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The Journal of Surgical Research Nov 2020The use of sutures remains the first choice for wound closure. However, incorrect use of a suture technique can lead to impaired healing. Many techniques are described... (Comparative Study)
Comparative Study
BACKGROUND
The use of sutures remains the first choice for wound closure. However, incorrect use of a suture technique can lead to impaired healing. Many techniques are described for high-tension wounds, but not much is known about their mechanical properties. Complications of excessive tension include dehiscence, infection, and ischemic necrosis and could be prevented. This study aimed to compare forces in five techniques (single, horizontal mattress, vertical mattress, pulley, and modified pulley suture) in a standardized wound tension model.
MATERIALS AND METHODS
A standardized neoprene wound model was developed on the ForceTRAP system (MediShield B.V., Delft, The Netherlands) to mimic a 5 Newton (N) wound. Five different suture techniques were each repeated 10 times by a student, resident dermatology, and dermsurgeon. The pulling force of the suture's first throw was measured with the Hook-in-Force sensor (Technical University Delft, The Netherlands). Changes in wound tension were measured by the ForceTRAP system. The ForceTRAP is a platform measuring forces from 0 to 20 N in three dimensions with an accuracy of 0.1 N. The Hook-in-Force is a force sensor measuring 0-15 N with an accuracy of 0.5 N. Maximum and mean forces were calculated for each suture technique and operator.
RESULTS
Mean maximum pulling force: 5.69 N (standard deviation [SD], 0.88) single, 7.25 N (SD, 1.33) vertical mattress, 8.11 N (SD, 1.00) horizontal mattress, 3.46 N (SD, 0.61) pulley, and 4.52 N (SD, 0.67) modified pulley suture. The mean force increase on the skin (substitute) ranged between 0.80 N (pulley) and 0.96 N (vertical mattress).
CONCLUSIONS
The pulley suture requires less pulling force compared with other techniques. The mechanical properties of sutures should be taken in consideration when choosing a technique to close wounds.
Topics: Dermatologic Surgical Procedures; Materials Testing; Suture Techniques; Sutures; Tensile Strength
PubMed: 32543379
DOI: 10.1016/j.jss.2020.05.033 -
Surgical Innovation Oct 2015Knotless barbed sutures are an innovative suturing material that can facilitate laparoendoscopic operations. The purpose of this study is to examine the available... (Meta-Analysis)
Meta-Analysis Review
Knotless barbed sutures are an innovative suturing material that can facilitate laparoendoscopic operations. The purpose of this study is to examine the available evidence on the application of barbed sutures on both laparoscopic and robotic operations in the field of gynecologic surgery. A systematic search was performed in PubMed, Scopus, and Cochrane databases. In total, 1991 patients were included in the study. The duration of closure with knotless suture ranged from 3.9 to 13 minutes, which was less than the use of conventional suture in every study. The duration of suturing was significantly less in the barbed suture group during hysterectomy, the mean difference between the observed groups was 2.41 minutes per operation (95% confidence interval, 1.23-3.59) whereas in myomectomy there was no statistically significant difference between compared groups. Concerning the estimated blood loss and the presence of major bleeding in hysterectomy, no statistical difference between the 2 groups was observed, while the estimated blood loss in myomectomy was found to be statistically significant (P = .04). Regarding the dehiscence of vaginal cuff in hysterectomy, no statistically significant difference was observed (1031 patients, odds ratio = 1.63; 95% confidence interval = 0.37-7.25). The complete absence of knots, the even distribution of tissue strength along the wound, and the reduction of operation time are the main advantages of this type of sutures. Additional clinical trials of higher methodological quality are necessary to further clarify suturing advantages and postoperative outcomes of the barbed sutures.
Topics: Female; Gynecologic Surgical Procedures; Humans; Middle Aged; Suture Techniques; Sutures
PubMed: 25320107
DOI: 10.1177/1553350614554235 -
The Journal of International Medical... Oct 2023To simulate hysteroscopic suturing in vitro and analyze the learning curve of gynecologists with different experience levels.
