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Single-layer continuous colon and rectal anastomosis using monofilament absorbable suture (Maxon®)
PURPOSE: The study purpose was to evaluate the results of continuous, single-layer colon and rectal anastomoses using a monofilament absorbable suture material (Maxon®). METHODS: Four hundred ninety-two consecutive patients undergoing five hundred colon and rectal anastomoses with the above technique were evaluated for outcome, including anastomotic leakage, stricture, and other complications, by means of chart review. RESULTS: Three patients (0.6
W. L. Law; H. Randolph Bailey; Ernest Max; Donald R. Butts; Kenneth W. Smith; David A. Thompson; Gary B. Skakun; Ernie Graves
Effectiveness of glycomer 631 monofilament sutures in closing musculoaponeurotic incisions.
The purpose of this study was to quantitate the effect of two monofilament synthetic absorbable sutures as well as a new monofilament synthetic absorbable suture, glycomer 631, in healing musculoaponeurotic incisions in rats. Because these three monofilament synthetic absorbable sutures provided secure closure of laparotomy incisions, their clinical use in laparotomy incisions is recommended. PMID:10186968
Rodeheaver, G T; Salopek, L S; Green, C W; Foresman, P A; Suber, F; Neal, J G; Edlich, R F
Prolene monofilament suture in Boston Keratoprosthesis surgery
Summary Toxic reaction to nylon following uncomplicated cataract surgery and vitrectomy has been documented in the literature. We report the case of an aniridic patient with a known adverse reaction to nylon in whom Prolene suture was used in Boston Keratoprosthesis type 1 (KPro) surgery. During follow-up the cornea was checked for signs of inflammation and toxic reaction; at last follow-up (18 months) the patient showed no signs of complications due to Prolene. Our study suggests that Prolene suture may be used as an alternative to nylon in Boston KPro surgery in patients with a history of nylon toxicity.
Kyrillos,, Ralph; Harissi-Dagher, Mona
Experimental evaluation of horse hair as a nonabsorbable monofilament suture
Background: Success of surgery depends on wound closure and healing. Ancients had coated many suture materials from plant and animal origin. As the quest for natural nonabsorbable, monofilament surgical suture continues, horsehair has been taken for study, which is mentioned in ancient literature. Objectives: Aim of the study was to evaluate detail mechanical and biophysical properties of horsehair. Materials and Methods: Physical properties, that are diameter, straight pull and knot pull tensile strength, bioburden, sterility tests were performed. Visual and histological wound healing parameters were studied in experimental Wistar rat incision wound model. Two experimental wounds about 5 cm long were created on each side of dorsal midline. Each animal received two sutures-Horsehair 4-0 and Ethilon 4-0. The sutured areas were grossly examined on 3rd and 7th days for visual observations like congestion, edema, infection, wound disruption, and impression of suture material on healed wound and then subjected for histological study. Results: Revealed that horsehair has got diameter of 0.19 mm which complies with the 4-0 size USP standard. Straight pull tensile strength was found 0.5851 ± 0.122 kg and knot pull tensile strength was 0.3998 ± 0.078 kg, which complies with the standards of United State Pharmacopia for class II nonabsorbable suture materials. In vivo study revealed that there was no evidence of edema, congestion, and discharge in both the groups. Wounds healed with minimum impressions of suture material with minimum scar mark. Mean histological scoring shows very mild tissue reaction. Conclusion: Horsehair has got properties of standard suture material except low tensile strength and hence can be used in reconstructive, plastic surgeries, and ophthalmic surgeries.
Yedke, Swati R.; Raut, Subhash Y.; Jangde, C. R.
Flexor Tenorrhaphy Using Absorbable Suture Materials
Background Nonabsorbable sutures are favorable for repairing flexor tendons. However, absorbable sutures have performed favorably in an animal model. Methods Two-strand sutures using the interlocking modified Kessler method with polydioxanone absorbable sutures 4-0 were used to repair completely ruptured flexor tendons in 55 fingers from 41 consecutive patients. The medical records of average 42 follow up weeks were analyzed retrospectively. The data analyzed using the chi-squared test, and Fisher's exact test was used for postoperative complications. The results were compared with those of other studies. Results Among the index, middle, ring, and little fingers were injured in 9, 17, 16, and 13 fingers, respectively. The injury levels varied from zone 1 to 5. Of the 55 digits in our study, there were 26 (47%) isolated flexor digitorum profundus (FDP) injuries and 29 (53%) combined FDP and with flexor digitorum superficialis injuries. Pulley repair was also conducted. Concomitant injuries of blood vessels and nerves were found in 17 patients (23 fingers); nerve injuries occurred in 5 patients (10 fingers). Two patients had ruptures (3.6%), and one patient had two adhesions (3.6%). Using the original Strickland criteria, all the patients were assessed to be excellent or good. Also, fibrosis and long-term foreign body tissue reactions such as stitch granuloma were less likely occurred in our study. Compared to the Cullen's report that used nonabsorbable sutures, there was no significant difference in the rupture or adhesion rates. Conclusions Therefore, this study suggests that appropriate absorbable core sutures can be used safely for flexor tendon repairs.
Kang, Hyung Joo; Kim, Jin Soo; Ki, Sae Hwi; Roh, Si Young; Yang, Jae Won
Long-term corneal astigmatism related to selected elastic, monofilament, nonabsorbable sutures.
The long-term decay of surgically induced corneal astigmatism following planned extracapsular cataract extraction has been studied in 395 patients who had limbal or scleral pocket incisions of 60 to 140 degrees. Limbal incisions were closed with a full-thickness shoelace closure; scleral pocket incisions, with a new, modified shoelace closure. Suture material was 10-0 nylon, 9-0 nylon, 10-0 polypropylene (Prolene), and 10-0 polyester (Mersilene). The nylon sutures demonstrated clinically significant hydrolysis beginning at five months (10-0) and 12 months (9-0). Because of the adverse hydrolytic effects, 10-0 nylon was eliminated from the scleral pocket closure group. The hydrolysis of 9-0 nylon caused excessive late astigmatic changes in patients who did not heal normally. Prolene and Mersilene showed no tendency toward hydrolysis; however, the elasticity of Prolene produced more against-the-rule change in astigmatism than desired even though it was stable over the long run. I stopped using nylon sutures in cataract (and keratoplasty) wound closures and switched to routine use of Mersilene. PMID:2646431
Cravy, T V
Interrupted or continuous slowly absorbable sutures - Design of a multi-centre randomised trial to evaluate abdominal closure techniques INSECT-Trial [ISRCTN24023541
Background The closure of the abdomen after median laparotomy is still a matter of debate among surgeons. Further well designed and performed randomised controlled trials determining the optimal method of abdominal fascial closure are needed. Design This is a three armed, multi-centre, intra-operatively randomised, controlled, patient blinded trial. Over 20 surgical departments will enrol 600 patients who are planned for an elective primary abdominal operation. The objective of this study is to compare the frequency of abdominal incisional hernias between two continuous suture techniques with different, slowly absorbable monofilament materials and an interrupted suture using an absorbable braided suture material at one year postoperatively. Conclusion This trial will answer the question whether the continuous abdominal wall closure with a slowly absorbable material with longitudinal elasticity is superior to the continuous suture with a material lacking elasticity and to interrupted sutures with braided thread.
Knaebel, Hanns-Peter; Koch, Moritz; Sauerland, Stefan; Diener, Markus K; Buchler, Markus W; Seiler, Christoph M
The influence of absorbable subcuticular staples, continuous subcuticular absorbable suture, and percutaneous metal skin staples on infection in contaminated wounds.
Wound infection is a threatening, troublesome, and costly complication contributing to increased mortality and morbidity. The methods and materials used to close a wound significantly influence the quality of the repair process and the risk of surgical site infection. Six pigs were used to evaluate the influence of four separate skin-closure modalities on the potentiation of infection in contaminated wounds. Full-thickness skin wounds on the abdomen were contaminated with S. aureus and then closed with one of four devices: a novel absorbable staple (InsorbTM) placed in the subcuticular tissue; a braided absorbable suture (VicrylTM); a monofilament absorbable suture (MonocrylTM); percutaneous metal staples. Wound infection was assessed 7 days after closure by clinical signs and quantitative bacterial swabs. InsorbTM staples had significantly lower infection rates than continuous VicrylTM (39% vs. 100%, p=0.002) or MonocrylTM suture (39% vs. 89%, p=0.014). The InsorbTM subcuticular staple and the metal percutaneous skin staple were statistically equivalent in wound infection rate and parameters of inflammation. The combined data for both interrupted staple modalities documented less inflammation compared to the combined data for continuous sutures. These lower levels of inflammatory metrics were statistically significant for edema (p=0.018), gauze exudate observed (p=0.007) and purulent exudate in wound (p<0.0001). In conclusion, InsorbTM staples were shown to be an acceptable choice for the closure of contaminated wounds because they had a significantly lower incidence of wound infection and inflammation when compared to continuous intradermal suture. PMID:23428250
Pineros-Fernandez, Angela; Salopek, Lisa S; Rodeheaver, Pamela F; Rodeheaver, George
21 CFR 878.4830 - Absorbable surgical gut suture.
Code of Federal Regulations, 2013 CFR
... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4830 Absorbable surgical gut suture. (a) Identification. An...
Copolymers of 1,5-Dioxepan-2-one and Glycolide as Absorbable Monofilaments
This is a study of the synthesis of absorbable fiber-forming copolymers based on the components of a traditionally absorbable, crystalline fiber-forming and a relatively new liquid slow-absorbing polymer. The copolymers of glycolide (GLY) and 1,5-dioxepan-2-one (DXO) were prepared and characterized. The properties of the fibers made therefrom were assessed for their biological ap plication as absorbable materials.
Adel Kafrawy; Shalaby W. Shalaby
21 CFR 878.4494 - Absorbable poly(hydroxybutyrate) surgical suture produced by recombinant DNA technology.
Code of Federal Regulations, 2013 CFR
...FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4494 Absorbable poly(hydroxybutyrate) surgical suture produced by recombinant...
21 CFR 878.4493 - Absorbable poly(glycolide/l-lactide) surgical suture.
Code of Federal Regulations, 2013 CFR
... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4493 Absorbable poly(glycolide/l -lactide) surgical suture. (a)...
A ganglion cyst generated by non-absorbable meniscal repair suture material.
Arthroscopic meniscal repair has been a common procedure for the treatment of a torn meniscus, since the importance of meniscal preservation is widely understood. Over the years, the complications associated with suture material have been reported. Meniscal cyst is also one of those things. But ganglion cyst triggered by non-absorbable suture material was not documented in the literature. We report the case of a 19-year-old boy who underwent arthroscopic ACL reconstruction and repair of the medial meniscus by inside-out technique using 2-0 non-absorbable polyester sutures. The patient returned to our clinic at 4-year F/U with right knee pain due to medial meniscus tear and ganglion cyst. We suspect non-absorbable suture materials itself might have caused soft tissue irritation with repetitive trauma that lead to mucoid degeneration which results in ganglion cyst formation in the end. PMID:22858108
Kang, H J; Chun, C H; Kim, S H; Kim, K M
Evaluation of tensile strength of surgical synthetic absorbable suture materials: an in vitro study
Purpose The purpose of this study was to evaluate the tensile strength of surgical synthetic absorbable sutures over a period of 14 days under simulated oral conditions. Methods Three suture materials (polyglycolic acid [PGA], polyglactin [PG] 910, and poly (glycolide-co-?-caprolactone) [PGC]) were used in 4-0 and 5-0 gauges. 210 suture samples (35 of each material and gauge) were used. All of the samples were tested preimmersion and 1 hour and 1, 3, 7, 10, and 14 days postimmersion. The tensile strength of each suture material and gauge was assessed. The point of breakage and the resorption pattern of the sutures were also assessed. Results During the first 24 hours of immersion, all 4-0 and 5-0 samples of PGA, PG 910, and PGC maintained their initial tensile strength. At baseline (preimmersion), there was a statistically significant (P<0.001) difference in the tensile strengths between the 4-0 and 5-0 gauge of PGA, PG 910, and PGC. PGA 4-0 showed the highest tensile strength until day 10. At 7 days, all the 4-0 sutures of the three materials had maintained their tensile strength with PGA 4-0 having significantly greater (P=0.003) tensile strength compared to PG. Conclusions 4-0 sutures are stronger and have greater tensile strength than 5-0 sutures. The PGA 4-0 suture showed the highest tensile strength at the end of day 10.
Ranganath, V.; Nichani, Ashish Sham
Arthroscopic absorbable suture fixation for tibial spine fractures.
The purpose of this technical note and accompanying video is to describe a modified arthroscopic suture fixation technique to treat tibial spine avulsion fractures. Twenty-one patients underwent arthroscopic treatment for tibial spine avulsion with our technique; they were clinically and biomechanically evaluated at 2 years' follow-up and showed optimal clinical and radiographic outcomes. Repair with this arthroscopic technique provides a significant advantage in the treatment of type III and IV fractures of the tibial eminence by obtaining arthroscopic fixation within the substance of the anterior cruciate ligament: suture methods based on the avulsed bone fragment are technically impossible, but sutures through the base of the ligament itself provide secure fixation, reducing the risks of comminution of the fracture fragment and eliminating the time for hardware removal. This arthroscopic technique restores the length and the integrity of the anterior cruciate ligament and provides a simplified, reproducible method of treating patients, including young patients, with low hardware costs in comparison to sutures using anchors or other hardware. PMID:24749022
Verdano, Michele Arcangelo; Pellegrini, Andrea; Lunini, Enricomaria; Tonino, Pietro; Ceccarelli, Francesco
Arthroscopic Absorbable Suture Fixation for Tibial Spine Fractures
The purpose of this technical note and accompanying video is to describe a modified arthroscopic suture fixation technique to treat tibial spine avulsion fractures. Twenty-one patients underwent arthroscopic treatment for tibial spine avulsion with our technique; they were clinically and biomechanically evaluated at 2 years' follow-up and showed optimal clinical and radiographic outcomes. Repair with this arthroscopic technique provides a significant advantage in the treatment of type III and IV fractures of the tibial eminence by obtaining arthroscopic fixation within the substance of the anterior cruciate ligament: suture methods based on the avulsed bone fragment are technically impossible, but sutures through the base of the ligament itself provide secure fixation, reducing the risks of comminution of the fracture fragment and eliminating the time for hardware removal. This arthroscopic technique restores the length and the integrity of the anterior cruciate ligament and provides a simplified, reproducible method of treating patients, including young patients, with low hardware costs in comparison to sutures using anchors or other hardware.
Verdano, Michele Arcangelo; Pellegrini, Andrea; Lunini, Enricomaria; Tonino, Pietro; Ceccarelli, Francesco
Quantitative evaluation of stiffness of commercial suture materials.
