• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.3
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• pp.500-514
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• 1996

The purpose of this study was to observe the tissue response in applying staples and various suture materials to both scalp and buccal mucosa in rabbits. 18 rabbits were divided into 6 groups. The incised wounds of both scalp and buccal mucosa were sutured with staples, polyglactin 910, chromic catgut, mer silk and nylon. The experimental animals were sacrificed after 1, 3, 5, 7, 10, 14 days posto peratively 3 animals at one time. The tissue was stained with Hematoxylin and eosin, and Masson's Trichrom. In light microscopic examinations, the sutured sites were examined histologi cally according to 6 degrees about inflammation and collagen deposit. The results were obtained as follows, 1. The chromic catgut, an absorbable suture material, was absorbed by 7 days, whereas polyglactin 910 and mersilk began to get absorbed after 7 days. 2. Mersilk manifested a broad range of inflammation in the scalp, and both staple and nylon showed a severe inflammatory reaction in the buccal mucosa. 3. With polyglactin 910, both tissue samples showed only minor foreign body reaction, however in the scalp, the process of fibrosis took place compara tively slowly, whereas in the buccal mucosa, it occurred promptly and manifested active fibrosis by 7 days. 4. Mersilk showed widespread a matrix formation in both scalp and buccal mucosa, and showed the most severe inflammatory reaction by 3 days, which did not seem to decrease even after 7 days. 5. Both staple and nylon showed relatively a severe inflammatory reaction, however fibrosis took place rather promptly compared to the other groups. 6. Generally, in the buccal mucosa fibrosis occurred more promptly than in the scalp in both control and experimental groups. 7. Retention of the suture material and stability of the knot were the best with the staple, and better stability was manifested by the multi-stranded poly glactin 910 and mersilk than singlestranded chromic catgut and nylon. From above results, in the buccal mucosa absorbable suture materials especially polyglactin 910 showed better response in the aspect of inflammatory reaction, while in the scalp monofilament suture materials such as staple and nylon manifested a early fibrosis and collagen formation.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.2
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• pp.131-136
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• 2016

Background: This study aimed to evaluate the patient's pain and quality of life after suture removal at either 3 or 7 days following the bilateral surgical extraction of impacted lower third molars. Methods: This study was a prospective, randomized controlled clinical trial carried out in 30 patients, who acted as their own control. Each patient required the bilaterally impacted mandibular third molars to be extracted. The impacted teeth were removed and the wound margins were approximated and sutured with black braided silk. The suture material was removed on day 3 on one side and on day 7 on the other. Each participant was asked to complete a questionnaire after the removal of the suture material on each designated day. Results: Regarding overall clinical symptoms, the mean VAS scores of male and female participants on day 3 were not significantly different from those on day 7. A significant difference was found in female participants, in that overall daily activity was better on day 7. There were significant differences in the ability to smile and laugh in both sexes and the ability to chew in the male participants was better on day 7. Conclusions: There were no significant differences in the patient's pain and quality of life between suture removal on day 3 or on day 7 following surgery to remove impacted lower third molars.

• Archives of Plastic Surgery
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• v.38 no.5
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• pp.590-593
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• 2011

Purpose: Surgical site infections (SSIs) are the third most frequently reported nosocomial infection. Of these SSIs, mostly were confined to the incision associated with underlying disease as diabetes, cigarette smoking, systemic steroid use, obesity, operating room environment, suture and surgical technique. This study has been planned to reduce the SSIs by using Vicryl $plus^{(R)}$ (Ethicon, USA) which contains triclosan, a broad-spectrum antibacterial agent, into the infected wound to evaluate whether or not Vicryl $plus^{(R)}$ (Ethicon, USA) is effective to nosocomial bacteria using a zone of inhibition assay. Methods: We did a comparison of Vicryl $plus^{(R)}$ suture (with triclosan) size 2-0, 5-0 with $Vicryl^{(R)}$ suture (without triclosan) size 4-0 each as treatment and control group, applied in Mueller-Hinton agar infected by following mircroorganisms: Methicillin-sensitive $Staphylococcus$ $aureus$ (MSSA), Methicillin-resistant $Staphylococcus$ $aureus$ (MRSA), Acinetobacter baumanii, $Escherichia$ $coli$, Enterobacter faecalis, Pseudomonas aeruginosa, Candida albicans. Cultures were made of the selected mircroorganisms, seeding the study strain in agar plates for 24 and 48-hour period in an oven at $37^{\circ}C$ followed by zone of inhibition assay. Results: Vicryl $plus^{(R)}$ group has demonstrated to create a zone of inhibition against MRSA, MSSA and $A.$ $baumanii$, but no effect on $E.$ $faecalis$, $P.$ $aeruginosa$, $C.$ $albicans$. Vicryl $plus^{(R)}$ suture size 2-0 also had antibactericidal effect while Vicryl $plus^{(R)}$ suture size 5-0 did not. $Vicryl^{(R)}$ group had no zones of inhibition showing colonization at all mircroorganisms. Conclusion: Our results seem to warrant the use of Vicryl $plus^{(R)}$ as absorbable buried suture when concerning SSIs as a prophylaxis against surgical nosocomial infection.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.1
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• pp.28-35
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• 2020

