• Title/Summary/Keyword: Wound suture

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A dual-plane approach for surgical treatment of pseudoaneurysm with arteriovenous fistula in hemodialysis patients

  • Kim, Ji Min;Tak, Min Sung;Kang, Jin Seok;Moon, Chul
    • Archives of Plastic Surgery
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    • v.48 no.3
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    • pp.287-292
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    • 2021
  • Background We report the efficacy of a dual-plane approach using a Dufourmentel skin flap with a purse-string suture of the de-epithelized dermis to manage pseudoaneurysm at the vascular access site for hemodialysis. Methods A retrospective analysis was conducted of 61 patients from 2013 to 2018 with pseudoaneurysms at the arteriovenous fistula or graft who were treated with rhomboid excision, vessel repair with a purse-string suture, and a full-thickness Dufourmentel skin flap. The success rate was defined as the probability of complete wound closure and intact vascular access patency without infection or other complications. Results The success rate was 93.4% at 6 months postoperatively. Complications included newly occurring pseudoaneurysms (n=2), wound dehiscence (n=1) and bleeding (n=1). There were no complications such as stenosis or thrombosis from the procedure. Conclusions A dual-plane approach using a Dufourmentel skin flap with a purse-string suture for vessel repair was shown to be a favorable option for managing stable, small (diameter <2 cm) pseudoaneurysms without infection, rapid expansion, or patency issues of the vascular access.

Minimal-incision tenorrhaphy in flexor tendon injury (굴곡건 손상에서 최소절개 건 봉합술)

  • Jang, Ju Yun;Oh, Sang Ah;Kang, Dong Hee;Lee, Chi Ho
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.516-518
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    • 2009
  • Purpose: To retrieve the retracted flexor tendon, additional incision and wide dissection are conventionally required. We introduce minimal - incision tenorrhaphy using 1 cm - length incision and minimal dissection. Methods: Transverse incision about 1 cm - length is made over the level of retracted tendon. Nelaton's catheter is advanced into tendon sheath from distal primary laceration wound to emerge proximally through the incisional wound. Catheter is sutured to proximal tendon in end - to - end fashion. By gently pulling the catheter, retracted tendon is delivered to distal wound. Tenorrhaphy with core suture and epitendinous suture is then carried out. Results: This retrieving technique provides minimal incision, minimal dissection, minimal bleeding, minimal injury to tendon end, and shorter operation time with preservation of vincula tendinum and pulley system. Conclusion: In case of flexor tendon rupture with retraction, this operative method is believed to allow reliable and effective tenorrhaphy and excellent postoperative outcomes.

Usefulness of an Additional Mattress Suture for the Extracranial Drainage Catheter

  • Eom, Dong Woong;Kim, Jung Soo;Jeon, Kyoung Dong;Kim, Hoon;Choi, Byeong Sam
    • Journal of Korean Neurosurgical Society
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    • v.54 no.5
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    • pp.444-447
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    • 2013
  • In most intracranial surgery cases, a drain catheter is inserted to prevent the collection of the wound hematoma or seroma. A drain catheter is also inserted to drain the hematoma or the cerebrospinal fluid. The drain catheter itself does not cause complications; but many complications occur during its removal, such as hematoma, seroma, air collection and pseudomeningocele formation. To prevent these complications, neurosurgeons perform a suture on the catheter to remove the site. In this study, an additional horizontal mattress suture and an anchoring suture to the drainage catheter are proposed. This method maintains negative pressure in the catheter insertion site during the catheter removal, compresses the catheter tunnel site and attaches the external wounds strongly. The technique is easy and safe to perform, and does not require an additional suture to remove the catheter.

Microvascular Anastomosis Using Horizontal Mattress Suture Technique (Horizontal Mattress Suture Technique을 이용한 미세혈관 문합)

  • Woo, Sang-Hyun;Kim, Jeong-Cheol;Jung, Yung-Sik;Choi, See-Ho;Choi, Won-Hee
    • 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.