The bending stiffness of 22 commercial suture materials of varying size, chemical structure and physical form was quantitatively evaluated using a stiffness tester (Taber V-5, model 150B, Teledyne). The commercial sutures were Chromic catgut; Dexon (polyglycolic acid); Vicryl (polyglactin 910); PDS (polydioxanone); Maxon (polyglycolide-trimethylene carbonate); Silk (coated with silicone); Mersilene (polyester fiber); Tycron (polyester fiber); Ethibond (polyethylene terephthalate coated with polybutylene); Nurolon (nylon 66); Surgilon (nylon 66 coated with silicone); Ethilon (coated nylon 66), Prolene (polypropylene); Dermalene (polyethylene), and Gore-tex (polytetraflouroethylene). These are both natural and synthetic, absorbable and nonabsorbable and monofilament and multifilament sutures. All of these sutures were size 2-0, but Prolene sutures with sizes ranging from 1-0 to 9-0 were also tested to determine the effect of suture size on stiffness. The bending stiffness data obtained showed that a wide range of bending stiffness was observed among the 22 commercial sutures. The most flexible 2-0 suture was Gore-tex, followed by Dexon, Silk, Surgilon, Vicryl (uncoated), Tycron, Nurolon, Mersilene, Ethibond, Maxon, PDS, Ethilon, Prolene, Chromic catgut, coated Vicryl, and lastly, Dermalene. The large porous volume inherent in Gore-tex monofilament suture was the reason for its lowest flexural stiffness. Sutures with a braided structure were generally more flexible than those of a monofilament structure, irrespective of the chemical constituents. Coated sutures had significantly higher stiffness than the corresponding uncoated ones. This is particularly true when polymers rather than wax were used as the coating material. This increase in stiffness is attributable to the loss of mobility under bending force in the fibers and yarns that make up the sutures. An increase in the size of the suture significantly increased the stiffness, and the magnitude of increase depended on the chemical constituent of the suture. The flexural stiffness of sutures was also found to depend on the duration of bending in the test for stiffness. In general, monofilament sutures exhibited the largest time-dependent stiffness. This was most pronounced with the Gore-tex suture. Most braided sutures also showed less time-dependence in stiffness. Nylon sutures did not exhibit this time-dependent phenomenon regardless of physical form. PMID:2919353
Chu, C C; Kizil, Z
A randomised controlled trial of absorbable versus non-absorbable sutures for skin closure after open carpal tunnel release.
We compared the aesthetic outcome of scars after closure of open carpal tunnel incisions with either absorbable 4-0 Vicryl Rapide or non-absorbable 4-0 Novafil. Patients were recruited in a randomized controlled trial and scars were scored at 6 weeks using a modified Patient and Observer Scar Assessment Scale. Scores demonstrated differences only for pain, vascularity and cross-hatching between both groups, though none of these were statistically significant. The dissolving and falling out of Vicryl Rapide was significantly more comfortable than removal of 4-0 Novafil sutures, assessed on a numerical analogue scale. There was no difference in infection rate between both study groups, supporting overall the use of Vicryl Rapide for the closure of palmar hand incisions, in light of the convenience and cost savings associated with absorbable sutures. PMID:21987279
Theopold, C; Potter, S; Dempsey, M; O'Shaughnessy, M
21 CFR 878.4840 - Absorbable polydioxanone surgical suture.
Code of Federal Regulations, 2013 CFR
...SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4840 Absorbable polydioxanone...cardiovascular tissue where growth is expected to occur, and ophthalmic surgery. It may be coated or uncoated, undyed or dyed, and...
Comparison of tensile and knot security properties of surgical sutures.
Sutures are classified into non-absorbable and absorbable, and mechanical properties of these materials vary by the composition. Knotting induces decrease in mechanical properties. The objective of this study was to measure the tensile and knot security properties depending on the type and caliber of sutures. Changes in properties after tensile loading were measured with absorbable sutures. Tensile properties such as maximum tensile load, elongation rate, stiffness and energy absorbed before breakage of seven kinds of surgical sutures were measured. Absorbable sutures were immersed in 37 degrees C Hank's balanced salt solution up to 14 days under the tensile load of 100 g/thread, and properties were measured again. Knot was formed with surgeon's knot method, and tensile properties were measured. Five specimens were tested for each condition. Values were analyzed with one- or two-way analysis of variance (alpha = 0.05). Maximum tensile load of seven sutures (caliber = 4-0) ranged from 10.0 N to 14.3 N. In non-absorbable sutures, the type of suture material influenced the tensile properties (P < 0.05). In absorbable sutures, the maximum tensile load after tensile loading decreased, which was significant in chromic catgut (CC). Knot security of seven sutures (caliber = 4-0) ranged from 8.7 N to 11.9 N. Type of non-absorbable suture influenced knot security (P < 0.05), and the synthetic monofilament materials showed a tendency to be untied easily. Since no single suture material possesses all of the requirements, proper type and caliber suture should be selected based on this study. PMID:17569012
Kim, Jin-Cheol; Lee, Yong-Keun; Lim, Bum-Soon; Rhee, Sang-Hoon; Yang, Hyeong-Cheol
Open Reduction of Proximal Interphalangeal Fracture-Dislocation through a Midlateral Incision Using Absorbable Suture Materials
Background Fracture-dislocation of the proximal interphalangeal (PIP) joint is a relatively common injury. Various treatments for fracture-dislocation of the PIP joint have been reported. In the present study, we performed open reduction through a midlateral incision using absorbable sutures to reduce the small bone fragments and performed volar plate repair. Methods We treated nine patients with fracture-dislocation of the PIP joint with small fractured bone fragments too small for pinning or screw fixation. Patients with volar plate injury were treated with open reduction and volar plate repair at the periosteum of the middle phalangeal bone base by the modified Kessler method using absorbable sutures. All patients were placed in a dorsal aluminum extension block splint, which maintained the PIP joint in approximately 30 degrees of flexion to avoid excessive tension on the sutured volar plate. Results At a mean final follow-up of postoperative 9 months, all patients were evaluated radiographically and had adequate alignment of the PIP joint and reduction of the displaced bone fragments. Range of motion was improved and there were no complications. Conclusions This technique is an excellent alternative to the current method of treating patients with fracture-dislocations that include small fragments that are too small for pinning or screw fixation. It is a less invasive surgical method and enables stable reduction and early exercise without noticeable complications.
Lee, Jae Jun; Choi, Hyun Gon; Shin, Dong Hyeok; Uhm, Ki Il
Ureteral pseudodiverticulum associated with absorbable suture clips after laparoscopic pyeloplasty: case report.
A 48 year-old woman with pyelonephritis was found to have bilateral ureteropelvic junction (UPJ) obstruction and a nonfunctioning right kidney. She initially underwent a laparoscopic left nondismembered pyeloplasty using absorbable polydioxanone Lapra-Ty suture clips (Ethicon Endosurgery, Cincinnati, OH) to secure the anastomosis. An antegrade endopyelotomy was later necessitated. Both procedures were complicated by postoperative bacteruria and funguria. She then underwent a laparoscopic dismembered pyeloplasty, again utilizing Lapra-Ty suture clips to secure the anastomosis. Postoperatively, her course was complicated by anastomotic extravasation, bacteriuria, and funguria. Subsequently, an antegrade nephrostogram revealed a 2.5-cm diverticulum just distal to the UPJ, which contained numerous 2- to 4-mm filling defects. Nephroscopic exploration of the pseudodiverticulum revealed numerous Lapra-Ty clips, which were basket extracted. The pseudodiverticulum was fulgurated with a holmium laser. She eventually had restricturing with recurrence of the pseudodiverticulum and was treated successfully by open ureterocalicostomy. PMID:16053365
Finley, David S; Perer, Elise; Eichel, Louis; Clayman, Ralph V
A muscle-clamping system with an absorbable jaw clip to reduce suturing in strabismus surgery.
Most of the ocular complications of strabismus surgery are related to needle trauma during the suturing of muscles. The authors have developed a muscle-clamping system with an absorbable jaw clip to facilitate exact techniques of eye muscle surgery and to reduce the risk of complications. The absorbable jaw clip is composed of a lower fixing body with three jaws and an upper supporting body. The clip is used to tie an extraocular muscle (which is moved and reattached with the membrane) with a single scleral bite. Using the absorbable jaw clip, the authors performed superior rectus recession on 16 eyes of eight rabbits. The authors examined the conjunctival injection, muscle adhesion power, and light microscopic findings at 1, 2, 4, and 8 weeks postoperatively. The conjunctival injection diminished with time. Bond strengths ranged from 380 to 620 gram gravity, which is sufficient to withstand the normal pull of human extraocular muscles. Some inflammatory cells were found microscopically, and fibrosis increased with time. The muscle-clamping method with the newly invented clip was technically easy, fast, and exact, and it may reduce suturing and complications during strabismus surgery. PMID:9507262
Min, B M; Kim, S Y; Yang, J M
Soft tissue reconstruction in the shoulder. Comparison of suture anchors, absorbable staples, and absorbable tacks.
We evaluated three mechanical soft tissue fixation devices (SuperAnchor, Suretac, and the Instrument Makar [IM] Bioabsorbable Staple) in a cadaveric model by examining ultimate tensile failure and modes of failure in simulated Bankart repairs. We attempted to realistically evaluate the strengths of soft tissue reattachment procedures at the anterior glenoid under worst-case conditions--load to failure. Twenty fresh-frozen cadaveric shoulders were used in this investigation. Each of the three techniques was performed in each anterior glenoid rim at one of three locations: superior, middle, or inferior. The subscapularis muscle-tendon was harvested, used in the repair, and loaded to failure. The mean load at failure for the SuperAnchor was 217.32 N; for the IM Staple, 132.32 N; and for the Suretac, 122.37 N. A two-sample t-test demonstrated that the load at failure for the SuperAnchor was statistically greater (P < 0.001) when compared with the IM Staple and Suretac. There was no statistical difference between load at failure for the Suretac and the IM Staple. The most common failure mode for the Mitek was suture breakage (71%). Anchor pullout from bone was the most common failure mode for the IM Staple (75%) and Suretac (94%). PMID:7810799
Shall, L M; Cawley, P W
21 CFR 878.4494 - Absorbable poly(hydroxybutyrate) surgical suture produced by recombinant DNA technology.
Comparison of absorbable and nonabsorbable sutures for intradermal skin closure in cats
Paired skin incisions were made in 6 cats and closed intradermally with the copolymer of glycolide, ?-caprolacton, and trimethylene-carbonate, or polypropylene suture. The macroscopic and histologic appearance of the incisions was compared. Polypropylene suture compared favorably to glycolide, ?-caprolacton, and trimethylene-carbonate suture for closure of skin incisions in cats.
Papazoglou, Lysimachos G.; Tsioli, Vassiliki; Papaioannou, Nikolaos; Georgiadis, Marios; Savvas, Ioannis; Prassinos, Nikitas; Kouti, Vasileia; Bikiaris, Dimitrios; Hadzigiannakis, Christos; Zavros, Nikolaos
Quality of Scar after Total Thyroidectomy: A Single Blinded Randomized Trial Comparing Octyl-Cyanoacrylate and Subcuticular Absorbable Suture
Objective. To compare the quality of resulting scar at 6 weeks after total thyroidectomy with the use of the tissue adhesive octyl-cyanoacrylate or subcuticular absorbable suture for the closure of cervicotomy. Material and Methods. There are 50 patients undergoing a cervicotomy for total thyroidectomy. Twenty-five patients were randomly assigned to closure with tissue adhesive and 25 with subcuticular absorbable suture. At week 6 the scar was evaluated by blinded assessors with the Italian version of POSAS questionnaire, a validated wound scale composed of an observer's and a patient's subscale. Results. Assessment of scar appearance showed a statistically significant difference (p = 0.?038) in favor of subcuticular suture with respect to tissue adhesive on observer's assessment. The difference on patients' self-assessment was not significant. A multivariate analysis of six qualitative features of scars showed a significant influence on assessment for hyperpigmentation and relief of scar. The Italian version of POSAS proved to be reliable. Conclusion. Though tissue adhesive represents a valid method of skin closure, subcuticular absorbable suture provides a better aesthetic outcome in small cervical incisions in the early phase after thyroid surgery.
Mancuso, Rosaria; Piccolo, Annalisa; Pretore, Eugenio; Antonaci, Alfredo
Microbiology of Explanted Suture Segments from Infected and Noninfected Surgical Patients
Sutures under selective host/environmental factors can potentiate postoperative surgical site infection (SSI). The present investigation characterized microbial recovery and biofilm formation from explanted absorbable (AB) and nonabsorbable (NAB) sutures from infected and noninfected sites. AB and NAB sutures were harvested from noninfected (70.9%) and infected (29.1%) sites in 158 patients. At explantation, devices were sonicated and processed for qualitative/quantitative bacteriology; selective sutures were processed for scanning electron microscopy (SEM). Bacteria were recovered from 85 (53.8%) explanted sites; 39 sites were noninfected, and 46 were infected. Suture recovery ranged from 11.1 to 574.6 days postinsertion. A significant difference in mean microbial recovery between noninfected (1.2 isolates) and infected (2.7 isolates) devices (P < 0.05) was noted. Staphylococcus epidermidis, Staphylococcus aureus, coagulase-negative staphylococci (CNS), Peptostreptococcus spp., Bacteroides fragilis, Escherichia coli, Enterococcus spp., Pseudomonas aeruginosa, and Serratia spp. were recovered from infected devices, while commensal skin flora was recovered from noninfected devices. No significant difference in quantitative microbial recovery between infected monofilament and multifilament sutures was noted. Biofilm was present in 100% and 66.6% of infected and noninfected devices, respectively (P < 0.042). We conclude that both monofilament and braided sutures provide a hospitable surface for microbial adherence: (i) a significant difference in microbial recovery from infected and noninfected sutures was noted, (ii) infected sutures harbored a mixed flora, including multidrug-resistant health care-associated pathogens, and (iii) a significant difference in the presence or absence of a biofilm in infected versus noninfected explanted devices was noted. Further studies to document the benefit of focused risk reduction strategies to minimize suture contamination and biofilm formation postimplantation are warranted.
Krepel, Candace J.; Marks, Richard M.; Rossi, Peter J.; Sanger, James; Goldblatt, Matthew; Graham, Mary Beth; Rothenburger, Stephen; Collier, John; Seabrook, Gary R.
Comparison of Piezoresistive Monofilament Polymer Sensors
The development of flexible polymer monofilament fiber strain sensors have many applications in both wearable computing (clothing, gloves, etc.) and robotics design (large deformation control). For example, a high-stretch monofilament sensor could be integrated into robotic arm design, easily stretching over joints or along curved surfaces. As a monofilament, the sensor can be woven into or integrated with textiles for position or physiological monitoring, computer interface control, etc. Commercially available conductive polymer monofilament sensors were tested alongside monofilaments produced from carbon black (CB) mixed with a thermo-plastic elastomer (TPE) and extruded in different diameters. It was found that signal strength, drift, and precision characteristics were better with a 0.3 mm diameter CB/TPE monofilament than thick (?2 mm diameter) based on the same material or commercial monofilaments based on natural rubber or silicone elastomer (SE) matrices.
Melnykowycz, Mark; Koll, Birgit; Scharf, Dagobert; Clemens, Frank
Comparison of piezoresistive monofilament polymer sensors.
The development of flexible polymer monofilament fiber strain sensors have many applications in both wearable computing (clothing, gloves, etc.) and robotics design (large deformation control). For example, a high-stretch monofilament sensor could be integrated into robotic arm design, easily stretching over joints or along curved surfaces. As a monofilament, the sensor can be woven into or integrated with textiles for position or physiological monitoring, computer interface control, etc. Commercially available conductive polymer monofilament sensors were tested alongside monofilaments produced from carbon black (CB) mixed with a thermo-plastic elastomer (TPE) and extruded in different diameters. It was found that signal strength, drift, and precision characteristics were better with a 0.3 mm diameter CB/TPE monofilament than thick (~2 mm diameter) based on the same material or commercial monofilaments based on natural rubber or silicone elastomer (SE) matrices. PMID:24419161
Melnykowycz, Mark; Koll, Birgit; Scharf, Dagobert; Clemens, Frank
Reduction of skin closure time without loss of healing quality: a multicenter prospective study in 100 patients comparing the use of Insorb absorbable staples with absorbable thread for dermal suture.
The authors report the results of a multicenter prospective study evaluating a novel technology: dermal suture using absorbable staples composed of polylactic and polyglycolic acids. From January to June 2009, 59 dermal sutures were performed with Insorb absorbable staples and 41 with absorbable thread. All patients in the study underwent abdominal dermolipectomy (N = 65) or surgery for breast hypertrophy (N = 35). The purpose of the study was to compare the closure time and healing quality obtained with the 2 methods. Ninety-five patients were reexamined by the surgeon after 1 year of follow-up to assess scar width, suppleness, inflammation, and hypertrophy. The overall results were good and quite similar for the 2 groups. Thus, the use of Insorb staples reduced closure time while ensuring good healing quality. PMID:22589018
Duteille, Franck; Rouif, Michel; Alfandari, Bruno; Andreoletti, Jean-Baptiste; Sinna, Raphael; Laurent, Bruno; Perrot, Pierre
Novafil. A dynamic suture for wound closure.
