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Urologic Involvement
Published in Nazar N. Amso, Saikat Banerjee, Endometriosis, 2022
Jörg Keckstein, Gernot Hudelist, Simon Keckstein
Cystotomy is closed with a continuous suture in the horizontal direction (Figures 12.25 and 12.26). A 3-0 Vicryl® (Ethicon) suture is recommended. Chamsy et al. (66) reported better efficiency and more-secure wound closure with barbed sutures. Wound edges should be loosely adaptable, if necessary further mobilization of the surrounding bladder structures is required. In case the defect reaches far into the direction of the trigonum vesicae, a T-shaped suture, first in the vertical and then in the horizontal direction, can facilitate tension-free closure. The stitches should, if possible, exclude the lamina mucosae and create sufficient tension to ensure the tightness of the bladder. The single-layer closure is acceptable unless the leak test is unsatisfactory. At the end of the procedure, bladder tightness is checked and a cystogram is performed at intervals of 7–10 days before removal of the urinary catheter.
Injuries in Children
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
The cosmetic result for a wound closed with tissue adhesive is the same as for wound closure achieved with sutures, staples or adhesive strips. However, because of the weaker tensile strength of glues they can be used only on low-tensile, immobile wounds less than 3 cm in length. There is a slight increase in the incidence of wound dehiscence, but all other wound complications are the same.
How to perform revision lumbar decompression at the index level through a minimally invasive (MIS) approach
Published in Gregory D. Schroeder, Ali A. Baaj, Alexander R. Vaccaro, Revision Spine Surgery, 2019
Aaron Hillis, Christoph Wipplinger, Sertac Kirnaz, Franziska A. Schmidt, Roger Härtl
Because wound closure is performed intracutaneously, removal of sutures is not necessary. However, we schedule an early follow-up on day 7 for wound inspection and removal of steristrips. Further follow-up is not required, so long as the patient is free of symptoms.
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].
Analysis of study designs and primary outcome measures in clinical trials of investigational suture materials
Published in Expert Review of Medical Devices, 2022
Nahathai Dukaew, Wannachai Sakuludomkan, Mingkwan Na Takuathung, Dumnoensun Pruksakorn, Winita Punyodom, Nut Koonrungsesomboon
Of 4,013 records identified from the database searches, a total of 46 studies 18,19–63] were eligible for inclusion (Figure 1); the individual study characteristics of 46 studies are summarized in Table S1. Of the 46 eligible studies, 24 of which (52.2%) were pilot/feasibility trials while the others (n = 22, 47.8%) were pivotal trials (Table 1). The trials were conducted in various countries, mainly in Asia and North America (Figure 2). Most studies applied investigational suture materials primarily for wound closure (n = 39, 84.8%) while a few studies (n = 7, 15.2%) used them for other purposes, such as mesh or organ fixation and facial lifting. The type of surgery in which investigational suture materials were used was highly variable among studies, with intra-oral surgery (n = 7, 15.2%) and gynecologic laparoscopic surgery (n = 7, 15.2%) being the most common type. Common intervention characteristics included barbed vs non-barbed or different types of barbed suture materials (n = 15, 32.6%), absorbable vs non-absorbable suture materials (n = 12, 26.1%), and antibacterial-coated vs non-coated or different types of antibacterial-coated suture materials (n = 9, 19.6%).
Skin hypersensitivity following application of tissue adhesive (2-octyl cyanoacrylate)
Published in Baylor University Medical Center Proceedings, 2021
Raymond P. Shupak, Sid Blackmore, Roderick Y. Kim
Skin adhesives are frequently used for wound closure. Advantages include added strength to wound closure, microbial barrier protection, and patient comfort, convenience, and cosmesis.1–3 One common skin adhesive available for use is 2-octyl cyanoacrylate (DermabondTM). Dermabond is indicated for closely approximated surgical skin wounds and cleansed traumatic lacerations.4 It is contraindicated in areas of infection and in mucosal surfaces/junctions of skin and mucosa, as well as in patients with a hypersensitivity to cyanoacrylate, formaldehyde, or benzalkonium.4 Typically, skin adhesives are generally very well tolerated; however, there have been rare reports of adverse reactions. Infection, hypersensitivity reactions, wound dehiscence, pruritus, and skin blistering are potential adverse side effects of its use. Skin reactions can present immediately or in a delayed fashion.5 This report describes two incidents of allergic hypersensitivity reaction to skin adhesive following topical application in head and neck surgery.