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Ear, Nose, & Throat Journal May 2024Assessing the effectiveness of transseptal suturing septoplasty in elderly individuals. The method used in this study involved the prospective separation of...
Assessing the effectiveness of transseptal suturing septoplasty in elderly individuals. The method used in this study involved the prospective separation of septoplasty candidates over 65 into 2 groups. The first group underwent nasal packing, while the transseptal suture technique was used on the second group. Postoperative pain was measured using the visual analog scale, and the effectiveness of the surgery was assessed using the Standardized Cosmesis and Health Nasal Outcomes-Obstruction scale. In addition, the patients' oxygen saturation levels were monitored using a pulse oximeter, and the results of the 2groups were compared. The study included 26 patients with an average age of 66 years, ranging from 65 to 74 years. Of these patients, 13 received nasal packing, and the transseptal suture technique was used on the other 13. The results showed no statistically significant difference between the Standardized Cosmesis and Health Nasal Outcomes-Obstruction scores ( > .05). However, the oxygen saturation levels in group 1 were significantly lower, and the pain scores were significantly higher ( < .05) than those recorded for the other group. We concluded that transseptal suturing septoplasty is an effective, safe, and more comfortable surgical option for the elderly.
PubMed: 38771072
DOI: 10.1177/01455613241255994 -
Aesthetic Plastic Surgery Dec 2023The purpose of this study was to summarize the misdiagnosis and treatment of corneal complications associated with suture exposure in cases of buried-suture...
PURPOSE
The purpose of this study was to summarize the misdiagnosis and treatment of corneal complications associated with suture exposure in cases of buried-suture double-eyelid blepharoplasty.
METHODS
This study retrospectively analyzed 14 patients with palpebral conjunctival and corneal complications due to suture exposure after buried-suture double-eyelid blepharoplasty at the First Affiliated Hospital of Harbin Medical University from January 2020 to July 2022. The patients' clinical symptoms included photophobia, lacrimation, pain, foreign body sensation, swelling of the eyelids, conjunctival hyperemia, secretion, etc. We recorded the patient's sex, age, surgical method, length of exposed suture, suture type, number of double-eyelid surgeries, surgical site, timepoint when eye discomfort occurred, misdiagnosed disease and treatment.
RESULTS
Three patients were misdiagnosed with dry eye, nine patients were misdiagnosed with viral keratitis, and two patients were misdiagnosed with allergic conjunctivitis. All 14 patients had manifestations of photophobia, lacrimation, pain, foreign body sensation and conjunctival hyperemia. Eight patients had manifestations of swelling of the eyelids. Five patients had manifestations of eye secretions. There were 8 patients with corneal epithelial injuries and 6 patients with corneal ulcers. All patients underwent suture removal without further progression. Ten patients were treated with artificial tears, and 4 patients were treated with calf serum deproteinized gel after suture removal.
CONCLUSION
If there is postoperative eye discomfort caused by eyelid and corneal complications in patients after buried-suture double-eyelid blepharoplasty, clinicians should carefully check whether there is suture exposure and determine the cause in a timely manner. Suture removal is the best way to treat this complication.
LEVEL OF EVIDENCE IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Topics: Humans; Blepharoplasty; Retrospective Studies; Hyperemia; Photophobia; Suture Techniques; Asian People; Eyelids; Sutures; Diagnostic Errors; Pain; Foreign Bodies
PubMed: 37653179
DOI: 10.1007/s00266-023-03606-6 -
Reproductive Health Aug 2023Most treatments for postpartum haemorrhage (PPH) lack evidence of effectiveness. New innovations are ubiquitous but have not been synthesized for ready access. (Review)
Review
BACKGROUND
Most treatments for postpartum haemorrhage (PPH) lack evidence of effectiveness. New innovations are ubiquitous but have not been synthesized for ready access.