Abdominal wound dehiscence was quantitatively studied in a rat model. Polybutester suture is a new monofilament nonabsorbable suture that has unique stress-strain properties that are potentially beneficial for abdominal wound closure. The abdominal volume at the moment of wound dehiscence was correlated with the extensibility of the suture material used for closure. Interrupted sutures of polybutester cut through the tissues at a mean abdominal volume of 212 +/- 3 ml. This volume was significantly (p less than or equal to 0.005) greater than the mean volumes reached with nylon (197 +/- 3 ml) or polyglycolic acid (187 +/- 4 ml). Closure of abdomens with continuous polybutester suture resulted in a mean rupture volume of 218 +/- 3 ml, which was significantly (p less than or equal to 0.005) greater than that achieved with the same suture employed as simple interrupted sutures (212 +/- 4 ml). The influence of width of tissue bite, suture size, and needle configuration was also evaluated.
Rodeheaver, G T; Nesbit, W S; Edlich, R F
Effect of suture material and construction on frictional properties of sutures.
The results overwhelmingly support the view that the coefficient of friction is not a material constant of the sutures but a function of several variables, including applied tension, suture construction and suture material. The coefficient of friction decreased with an increase in applied tension with the rate of change depending upon the suture material. Prolene and Ethilon had the highest frictional values among all sutures at low tension, but dropped to a position of lowest values at high tension. On an average, braided sutures gave higher frictional values than did the monofilament sutures. Sutures with special surface coatings (silicone or Teflon) generally gave lower values than did the sutures without any such coatings. Similar results were reported in other studies on coated materials. The differences in frictional profiles are governed by the differences in the viscoelastic nature of the suture materials. The unusual traces produced by Prolene were considered as being due to its high degree of stretch and elasticity. Others similarly found that Prolene behaved peculiarly due to a high degree of stretch. Finally, coefficient of friction is an important property of suture materials as it is expected to have a direct bearing on the security of knots. A careful study of this parameter under a variety of clinical conditions is essential to gain an understanding of the behavior of surgical knots in clinical practice. The present study gives detailed information on the frictional behavior of various types of surgical suture materials. PMID:4012537
Gupta, B S; Wolf, K W; Postlethwait, R W
Does UV disinfection compromise sutures? An evaluation of tissue response and suture retention in salmon surgically implanted with transmitters
Ultraviolet radiation (UVR) can be used as a tool to disinfect surgery tools used for implanting transmitters into fish. However, the use of UVR could possibly degrade monofilament suture material used to close surgical incisions. This research examined the effect of UVR on monofilament sutures to determine if they were compromised and negatively influenced tag and suture retention, incision openness, or tissue reaction. Eighty juvenile Chinook salmon Oncorhynchus tshawytscha were surgically implanted with an acoustic transmitter and a passive integrated transponder. The incision was closed with a single stitch of either a suture exposed to 20 doses of UV radiation (5 minute duration per dose) or a new, sterile suture. Fish were then held for 28 d and examined under a microscope at day 7, 14, 21 and 28 for incision openness, ulceration, redness, and the presence of water mold. There was no significant difference between treatments for incision openness, redness, ulceration or the presence of water mold on any examination day. On day 28 post-surgery, there were no lost sutures; however, 2 fish lost their transmitters (one from each treatment). The results of this study do not show any differences in negative influences such as tissue response, suture retention or tag retention between a new sterile suture and a suture disinfected with UVR.
Walker, Ricardo W.; Brown, Richard S.; Deters, Katherine A.; Eppard, M. B.; Cooke, Steven J.
Large-diameter carbon-composite monofilaments. [production method and characteristics of carbon composite monofilaments
NASA Technical Reports Server (NTRS)
Large-diameter carbon composite monofilaments with high strength and high modulus were produced by pregging multifiber carbon bundles with suitable organic resins and pyrolysing them together. Two approaches were developed to increase the utilization of fiber tensile strength by minimizing stress concentration defects induced by dissimilar shrinkage during pyrolysis. These were matrix modification to improve char yield and strain-to-failure and fiber-matrix copyrolysis to alleviate matrix cracking. Highest tensile strength and modulus were obtained by heat treatments to 2873 K to match fiber and matrix strain-to-failure and develop maximum monofilament tensile-strength and elastic modulus.
Bradshaw, W. G.; Pinoli, P. C.; Karlak, R. F.
Suturing principles for the dentoalveolar surgeon.
Dentists should be aware of the characteristics of suture material, and the technique used should provide effectiveness and ease. Dentists who routinely perform dentoalveolar surgery should have at least 1 type of absorbable and 1 type of nonabsorbable suture readily available within their operatory supply. This article focuses on the physical properties of suture materials and their tissue reactivity, and it reviews various suturing techniques used in contemporary dentoalveolar surgery. Familiarity with the concepts presented in this article, and continuous practice of the surgical skills presented, enhances surgical acumen and allows for improved healing, increased postoperative comfort, and successful surgery. PMID:22117956
Brandt, M Todd; Jenkins, W Scott
Additional development of large diameter carbon monofilament. [from boron, hydrogen, and methane gas mixture
NASA Technical Reports Server (NTRS)
The chemical vapor process for preparing a large diameter carbon-base monofilament from a BCl3, Ch4 and H2 gas mixture with a carbon substrate fiber was studied. The effect of reactor geometry, total gas flows and deposition temperature on the tensile strength of the monofilament were investigated. It was noted that consistent results could only be obtained when the carbon substrate fiber was cleaned. The strength of the monofilament was found to depend on the highest temperature and the temperature profile of the monofilament in the reactor. The strength of monofilament produced in the dc and RF reactors were found to be similar and similar alloy compositions in the monofilament were attained when the same gas ratios were used. The tensile strength of the monofilament at 500 C was found to be 60 to 70% of the room temperature tensile strength. No degradation was noted after exposure to molten aluminum.
Jacob, B. A.; Veltri, R. D.
Further development of chemical vapor deposition process for production of large diameter carbon-base monofilaments
NASA Technical Reports Server (NTRS)
The development of large diameter carbon-base monofilament in the 50 micron to 250 micron diameter range using the chemical vapor deposition process is described. The object of this program was to determine the critical process variables which control monofilament strength, monofilament modulus, and monofilament diameter. It was confirmed that wide scatter in the carbon substrate strength is primarily responsible for the scatter in the monofilament strength. It was also shown through etching experiments that defective substrate surface conditions which can induce low strength modular growth in the monofilament layers are best controlled by processing improvements during the synthesis of the substrate. Modulus was found to be linearily proportional to monofilament boron content. Filament modulus was increased to above 27.8MN/sq cm but only by a considerable increase in monofilament boron content to 60 wt. % or more. Monofilament diameter depended upon dwell time in the synthesis apparatus. A monofilament was prepared using these findings which had the combined properties of a mean U.T.S. of 398,000 N/sq cm, a modulus of 18.9 MN/sq cm (24,000,000 psi), and a diameter of 145 microns. Highest measured strength for this fiber was 451,000 N/sq cm (645,000 psi).
Hough, R. L.; Richmond, R. D.
A microsurgical procedure for middle cerebral artery occlusion by intraluminal monofilament insertion technique in the rat: a special emphasis on the methodology
Introduction Although there are many experimental studies describing the methodology of the middle cerebral artery occlusion (MCAO) in the literature, only limited data on these distinct anatomical structures and the details of the surgical procedure in a step by step manner. The aim of the present study simply is to examine the surgical anatomy of MCAO model and its modifications in the rat. Materials and methods Forty Sprague-Dawley rats were used; 20 during the training phase and 20 for the main study. The monofilament sutures were prepared as described in the literature. All surgical steps of the study were performed under the operating microscope, including insertion of monofilament into middle cerebral artery through the internal carotid artery. Results After an extensive training period, we lost two rats in four weeks. The effects of MCAO were confirmed by the evidence of severe motor deficit during the recovery period, and histopathological findings of infarction were proved in all 18 surviving rats. Conclusion In this study, a microsurgical guideline of the MCAO model in the rat is provided with the detailed description of all steps of the intraluminal monofilament insertion method with related figures.
Comparison of 10-0 polypropylene and 10-0 nylon sutures in rat arterial anastomosis.
The selection of suture materials is an important factor in further improving the results of microsurgical operations. In this study, two kinds of nonabsorbable suture materials, 10-0 polypropylene and 10-0 nylon monofilament, were compared in end-to-end anastomosis of 66 femoral arteries of adult rats. Both suture types were of identical size (70 microns needle/28 microns suture) and each artery received eight sutures. The vessels were harvested at various intervals from 2 hr to 180 days postoperatively and were evaluated by pathology, radiology, and tensile strength test. The results show that both sutures are capable of achieving excellent long-term patency (100%) of anastomosed sites. Polypropylene suture was equivalent to nylon in mechanical integrity of the anastomosis sites but was superior in handling, knotting, and biocompatibility. These physical and biological properties of polypropylene sutures may offer the benefits of diminished early and late complications at anastomosis sites and reduced operation time. Enhancement of contrast against surrounding tissue may make polypropylene a superior alternative to nylon sutures for microsurgical use. PMID:8332053
Chen, L E; Seaber, A V; Urbaniak, J R
Local Delivery of Growth Factors Using Coated Suture Material
The optimization of healing processes in a wide range of tissues represents a central point for surgical research. One approach is to stimulate healing processes with growth factors. These substances have a short half-life and therefore it seems useful to administer these substances locally rather than systemically. One possible method of local delivery is to incorporate growth factors into a bioabsorbable poly (D, L-lactide) suspension (PDLLA) and coat suture material. The aim of the present study was to establish a procedure for the local delivery of growth factors using coated suture material. Sutures coated with growth factors were tested in an animal model. Anastomoses of the colon were created in a rat model using monofilament sutures. These were either untreated or coated with PDLLA coating alone or coated with PDLLA incorporating insulin—like growth factor-I (IGF-I). The anastomoses were subjected to biomechanical, histological, and immunohistochemical examination. After 3 days the treated groups showed a significantly greater capacity to withstand biomechanical stress than the control groups. This finding was supported by the results of the histomorphometric. The results of the study indicate that it is possible to deliver bioactive growth factors locally using PDLLA coated suture material. Healing processes can thus be stimulated locally without subjecting the whole organism to potentially damaging high systemic doses.
Fuchs, T. F.; Surke, C.; Stange, R.; Quandte, S.; Wildemann, B.; Raschke, M. J.; Schmidmaier, G.
Ghost fishing by monofilament and multifilament gillnets in Izmir Bay, Turkey
To investigate and compare ghost fishing by monofilament and multifilament gillnets, six monofilament and six multifilament experimental gillnets (each 33m long) were deployed at two locations, set at various depths between 9 and 14m in Izmir Bay (eastern Aegean Sea). The gillnets were monitored every other day by divers. Each captured fish or crustacean was tagged to enumerate the total
Adnan Ayaz; Deniz Acarli; Ugur Altinagac; Ugur Ozekinci; Ali Kara; Ozcan Ozen
Microvascular anastomoses in growing vessels: a long-term evaluation of nonabsorbable suture materials.
Diametric growth at the anastomotic site, following microvascular anastomoses in pediatric patients, remains a problem, when nonabsorbable suture material is used. This study investigated the long-term effects of femoral artery anastomoses with nonabsorbable sutures in 20 growing rats with a mean weight of 101 g. The right femoral artery was anastomosed with 10-0 polypropylene monofilament suture and the left with identical nylon suture, using 5 to 6 interrupted sutures for each end-to-end anastomosis. At a 6-month harvest, the mean body weight had increased by 729 percent and the diameter of the femoral artery by 240 percent. The patency rate at the anastomotic sites was 97.5 percent and the complication rate was 10 percent, including one occlusion and three aneurysm formations at the sites. Angiography, diameter measurement, and histology demonstrated no stenosis or thrombus formation in all animals. Histology also showed normal vessel lumen size and well-organized re-endothelialization, without intimal hyperplasia at the anastomosis sites. With an interrupted suture technique, nonabsorbable sutures do not compromise growth at the anastomosis site or long-term patency of the anastomosed vessels. This study indicates that interrupted nonabsorbable suture materials are able to create excellent long-term results in microvascular anastomoses in rapidly growing hosts. PMID:8515396
Chen, L E; Seaber, A V; Urbaniak, J R
The effect of temperature and drawing ratio on the mechanical properties of polypropylene monofilaments
NASA Astrophysics Data System (ADS)
In this work, the simultaneous effect of both temperature and drawing ratio during processing of polypropylene monofilaments has been investigated. The basis of this work specifically aims at emphasizing the conditions of temperature and drawing ratio applied in the cooling bath, in order to find out under which conditions the named parameters can be applied in a processing line under continuous extrusion. The effects of temperature are studied for a constant total drawing ratio to analyze the influences on mechanical properties and structural differences of the final polypropylene monofilament. The quenched monofilaments were drawn around an adjustable guide assembly in the quench bath and first drawing stage, imparting thermal and mechanical treatments to the filaments. In the heating stage, monofilaments are affected to high-speed draw rolls while passing through the oven. As such, the best conditions to produce a polypropylene monofilament with high tenacity strength were determined. Results of this study show that the monofilament properties are significantly affected by temperature in the cooling zone. The nature of the first drawing had a significant effect on the end properties and monofilaments with modulus of 637 MPa have finally been manufactured. We have also proposed a new hypothesis, which is termed "gap nucleation" and determine this phenomenon in the gap between die and cooling bath.
Taheri, Hesam; Nóbrega, Joăo Miguel; Samyn, Pieter; Covas, José Antonio
Bidirectional Barbed Sutures for Wound Closure: Evolution and Applications
Traditionally, wound closure sutures have in common the need to tie knots with the inherent risk of extrusion, palpability, microinfarcts, breakage, and slippage. Bidirectional barbed sutures have barbs arrayed in a helical fashion in opposing directions on either side of an unbarbed midsegment. This suture is inserted at the midpoint of a wound and pulled through till resistance is encountered from the opposing barbs; each half of the suture is then advanced to the lateral ends of the wound. This design provides a method of evenly distributing tension along the incision line, a faster suture placement and closure time with no need to tie knots, and the possibility of improved cosmesis. Bidirectional barbed sutures, which are available in both absorbable and nonabsorbable forms, can be used for simple closures, multilayered closures, and closure of high-tension wounds in a variety of surgical settings.
Paul, Malcolm D.
Suture anchor failure strength--an in vivo study.
