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Journal articles on the topic 'Suture'
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Shin, Yong Un, Mincheol Seong, Hee Yoon Cho, and Min Ho Kang. "Novel Technique to Overcome the Nonavailability of a Long Needle 9-0 Polypropylene Suture for Sutured Scleral Fixation of the Posterior Chamber Intraocular Lens Using a Single Fisherman’s Knot." Journal of Ophthalmology 2017 (2017): 1–4. http://dx.doi.org/10.1155/2017/2683415.
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Purpose. To describe a method to overcome the nonavailability of a long needle 9-0 polypropylene suture for sutured scleral fixation of the posterior chamber intraocular lens (PC-IOL) using a single fisherman’s knot (SFK). Methods. First, a 10-0 polypropylene suture was passed from the sclera to the ciliary sulcus using a long needle. A 9-0 suture was tied to the unpassed portion of the 10-0 suture with an SFK. We pulled the 10-0 suture to pass the SFK through the sclera, and then we cut the knot and removed the 10-0 suture. IOL fixation with 9-0 sutures used the conventional techniques used for sutured scleral-fixated IOL. Preoperative and postoperative visual acuity, corneal astigmatism, and endothelial cell count and intraoperative/postoperative complications were evaluated. Results. An SFK joining the two sutures was passed through the sclera without breakage or slippage. A total of 35 eyes from 35 patients who underwent sutured scleral fixation of the IOL. An intraoperative complication (minor intraocular hemorrhage) was recorded in four cases. Knot exposure, IOL dislocation, subluxation, and retinal detachment were not observed. Conclusions. The SFK offers the opportunity to use 9-0 sutures for the long-term safety and may not require the surgeon to learn any new technique.
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Kokame, Gregg T., Tarin T. Tanji, and Jase N. Omizo. "Long-Term Stability of Sutured Scleral Fixation of a Posterior Chamber Intraocular Lens With 10-0 Polypropylene for More Than 30 Years." Journal of VitreoRetinal Diseases 5, no. 5 (January 8, 2021): 452–54. http://dx.doi.org/10.1177/2474126420978870.
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Purpose: We report the longest follow-up to our knowledge of stable scleral fixation of a posterior chamber intraocular lens (PC IOL) with 10-0 polypropylene sutures. Methods: A retrospective review is presented of a case with more than 30 years’ follow-up after performing sutured scleral fixation with 10-0 polypropylene suture using 2 sutures tied together under a scleral flap. One suture was a cow-hitch looped around the haptic, and the other suture was passed through the sclera to create the scleral fixation. Results: The scleral fixation with 10-0 polypropylene suture knots for both haptics of the PC IOL allowed central optic positioning with excellent vision for more than 30 years without suture breakage. Conclusions: Polypropylene sutures for scleral fixation of PC IOLs remained stable for more than 30 years with central positioning of the PC IOL, without exposure of the fixation suture knots through the conjunctiva, and without suture breakage.
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Takeuchi, N., T. Okada, N. Kozono, T. Shimoto, H. Higaki, and Y. Iwamoto. "Symmetric Peripheral Running Sutures are Superior to Asymmetric Peripheral Running Sutures for Increasing the Tendon Strength in Flexor Tendon Repair." Journal of Hand Surgery (Asian-Pacific Volume) 22, no. 02 (May 15, 2017): 208–13. http://dx.doi.org/10.1142/s0218810417500265.
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Background: The fatigue strength of three peripheral suture techniques for flexor tendon repair was compared by cyclic loading of the repairs in the porcine flexor digitorum tendon. Methods: Thirty-six tendons were sutured using only peripheral sutures with 6-0 Nylon. An initial cyclic load of 10 N for 500 cycles was applied and increased by 10 N for an additional 500 cycles at each new load until rupture. Results: The fatigue strength of the symmetric running peripheral suture was 85.0% and 144.8% greater than that of the two kinds of the asymmetric running peripheral sutures. Conclusions: Symmetric running sutures can enhance the suture strength and appears to be a useful technique for increasing the strength of the peripheral suture.
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V., Shashikala, Abhilash S. B., Abhishek G., and Prajwal S. Fernandes. "A comparative study between continuous and x-interrupted sutures in emergency midline laparotomies." International Surgery Journal 5, no. 5 (April 21, 2018): 1753. http://dx.doi.org/10.18203/2349-2902.isj20181437.
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Background: Midline laparotomy is the most common technique of abdominal incisions in both emergency and elective settings. Wound dehiscence is related to several factors pertaining to patient besides suture material and method of closure. This study tries to compare continuous sutures with x-interrupted sutures in mass closure of midline laparotomy wound in patients undergoing emergency midline laparotomy for acute peritonitis.Methods: A total of 60 patients undergoing emergency midline laparotomy for secondary peritonitis were considered for the study, 30 of whom underwent closure of abdominal wall with continuous sutures (Group A) and the other 30 with x-interrupted sutures (Group B) using non-absorbable, monofilament, polypropylene suture. Necessary preoperative data, the time required for rectus closure, length of the suture material required, post-operative complications like surgical site infection, wound dehiscence were analyzed.Results: The groups were comparable in means of age and sex distribution. Group A was found to have lesser time for closure of rectus, lesser suture length and lesser suture to wound length ratio when compared with Group B. Surgical site infections were similar in both groups. Patients with rectus sheath sutured in x-interrupted sutures (n=2) had significantly less wound dehiscence as compared with continuous sutures (n=8) (p<0.05).Conclusions: Interrupted -X suture method of suturing reduces post-operative wound dehiscence, although requires more suture and consumes more time than the continuous method of suturing.
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Inyutin, A. S., A. V. Fedoseev, S. Yu Muraviev, V. N. Budarev, and A. V. Barinova. "Experimental study of method for suturing laparotomy wound with mesh thread." NAUKA MOLODYKH (Eruditio Juvenium) 9, no. 2 (June 30, 2021): 203–11. http://dx.doi.org/10.23888/hmj202192203-211.
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Aim. Development of an alternative to preventive prosthetics method of primary closure of a laparotomy wound, superior in morphological and physical properties to the method of closure with traditional suture materials. Materials and Methods. The team of authors developed a method of laparorrhaphy, where the white line of the abdomen is sutured first with strengthening sutures with a mesh thread in places of highest tension, and then a continuous suture is applied. The effectiveness of this variant of wound closure was studied in a cadaver experiment and on tissues of laboratory pigs. In the course of the cadaver experiment, in 10 corpses of both genders a midline laparotomy was performed with suturing of the white line of the abdomen by the above-described technique with creation of intra-abdominal hypertension up to 140 mm Hg using a device designed for this. In the course of the experiment on animals, in 8 pigs under general anesthesia upper-median laparotomy up to the peritoneum 10-12 cm long was performed. The white line of the abdomen was sutured using the above-described technique with a mesh thread in the lower part of the wound. The upper part of the wound was closed with a checkerwise-reinforcing suture. At the second stage of the experiment, on the 14th day from the moment of the first operation, all animals were reoperated. A macroscopic assessment of the wound process was performed. Then the sutured sections of the aponeurosis were excised and subjected to strain gauge examination on an electronic dynamometer. For comparison, a similar study was carried out on an intact aponeurosis. Results. In the course of studies carried out on corpses, no cases of suture failure with the underlying created intra-abdominal hypertension were noted. The tensometry of the studied sutures proved that the initial strength of the reinforcing suture made of «mesh thread» was higher than that of one checker wise-reinforcing suture (tCt=27.053±0.745; p<0.01) and two nodal sutures (tCt=-18.834±0.582; p<0.01). On the 14th day, the strength of checkerwise-reinforcing suture was also lower than that of the reinforcing suture with a «mesh thread» (tCt=11.198±1.499; p<0.01). Conclusions. The method of suturing with «mesh thread» provides greater strength compared to other types of sutures due to good conditions for even distribution of the load on all suture stitches and the formation of a strong scar in the future.
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Kaba, Metin. "Uterosacral Ligament Dissection during McCall Culdoplasty to Prevent Ureteral Kinking, and Round Ligament Fixation to Support Vaginal Vault: A New Surgical Technique." Medical Science and Discovery 9, no. 9 (September 13, 2022): 485–87. http://dx.doi.org/10.36472/msd.v9i9.810.
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Objective: This study aims to describe a new surgical technique to prevent ureteral kinking via dissection uterosacral ligament from parietal peritoneum before McCall culdoplasty suture placement, and vaginal cuff fixation to round ligament to prevent apical vaginal vault prolapse after vaginal hysterectomy. Materials and Methods: At the initial step of vaginal hysterectomy, a circumferential incision was done on vaginal tissue, which covers the uterine cervix. Then posterior cul-de-sac was entered. Bilateral uterosacral ligament was identified, separately clamped, cut and sutured. Classical vaginal hysterectomy was completed up to the round ligament, which was separately grasped, cut and sutured. After the vaginal hysterectomy, the uterosacral ligament dissected from cardinal ligament and parietal peritoneum to prevent ureteral kinking during McCall Culdoplasty suture placement. Two internal McCall sutures with non-absorbable sutures and one external suture with absorbable sutures were place on the uterosacral ligament. Then bilateral apical lateral vaginal walls were fixated to ipsilateral round ligament to further support to vaginal vault. Results: I have applied the new technique to my patients with pelvic organ prolapse for about one year. Ureteral kinking has not occurred in any patient. Early complications such as hemorrhage, bladder and ureter injury did not observed. Conclusion: Ureteral kinking is a challenging problem for gynecologists during suture placement on the uterosacral ligament. Dissection of the uterosacral ligament from the cardinal ligament and parietal peritoneum yielded the surgeon to safe suture passage during McCall Culdoplasty suture placement and eliminated the requirement of cystoscopy evaluation to check ureteral competency.
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Takeuchi, N., H. Mitsuyasu, S. Hotokezaka, H. Miura, H. Higaki, and Y. Iwamoto. "Strength enhancement of the interlocking mechanism in cross-stitch peripheral sutures for flexor tendon repair: biomechanical comparisons by cyclic loading." Journal of Hand Surgery (European Volume) 35, no. 1 (September 28, 2009): 46–50. http://dx.doi.org/10.1177/1753193409345804.
