• Title/Summary/Keyword: Repair technique

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Unilateral cleft lip: evaluation and comparison of treatment outcome with two surgical techniques based on qualitative (subject/guardian and professional) assessment

  • Adetayo, Adekunle Moses;Adetayo, Modupe Olushola;Adeyemo, Wasiu Lanre;James, Olutayo O.;Adeyemi, Michael O.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.3
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    • pp.141-151
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    • 2019
  • Objectives: The outcomes of the treatment of unilateral cleft lip can vary considerably due to variations in repair techniques. The aim of this study was to evaluate and compare treatment outcomes of surgical repair of unilateral cleft lip using either the Tennison-Randall or Millard technique based on (qualitative) parent/subject and professional assessments. Materials and Methods: This was a prospective, randomized, controlled study conducted at Lagos University Teaching Hospital between January 2013 and July 2014. A total of 56 subjects with unilateral cleft lip presenting for primary surgery who satisfied the inclusion criteria were recruited for the study. Subjects were randomly allocated to surgical groups A or B through balloting. Group A underwent cleft repair with the Tennison-Randall technique, while group B underwent cleft repair with the Millard rotation advancement technique. Surgical outcome was assessed using qualitative evaluation by the guardian/subject and independent assessors based on a modified form of the criteria described by Christofides and colleagues. Results: Of the 56 subjects enrolled in this study, 32 were male, with a male to female ratio of 1.3:1. Fifteen of the guardians/subjects in the Tennison-Randall group were most bothered about the lower part of the residual lip scar, while 12 guardians/subjects in the in the Millard group were most bothered about the upper part of the scar. More noses were judged to be flattened in the Millard group than in the Tennison-Randall group. Assessors observed a striking disparity in scar transgression of the philtral ridges between the two groups. Conclusion: Essentially, there were no major difference in the overall results between Millard rotation-advancement and Tennison-Randall repairs. Both Millard and Tennison-Randall's techniques require significant improvements to improve the appearance of the scar on the upper part and lower part of the lip, respectively.

Traumatic Aortic Injury: Single-center Comparison of Open versus Endovascular Repair

  • Cho, Jun Woo;Kwon, Oh Choon;Lee, Sub;Jang, Jae Seok
    • Journal of Chest Surgery
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    • v.45 no.6
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    • pp.390-395
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    • 2012
  • Background: Conventional open repair is a suboptimal therapy for blunt traumatic aortic injury (BTAI) due to the high postoperative mortality and morbidity rates. Recent advances in the thoracic endovascular repair technique may improve outcomes so that it becomes an attractive therapeutic option. Materials and Methods: From August 2003 to March 2012, 21 patients (mean age, 45.81 years) with BTAI were admitted to our institution. Of these, 18 cases (open repair in 11 patients and endovascular repair in 7 patients) were retrospectively reviewed and the early perioperative results of the two groups were compared. Results: Although not statistically significant, there was a trend toward the reduction of mortality in the endovascular repair group (18.2% vs. 0%). There were no cases of paraplegia or endoleak. Statistically significant reductions in heparin dosage, blood loss, and transfusion amounts during the operations and in procedure duration were observed. Conclusion: Compared with open repair, endovascular repair can be performed with favorable mortality and morbidity rates. However, relatively younger patients who have acute aortic arch angulation and a small aortic diameter may be a therapeutic challenge. Improvements in graft design, delivery sheaths, and graft durability are the cornerstone of successful endovascular repair.

Early outcomes of cleft and palatal width following anterior palate repair (vomerine flap) in infants with wide cleft lip and palate