Suture anchors are increasingly used to secure tendons or ligaments to bone. These devices are applicable for arthroscopic shoulder stabilization and rotator cuff repair. This study reports the in vivo characteristics of four anchors, including one absorbable anchor composed of poly-L-lactic acid. Failure strength and method of failure were recorded for these anchors as a function of time. Samples of four anchors [Mitek G2, Zimmer Statak, Acufex TAG wedge, and the absorbable Arthrex expanding suture plug (ESP)] were implanted into ram femurs and harvested at intervals. Each bone-anchor-suture system was stressed to failure. The failure force and failure method was recorded. Mitek G2 and Statak suture anchors failed consistently at 30 pounds by suture breakage. They had no implantation difficulties. The TAG wedge exhibited suture pull-out and implant flipping at insertion. The TAG wedge failed by suture cut-out, anchor pull-out, and suture breakage. Its average failure strength was initially 16 pounds, but increased to 28 pounds at 2 weeks and reached the 30-pound level by 4 weeks. The ESP poly-L-lactic acid anchors experienced implantation breakage in 20% because of their greater length and composition. At pull-out testing, the ESP failed by suture cut-out, anchor pull-out, and suture breakage. Failure strength was initially 27 pounds, was 17 pounds at 2 weeks, and increased to 30 pounds by 6 weeks. The absorbable ESP does not have initial pull-out strength comparable with the Mitek and Statak suture anchors but does achieve this strength by 6 weeks.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8305100
Barber, F A; Cawley, P; Prudich, J F
Radiation Sterilizable Bioabsorbable Monofilaments Based on Copolymers of Glycolide and 1, 5-Dioxepan-2One
Copolymers of glycolide (GLY) and 1,5-dioxepan-2-one (DXO) were prepared with small amounts of a partially aromatic polyester (PG-2) of 1,4-phenylene- bis-oxyacetic acid and ethylene glycol incorporated in the final copolymeric macromolecular chain. The copolymers were extruded, drawn, and annealed into monofilaments which exhibited good tensile properties. When the monofilaments were sterilized by gamma radiation at 2.5 Mrads, the resultant fibers
Adel Kafrawy; Dennis D. Jamiolkowski; Shalaby W. Shalaby
Gross and histologic evaluation of 5 suture materials in the skin and subcutaneous tissue of the California sea hare (Aplysia californica).
Invertebrates are increasing in their importance to both the public and private aquarium trade and play a vital role in biomedical research. Surgical techniques have become an important approach to obtaining data and maintaining good health in both of these areas. However, studies examining tissue reaction to suture material in invertebrates are lacking. The current study evaluated the gross and histologic reaction of Aplysia californica to 5 commonly used suture materials, including polydioxanone, black braided silk, polyglactin 910, monofilament nylon, and monofilament poliglecaprone. Histologic samples were graded on the amount of edema (score, 1 to 4), inflammation (1 to 4), and granuloma formation (1 to 4) present, and a final overall histology score (1 to 6) was assigned to each sample. Compared with untreated control tissue, all suture materials caused significantly increased tissue reaction, but the overall histology score did not differ among the suture materials. Silk was the only suture that did not have a significantly increased granuloma score when compared with the control. Although none of the suture materials evaluated seemed clearly superior for use in Aplysia, we recommend silk because of its less robust granuloma induction, which is favorable in a clinical and research setting. PMID:20122319
Anderson, Eric T; Davis, A Sally; Law, J McHugh; Lewbart, Gregory A; Christian, Larry S; Harms, Craig A
Hypersensitivity to Suture Anchors
Hypersensitivity to suture anchor is extremely rare. Herein, we present a case in which hypersensitivity to suture anchor was strongly suspected. The right rotator cuff of a 50-year-old woman was repaired with a metal suture anchor. Three weeks after the surgery, she developed erythema around her face, trunk, and hands, accompanied by itching. Infection was unlikely because no abnormalities were detected by blood testing or by medical examination. Suspicious of a metallic allergy, a dermatologist performed a patch testing 6 months after the first surgery. The patient had negative reactions to tests for titanium, aluminum, and vanadium, which were the principal components of the suture anchor. The anchor was removed 7 months after the first surgery, and the erythema disappeared immediately. When allergic symptoms occur and persist after the use of a metal anchor, removal should be considered as a treatment option even if the patch test result is negative.
Goto, Masafumi; Gotoh, Masafumi; Mitsui, Yasuhiro; Tanesue, Ryo; Okawa, Takahiro; Higuchi, Fujio; Shiba, Naoto
Comparative fixed gear studies in the Cyclades (Aegean Sea): size selectivity of small-hook longlines and monofilament gill nets
Fishing trials with monofilament gill nets and longlines using small hooks were carried out at the same fishing grounds in Cyclades (Aegean Sea) over 1 year. Four sizes of MUSTAD brand, round bent, flatted sea hooks (Quality 2316 DT, numbers 15, 13, 12 and 11) and four mesh sizes of 22, 24, 26 and 28mm nominal bar length monofilament gill
Konstantinos I. Stergiou; Karim Erzini
The three main characteristics of the nasal tip are projection, rotation, and contour. During rhinoplasty the surgeon will strive to preserve or change these characteristics in a predictable fashion, avoiding undesirable sequelae, even after long-term follow-up. Conservation, relocation and augmentation rather than reduction are key principles in modern rhinoplasty, i.e. for obtaining gratifying tip surgery. Interdomal suture, transdomal suture, and lateral crural steal follow these modern principles, while having their clear indications for different nasal tip pathology. All three types of techniques involve (semi-)permanent sutures to change the shape of alar cartilages and can be considered complementary. Based on the same surgical philosophy these three techniques can be captured with the term "suture tip plasty". The objective of this paper is to describe, in a retrospective fashion, a series of 112 patients in whom suture tip plasty has been used as part of the rhinoplasty procedure. The technique proved versatile with predictable results and few manageable complications. PMID:7784792
Vuyk, H D
A prospective, randomized controlled trial comparing n-butyl cyanoacrylate tissue adhesive (LiquiBand) with sutures for skin closure after laparoscopic general surgical procedures.
The aim of this study was to compare the efficacy of n-butyl-cyanoacrylate tissue adhesive (Liquiband) with nonabsorbable monofilament sutures for laparoscopic port site closure. Adult patients having elective laparoscopic procedures were randomly allocated to wound closure with sutures or tissue adhesive. End points included skin closure time, wound dressing requirements, wound complications, and cosmesis, assessed at discharge, 4 to 6 weeks and 3 months. Seventy-eight patients randomized to receive sutures and 76 to receive tissue adhesive were eligible for final analysis. Mean closure time was significantly longer for sutures (220 vs. 125 s, P < 0.001). Fewer dressings were required in the tissue adhesive group immediately postoperatively (21% vs. 97%, P < 0.001) and at discharge (24% vs. 82%, P < 0.001). There were no significant differences in wound complications or in cosmesis at either 4 to 6 weeks or at 3 months. Tissue adhesive for laparoscopic port site closure offers potential savings with respect to time and has comparable wound complication rates and cosmetic outcomes when compared with nonabsorbable monofilament sutures. PMID:16804456
Dowson, Charlotte C; Gilliam, Andrew D; Speake, William J; Lobo, Dileep N; Beckingham, Ian J
The Use of Large Diameter Monofilament for Improving Peel Resistance of a Brittle High Temperature Adhesive
Peel force measurements as a function of adherend thickness are reported for adhesively bonded specimens based on a cyanate ester resin and aluminium adherends. It has been demonstrated that by incorporating large diameter (0.28mm) PTFE monofilament within the adhesive bond then the peel force and associated fracture energy can be increased significantly over that for specimens based on adhesive alone.
S. Azam; J. P. Sargent
Tension free monofilament macropore polypropylene mesh (Gynemesh PS) in female genital prolapse repair
Objectives: To review intraoperative and postoperative complications associated to the correction of cystocele and recto- cele with polypropylene mesh macropore monofilament (Gynemesh PS) using transvaginal free tension technique. Materials and Methods: Prospective study of patients that have been submitted to correction of cystocele and\\/or rectocele between November 2004 and August 2005 in the Urogynecology and Vaginal Surgery Unit of Gynecology
Vicente Sola; Jack Pardo; Paolo Ricci; Enrique Guiloff
Heat welding for surgical sutures.
The purpose of this experimental study was to test the potential value of heat welding to cut the ends of knotted surgical sutures. This heat process resulted in knot security in a coated polyglactin suture with fewer throws than those needed for the same suture with knotted ends cut by scissors. Results of mechanical performance testing of the knotted sutures cut either by scissors or welding did not differ significantly. With refinements in the technical design of the heat source, suture welding may have important applications in surgery. PMID:3898890
Masterson, T M; Thacker, J G; Rodeheaver, G T; Edlich, R F
Optimizing the tissue anchoring performance of barbed sutures in skin and tendon tissues.
The focus of the current work was to study how the geometric design of a single barbed monofilament suture effects its biomechanical behavior. Different cut angles and cut depths of barbs were prepared and tested in vitro for their tensile and tissue anchoring properties by means of a novel suture/tissue pullout test. Experiments were also performed using bovine tendon and porcine skin tissues. The experimental results revealed that since tendon tissue has a higher modulus than skin it needs a more rigid barb to penetrate and anchor the surrounding tissue. A cut angle of 150 degrees and a cut depth of 0.18 mm are therefore recommended. On the other hand, for the softer skin tissue, a cut angle of 170 degrees and a cut depth of 0.18 mm provides a more flexible barb that gives superior skin tissue anchoring. These findings confirm that the future development of barbed suture technology requires a detailed understanding of the biomechanical properties of the tissue in which they are to be used. This will lead to the future development of a range of tissue-specific barbed sutures. PMID:19883915
Ingle, N P; King, M W
Suture materials in orthopaedic surgery are used for closure of wounds, repair of fascia, muscles, tendons, ligaments, joint capsules, and cerclage or tension band of certain fractures. The purpose of this study was to compare the biomechanical properties of eleven commonly used sutures in orthopaedic surgery. Three types of braided non-absorbable and one type of braided absorbable suture material with different calibers (n=77) underwent biomechanical testing for maximum load to failure, strain, and stiffness. All samples were tied by one surgeon with a single SMC (Seoul Medical Center) knot and three square knots. The maximum load to failure and strain were highest for #5 FiberWire and lowest for #0 Ethibond Excel (p<0.001). The stiffness was highest for #5 FiberWire and lowest for #2-0 Vicryl (p<0.001). In all samples, the failure of the suture material occurred at the knot There was no slippage of the knot in any of the samples tested. This data will assist the orthopaedic surgeon in selection and application of appropriate suture materials and calibers to specific tasks.
Najibi, S; Banglmeier, R; Matta, JM; Tannast, M
Bone suture anchors versus the pullout button for repair of distal profundus tendon injuries: a comparison of strength in human cadaveric hands.
Avulsion or distal tendon laceration of flexor digitorum profundus (FDP) is classically repaired to the base of the distal phalanx via a pullout suture over a button. Bone suture anchors, used extensively in other surgical areas, have recently been proposed for reattachment of the FDP to the distal phalanx. The FDP tendons of the index, long, and ring fingers in 9 fresh frozen cadeveric hands were randomized to 1 of 3 repair techniques after simulated distal avulsion injuries. These were the pullout button using 3-0 monofilament nylon in a 2-strand Bunnell suture pattern, the 1.8 mm Mini QuickAnchor (Mitek Products, Norwood, MA) using 3-0 braided polyester in a 2-strand Bunnell suture pattern, and the Mitek micro anchor using 3-0 braided polyester with a modified 4-strand Becker suture pattern. Nine specimens were loaded to failure, noting maximum load and mode of failure. The 1.3 mm Micro QuickAnchor (Mitek) technique (69.6 +/- 10.8 N) was significantly stronger than the pullout button (43.3 +/- 4.8 N) or the Mini anchor technique (44.6 +/- 12.7 N). The Micro bone suture anchor provides a stronger tendon to bone repair than the pullout button or the Mini anchor. Given the disadvantages of the pullout button, the Micro bone suture anchor with the modified Becker technique is worth consideration as an alternative method to repair distal FDP avulsions. PMID:11418912
Brustein, M; Pellegrini, J; Choueka, J; Heminger, H; Mass, D
Silk / absorbable polyester hybrid medical devices and applications thereof
US Patent & Trademark Office Database
Silk/absorbable polyester hybrid medical devices for tissue repair and regeneration are formed of degummed, naturally produced, multifilament silk yarn in combination with at least one absorbable polyester in the form of a surface coating, with or without an antimicrobial agent, for producing value-added braided silk sutures and multifilament yarn, as well as silk/absorbable polyester fiber composites, for producing tailored hybrid sutures, meshes, and scaffolds for tissue regeneration.
[Experiments on suture material prolene 10-0 and vicryl 11-0 compared with nylon 10-0 in the rabbit cornea (author's transl)].
Synthetic absorbable suture material Vicryl 11-0 and not absorbable Prolene 10-0 are tolerated well by the corneal tissue as compared with nylon 10-0. Vicryl 11-0 sutures remained intact for only 13.2 days on an average, this is too short for normal corneal surgery. As nylon shows signs of absorption with time Prolene may be preferable to nylon where permanent sutures are necessary. PMID:886803
Faulborn, J; Theopold, H
Releasable suture technique for trabeculectomy.
A retrospective review of 154 trabeculectomies with releasable sutures was performed to assess the effect of suture release on intraocular pressure (IOP) at various postoperative periods. Release of the suture was necessary in 38% of cases. The immediate reduction in IOP was significant (p < 0.01) when the suture was released during the first three postoperative weeks. Seventy percent of eyes had a reduction in IOP more than 5 mmHg if released within the first week compared to 20% after the third week. With suture release after the third postoperative week, there was no clinically significant decrease in IOP. The decrease in IOP was similar in eyes undergoing trabeculectomy alone or when cataract extraction through a separate corneal incision was undertaken simultaneously. The period during which release of suture was effective was not prolonged by use of antimetabolites. Complications included a typical windshield-wiper keratopathy (18 eyes), failure to release the suture (13 eyes), epithelial abrasion (6 eyes) and a sub-conjunctival bleed (1 eye). PMID:9475010
Thomas, R; Jacob, P; Braganza, A; Mermoud, A; Muliyil, J
Suture-wick endophthalmitis with sutured posterior chamber intraocular lenses.
A patient had a corneal transplant with removal of an anterior chamber lens. As part of the procedure, an exchange posterior chamber lens was inserted and sutured transsclerally into the ciliary sulcus with two subconjunctival 10-0 polypropylene (Prolene) sutures. One month later the patient experienced a sudden decrease in vision and severe eye pain. Streptococcus viridans was cultured from the vitreous tap and the eye eventually was lost from this endophthalmitis. The infecting organism appeared to gain access to the eye through one of the Prolene sutures that had eroded through the conjunctiva and become exteriorized. This report presents a case in which an eroding 10-0 Prolene suture used for transscleral posterior chamber lens fixation was the probable mechanism causing endophthalmitis. This complication represents an avoidable risk unique to this type of intraocular lens fixation. PMID:2258814
Schechter, R J
Arthroscopic Suture Anchor Tenodesis: Loop-Suture Technique
With advancements in arthroscopic surgery, arthroscopic biceps tenodesis with suture anchor recently has been reported to be a reasonable option for the treatment of biceps pathologies, especially for those that are symptomatic or accompanied by a rotator cuff tear. We introduce our technique of arthroscopic biceps tenodesis with suture anchor that we call the loop-suture technique, which is constructed with 1 loop strand and another sutured strand. This technique can help to improve biceps grip and simultaneously minimize longitudinal splitting of the tendon. In addition, it is relatively simple and can be performed with the use of conventional devices and arthroscopic portals used for rotator cuff repair, without the formation of additional portals or a separate incision for the tenodesis.
Shon, Min Soo; Koh, Kyoung Hwan; Lim, Tae Kang; Lee, Seung Won; Park, Young Eun; Yoo, Jae Chul
The history of barbed sutures.
