• Archives of Plastic Surgery
• /
• v.36 no.6
• /
• pp.727-734
• /
• 2009

Purpose: The Inaba's procedure, the treatment of osmidrosis axillae, has the advantages of low recurrent rate and easy to learn, yet it produces early postoperative discomfort and scar formation by tie - over dressing. The authors modified the Inaba's procedure by using delayed suture of the incision wound and omitting tie - over dressing. The comparative study of Inaba's procedure and its modification was performed to confirm the advantages of modified procedure. Methods: The study contains the retrospective analysis of the medical records of 296 patients with osmidrosis who were treated using the Inaba's procedure from December, 1996 to February, 2007. The study also contains the prospective analysis of 20 patients, from March, 2007 to July, 2008, who were treated by the modified Inaba's procedure with delayed suture of the incision wound and gentle pressure dressing instead of tie - over dressing. The operative results of two groups were compared and verified by Mann - Whitney U test(SPSS 12.0). Results: The incidence of complications was 14.5% in the Inaba's procedure, whereas 6.2% in the modified Inaba's procedure. Both procedures have the same basic surgical procedure in terms of the location of incision site and subdermal shaving of the sweat glands, and therefore similar good results were obtained in the aspect of postoperative axillary odor, recurrent rate and postoperative condition of axillary hair. Certainly, the modified Inaba's procedure had better outcome in each element of PSS(Patient Scar Self-Rating Scale), compared to the Inaba's procedure. In addition, the modified Inaba's procedure showed a statistical significance in dressing - related pain reduction and overall satisfaction. Conclusion: The modified Inaba's procedure had advantages of decreased early postoperative complications such as hematoma, discomfort and pain caused by tie - over dressing, and decreased scar formation. However, the drawback was delayed suture of the incision wound after 48 hours.

• Korean Journal of Veterinary Research
• /
• v.54 no.2
• /
• pp.121-122
• /
• 2014

A 2-year-old male Tosa was admitted for treatment of a non-healing wound on the right forelimb. Skin tests were unremarkable; however, the lesion contained severe proliferative tissue. Surgical treatment was conducted due to the extensive skin defect and granulation tissue present. Following removal of the proliferative tissue, the wound was closed using the adjustable horizontal mattress suture method with multiple punctate relaxing incisions. The proliferative tissue healed completely after the surgical treatment. This technique can be considered an alternative treatment for the proliferative tissue when conditions require a skin graft or flap after surgical treatment.

• Archives of Reconstructive Microsurgery
• /
• v.10 no.1
• /
• pp.49-54
• /
• 2001

Sutures support wound healing during the initial phase. As the tensile strength of a wound increases, the need for the presence of sutures becomes less important. For this reason, absorbable suture materials have been sought. Nowadays, commonly used suture materials are Chromic Catgut, Coated Vicryl, and PDS. Among these materials, Coated Vicryl is the most popular. Studies were conducted to compare the handling properties, reliability of knots, wound healing, and tissue reactivity(Inflammation, Fibroblast proliferation, Collagen deposition, Giant cell reaction, Absorption) between AILEE vicryl and ETHICON vicryl. We used twelve purebred New Zealand white rabbits, and biopsied the tissue at three, seven, fourteen, and thirty days post implantation. The results showed that both were supple and easy to handle and tie, and gross and histologic differences were not apparent.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.11 no.2
• /
• pp.177-182
• /
• 2011

There are five principal causes for excessive bleeding in the immediate postextraction phase ; (1) Vascular wall alteration (wound infection, scurvy, chemicals, allergy) (2) Disorders of platelet function (genetic defect, drug-aspirin, autoimmune disease) (3) Thrombocytopenic purpuras (radiation, leukemia), (4) Inherited disorders of coagulation (hemophilia, Christmas disease, vitamin deficiency, anticoagulation drug-heparin, coumarin, aspirin, plavix). If the hemorrhage from postextraction wound is unusually aggressive, and then dehydration and airway problem are occurred, the socket must be packed with gelatine sponge(Gelfoam) that was moistened with thrombin and wound closure & pressure dressing are applied. The thrombin clots fibrinogen to produce rapid hemostasis. Gelatine sponges moistened with thrombin provide effective coagulation of hemorrhage from small veins and capillaries. But, in dental alveoli, gelatine sponges may absorb oral microorganisms and cause alveolar osteitis (infection). This is a case report of bleeding and infection control by the circumferential suture and iodoform gauze drainage on infected active bleeding extraction socket under sedation and local anesthesia in a 71-years-old male patient with anticoagulation drug.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.31 no.1
• /
• pp.86-91
• /
• 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
• /
• v.7 no.1
• /
• pp.403-406
• /
• 1990

