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Zhong Nan Da Xue Xue Bao. Yi Xue Ban =... Jan 2024Glaucoma is a multifactorial optic neuropathy with a high rate of irreversible visual loss, and its pathogenesis is complex and still unclear. Elevated intraocular...
OBJECTIVES
Glaucoma is a multifactorial optic neuropathy with a high rate of irreversible visual loss, and its pathogenesis is complex and still unclear. Elevated intraocular pressure (IOP) is well recognized as the sole modifiable risk factor for the development of glaucoma in the majority of cases. This study aims to compare 2 different methods of inducing chronic ocular hypertension by circumlimbal suture or by laser burns in degree and lasting time of the IOP, different status of the retina and retinal ganglion cells (RGCs), and changes of the microstructure of neurons.
METHODS
The chronic ocular hypertension models were induced by 2 different ways. One kind of the models was built by unilateral circumlimbal suture (10/0) implantation (suture group), another kind of model was built by laser burns at trabecular meshwork and episcleral veins (laser group). The untreated contralateral eye served as the control group. Changes in IOP were observed and regularly monitored in the 2 groups of rats. HE staining was applied to observe the retinal and optic nerve pathology. Transmission electron microscope (TEM) was used to observe the mitochondrial morphology. RGCs were specifically labeled with Brn3b antibody and counted. The expression of caspase-3 was detected by Western blotting to clarify the apoptosis of RGCs.
RESULTS
Compared with the control group, IOP were significantly increased in the suture group and the laser group (both <0.05). The suture group induced a 1.5-fold elevation of IOP, and sustained for 8 weeks. The laser group induced a 2-fold elevation of IOP for 12 weeks. Both methods could cause RGCs loss (both <0.05), which were verified by pathology and immune staining of Brn3b. The expressions of caspase-3 were also increased (both <0.05). The mitochondrial morphology became more fragment, which changed from long shape to round and small one under TEM in 2 models. For comparison, the pathology changes of retinal structure in suture group were not obviously than those in the laser group.
CONCLUSIONS
Circumlimbal suture can build an effective model of chronic elevated IOP and induce glaucomatous pathologic changes similar to those in the laser photocoagulation, but the pathologic changes are milder than those in laser photocoagulation. Compare with translimbal laser photocoagulation, equipment and skill demand for circumlimbal suture is less.
Topics: Animals; Rats; Caspase 3; Glaucoma; Neurosurgical Procedures; Ocular Hypertension; Sutures; Burns
PubMed: 38615170
DOI: 10.11817/j.issn.1672-7347.2024.230112 -
Journal of the Royal Society, Interface Oct 2020Cranial sutures play critical roles in facilitating postnatal skull development and function. The diversity of function is reflected in the highly variable suture...
Cranial sutures play critical roles in facilitating postnatal skull development and function. The diversity of function is reflected in the highly variable suture morphology and complexity. Suture complexity has seldom been studied, resulting in little consensus on the most appropriate approach for comparative, quantitative analyses. Here, we provide the first comprehensive comparison of current approaches for quantifying suture morphology, using a wide range of two-dimensional suture outlines across extinct and extant mammals ( = 79). Five complexity metrics (sinuosity index (SI), suture complexity index (SCI), fractal dimension (FD) box counting, FD madogram and a windowed short-time Fourier transform with power spectrum density (PSD) calculation) were compared with each other and with the shape variation in the dataset. Analyses of suture shape demonstrate that the primary axis of variation captured attributes other than complexity, supporting the use of a complexity metric over raw shape data for sutural complexity analyses. Each approach captured different aspects of complexity. PSD successfully discriminates different sutural features, such as looping patterns and interdigitation amplitude and number, while SCI best-captured variation in interdigitation number alone. Therefore, future studies should consider the relevant attributes for their question when selecting a metric for comparative analysis of suture variation, function and evolution.