Ligatures have been used for millennia to close wounds. Sterilization and synthetic polymers that degrade in a commensurate fashion with wound healing have been the most significant improvements in these age-old devices. However, the constricting loop of a traditional suture and subsequent ischemia ("approximate, don't strangulate") still account for the most common cause of wound dehiscence-necrosis. Inspired by the quill of the North American porcupine, I envisioned a bidirectional array of barbs that could secure tissue without relying on constricting loops. One set of barbs could anchor the other. In this article, I document the development process of these barbed sutures from concept to patent to manufacture and US Food and Drug Administration approval. Knotless, strong, and easy to place, barbed sutures could foreseeably supplant conventional sutures, particularly as endoscopic procedures become more common. They also offer the intriguing potential to suspend ptotic tissues without surgical intervention. PMID:24084875
Ruff, Gregory L
Preirradiation grafting of acrylonitrile onto polypropylene monofilament for biomedical applications: I. Influence of synthesis conditions
NASA Astrophysics Data System (ADS)
Graft polymerization of acrylonitrile onto polypropylene (PP) monofilament was carried out by a preirradiation method using a 60Co gamma radiation source. The influence of synthesis conditions, such as preirradiation dose, reaction time, monomer concentration, reaction temperature and additives was determined. The grafting was considerably influenced by the instantaneous swelling of the monofilament in the reaction mixture during the course of the grafting process. The order of dependence of the rate of grafting on monomer concentration was found to be 1.04. The nature of the medium of the grafting and the additives had profound influence over the grafting reaction. The accelerative effects of solvent medium on the grafting were higher in methylethyl ketone (MEK) and dimethylformamide (DMF) as compared to methanol. At the same time, partial replacement of DMF with water led to acceleration in the grafting with peak maxima at 20% solvent composition. The addition of a small amount of sulfuric acid to the reaction mixture also resulted in a significant acceleration of the degree of grafting.
Gupta, Bhuvanesh; Jain, Rachna; Anjum, Nishat; Singh, Harpal
Comparison of the urethrovesical anastomoses with polyglecaprone (Monocryl®) and bidirectional barbed (V-Loc 180®) running sutures in laparoscopic radical prostatectomy.
Objective: We compared polyglecaprone (Monocryl®) and bidirectional barbed (V-Loc® 180) running sutures during urethrovesial anastomosis (UVA) in laparoscopic radical prostatectomy (LRP). Materials and methods: A total of 92 consecutive patients underwent extraperitoneal LRP for prostate cancer. In the first 47 patients, the running UVA was performed using 3-0 monofilament polyglecaprone (Monocryl®) suture (Group 1). In the subsequent 45 patients, the running UVA was performed with the 3-0 barbed suture (V-Loc® 180) (Group 2). Rhabdosphincter reconstruction was performed in all the patients. Results: The mean prostatectomy time was 196 and 179 minutes in Group 1 and 2, respectively (p < 0.001). Moreover, the mean UVA time was 40 and 24 minutes in Group 1 and 2, respectively (p < 0.001). Also, catheterization time, lenght of hospital stay and the number of the patients with urine leakage were significantly lower in Group 2 than the other (p < 0.001). No patients in V-Loc® 180 suture group and 5 patients in Monocryl® suture group experienced postoperative drain leakage in the present study. Overall pad usage at 6th month was higher in group 1 than the other group. In group 1 and 2, 78.7% and 93.3% of the patients reported 0 to 1 pads daily, whereas 21.3% and 6.7% reported ? 2 pads daily (p = 0.002). Conclusions: We therefore consider that use of barbed suture running UVA during LRP is associated with a significantly shorter operative time maintaining a proper suturing tension compared with standard suture and it is not associated with a higher incidence of adverse events with no postoperative complications. PMID:25017586
Arslan, Murat; Tuncel, Altug; Aslan, Yilmaz; Kozacioglu, Zafer; Gunlusoy, Bulent; Atan, Ali
Comparison of autologous in situ blood coagulum versus sutures for conjunctival autografting after pterygium excision.
Our aim was to compare the efficacy and safety of autologous in-situ blood coagulum versus sutures for attaching conjunctival limbal autografts (CAG) among patients undergoing primary pterygium excision over a period of 1 year. Thirty-two eyes of 32 patients with primary pterygium were randomly divided in into two groups: group I (16 eyes) underwent CAG with 10-0 monofilament nylon sutures and group II (16 eyes) underwent CAG with patient's own in-situ blood coagulum acting as bioadhesive or fixative followed by bandaging for 48 h. Patients were followed up postoperatively on the 2nd day, 1 week, 2 weeks, 4 weeks, and 12 months. All the surgeries were done by the same surgeon. Graft success, recurrence rate, operating time, patient comfort, graft retraction or any other complication were studied. The duration of surgery was significantly less (P < 0.001) in group II (mean duration 15 ± 2 min) than group I (mean duration 67 ± 2 min). Postoperative symptoms were fewer for group II than group I. Rate of recurrence was equal in both groups (one patient in each group, 6.25 %). But complications regarding graft failure and graft retraction were more common in group II (two patients, 12.5 %) than group I (one patient, 6.25 %); however, the difference was not statistically significant (Z = 0.61). Thus, autologous in-situ blood coagulum is a useful method for graft fixation in pterygium surgery with shorter operating time and less postoperative discomfort. PMID:23733278
Choudhury, Somnath; Dutta, Jayanta; Mukhopadhyay, Somnath; Basu, Rivu; Bera, Sumanta; Savale, Smruti; Sen, Debanjan; Datta, Himadri
Barbed sutures in aesthetic plastic surgery: evolution of thought and process.
The evolution of barbed suture technologies and their application in the field of plastic surgery is now in its third decade. Much has been learned along the way. Initial excitement was often followed by disappointment as we learned more about the limited longevity of minimally invasive procedures and complications arising from various suture designs of the past. Some of the early designs, developed primarily for use in aesthetic facial procedures, included free-floating, bidirectionally barbed, nonabsorbable sutures; unidirectional barbed, nonabsorbable sutures; anchored, bidirectional, nonabsorbable double-threaded sutures; and a technology combining a nonabsorbable knotted thread and absorbable cones. More recently, a new, absorbable, unidirectional barbed suture design has become available. However, it should be noted that very limited data are available for any of the modified suture designs used in this field, and much of what has been published is based on the experience of a single user. The author has used the bidirectionally barbed Quill Knotless Tissue-Closure Device (Angiotech Pharmaceuticals, Inc, Vancouver, British Columbia, Canada), the most common barbed suture in both facial and other aesthetic plastic surgery procedures, with considerable success in various open aesthetic facial procedures, including suspension of the brow and midface, platysmaplasty, and lateral neck suspension. It is the author's experience that completion of 1 to 2 cases with this technology is sufficient to achieve competency in the closure techniques discussed in this article and that time savings can be realized using this device in various breast and body contouring procedures, including mastopexy, reduction mammoplasty, abdominoplasty, bodylift, and brachioplasty. PMID:24084876
Paul, Malcolm D
Threshold for detection of diabetic peripheral sensory neuropathy using a range of research grade monofilaments in persons with Type 2 diabetes mellitus
Aims To identify the threshold of reduced sensory perception in Type 2 diabetes mellitus (Type 2 DM) using a range of research grade monofilaments. Methods Three groups of participants were recruited into a between subject, cross-sectional study. Group 1(NEW), persons with Type 2 DM diagnosed for less than 2 years (n = 80); Group 2 (EST) persons with Type 2 DM diagnosed for more than 2 years (n = 91), and Group 3, a Comparison group without Type 2 DM (n = 73), resulted in a total study population, n = 244. Research grade monofilaments (2, 4, 6, 8 and 10-gram) were employed using standardised protocol, at 6 sites on the plantar aspect of both feet. The demographic and anthropometric measures of gender, age, height, weight, body mass index (BMI), blood pressure and duration of Type 2 DM since diagnosis (if applicable) of the participants were analysed. Results Perception of the research grade monofilaments differed significantly between the 3 groups (p < 0.05). The 6-gram monofilament was found to be the threshold of normal perception, based on 90% of the Comparison group perceiving the 6-gram monofilament at all sites in contrast to 64% of NEW and 48% of EST groups. Conclusion The 6-gram monofilament was identified as the threshold of normal sensory perception. Inability to perceive the 6-gram monofilament indicates, when using the method described in this study, that diminution of sensory perception is evident. Employing a range of monofilaments, 6, 8 and 10-grams in Type 2 DM foot screening would allow the clinical detection of deteriorating sensory perception and enable implementation of foot protection strategies at an earlier stage than is currently practised.
Thomson, Mary P; Potter, Julia; Finch, Paul M; Paisey, Richard B
The influence of process parameters on consolidation efficiency when forming composites by spraying onto monofilaments
Composites have been produced by spraying titanium powder onto parallel arrays of tungsten monofilaments, using the vacuum plasma spray technique. The main variables studied were powder particle size, chamber pressure, fiber spacing and plasma gun operating variables. Porosity levels were measured by a gravimetric technique and also studied metallographically. It was found that relatively high porosity levels, largely located in the ``shadow`` of the fibers, persisted in all of the composites produced. These were measured as ranging from 10--15% to over 30%. Similar trends were apparent from metallographic sections, although the void contents appeared lower. It was found that lower porosity levels were favored by larger particle sizes and lower chamber pressures, although the latter trend was not very clear-cut. Porosity increased sharply as the ratio of the gap between the fibers to the droplet diameter became less than a value of about 5. These results have been considered in terms of the mechanisms by which droplet impingement leads to envelopment of an array of fibers. It is concluded that it will be very difficult to identify a combination of operating parameters which will allow production of composite material with both fiber contents of commercial interest and suitably low porosity levels. The technique does not at present appear to represent an attractive option for commercial exploitation.
Clyne, T.W.; Roberts, K.A. [Univ. of Cambridge (United Kingdom). Dept. of Material Science and Metallurgy] [Univ. of Cambridge (United Kingdom). Dept. of Material Science and Metallurgy
Thermal fatigue damage in monofilament reinforced copper for heat sink applications in divertor elements
NASA Astrophysics Data System (ADS)
In fusion reactor systems extreme conditions require materials with high temperature and radiation resistance. The divertor component consists of a plasma facing W plate attached to a Cu heat sink to extract the heat from the nuclear reaction chamber coolant. The Coefficient of Thermal Expansion (CTE) mismatch between the W plate and the Cu heat sink causes interface delamination reducing the long term stability of the divertor. To avert this problem, composites are developed as interlayer materials with a high thermal conducting Cu matrix reinforced with up to 50 vol.% SiC or W monofilaments to increase the mechanical strength and to reduce the CTE mismatch. Thermal stresses are transferred from the macroscopic interface between the components into the bulk of the composite. Oscillating micro stresses may lead to fiber delamination and matrix damage during thermal cycling. Different matrix alloys, fiber materials and interface designs are investigated. In situ neutron diffraction performed during thermal cycling show the effect of bonding strength on the stress amplitudes expected under service conditions. The long term stability is tested by measurements after further ex situ cycling. Thermal fatigue damage and its propagation are visualized by in situ as well as ex situ high resolution synchrotron tomography. The combination of both methods helps to understand the strain induced damage mechanisms. Weak bonding leads to delamination of the fiber-matrix interfaces. Strong bonding causes severe matrix deformation and damage. Fiber cracks originating from sample production cause accumulating thermal fatigue damage during thermal cycling.
Schöbel, M.; Jonke, J.; Degischer, H. P.; Paffenholz, V.; Brendel, A.; Wimpory, R. C.; Di Michiel, M.
Tissue welding for corneal wound suture with a CW 1.9-um diode laser: an in-vivo preliminary study
NASA Astrophysics Data System (ADS)
This study aimed to evaluate the interest of a 1.9 micrometer diode laser for corneal wound suture. Six adult albino rabbits were anesthetized. A 7 mm corneal incision was practiced on the right eye. For 3 animals (laser plus stitch) the incision was surgically sutured with 2 stitches of a nylon monofilament and laser impacts were performed between the stitches. For 3 animals (laser only) juxtaposed lasers impacts were realized to suture the wound. After the procedure the animals were examined daily for signs of inflammation, infection and for healing of the corneal wound. Material was obtained for histological examination 1 month after the procedure. Approximation of the edges of the would was successfully obtained in the (laser plus stitch) group. In the (laser only) group this approximation remained troublesome. After the procedure, one cornea of the (laser only) group disclosed a little leakage during 2 days. Histological examination assessed the welding of the corneal wound in the two groups provided structural modifications and some inflammatory signs. Corneal welding using a 1.9 micrometer diode laser is possible either with laser and stitch or with laser only. The approximation of the edges of the wound with additional stitches is an evident drawback. The use of additional stitches should be avoided to keep the theoretical advantages of corneal would suture using laser welding.
Desmettre, Thomas; Mordon, Serge R.; Mitchell, Valerie A.
Effects of Suture Choice on Biomechanics and Physeal Status After Bioenhanced Anterior Cruciate Ligament Repair in Skeletally Immature Patients: A Large-Animal Study
Purpose The objective of this study was to assess the effect of absorbable or nonabsorbable sutures in bioenhanced anterior cruciate ligament (ACL) repair in a skeletally immature pig model on suture tunnel and growth plate healing and biomechanical outcomes. Methods Sixteen female skeletally immature Yorkshire pigs were randomly allocated to receive unilateral, bioenhanced ACL repair with an absorbable (Vicryl) or nonabsorbable (Ethibond) suture augmented by an extracellular matrix-based scaffold (MIACH). After 15 weeks of healing, micro–computed tomography was used to measure residual tunnel diameters and growth plate status, and biomechanical outcomes were assessed. Results At 15 weeks postoperatively, there was a significant difference in tunnel diameter with significantly larger diameters in the nonabsorbable suture group (4.4 ± 0.3 mm; mean ± SD) than in the absorbable group (1.8 ± 0.5 mm; P <.001). The growth plate showed a significantly greater affected area in the nonabsorbable group (15.2 ± 3.4 mm2) than in the absorbable group (2.7 ± 0.8 mm2, P < .001). There was no significant difference in the linear stiffness of the repairs (29.0 ± 14.8 N/mm for absorbable v 43.3 ± 28.3 N/mm for nonabsorbable sutures, P = .531), but load to failure was higher in the nonabsorbable suture group (211 ± 121.5 N) than in the absorbable suture group (173 ± 101.4 N, P =.002). There was no difference between the 2 groups in anteroposterior laxity at 30° (P = .5117), 60° (P = .3150), and 90° (P = .4297) of knee flexion. Conclusions The use of absorbable sutures for ACL repair resulted in decreased physeal plate damage after 15 weeks of healing; however, use of nonabsorbable sutures resulted in 20% stronger repairs. Clinical Relevance Choice of suture type for ACL repair or repair of tibial avulsion fractures may depend on patient skeletal age and size, with absorbable sutures preferred in very young, small patients at higher risk with physeal damage and nonabsorbable sutures preferred in larger, prepubescent patients who may place higher loads on the repair.
Vavken, Patrick; Proffen, Benedikt; Peterson, Chris; Fleming, Braden C.; Machan, Jason T.; Murray, Martha M.
New suture anchors continue to become available. Our prior reports on the pullout strength of over 50 different anchors is supplemented by a similar test conducted on 25 additional new anchors. This anchor comparison, using an established protocol in fresh porcine femurs, recorded failure strength, failure mode (anchor pullout, suture eyelet cutout, or wire breakage), eyelet size, minor and major diameters, and drill hole sizes. These new anchors were tested in diaphyseal cortex, metaphyseal cortex, and a cancellous trough. Tensile stress parallel to the axis of insertion was applied at a rate of 12.5 mm/sec by an Instron 1321 until failure and mean anchor failure strengths were calculated. Anchors tested included DePuy 4.5 prototypes D1, D2 Catera 4.5, and D3; DePuy 3.5 prototypes D4- Catera 3.5, D5, and D6; Mainstay 2.7, 3.5, 4.5; ROC EZ 2.8, EZ 3.5, and XS 3.5; Ultrafix RC and Ultrafix MiniMite; 1.3 MicroMitek, Panalok 3.5, and Tacit 2.0; Umbrella Harpoon; PeBA 2.8, 4.0, 6.5; and Stryker 1.9, 2.7, 3.4, and 4.5 prototypes. Screw anchors still tend to have higher values, but for the newer nonscrew designs this distinction is less apparent. The new biodegradable anchors were all composed of poly L-lactic acid suggesting a trend away from other polymers, and these new biodegradable anchors showed load-to-failure strengths comparable to others in their class. All anchors were stronger than the suture for which they are designed to accommodate. PMID:10524819
Barber, F A; Herbert, M A
21 CFR 878.5030 - Natural nonabsorbable silk surgical suture.
Code of Federal Regulations, 2010 CFR
...Natural nonabsorbable silk surgical suture. ...Natural nonabsorbable silk surgical suture is...composed of an organic protein called fibroin. This protein is derived from the domesticated...Natural nonabsorbable silk surgical suture is...