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The fatigue strength of three peripheral suture techniques for flexor tendon repair was compared by cyclic loading of repairs in a cotton dental roll tendon model. Thirty pairs of dental roll were sutured using only peripheral sutures with 6-0 polypropylene. An initial cyclic load of 5 N for 500 cycles was applied and increased by 5 N for an additional 500 cycles at each new load until rupture. The fatigue strength of an interlocking cross-stitch suture was 113% greater than a running suture and 36% greater than a standard cross-stitch suture. Interlocking the cross-stitch prevented shortening of the transverse portions under load and appears to be a useful technique for increasing the strength of the peripheral suture.
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Bíró, Vilmos. "A varrattechnika fejlődése a kéz hajlítóín-sérüléseiben az elmúlt tizenöt esztendő során." Orvosi Hetilap 157, no. 6 (February 2016): 212–18. http://dx.doi.org/10.1556/650.2015.30355.
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In the reconstruction of hand flexor tendon injuries it is fundamental to select the best suture technique, which makes possible early, active postoperative mobilization and achievement of the best results. The author reviews the development of suture techniques of the flexor tendon injuries during the last fifteen years, and discusses experimental tendon reconstruction results as well as clinical outcomes. The author describes the importance of different tendon suture materials, the significance of the pulley system of the fingers, the stretching between the sutured tendon ends by tendon sutures and, finally, the importance of the moving course in the reconstructed tendon. He states, that the wide-range adoption of the discussed modern tendon sutures would be necessary for better postoperative results. Orv. Hetil., 2016, 157(6), 212–218.
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Takeuchi, N., H. Mitsuyasu, K. Kikuchi, T. Shimoto, H. Higaki, and Y. Iwamoto. "The biomechanical assessment of gap formation after flexor tendon repair using partial interlocking cross-stitch peripheral sutures." Journal of Hand Surgery (European Volume) 36, no. 7 (May 5, 2011): 584–89. http://dx.doi.org/10.1177/1753193411406632.
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The gap formation of five core plus peripheral suture techniques for flexor tendon repair was evaluated by cyclic load testing. Fifty pairs of dental roll tendon models were sutured using six-strand Pennington modified Kessler core suture with 4-0 Polypropylene. One-half or three-fourths circumferential interlocking cross-stitch, or three complete circumferential peripheral suture techniques were performed using 6-0 Polypropylene. An initial cyclic load of 10 N for 500 cycles was applied and increased by 5 N for an additional 500 cycles at each new load until rupture. The complete circumferential interlocking cross-stitch had the greatest fatigue strength. The partial circumferential cross-stitches resulted in significantly larger gap formations at both the repaired and unrepaired sides than the complete circumferential sutures, and were also associated with early rupture. The full circumference of the cut tendon must be sutured using an interlocking cross-stitch peripheral suture to improve strength and avoid gap formation.
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Nakanishi, Yuta, Yuichi Hoshino, Kouki Nagamune, Tetsuya Yamamoto, Kanto Nagai, Daisuke Araki, Noriyuki Kanzaki, Takehiko Matsushita, and Ryosuke Kuroda. "Radial Meniscal Tears Are Best Repaired by a Modified “Cross” Tie-Grip Suture Based on a Biomechanical Comparison of 4 Repair Techniques in a Porcine Model." Orthopaedic Journal of Sports Medicine 8, no. 7 (July 1, 2020): 232596712093581. http://dx.doi.org/10.1177/2325967120935810.
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Background: The tie-grip suture can fix radial tears more rigidly than simple conventional sutures. However, one shortcoming is the residual gap at the central margin of the tear. The tie-grip suture was modified to address this issue and named the “cross tie-grip suture.” Purpose/Hypothesis: The purpose of this study was to compare the suture stability and strength among 4 suturing techniques: the original tie-grip, cross tie-grip, and 2 conventional sutures (double horizontal and cross). It was hypothesized that the cross tie-grip suture would show the least displacement and resist the greatest maximum load. Study Design: Controlled laboratory study. Methods: A total of 40 fresh-frozen porcine knees were dissected to acquire 80 menisci; 20 menisci were tested in each suture group. A radial tear was created at the middle third of the meniscal body. Repair was performed with the following: original tie-grip, cross tie-grip, double horizontal, and cross sutures. The mechanical strength of sutured menisci was evaluated using a tensile testing machine. All menisci underwent submaximal loading and load to failure. The gap distance and ultimate failure load were compared using analysis of variance. The failure mode was recorded after load-to-failure testing. Results: Displacement after 500 cycles was significantly smaller in the cross tie-grip group (0.4 ± 0.3 mm) compared with the tie-grip (0.9 ± 0.6 mm), double horizontal (1.2 ± 0.7 mm), and cross suture groups (1.4 ± 0.6 mm) ( P < .05). The ultimate failure load was significantly greater in the cross tie-grip (154.9 ± 29.0 N) and tie-grip (145.2 ± 39.1 N) groups compared with the double horizontal (81.2 ± 19.9 N) and cross suture groups (87.3 ± 17.7 N) ( P < .05). Tissue failure was the most common mode of failure in all groups. Conclusion: Upon repair of radial meniscal tears, the cross tie-grip suture showed less displacement compared with that of the tie-grip, double horizontal, and cross sutures and demonstrated equivalent load to failure to that of the tie-grip suture at time zero. Clinical Relevance: The cross tie-grip suture provided high resistance to displacement after repair of radial tears and may be advantageous in healing for radial meniscal tears.
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Yi, Hyung-suk, Byeong-seok Kim, Yoon-soo Kim, Jin-hyung Park, and Hong-il Kim. "What Is the Minimum Number of Sutures for Microvascular Anastomosis during Replantation?" Journal of Clinical Medicine 12, no. 8 (April 15, 2023): 2891. http://dx.doi.org/10.3390/jcm12082891.
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As vessel diameter decreases, reperfusion after anastomosis becomes more difficult. When a blood vessel is sutured, its inner diameter becomes narrower owing to the thickness of the suture material and the number of sutures. To minimize this, we attempted replantation using a 2-point suture technique. We reviewed cases of arterial anastomosis in vessels with a diameter of less than 0.3 mm during replantation performed over a four-year period. In all cases, close observation was followed by absolute bed rest. If reperfusion was not achieved, a tie-over dressing was applied, and hyperbaric oxygen therapy was administered in the form of a composite graft. Of the 21 replantation cases, 19 were considered successful. Furthermore, the 2-point suture technique was performed in 12 cases, of which 11 survived. When three or four sutures were performed in nine patients, eight of these cases survived. Composite graft conversion was found in three cases in which the 2-point suture technique was used, and two of these cases survived. The survival rate was high in cases where 2-point sutures were used, and there were few cases of conversion to a composite graft. Reducing the number of sutures aids in optimizing reperfusion.
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Ng, Jacqueline, Soroosh Behshad, and Marjan Farid. "Review of Surgical Techniques for Posterior Chamber Intraocular Lens Fixation in the Absence of Capsular Lens Support." US Ophthalmic Review 08, no. 02 (2015): 86. http://dx.doi.org/10.17925/usor.2015.08.02.86.
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This is a review of surgical options for posterior chamber intraocular lens (IOL) fixation in the absence of adequate capsular support. The indications, techniques, and outcomes for posterior chamber iris-sutured and scleral-fixated IOLs, including trans-scleral sutured and trans-scleral tunnel glued fixation, are reviewed. Iris-sutured IOL fixation may be appropriate in cases in which small corneal incisions with a foldable IOL are desired, but are only possible in cases of adequate iris tissue, and may be complicated by pupil ovaling and iris trauma, which can lead to prolonged inflammation in some studies. Scleral-sutured IOL fixation does not require robust iris tissue and decreases the risk for iris trauma, but is technically more demanding, may require larger incisions, and poses potentially more posterior segment complications. There are also ongoing concerns for suture exposure, erosion, and late suture breakage and IOL dislocation. Scleral tunnel-glued IOL fixation is a more recent innovation that avoids sutures and concerns for suture-related complications, and can be completed through smaller incisions with a foldable IOL. However, long-term studies are pending.
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Flanagan, Dennis. "The Bis-Acryl Stent." Journal of Oral Implantology 39, no. 1 (February 1, 2013): 69–72. http://dx.doi.org/10.1563/aaid-joi-d-11-00129.
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When placing dental implants, there may be a surgical flap to reposition. The flap can be sutured or held in place with a stent that protects the flap and maintains its position and immobility. Use of a bis-acryl stent may be preferable to sutures or other materials in many cases. Bis-acryl is easily applied from an auto-mixing gun. Stents may be preferable to sutures in that there is no “wicking effect,” where bacteria colonize the suture beneath the healing surgical wound. Additionally, many times there is no submucosa to suture to, and the sides of the wound may not allow appropriate flap positioning and immobility with sutures. In these situations an acryl stent may be placed for easy and proper flap positioning and healing.
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Bausili Portabella, Maria Montserrat, Jeroni Nadal, Juan Alvarez de Toledo, María Fideliz de la Paz, and Rafael Ignacio Barraquer. "Long-term outcome of scleral-sutured posterior chamber intraocular lens: a case series." British Journal of Ophthalmology 104, no. 5 (August 21, 2019): 712–17. http://dx.doi.org/10.1136/bjophthalmol-2019-314054.
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PurposePurpose: To evaluate the long-term stability of scleral-sutured intraocular lenses (IOLs) and analyse the possible causes of suture breakage.SettingBarraquer Institute in Barcelona, Spain.DesignRetrospective study of consecutive cases.MethodsStudy of patients with scleral-sutured IOL with aphakia, subluxated or luxated IOL were included. Follow-up was longer than 6 months and patients over 18 years of age. Preoperative data (best-corrected visual acuity testing (BCVA), intraocular pressure (IOP), axial length and slit-lamp examination), intraoperative data (characteristics of the scleral flaps, suture material (Prolene or Mersilene) and scleral-sutured IOL) and postoperative data (BCVA, IOP, slit-lamp examination and complications) through 10 years were collected for analysis.Results345 consecutive cases of scleral-sutured IOL were included. 25 eyes underwent a second operation after a prior sutured IOL due to suture breakage (mean 40.2±39.6 months after the first surgery) and three of them needed a third surgery. Younger adults (less than 40-year old), the use of a combination of Prolene and Mersilene sutures to perform the surgery and suturing only one flap were found to have higher risk of suture breakage after a follow-up of 10 years. The probability of surviving of the scleral-sutured IOL at 10 years after surgery was 0.79.ConclusionsScleral-sutured posterior chamber IOL in eyes with a lack of capsular support is a safe and effective procedure with a low rate of complication and stable visual acuity. Further studies with special focus on young adults or myopic eyes are required to demonstrate long-term safety in those special cases.