OBJECTIVE
To simulate hysteroscopic suturing in vitro and analyze the learning curve of gynecologists with different experience levels.
METHODS
Three gynecologists were trained on uterine models in a circulating water box. The posterior uterine wall was sutured 10 times under hysteroscopy for 5 consecutive days, and the time of each suture procedure was recorded.
RESULTS
Doctors A, B, and C completed 50 posterior uterine sutures. After Dr. C completed 50 sutures on the posterior wall, he added 50 sutures on the anterior wall (Group D). The mean suturing time was 71.54 ± 68.158 s in Group A, 50.10 ± 28.060 s in Group B, 34.04 ± 10.457 s in Group C, and 30.38 ± 8.734 s in Group D. The difference between Groups C and B and between Groups B and A was statistically significant. There was no statistically significant difference between Groups C and D. Simulation curves were created using the number of features as the abscissa and cumulative sum as the coordinate, with peak curves of 19, 27, and 18 cases for Group A, B, and C, respectively.
CONCLUSION
Doctors with experience in single-hole laparoscopic surgery or hysteroscopic suture surgery can significantly shorten the hysteroscopic suturing time.
Topics: Male; Female; Pregnancy; Humans; Levonorgestrel; Learning Curve; Hysteroscopy; Sutures; Simulation Training
PubMed: 37862790
DOI: 10.1177/03000605231205760 -
Australian Veterinary Journal Mar 2003Suture materials play an important role in veterinary surgery by providing support for healing tissues during wound repair. As there is no single ideal suture material,... (Review)
Review
Suture materials play an important role in veterinary surgery by providing support for healing tissues during wound repair. As there is no single ideal suture material, clinicians must compromise on some properties when selecting a material for a specific purpose. By reviewing the characteristics of absorbable and non-absorbable materials, general recommendations can be made on their usage in skin, fascia, viscera and other tissues.
Topics: Absorbable Implants; Animals; Surgery, Veterinary; Suture Techniques; Sutures; Tensile Strength; Wound Healing; Wounds and Injuries
PubMed: 15080426
DOI: 10.1111/j.1751-0813.2003.tb11075.x -
Journal of Perioperative Practice Sep 2006
Topics: Costs and Cost Analysis; Nursing; Sutures
PubMed: 17001930
DOI: No ID Found -
Enfermeria Clinica (English Edition) 2023To assess the effect of the continuous suture technique of the perineal wound on the capacity and functional recovery of women when carrying out their self-care routine,... (Clinical Trial)
Clinical Trial
OBJECTIVE
To assess the effect of the continuous suture technique of the perineal wound on the capacity and functional recovery of women when carrying out their self-care routine, the care of the newborn (NB), breastfeeding (BF) and Activities of Daily Living (ADLs), both basic activities of daily living (BADL) and instrumental (IADL), during the postpartum period.
METHODS
Non-randomised clinical trial with blinding allocation to study groups, carried out at the Arnau de Vilanova tertiary hospital in Lérida. The intervention group received continuous suture for perineal repair and the control group discontinuous suture. The study population was women with eutocic delivery and second-degree perineal tears or episiotomy. Three postpartum assessment were performed (48 h, 7-10 days and one month).
RESULTS
126 women with eutocic delivery and second degree perineal tears or episiotomy participated (n = 126); 64 sutured with continuous technique (intervention group) and 62 with discontinuous technique (control group). At 48 h postpartum, 85% of women from the continuous suture technique group were able to perform their self-care and 46,7% of them had recovered functionally. At 7-10 days, 96,7% of women with continuous suturing had acquired the ability to perform instrumental activities of daily living and 60% had recovered functionally compared to 68,3% and 15% respectively of women with discontinuous suturing (p < 0.001). At 7-10 days, 100% of women with continuous suturing achieved functional recovery for newborn care and 80% for breastfeeding and in the control group 81,7% and 30% respectively (p < 0.001 and p < 0.001).