21 CFR 878.5030 - Natural nonabsorbable silk surgical suture.
Code of Federal Regulations, 2010 CFR
...Natural nonabsorbable silk surgical suture. ...Natural nonabsorbable silk surgical suture is...composed of an organic protein called fibroin. This protein is derived from the domesticated...Natural nonabsorbable silk surgical suture is...
21 CFR 878.5020 - Nonabsorbable polyamide surgical suture.
Code of Federal Regulations, 2010 CFR
...2009-04-01 false Nonabsorbable polyamide surgical suture. 878.5020 Section...Devices § 878.5020 Nonabsorbable polyamide surgical suture. (a) Identification. Nonabsorbable polyamide surgical suture is a...
21 CFR 878.5020 - Nonabsorbable polyamide surgical suture.
Code of Federal Regulations, 2010 CFR
...2010-04-01 false Nonabsorbable polyamide surgical suture. 878.5020 Section...Devices § 878.5020 Nonabsorbable polyamide surgical suture. (a) Identification. Nonabsorbable polyamide surgical suture is a...
21 CFR 878.4930 - Suture retention device.
Code of Federal Regulations, 2010 CFR
...suture retention device is a device, such as a retention bridge, a surgical button, or a suture bolster, intended to aid wound healing by distributing suture tension over a larger area in the patient. (b) Classification. Class I...
NSDL National Science Digital Library
In this activity, learners investigate how different materials repel or absorb water. Learners use spray bottles to explore how everyday items like sponges, cardboard, feathers, etc. respond to water differently. This activity also introduces learners to the scientific method as learners make predictions about which materials will absorb or repel water.
Museum, Kohl C.
Biomechanical comparison of screw-in suture anchor–suture combinations used for Bankart repair
Introduction Bankart repair laxity may contribute to pathologic joint instability. This biomechanical study compared two screw-in suture\\u000a anchor–suture combinations under tensile loads.\\u000a \\u000a \\u000a \\u000a Methods Twelve pairs of scapulae were implanted with either a 3 mm diameter, 14 mm long poly-l\\/d-lactide suture anchor with a suture eyelet (Group 1) or a 3.1 mm diameter, 11 mm long polylactide suture anchor with a molded\\u000a eyelet (Group 2). Constructs were
Brad S. Sparks; John Nyland; Akbar Nawab; Ethan Blackburn; Ryan Krupp; David N. M. Caborn
Did you choose the right suture material for skin closure in elective caesarean section?
Surgical incision should heal with first intension with minimum deformity. Pain perception during postoperative period (short term) and appreciation of scar (long term) are two key components assessed by patients after a caesarean section. The present study compares these parameters using absorbable and non-absorbable material for skin closure using subcuticular stitch. The study shows a significant difference in pain perception on 1st postoperative week along with shorter duration of hospital stay and patients appreciation of scar quality on long term are significantly better in absorbable suture group. PMID:23741838
Naskar, Tapan Kumar; Chakraborty, Somajita; Mukhopadhyay, Sima; Agnes, Charang; Majumdar, Palash
Mesenchymal stem cell-coated sutures enhance collagen depositions in sutured tissues.
Sutures are commonly used for surgical procedures and new sutures are being developed to improve wound healing. In the past decade, it has been extensively shown that mesenchymal stem cells (MSCs) have a wound healing potential. To benefit the overall wound healing process, we aimed to analyze the usage of pretreated sutures for improving the implantation of MSCs in the tissues. Our results firstly showed that suture pretreatments with gelatin, poly-L-lysine, and NaOH improved the adhesive strength of MSCs to sutures. These cells remained surrounding the sutured tissue and no significant phenotypic changes were found in those cells cultured onto pretreated sutures. In vivo experiments showed that the implantation of MSCs by suturing increases the collagen content in the sutured tissue. Moreover, proteomics analysis of secreted proteins showed that collagen alpha-1(I) chain was the most abundant collagen found. To our knowledge, this is the first report that aimed to improve the implantation of MSCs in tissue by suture pretreatments. Moreover, in vivo experiments suggest that MSC-coated sutures may enhance wound healing and tissue remodeling through the release of different collagen types being applicable for those patients that tend to have difficulty healing. PMID:24635176
Casado, Javier G; Blazquez, Rebeca; Jorge, Inmaculada; Alvarez, Veronica; Gomez-Mauricio, Guadalupe; Ortega-Muńoz, Mariano; Vazquez, Jesus; Sanchez-Margallo, Francisco M
Modified method for microvascular anastomosis suturing
Background: Suturing of microvascular anastomosis is still a time-consuming procedure, despite the fact that different techniques and devices were designed to reduce the operation time and increase the patency rate. This paper reports a method for microvascular anastomosis suturing, using foam rubber cylindrical mandrel, which helps to solve the above-stated problems. Methods: The principle of method is based on running suture, imposed around the foam rubber mandrel. Then the suture is divided into separate stitches. After the visual control of anastomosis lumen knots are tightened. The procedure is the same for front and back parts of anastomosis. Results: Testing of technique in the laboratory showed the possibility of using a single thread per anastomosis and reducing the time for suturing from 17.3 to 15.4 min compared with standard procedure. Conclusions: Described technique allows surgeon to control the lumen of anastomosis before tightening knots, reduces time of work, and does not increase the cost of operation.
Solomiichuk, Volodymyr O.
Non-Curling Polyhydroxyalkanoate Sutures.
National Technical Information Service (NTIS)
Absorbable polyester fibers, braids, and surgical meshes with improved handling properties have been developed. These devices are preferably derived from biocompatible copolymers or homopolymers of 4-hydroxybutyrate. These devices provide a wider range of...
S. Rizk
The double loop mattress suture.
An interrupted stitch type with favorable tissue characteristics will reduce local wound complications. We describe a novel high-strength, low-tension repair for the interrupted closure of skin, cartilage, and muscle, the double loop mattress stitch, and compare it experimentally with other interrupted closure methods. The performance of the double loop mattress technique in porcine cartilage and skeletal muscle is compared with the simple, mattress, and loop mattress interrupted sutures in both a novel porcine loading chamber and mechanical model. Wound apposition is assessed by electron microscopy. The performance of the double loop mattress in vivo was confirmed using a series of 805 pediatric laparotomies/laparoscopies. The double loop mattress suture is 3.5 times stronger than the loop mattress in muscle and 1.6 times stronger in cartilage (p???0.001). Additionally, the double loop mattress reduces tissue tension by 66% compared with just 53% for the loop mattress (p???0.001). Wound gapping is equal, and wound eversion appears significantly improved (p???0.001) compared with the loop mattress in vitro. In vivo, the double loop mattress performs as well as the loop mattress and significantly better than the mattress stitch in assessments of wound eversion and dehiscence. There were no episodes of stitch extrusion in our series of patients. The mechanical advantage of its intrinsic pulley arrangement gives the double loop mattress its favorable properties. Wound dehiscence is reduced because this stitch type is stronger and exerts less tension on the tissue than the mattress stitch. We advocate the use of this novel stitch wherever a high-strength, low-tension repair is required. These properties will enhance wound repair, and its application will be useful to surgeons of all disciplines. PMID:24698436
Biddlestone, John; Samuel, Madan; Creagh, Terry; Ahmad, Tariq
Nasal capsular cartilage is required for rat transpalatal suture morphogenesis.
In the cranial vault, suture morphogenesis occurs when the growing cranial bones approximate and overlap or abut one another. Patency of developing sutures is regulated by the underlying dura mater. Once cranial sutures form, bone growth proceeds from the sutures in response to growth signals from the rapidly expanding neurocranium. Facial sutures do not develop in contact with the dura mater. It was therefore hypothesized that facial suture morphogenesis and bone growth from facial sutures are regulated by tissues with an equivalent role to the dura mater. The present study was designed to test this hypothesis by characterizing the morphology and growth factor expression in developing transpalatal (TP) sutures and their surrounding tissues, and then assessing the role of the overlying nasal capsular (NC) cartilages in maintaining suture patency. TP sutures develop as overlapping sutures, similar to cranial coronal sutures, and expression of Tgf-betas in TP sutures was similar to their distribution in cranial coronal sutures. To establish whether NC cartilages play a role in regulating TP suture morphogenesis, fetal rat TP sutures were cultured with associated attached NC cartilages or with NC cartilages removed. Sutures cultured for upward of 5 days with intact NC cartilages remained patent and maintained their cellular and fibrous components. However, in the absence of NC cartilages, the cellular nature of the sutures was not maintained and they became progressively acellular, with bony bridging across the suture. This finding is similar to that for cranial vault sutures cultured in the absence of dura mater, indicating that NC cartilages play an equivalent role to dura mater in maintaining the patency of developing sutures. These studies indicate that tissue interactions likely regulate morphogenesis of all cranial and facial sutures. PMID:14641330
Adab, Katayoun; Sayne, Jennifer R; Carlson, David S; Opperman, Lynne A
Rescue of coronal suture fusion using transforming growth factor-beta 3 (Tgf-beta 3) in rabbits with delayed-onset craniosynostosis.
Craniosynostosis results in cranial deformities and increased intracranial pressure, which pose extensive and recurrent surgical management problems. Developmental studies in rodents have shown that low levels of transforming growth factor-beta 3 (Tgf-beta 3) are associated with normal fusion of the interfrontal (IF) suture, and that Tgf-beta 3 prevents IF suture fusion in a dose-dependent fashion. The present study was designed to test the hypothesis that Tgf-beta 3 can also prevent or "rescue" fusing sutures in a rabbit model with familial craniosynostosis. One hundred coronal sutures from 50 rabbits with delayed-onset, coronal suture synostosis were examined in the present study. The rabbits were divided into five groups of 10 rabbits each: 1) sham controls, 2) bovine serum albumin (BSA, 500 ng) low-dose protein controls, 3) low-dose Tgf-beta 3 (500 ng), 4) high-dose BSA (1,000 ng) controls, and 5) high-dose Tgf-beta 3 (1,000 ng). At 10 days of age, radiopaque amalgam markers were implanted in all of the rabbits on either side of the coronal suture to monitor sutural growth. At 25 days of age, the BSA or Tgf-beta 3 was combined with a slow-absorbing collagen vehicle and injected subperiosteally above the coronal suture. Radiographic results revealed that high-dose Tgf-beta 3 rabbits had significantly greater (P < 0.05) coronal suture marker separation than the other groups. Histomorphometric analysis revealed that high-dose Tgf-beta 3 rabbits also had patent coronal sutures and significantly (P < 0.01) greater sutural widths and areas than the other groups. The results suggest that there is a dose-dependent effect of TGF-beta 3 on suture morphology and area in these rabbits, and that the manipulation of such growth factors may have clinical applications in the treatment of craniosynostosis. PMID:12973720
Chong, Sherri Lyn; Mitchell, Ronal; Moursi, Amr M; Winnard, Phillip; Losken, H Wolfgang; Bradley, James; Ozerdem, Omer R; Azari, Kodi; Acarturk, Oguz; Opperman, Lynne A; Siegel, Michael I; Mooney, Mark P
Corneal autograft patches for covering exposed transscleral sutures.
This article details the authors' experience with a relatively unknown technique for covering exposed ends of transscleral sutures. During combined transscleral suturing of a posterior chamber intraocular lens (PC IOL) with a penetrating keratoplasty, buttons from the excised recipient cornea are sutured with 10-0 nylon over the protruding suture ends. This technique has been used successfully in four cases. PMID:9150528
Lifshitz, T; Wender, A; Lapid-Gortzak, R
Suture Anchor Arthroplasty for Thumb Carpometacarpal Osteoarthritis.
National Technical Information Service (NTIS)
To describe a technique termed Suture Anchor Arthroplasty' (SAA), for thumb carpometacarpal joint osteoarthritis and to report the clinical results. SAA is a surgical technique similar to Ligament Reconstruction Tendon Interposition' (LRTI) Arthroplasty, ...
N. L. Taylor R. Strauch
Subscapularis Repair With the Suture Shuttle Loop Technique
Successful techniques for arthroscopic repair of subscapularis tendon tears have been previously described in the literature. Recommendations regarding portal placement, tissue mobilization, and suture passage have been published. We present a novel technique that uses a shuttle suture passed with the Viper suture passer (Arthrex, Naples, FL) through a standard anterior arthroscopy portal. The described technique easily passes a suture through the subscapularis tendon while the surgeon visualizes suture placement from the posterior portal.
Nystrom, Stephen; Fagan, Paul; Vedder, Kristin; Heming, James
Threshold for detection of diabetic peripheral sensory neuropathy using a range of research grade monofilaments in persons with Type 2 diabetes mellitus
AIMS: To identify the threshold of reduced sensory perception in Type 2 diabetes mellitus (Type 2 DM) using a range of research grade monofilaments. METHODS: Three groups of participants were recruited into a between subject, cross-sectional study. Group 1(NEW), persons with Type 2 DM diagnosed for less than 2 years (n = 80); Group 2 (EST) persons with Type 2
Mary P Thomson; Julia Potter; Paul M Finch; Richard B Paisey
Functional implications of squamosal suture size in paranthropus boisei.
It has been hypothesized that the extensively overlapping temporal and parietal bones of the squamosal sutures in Paranthropus boisei are adaptations for withstanding loads associated with feeding. Finite element analysis (FEA) was used to investigate the biomechanical effects of suture size (i.e., the area of overlap between the temporal and parietal bones) on stress, strain energy, and strain ratio in the squamosal sutures of Pan troglodytes and P. boisei (specimen OH 5) during biting. Finite element models (FEMs) of OH 5 and a P. troglodytes cranium were constructed from CT scans. These models contain sutures that approximate the actual suture sizes preserved in both crania. The FEM of Pan was then modified to create two additional FEMs with squamosal sutures that are 50% smaller and 25% larger than those in the original model. Comparisons among the models test the effect of suture size on the structural integrity of the squamosal suture as the temporal squama and parietal bone move relative to each other during simulated premolar biting. Results indicate that with increasing suture size there is a decreased risk of suture failure, and that maximum stress values in the OH 5 suture were favorable compared to values in the Pan model with the normal suture size. Strain ratios suggest that shear is an important strain regime in the squamosal suture. This study is consistent with the hypothesis that larger sutures help reduce the likelihood of suture failure under high biting loads. PMID:24242913
Dzialo, Christine; Wood, Sarah A; Berthaume, Michael; Smith, Amanda; Dumont, Elizabeth R; Benazzi, Stefano; Weber, Gerhard W; Strait, David S; Grosse, Ian R
Pullout strength of suture anchors in comparison with transosseous sutures for rotator cuff repair.