Topics: Animals; Benchmarking; Cranial Sutures; Fractals; Skull; Sutures
PubMed: 33023399
DOI: 10.1098/rsif.2020.0476 -
International Journal of Dermatology Sep 1982The development of modern suture material offers the dermatologic surgeon an important choice in would closure. This review, although prejudiced in some instances by the... (Review)
Review
The development of modern suture material offers the dermatologic surgeon an important choice in would closure. This review, although prejudiced in some instances by the author's experience, likes, and dislikes, is an attempt to clarify the difference between various absorbable and nonabsorbable sutures. Properties of suture material are discussed in detail. Guidelines for choice in regard to wound healing, location of incision, and surgical needles are offered. Lastly, the use of staples in wound closure is mentioned.
Topics: Absorption; Biocompatible Materials; Catgut; Humans; Needles; Polyesters; Polypropylenes; Surgical Instruments; Surgical Staplers; Sutures; Tensile Strength; Wound Healing; Wounds and Injuries
PubMed: 6752052
DOI: 10.1111/j.1365-4362.1982.tb03154.x -
Endoscopy Dec 2024
Topics: Humans; Stomach; Sutures; Suture Techniques
PubMed: 38569500
DOI: 10.1055/a-2282-9977 -
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 -
Hernia : the Journal of Hernias and... Dec 2020After closure of laparotomies, sutures may pull through tissue due to too high intra-abdominal pressure or suture tension, resulting in burst abdomen and incisional...
PURPOSE
After closure of laparotomies, sutures may pull through tissue due to too high intra-abdominal pressure or suture tension, resulting in burst abdomen and incisional hernia. The objective of this study was to measure the suture tension in small and large bites with a new suture material.
METHODS
Closure of the linea alba was performed with small bites (i.e., 5 mm between two consecutive stitches and 5 mm distance from the incision) and large bites (i.e., 10 mm × 10 mm) with Duramesh™ size 0 (2 mm) and PDS II 2-0 in 24 experiments on six porcine abdominal walls. The abdominal wall was fixated on an artificial computer-controlled insufflatable abdomen, known as the 'AbdoMan'. A custom-made suture tension sensor was placed in the middle of the incision.
RESULTS
The suture tension was significantly lower with the small bites technique and Duramesh™ when compared with large bites (small bites 0.12 N (IQR 0.07-0.19) vs. large bites 0.57 N (IQR 0.23-0.92), p < 0.025). This significant difference was also found in favour of the small bites with PDS II 2-0 (p < 0.038). No macroscopic tissue failure was seen during or after the experiments.
CONCLUSION
Closure of the abdominal wall with the small bites technique and Duramesh was more efficient in dividing suture tension across the incision when compared to large bites. However, suture tension compared to a conventional suture material was not significantly different, contradicting an advantage of the new suture material in the prevention of burst abdomen and incisional hernia during the acute, postoperative phase.
Topics: Animals; Disease Models, Animal; Herniorrhaphy; Humans; Incisional Hernia; Laparotomy; Suture Techniques; Sutures; Swine
PubMed: 32086634
DOI: 10.1007/s10029-020-02140-7 -
The Canadian Veterinary Journal = La... May 2022To determine differences in suture time and bursting strength on a longitudinal thelotomy closure using innovative barbed conventional smooth suture materials.
OBJECTIVE
To determine differences in suture time and bursting strength on a longitudinal thelotomy closure using innovative barbed conventional smooth suture materials.
SAMPLE POPULATION
Twenty-four teats from 6 udders of culled beef cows.
STUDY DESIGN
Experimental surgical study.
METHODS
Thelotomies (length: 2 cm) were performed on every teat and randomly allocated to closure with either a 3-0 bidirectional barbed suture for both mucosa and connective layers or a conventional 3-layer suture, using 3-0 smooth polydioxanone. For both groups, skin was closed with 2-0 polypropylene monofilament suture. Duration of suturing time for inner layers and bursting strength of the repair were recorded and compared.
RESULTS
Suturing was faster with barbed conventional sutures (527.7 ± 64.5 727.1 ± 60.7 s, respectively; < 0.0001). However, bursting strength was not significantly different between the 2 types of sutures.
CONCLUSION
Using the barbed suture significantly reduced the time required to suture the mucosa and conjunctiva layers, with no significant difference between sutures in their bursting strength.
CLINICAL SIGNIFICANCE
Bidirectional barbed suture material is suitable for closure of thelotomies in cattle.