  • Saad, Arman Zaharil Mat;Chai, Koh Siang;Sulaiman, Wan Azman Wan;Johar, Siti Fatimah Noor Mat;Halim, Ahmad Sukari
    • Archives of Plastic Surgery
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    • v.46 no.6
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    • pp.518-524
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    • 2019
  • Background Anterior palatal repair performed during cleft lip repair using a vomerine flap may assist in recruiting additional soft tissue for subsequent completion of palatoplasty, especially in patients with a wide cleft. We present our early results in the hope of triggering a re-evaluation of this technique regarding its advantages for maxillary growth through further studies of patients with a wide cleft. Methods A retrospective analysis of patients with complete unilateral and bilateral cleft lip and palate was performed, including cleft and palatal measurements taken during initial surgery (lip repair together with anterior palate repair) and upon completion of palatoplasty. Results In total, 14 patients were included in this study, of whom nine (63.3%) had unilateral cleft lip and palate and five (37.5%) had bilateral cleft. All patients had a wide cleft palate. Lip and anterior palate repair was done at a median age of 3 months, while completion of palatoplasty was done at a median age of 10.5 months. Measurements taken upon completion of palatoplasty showed significant cleft width reduction in the mid-palate and intertubercle regions; however, the palatal arch distances at nearby landmarks showed non-significant marginal changes. Conclusions Anterior palate repair using a vomerine flap significantly reduced the remaining cleft width, while the palatal width remained. Further research is warranted to explore the long-term effects of this technique in wide cleft patients in terms of facial growth.

Simulation on Optimum Repairing Number of Carbonated RC Structure Based on Probabilistic Approach (확률론을 고려한 탄산화된 RC 구조물의 최적 보수시기 해석)

  • Kwon, Seung-Jun
    • Journal of the Korean Recycled Construction Resources Institute
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    • v.5 no.3
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    • pp.230-238
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    • 2017
  • Carbonation is a representative deterioration for underground structure, which causes additional repair for service life. This study proposes a simplified equation for optimum repair timing without complicated probability calculation, considering initial and repair conditions For the work, initial service life, extended service life through repair, and their COVs(Coefficient of Variation) are considered, and the periods which can reduce number of repair are evaluated. Assuming the two service lives to be independent, the repair timings are derived from 10 to 50 years based on the probabilistic method, and the regression analysis technique for optimum repairing timing is proposed. Decreasing COV has insignificant effect on reducing repairing number but shows a governing effect on changes in probability near the critical repairing stage. The extension of service life through repairing is evaluated to be a critical parameter for reducing repairing number. The proposed technique can be efficiently used for maintenance strategy with actual COV of initial and additional service life due to repairing.

Barbed sutures versus conventional tenorrhaphy in flexor tendon repair: An ex vivo biomechanical analysis

  • Colak, Ozlem;Kankaya, Yuksel;Sungur, Nezih;Ozer, Kadri;Gursoy, Koray;Serbetci, Kemal;Kocer, Ugur
    • Archives of Plastic Surgery
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    • v.46 no.3
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    • pp.228-234
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    • 2019
  • Background The management of flexor tendon injuries has evolved in recent years through industrial improvements in suture materials, refinements of repair methods, and early rehabilitation protocols. However, there is no consensus on the ideal suture material and technique. This study was conducted to compare the tensile strength, repair time, and characteristics of 4-strand cruciate, modified Kessler, and 4-strand horizontal intrafiber barbed sutures for flexor tenorrhaphy with a 12-mm suture purchase length in an animal model. Methods The right third deep flexors of 60 adult Leghorn chicken feet were isolated and repaired with a 12-mm suture purchase length. The tendons were randomly assigned to three groups of equal number (n=20 each). Groups 1 and 2 received 4-strand cruciate and modified Kessler repair with conventional suture materials, respectively. A 4-strand horizontal intrafiber barbed suture technique was used in group 3. The repaired tendons were biomechanically tested for tensile strength, 2-mm gap resistance, and mode of failure. Repair times were also recorded. Results The maximum tensile strength until failure was $44.6{\pm}4.3N$ in group 1, $35.7{\pm}5.2N$ in group 2, and $56.7{\pm}17.3N$ in group 3. The barbed sutures were superior to the other sutures in terms of the load needed for 2-mm gap formation (P<0.05). Furthermore, the barbed sutures showed the shortest repair time (P<0.05). Conclusions This study found that 4-strand horizontal intrafiber barbed suture repair with a 12-mm purchase length in a chicken flexor tendon injury model showed promising biomechanical properties and took less time to perform than other options.