Suture anchors are increasingly gaining importance in rotator cuff surgery. This means they will be gradually replacing transosseous sutures. The purpose of this study was to compare the stability of transosseous sutures with different suture anchors with regard to their pullout strength depending on bone density. By means of bone densitometry (CT scans), two groups of human humeral head specimens were determined: a healthy and a osteopenic bone group. Following anchor systems were being tested: SPIRALOK 5.0 mm (resorbable, DePuy Mitek), Super Revo 5 mm (titanium, Linvatec), UltraSorb (resorbable, Linvatec) and the double U-sutures with Orthocord USP 2 (partly resorbable, DePuy Mitek) and Ethibond Excel 2 (non-resorbable, Ethicon). The suture anchors/double U-sutures were inserted in the greater tuberosity 12 times. An electromechanical testing machine was used for cyclic loading with power increasing in stages. We recorded the ultimate failure loads, the system displacements and the modes of failure. The suture anchors tended to bring about higher ultimate failure loads than the transosseous double U-sutures. This difference was significant in the comparison of the Ethibond suture and the SPIRALOK 5.0 mm-both in healthy and osteopenic bone. Both the suture materials and the SPIRALOK 5.0 mm showed a significant difference in pullout strength on either healthy or osteopenic bone; the titanium anchor SuperRevo 5 mm and the tilting anchor UltraSorb did not show any significant difference in healthy or osteopenic bone. There was no significant difference concerning system displacement (healthy and osteopenic bone) between the five anchor systems tested. The pullout strength of transosseous sutures is neither on healthy nor on osteopenic bone higher than that of suture anchors. Therefore, even osteopenic bone does not constitute a valid reason for the surgeon to perform open surgery by means of transosseous sutures. The choice of sutures in osteopenic bone is of little consequence anyway since it is mostly the bone itself which is the limiting factor. PMID:18193198
Pietschmann, Matthias F; Fröhlich, Valerie; Ficklscherer, Andreas; Hausdorf, Jörg; Utzschneider, Sandra; Jansson, Volkmar; Müller, Peter E
The history and evolution of sutures in pelvic surgery
Summary The purpose of the study is to review the history and innovations of sutures used in pelvic surgery. Based on a review of the literature using electronic- and hand-searched databases we identified appropriate articles and gynaecology surgical textbooks regarding suture for wound closure. The first documented uses of suture are explored and then the article focuses on the use of knotted materials in pelvic surgery. The development of suture of natural materials is followed chronologically until the present time where synthetic suture is implanted during countless surgeries every day. This millennial history of suture contains an appreciation of the early work of Susruta, Celsus, Paré and Lister, including a survey of some significant developments of suture methods over the last 100 years. Most surgeons know little about the history and science of sutures. A retrospective view of suture is critical to the appreciation of the current work and development of this common tool.
Muffly, Tyler M; Tizzano, Anthony P; Walters, Mark D
A bidirectional interface growth model for cranial interosseous suture morphogenesis
Interosseous sutures exhibit highly variable patterns of interdigitation and corrugation. Recent research has identified fundamental molecular mechanisms of suture formation, and computer models have been used to simulate suture morphogenesis. However, the role of bone strain in the development of complex sutures is largely unknown, and measuring suture morphologies beyond the evaluation of fractal dimensions remains a challenge. Here we propose a morphogenetic model of suture formation, which is based on the paradigm of Laplacian interface growth. Computer simulations of suture morphogenesis under various boundary conditions generate a wide variety of synthetic sutural forms. Their morphologies are quantified with a combination of Fourier analysis and principal components analysis, and compared with natural morphological variation in an ontogenetic sample of human interparietal suture lines. Morphometric analyses indicate that natural sutural shapes exhibit a complex distribution in morphospace. The distribution of synthetic sutures closely matches the natural distribution. In both natural and synthetic systems, sutural complexity increases during morphogenesis. Exploration of the parameter space of the simulation system indicates that variation in strain and/or morphogen sensitivity and viscosity of sutural tissue may be key factors in generating the large variability of natural suture complexity.
Zollikofer, Christoph P E; Weissmann, John David
The cell biology of suturing tendons
Trauma by suturing tendon form areas devoid of cells termed "acellular zones" in the matrix. This study aimed to characterise the cellular insult of suturing and acellular zone formation in mouse tendon. Acellular zone formation was evaluated using single grasping sutures placed using flexor tendons with time lapse cell viability imaging for a period of 12 h. Both tension and injury were required to induce cell death and cell movement in the formation of the acellular zone. DNA fragmentation studies and transmission electron microscopy indicated that cells necrosed. Parallel in vivo studies showed that cell-to-cell contacts were disrupted following grasping by the suture in tensioned tendon. Without tension, cell death was lessened and cell-to-cell contacts remained intact. Quantitative immunohistochemistry and 3D cellular profile mapping of wound healing markers over a one year time course showed that acellular zones arise rapidly and showed no evidence of healing whilst the wound healing response occurred in the surrounding tissues. The acellular zones were also evident in a standard modified "Kessler" clinical repair. In conclusion, the suture repair of injured tendons produces acellular zones, which may potentially cause early tendon failure.
Wong, J.K.F.; Alyouha, S.; Kadler, K.E.; Ferguson, M.W.J.; McGrouther, D.A.
Fourier technique for studying ammonoid sutures
Suture patterns have long been recognized as being of primary importance in the study of ammonoids. The authors have developed a technique to use Fourier analysis to study these structures by using a simple transformation: x-y data of a digitized suture are transformed to angle of slope versus position along the suture's length. A Fast Fourier Transform applied to the data produces a power spectrum (amplitude versus wave number) providing a precise and accurate measure of suture shape. The authors have applied this technique to the analysis of ontogenetic change in suture morphology. In goniatitic, ceratitic and preadult ammonitic patterns most of the change is exhibited in the amplitudes of the lowest ten wave numbers. Their Fourier coefficients clearly show trends not readily apparent by visual inspection. The more complex ammonitic patterns are reflected in increased amplitudes of higher wave numbers (a broader peak of the power spectrum) and their analysis is necessarily more complex. The Fourier approach presents the opportunity to quantitatively measure and describe the tempo and mode of evolution in the Ammonoidea. Potential applications of the new technique, as well as limitations, are discussed with special attention to investigations of ammonoid ontogeny and phylogeny.
Gildner, R.F.; Ackerly, S.C.
New anti-infective coatings of surgical sutures based on a combination of antiseptics and fatty acids.
Wound infection is a complication feared in surgery. The aim of this study was to develop new anti-infective coatings of surgical sutures and to compare the anti-microbial effectiveness and biocompatibility to the well-established Vicryl Plus. Synthetic absorbable PGA surgical sutures were coated with three different chlorhexidine concentrations and two different octenidine concentrations in combination with palmitic acid and lauric acid. Drug-release kinetics lasting 96 h were studied in phosphate-buffered saline at 37 degrees C. Anti-infective characteristics were determined by measuring the change in optical density of Staphylococcus aureus suspensions charged with coated sutures over time. Microorganisms adsorbed at the surface of coated sutures were assessed on blood agar plates and coated sutures eluted for 24 h were placed on bacterial lawns cultured on Mueller-Hinton plates to prove retained anti-microbial potency. A cell proliferation assay was performed to assess the degree of cytotoxicity. Anti-infective characteristics and biocompatibility were compared to Vicryl Plus. A coating technology for slow-release drug-delivery systems on surgical sutures could be developed. All coatings showed a continuous drug release within 96 h. Individual chlorhexidine and octenidine coated sutures showed superior anti-infective characteristics but inferior biocompatibility in comparison to Vicryl Plus. We conclude that the developed anti-infective suture coatings consisting of lipid-based drug-delivery systems in combination with antiseptics are highly effective against bacterial colonization in vitro; however, drug doses have to be adjusted to improve biocompatibility. PMID:19622281
Matl, F D; Zlotnyk, J; Obermeier, A; Friess, W; Vogt, S; Büchner, H; Schnabelrauch, H; Stemberger, A; Kühn, K-D
Scapholunate ligament repair using suture anchors.
Background. This article describes the surgical repair of scapholunate ligament injury using Mitek suture anchors. Material and methods. 3 patients with neglected injuries of the scapholunate ligament were operated from 8 weeks to 5 months after trauma. The authors found that using the Mitek anchor suture simplifies the operative technique, obviates the technical difficulties involved in guiding the tendon through the bone tunnel, and reduces the possibility of the complications seen in the standard ligament repair techniques. Results and Conclusions. The operative technique used in the Clinic of Hand Surgery at the Medical University of Gdansk combines reduction of the displaced scaphoid bone from the dorsal approach and temporary scaphocapitate fixation with K wires, bringing the ruptured ligament closer with capsulodesis using Mitek suture anchors. PMID:17603433
Baczkowski, Bogus?aw; Lorczy?ski, Adam; Kabu?a, Jaros?aw; Camilleri, Rafa?
Laparoscopic fascial suture repair of parastomal hernia.
Parastomal hernia is a recognised complication following stoma formation, representing a challenging problem to surgeons. At least three approaches for parastomal hernia repair have been described: fascial suture repair, relocation of stoma and local repair with use of mesh. In simple fascial suture repair only open techniques have been described. Relocation of stoma can be complicated with another parastomal hernia at the new site and risk of incisional hernia at the site of previous stoma. Mesh repair can be either open or laparoscopic. The recurrence rate and complications of parastomal hernia repair remain very high. We have invented a simple fascial suture laparoscopic repair of parastomal hernia with the use of the Crochet hook needle (EndoClose). This new technique may result in reduced pain, earlier discharge from hospital and reduced risk of infection as there is no mesh used as well as reduced risk of seroma formation. PMID:23780775
Zia, Khawaja; McGowan, David Ross; Moore, Etienne
Single interrupted sutures compared with Donati sutures after open carpal tunnel release: a prospective randomised trial.
Inversion of the wound edges is one of the potential causes of postoperative scar tenderness after open carpal tunnel release. When using vertical mattress sutures (also named Donati sutures), inversion of wound edges is less likely to occur compared with single interrupted sutures. The purpose of this study was to compare the use of both sutures after open carpal tunnel release and assess their effects on scar tenderness and functional outcome. A prospective randomised controlled trial was performed comparing single interrupted and Donati sutures. Eighty-nine hands were included in the study. Eight weeks postoperatively, scar formation was nice/very nice in 94% (single stitches) and 97% (Donati stitches) of the patients. Pain and disability scores were, in both groups, improved 8 weeks postoperatively, although the patients receiving Donati sutures had a 2-fold higher pain score. In conclusion, both Donati and single stitches are related to excellent scar formation. The Donati sutures are related to more prolonged postoperative pain. PMID:23710789
Bolster, Mireille; Schipper, Carlijn; Van Sterkenburg, Steven; Ruettermann, Mike; Reijnen, Michel
Smad7 modulates TGF? signaling during cranial suture development to maintain suture patency.
Craniosynostosis, the premature fusion of one or more sutures between the calvarial bones, is a common birth defect. Mutations in genes encoding receptors for the transforming growth factor-beta (TGF?) family of signaling molecules have been associated with craniosynostosis, but how TGF? signaling is regulated during suture development is not known. In the present study, we found that expression of Smad2 and Smad3, intracellular mediators of canonical TGF? signaling, gradually increases during early postnatal suture development in rat in both the coronal suture (CS), which remains patent throughout life, and the posterior frontal suture (PFS), which undergoes programmed closure by postnatal day 22. The amounts of phosphorylated Smad2 and Smad3 proteins showed a similar gradual increase in the PFS and CS, but in the CS, Smad2/3 activation was suppressed after neonatal day 10. The suppression of Smad2/3 activation in the CS correlated with upregulation of Smad7 expression. We demonstrate that siRNA-mediated knockdown of Smad7 caused increased phosphorylation of Smad2 and Smad3 and induced osseous obliteration of the CS from postnatal days 10 to 22. The Smad7 siRNA-induced CS closure was associated with significantly increased levels of Fgf10 and phosphorylated ERK1/2 in the suture mesenchyme. Moreover, addition of the Erk1/2 inhibitor U0126 partially blocked Smad7-siRNA-induced CS closure. These findings suggest that canonical TGF? signaling induces suture closure at least in part through activation of FGF and ERK signaling and that Smad7 plays an important role in maintaining suture patency by suppressing canonical TGF? signaling during suture development. PMID:23959527
Zhou, Hao; Zou, Shujuan; Lan, Yu; Fei, Wei; Jiang, Rulang; Hu, Jing
Suture needles in Oral Surgery: Alterations depending on the type and number of sutures
This study examined whether the number and type of sutures used in oral surgery influence two ad hoc variables (incision plane and displaced area), which are two variables related to whether the suture needle is suitable for the task. Seventy-five TB-15 needles were studied, which were used to suture between zero and three mucosa and/subperiosteal sutures, producing 15 groups with 5 needles in each one. The incision plane and displaced area were measured for each group, which are two variables related to how the needle has worn and altered. Statistical treatment was conducted using the Kruskal-Wallis H test to compare multiple values and the Mann-Whitney U test to compare pairs. A multi-stage regression model was applied with the aim of predicting the changes in the dependent variables based on the number and type of sutures performed. The incision plane ranged from 126.67 to 346.24?m among the different groups. The displaced area was measured as being between 14 524.83?m˛ and 128 311.91?m˛. The best predictive model for the incision plane obtained a coefficient of determination (R2) of 0.149, while it reached 0.249 for the displaced area. Subperiosteal sutures held more weighting among the variables studied. Mucosal sutures did not seem to greatly affect needle wear. Observations reported in this paper indicate that the needle should be changed after having performed two subperiosteal sutures, given the wear and change to the incision plane that is produced, which causes the needle's cutting ability to reduce. Key words: Needles, sutures, material testing, oral surgery, third molar, scanning electron microscope.
Barranco-Piedra, Sebastian; Rodriguez-Caballero, Angela; Serrera-Figallo, Maria-Angeles; Segura-Egea, Juan-Jose; Gutierrez-Perez, Jose-Luis
21 CFR 878.5035 - Nonabsorbable expanded polytetrafluoroethylene surgical suture.
Code of Federal Regulations, 2010 CFR
...monofilament, nonabsorbable, sterile, flexible thread prepared from ePTFE and is intended for use in soft tissue approximation and ligation, including cardiovascular surgery. It may be undyed or dyed with an approved color additive and may be provided with or...
Histopathological evaluation of rotation sutures for involutional entropion.
Rotation sutures are a popular method of temporarily correcting involutional entropion. The permanence of the procedure depends on a fibrotic scar along the suture tracks. Sutures which create generous scars would probably produce the most satisfactory results. In this study 4-0 chromic gut, nylon, and silk sutures were evaluated in rabbit lower eyelids for their ability to create histologically demonstrable fibrous tracks. All three sutures incited inflammatory cells and fibroblastic activity with collagen formation at two and four weeks. Residual scar tracks were observed at six weeks (two weeks after suture removal) also. Human specimens showed similar types of scar formation from the sutures. It was apparent that all three sutures create fibrotic scars along their tracks sufficient to correct, at least temporarily, involutional entropion. Images
Seiff, S R; Kim, M; Howes, E L
Sutures Bested Staples After C-Section in Study
No man's craniosynostosis: the arcana of sutural knowledge.
No man's craniosynostosis is discussed under the following headings: historical notes, sutural development, suture closure, craniosynostotic patterns, anatomic and genetic perspectives, types of craniosynostosis, and 2 unusual types of craniosynostosis with large head circumferences. PMID:22337438
Cohen, M Michael
21 CFR 878.4930 - Suture retention device.
Code of Federal Regulations, 2013 CFR
... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4930 Suture retention device. (a) Identification. A suture retention...
Advances in Suture Material for Obstetric and Gynecologic Surgery
Despite millennia of experience with wound closure biomaterials, no study or surgeon has yet identified the perfect suture for all situations. Tissue characteristics, tensile strength, reactivity, absorption rates, and handling properties should be taken into account when selecting a wound closure suture. This review discusses the wound healing process and the biomechanical properties of currently available suture materials to better understand how to choose suture material in obstetrics and gynecology.