NARRATIVE REVIEW
Pubmed 2020 to 2021 was searched on 'postpartum haemorrhage treatment', and novel reports among 755 citations were catalogued. New health care strategies included early diagnosis with a bundled first response and home-based treatment of PPH. A calibrated postpartum blood monitoring tray has been described. Oxytocin is more effective than misoprostol; addition of misoprostol to oxytocin does not improve treatment. Heat stable carbetocin has not been assessed for treatment. A thermostable microneedle oxytocin patch has been developed. Intravenous tranexamic acid reduces mortality but deaths have been reported from inadvertent intrathecal injection. New transvaginal uterine artery clamps have been described. Novel approaches to uterine balloon tamponade include improvised and purpose-designed free-flow (as opposed to fixed volume) devices and vaginal balloon tamponade. Uterine suction tamponade methods include purpose-designed and improvised devices. Restrictive fluid resuscitation, massive transfusion protocols, fibrinogen use, early cryopreciptate transfusion and point-of-care viscoelastic haemostatic assay-guided blood product transfusion have been reported. Pelvic artery embolization and endovascular balloon occlusion of the aorta and pelvic arteries are used where available. External aortic compression and direct compression of the aorta during laparotomy or aortic clamping (such as with the Paily clamp) are alternatives. Transvaginal haemostatic ligation and compression sutures, placental site sutures and a variety of novel compression sutures have been reported. These include Esike's technique, three vertical compression sutures, vertical plus horizontal compression sutures, parallel loop binding compression sutures, uterine isthmus vertical compression sutures, isthmic circumferential suture, circumferential compression sutures with intrauterine balloon, King's combined uterine suture and removable retropubic uterine compression suture. Innovative measures for placenta accreta spectrum include a lower uterine folding suture, a modified cervical inversion technique, bilateral uterine artery ligation with myometrial excision of the adherent placenta and cervico-isthmic sutures or a T-shaped lower segment repair. Technological advances include cell salvage, high frequency focussed ultrasound for placenta increta and extra-corporeal membrane oxygenation.
CONCLUSIONS
Knowledge of innovative methods can equip clinicians with last-resort options when faced with haemorrhage unresponsive to conventional methods.
Topics: Female; Pregnancy; Humans; Postpartum Hemorrhage; Oxytocin; Misoprostol; Placenta; Hemostatics
PubMed: 37568196
DOI: 10.1186/s12978-023-01657-1 -
Journal of Clinical Medicine Oct 2023The loop and knot securities of two polyfilament and two monofilament sutures of four diameters (3.0, 2.0, 0, 1) were evaluated with a tensiometer for four four-throw...
The loop and knot securities of two polyfilament and two monofilament sutures of four diameters (3.0, 2.0, 0, 1) were evaluated with a tensiometer for four four-throw knots, known to be secure with a 2.0 polyfilament suture. Loop security of Monocryl 1 is low, being 14.7 ± 3.0 Newton (N) for a three-throw half-knot (H3) and 15.4 ± 2.4 N and 28.3 ± 10 N for two (SSs) and four (SSsSsSs) symmetrical sliding half-hitches. This is lower than 18, 24, and 46 N for similar knots with Vicryl. Polyfilament sutures have excellent knot security for all four diameters. Occasionally, some slide open with slightly lower knot security, especially for larger diameters, although this is not clinically problematic. Knot security of monofilament sutures was unpredictable for all four knots, especially for larger diameters, resulting in many clinically insecure knots. A secure monofilament knot requires a six-throw knot with two symmetrical sliding half-hitches or two symmetrical half-knots secured with four asymmetric blocking half-hitches. In conclusion, with polyfilament sutures, four- or five-throw half-knot or half-hitch sequences result in secure knots. For monofilament sutures, loop and knot security is much less, half-knot combinations should be avoided, and secure knots require six-throw knots with four asymmetric blocking half-hitches.
