• Title/Summary/Keyword: suture

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Interrupted Single-layer Suture Technique in Esophageal Anastomosis Using Monofilament Polypropylene Suture (Monofilament Polypropylene사를 이용한 단속단층 식도문합술)

  • 성시찬;편승환
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.711-717
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    • 1998
  • Background: Although various anastomotic techniques and suture materials have been used in esophageal anastomosis, anastomotic leakage and stenosis are still somewhat frequent and serious complications when compared to other intestinal anastomoses. We have used interrupted single-layer suture technique using monofilament polypropylene suture in various esophageal anastomoses, including repair of the esophageal atresia, since 1990. Methods and method: We retrospectively evaluated the efficacy of this technique on postoperative leakage and stenosis in several esophageal reconstructions. The esophageal reconstructions using this technique were performed in 90 patients at Dong-A University Hospital from April 1990 through December 1996. Results: Anastomotic leakage occurred in 5 patients(5.6%) with one operative death. Stenosis at the anastomotic site occurred in 15 patients(n=86, 17.4%), which was most common in esophagogastrostomy(22%) and least common in esophagocolostomy (5%). This result was comparable to other methods including the autosuture technique. Conclusions: We concluded that this suture technique in esophageal anastomosis can be used with reasonable results in various esophageal reconstructions including correction of the esophageal atresia.

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AN EXPERIMENTAL STUDY OF TISSUE REACTION OF ABSORBABLE SUTURE MATERIALS (수종(數種)의 흡수성(吸收性) 봉합사(縫合絲)가 조직반응(組織反應)에 미치는 영향(影響)에 관(關)한 실험적(實驗的) 연구(硏究))

  • Song, Sun-Chul;Kim, Kyung-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.4
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    • pp.381-390
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    • 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.

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Comparing Conventional Suture Method Versus Wound Closure Using Tissue Glue(Histoacryl Blue®): a Prospective Randomized Clinical Trial (기존의 창상봉합과 Histoacryl Blue®를 이용한 창상봉합의 비교 분석: 전향적 무작위 임상실험)

  • Choi, Jong Woo;Hyun, Kyung Bae;Kim, Yong Oock;Park, Beyoung Yun
    • Archives of Plastic Surgery
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    • v.32 no.1
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    • pp.19-23
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    • 2005
  • Tissue adhesives have gained popularity for quicker and painless closure of lacerations. The use of tissue glue is currently popular for the closure of superficial lacerations, especially in children. Histoacryl $Blue^{(R)}$(2-N-butylcyanoacrylate) is a topical wound closure that precludes the need for foreign bodies to close wounds. The purpose of this study was to compare the applications of Histoacryl $Blue^{(R)}$(HAB) and conventional suture, regarding cosmetic outcome. To compare the short term and long term results of various repair methods, we designed the prospective, randomized, blind study. Patients with laceration undergoing repair were randomly allocated to conventional suture, subcutaneous suture plus HAB, and HAB only groups. The exclusion criterions were large wound that require large tension for repair or avulsion wound. An independent, blinded observer assessed cosmetic result at 7-10 days after repair and 3-9 months postoperatively. Physician's satisfaction with wound appearance was recorded on 100 mm Visual Analogue Scale(VAS)(0=worst, 100=best). The difference in VAS score between conventional suture method and subcutaneous suture plus HAB methods were not significant. Tissue glue being easy to use with no complications and still resulting in equivalent cosmetic outcomes has several benefits. Especially in the case of children, the wound closure with Histoacryl $Blue^{(R)}$ could be a good alternative for repair of laceration in emergency room.

Quantitative evaluation of midpalatal suture maturation via fractal analysis

  • Kwak, Kyoung Ho;Kim, Seong Sik;Kim, Yong-Il;Kim, Yong-Deok
    • The korean journal of orthodontics
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    • v.46 no.5
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    • pp.323-330
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    • 2016
  • Objective: The purpose of this study was to determine whether the results of fractal analysis can be used as criteria for midpalatal suture maturation evaluation. Methods: The study included 131 subjects aged over 18 years of age (range 18.1-53.4 years) who underwent cone-beam computed tomography. Skeletonized images of the midpalatal suture were obtained via image processing software and used to calculate fractal dimensions. Correlations between maturation stage and fractal dimensions were calculated using Spearman's correlation coefficient. Optimal fractal dimension cut-off values were determined using a receiver operating characteristic curve. Results: The distribution of maturation stages of the midpalatal suture according to the cervical vertebrae maturation index was highly variable, and there was a strong negative correlation between maturation stage and fractal dimension (-0.623, p < 0.001). Fractal dimension was a statistically significant indicator of dichotomous results with regard to maturation stage (area under curve = 0.794, p < 0.001). A test in which fractal dimension was used to predict the resulting variable that splits maturation stages into ABC and D or E yielded an optimal fractal dimension cut-off value of 1.0235. Conclusions: There was a strong negative correlation between fractal dimension and midpalatal suture maturation. Fractal analysis is an objective quantitative method, and therefore we suggest that it may be useful for the evaluation of midpalatal suture maturation.

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.