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Naykodi, Trupti Bhaskar, and Aditya Kiran Shinde. "A Comparative Evaluation of Human Gingival Tissue Response to Silk & M-Polytetrafluoroethylene Sutures – A Clinico-Histological Study." Journal of Evolution of Medical and Dental Sciences 10, no. 17 (April 26, 2021): 1213–18. http://dx.doi.org/10.14260/jemds/2021/259.
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BACKGROUND Sutures require specific physical characteristics and properties such as good tensile strength, dimensional stability, lack of memory, knot security and sufficient flexibility to avoid damage to the oral mucosa. The strength and adherence of the sutured tissue increases over time. Tissue reaction characteristics involve varying degree of inflammatory reactions. Therefore, the purpose of this study was to assess clinically and histologically human gingival tissue reaction to silk & m- polytetrafluoroethylene (m-PTFE) sutures in periodontal surgical procedures. METHODS The present study is a prospective clinical randomised split mouth study. A total of 15 patients of both sexes were included in the study. All the patients were provided with thorough scaling and root planing before the commencement of the study. The patients were re-evaluated at 4 weeks and sutures were placed in the surgical area where there was a need for excision of gingival tissue as a part of routine periodontal surgery. After placement of sutures, the change of bite, change of slack, clinical changes in plaque index, modified gingival index & sulcus bleeding index and the histological changes in mean thickness of the peri sutural epithelial sleeve, proportion of inflammatory cells to peri sutural epithelial cells, diameter of the connective tissue inflammatory infiltrate (measured in mm) from the periphery of the epithelialization of the sutures from the insertion day (day 0) to the day of scheduled surgery (day 7) were recorded. RESULTS Silk sutures presented an increase in the change of bite and change of slack of the suture loop than m-PTFE. Diameter of the connective tissue infiltrate was greater around the multifilament suture (SILK) as compared to the monofilament suture (mPTFE) though the difference was not statistically significant. (P-value = 0.321). Monofilament suture (m-PTFE) showed the least amount of inflammatory infiltrate around the suture track. The proportion of inflammatory cells to epithelial cells was statistically not significant between the two suture materials (P-value = 0.82). CONCLUSIONS Though the clinical and histological parameters are statistically non-significant, mpolytetrafluoroethylene has shown better results compared to silk. Silk sutures cause a more extensive inflammatory tissue reaction in an environment characterized by moisture and infectious potential compared to m-PTFE sutures. KEY WORDS PTFE, Inflammatory Response, Sutures, Gingiva
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BERNSTEIN, GERALD. "SUTURES: Polybutester Suture." Journal of Dermatologic Surgery and Oncology 14, no. 6 (June 1988): 615–16. http://dx.doi.org/10.1111/j.1524-4725.1988.tb03387.x.
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Araki, Daisuke, Kouki Nagamune, Tetsuya Yamamoto, Kanto Nagai, Noriyuki Kanzaki, Yuichi Hoshino, Takehiko Matsushita, Ryosuke Kuroda, and Yuta Nakanishi. "Biomechanical Analysis of Four Suturing Techniques for Radial Meniscal Tears Demonstrated the Advantage of the Cross-Tie Grip Suture." Orthopaedic Journal of Sports Medicine 8, no. 7_suppl6 (July 1, 2020): 2325967120S0044. http://dx.doi.org/10.1177/2325967120s00443.
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Objectives: The “Tie Grip suture” was designed to fix radial meniscal tears more rigidly than simple conventional sutures. However, one shortcoming was residual gapping at the central margin of the tear. We modified the original method to address this point and named it the “Cross Tie Grip suture”. The purpose of this study was to perform biomechanical tests to compare suture strength and stability between four suturing techniques; the original “Tie Grip suture”, the “Cross Tie Grip suture” and two conventional suture methods, the double horizontal and cross sutures. It was hypothesized that the Cross Tie Grip suture will show the least displacement and resist the greatest maximum load. Methods: Forty fresh-frozen porcine knees were dissected to acquire 80 menisci. 20 menisci were tested in each group: original Tie Grip, Cross Tie Grip, double horizontal, and cross suture groups. A radial tear was created from the central margin to 2 mm to the menisco-capsular junction at the middle third of the meniscal body, equidistance from the anterior and posterior horns. Suture configurations are shown in Figure 1. The sutured menisci were set in a custom clamp, with a metric ruler positioned parallel to the clamp to serve as a measurement scale. All menisci underwent preconditioning from 5 to 20 N for 300 cycles at 0.5 Hz. Subsequently, submaximal loading was performed for 500 cycles from 5 to 20 N at 1 Hz. The cycle was paused at cycles 0, 100, 250, and 500 for digital photographs to be taken under a 5 N load. An image processing software (ImageJ; US National Institutes of Health) was utilized to analyze the digital photographs for gap measurement. Load to failure testing was done at 5 mm/min and failure mode was recorded. An a priori power analysis based on preliminary experiments with statistical power of 80%, and significance set at .05, sample size required was at least 18 per group. The data was analyzed by one-way analysis of variance and Tukey-Kramer post hoc test. P-values <0.05 were considered statistically significant. Results: Displacement after 500 submaximal cycles was significantly small in the Cross Tie Grip suture group (0.4 ± 0.3 mm) compared to the 3 other suture methods (Table 1). Displacement was, 0.9 ± 0.6 mm, 1.2 ± 0.7 mm, 1.4 ± 0.6 mm (P < .05) for Tie Grip, double horizontal, and cross suture groups, respectively. Maximum failure load was significantly greater in the Cross Tie Grip (154.9 ± 29.0N) and Tie Grip (145.2± 39.1N) groups compared to the double horizontal (81.2±19.9N) and cross suture (87.3±17.7N) groups (P < .05) (Table 1). Tissue failure was the most common mode of failure in all groups. Conclusions: The Cross Tie Grip suture showed greater resistance to displacement compared to the original method and both conventional methods, the double horizontal and cross sutures. In respect to maximum load, the Cross Tie Grip suture was equivalent to the original method. Both Tie Grip sutures showed greater maximum load compare to the other conventional sutures; double horizontal and cross. [Table: see text]
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Bradley, James P., Jamie P. Levine, Christopher Blewett, Thomas Krummel, Joseph G. Mccarthy, and Michael T. Longaker. "Studies in Cranial Suture Biology: In Vitro Cranial Suture Fusion." Cleft Palate-Craniofacial Journal 33, no. 2 (March 1996): 150–56. http://dx.doi.org/10.1597/1545-1569_1996_033_0150_sicsbv_2.3.co_2.
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The biology underlying craniosynostosis remains unknown. Previous studies have shown that the underlying dura mater, not the suture itself, signals a suture to fuse. The purpose of this study was to develop an in vitro model for cranial-suture fusion that would still allow for suture-dura interaction, but without the influence of tensional forces transmitted from the cranial base. This was accomplished by demonstrating that the posterior frontal mouse cranial suture, known to be the only cranial suture that fuses in vivo, fuses when plated with its dura in an organ-culture system. In such an organ-culture system, the sutures are free from both the influence of dural forces transmitted from the cranial base and from hormonal influences only available in a perfused system. For the cranial-suture fusion in vitro model study, the sagittal sutures (controls that remain patent in vivo) and posterior frontal sutures (that fuse in vivo) with the underlying dura were excised from 24-day-old euthanized mice, cut into 5 × 4 × 2-mm specimens, and cultured in a chemically defined, serum-free media. One hundred sutures were harvested at the day of sacrifice, then every 2 days thereafter until 30 days in culture, stained with H & E, and analyzed. A subsequent cranial-suture without dura in vitro study was performed in a similar fashion to the first study, but only the calvariae with the posterior frontal or sagittal sutures (without the underlying dura) were cultured. Results from the cranial-suture fusion in vitro model study showed that all sagittal sutures placed in organ culture with the underlying dura remained patent. More importantly, the posterior frontal sutures with the underlying dura, which were plated-down as patent at 24 days of age, demonstrated fusion after various growth periods in organ culture. In vitro posterior frontal mouse-suture fusion occurred in an anterior-to-posterior direction but in a delayed fashion, 4 to 7 days later than in vivo posterior frontal mouse-suture fusion. In contrast, the subsequent cranial-suture without dura in vitro study showed patency of all sutures, including the posterior frontal suture. These data from in vitro experiments indicate that: (1) mouse calvariae, sutures, and the underlying dura survive and grow in organ-culture systems for 30 days; (2) the local dura, free from external influences transmitted from the cranial base and hormones from distant sites, influences the cells of its overlying suture to cause fusion; and (3) without dura influence, all in vitro cranial sutures remained patent. By first identifying the factors involved in dural-suture signaling and then regulating these factors and their receptors, the biologic basis of suture fusion and craniosynostosis may be unraveled and used in the future to manipulate pathologic (premature) suture fusion.
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Karjalainen, T., M. He, A. K. S. Chong, A. Y. T. Lim, H. Göransson, and J. Ryhänen. "Comparison of the holding capacity of round monofilament, round multifilament, and flat multifilament nitinol suture loops in human cadaveric flexor tendon." Journal of Hand Surgery (European Volume) 37, no. 5 (November 24, 2011): 459–63. http://dx.doi.org/10.1177/1753193411430034.
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Tendon repairs done with strong suture materials fail by suture pull out. To avoid pull out, suture loop needs to have a strong grip on the tendon. The aim of this study was to determine whether a single suture loop has a better grip of the tendon when multifilament or flat sutures are used compared with a conventional monofilament round suture. A cross-locking or simple grasping suture loop was placed into the distal end of a human cadaveric tendon using nitinol wire sutures in the following configurations: round monofilament (200 µm), round multifilament (4 × 100 µm), and flat multifilament (4 × 30 µm × 445 µm). The mean pull-out strength of the round multifilament (49.4 N) and flat multifilament sutures (50.7 N) were significantly higher than that of the round monofilament nitinol suture (36.5 N) when a locking loop was used. Suture grip can be improved by using a multifilament suture and a locking type of suture configuration.