PubMed: 37835063
DOI: 10.3390/jcm12196418 -
Journal of Abdominal Wall Surgery : JAWS 2023Incisional hernia prevention has become an important concept for surgeons operating on the abdominal wall. Several techniques have been proposed to help decrease... (Review)
Review
Incisional hernia prevention has become an important concept for surgeons operating on the abdominal wall. Several techniques have been proposed to help decrease incisional hernia formation with suture closure of the abdominal wall being one of the cornerstones. Technical details that have been reported to decrease incisional hernia rates include achieving a 4:1 Suture to Wound length ratio and the use of a small bites technique. Despite evidence to support many of these techniques there appears to be a gap in practice patterns amongst practicing surgeons. Introducing and promoting these principles in surgical residency may help to close this gap. This paper reviews our experience with surgical training for abdominal wall closures at our institution. Programs and projects related to abdominal wall closure were reviewed from our institution from 2010-Present. Type of project, intervention, and impact on education was evaluated and summarized. Seven projects were identified relating to surgical training and abdominal wall closure. Three projects dealt with skills training using an abdominal wall simulation model and related to suturing techniques. Two projects were clinical studies focused on suture to wound length ratios and improving outcomes with this variable in a residency training program. Two projects dealt with models relating to abdominal wall closure and education. Implementation of educational programs in surgical residency programs can lead to improvements in technique and knowledge around abdominal wall closure and help in research endeavors.
PubMed: 38312420
DOI: 10.3389/jaws.2023.12159 -
Journal of Traditional Chinese Medicine... Aug 2023To explore the difference of catgut embedding effect between acupoints and non-acupoints in patients with abdominal obesity (AO). (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To explore the difference of catgut embedding effect between acupoints and non-acupoints in patients with abdominal obesity (AO).
METHODS
In this multicenter, double-blind, randomized controlled trial, all subjects were randomly assigned into the acupoint catgut embedding (ACE) group and control group (catgut embedding at non-acupoints). With a 12-week actual intervention period and a 4-week period of follow-up. Waist circumference (WC), body weight, body mass index (BMI), hip circumference (HC) and appetite were applied and assessed at baseline and after 6, 12 and 16 weeks.
RESULTS
After the total intervention phase (12 weeks), the WC, body weight, BMI, HC and visual analogue scale scores of appetite, decreased significantly in the two groups as compared to the baseline (0.001). Meanwhile, after the 4-week follow-up, the indicators still decreased significantly in the ACE group (0.001). At 12 and 16 weeks, catgut embedding at acupoints showed significantly advantages to non-acupoints in WC and appetite (0.05). No serious adverse events were observed in ACE group and control group.
CONCLUSIONS
Catgut embedding at acupoints and non-acupoints are all effective and safe for AO. ACE can effectively treat AO as expected and deliver lasting results.
Topics: Humans; Obesity, Abdominal; Acupuncture Therapy; Catgut; Obesity; Body Weight; Acupuncture Points
PubMed: 37454263
DOI: 10.19852/j.cnki.jtcm.20230608.002 -
Indian Journal of Ophthalmology Jul 2024Traboulsi syndrome is a sporadic autosomal recessive disorder. Very few cases reported and no surgical treatment has been described.
BACKGROUND
Traboulsi syndrome is a sporadic autosomal recessive disorder. Very few cases reported and no surgical treatment has been described.
PURPOSE
The purpose of the study was to describe the surgical treatment of a case of Traboulsi syndrome with intercalary staphyloma.
SYNOPSIS
Traboulsi syndrome[1-3] is a type of spontaneous filtering bleb. The case was of a 31-year-old lady with a flat anterior chamber and large intercalary staphyloma, with a subluxated clear lens. Liberal peritomy was done. The staphyloma was cut and the displaced lens was delivered through it. It was closed with 7-0 vicryl continuous suture. A cross-linked cornea was used after removing the Descemet membrane. It was modified to match the crescentic shape of the limbus by using 11 and 6 mm trephine. Two wedge-shaped defects were created and tissue was excised between them, which were then sutured to increase the arc radius. A peripheral flange at the corneal edge was created. A pocket was created in the host cornea to accommodate the donor corneal flange. The donor cornea was tucked in and the graft was sutured. The sclera was used to suture another side prophylactically, making a 360-degree encirclage. The patient got ambulatory vision postsurgery. The use of the cornea as biological encirclage has not been described previously.