3D analysis of soft tissue around implant after flap folding suture (Flap folding suture를 활용한 판막의 고정에 따른 임플란트 주변 연조직 3차원 부피 변화 관찰)

  • Jung, Sae-Young;Kang, Dae-Young;Shin, Hyun-Seung;Park, Jung-Chul
    • Journal of Dental Rehabilitation and Applied Science
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    • v.37 no.3
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    • pp.130-137
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    • 2021
  • Purpose: The various suture techniques can be utilized in order to maximize the keratinized tissue healing around dental implants. The aim of this study is to compare the soft tissue healing pattern between two different suture techniques after implant placement. Materials and Methods: 15 patients with 18 implants were enrolled in this study. Simple implant placement without any additional bone graft was performed. Two different suture techniques were used to tug in the mobilized flap near the healing abutment after paramarginal flap design. Digital intraoral scan was performed at baseline, post-operation, stitch out, and 3 months after operation. The scan data were aligned using multiple points such as cusp, fossa of adjacent teeth, and/or healing abutment. After subtracting scan data at baseline with other time-point results, closed space indicating volume increment of peri-implant mucosa was selected. The volume of the close space was measured in mm3. The volume between two suture techniques at three time-points was compared using nonparametric rank-based analysis. Results: Healing was uneventful in both groups. Both suture technique groups showed increased soft tissue volume immediately after surgery. The amount of volume increment significantly decreased after 3 months (P < 0.001). Flap folding suture group showed higher median of volume increment than interrupted suture group after 3 months without any statistical significance (P > 0.05). Conclusion: After paramarginal flap reflection, the raised flaps stabilized by flap folding suture showed relatively higher volume maintenance after 3-month healing period. However, further studies are warranted.

Loop Suture Technique for Flexor Digitorum Profundus Tendon Repair in the Insertion Site (고리 봉합법을 이용한 심부 수지 굴건 종지부에서의 건봉합)

  • Lee, Kyu-Cheol;Lee, Dong-Chul;Kim, Jin-Soo;Ki, Sae-Hwi;Roh, Si-Young;Yang, Jae-Won
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.650-658
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    • 2010
  • Purpose: In the case of repair for far distal parts of FDP (Flexor digitorum profundus) division, the method of either pull-out suture or fixation of tendon to the distal phalanx is preferred. In this paper, the results of a modified loop suture technique used for the complete division of FDP from both zone 1a and distal parts of zone 1b in Moiemen classification are presented. Methods: From July 2006 to July 2009, the modified loop suture technique was used for the 10 cases of FDP in complete division from zone 1a and distal parts of zone 1b, especially where insertion sites were less than 1 cm apart from a tendon of a stump. In a suture technique, a loop is applied to each distal and proximal parts of tendon respectively. Core suture of 2-strand and epitendinous suture are done with PDS 4-0. Out of 10 patients, the study was done on 6 patients who were available for the followup. The average age of the patients was 49.1 years (in the range from 26 to 67). 5 males and 1 female patients were involved in this study. There were 3 cases with zone 1a and distal parts of zone 1b. The average distance to the distal tendon end was 0.6 cm. There were 5 cases underwent microsurgical repair where both artery and nerve divided. One case of only tendon displacement was presented. The dorsal protective splint was kept for 5 weeks on average. The results of the following tests were measured: active & passive range of motion, grip strength test, key pinch and pulp pinch test. Results: The follow-up period on average was 11 months, in the range from 2 to 20 months. There was no case of re-rupture, but tenolysis was performed in 1 cases. In all 6 cases, the average active range of motion of distal interphalangeal joint was 50.8 degree. The grip strength (ipsilateral/contralateral) was measured as 88.7% and the pulp pinch test was 79.2% as those of contralateral side. Flexion contracture was presented in 2 cases (15 degree on average) and there was no quadrigia effect found. Conclusion: Despite short length of tendon from the insertion site in FDS rupture in zone 1a and distal parts of zone 1b, sufficient functional recovery could be expected with the tendon to tendon repair using the modified loop suture technique.

Alternative Technique of Aortic Valve Replacement -Implantation of Mechanical Aortic Valve at a Supra-Annular Level- (기계판막을 판륜상연에 위치시킨 대동맥판 치환술)

  • 최종범;이삼윤
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.504-509
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    • 1996
  • When a valve prosthesis is to be implanted in the aortic position, simple interrupted suture, figure-of- eight suture, or horizontal mattress suture technique is used as a suture method. However, the suture techniques may be unacceptable for aortic valve replacement in patients with friable annulus caused by some lesions, such as endocarditis and degenerative change. We used an alternative technique for the aortic vlave replacement in 4 patients with valve endocarditis, ) patients with degenerative valvular lesion, and 1 with rheumatic valvular disease. Mattress sutures through the annulus were placed with pledgets on the ventricular side of the annulus, whi h resulted in implantation of the prosthesis at a supra-annular level. Mechanical valves of 21 mm or larger were implanted in the supra-annular position in all patients and there was no impeded motion of leaflets during the follow-up period of mean 13.3 mouths. The transvalvular pressure gradient was less than 6 mm Hg in 3 patients and 20 to 40 mm Hg in 5 patients. The supra-annular implantation of mechanical aortic valve using a vertical mattress suture technique may be a useful alternative method of aortic valve replacement for the selected patients with friable or destroyed aortic annulus.

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