The effects of enternal feeding on wound healing and intestinal movement in 30 gastrotomized dogs were investigated. The dogs were divided into enteral and parenteral feeding groups. Wound healing was evaluated with tensile strengh on the suture line 4 days after surgery and intestinal movement with the auscultation of borborygmus sound in the abdomen. There was no difference of the tensile strengh on the suture line between enternal and parenteral feeding groups. Borborygmus was auscultated in all dogs of the enteral feeding groups from day2 after surgery. It was thought that enteral feeding had no detrimental effect on wound healing as compared with the parenteral feeding and had good effect on the prevention of ileus in gastrotomized dogs.

• Journal of Korean Medicine Rehabilitation
• /
• v.26 no.2
• /
• pp.29-50
• /
• 2016

Objectives There is few Korean medicinal studies about post-operation wound healing despite much effort for minimizing wound or post-op scar. The aim of this study is to evaluate the wound healing effect of Gyejibokryeong-hwan (Guizhifuling-wan, GBH) after skin suture. Methods < In vitro > We observed anti-oxidative and anti-inflammatory effect by using lipopolysaccharide (LPS)-treated RAW 264.7 cells. For anti-oxidation, we mesured the total amount of polyphenol, flavonoid, DPPH scavenging ability, ABTS scavenging ability and the value of ROS production, and for anti-inflammation, we mesured the amount of NO and pro-inflammatory cytokines ($TNF-{\alpha}$, $IL-1{\beta}$, IL-6). < In vivo > Thirty SD rats were divided into five equal groups (n=6, one normal, two controls and two experimentals). All groups except normal group were made a scar (around $1{\times}4cm^2$) in the back by the depth of the fascia and then sutured by a thread and needle. Normal group rats received no treatment at all. Control group rats were fed distilled water, and positive control group rats were percutaneously applied terramycin once in 2 days. GBH 200 group rats were orally medicated GBH 200 mg/kg, and GBH 400 group rats were orally medicated GBH 400 mg/kg per day for two weeks. We analyzed the blood samples (WBC, neutrophil, lymphocyte, monocyte, eosinophil), and the serums (TIMP-1, MMP-2, MMP-2. $PGE_2$, $TGF-{\beta}$, VEGF), and examined the wounded skin tissue histopathologically. Results < in vitro > 1. DPPH and ABTS scavenging activity was increased concentration-dependantly, and ROS production was significantly increased in GBH treated cells ($100{\mu}g/ml$). Therefore in this study, Gyejibokryeong-hwan appears to have the anti-oxidative. 2. NO production was significantly reduced in GBH treated cells ($100{\mu}g/ml$), and $IL-1{\beta}$ production was significantly reduced in GBH treated cells ($1{\mu}g/ml$). But, $TNF-{\alpha}$ and IL-6 did not show uneffective action. Therefore in this study, Gyejibokryeong-hwan did not show any significant effect on anti-inflammatory process. < in vivo > 1. Monocyte and neutrophil was significantly increased in GBH (200, 400) groups. WBC, lymphocyte and eosinophil did not show significant change. 2. TIMP-1, MMP-2, VEGF were significantly increased in GBH 400 group, $PGE_2$ was significantly reduced in GBH 400 group. $TGF-{\beta}$ was significantly increased in GBH (200, 400) groups, and MMP-9 was increased concentration-dependantly in GBH groups, but there was no significance. 3. In histopathological examinations, collagen was significantly increased and keratin was significantly decreased in GBH (200, 400) groups. Conclusions According to in vitro experiment, GBH appears to have the anti-oxidative effect and in vivo experiment, GBH stimulate the wound healing process hematologically and histopathologically. In conclusion, the results suggest that GBH promotes wound healing after skin suture.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.13 no.4
• /
• pp.381-390
• /
• 1991

