• Journal of Yeungnam Medical Science
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• v.6 no.2
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• pp.71-78
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• 1989

Horizontal mattress suture technique on microvascular anastomosis of rat(body weight : 200-250gm) femoral artery was evaluated. The present study was conducted to compare the horizontal mattress suture with simple interrupted suture on the suture time, patency rate of the sutured vessels, and the histological changes of surgical site of the vessel wall during wound healing period. The mean suture time of the vessel wall with horizontal mattress suture technique was 15min. 49sec. ${\pm}$ 2.14, which is significantly shorter than that of simple interrupted suture technique. The patency rate of the sutured vessel in both groups was statistically not different each other till post-operative 3rd day but patency rate of horizontal mattress suture was higher than that of simple interrupted suture at post-operative 3rd week. The histological findings such as intimal noss, medial degenention and intimal regeneration were similar in both groups.

• Journal of Veterinary Clinics
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• v.39 no.6
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• pp.353-359
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• 2022

Several suture patterns can be used for cystotomy closure, and a continuous suture pattern is the most commonly used. In this study, the fluid-tight ability and other suitabilities of continuous appositional sutures, such as the simple continuous suture pattern (SC), running suture pattern (RN), and Ford interlocking suture pattern (FI), were compared for cystotomy closure. Cystotomy closure was performed using each suture method in 10 cases of ex vivo swine bladders in each group. Suture time, leakage site, suture length, bursting pressure (BP), bursting volume (BV), and circular bursting wall tension (CBWT) were measured. Suture time and suture length were the shortest in RN and the longest in FI. Leakage occurred in two places: the incision line directly and the hole made by the suture. Leakage occurred through the incision line in 4 bladders of the RN group and 2 bladders of the FI group, but not in the SC group, and in the rest of the bladders, leakage occurred through the suture hole. The values of BP, BV, and CBWT increased in the order of FI, SC, and RN. Suture time and suture length can be considered as factors related to healing and side effects. In this study, leakage through the incision was found in a less appositional area; therefore, leakage through the hole could be considered an indicator of better apposition. Good apposition is one of the conditions required for ideal cystotomy closure. The bursting strength representing the fluid-tight ability can be expressed as the CBWT. RN is expected to be efficient and cause a small degree of foreign body reaction; however, it is expected to be less stable. FI has the greatest fluid-tightness ability, but it has been proposed that side effects due to foreign body reactions most frequently occur in FI. In conclusion, SC, which is expected to have a sufficient degree of fluid-tightness and appropriate recovery, is preferable to other continuous appositional suturing methods for cystotomy closure.

• Journal of Veterinary Clinics
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• v.18 no.2
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• pp.124-132
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• 2001

The purpose of this study is to know whether single layer continuous connell suture is an acceptable alternative to simple interrupted approximating suture for end-to-end intestinal anastomosis in dogs. Fourteen mixed-breed dogs weighing 2 to 5 kg were allotted to group treated with simple interrupted approximating suture (Group I) and group treated with single layer continuous Connell suture (Group II), each of 7 dogs. All dogs in each suture pattern were compared with time for total operation ad suture elapsed for intestines to anastomose, clinical signs, changing of pre-and postoperative luminal size, status of feces, adhesion at anastomotic site for 14 days after operation. Time for total operation and suture time for intestinal anastomosis were none significant between Group I and Group II, although those in Group II was about 3 minutes shorter than those in Group I, respectively. Group I spent average 47.08${\pm}$11.10 minutes on total operation, 20.97${\pm}$5.54 minutes on suture time for intestinal anastomosis and Group II spent average 44.74${\pm}$7.77 minutes, 17.73${\pm}$3.05 minutes, respectively. All dogs were no special differences in vitality, vomiting, appetite between Group I and Group II for 14 days after operation. All dogs, except one dog in Group I, had showed normal vitality and appetite since 6~8 days after operation. Initial return of fecal passage showed in all dogs before 6 days after operation and thereafter most dogs showed normal feces. According to results, it was thought that all dogs with normal vitality and appetite before 8 days had showed good prognosis. There were no changes of intestinal luminal size in 2 dogs performed Group In and one dog performed Group II between at operation and 14 days after operation. Narrowing rate of intestinal lumen in Group I was average 9.3% of the normal diameter, whereas in Group II, 9.5% of normal diameter. In complications after operation, only one dog in Group I showed intestinal intussusception but the others didn't. Length of adhesion was measured between intestinal anastomotic site and omental graft. Length of adhesion in dogs performed Group II was mostly shorter than that of Group I. Adhesion with proximate intestines occurred in five dogs, which consisted of 3 dogs performed Group I and 2 dogs performed Group II. Concurrently, they had a great length of adhesion between anastomotic site and omental graft. There were no great differences between Group I and Group II about speed of operation, clinical signs, complications such as leakage and stricture. And all dogs performed intestinal anastomosis showed good clinical condition and prognosis. In conclusion, Single layer continuous Connell suture can safely perform an intestinal anastomosis and be an alternative of simple interrupted approximating suture in aspect of speed clinically.