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Eleven Cases on Peripheral Arterial Injuries (말초동맥손상 11례 보고)

  • 이승진;이남수;김형묵
    • Journal of Chest Surgery
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    • v.7 no.1
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    • pp.109-116
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    • 1974
  • Eleven cases of peripheral arterial injuries treated at Korea University Woo Sok Hospital during these 3 years and 3 months from Feb. 1971Eleven cases of peripheral arterial injuries treated at Korea University Woo Sok Hospital during these 3 years and 3 months from Feb. 1971 to May 1974 were reviewed. Common causes of injuries were stab wound, automobile accidents and iatrogenic injuries during operation. Of the 11 arterial injuries 3 were femoral artery which` was the commonest in frequency and the next was 2 cases of brachial artery. The most frequent type of injury was transection. Laceration, contusion and spasm was also recognized. The need to operate immediately following an injury was emphasized. Operative procedures were end to end anastomosis and saphenous vein graft in 5 and 2 cases, respectively. Other cases were undergone multiple suture ligature due to staphyllococcal infection, insertion of polyethylene catheter, and lateral suture after thromboendarterectomy. Fractures and extensive soft tissue damage associated with arterial injuries with widespread destruction of the collateral circulation aggravated the situation and complicated the amputation of lower extremity in 4 cases. The factors influencing the amputation were time lag, presence of associated injuries and complications.[KTCS 1974;1:109-116] Common causes of injuries were stab wound, automobile accidents and iatrogenic injuries during operation. Of the 11 arterial injuries 3 were femoral artery which` was the commonest in frequency and the next was 2 cases of brachial artery. The most frequent type of injury was transection. Laceration, contusion and spasm was also recognized. The need to operate immediately following an injury was emphasized. Operative procedures were end to end anastomosis and saphenous vein graft in 5 and 2 cases, respectively. Other cases were undergone multiple suture ligature due to staphyllococcal infection, insertion of polyethylene catheter, and lateral suture after thromboendarterectomy. Fractures and extensive soft tissue damage associated with arterial injuries with widespread destruction of the collateral circulation aggravated the situation and complicated the amputation of lower extremity in 4 cases. The factors influencing the amputation were time lag, presence of associated injuries and complications.

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A Case of Dissection and Resuture Performed at the Department of Korean Medicine for Excessive Granulation Tissue Caused by Suturing Failure (봉합 실패로 발생된 과다 육아조직에 대해 한의과에서 시행한 절제 및 재봉합 증례)

  • Eun-na Heo;Kang Kwon;Hyung-Sik Seo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.36 no.4
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    • pp.181-186
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    • 2023
  • Objectives : The purpose of this study is to report case of hypergranulation tissue that occurred after laparotomy and dissected by CO2 laser. Methods : A 72-year-old female had hypergranulation tissue on the epigastrium. Local anesthesia was achieved with bufonis venenum pharmacopuncture. The CO2 laser was used for dissection. After removal of granulation, irrigation with soyeom pharmacopuncture solution and simple interrupted suture were performed. Yeonkyopaedok-san were administered for 7 days and the suture was removed after 14 days. At last, saengkigo was applied. Results : Hypergranulation tissue sized 1.0×1.0×1.0cm was clearly removed. Including excessive growing of granulation tissue, adverse effects were not reported until the clear skin adhesion. Conclusions : Hypergranulation tissue was surgically removed and sutured completely without any complications by using pharmacopuncture, oral herbal medicine and ointment that have anti-inflammatory effects and wound healing. Through this study, it is hoped that surgery including suture will be actively performed in more diverse diseases in the Korean medicine community.

Emergency bleeding control in a mentally retarded patient with active oral and maxillofacial bleeding injuries: report of a case (구강악안면 손상 후 과도한 출혈을 보인 정신지체 응급환자에서 신속지혈 예: 증례보고)

  • Mo, Dong-Yup;Yoo, Jae-Ha;Choi, Byung-Ho;Sul, Sung-Han;Kim, Ha-Rang;Lee, Chun-Ui
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.4
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    • pp.303-308
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    • 2010
  • Excessive oral and maxillofacial bleeding causes upper airway obstruction, bronchotracheal and gastric aspiration and hypovolemic shock. Therefore, the rapid and correct bleeding control is very important for saving lives in the emergency room. Despite the conventional bleeding control methods of wiring (jaw fracture, wound suture and direct pressure), continuous bleeding can occur due to the presence of various bleeding disorders. There are five main causes for excessive bleeding disorders in the clinical phase; (1) vascular wall alteration (infection, scurvy etc.), (2) disorders of platelet function (3) thrombocytopenic purpura (4) inherited disorders of coagulation, and (5) acquired disorders of coagulation (liver disease, anticoagulant drug etc.). In particular, infections can alter the structure and function of the vascular wall to a point at which the patient may have a clinical bleeding problem due to vessel engorgement and erosion. Wound infection is a frequent cause of postoperative active bleeding. To prevent postoperative bleeding, early infection control using a wound suture with proper drainage establishment is very important, particularly in the active bleeding sites in a contaminated emergency room. This is a case report of a rational bleeding control method by rapid wiring, wound suture with drainage of a rubber strip & iodoform gauze and wet gauze packing, in a 26-year-old male cerebral palsy patient with active oral and maxillofacial bleeding injuries caused by a traffic accident.