The purpose of this study was to select the absorbable suture material with the lowest level of foreign body reaction in the extraoral field. The absorbable sutures tested were polyglactin 910(Vicryl), polyglycolic acid(Dexon), and chromic gut. Black silk served as to control suture. Eighteen domestic rabbits served as the animal model for testing purposes. After shaving the fur, A six centimeter incision was made in the hind quarter of all eighteen animals. Each wound was then closed wit two Vicryl, two Dexon, and two chromic gut sutures. All wounds were closed in the same manner. A similar wound was made on the oppsite side and closed with black silk suture. Three rabbits were then sacrificed on postoperative day one, three, seven fourteen, twenty-one, and twenty-eight. The surgical sites were then examined histologically. 1. On days one, three, and seven all suture materials as a similar severe level of inflammatory response. On the fourteenth day the inflammatory reaction of Vicryl was minimal, chromic gut was moderate, and Dexon was severe, Black silk control groups demosnstrated the most severe levels of inflammation of all sutures tested from day fourteen to twenty-eight. 2. On the fourteenth day all absorbable suture materials demonstrated similar minimal levels of resorption. At twenty-eight days Vicryl demonstrated a greater amount of resorption than Dexon or cromic gut suture. There was no resorption noted in the black silk control groups through day twenty-eight. 3. Due to its decreased level of inflammatory response in the animal model, Vicryl might be expected to as a decreased level of response in humans. It is felt that Vicryl is preferred to Dexon or chromic gut for extraoral suturing.

• Journal of The Korean Society of Emergency Medicine
• /
• v.29 no.6
• /
• pp.649-655
• /
• 2018

Objective: This paper reports the possibility of using of a locking horizontal mattress suture technique in repairing lacerations that are difficult to suture with staples. Methods: Data were collected retrospectively over a 6-month period regarding the routine repair of scalp lacerations: those in areas injured by a high energy blunt mechanism, continued to bleed after pressure, nonlinear or damaged skin repaired with a locking horizontal mattress technique, and simple interrupted technique. The effects of the two techniques used to repair scalp lacerations on wound healing, complication rate, and patient satisfaction were examined. The categorical variables are expressed as the number and percent. A Mann-Whitney-Wilcoxon test was used for statistical analysis. A P-value less than 0.05 was considered significant. Results: Thirty-seven consecutive patients with scalp lacerations presented for care. Wound closure was accomplished with the locking horizontal mattress sutures in 40.5% (n=15) (median length, 5.0 cm; interquartile range [IQR], 4.0-7.0 cm). Simple interrupted sutures (median length, 4 cm; IQR, 3.0-5.0 cm) were used in 59.5% (n=22) (P=0.015). The frequency of additional bandage compression (P=0.008), frequency of exudative hemorrhage (P=0.018), and suture mark frequency at suture removal (P=0.047) were significantly lower in the locking horizontal mattress group. Conclusion: The locking horizontal mattress suture, which has the advantage of a horizontal mattress suture, may be one of the ways that can be used alternatively to treat scalp lacerations that difficult to suture with staples.

• Archives of Craniofacial Surgery
• /
• v.22 no.4
• /
• pp.183-192
• /
• 2021

Background: The purse-string suture (PSS) is a simple and rapid wound closure method that results in minimal scarring. It has been used to treat circular or oval skin defects caused by tumor excision or trauma. However, due to obscurity, it is not widely used, especially for the head and neck. This study aimed to modify the PSS to obtain predictable and acceptable results. Methods: A total of 45 sites in 39 patients with various types of skin and soft tissue defects in the head and neck were treated with PSS. We used PDS II (2-0 to 5-0), which is an absorbable suture. Minimal dissection of the subcutaneous layer was performed. The suture knot was hidden by placing it in the dissection layer. Depending on the characteristics of the skin and soft tissue defects, additional surgical interventions such as side-to-side advancement sutures, double PSS, or split-thickness skin graft were applied. Results: All wounds healed completely without any serious complications. Large defects up to 45 mm in diameter were successfully reconstructed using only PSS. Postoperative radiating folds were almost flattened after approximately 1-2 months. Conclusion: PSS is simple, rapid, and relatively free from surgical design. Owing to the circumferential advancement of the surrounding tissue, PSS always results in a smaller scar than the initial lesion and less distortion of the body structures around the wound in the completely healed defect. If the operator can predict the process of healing and immediate radiating folds, PSS could be a favorable option for round skin defects in the head and neck.