• Journal of Trauma and Injury
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• v.19 no.2
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• pp.121-125
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• 2006

Purpose: There is ongoing demand to deliver better procedural training to medical students in the emergency department. Thus, we studied the efficacy of a cadaver-based training model for teaching simple suture techniques to medical students. Methods: We investigated ten fourth-year medical students, who were rounding and being trained in the Emergency Department of Chungnam National University Hospital. They were educated with slides about a simple suture technique for 30 minutes to evaluate the efficacy of the cadaver-based training model. We prospectively measured their skill by administering a test on the cadaver-based simple suture technique in 3cm sized linar wound separately to each of them. Results: A total of ten fourth-year medical students completed the investigation. The tension, the direction of suture, the degree of cleanness, the number of sutures, the adequacy of the cutting thread length, and the suturing time in the first attempt were compared with those in the second one. The second results were compared with those in the third one, and the third results were compared with those in the fourth one. All the results had statistical significance. Conclusion: These findings support the value of the cadaver-based simple suture technique training model as a medical student teaching model. The cadaver-based simple suture technique teaching model is a good way of teaching several medical skills to medical students.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.159-159
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• 2009

Repeated pulling-out of a suture anchor in the lateral row despite repeated attempts at insertion during a rotator cuff repair is not uncommon with the suture-bridge technique, especially in patients with osteoporosis. We describe a simple procedure for dealing with the pull-out of a PushLock anchor in the lateral row using a suture anchor with a suture eyelet during rotator cuff repair applying the suture-bridge technique.

• Archives of Reconstructive Microsurgery
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• v.3 no.1
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• pp.45-53
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• 1994

Suture microvascular anastomosis is time-consuming and tedious and demands long and continuous training. Techinique of anastomosis of microvessel was presented interrupted suture and continuous suture. Recently the unilink instrument system is created as a fast and simple method to achieve high patency rates without long and continuous training in the anastomosis of small vessels. The author experimentally studied the femoral artery of 20 mice(0.5-1.0mm, av. 0.7mm), the femoral vein of 20 mice(0.8-1.6mm, av. 1.2mm) after anastomosis with interrupted suture in 20 cases and continuous sutre in 20 cases. For the unilink apparatus we used the carotid arteries of 15 cases in 14 rabbits(1.0-1.6mm, av. 1.3mm) and facial veins of 12 cases in 14 rabbits(0.9mm-2.2mm, av. 1.5mm). A total of 27 arterial and venous anastomoses were performed. We examined the postoperative patency at immediate, 2 weeks, and 8 weeks. The results were as followings, 1. In the arterial anastomosis the rate of patency was 90%(18/20) in interrupted suture, 90%(18/20) in continuous suture and 93%(13/15) in unilink apparatus. In the venous anastomosis the rate of patency was 90%(18/20) in interrupted suture, 80%(16/20) in continuous suture and 100%(9/9) in unilink apparatus. 2. The mean time for completion of the arterial anastomosis were 12.2 minutes in interrupted suture group, 10.3 minutes in continouous suture group and 8.5 minutes in unillnk apparatus group. The mean time for completion of the venous anastomosis were 13.6 minutes in interrupted suture group, 11.0 minutes in continuous suture group and 6.2 minutes in unilink apparatus group. 3. At the histological examination of suture group, hyperplastic reaction of middle layer and subintimal hyperplasia were observed. In unilink apparatus group, the endothelium layer was continued and the thickness of vessel wall was decreased due to moderate atrophy of the media and mild degree of nonspecific chronic inflammation were seen around the unilink apparatus. 4. No significants was noticied in foreign body reaction among the interrupted, continuous and unilink apparatus group. 5. A case of the arterial anastomosis was released with acting out at 15 minutes after operation. 6. The important factors in the technical problems were accurate apposition of the cut vessel edges in suture group and the proper selection of the ring size and optimal fitting between two rings in unilink apparatus group. Even though the outer diamater of vessel in suture group was different from that in unilink apparatus group the unilink method provides a very safe, fast, and simple way to perform microvascular anastomoses especially in anastomosis of vein. But howerver suture was needed in vessels below 1 mm outer diamater. In that situation continuous suture was benefit than the interrupted suture in operation time.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.1
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• pp.86-91
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• 2009