Importance of various skin sutures in cheiloplasty of cleft lip

  • Kim, Soung Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.6
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    • pp.374-376
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    • 2019
  • Last week, after our receiving online journal regarding Journal of the Korean Association of Oral and Maxillofacial Surgeons, we found a recently published original article by Alawode et al., entitled "A comparative study of immediate wound healing complications following cleft lip repair using either absorbable or non-absorbable skin sutures". Although this clinical article was well written and provided a great deal of information regarding the suture materials in the cleft lip repair, I would like to add a few additional comments based on the importance of skin suture during cheiloplasties in the primary cleft lip or secondary revision patients with representative figures.

Comparative Study of Tissue Response of Various Suture Materials in Rats (수종의 봉합사의 조직반응에 관한 비교연구)

  • Kim, Jae-seok;Park, Joon-Bong;Lee, Man-Sup;Herr, Yeek
    • Journal of Periodontal and Implant Science
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    • v.32 no.1
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    • pp.113-127
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    • 2002
  • The purpose of this study is to evaluate histologically the tissue response and resorption of various nonresorbable and resorbable suture materials used for periodontal surgery, using a subcutaneous model on the dorsal surface of the rat. In this study, 10 Sprague-Dawley male rats (mean BW 150gm) were used and the commercially available materials included polyglactin 910, pain gut, nylon, e-PTFE. Animals were sacrificed at 3 days, 1, 2 and 4 weeks after implantation of various nonresorbable and resorbable suture materials. Specimens were prepared with Hematoxylin-Eosin stain for light microscopic evaluation. The results of this study were as follows: 1. Resorption : The resorption of plain gut was showed at 1 week after implantation, was lost their structure and almost resorbed at 4 weeks. The resorption of polyglactin 910 was started at 2 weeks and slowly absorbed untill 4 weeks. 2. Tissue response : Plain gut showed persistent and severe inflammatory reactions from 3 days to 4 weeks. Polyglactin 910, e-PTFE and nylon showed mild inflammatory reactions. Suture material should be biocompatible and be able to be functioned until tissue tensile strength reaches maximum level. In this study, polyglactin 910, nylon and e-PTFE are considered to be proper suture materials for periodontal surgery.

Comparative Study of Wound Healing in Porcine Stomach with $CO_2$ Laser and Scalpel Incisions (돼지에서 $CO_2$ laser와 외과용 수술도를 이용한 위 절개 시 창상 치유 평가)

  • Byun, Hong Seob;Lee, Jae Yeon;Kim, Myung Cheol
    • Journal of Veterinary Clinics
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    • v.30 no.4
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    • pp.247-252
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    • 2013
  • We compared wound healing with $CO_2$ laser incision and scalpel incision by measuring the extent of bleeding, the ease of incision, time, degrees of adhesion and histological observation in pig's stomach. Eight healthy pigs were used. Two symmetrical incisions were made in ventral aspect of the stomach between the greater curvature and lesser curvature were made with scalpel and 2 mm spot diameter $CO_2$ laser (8W, continuous wave) in eight pigs. And then each wound was closed with absorbable suture in a two-layer inverting seromuscular pattern. At 7 and 14 days after initial wounding, each wound was taken for histological observation. On surgery, the extent of bleeding, the ease of incision and incision time showed significant differences between the two groups. The $CO_2$ laser provided better hemostasis (p < 0.01) and smaller postoperative adhesion compared with the scalpel. However, the scalpel produced faster speed of incision and was easier to handle than the $CO_2$ laser group (p < 0.01). There was no considerable difference between the two groups in histological observation.