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Clinical Oral Investigations Mar 2022This study aimed to assess the success rate and the amount of suture separation after the miniscrew-assisted rapid palatal expansion (MARPE) procedure in relation to the...
OBJECTIVES
This study aimed to assess the success rate and the amount of suture separation after the miniscrew-assisted rapid palatal expansion (MARPE) procedure in relation to the chronological age and sex of the patients.
MATERIALS AND METHODS
The periapical radiographs of 215 subjects (95 male; 120 female; range, 6-60 years) who had undergone MARPE treatment were retrospectively analyzed. The success of suture separation was determined and, in suture-separated subjects, the amount of suture separation was evaluated by suture separation ratio calculated from the periapical radiograph obtained after active expansion. Association tests were performed using linear-by-linear association, the Jonckheere-Terpstra test, Fisher's exact test, and the Mann-Whitney U test, and linear regression models were also developed.
RESULTS
The success rate of suture separation was 61.05% in male, 94.17% in female, and 79.53% in both sexes. There was a statistically significant association between older age and suture nonseparation in male (p < 0.001), but not in female (p = 0.221). In suture-separated subjects, there was a statistically significant trend toward a low amount of suture separation with older age subgroups in both sexes (p < 0.001); however, there was no statistically significant difference in the amount of suture separation between male and female in all age subgroups.
CONCLUSIONS
Older patients treated with MARPE, particularly in male, may have a reduced likelihood of both success in suture separation and sufficient basal bone expansion.
CLINICAL RELEVANCE
This study demonstrates that clinicians should consider that the success rate of MARPE and the amount of suture separation may depend on chronological age and sex.
Topics: Female; Humans; Male; Maxilla; Palatal Expansion Technique; Palate; Retrospective Studies; Sutures
PubMed: 34821980
DOI: 10.1007/s00784-021-04281-0 -
Thoracic Cancer Sep 2019Surgical method improvements aim to optimize the patient experience. The problem of healing of the drainage tube hole has not received attention and is of concern...
Surgical method improvements aim to optimize the patient experience. The problem of healing of the drainage tube hole has not received attention and is of concern because it can plague patient recovery. In this article we report on how we have improved the method of suturing the drainage tube hole and explore the safety and effectiveness of this method. Between December 2017 to August 2018, 102 patients underwent thoracoscopic lung resection (single port or single utility port) using different methods of suturing drainage tube holes. The intervention group received improved methods with subcuticular and intradermal suture and removal-free stitches, whilst the control group received a conventional mattress suture and fixed chest tube. A preset line was left to tie knots and close the hole after the removal of the chest tube. The stitches were removed 7-12 days after surgery. The baseline clinical features of the patients were subsequently analyzed. The objective and subjective conditions of scars were evaluated using the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scale (POSAS) at one month after surgery. The intervention group (n = 71) and control group (n = 31) had balanced baseline clinical characteristics. There were no significant differences between the two groups in terms of three-day postoperative pain and postoperative hospital stay. In the intervention group, three patients (4.23%) had wound splitting that required re-suturing, which was better than five patients (16.13%) in the control group (P < 0.05). The incidence of pleural fluid outflow, wound infection, post-removal pneumothorax, chest tube prolapse and incisional hernia were not different between the two groups. We conclude that the objective and subjective evaluation results of scars were significantly different between the two groups (P < 0.05), and the experimental group was superior to the control group. A balanced result between aesthetic appearance and safety as regards video-assisted thoracic surgery can be achieved through the chest tube hole improved suture method. This method also improves the patient's recovery experience.
Topics: Adult; Aged; Drainage; Female; Follow-Up Studies; Humans; Lung Neoplasms; Male; Middle Aged; Pneumonectomy; Postoperative Care; Prognosis; Retrospective Studies; Sutures; Thoracic Surgery, Video-Assisted
PubMed: 31368233
DOI: 10.1111/1759-7714.13157 -
IEEE Transactions on Bio-medical... Apr 2019As robotic surgery has increased in popularity, the lack of haptic feedback has become a growing issue due to the application of excessive forces that may lead to...
As robotic surgery has increased in popularity, the lack of haptic feedback has become a growing issue due to the application of excessive forces that may lead to clinical problems such as intraoperative and postoperative suture breakage. Previous suture breakage warning systems have largely depended on visual and/or auditory feedback modalities, which have been shown to increase cognitive load and reduce operator performance. This work catalogues a new sensing technology and haptic feedback system (HFS) that can reduce instances of suture failure without negatively impacting performance outcomes including knot quality. Suture breakage is common in knot-tying as the pulling motion introduces prominent shear forces. A shear sensor mountable on the da Vinci robotic surgical system's Cadiere grasper detects forces that correlate to the suture's internal tension. HFS then provides vibration feedback to the operator as forces near a particular material's failure load. To validate the system, subjects tightened a total of four knots, two with the Haptic Feedback System (HFS) and two without feedback. The number of suture breakages were recorded and knot fidelity was evaluated by measuring knot slippage. Results showed that instances of suture failure were significantly reduced when HFS was enabled (p = 0.0078). Notably, knots tied with HFS also showed improved quality compared to those tied without feedback (p = 0.010). The results highlight the value of HFS in improving robotic procedure outcomes by reducing instances of suture failures, producing better knots, and reducing the need for corrective measures.