HIGHLIGHTS
Using a cross-linked cornea. Creating wedge-shaped defects in crescentic corneal graft to increase arc radius. Use of cornea as encirclage.Link of video:https://youtu.be/T3b5rkvFmlc.
Topics: Humans; Adult; Female; Visual Acuity; Anterior Chamber; Syndrome; Lens Subluxation; Ophthalmologic Surgical Procedures; Suture Techniques; Intraocular Pressure
PubMed: 38905471
DOI: 10.4103/IJO.IJO_1968_23 -
Cureus Jul 2023Background In the setting of the COVID-19 pandemic, the development of care processes that reduce the need for in-person clinic visits while maintaining low complication...
Background In the setting of the COVID-19 pandemic, the development of care processes that reduce the need for in-person clinic visits while maintaining low complication rates is needed. The purpose of this study is to assess the outcomes of patients undergoing trigger finger release with various suture and follow-up visit types to assess the feasibility of shifting towards telemedicine-based follow-up protocols. Methods A retrospective review of 329 patients undergoing trigger finger release was performed. Patients were classified based on whether or not they received in-office follow-ups; whether they received absorbable or non-absorbable sutures; and whether they were treated using a telemedicine and absorbable suture protocol or other combination of sutures and follow-ups. Univariate statistics were performed to compare outcomes between groups. Results Patients who did not undergo in-office follow-up were more likely to experience residual stiffness or contracture (11.4% vs. 4.1%; p=0.033) but had no significant differences in 30-day reoperation, emergency department (ED) returns, wound complaints, and Quick DASH (Disabilities of the Arm, Shoulder, and Hand) scores. When comparing chromic absorbable sutures to non-absorbable sutures, those with absorbable sutures were significantly more likely to have telemedicine visits but were also more likely to have wound complaints (17.9% vs. 8.5%; p=0.022). There was no significant difference in two- and six-week pain scores, 30-day reoperation, ED returns, residual symptoms, and Quick DASH scores. When comparing patients treated using the absorbable suture and telemedicine protocol with those receiving any other type of suture and postoperative follow-up, no significant differences in any postoperative clinical outcome measures were observed. Conclusion The results of this study demonstrate that the use of an absorbable suture and telemedicine protocol for patients undergoing trigger finger release yields similar outcomes as traditional methods of care. However, the use of absorbable sutures may result in decreased patient satisfaction with surgical wound healing.
PubMed: 37637594
DOI: 10.7759/cureus.42486 -
Cureus Mar 2024Akin osteotomy is commonly used to correct hallux valgus interphalangeus (HVI) deformity. The preferred implant for fixation remains an area of debate, often influenced... (Review)
Review
Akin osteotomy is commonly used to correct hallux valgus interphalangeus (HVI) deformity. The preferred implant for fixation remains an area of debate, often influenced by the surgeon's inclinations and expertise. This review compares the outcomes of contemporary fixation methods utilized in Akin osteotomy. PubMed served as the primary electronic database for the search. The interventions encompassed the use of screw(s), staple(s), and suture(s). The participants considered were adults aged 18 and above, undergoing Akin osteotomy either as a primary procedure or as an adjunct. Excluded were osteotomies performed via percutaneous or minimally invasive methods. Seven studies involving 590 feet were analysed, showcasing an impressive 99.8% overall union rate. The incidence of overall complications stood at 8.98%, with metal prominence notably higher in the screw fixation group (10.5%). All studies exhibited postoperative improvement in radiological angles. Screw, staple, and suture fixations demonstrated excellent union rates. While screws and staples offer robust osteotomy fixation, they pose risks of metal irritation and prominence. Suture fixation delivers comparable outcomes to the other two stabilization methods at a lower cost.
PubMed: 38681272
DOI: 10.7759/cureus.57026