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Boyajian, Michael K., Hanny Al-Samkari, Dennis C. Nguyen, Sybill Naidoo, and Albert S. Woo. "Partial Suture Fusion in Nonsyndromic Single-Suture Craniosynostosis." Cleft Palate-Craniofacial Journal 57, no. 4 (February 4, 2020): 499–505. http://dx.doi.org/10.1177/1055665620902299.
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Introduction: Partial synostosis of cranial sutures has been shown to have clinical and diagnostic significance. However, there is limited published information about how suture fusion progresses over time. In this study, we evaluate patients with nonsyndromic single-suture synostosis. We aim to define the incidence of partial versus complete suture fusion and whether a correlation exists between the degree of suture fusion and age. Methods: Two hundred fifty-four patients with nonsyndromic single-suture synostosis were evaluated. Preoperative computed tomography (CT) scans were rendered in 3-dimensions, all sutures were visualized and assessed for patency or fusion, and length of fusion was measured. Findings were grouped according to suture type (sagittal, coronal, metopic, or lambdoid), the degree of fusion (full, >50%, or <50%), and patient age at time of CT scan (0-90, 91-180, 181-360, or >360 days). Data were analyzed to correlate patient age versus the degree of suture fusion. Results: For all patients, 72% had complete and 28% had partial synostosis. Ratios of full to partial fusion for each suture type were as follows: sagittal 97:36, coronal 35:22, metopic 46:4, and lambdoid 4:10. The sagittal, coronal, and metopic groups demonstrated greater probabilities of complete suture fusion as patient age increases ( P = .021, P < .001, P = .001, respectively). This trend was also noted when all sutures were considered together by age-group ( P < .001). Conclusion: We note a partial suture fusion rate of 28.3%. Our analysis shows a correlation between the extent of suture synostosis and patient age. Finally, we demonstrate that different sutures display different patterns of partial and complete fusion.
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Dragovic, Miroslav, Marko Pejovic, Jelena Stepic, Svetlana Dragovic, Nadja Nikolic, Jovana Kuzmanovic-Pficer, Snjezana Colic, and Jelena Milasin. "Microbial adherence affinity and clinical characteristics of polypropylene versus silk sutures in oral surgery." Srpski arhiv za celokupno lekarstvo 146, no. 5-6 (2018): 258–63. http://dx.doi.org/10.2298/sarh170428184d.
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Introduction/Objective. The purpose of this study was to compare polypropylene and silk suture materials in terms of bacterial adherence and clinical features including the impact on soft tissue healing. Methods. Ten healthy patients were included in this study. Unilateral upper and lower wisdom teeth were extracted at the same time and wounds were sutured with different threads (one monofilament ? polypropylene ? and one multifilament ? silk suture). Stitches were removed seven days postoperatively. Real-time polymerase chain reaction was used to analyze bacterial adherence. Intraoperative handling and ease of removal were assessed with the help of Visual Analogue Scale. Landry healing index was used for evaluation of soft tissue healing. Results. Significantly more pronounced bacterial adherence was found on silk compared to polypropylene sutures (p = 0.005). Superior intraoperative handling properties were registered suturing with polypropylene compared to silk (p = 0.005). Soft tissue healing was significantly better around polypropylene sutures, both on the third and the seventh postoperative day (p = 0.016). Patient discomfort was slightly higher for polypropylene sutures, but without statistical significance. Conclusion. Polypropylene suture material showed significantly lower bacterial adherence and superior clinical features compared to silk, including better soft tissue healing.
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Chittoria, Ravi Kumar, and Bharath Prakash Reddy. "Suture materials – Recent advances." Cosmoderma 3 (December 7, 2023): 175. http://dx.doi.org/10.25259/csdm_176_2023.
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A surgical suture, also known as a suture, is a medical device used to hold body tissues together and to hold wound edges together after injury or surgery. Surgical sutures are used to facilitate the closure and healing of surgical or traumatic wounds by holding tissues together to facilitate the healing process. There are many different types of suture materials for medical purposes, and the main types are absorbable and non-absorbable. Recently, there has been an increase in the development of classes of suture materials based on their properties and abilities to improve tissue convergence and wound closure. This review describes and discusses current and emerging trends in suture technology, including knotless needle sutures, antimicrobial sutures, bioactive sutures such as drug-eluting and stem cell sutures, and smart sutures, including elastic and electronic sutures. These newer strategies expand the versatility of sutures from being used only as a physical unit that brings opposing tissues closer to a more biologically active component that allows the delivery of drugs and cells to the desired location, with enormous potential for both therapeutic and diagnostic use.
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Balamurugan, R., Masroor Mohamed, Hari Krishna Rao Katikaneni, and KR Ashok Kumar. "Clinical and Histological Comparison of Polyglycolic Acid Suture with Black Silk Suture after Minor Oral Surgical Procedure." Journal of Contemporary Dental Practice 13, no. 4 (2012): 521–27. http://dx.doi.org/10.5005/jp-journals-10024-1179.
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ABSTRACT Any suture material, absorbable or nonabsorbable, elicits a kind of inflammatory reaction within the tissue. Nonabsorbable black silk suture and absorbable polyglycolic acid suture were compared clinically and histologically on various parameters. Materials and methods This study consisted of 50 patients requiring minor surgical procedure, who were referred to the Department of Oral and Maxillofacial Surgery. Patients were selected randomly and sutures were placed in the oral cavity 7 days preoperatively. Polyglycolic acid was placed on one side and black silk suture material on the other. Seven days later, prior to surgical procedure the sutures will be assessed. After the surgical procedure the sutures will be placed postoperatively in the same way for 7 days, after which the sutures will be assessed clinically and histologically. Results The results of this study showed that all the sutures were retained in case of polyglycolic acid suture whereas four cases were not retained in case of black silk suture. As far as polyglycolic acid suture is concerned 25 cases were mild, 18 cases moderate and seven cases were severe. Black silk showed 20 mild cases, 21 moderate cases and six severe cases. The histological results showed that 33 cases showed mild, 14 cases moderate and three cases severe in case of polyglycolic acid suture. Whereas in case of black silk suture 41 cases were mild. Seven cases were moderate and two cases were severe. Black silk showed milder response than polyglycolic acid suture histologically. Conclusion The polyglycolic acid suture was more superior because in all 50 patients the suture was retained. It had less tissue reaction, better handling characteristics and knotting capacity. How to cite this article Balamurugan R, Mohamed M, Pandey V, Katikaneni HKR, Kumar KRA. Clinical and Histological Comparison of Polyglycolic Acid Suture with Black Silk Suture after Minor Oral Surgical Procedure. J Contemp Dent Pract 2012;13(4):521-527.
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Sutton, Nadia Y., and Niels-Derrek Schmitz. "Real-world Bleeding Outcomes and Costs Following Vascular Graft Anastomosis Using PROLENE Sutures with HEMO-SEAL Technology in Patients Undergoing Abdominal Aortic Aneurysm Repair." Journal of Health Economics and Outcomes Research 5, no. 2 (September 1, 2017): 140–49. http://dx.doi.org/10.36469/9806.
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Background: Suture hole bleeding is a common complication of vascular graft anastomosis that has potential to prolong vascular procedures, increase costs, and compromise patient outcomes.</p> Objectives: Compare real-world bleeding-related outcomes and costs following vascular anastomosis using PROLENE sutures with HEMO-SEAL technology (HEMO-SEAL sutures) compared with standard PROLENE sutures in patients receiving abdominal aortic aneurysm (AAA) repair in the United States. Methods: AAA repair procedures using hemostats and either HEMO-SEAL sutures or standard PROLENE sutures were identified from 2009 to 2013 using the Premier Healthcare Database. The primary outcome was the number and cost of hemostat units. Secondary outcomes were number and cost of sutures, bleeding complications, and transfusions. Results: A total of 5082 discharges for AAA repairs using hemostats and HEMO-SEAL sutures or standard PROLENE sutures were identified. HEMO-SEAL sutures were used in 79 (1.6%) discharges, standard PROLENE sutures were used in 4946 (97.3%); both sutures (excluded from the analysis) were used in 57 (1.1%). Discharge demographics were similar across suture groups, with the exception of disease severity; the HEMO-SEAL suture group had a higher proportion of minor discharges and a lower proportion of extreme discharges compared with the standard PROLENE suture group. Mean number of hemostat units used per discharge (2.34 vs 3.30; median = 2.0 in both groups; p=0.026) and median hemostat costs per discharge ($111 vs $186; p<0.01) were significantly lower in the HEMO-SEAL suture group compared with the standard PROLENE suture group. Fewer sutures per discharge (p<0.0001), lower mean costs of sutures per discharge, higher median costs of sutures per discharge (p=0.0045), and fewer transfusions (0.0019) were also seen in the HEMO-SEAL suture group compared with the standard PROLENE suture group. No statistically significant difference in bleeding complications was observed between suture groups. Conclusion: The results indicate that real-world use of HEMO-SEAL sutures may be associated with reduced hemostat usage and costs, and reduced bleeding that requires additional hemostats and/or transfusions.
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Wilkinson, C. Corbett, Cesar A. Serrano, Brooke M. French, Sarah J. Graber, Emily Schmidt-Beuchat, Lígia Batista-Silverman, Noah P. Hubbell, and Nicholas V. Stence. "Fusion patterns of minor lateral calvarial sutures on volume-rendered CT reconstructions." Journal of Neurosurgery: Pediatrics 26, no. 2 (August 2020): 200–210. http://dx.doi.org/10.3171/2020.2.peds1952.