Objectives: The need for proper wound closure is of paramount importance after any intra-oral surgery. Various wound closure techniques have been described in literature using traditional non-absorbable suture materials. These include like synthetic absorbable sutures, surgical staples and tissue adhesives. Cyanoacrylates are among the most commonly used biocompatible tissue adhesives. To evaluate and compare intraoral wound healing using 3-0 silk sutures and n-butyl-2-cyanoacrylate after alveoloplasty. Materials and Methods: A total of 20 patients requiring bilateral alveoloplasty in the same arch (upper or lower) were included in this study. Patients with any pre-existing pathology or systemic disease were excluded. After alveoloplasty was performed, the wound was closed using 3-0 braided silk sutures on one side, and using n-butyl-2-cyanoacrylate bio adhesive on the other side. Patients were evaluated based on the following parameters: time required to achieve wound closure; the incidence of immediate and postoperative hemostasis; the time to the use of the first rescue medication; the side where pain first arises; and the side where wound healing begins first. Results: Compared to 3-0 silk sutures, cyanoacrylate demonstrated better hemostatic properties, reduced operative time, reduced postoperative pain and better wound healing. Conclusion: These data suggest that cyanoacrylate glue is an adequate alternative to conventional sutures to close the surgical wound after alveoloplasty, and better than are 3-0 silk sutures.

• Journal of Veterinary Clinics
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• v.24 no.2
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• pp.114-118
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• 2007

The objective of this study was to investigate the effects of implanted chitosan applied to surgically created wound in pigs. Six healthy $2{\sim}3$ months old Landrace and Yorkshire mixed breeds of both genders were used. A 2 cm straight skin incision was made and undermined skin ($2{\times}2cm$) over on the each pig's both sides of dorsal midline at 0, 7. 14 and 18 days. One wound (left side) was implanted 0.4 mg of cotton type chitosan and other wound was treated saline (3 ml). Each wound was closed with two interrupted suture of 2-0 sutures. The wounds created at 18, 14.7 and 0 days were named post-wounding day (PWD) 3, 7, 14 and 21, respectively. At 21 days after initial wounding, each wound was taken for histological observations. Reepithelialization tended to be greater in the chitosan group than in the control group at PWD 3 and 14. Granulation tissue formation did not show especial differences in two groups. Number of inflammatory cells was lesser statistically in level in the chitosan group than those in the control group at 21 days after wounding (p<0.05). Fibroblasts and neovasculature tended to be greater in the chitosan group than in the control group at PWD 3 and 7, and tended to be lesser in the chitosan group than in the control group at PWD 14 and 21. Collagen and fibrin were observed to be evenly distributed around the wound in the chitosan group. But collagen and fibrin were observed to be converged along the wound in the control group.

