with respect to various risk factors for postoperative wound complications. Early evaluation revealed no differences between the continuous and interrupted suture groups with respect to wound infection (3% vs 1%), superficial wound dehiscence (2% vs 4%), and deep wound dehiscence (0.6% vs 0%). Late evaluation showed no differences between the two groups either. Continuous polyglyconate and interrupted polyglactin 910 sutures had a similar incidence of suture fistula (0% vs 2%), wound pain (1% vs 2%), and incisional hernia (3% vs 4%). Continuous closure was done faster and resulted in less foreign-body suture material. Despite its smaller diameter, the polyglyconate suture also retains a higher tensile strength after surgery than does the quicker-degrading polyglactin 910 suture. Results of this study lead to the conclusion that a running polyglyconate suture is the better choice for closure of the abdominal-wall fascia following midline laparotomy.

Abdominal Muscles↗