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OBJECTIVESeveral years ago, the authors treated an infant with sagittal and bilateral parietomastoid suture fusion. This made them curious about the normal course of fusion of “minor” lateral sutures (sphenoparietal, squamosal, parietomastoid). Accordingly, they investigated fusion of these sutures on 3D volume-rendered head CT reconstructions in a series of pediatric trauma patients.METHODSThe authors reviewed all volume-rendered head CT reconstructions obtained from 2010 through mid-2012 at Children’s Hospital Colorado in trauma patients aged 0–21 years. Each sphenoparietal, squamosal, and parietomastoid suture was graded as open, partially fused, or fused. In several individuals, one or more lateral sutures were fused atypically. In these patients, the cephalic index (CI) and cranial vault asymmetry index (CVAI) were calculated. In a separately reported study utilizing the same reconstructions, 21 subjects had fusion of the sagittal suture. Minor lateral sutures were assessed, including these 21 individuals, excluding them, and considering them as a separate subgroup.RESULTSAfter exclusions, 331 scans were reviewed. Typically, the earliest length of the minor lateral sutures to begin fusion was the anterior squamosal suture, often by 2 years of age. The next suture to begin fusion—and first to complete it—was the sphenoparietal. The last suture to begin and complete fusion was the parietomastoid. Six subjects (1.8%) had posterior (without anterior) fusion of one or more squamosal sutures. Six subjects (1.8%) had fusion or near-complete fusion of one squamosal and/or parietomastoid suture when the corresponding opposite suture was open or nearly open. The mean CI and CVAI values in these subjects and in age- and sex-matched controls were normal and not significantly different. No individuals had a fused parietomastoid suture with open squamosal and/or sphenoparietal sutures.CONCLUSIONSFusion and partial fusion of the sphenoparietal, squamosal, and parietomastoid sutures is common in children and adolescents. It usually does not represent craniosynostosis and does not require cranial surgery. The anterior squamosal suture is often the earliest length of these sutures to fuse. Fusion then spreads anteriorly to the sphenoparietal suture and posteriorly to the parietomastoid. The sphenoparietal suture is generally the earliest minor lateral suture to complete fusion, and the parietomastoid is the last. Atypical patterns of fusion include posterior (without anterior) squamosal suture fusion and asymmetrical squamosal and/or parietomastoid suture fusion. However, these atypical fusion patterns may not lead to atypical head shapes or a need for surgery.
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TZIMTZIMIS (Ε. ΤΖΙΜΤΖΙΜΗΣ), E., and L. PAPAZOGLOU (Λ. ΠΑΠΑΖΟΓΛΟΥ). "Κριτήρια επιλογής ραμμάτων και εναλλακτικοί τρόποι σύγκλεισης τραυμάτων στη χειρουργική των ζώων συντροφιάς." Journal of the Hellenic Veterinary Medical Society 64, no. 1 (December 18, 2017): 47. http://dx.doi.org/10.12681/jhvms.15479.
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Selection of appropriate suture material is important for successful healing; it is based principally on the propertiesof suture, the type of the tissue to be sutured and the condition of the wound. The mechanical and biological propertiesof a suture and the suture’s size should correlate well to type and properties of the tissue to be sutured. Strategy of sutureselection for specific tissues is discussed. Presence of sutures in a wound can increase the rate of infection of the wound. Theseverity of the infection is related to the suture’s properties when the wound is clean. Closure of infected wounds should beavoided. Stapling is an alternative method for wound closure and offers a significant reduction in the operative time. Varioustypes of staplers are available, depending on type of the tissue and the surgical procedure. Skin staples are widely usedin the skin and other tissues. The use of vascular clips is an alternative way to ligate blood vessels. Tissue adhesives arematerials that can also be used in closure of specific types of wounds. Surgical mesh is useful for closure of large defects.
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Tang, Peter, Keiji Fujio, Robert Strauch, Melvin Rosenwasser, and Taiichi Matsumoto. "The Optimal Suture Placement and Bone Tunnels for TFCC Repair: A Cadaveric Study." Journal of Wrist Surgery 07, no. 05 (June 26, 2018): 375–81. http://dx.doi.org/10.1055/s-0038-1661361.
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Background Transosseous repair of foveal detachment of the triangular fibrocartilage complex (TFCC) is effective for distal radioulnar joint stabilization. However, studies of the optimal foveal and TFCC suture positions are scant. Purpose The purpose of this study was to clarify the optimal TFCC suture position and bone tunnels for transosseous foveal repair. Materials and Methods Seven cadavers were utilized. The TFCC was incised at the foveal insertion and sutured at six locations (TFCCs 1–6) using inelastic sutures. Six osseous tunnels were created in the fovea (foveae 1–6). Fovea 2 is located at the center of the circle formed by the ulnar head overlooking the distal end of the ulna (theoretical center of rotation); fovea 5 is located 2 mm ulnar to fovea 2. TFCC 5 is at the ulnar apex of the TFCC disc; TFCC 4 is 2 mm dorsal to TFCC 5. TFCC 1 to 6 sutures were then placed through each of the six osseous tunnels, resulting in 36 combinations, which were individually tested. The forearm was placed in five positions between supination and pronation, and the degree of suture displacement was measured. The position with the least displacement indicated the isometric point of the TFCC and fovea. Results The mean distance of suture displacement was 2.4 ± 1.6 mm. Fovea 2, combined with any TFCC location, (0.7 ± 0.6 mm) and fovea group 5, combined with TFCC 4 location (0.8 ± 0.8) or with TFCC 5 location (0.9 ± 0.6) had statistically shorter suture displacements than any other fovea groups. Conclusion For TFCC transosseous repair, osseous tunnel position was more important than TFCC suture location.
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Babovic, Nikola, Derek Klaus, Matthew J. Schessler, Patrick J. Schimoler, Alexander Kharlamov, Mark C. Miller, and Peter Tang. "Assessment of Conduit-Assisted Primary Nerve Repair Strength With Varying Suture Size, Number, and Location." HAND 14, no. 6 (April 5, 2018): 735–40. http://dx.doi.org/10.1177/1558944718769382.
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Background: Outcomes following digital nerve repair are suboptimal despite much research and various methods of repair. Increased tensile strength of the repair and decreased suture material at the repair site may be 2 methods of improving biologic and biomechanical outcomes, and conduit-assisted repair can aid in achieving both of these goals. Methods: Ninety-nine fresh-frozen digital nerves were equally divided into 11 different groups. Each group uses a different combination of number of sutures at the coaptation site and number of sutures at each end of the nerve-conduit junction, as well as 2 calibers of nylon suture. Nerves were transected, repaired with these various suture configurations using an AxoGuard conduit, and loaded to failure. Results: The 2-way analysis of variance (ANOVA) showed that repairs performed with 8-0 suture have significantly higher maximum failure load compared with 9-0 suture repairs ( P < .01). Increasing the number of sutures in the repair significantly increased the maximum failure load in all groups regardless of suture caliber used ( P < .01). Repairs with 9-0 suture at the coaptation site did not jeopardize repair strength when compared with 8-0 suture. Conclusions: Conduit-assisted primary digital nerve repairs with 8-0 suture increases the maximum load to failure compared with repairs with 9-0 suture, as does increasing the overall number of sutures. Using 9-0 suture at the coaptation site with 8-0 suture at the nerve-conduit junction does not jeopardize tensile strength when compared with similar repairs using all 8-0 suture and may decrease inflammation at the repair site while still achieving sufficient tensile strength.
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Malishevsky, V. M., R. V. Paskov, and K. S. Sergeev. "Comparative experimental study of biomechanical features of suture materials in tendon repair." Genij Ortopedii 30, no. 1 (February 21, 2024): 99–106. http://dx.doi.org/10.18019/1028-4427-2024-30-1-99-106.
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Introduction Many different suture configurations and pathomorphology of tendon repair have been described for tendon repair over the past 20 years. However, the biomechanical properties of suture material at primary flexor tendon repair have not been sufficiently explored. A cyclic loading test is performed to evaluate the performance of the different sutures under repeated loading conditions simulating dynamic conditions in postoperative rehabilitation procedures.The objective was to compare the strength of suture materials under cyclic loading on a biological model of a tendon.Material and methods Eighty porcine digital flexor tendons were examined in a pilot study. The sutured tendons were tested with a universal testing machine. Tendon repair was produced using polypropylene in group I, braided polyamide suture in group II, complex polytetrafluoroethylene thread in group III and a thread of superelastic titanium nickelide in group IV. The standard Chang protocol was used for cyclic loading.Results The percentage of intact sutures was 25 % in group I and in group II, 80 % in group III and 85 % in group IV after completing the entire load cycle. A pairwise comparison showed suture disruption being more common for group I and group II as compared to group III and group IV. Irreversible gap was more common for group 1 as compared to group IV. Neither knot ruptures nor tissue cutting were seen in the groups.Discussion The topic of biomechanical properties of suture material remains poorly understood. Although static load testing is commonly used in current experimental studies and cyclic testing is suitable for simulating postoperative conditions. The search continues for the “ideal” suture material for flexor tendon repair to prevent tears and retain tensile properties until the repair reaches strength.Conclusion The threads of polytetrafluoroethylene and nickelide-titanium showed the best biomechanical properties for tendon repair in the form of linear strength, good elasticity and low plasticity of the suture material. There were no significant differences between polypropylene and braided polyamide threads.
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Alsarhan, Mohammed, Hourya Alnofaie, Rawan Ateeq, and Ahmed Almahdy. "The Effect of Chlorhexidine and Listerine® Mouthwashes on the Tensile Strength of Selected Absorbable Sutures: An In Vitro Study." BioMed Research International 2018 (November 13, 2018): 1–8. http://dx.doi.org/10.1155/2018/8531706.
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Background. Suturing plays a critical role in the healing of surgical wounds. The tensile strength of suture materials indicates the ability of the material to withstand stress during knotting and protect the wound during an extended period of healing. Objective. An in vitro study was conducted to determine the effect of two commercially available mouthwashes on the tensile strength and breakage mode of two absorbable intraoral sutures. Materials and Methods. Two common absorbable sutures, Vicryl® and Monocryl®, both with 4-0 and 5-0 gauges were used. A total of 400 specimens were sutured around rubber rods and immersed in three thermostatically controlled experimental conditions: artificial saliva, 0.2% chlorhexidine gluconate (Parodontax® extra), and essential oils-based rinse (Listerine® Zero™), and these were compared to a nonimmersed dry condition. All specimens were stored in an incubator at 37°C. Tensile strengths were assessed after days 1, 3, 7, 10, and 14 of immersion using a universal Instron® testing machine. The maximum load for suture breakage and the location of the point of breakage were assessed. Results. Unlike Monocryl® 4-0, the tensile strength of both gauges of Vicryl® sutures significantly increased in chlorhexidine and Listerine®. There was a significant decrease in the strength for all suture types after day 10, regardless of the immersion solution. Listerine® significantly reduced the tensile strength of Monocryl® 5-0. Conclusion. Oral surgeons and periodontists should be cautious when prescribing commercial mouthwashes for patients relative to their selection of suture materials. However, further studies are needed to understand the molecular changes in sutures when exposed to chemical solutions found in mouthwashes.