Topics: Animals; Cattle; Female; Skin; Suture Techniques; Sutures
PubMed: 35502261
DOI: No ID Found -
Journal of the American Academy of... May 2022
Topics: Humans; Suture Techniques; Sutures
PubMed: 33892012
DOI: 10.1016/j.jaad.2021.04.035 -
International Urogynecology Journal Jun 2021Pelvic organ prolapse is a common problem in urogynecological surgery. Abdominal and laparoscopic sacrocolpopexy is currently considered to be the gold standard of...
INTRODUCTION
Pelvic organ prolapse is a common problem in urogynecological surgery. Abdominal and laparoscopic sacrocolpopexy is currently considered to be the gold standard of treatment. The main problem remains the anatomical point of fixation as well as how sutures are placed. We evaluated the biomechanical difference between an in-line ligament suture versus an orthogonal ligament suture and a single suture versus a continuous suture at the anterior longitudinal ligament in an in-vitro, sacrocolpopexy model.
METHODS
Biomechanical in-vitro testing was performed on human, non-embalmed, female cadaver pelvises. An Instron test frame (tensinometer) was used for load/ displacement analysis. The average patient age was 75 years. Ligament preparation yielded 15 ligaments available for testing. Recorded parameters were the ultimate load, failure displacement, and stiffness.
RESULTS
This in-vitro analysis of different suturing methods showed the difference between an orthogonal and an in-line approach to be the ultimate load. Orthogonal sutures displayed an ultimate load of 80 N while in-line suturing yielded only 57 N (p < 0.05). For the anterior longitudinal ligament, this study demonstrated that continuous suture is significantly superior to a single suture regarding failure displacement (p < 0.05).
CONCLUSION
We established baseline biomechanical parameters for the sacrospinous ligament and anterior longitudinal ligament. An orthogonal suture is superior to an in-line suture in an in-vitro model. A continuous suture is superior to a single suture at the anterior longitudinal ligament. Clinical trials might be able to evaluate whether any clinical significance can be established from these findings.
Topics: Aged; Biomechanical Phenomena; Female; Humans; Ligaments, Articular; Pelvic Organ Prolapse; Suture Techniques; Sutures
PubMed: 33263782
DOI: 10.1007/s00192-020-04609-6 -
Innovations (Philadelphia, Pa.) 2022This study evaluated the ergonomics and time requirements of using a novel automated suturing and titanium fastener deployment technology for chordal replacement in...
OBJECTIVE
This study evaluated the ergonomics and time requirements of using a novel automated suturing and titanium fastener deployment technology for chordal replacement in human heart specimens in open and minimally invasive cardiac surgery (MICS) simulators.
METHODS
Five cardiac surgeons used novel, manually powered expanded polytetrafluoroethylene (ePTFE) suturing devices to automate suture placement between mitral leaflets and papillary muscles in explanted cadaver hearts, along with customized titanium fastener delivery devices to secure suture and trim suture tails. This mitral chordal replacement test was conducted using surgical models simulating open and MICS mitral repair access. The study was approved by the institutional ethical board.
RESULTS
After a brief introduction to this technique using plastic models, study surgeons performed 48 chordal replacements in human mitral valves, placing 18 in an open model and 30 in a right minithoracotomy model. The time range to complete a single chordal replacement was between 55 s and 8 min, with an overall mean duration of 3.6 ± 1.5 min. No difference in duration of implantation was recorded for the MICS and open sternotomy simulators used. Good control of suture delivery was reported in 95.8% ( = 46) of leaflet aspect of the sutures and in 100% ( = 48) of papillary muscle sutures.
CONCLUSIONS
Automated mitral chordal ePTFE suturing simulated through open and MICS access demonstrated quality handling and accurate placement of sutures in human heart specimens. A clinical trial using this technology is currently ongoing. This innovation may present an important advance facilitating enhanced minimally invasive mitral valve repair.
Topics: Humans; Mitral Valve Prolapse; Titanium; Chordae Tendineae; Mitral Valve; Mitral Valve Insufficiency; Sutures; Polytetrafluoroethylene; Suture Techniques; Heart Valve Prosthesis Implantation
PubMed: 36447382
DOI: 10.1177/15569845221133381