• Journal of Minimally Invasive Surgery
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• v.21 no.4
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• pp.160-167
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• 2018

Purpose: The aim of our study was to present an abdominal wall closure technique using barbed suture $V-Loc^{TM}$ 90 after single incision laparoscopic appendectomy (SILA) and to compare perioperative outcomes with conventional layer by layer abdominal wall closure after SILA. Methods: From March 2014 to July 2016, a retrospective case-control study was conducted for a total of 269 consecutive patients who underwent SILA. According to abdominal wall closure methods, 129 patients were classified into the V-Loc closure group and 140 patients were assigned into the conventional layer by layer closure group. In the V-Loc group, abdominal wall closure was performed from the fascia to the skin with a single thread of unidirectional absorbable barbed suture $V-Loc^{TM}$ 90 2-0 using continuous running suture and reverse overlapping reinforced running technique. Subcutaneous closure and subcuticular suture were performed with the remaining portion of V-Loc. Results: The V-Loc closure group showed shorter total operation time ($40.0{\pm}15.4min$ vs. $44.9{\pm}16.3min$, p=0.013) and abdominal wall cusing continuous running suture and reverse overlapping reinforced running technique. Subcutaneous closure and subcuticular suture were performed with the remaining portion of V-Loc. Results: The V-Loc closure group showed shorter total operation time losure time ($5.5{\pm}0.9min$ vs. $6.5{\pm}0.8min$, p<0.001). Postoperative incision length was significantly shorter in the V-Loc closure group ($1.1{\pm}0.3cm$ vs. $1.8{\pm}0.4cm$, p<0.001). Postoperative wound pain, time to resume diet, postoperative hospital stay, complications including surgical site infection, or mean patient satisfaction score at one month after hospital discharge was not significantly different between the two groups. Conclusion: In conclusion, unidirectional knotless barbed suture is a safe alternative method for abdominal wall closure after SILA. It can save time while providing comparable cosmesis.

• Clinics in Shoulder and Elbow
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• v.20 no.2
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• pp.59-67
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• 2017

Background: The purpose of this study was to examine the clinical and radiological results of the all-arthroscopic, suture-button fixation technique to treat acute acromioclavicular (AC) joint separations. Methods: All patients with acute AC joint separations received all-arthroscopic, single suture-button (TightRope) procedure without a special guide. Postoperative Constant score (CS), pain level according to visual analogue scale, and range of motion (ROM) were evaluated. For radiological evaluation, coracoclavicular distances were measured bilaterally. Results: Between December 2010 and June 2012, 18 consecutive patients (4 women and 14 men; mean age, 29.3 years) with acute AC joint separations underwent surgical treatment after 6.4 days (range, 2-20 days) following the initial trauma. The average postoperative follow-up was 16.9 months. The mean CS was 92.4 (range, 84-96). The mean external rotation, forward flexion, and abduction were $75.8^{\circ}$ (range, $50^{\circ}-90^{\circ}$), $170^{\circ}$ (range, $150^{\circ}-180^{\circ}$), and $163.8^{\circ}$ (range, $140^{\circ}-180^{\circ}$), respectively. Five patients exhibited coracoclavicular ossifications. In two patients, superficial wound infections were successfully treated with antibiotic therapy. In one patient, a coracoid fracture was observed. No significant differences were found regarding pain, ROM, or strength parameters between both sides. The coracoclavicular distance was discovered to be approximately 2.8 mm greater on the affected side; however, this minimal reduction loss did not affect the functional results. Conclusions: The findings of this study suggests that all-arthroscopic treatment of AC joint separations using the single suture-button technique without a drill guide is safe, yielding good to excellent clinical results.

• Journal of Chest Surgery
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• v.51 no.4
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• pp.277-279
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• 2018

A 68-year-old man presented with a posterior tracheal wall injury caused by percutaneous dilatational tracheostomy. The wound was immediately covered with an absorbable polyglycolic acid sheet. Ten days after the injury, the perforation was closed with knotless sutures using a Castroviejo needle-holder through the tracheostomy. The successful repair in this case indicates the feasibility of the knotless suture technique for perforations. The technique is described in detail in this report. The patient was weaned from the mechanical ventilator on postoperative day 25. In cases of posterior tracheal posterior wall perforation, every effort should be made to repair the perforation through an existing opening.

• Journal of Sericultural and Entomological Science
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• v.52 no.2
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• pp.89-95
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• 2014

Silk polymer has been focused recently on medical applications as a novel biomaterials. The factors for biomaterials were considered and reviewed recent research on surgical suture, wound dressing, tympanic regeneration patch, guided bone regeneration membrane, bone implant and ligament. Silk polymer is good mechanical properties and biocompatibility. Therefore it might be used as one of promising materials for medical application.

• 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.