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IGNA, Cornel, Roxana DASCĂLU, Cristian ZAHA, Bogdan SICOE, Ileana BRUDIU, and Larisa SCHUSZLER. "Simple Continuous Versus Cushing Suture for Jejunal end-to-end Anastomosis in the Dogs: a Comparative Study." Bulletin of University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca. Veterinary Medicine 79, no. 2 (November 14, 2022): 32–41. http://dx.doi.org/10.15835/buasvmcn-vm:2022.0020.
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For the anastomosis of canine jejunum, single-layer appositional closures are preferred to inverting or everting patterns, whereas inverted or everted closures require second-intention healing and increase the risk of luminal stenosis or anastomosis site leakage. Nevertheless, following simple continuous sutures, the dehiscence rates remain high. Our objectives were to compare the appositional simple continuous sutures with the inverting Cushing sutures, investigating: suture resistance, bursting pressure, lumen diameters on canine cadavers, as well as survival and complication rates in canine clinical cases. Our ex vivo experimental results indicate that: the efforts to which sutures are submitted to in anastomoses are minimal for the Cushing suture, the differences between the bursting pressure measured for the two types of sutures indicate the superiority of the Cushing suture, the difference in size of the anastomoses’ lumen between the two sutures are minimal. The retrospective analysis of intestinal end-to-end anastomoses (123 - simple continuous sutures and 388 - Cushing sutures) revealed 7 anastomotic complications, all following simple continuous anastomoses. Our results reveal the superiority of the Cushing suture, compared to simple continuous suture, which emphasizes the fact that the Cushing suture should be considered a good option when performing end-to-end jejunal anastomoses in canine patient.
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Debbabi, Faten, Sondes Gargoubi, Mohamed Adnene Hadj Ayed, and Saber Ben Abdessalem. "Development and characterization of antibacterial braided polyamide suture coated with chitosan-citric acid biopolymer." Journal of Biomaterials Applications 32, no. 3 (July 27, 2017): 384–98. http://dx.doi.org/10.1177/0885328217721868.
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Braided polyamide sutures are frequently used in dermatologic surgery for wound closure. However, braided sutures promote bacteria proliferation. In order to prevent wound complications due to this effect, antibacterial sutures should be used. The main objective of this study is the development of new non-absorbable antibacterial polyamide braided suture. This paper suggests new coating process that leads to obtain suture uniformly covered by antibacterial film enclosing chitosan, which is known for its antibacterial benefit. Mechanical properties and surface morphology of developed sutures were investigated by using mechanical tests. Sutures surfaces were also examined by scanning electron microscope, to perceive spreading of coating product on suture surface. In order to identify potential reactions between chemical compounds present in coating solution and suture material, sutures were analyzed by ATR-IF spectroscopy. It has been demonstrated that many eventual bonds between compounds present in coating solutions and polyamide macromolecular chain may occur. The existence of these bonds implies the fixation of biopolymer coating on suture surface. It has been demonstrated that uniform surface may be obtained by progressively applying coating solution containing little amount of chitosan on suture surface. We have also found that developed coating process has not affected mechanical properties of suture, which still meet United States Pharmacopeia requirement. Finally, antibacterial effects against four colonies, very widespread in hospitals, were studied. Prominent antibacterial effects of braided polyamide suture against two gram-positive ( S Aureus, S epidermidis) and two gram-negative ( E coli and P aeruginosa) colonies are presented. Optimal result of best properties is obtained by applying three layers of biopolymer coating comprising 1% chitosan and 10% citric acid. The new developed suture coating process appears as a promising method for obtaining important antibacterial effect with smooth suture surface.
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Lipatov, Vyacheslav A., Dmitriy A. Severinov, Artem A. Denisov, Sergey V. Lazarenko, and Nikolay N. Grigor’yev. "Research of physical and mechanical characteristics of suture material in experiment in operations on liver." I.P. Pavlov Russian Medical Biological Herald 28, no. 2 (July 3, 2020): 193–99. http://dx.doi.org/10.23888/pavlovj2020282193-199.
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Taking into account the peculiarities of the blood supply to the liver and the structure of its parenchyma, and, as a result, considerable difficulties in providing reliable hemostasis without additional traumatization, a surgeon needs to be careful when performing a surgical manipulation. Despite a large number of modern methods for stopping parenchymal bleeding, many practi-tioners give preference to classic methods of hemostasis, including ligation of bleeding vessels in the bulk of the organ using specialized sutures. One of the most serious complications of the use of suture material is cutting of organ tissue, which leads to enhanced bleeding and expansion of the area of damage. At the moment, the tactics of choosing suture material for surgical procedures is empirical. In this context, the aim of this study was to assess the physico-mechanical properties of suture material regarding its structure, and to develop a criterion for choosing surgical sutures for surgical procedures. For the study, the liver was removed out of corpses of males of 35 to 40 years of age, after which separate sections of 7.574 cm in size were obtained from it. Then a wound 3 cm long and 2 cm deep was made. The wound was sutured with a simple interrupted suture without tightening, but with application of one simple half-node. For suturing, catgut, twisted capron and polyglycolide thread were used. Attention was paid to the maximal force applied at the moment of cutting (Fmax) and the degree of pulling the thread at the moment of cutting (Lu). The analysis of the data was based on comparison of Fmax and Lu parameters. This method permits to refuse from the empirical approach to the choice of suture material for operations on the liver, and to develop a criterion for choosing surgical sutures.
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SALASCHE, COL STUART J., LTC ROBERT JARCHOW, CDR BRUCE D. FELDMAN, CPT MARY JOANNE DEVINE-RUST, and LTC JOHN ADNOT. "Sutures: The Suspension Suture." Journal of Dermatologic Surgery and Oncology 13, no. 9 (September 1987): 973–82. http://dx.doi.org/10.1111/j.1524-4725.1987.tb00573.x.
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Akentyeva, T. N., D. K. Shishkova, A. Yu Burago, and Yu A. Kudryavtseva. "Local inflammatory response to suture material in surgical practice: experimental data." Russian Journal of Transplantology and Artificial Organs 22, no. 2 (July 12, 2020): 151–57. http://dx.doi.org/10.15825/1995-1191-2020-2-151-157.
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Objective: to study the effect of various types of suture materials, potentially suitable for cardiovascular surgery, on experimental surgical outcomes. Materials and methods. Polypropylene sutures (Prolene 6/0), titanium nickelide (TiNi) sutures (6/0) and absorbable polydioxanone sutures (Monoplus 6/0) were used in the study. Male Wistar rats were used for in vivo studies. The effect of suture materials on abdominal adhesions was studied. In vivo calcification process was examined, and response of blood components in contact with suture materials was also assessed in vitro. Results. There is a negative inflammatory response to suture materials. The severity of this response depended on the type of material used. Polypropylene sutures demonstrated the most severe inflammatory response provoking massive adhesion formation. In addition, large calcium deposits were found both in the suture area and in the thickness of the biomaterial, stitched with prolene and implanted subcutaneously in the rats. Titanium nickelide sutures showed high hemocompatibility and biocompatibility. The Monoplus sutures caused minimal inflammatory response and provoked calcification of the biomaterial to a lesser degree. Conclusion. The suture material could have significant effects on surgical outcomes and could cause postoperative complications.
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Abhari, Roxanna E., Joana A. Martins, Hayley L. Morris, Pierre-Alexis Mouthuy, and Andrew Carr. "Synthetic sutures: Clinical evaluation and future developments." Journal of Biomaterials Applications 32, no. 3 (July 17, 2017): 410–21. http://dx.doi.org/10.1177/0885328217720641.
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Today’s sutures are the result of a 4000-year innovation process with regard to their materials and manufacturing techniques, yet little has been done to enhance the therapeutic value of the suture itself. In this review, we explore the historical development, regulatory database and clinical literature of sutures to gain a fuller picture of suture advances to date. First, we examine historical shifts in suture manufacturing companies and review suture regulatory databases to understand the forces driving suture development. Second, we gather the existing clinical evidence of suture efficacy from reviewing the clinical literature and the Food and Drug Administration database in order to identify to what extent sutures have been clinically evaluated and the key clinical areas that would benefit from improved suture materials. Finally, we apply tissue engineering and regenerative medicine design hypotheses to suture materials to identify routes by which bioactive sutures can be designed and passed through regulatory hurdles, to improve surgical outcomes. Our review of the clinical literature revealed that many of the sutures currently in use have been available for decades, yet have never been clinically evaluated. Since suture design and development is industry driven, incremental modifications have allowed for a steady outflow of products while maintaining a safe regulatory position and limiting costs. Until recently, there has been little academic interest in suture development, however the rise of regenerative medicine strategies is shifting the suture paradigm from an inert material, which mechanically approximates tissue, to a bioactive material, which also actively promotes cell-directed repair and a positive healing response. These materials hold significant therapeutic potential, but could be associated with an increased regulatory burden, cost, and clinical evaluation compared with current devices.
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Haravu, Pranav N., Miguel Gonzalez, Shelby L. Nathan, Callum F. Ross, Olga Panagiotopoulou, and Russell R. Reid. "The biomechanics of chewing and suckling in the infant: A potential mechanism for physiologic metopic suture closure." PLOS Computational Biology 19, no. 6 (June 22, 2023): e1011227. http://dx.doi.org/10.1371/journal.pcbi.1011227.
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Craniosynostosis is a condition with neurologic and aesthetic sequelae requiring invasive surgery. Understanding its pathobiology requires familiarity with the processes underlying physiologic suture closure. Animal studies have shown that cyclical strain from chewing and suckling influences the closure of cranial vault sutures, especially the metopic, an important locus of craniosynostosis. However, there are no human data correlating strain patterns during chewing and suckling with the physiologically early closure pattern of the metopic suture. Furthermore, differences in craniofacial morphology make it challenging to directly extrapolate animal findings to humans. Eight finite-element analysis (FEA) models were built from craniofacial computer tomography (CT) scans at varying stages of metopic suture closure, including two with isolated non-syndromic metopic craniosynostosis. Muscle forces acting on the cranium during chewing and suckling were simulated using subject-specific jaw muscle cross-sectional areas. Chewing and suckling induced tension at the metopic and sagittal sutures, and compressed the coronal, lambdoid, and squamous sutures. Relative to other cranial vault sutures, the metopic suture experienced larger magnitudes of axial strain across the suture and a lower magnitude of shear strain. Strain across the metopic suture decreased during suture closure, but other sutures were unaffected. Strain patterns along the metopic suture mirrored the anterior to posterior sequence of closure: strain magnitudes were highest at the glabella and decreased posteriorly, with minima at the nasion and the anterior fontanelle. In models of physiologic suture closure, increased degree of metopic suture closure correlated with higher maximum principal strains across the frontal bone and mid-face, a strain regime not observed in models of severe metopic craniosynostosis. In summary, our work provides human evidence that bone strain patterns from chewing and suckling correlate with the physiologically early closure pattern of the metopic suture, and that deviations from physiologic strain regimes may contribute to clinically observed craniofacial dysmorphism.
