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Anorectal malformation
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Marc A. Levitt, Richard J. Wood
Once the dissection has been completed, the electrical stimulator is used to determine the limits of the sphincteric mechanism. The limits should be marked at the start of the case before beginning the dissection. The anterior limit of the external sphincter and the anterior edge of the muscle complex are reapproximated as previously described, creating the perineal body (Figure 43.30). These sutures are key to allowing for good perineal body healing. The levator muscle is usually not exposed and therefore does not have to be reconstructed. The muscle complex is reconstructed posterior to the rectum with a small bite of rectal wall. The anoplasty is performed as previously described.
Extracorporeal Membrane Oxygenation (ECMO) Support for Cardiorespiratory Failure
Published in Wayne E. Richenbacher, Mechanical Circulatory Support, 2020
Ralph E. Delius, Angela M. Otto
Removal of cervically placed cannulae is performed at the bedside. Our preference is to have the assistance of surgical nurses but some programs have a decannulation kit available. The position of the patient is identical to that for cannulation. The sutures are removed and the wound irrigated with warm saline. A 2-0 silk ligature is placed around the proximal internal jugular vein. The ties around the vein are then cut with a #15 blade on the previously placed vessel loop segments. The cannula is quickly removed and a vascular clamp applied. The tie is then secured. The arterial cannula, if present, is removed in an identical manner. The wound is then irrigated, hemostasis is obtained and the wound is closed with a running 4-0 nylon suture.
The Role of Lymphaticovenous Anastomoses in the Treatment of Postmastectomy Edema
Published in Waldemar L. Olszewski, CRC Handbook of Microsurgery, 2019
Wound healing was checked on day 5 after the operation and the patient was discharged. The sutures were removed after 10 days by local physicians or in the outpatient department of our clinic. The first appointment for a control visit was made 6 weeks postoperatively.
Nanoencapsulation and characterisation of Hypericum perforatum for the treatment of neuropathic pain
Published in Journal of Microencapsulation, 2023
Radha Goel, Nitin Kumar, Neelam Singh, Rosaline Mishra
The partial sciatic nerve ligation (PSNL/Seltzer model) strategy, which was previously published, convinced peripheral neuropathy (Seltzer et al.1990). Through the intraperitoneal dose of xylazine (5 mg/kg) and ketamine (50 mg/kg), rats were given anaesthesia. Iodine was used to cleanly shave and sanitise the right thigh. The right upper thigh was dissected to reveal the sciatic nerve. The sciatic nerve’s dorsal half was then securely sutured with an 8-0 silk suture. The sutures were used to close the incisions after the surgery. After surgery, each rat was kept separated for recovery. The animals showed signs of discomfort and hyperalgesia in their behaviour. Animals were randomly divided into six groups with eight animals each, as stated below:Group 1 (control group) received 0.9% saline orally.Group 2 (sham) received 0.9% saline orally.Group 3 (PSNL) received 0.9% saline orally.Group 4 (standard group) was given with gabapentin orally (100 mg/kg).Group 5 (test group) received HPE orally (200 mg/kg).Group 6 (test group) received NPHPE orally (20 mg/kg).
Anterior approach ptosis surgery: comparison of absorbable polyglactin sutures and non-absorbable polyester sutures. Does Vicryl stand the test of time?
Published in Orbit, 2022
Gemma S. L. Manasseh, Samantha V. Hunt, Helen Garrott, Rebecca L. Ford, Richard Caesar, Richard A. Harrad
While this study suggests the superiority of non-absorbable over absorbable sutures, there are a number of limitations in its retrospective study design. The BOPSS National Ptosis Survey stipulates a series of post-operative lid metrics as objective measures of success. These include the upper lid margin reflex distance (uMRD) and the inter-eyelid differences in: MRD, lid show, skin crease, and lid contour.2 Since these are not routinely recorded in the patient records, they could not be used to determine the primary endpoint in this study. Therefore, re-operation rates have been used as a proxy for failure rates. The National Ptosis Survey demonstrated that patients’ assessment of surgery is less critical than that of the surgeon2; therefore, patients may not have pursued repeat surgery despite it being recommended by the surgeon. The threshold for recommending further surgery may also differ between surgeons. Furthermore, patients may have moved out of the area or sought repeat surgery elsewhere, and these would not have been captured in this study.
Injectable and adhesive hydrogels for dealing with wounds
Published in Expert Opinion on Biological Therapy, 2022
Parisa Ghandforoushan, Nasim Golafshan, Firoz Babu Kadumudi, Miguel Castilho, Alireza Dolatshahi-Pirouz, Gorka Orive
For many years, suturing has been considered the adequate option for wound closure and bleeding control, mostly due of its high mechanical properties and low dehiscence. However, drawbacks associated with suturing such as high infection rate, discomfort in handling, further tissue trauma, and concern about probable transmission of blood-borne illness via needles have led to developing new strategies [32]. These included the use of multiple hemostasis agents, clips, staples, tapes, and tissue adhesives to assist in the quicker and more efficient control of bleeding from limited wound closure [33]. Although promising, these strategies were still not effective in ensuring adequate fitting to the wound and instant sealing. As an alternative, injectable bioadhesive sealants have been recently introduced. Tissue adhesives and sealants are can substitute sutures and staples for improved closure, minimized blood loss, swifter execution, and easier and less painful operation. In this regard, a variety of biomaterials has been explored. The primary challenge in developing an appropriate sealant or bioadhesive biomaterial is to attain adequate tissue adhesion strength in a moist environment without compromising the tissue function, while ensuring biodegradability. Besides, a highly elastic surgical sealant/adhesive is needed to adapt to the dynamic motion of native tissues [1].