Rationale and Technique of Arthroscopic Primary Repair of Posterior Cruciate Ligament (후방 십자 인대 관절경하 일차수복술의 이론적 근거와 술기)

  • Kim, Jung-Man
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.21-24
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    • 1998
  • There are many controversies in managing fresh substance tear of PCL. Conservative treatment of partial tear is generalby accepted idea, and less than 10mm posterior instability is known to be acceptable in terms of funtion. More than 10mm posterior instability and complete fresh tear of the ligament are regarded as candidates of reconstruction of the ligament. However, many authors believe that posterior instability may be a cause of early osteoarthritis in the long run. Author described the rationale and the technique of arthroscopic primary repair of the PCL in case of proximal and mid 1/3 substance tear. Postoperative rehabilitation program and their rationale were also described.

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Assessment of Appropriate Period and Cost(P&C) of Repair and Improvement for Irrigational Structures (논문 - 수리시설물의 적정개보수 주기 및 비용 산정)

  • Lee, Joon-Gu;Kim, Myong-Won;Shin, Tae-Ho
    • KCID journal
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    • v.18 no.2
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    • pp.142-160
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    • 2011
  • This study was performed to apply the preventive management technique that is known for more economic and preventive for disaster than corrective technique to Repair & Improvement(R&I) Project policy of irrigational facilities. The appropriate periods of R&I Project had been driven to 40yrs, 24yrs, 27yrs, and 29yrs for reservoir, Pumping and drainage pumping station, Diversion weir and Irrigation & drainage canal respectively. The cost of R&I Project for 10 years had been estimated as 616.9 billion won per year including the 85 billion won for the project of 'Disaster prevention and Function continuity'. After the period of 'Improvement all at once', about 30yrs, 421.8 billion won was requested for 'Function continuity'.

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Single-Suture Neochorda-Folding Plasty for Mitral Regurgitation

  • Park, Jong Myung;Je, Hyung Gon;Lee, Sang Kwon
    • Journal of Chest Surgery
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    • v.49 no.1
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    • pp.70-72
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    • 2016
  • The single-suture neochorda-folding plasty technique is a modification of existing mitral valve repair techniques. In the authors' experience, its simplicity, reliability, and versatility make it a useful technique for mitral valve repair, especially when a minimally invasive approach is used.

Experimental evaluation of fatigue strength for small diameter socket welded joints under vibration loading condition

  • Oh, Chang-Young;Lee, Jun-Ho;Kim, Dong-Woo;Lee, Sang-Hoon
    • Nuclear Engineering and Technology
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    • v.53 no.11
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    • pp.3837-3851
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    • 2021
  • To investigate how the fabrication and repair of socket welded joints could be used to enhance fatigue resistance under vibration condition, experimental test data of installation conditions that potentially influence fatigue strength were analyzed with the S-N curve. It was found that the decreasing fatigue strength of stainless steel socket welded joints was attributed to the effect of high heat input of welding process. The effect of welding method, slip-on gap and radial-gap conditions on fatigue strength was insignificant. The test data of repair technique application, 2 × 1 leg length and of socket weld overlay, clearly showed higher fatigue strength but there was a limitation for higher stress region because of the weld toe crack.

Clinical Result of Modified Percutaneous Repair Technique of Ruptured Achilles Tendon (변형된 경피적 술식을 이용한 아킬레스 건 봉합술의 임상적 결과)

  • Baek, Jong-Ryoon;Kwak, Ji-Hoon;Won, Jun-Sung;Park, Hong-Gi
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.3
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    • pp.144-148
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    • 2011
  • Purpose: To investigate the results of percutaneous repair technique of Achilles tendon ruptures, and to describe the surgical technique. Materials and Methods: We retrospectively analyzed the outcomes of 73 patients with ruptured Achilles tendon from October 1995 to September 2009. 28 patients were excluded due to short follow up period. 34 patients were male and 11 patients were female. The mean patient age was 37.19 (10~62) years. The location of rupture site was 6.58 cm proximal to the tendon insertion into the calcaneus on average. Mean follow up period was 55 months and All patients were surgically repaired using percutaneous technique with sural nerve isolation. Results: Arner-lindholm score were excellent in 32 (71%), good in 12 (27%), poor in 1 (2%) case. 44 cases (98%) had the score more than good. Mean American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot function score was 92.93 (67~100). We had 1 case of superficial infection, 1 case of soft tissue irritation by suture knot. Conclusion: Percutaneous repair with sural nerve isolation in treating ruptured Achilles tendon showed low complication rate and reliable clinical outcome.