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Delashaw, Johnny B., John A. Persing, William C. Broaddus, and John A. Jane. "Cranial vault growth in craniosynostosis." Journal of Neurosurgery 70, no. 2 (February 1989): 159–65. http://dx.doi.org/10.3171/jns.1989.70.2.0159.
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✓ Skull growth after single suture closure was described in 1851 by Virchow, who noted that growth in the plane perpendicular to a fused suture was restricted. However, this observation failed to predict compensatory growth patterns that produce many of the deformities recognized as features of individual syndromes. The deformities resulting from premature closure of a coronal, sagittal, metopic, or lambdoid suture can be predicted on the basis of the following observations: 1) cranial vault bones that are prematurely fused secondary to single suture closure act as a single bone plate with decreased growth potential; 2) asymmetrical bone deposition occurs mainly at perimeter sutures, with increased bone deposition directed away from the bone plate; 3) sutures adjacent to the prematurely fused suture compensate in growth more than those sutures not contiguous with the closed suture; and 4) enhanced symmetrical bone deposition occurs along both sides of a non-perimeter suture that is a continuation of the prematurely closed suture. These observations regarding growth in craniosynostosis are illustrated with clinical material in this report.
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Durmaz, A., A. Kilic, R. Gumral, U. Yildizoglu, and B. Polat. "The effects of different suture materials in the nasal cavity." Journal of Laryngology & Otology 130, no. 4 (February 9, 2016): 352–56. http://dx.doi.org/10.1017/s002221511600027x.
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AbstractObjective:To investigate the effects of different suture materials in the nasal cavity on encrustation and micro-organism colonisation.Methods:Four different suture materials were used to suture the nasal septum. The effects of suture materials on intranasal encrustation were evaluated with anterior rhinoscopy. The sutures were removed and evaluated in terms of micro-organism colonisation on the 7th and 21st post-operative days.Results:Monofilament sutures were found to cause less encrustation and micro-organism colonisation. There was increased late-stage encrustation if an absorbable monofilament suture remained in place for a long time. The removal of a non-absorbable monofilament suture in the early or late post-operative period made no difference in terms of micro-organism growth on the suture.Conclusion:The material and physical characteristics of sutures placed inside the nose may indirectly affect the healing process. It may be more appropriate to use different materials depending on the length of time the suture is to remain in place.
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Liu, Shuqiang, Gaihong Wu, Xiaogang Chen, Xiaofang Zhang, Juanjuan Yu, Mingfang Liu, Yao Zhang, and Peng Wang. "Degradation Behavior In Vitro of Carbon Nanotubes (CNTs)/Poly(lactic acid) (PLA) Composite Suture." Polymers 11, no. 6 (June 8, 2019): 1015. http://dx.doi.org/10.3390/polym11061015.
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Poly(lactic acid) (PLA) suture can be absorbed by the human body, and so have wide applications in modern surgery operations. The degradation period of PLA suture is expected to meet with the healing time of different types of wounds. In order to control the degradation period of the PLA suture, the carbon nanotubes (CNTs) were composited with PLA suture, and the degradation experiment in vitro was performed on sutures. The structure and properties of sutures during degradation, such as surface morphology, breaking strength, elongation, mass and chemical structure, were tracked and analyzed. The results indicated that the degradation brought about surface defects and resulted in 13.5 weeks for the strength valid time of the original PLA suture. By contrast, the strength valid time of the CNTs/PLA suture was increased to 26.6 weeks. Whilst the toughness of both the pure PLA and CNTs/PLA sutures decreased rapidly and almost disappeared after 3 to 4 weeks of degradation. The mass loss demonstrated that the time required for complete degradation of the two sutures was obviously different, the pure PLA suture 49 weeks, while CNTs/PLA sutures 63 to 73 weeks. The research proved that CNTs delayed PLA degradation and prolonged its strength valid time in degradation.
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Jassem, Muhammed, Alexander T. Rose, Keith Meister, Peter A. Indelicato, and Donna Wheeler. "Biomechanical Analysis of the Effect of Varying Suture Pitch in Tendon Graft Fixation." American Journal of Sports Medicine 29, no. 6 (November 2001): 734–37. http://dx.doi.org/10.1177/03635465010290061101.
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The purpose of this study was to biomechanically assess the effect of varying suture pitch on the holding power of the Krackow suture technique for tendon graft fixation. Seven pairs of rabbit Achilles tendons were sutured with single No. 5 Ti-Cron suture using the Krackow technique. One tendon from each pair was sutured using a 0.5-cm suture pitch (half-pitch group) while the contralateral tendon from each pair was sutured with a 1.0-cm suture pitch (one-pitch group). The tendons were loaded to failure using a servohydraulic materials test system at a loading rate of 0.5 mm/sec. There were no statistically significant differences noted in suture slippage at failure (1.58 cm for half pitch versus 1.45 cm for one pitch) or maximal force to failure (158.5 N for half pitch versus 168.2 N one pitch) between the two treatment groups. However, the construct with the 1-cm suture pitch was significantly stiffer than the construct with the 0.5-cm suture pitch, with stiffness values of 106.2 N/cm and 91.4 N/cm, respectively. The most common mechanism of failure was slippage of the suture at the first suture throw and tearing of the first knot through the most distal portion of the tendon. Four constructs failed by suture rupture, two from each experimental group.
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Kavitha, CV. "Outcome of conjunctival autograft sutured with polyamide black sutures in pterygium surgery." Nepalese Journal of Ophthalmology 5, no. 1 (March 26, 2013): 94–99. http://dx.doi.org/10.3126/nepjoph.v5i1.7833.
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Introduction: Pterygium excision with conjunctival autografting is the most effective way of treating pterygium with the least recurrence rate. The sutures which can be used to suture the conjunctival autograft are absorbable polyglactin 10-0 sutures or nonabsorbable polyamide 10-0 sutures. The polyamide sutures are inert, elicit minimal acute inflammatory reaction, do not support infection and allow easy removal without tissue adherence. They are very cost-effective compared to polyglactin sutures. Objective: This study was aimed to assess the efficacy of the cost-effective polyamide sutures in terms of patient comfort, graft stability, need for suture removal and recurrence. Materials and methods: In this prospective, non-comparative study, 56 eyes of 56 patients with primary pterygium underwent pterygium excision with conjunctival autograft transplantation sutured with 10-0 polyamide black sutures. The patients’ comfort, graft stability, need for suture removal and recurrence were assessed within a mean follow- up period of 28.75 months (range 47 - 14 months). Results: Mild discomfort was found in 14 (25 %) patients for up to 3 weeks, moderate discomfort in 8 (14.2 %) for up to 1 week, no patients had severe discomfort beyond the first day, and all patients were comfortable at the end of the sixth post-operative week. The graft was stable in all patients. Nine sutures in 5 patients out of 392 sutures in 56 patients, that is, 2.29 % of the sutures, needed to be removed at the end of the sixth post-operative week. Two patients, or 3.57 %, had a recurrence. Conclusion: In pterygium surgery, suturing the conjunctival autograft with cost-effective polyamide black sutures is efficient and safe. Nepal J Ophthalmol 2013; 5(9):94-99 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7833
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Rukhsar, Aeliya, Saiyad Shah Alam, and Gulamuddin Sofi. "Evolution of Suture Material - A Systemic Review." South Asian Research Journal of Nursing and Healthcare 5, no. 01 (April 15, 2023): 22–27. http://dx.doi.org/10.36346/sarjnhc.2023.v05i01.004.
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Reviewing the development and history of sutures used in surgery is the goal of the study. Based on a review of the literature, we identified pertinent papers and surgical textbooks regarding suture for wound closure using computerised and manual database searches. The essay explores those earliest known applications of suture by Edwin Smith surgical papyrus and after that the name suture comes from Latin term was first used by Hippocrates in 400 BC. He used linen as suture material. The development of sutures made of natural materials is traced chronologically up to the present, when synthetic sutures are used in an increasing number of daily surgeries. In this millennium, long history of sutures, the early work of Edwin smith, Hippocrates, Sushruta, Galen, Albucasis, Avicenna Celsus, Paré, and Lister is recognised. Because the science and history of sutures are not well-known to the majority of surgeons. Suture needs a holistic review to understand current research and progress on this widely used product.
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Regelsberger, Jan, Tobias Schmidt, Björn Busse, Julia Herzen, Michael Tsokos, Michael Amling, and Felix Beckmann. "Synchrotron–microcomputed tomography studies of normal and pathological cranial sutures: further insight." Journal of Neurosurgery: Pediatrics 5, no. 3 (March 2010): 238–42. http://dx.doi.org/10.3171/2009.10.peds09138.