Topics: Equipment Design; Feedback; Humans; Materials Testing; Robotic Surgical Procedures; Suture Techniques; Sutures; Task Performance and Analysis; Tensile Strength
PubMed: 30207946
DOI: 10.1109/TBME.2018.2869417 -
Scientific Reports Jan 2022Surgical site infections (SSIs) account for a massive economic, physiological, and psychological burden on patients and health care providers. Sutures provide a surface...
Surgical site infections (SSIs) account for a massive economic, physiological, and psychological burden on patients and health care providers. Sutures provide a surface to which bacteria can adhere, proliferate, and promote SSIs. Current methods for fighting SSIs involve the use of sutures coated with common antibiotics (triclosan). Unfortunately, these antibiotics have been rendered ineffective due to the increasing rate of antibiotic resistance. A promising new avenue involves the use of metallic nanoparticles (MNPs). MNPs exhibit low cytotoxicity and a strong propensity for killing bacteria while evading the typical antibiotic resistance mechanisms. In this work, we developed a novel MNPs dip-coating method for PDS-II sutures and explored the capabilities of a variety of MNPs in killing bacteria while retaining the cytocompatibility. Our findings indicated that our technique provided a homogeneous coating for PDS-II sutures, maintaining the strength, structural integrity, and degradability. The MNP coatings possess strong in vitro antibacterial properties against P aeruginosa and S. aureus-varying the %of dead bacteria from ~ 40% (for MgO NPs) to ~ 90% (for FeO) compared to ~ 15% for uncoated PDS-II suture, after 7 days. All sutures demonstrated minimal cytotoxicity (cell viability > 70%) reinforcing the movement towards the use MNPs as a viable antibacterial technology.
Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Bacterial Infections; Coated Materials, Biocompatible; Drug Resistance, Bacterial; Metal Nanoparticles; Pseudomonas aeruginosa; Staphylococcus aureus; Surgical Wound Infection; Sutures; Technology, Pharmaceutical; Triclosan
PubMed: 35039588
DOI: 10.1038/s41598-022-04925-5 -
Cartilage Dec 2021To determine the extent of acute cartilage injury by using trans-articular sutures.
OBJECTIVE
To determine the extent of acute cartilage injury by using trans-articular sutures.
METHODS
Five different absorbable sutures, monofilament polydioxanone (PDS) and braided polyglactin (Vicryl), were compared on viable human osteochondral explants. An atraumatic needle with 30 cm of thread was advanced through the cartilage with the final thread left in the tissue. A representative 300 μm transversal slice from the cartilage midportion was stained with Live/Dead probes, scanned under the confocal laser microscope, and analyzed for the diameters of (a) central "Black zone" without any cells, representing thread thickness and (b) "Green zone," including the closest Live cells, representing the maximum injury to the tissue. The exact diameters of suture needles and threads were separately measured under an optical microscope.
RESULTS
The diameters of the Black (from 144 to 219 µm) and the Green zones (from 282 to 487 µm) varied between the different sutures ( < 0.001). The Green/Black zone ratio remained relatively constant (from 1.9 to 2.2; = 0.767). A positive correlation between thread diameters and PDS suturing material, toward the Black and Green zone, was established, but needle diameters did not reveal any influence on the zones.
CONCLUSIONS
The width of acute cartilage injury induced by the trans-articular sutures is about twice the thread thickness inside of the tissue. Less compressible monofilament PDS induced wider tissue injury in comparison to a softer braided Vicryl. Needle diameter did not correlate to the extent of acute cartilage injury.
Topics: Cartilage; Humans; Polydioxanone; Polyglactin 910; Sutures; Wound Healing
PubMed: 34235942
DOI: 10.1177/19476035211029704 -
Scientific Reports Mar 2022Esophageal elongation is one of the methods of long gap esophageal atresia treatment. The aim of the study was to determine the best type of traction suture for...
