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Surgical Facilities, Peri-Operative Care, Anesthesia, and Surgical Techniques
Published in Yuehuei H. An, Richard J. Friedman, Animal Models in Orthopaedic Research, 2020
Alison C. Smith, M. Michael Swindle
Use of good surgical technique is critical to produce the minimal amount of tissue damage necessary to the procedure. Gentle tissue handling, meticulous hemostasis, and closure of dead space all contribute to minimizing the intensity and duration of the inflammatory response and preventing hematoma or seroma formation that favor bacterial growth. Incisional margins should be carefully apposed to avoid excessive tension which can create irritation postoperatively and result in self-mutilation. Suture material should be selected to minimize the inflammatory response, making synthetic absorbable suture materials preferable to catgut and silk. In species with an adequate amount of subcutaneous tissue, skin closure is best accomplished with a buried suture line using a subcuticular pattern. Monofilament nylon or stainless steel wound clips can be used for skin closure of rodents; however, rodents may succeed in chewing out sutures or staples if tissue irritation occurs. Routine wound care for many procedures usually only requires observation of the incisional area for normal healing. Veterinary surgical textbooks should be consulted for species-specific techniques and practices.16,25-29
Approach to one or more second-trimester painless abortions
Published in Minakshi Rohilla, Recurrent Pregnancy Loss and Adverse Natal Outcomes, 2020
Advantages and disadvantages of a particular suture material over another are not reported. The most commonly used sutures are braided Mersilene (Ethicon) tape and Prolene (Ethicon). Mesh can also be used, but there are no data comparing that with the traditional methods. Delayed absorbable sutures are better according to some surgeons, but this requires greater validation.
External Rhinoplasty
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Meticulous closure is imperative with slight eversion of the wound edges (Figure 82.2h). Authors have favoured both fine non-absorbable suture material (6/0 ethilon or prolene) although the use of a rapidly absorbable suture such as 6/0 Vicryl Rapide negates the need for suture removal, which can prove very uncomfortable. To prevent tension, it can be helpful to place an initial subcutaneous absorbable suture, although this is not usually necessary. Between five and nine fine sutures are then used to close the incision with attention importantly focused to the lateral edges of the columella where irregularities may be most visible. The vertical incisions along the vestibular edge are closed and a single suture to approximate the lateral marginal incision normally suffices.
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
A surgical suture is one of the most common medical devices used to sew body tissues together and stitch a wound closed during surgical procedures [1]. It typically provides the mechanical support necessary to maintain wound closure, control bleeding, and minimize the risk of infection until the wound is healed [2]. Alternatively, suture materials can also be used for other medical purposes, such as repairing damaged tissue, facial thread lifting [3], mesh fixation [4], and organ fixation [5]. Since no single suture material is suitable for all types of surgical procedures, there is a wide range of suture materials currently being used in clinical practice [6]. Suture materials can be categorized based on their origin (e.g. natural or synthetic), absorbability (e.g. absorbable or non-absorbable), structural configuration (e.g. monofilament or multifilament), or certain additional advanced techniques (e.g. antibacterial-coated or knotless barbed) [7–9]. Although an ever-increasing array of suture materials are now available, surgeons are still in need of novel ones with regard to the types and complexity of surgical procedures currently being performed [10]. For any novel (investigational) suture materials, clinical trials are a prerequisite prior to a market approval application.
Does Suture Material Affect Uterine Scar Healing After Cesarean Section? Results from a Randomized Controlled Trial
Published in Journal of Investigative Surgery, 2019
Alper Başbuğ, Ozan Doğan, Aşkı Ellibeş Kaya, Çiğdem Pulatoğlu, Mete Çağlar
A number of studies have been published that support the notion of surgical processes as a determinant CSD. However, these analyses fail to address the importance of scar healing in CSD development, in which suture materials are a main component. Historically, many materials have been used to heal scars due to traumas or surgeries, with modern surgeries typically relying on an array of advanced synthetic suture materials. The task of any suture material is to bring the wound lips together by positioning them face to face and to control bleeding from the wound. For this purpose, during cesarean section, multifilament sutures are preferred by 95% of obstetricians in general practice.23 Although the exact reasons behind this preference may vary, we suspect that the primary reason underlying a preference for multifilament suture materials is that they provide better hemostasis. In the CORONIS study, researchers found no difference in postpartum blood loss when catgut, a monofilament suture, was compared to glycolide-co-lactide (PG-910, Vicryl), a multifilament suture.24 Although we did observe significantly higher blood loss in the monofilament suture group, this loss was not enough to require blood transfusion. The exact relationship between monofilament sutures and blood loss remains uncertain, although the greater number of knotting throws, low tensile strength, and longer operation time with monofilament sutures does appear to be less beneficial for hemostasis.
Flap suturing endonasal dacryocystorhinostomy assisted by ultrasonic bone aspirator
Published in Acta Oto-Laryngologica, 2022
Hirohiko Tachino, Hiromasa Takakura, Hideo Shojaku, Michiro Fujisaka, Shinsuke Ito, Yutaro Oi, Anh Tram Do, Chiharu Fuchizawa, Tatsuya Yunoki, Atsushi Hayashi
After the bone was removed and the entire sac was exposed, the lacrimal endoscope was reinserted into the lacrimal sac to push on the medial wall of the sac. Endonasally, the tented lacrimal sac was incised vertically at the center of the exposed sac by a microsurgical knife. Then, the anterior flap between the lacrimal sac mucosa and nasal mucosa was first united by placing a suture at the upper and lower one fourth of the flaps (Figure 1(E)). The posterior flap was united in a similar manner by placing a suture at the upper and lower one fourth of the flaps. A bayonet-type micro needle holder Yasargil FD097R (B. Brown, Tuttlingen, Germany) was easiest to use when suturing with 6-0 PROLENE BV-1 (Ethicon, NJ, USA) in the confined working space. Both the nasal mucosal flap with the periosteum and the lacrimal sac flap were pierced with the suture needle, respectively. To tie the free ends of the suture, the surgical knot was made outside the nose and it was brought in with a Hope knot pusher KP001 (Hope Denshi Co., Chiba, Japan) (Figures 1(F,G) and 2). The suture was cut leaving 2–3 mm of suture material. Finally, a Lacrifast lacrimal intubation tube (Kaneka Medical Products, Osaka, Japan) was placed through the upper and lower puncta and retrieved endonasally (Figure 1(H)). Sorbusan alginate dressing (Alcare, Tokyo, Japan) was placed around the marsupialized lacrimal sac of the lateral nasal wall as packing material and was removed a few days after surgery. Eye drops with tosufloxacin and fluorometholone were administered for one week after surgery. We did not remove the suture after surgery. The lacrimal intubation tube was removed 4 weeks after the operation.