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Object Both CT and high-frequency ultrasound have been shown to be reliable diagnostic tools used to differentiate normal cranial sutures from suture synostosis. In nonsynostotic plagiocephaly, overlapping of the bony plates and the so-called “sticky suture” is still controversial and is believed to represent a pathological fusion process. Synchrotron–microcomputed tomography (SRmCT) studies were undertaken to determine whether positional head deformities can be assumed to be true suture pathologies. Methods Morphological features and growth development of 6 normal cranial sutures between the ages of 3 and 12 months were analyzed histologically. Additionally 6 pathological sutures, including sagittal synostosis and nonsynostotic plagiocephaly (NSP), were compared with the group of normal sutures by histological and SRmCT studies. Synchrotron-microcomputed tomography is a special synchrotron radiation source with a high photon flux providing a monochromatic x-ray beam with a very high spatial resolution. Morphological characteristics of the different suture types were evaluated and bone density alongside the sutures was measured to compare the osseous structure of the adjacent bony plates of normal and pathological sutures. Results Histologically jointlike osseous edges of the normal sutures were seen in the 1st month of life and interlocking at the age of approximately 12 months. During this 1st year, bone thickness increases and suture width decreases. The SRmCT studies showed that: 1) sutures and adjacent bones in NSP are comparable to normal sutures in terms of their morphological aspects; 2) bone densities in the adjacent bony plates of NSP and normal sutures are not different; 3) thickening of the diploe with ridging of the bone in sagittal synostosis is associated with significantly higher bone density; 4) synostotic sutures are only partially fused but vary in their extent; and 5) nonfused sections in sagittal synostosis behave like normal sutures without any signs of pathological bone formation. Conclusions Sutures in patients with NSP were found without any morphological irregularities or different osseous structures alongside those compared with normal sutures. Thus, a true suture pathology or osseous change of the adjacent bony plates is highly unlikely in NSP. Even though the number of specimens is limited in this series, cranial suture fusion seems to start at one undetermined point and spread along the suture, whereas other parts of the same suture are not involved according to morphological aspects and bone density measurements of the adjacent bones. This theory may represent a dynamic fusion process completed over time but just starting too early.
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Ye, Mao, Hangzhou Zhang, and Qingwei Liang. "Clinical Outcomes After Medial Patellofemoral Ligament Reconstruction Using Transosseous Sutures Versus Suture Anchors: A Prospective Nonrandomized Controlled Trial." Orthopaedic Journal of Sports Medicine 8, no. 5 (May 1, 2020): 232596712091711. http://dx.doi.org/10.1177/2325967120917112.
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Background: Patellar instability remains a challenging problem for orthopaedic surgeons. Recurrent patellar instability is traditionally treated with medial patellofemoral ligament (MPFL) reconstruction using a suture anchor or bone tunnel technique. Although the use of transosseous sutures was recently described for MPFL reconstruction, relevant clinical data have not been reported. Purpose/Hypothesis: The purpose of this study was to compare a new transosseous suture fixation technique with the suture anchor technique for MPFL reconstruction. The hypothesis was that reconstruction with transosseous sutures would show similar clinical results to reconstruction with suture anchors. Study Design: Cohort study; Level of evidence, 2. Methods: There were 65 patients with recurrent lateral patellar dislocations from January 2014 to December 2016 who were included in this prospective nonrandomized controlled trial. In total, 31 patients underwent MPFL reconstruction with suture anchors at the patella site (suture anchor group), while the other 34 patients underwent MPFL reconstruction with transosseous sutures (transosseous suture group). The main outcome variable (patellar redislocation) was recorded at follow-up (range, 25-60 months). The International Knee Documentation Committee (IKDC) score, Kujala score, range of motion, congruence angle, patellar tilt, redislocation rate, and complications were collected preoperatively and/or postoperatively. Results: No recurrent dislocations or other complications were observed in any of the patients. No significant differences were found at follow-up between the suture anchor and transosseous suture groups for subjective IKDC score, Kujala score, congruence angle, patellar tilt, redislocation rate, or range of motion. Conclusion: This short-term study showed that after MPFL reconstruction (suture anchors or transosseous sutures), patellar stability could be restored. With the numbers available, no significant differences in outcome scores were observed between patients in the transosseous suture and suture anchor groups.
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Yavas, Arzu, Ozan Avinc, and Görkem Gedik. "Ultrasound and Microwave Aided Natural Dyeing of Nettle Biofibre (Urtica dioica L.) with Madder (Rubia tinctorum L.)." Fibres and Textiles in Eastern Europe 25 (August 31, 2017): 111–20. http://dx.doi.org/10.5604/01.3001.0010.2855.
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The success of suture yarn depends upon its tensile and bending properties. As sutures pass through the tissue, it should possess enough strength to hold the tissue together and should be flexible so as to be knotted. The aim of the present work was to improve the strength of silk suture without affecting its bending properties. Silk sutures were fabricated using a circular braiding machine. Structural variations were made by varying the diameter and by producing core sheath suture yarn. The resulting suture yarn is coated with chitosan – a biopolymer. The mechanical performances of suture materials coated with and without chitosan were studied and compared with commercial suture. It was observed that the suture with a core-sheath structure performed well during tensile and knot testing. The coarser yarns exhibited higher bending rigidity and lower knot strength than the finer suture yarns.
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Stoecker, Allison, Collin M. Blattner, Stephanie Howerter, Whitney Fancher, John Young, and William Lear. "Effect of Simple Interrupted Suture Spacing on Aesthetic and Functional Outcomes of Skin Closures." Journal of Cutaneous Medicine and Surgery 23, no. 6 (July 4, 2019): 580–85. http://dx.doi.org/10.1177/1203475419861077.
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Background Dermatologic surgeons are trained in fundamental wound closure techniques that minimize wound tension and tissue ischemia to optimize healing and create discrete scars. These include orienting excisions along resting skin tension lines, handling tissue edges with care, and avoiding strangulation while tying suture. Another variable that may affect wound healing and cosmetic outcomes is the spacing between sutures. Objective This prospective, single-centre, randomized, split-scar comparison trial was designed to explore how suture spacing distance affects wound complication rate and scar cosmesis. Methods Elliptical surgical wounds of the trunk and extremities were repaired with simple interrupted sutures with varying suture spacing. One half of each wound was repaired with high-density suture spacing (approximately 5 mm apart) and the other with low-density suture spacing (approximately 10 mm apart). Wounds were evaluated at 2-week suture removal for complications, and then reevaluated at 3 and 6 months for cosmesis using the Patient and Observer Scar Assessment Scale score. Results Results revealed no significant difference in minor wound complications during the early healing process between high- and low-density suture spacing. At 3 months postoperatively, physicians and patients alike preferred the aesthetics of the low-density suture placement. By 6 months postoperatively, this preference disappeared. Conclusions These results suggest that suture spacing may affect early scar formation. Additionally, placing sutures farther apart results in fewer total puncture wounds, decreases tissue trauma, and saves surgical time while conserving suture material. Therefore, dermatologic surgeons should consider placing fewer percutaneous sutures during wound repair.
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Orhan, Zeynep Dilan, and Levent Ciğerim. "Evaluation of the Effect of Polybutester and Polypropylene Sutures on Complications after Impacted Lower Third Molar Surgery." Applied Sciences 14, no. 4 (February 9, 2024): 1448. http://dx.doi.org/10.3390/app14041448.
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Complications that can occur in the postoperative period of impacted lower third molar extraction are factors that have an impact on the daily routine of patients. This study aimed to evaluate the efficacy of polybutester and polypropylene sutures on postoperative complications after impacted lower third molar surgery. Two different suture materials were used in the 35 patients with bilateral impacted lower third molars included in the study: polybutester sutures in group 1 and polypropylene sutures in group 2. Measurements were taken to evaluate swelling and trismus before surgery and on the 2nd and 7th days after surgery, and pain was evaluated using a visual analogue scale (VAS), which patients were asked to complete after surgery. Wound healing, suture-related injury and suture-related discomfort in patients were also evaluated. The pain and suture-related discomfort felt on the side where the polybutester suture was used was less on the second postoperative day than on the side where the polypropylene suture was used. These results support the use of polybutester sutures in impacted third molar surgery.
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Zhang, Z. Q., and J. L. Yang. "Biomechanical Dynamics of Cranial Sutures during Simulated Impulsive Loading." Applied Bionics and Biomechanics 2015 (2015): 1–11. http://dx.doi.org/10.1155/2015/596843.
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Background. Cranial sutures are deformable joints between the bones of the skull, bridged by collagen fibres. They function to hold the bones of the skull together while allowing for mechanical stress transmission and deformation.Objective. The aim of this study is to investigate how cranial suture morphology, suture material property, and the arrangement of sutural collagen fibres influence the dynamic responses of the suture and surrounding bone under impulsive loads.Methods. An idealized bone-suture-bone complex was analyzed using a two-dimensional finite element model. A uniform impulsive loading was applied to the complex. Outcome variables of von Mises stress and strain energy were evaluated to characterize the sutures’ biomechanical behavior.Results. Parametric studies revealed that the suture strain energy and the patterns of Mises stress in both the suture and surrounding bone were strongly dependent on the suture morphologies.Conclusions. It was concluded that the higher order hierarchical suture morphology, lower suture elastic modulus, and the better collagen fiber orientation must benefit the stress attenuation and energy absorption.
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Tale, Archana Kundlikrao, Fatima Bhopalwala Ali, Suvarna Kundilkrao Tale, Jitendra Gupta, and Santosh Shravanrao Fupare. "A Morphological Cross-Sectional Study of Metopic Suture in Human Adult Cadaveric Skulls." Journal of Evidence Based Medicine and Healthcare 8, no. 8 (February 22, 2021): 405–9. http://dx.doi.org/10.18410/jebmh/2021/79.
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BACKGROUND Metopic suture is located anterior to the coronal suture. There are two types: complete and incomplete metopic sutures. Knowledge regarding the metopic sutures in adults is necessary to avoid misinterpretation of radiographs as frontal bone fracture. Knowledge with regard to metopic suture is helpful for anatomists and medico legal experts. This study has been done to find out the incidence of metopic suture, classify the metopic sutures into complete and incomplete type and further classify the incomplete variety based on shape. METHODS This study was conducted on 50 skulls from the Department of Anatomy, Autonomous Government Medical College and Hospital, Ratlam (MP). Skulls with signs of disease and damaged skulls were excluded from the study. RESULTS In the present study, out of 50 dry adult cadaveric skulls, 2 skulls (4 %) showed complete metopism. Incomplete metopic sutures were present in 28 / 50 (56 %) and absent in 20 / 50 (40 %). Out of 28 incomplete metopic sutures, single linear metopic sutures were present in 12 / 28 (42.85 %). Double linear metopic sutures were present in 7 / 28 (25 %). V-shaped metopic sutures were present in 5 / 28 (17.85 %) and U shaped metopic sutures were present in 4 / 28 (14.28 %). CONCLUSIONS Detailed knowledge of the metopic suture is important for neurosurgeons and radiologists in routine practice. Vertical frontal bone fractures may be easily misdiagnosed with persistent metopic sutures. This anatomical knowledge of metopic sutures is very useful for doctors while treating traumatised patients and during surgical intervention including frontal craniotomy. KEYWORDS Suture, Metopism, Frontal Bone, Nasion, Bregma