Esophageal elongation is one of the methods of long gap esophageal atresia treatment. The aim of the study was to determine the best type of traction suture for esophageal lengthening on an animal model. White Pekin Duck's esophagi were used as a model (fresh-frozen and thawed). The esophagus was cut in half, then both ends were sutured together and extended on a tensiometer. Tested sutures involved simple suture, suture aided by a single or double clip, and suture aided by pledget (10 samples each). Constant and 2 methods of intermittent traction were also compared. The histological study showed similarities between duck's and newborn's esophagus. The highest maximal force was achieved with pledget suture (F = 8.59 N ± 1.45 N), then with double clip (F = 5.74 N ± 1.29 N) and the lowest with single suture (F = 3.80 N ± 0.54 N) (p < 0.001). Pledget suture also allowed for the greatest elongation (p < 0.01). Intermittent traction results in better elongation at the same breaking strength as constant traction (p < 0.05) if traction is maintained during breaks. Reinforced sutures (pledget or double clip) should be taken into consideration in internal traction. When performing traction sutures, it is worth step by step carefully tightening the sliding knot in short periods before its final binding.
Topics: Anastomosis, Surgical; Animals; Biomechanical Phenomena; Disease Models, Animal; Esophagus; Suture Techniques; Sutures; Tensile Strength; Traction
PubMed: 35233044
DOI: 10.1038/s41598-022-07348-4 -
BMC Women's Health Aug 2020Laparoscopic myomectomy (LM) is one of the techniques feasible for the treatment of intramural myoma. This technique is reported to be difficult when large fibroids are... (Comparative Study)
Comparative Study
BACKGROUND
Laparoscopic myomectomy (LM) is one of the techniques feasible for the treatment of intramural myoma. This technique is reported to be difficult when large fibroids are involved because of excessive blood loss during surgery. Skillful and fast suturing appears to be associated with reduced blood loss during LM. In this study we compared the surgical outcomes of using bidirectional Stratafix® barbed suture versus conventional suture during LM.
METHODS
This retrospective study included all patients who underwent LM for the treatment of intramural myoma in our institution between 2015 and 2020. The patients were divided into 2 groups according to the technique of suturing during LM: Group 1 comprised patients in whom Stratafix® barbed suture was used (n = 29), and group 2 comprised those in whom conventional suture was used (n = 15). Data of patient age, myoma size, the number of myoma nodes, hemoglobin levels, total operation time, total suturing time, and blood loss during surgery were compared between the 2 groups.
RESULTS
No significant differences in age (p = 0.463) or myoma size (P = 0.373) were observed between the 2 groups. Operation time (P = 0.0104), suturing time (P = 0.007), and blood loss (P = 0.0375) during surgery were significantly less with Stratafix® barbed suture than with conventional suture. No patient required intraoperative transfusion or conversion to laparotomy.
CONCLUSION
The use of bidirectional barbed suture reduces operation time, suturing time, and blood loss. As these new sutures have barbs, no knot-tying is required; thus, continuous suturing becomes very simple and maintaining hemostasis is easy. Unskilled gynecological surgeons who apply this suture technique can also perform LM easily. As the bidirectional barbed suture has multiple points of fixation, this suture technique can reapproximate tissue securely, which reduces the chances of reoperation because of proper suture knotting. Therefore, bidirectional Stratafix® barbed sutures could be an optimal and efficient alternative to conventional sutures for use by gynecological surgeons in Japan.
Topics: Adult; Female; Humans; Japan; Laparoscopy; Leiomyoma; Retrospective Studies; Suture Techniques; Sutures; Treatment Outcome; Uterine Myomectomy; Uterine Neoplasms
PubMed: 32758222
DOI: 10.1186/s12905-020-01030-5 -
Archives of Orthopaedic and Trauma... Sep 2021In this study, we evaluate the value of novel suture material based on monofilamentous-extruded polyfluoroethylene (PTFE) compared to polypropylene (PPL) and Fiberwire...
BACKGROUND
In this study, we evaluate the value of novel suture material based on monofilamentous-extruded polyfluoroethylene (PTFE) compared to polypropylene (PPL) and Fiberwire (FW).
MATERIALS AND METHODS
60 flexor tendons were harvested from fresh cadaveric upper extremities. 4-0 sutures strands were used in the PPL, FW and PTFE group. Knotting properties and mechanical characteristics of the suture materials were evaluated. A 4-strand locked cruciate (Adelaide) or a 6-strand (M-Tang) suture technique was applied as core sutures for a tendon repair. Two-way ANOVA tests were performed with the Bonferroni correction.
RESULTS
Stable knotting was achieved with 5 throws with the PPL material, 7 throws for FW and 9 throws for PTFE. In the PPL group, linear tensile strength was 45.92 ± 12.53 N, in the FW group 80.11 ± 18.34 N and in the PTFE group 76.16 ± 29.10 N. FW and PTFE are significantly stronger than PPL but show no significant difference among each other. Similar results were obtained in the subgroup comparisons for different repair techniques. The Adelaide and the M-Tang knotting technique showed no significant difference.