CONCLUSIONS
Women who undergo the continuous suture technique restore their ability and functional recovery to perform activities of daily living earlier and with less pain than women with discontinuous suturing, adapting more quickly and satisfactorily way to motherhood.
Topics: Pregnancy; Infant, Newborn; Humans; Female; Delivery, Obstetric; Activities of Daily Living; Obstetric Labor Complications; Episiotomy; Lacerations; Sutures
PubMed: 35843542
DOI: 10.1016/j.enfcle.2022.07.001 -
Dermatologic Surgery : Official... Apr 2020
Topics: Adult; Aged; Feasibility Studies; Female; Humans; Male; Middle Aged; Nails, Malformed; Suture Techniques; Sutures; Treatment Outcome; Young Adult
PubMed: 30741795
DOI: 10.1097/DSS.0000000000001818 -
Endoscopy Dec 2024
Topics: Humans; Endoscopy; Stomach; Sutures; Suture Techniques
PubMed: 38388944
DOI: 10.1055/a-2257-3427 -
BJS Open Oct 2019Most patients in Ghana undergo suture repair for primary inguinal hernia. Although there is strong evidence from high-income country settings to indicate superiority of... (Comparative Study)
Comparative Study
BACKGROUND
Most patients in Ghana undergo suture repair for primary inguinal hernia. Although there is strong evidence from high-income country settings to indicate superiority of mesh repair for inguinal hernia, the evidence to support the safety and effectiveness of mesh repair in the Ghanaian setting is limited. This study aimed to compare hernia recurrence rates following suture mesh repair in Ghana.
METHODS
Men aged 18 years or over presenting with symptomatic, reducible inguinal hernias were included. Over the first 6 months all consecutive patients were enrolled prospectively and underwent a standardized suture repair; an equal number of patients were subsequently enrolled to undergo mesh repair. The primary outcome was hernia recurrence within 3 years of the index operation. Multivariable analysis was adjusted for age and right or left side. Adjusted odds ratios (ORs) with 95 per cent confidence intervals are reported.
RESULTS
A total of 116 sutured and 116 mesh inguinal hernia repairs were performed. Three years after surgery, follow-up data were available for 206 of the 232 patients (88·8 per cent). Recurrence occurred significantly more frequently in the suture repair group (23 of 103, 22·3 per cent) than in the mesh group (7 of 103, 6·8 per cent) ( = 0·002). In multivariable analysis, suture repair was independently associated with an increased risk of recurrence (OR 4·51, 95 per cent c.i. 1·76 to 11·52; = 0·002).
CONCLUSION
In Ghana, mesh inguinal hernia repair was associated with reduced 3-year recurrence compared with sutured repair. Controlled dissemination across Ghana should now be assessed.
Topics: Adult; Follow-Up Studies; Ghana; Hernia, Inguinal; Humans; Male; Middle Aged; Outcome Assessment, Health Care; Prospective Studies; Recurrence; Surgical Mesh; Sutures
PubMed: 31592101
DOI: 10.1002/bjs5.50186 -
Journal of Clinical Neuroscience :... Feb 2020The ideal suturing technique for cerebrovascular anastomosis remains a point of debate. Although simple interrupted sutures are considered to achieve higher patency,...
The ideal suturing technique for cerebrovascular anastomosis remains a point of debate. Although simple interrupted sutures are considered to achieve higher patency, they require longer anastomosis time compared with running sutures. The authors describe a novel techniques named single loop interrupted suture to place interrupted sutures for cerebrovascular anastomosis. The single loop interrupted suture technique consists of repeatedly placing, tying and cutting a single loop between anchor stitches. A single loose loop was placed next to the anchor stitch, tied and cut, and then another loop was placed next to the knot. The loops resulted in efficiently placed interrupted sutures. This technique is employed for a range of end-to-side cerebrovascular anastomosis procedures, and is feasible in placing interrupted suture.
Topics: Anastomosis, Surgical; Humans; Neurosurgical Procedures; Suture Techniques; Sutures
PubMed: 31493997
DOI: 10.1016/j.jocn.2019.08.107