The success of implants essentially depends on a sufficient volume of healthy bone at the recipient site during implant placement. In patients who have the severe alveolar bone resorption or pneumatized maxillary sinus, it should be performed that bone regeneration procedure before implant placement. Development of barrier membrane makes it possible that predictable result of alveolar bone reconstruction. Many kind of materials used for barrier membrane technique are introduced, non-absorbable or absorbable membranes. But, when operation site was ruptured with membrane exposure, bacterias can be grow up at the bone graft site. Then morphology and migration of fibroblast will be changed. It works as a negative factor on healing process of bone graft site. In oral and maxillofacial department of Chonbuk national university dental hospital, we use variable suture technique like as subgingival suture, vertical mattress suture, simple interrupted suture, if need, tenting suture after GBR or block bone graft. Within these suture technique, wound healing was excellent without complication, so now we take a report of suture technique in reconstruction of alveolar bone surgery.

• Journal of Veterinary Clinics
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• v.39 no.6
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• pp.311-318
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• 2022

Appropriate suture technique is crucial for successful tracheal anastomosis. However, standards for an ideal suture method have not yet been established. A previous study suggested tracheal anastomosis using barbed sutures that do not require knots; however, their use in small animals has not been reported. In this study, we aimed to compare knotless barbed sutures with conventional smooth sutures in terms of maximum tensile strength and suturing time in canine tracheal models to demonstrate the feasibility of using barbed sutures in tracheal anastomosis in dogs. Tracheal segments harvested from nine beagle dog cadavers were randomly assigned to three suture groups: barbed suture (B), smooth suture in simple interrupted pattern (SI), and smooth suture in simple continuous pattern (SC). The maximum tensile force and suturing time were compared according to the suturing method, and the mode of failure was evaluated. The average suturing time was 3.29 min in the B group; 4.41 min, SC group; and 8.99 min, SI group (p < 0.001). The average maximum tensile force in the SC group was 134.97 N, which was stronger than the SI (110.57 N) and B groups (103.10 N) (p < 0.05 and p < 0.01, respectively). The difference between the B and SI groups was not significant (p = 0.05). The B group demonstrated comparable mechanical strength and shorter suture time compared with the SI group. Therefore, tracheal anastomosis using barbed sutures could be an effective alternative to conventional smooth sutures in dogs.

• Journal of Chest Surgery
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• v.46 no.4
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• pp.249-255
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• 2013

Background: The continuous suture (CS) technique has several advantages as a method for simple, fast, and secure aortic valve replacement (AVR). We used a simple CS technique without the use of a pledget for AVR and evaluated the surgical outcomes. Materials and Methods: Between October 2007 and 2012, 123 patients with aortic valve disease underwent AVR alone (n=28) or with other concomitant cardiac procedures (n=95), such as mitral, tricuspid, or aortic surgery. The patients were divided into two groups: the interrupted suture (IS) group (n=47), in which the conventional IS technique was used, and the CS group (n=76), in which the simple CS technique was used. Results: There were two hospital deaths (1.6%), which were not related to the suture technique. There were no significant differences in cardiopulmonary bypass time or aortic cross-clamp time between the two groups for AVR alone or AVR with concomitant cardiac procedures. In the IS group, two patients had prosthetic endocarditis and one patient experienced significant perivalvular leak. These patients underwent reoperations. In the CS group, there were no complications related to the surgery. Postoperatively, the two groups had similar aortic valve gradients. Conclusion: The simple CS method is useful and secure for AVR in patients with aortic valve disease, and it may minimize surgical complications, as neither pledgets nor braided sutures are used.

• Clinics in Shoulder and Elbow
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• v.22 no.3
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• pp.146-148
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• 2019

We report a simple technique for repairing capsular tear, using only a hook-like, cannulated instrument and braided sutures without relaying steps. A No. 2 braided suture is passed through the lumen of the instrument. Under direct arthroscopic view, the tip of the instrument is passed through the side of the capsule that has previously been separated with the probe. One end of the suture is retrieved with a grasper through a separate portal. The tip is moved back without withdrawing through the skin, and reinserted into the other side of the capsule. Holding the end retrieved earlier, the other end of the suture is retrieved with a suture retriever. After complete removal of the instrument, the suture is tied through a cannula using the standard knot tying techniques. The same procedures are repeated for other required knots.