CONCLUSION
Fiberwire showed superior handling and knotting properties in comparison to PTFE. However, PTFE allows easier approximation of the stumps. In both, M-Tang and Adelaide repairs, PTFE was equal to FW in terms of repair strength. Both PTFE and FW provide for a robust tendon repair so that early active motion regimens for rehabilitation can be applied.
Topics: Biomechanical Phenomena; Cadaver; Humans; Materials Testing; Polypropylenes; Polytetrafluoroethylene; Sutures; Tendons
PubMed: 33876291
DOI: 10.1007/s00402-021-03899-9 -
BMC Oral Health Nov 2022The type of suture used in periodontal surgery can affect post-surgical complications. This study aimed to compare simple with cross-mattress sutures for nondisplaced... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The type of suture used in periodontal surgery can affect post-surgical complications. This study aimed to compare simple with cross-mattress sutures for nondisplaced flaps of the maxillary molar region.
METHODS
This randomized controlled trial included 32 candidates of nondisplaced flap surgery of the maxillary molar region referred to the private office of a periodontist in Bandar Abbas, Iran from January 21 to May 4, 2020. First, the patients' age, sex, and plaque index were recorded. Then, they were randomized into two equal groups. In the first group, the interdental suturing was done using simple sutures with 4-0 vicryl threads, and in the second group, interdental suturing was performed using cross-mattress sutures with the same threads. The primary outcome was suture time, including the duration of the first suture and the total duration of all sutures. The secondary outcomes were bleeding on probing and the requirement of supplementary sutures immediately after the surgery, as well as the gingival index (at suture removal and one month after surgery).
RESULTS
The two groups were comparable regarding age, sex, and plaque index. The first suture duration was significantly longer in the simple group compared to the cross-mattress group (P < 0.001); however, the total suture time did not differ between groups. Moreover, a significantly higher number of patients in the simple group required supplementary sutures (50% vs. 6.3%, P = 0.006). There was no significant difference between groups regarding bleeding on probing and gingival index (at suture removal and one month after surgery).
CONCLUSIONS
Cross-mattress sutures were superior to simple sutures in terms of supplementary suture requirement for nondisplaced flaps of the maxillary molar region, while the two suturing techniques were alike regarding total suture time, gingival index, and probing on bleeding.
TRIAL REGISTRATION
Iranian Registry of Clinical Trials (IRCT), IRCT20191224045882N1. Registered 08/02/2020. Registered while recruiting, https://www.irct.ir/trial/44754 .
Topics: Humans; Iran; Sutures; Suture Techniques; Surgical Flaps; Molar
PubMed: 36384543
DOI: 10.1186/s12903-022-02551-1 -
Translational Vision Science &... Aug 2022This study investigated the feasibility and potential advantage of using a new microsurgical teleoperated robot, Symani Surgical System, in the ophthalmology field. In...
PURPOSE
This study investigated the feasibility and potential advantage of using a new microsurgical teleoperated robot, Symani Surgical System, in the ophthalmology field. In particular, considering the extreme precision of the system and the dexterity of the instrument, possible use of the Symani Surgical System has been explored for suturing in corneal graft surgery.
METHODS
Manual and robot-assisted suturing of partial corneal transplants was performed on the porcine eye model by an ophthalmologist with experience with the porcine model. Suturing execution time, suture placement, and tomographic parameters were analyzed to assess the regularity and distribution of corneal sutures for both manual and robotic treatment.
RESULTS
The two robot-assisted procedures were properly completed on the porcine model, confirming the ease of use of the system and its capabilities, as well as the dexterity of the microinstruments. Manual and robotic treatments were found to be equivalent in terms of distance and angular precision of suture placement and corneal surface regularity (Gaussian anterior curvature). The robotic procedure required longer suturing execution times compared with the manual procedure.
CONCLUSIONS
The technical and clinical feasibility of robot-assisted suturing of partial corneal graft using the Symani Surgical System has been confirmed for the first time, to our knowledge, using an ex vivo porcine model. Robotic suturing required longer time to complete but was equivalent to the manual procedure with regard to the imaging data collected.
TRANSLATIONAL RELEVANCE
This study evaluated the use of the Symani Surgical System in the ophthalmology field. Future investigations could further identify the advantages offered by the stability, dexterity, and motion precision of the system for corneal surgeries, paving the way for clinical use in both adult and even more challenging pediatric therapy.
Topics: Animals; Feasibility Studies; Humans; Ophthalmology; Robotics; Suture Techniques; Sutures; Swine
PubMed: 35976656
DOI: 10.1167/tvst.11.8.13