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Alar Base Surgery
Published in Suleyman Tas, Rhinoplasty in Practice, 2022
If no skin excision is required, then a bilateral small elliptical incision is made on the vestibular side of the alar groove, providing sufficient area to grip the alar base with a suture. 4/0 Polydioxanone should be used for this procedure because other permanent sutures may cause problems in the long term.
Third Stage Of Labor
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Alyssa R. Hersh, Jorge E. Tolosa
Absorbable synthetic materials should be used for all layers of the repair. Compared with catgut (plain or chromic), absorbable synthetic sutures (e.g. Vicryl) used for perineal repair decreased women’s experience of short-term (3-day) pain, less need for analgesia, reduced rate of suture dehiscence up to day 10, and less need for repeat suturing at <3 months. There is no significant difference in long-term pain or dyspareunia experienced by women [56]. More women with catgut sutures required repeat suturing compared with synthetic sutures, while more women in the standard synthetic suture group required suture removal compared with the rapidly absorbed group. Clinical experience has shown suture removal is necessary <5% of the time when using 3-0 or finer sutures and performing subcuticular skin closures [56]. Polyglactin (Vicryl) and polydioxanone (PDS) have similar outcomes [57].
Medical-Aesthetic Treatments in the Survivor Patient
Published in Paloma Tejero, Hernán Pinto, Aesthetic Treatments for the Oncology Patient, 2020
Absorbable threads (polydioxanone [PDO] or Polycaprolactone [PLC]): Patients should wait approximately 6 months after finishing treatments (1 year for those that generate a bigger tissue response such as a higher degree of inflammation that will require greater effort in recovering).
Synthetic biodegradable polyesters for implantable controlled-release devices
Published in Expert Opinion on Drug Delivery, 2022
Jinal U. Pothupitiya, Christy Zheng, W. Mark Saltzman
Polydioxanone (PDO) is a biodegradable polymer synthesized via ROP of p-dioxanone [161,162], which has long been used in FDA-approved products, such as sutures. The polymer material is reported to be nonantigenic, nonpyrogenic, and highly biocompatible. PDO is a semi-crystalline material with up to 55% crystallinity. It displays a Tg and Tm of −10-0°C and 110–115°C, respectively, and therefore can be extruded to different shapes at lower temperatures [162]. PDO degrades by hydrolysis, where the amorphous region degrades first followed by the crystalline region. The degraded monomers 2-hydroxy-ethoxy acetic acid (C4H8O4) are further broken down into water and carbon dioxide, which are excreted from the body via the respiratory and gastrointestinal tract and have been reported to be non-toxic [163]. There have been a handful of reports where PDO has been used as a drug delivery implant [33,164,165].
Loop-ileostomy reversal in a 23-h stay setting is safe with high patient satisfaction
Published in Scandinavian Journal of Gastroenterology, 2021
Kevin Afshari, Maziar Nikberg, Kenneth Smedh, Abbas Chabok
All operations were performed by either a general surgeon during subspecializing or a resident supervised by a consultant colorectal surgeon. All patients were operated under general anesthesia, with total intravenous analgesia. Loop-ileostomy closure was performed in a standardized manner using a circumstomal technique. The edges of both limbs were resected and the stoma was closed either with running sutures with absorbable monofilament (Biosyn®) 4–0 suture using a serosubmucosal technique or side-to-side anastomoses fashioned with a linear staple. The aponeurosis was closed using polydioxanone suture 0–0 (PDS). Before closing the skin, the wound was infiltrated with a local anesthetic (0.5% Marcain®). The skin was closed with non-absorbable monofilament (Ethilon®) 4–0 sutures a purse string suture. Patients were thereafter admitted to the postanesthesia care unit (PACU) for observation.
Benign biliary strictures treated with biodegradable stents in patients with surgically altered anatomy using double balloon enteroscopy
Published in Scandinavian Journal of Gastroenterology, 2020
Outi Lindström, Marianne Udd, Mia Rainio, Hannu Nuutinen, Kalle Jokelainen, Leena Kylänpää
In our cases, one patient had stent migration in 90 day follow up and needed second DBE-ERC with stenting (8.5 Fr plastic pigtail stent). However, this plastic stent migrated also in the follow up, so the migration problem could be more a biliary duct related than stent related. Interestingly, the migrated Archimedes stent had not degraded, and was found intact in the bowel after 12 weeks. With biodegradable stents some concern has been expressed about the stent degradation and potential foreign body reaction causing adverse hyperplasia, stone formation or restricturing of the duct, but the small human studies with polydioxanone stents have shown promising results about the safety [8]. Anderloni et al. has published a pilot study of Archimedes stents and their degradation times. In that study, the degradation time of slow degrading stents was controlled by abdominal radiograph in two time points, at 3 and 6 months, respectively. At 3 months, 32 of 35 (91.4%) slow degrading stents were found partially degraded, and at 6 months a complete degradation of the stents was found. Migration occurred in 3 of 35 (14.3%) of the stents placed for cholangitis. It was concluded that stent degradation time is reliable and consistent with expected times according to the manufacturer’s information [12]. We did not follow up the patients with MRCP or abdominal radiographs after discharging, so we can only assume that there were no other stent degrading related problems because no other procedures were needed.