Greenberg, James A; Clark, Rachel M
Fractal analysis of the Orce skull sutures
Methods of fractal geometry (Mandelbrot, 1983) are used here to analyse the relative complexity of the sagittal and lambdoid sutures visible in the skull fragment formed by parts of an occipital squame and parietals found in a sealed deposit at the early Lower Pleistocene site of Venta Micena (Orce, Granada, Spain), generally regarded as human bone but occasionally suggested as
J. Gibert; P. Palmqvist
Mechanical properties of biodegradable polymer sutures coated with bioactive glass
Combining commercially available Polyglactin 910 (Vicryl®) sutures with bioactive glass powder offers new possibilities for application of composite materials in tissue engineering. Commercial bioactive glass (45S5 Bioglass®) powder was used to coat Vicryl® sutures and the tensile strength of the sutures was tested before and after immersion in simulated body fluid (SBF) as a means to assess the effect of
A. Stamboulis; L. L. Hench; A. R. Boccaccini
Elastic behaviour of sutured calf pericardium: influence of the suture threads.
The purpose of this study was to assess the elastic behaviour of calf pericardium used in the construction of cardiac bioprosthesis valve leaflets, sutured with different types of commercially available sutures: silk, Gore-Tex, Surgilene and nylon. Thirty-two samples (four series of eight samples each) were subjected to tensile strength testing to breakage. The breaking stress (MPa) ranged between 4.89 MPa for samples sutured with Gore-Tex and 5.22 MPa for those sewn with nylon. Three samples from each series were subjected to a stepwise stress test, involving increasing levels of stress followed by return to zero, to define the elastic limit (the cut-off point beyond which strain is no longer reversible). Analysis of the results provided the mathematical functions that govern the elastic behaviour (stress/strain) within the elastic range for each type of sutured sample. The series sutured with Surgilene presented the highest mean value (1.649 MPa). Finally, a statistical study was carried out to determine which series showed the greatest probability of having the least interaction between the thread and the pericardium. Allowing an interval of +/- 10%, Gore-Tex showed the best probability in this respect. However, real fatigue testing is necessary to definitively determine which is the best suture to use. PMID:8866029
García Páez, J M; Carrera San Martin, A; García Sestafe, J V; Jorge Herrero, E; Navidad, R; Cordón, A; Castillo-Olivares, J L
The biomechanics of rapid maxillary sutural expansion.
Micro-displacements (fringe patterns) in the bones of the craniofacial complex as seen through laser holography during midpalatal sutural expansion with the Hyrax appliance are used to define the centers of rotation of the maxillary halves in both the frontal and occlusal views. Biomechanical analyses of the maxillary expansion force system are concomitant with the holographic findings and strongly suggest that the stainless steel wires joining the teeth to any expansion device be of the largest diameter possible. In addition, in the case of the Hyrax expansion device, it is recommended that the manufacturer increase the diameter of the activating screw as well as those of the 2 adjacent wire guides. And, importantly, the use of acrylic as a structural member to join the teeth to a sutural expansion device should be avoided if tipping of the maxillary halves is to be minimized, as the acrylic lacks sufficient rigidity. PMID:10982925
Braun, S; Bottrel, J A; Lee, K G; Lunazzi, J J; Legan, H L
[Paleopathologic findings of premature coronal suture closure].
The work describes paleopathologic finding of brachycephaly deformation in 4 adult skulls, caused by premature coronal suture closure. Skulls come from the 35 pieces collection of craniostenoses, found in osteologic collection of 745 skulls from Broumov Ossuary. They were examined by cranioscopy, craniometry, x-ray and CT methods. Presence of brachycephaly in Broumov collection of skulls ant their percentage in the collection of craniosynostoses is discussed in the context with recent clinical data. PMID:19569587
Pospísilová, Blanka; Procházková, Olga; Serbouti, Khalid
Influence of frontosphenoidal suture synostosis on skull dysmorphology in unicoronal suture synostosis.
Severity of the Harlequin deformity seen in unicoronal synostosis may be augmented when frontoparietal suture synostosis has an associated fusion of the frontosphenoidal suture or in cases of isolated frontosphenoidal synostosis. The purpose of the current study is to characterize various suture fusion patterns along the coronal ring using a modified orbital index (MOI), orbital angle (OA), and endocranial base (EB) angle.This study is a retrospective single institution cohort study. Charts were reviewed over the past 12 years; patients with isolated UCS were included. MOI, OA, and EB were used to identify 3 groups of UCS patients.Twenty-one patients were identified for inclusion in skeletal dysmorphology analysis using MOI, OA, and EB measures. Frontoparietal synostosis patients were diagnosed at significantly younger ages than frontoparietal + frontosphenoidal patients (P = 0.0001). Ipsilateral MOI measures were more severe for frontoparietal patients compared with frontoparietal + frontosphenoidal patients (P = 0.0239). There was a trend for more severe ipsilateral OA measures in frontoparietal patients compared with frontoparietal + frontosphenoidal patients (P = 0.181).Modified orbital index, OA, and EB measurements are useful in the diagnosis of suture fusion patterns in UCS patients. Frontoparietal synostosis has more severe Harlequin deformity compared with frontoparietal + frontosphenoidal patients. Frontosphenoidal fusion coinciding with frontoparietal synostosis may blunt the severity of skeletal dysmorphology in UCS patients and be associated with a delayed diagnosis. Attention must be paid to assessing the frontosphenoidal suture to assure adequate surgical release. PMID:23147332
Showalter, Brian M; David, Lisa R; Argenta, Louis C; Thompson, James T
Effect of suture material on postoperative astigmatism.
Two hundred patients were enrolled in a randomized, prospective clinical trial comparing the use of 10-0 nylon, 10-0 polypropylene (Prolene), 11-0 polyester (Mersilene), and 10-0 polyethylene (Novafil) suture materials on the amount and decay curves of surgically induced astigmatism following intraocular lens (IOL) surgery. Patients with Mersilene and nylon sutures had the highest amounts of induced with-the-rule (WTR) cylinder (significantly more than Prolene) at one day after surgery. However, the WTR cylinder decayed rapidly for nylon during the first three months but more slowly for Mersilene because of its lack of stretchability. The Prolene group had the lowest level of induced WTR cylinder at one day, but against-the-rule (ATR) drift occurred, leaving cases with ATR astigmatism by a year. The nylon group had the second highest amount of induced WTR cylinder at one day, which had decayed to ATR cylinder by five months. Between one and two years postoperatively, the nylon group experienced a significant ATR shift. The amount of early induced WTR cylinder seemed to be related to the knot-tying technique and tissue gripping characteristics, whereas the shape of the decay curve was related to the material characteristics of the suture. PMID:1531234
Gimbel, H V; Raanan, M G; DeLuca, M
Coracoclavicular stabilization using a suture anchor technique.
Multiple fixation options exist for coracoclavicular stabilization, but many are technically demanding and require hardware removal. In the study reported here, we reviewed a specific fixation technique that includes suture anchors moored in the base of the coracoid process. We retrospectively reviewed 24 consecutive cases of patients who underwent coracoclavicular stabilization with a suture anchor for a type III or type V acromioclavicular (AC) joint separation or a group II, type II or type V distal clavicle fracture. Eighteen of the 22 patients had full strength and painless range of motion (ROM) in the affected extremity by 3 months and at final follow-up (minimum, 24 months; mean, 39 months). Two patients were lost to follow-up. Four patients had early complications likely secondary to documented noncompliance. Two of these 4 patients underwent reoperation with a similar procedure and remained asymptomatic at a minimum follow-up of 15 months. One patient underwent osteophyte and knot excision 7 months after surgery and remained asymptomatic at 30 months. Our results suggest that coracoclavicular stabilization using a suture anchor technique is a safe and reliable method of treating acromioclavicular joint separations and certain distal clavicle fractures in the compliant patient. PMID:18716693
Friedman, Darren J; Barron, O Alton; Catalano, Louis; Donahue, Joseph P; Zambetti, George
A modified suture technique produces consistent cerebral infarction in rats
Intraluminal occlusion of the middle cerebral artery (MCA) is used extensively in cerebral ischemia research. We tested a modified nylon suture in a rat model of middle cerebral artery occlusion (MCAO) under two anesthesia regimens. Sprague-Dawley rats were divided into six groups (Group 1, Poly-L-lysine-coated suture under ketamine/xylazine anesthesia; Group 2, modified suture under ketamine/xylazine anesthesia; Group 3, Poly-L-lysine-coated suture under ketamine/xylazine anesthesia with mechanical ventilation; Group 4, modified suture under ketamine/xylazine anesthesia with mechanical ventilation; Group 5, Poly-L-lysine-coated suture under isoflurane anesthesia; Group 6, modified suture under isoflurane anesthesia) and subjected to 2 hours MCAO. Regional cerebral blood flow (rCBF) was monitored by Laser-Doppler flowmetry. Neurological evaluation and ischemic lesion (TTC stain) were assessed at 24 hr of reperfusion. The total ischemic lesion (sum of areas with lacking and intermediate TTC staining) was similar among all six groups. Compared with a Poly-L-lysine-coated suture technique, the modified suture technique produced a lower rCBF, larger infarct size, smaller variance of infarct size, and greater neurological deficit. In addition, isoflurane significantly reduced infarct size. We conclude that use of this modified suture technique with ketamine/xylazine anesthesia and mechanical ventilation produces a more consistent change in cerebral ischemic damage following MCAO in rats.
Zhao, Honggang; Mayhan, William G.; Sun, Hong
Cranial suture biology of the Aleutian Island inhabitants.
Research on cranial suture biology suggests there is biological and taxonomic information to be garnered from the heritable pattern of suture synostosis. Suture synostosis along with brain growth patterns, diet, and biomechanical forces influence phenotypic variability in cranial vault morphology. This study was designed to determine the pattern of ectocranial suture synostosis in skeletal populations from the Aleutian Islands. We address the hypothesis that ectocranial suture synostosis pattern will differ according to cranial vault shape. Ales Hrdlicka identified two phenotypes in remains excavated from the Aleutian Island. The Paleo-Aleutians, exhibiting a dolichocranic phenotype with little prognathism linked to artifacts distinguished from later inhabitants, Aleutians, who exhibited a brachycranic phenotype with a greater amount of prognathism. A total of 212 crania representing Paleo-Aleuts and Aleutian as defined by Hrdlicka were investigated for suture synostosis pattern following standard methodologies. Comparisons were performed using Guttmann analyses. Results revealed similar suture fusion patterns for the Paleo-Aleut and Aleutian, a strong anterior to posterior pattern of suture fusion for the lateral-anterior suture sites, and a pattern of early termination at the sagittal suture sites for the vault. These patterns were found to differ from that reported in the literature. Because these two populations with distinct cranial shapes exhibit similar patterns of suture synostosis it appears pattern is independent of cranial shape in these populations of Homo sapiens. These findings suggest that suture fusion patterns may be population dependent and that a standardized methodology, using suture fusion to determine age-at-death, may not be applicable to all populations. PMID:21328563
Cray, James; Mooney, Mark P; Siegel, Michael I
A Biomechanical Analysis of Anterior Bankart Repair Using Suture Anchors
Background: Arthroscopic repair of anterior Bankart lesions is typically done with single-loaded suture anchors tied with simple stitch configuration.Hypothesis: The knotless suture anchor will have similar biomechanical properties compared with two types of conventional suture anchors.Study Design: Controlled laboratory study.Methods: Fresh-frozen shoulders were dissected and an anteroinferior Bankart lesion was created. For phase 1, specimens were randomized into either simple
Shane J. Nho; Rachel M. Frank; Geoffrey S. Van Thiel; Fan Chia Wang; Vincent M. Wang; Matthew T. Provencher; Nikhil N. Verma
Techniques and applications of adjustable sutures.
The 'rediscovery' of adjustable sutures some 10 years ago has given the ophthalmic surgeon much more confidence in his ability to correct strabismus. Three methods of use are described: during surgery under general anaesthesia with adjustment during the operation using the 'springback' test to centralise the eye; during surgery under general anaesthesia and subsequent adjustment under local anaesthesia using the patient's subjective responses to obtain optimal positioning; and performance of the operation and adjustment under topical local anaesthesia in one procedure. Full details are given of each technique and the indications for their application to particular problems are discussed. PMID:3297111
Fells, P
Tendon-Bone Interface Motion in Transosseous Suture and Suture Anchor Rotator Cuff Repair Techniques
Background: Although many studies involving rotator cuff repair fixation have focused on ultimate fixation strength and ability to restore the tendon's native footprint, no studies have characterized the stability of the repair with regard to motion between the tendon and repair site footprint.Hypothesis: Suture anchor fixation for rotator cuff repair has greater interface motion between tendon and bone than does
Christopher S. Ahmad; Andrew M. Stewart; Rolando Izquierdo; Louis U. Bigliani
The effect of two nonresorbable suture types on the mechanical performance over a metal suture anchor eyelet.
An understanding of the mechanical properties of different suture materials is valuable when selecting the most appropriate suture and repair technique. Sutures should be strong, easy to handle and have high knot security. The introduction of suture anchors adds an additional variable regarding the effect of stress risers over the eyelet. Improving the mechanical properties of a suture may be a possible method to help avoid failure over stress risers such as the eyelet of suture anchor. This study examined the static and viscoelastic properties of a new polyethylene based non-resorbable suture (Fibrewire) over the eyelet of a standard anchor compared to braid polyester non-resorbable suture (Ethibond). Fibrewire had superior ultimate load properties compared to Ethibond (360.2 N+/-23.8 vs 191.9 N+/-17.3) as well as greater stiffness (61.3 N/mm+/-9.7 vs 8.1 N/mm+/-0.4) when tested in uniaxial tension through a metal anchor eyelet (Mitek) ( p<0.001). Fibrewire demonstrated greater stress relaxation than Ethibond ( p<0.05). Differences in the static and viscoelastic properties of suture may have implications in the post-operative period or during rehabilitation. PMID:13680105
Acton, D; Perry, A; Evans, R; Butler, A; Stephens, P; Bruce, W; Goldberg, J; Sonnabend, D; Walsh, W R
Are intracostal sutures better than pericostal sutures for closing a thoracotomy?
A best evidence topic was written according to a structured protocol. The question addressed was to identify which thoracotomy closure method lends itself to the least postoperative pain. Altogether 109 papers were found using the reported search; of which, seven represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that the closure by intracostal sutures with intercostal nerve sparing offers a superior postoperative pain profile for thoracotomy patients when compared with conventional techniques. Up to 1-year follow-up has shown that this technique (avoiding strangulation of the intercostal nerve) leads to lower postoperative pain and analgesic use, better ambulation and a quicker return to daily activities. Three papers (including two randomized trials) found intracostal sutures with intercostal nerve sparing techniques to be superior to conventional methods such as pericostal suture closure. Rib approximation with intercostal nerve sparing was found to be superior to rib approximation without nerve sparing in one study. Two studies associated with the creation of an intercostal muscle flap prior to the insertion of a rib retractor to be associated with significantly reduced postoperative pain. One study described a novel 'edge-closure' technique, comparable to the closure with intracostal sutures without drilling, to be superior to conventional closure with pericostal sutures. Postoperative pain is a significant issue faced by thoracic surgeons both in-hospital and in the longer term where patients may complain of chronic thoracotomy pain. We would therefore recommend that some form of intercostal nerve protection be implemented during thoracotomy opening and closure. PMID:22431654
Visagan, Ravindran; McCormack, David J; Shipolini, Alex R; Jarral, Omar A
Are intracostal sutures better than pericostal sutures for closing a thoracotomy?
A best evidence topic was written according to a structured protocol. The question addressed was to identify which thoracotomy closure method lends itself to the least postoperative pain. Altogether 109 papers were found using the reported search; of which, seven represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that the closure by intracostal sutures with intercostal nerve sparing offers a superior postoperative pain profile for thoracotomy patients when compared with conventional techniques. Up to 1-year follow-up has shown that this technique (avoiding strangulation of the intercostal nerve) leads to lower postoperative pain and analgesic use, better ambulation and a quicker return to daily activities. Three papers (including two randomized trials) found intracostal sutures with intercostal nerve sparing techniques to be superior to conventional methods such as pericostal suture closure. Rib approximation with intercostal nerve sparing was found to be superior to rib approximation without nerve sparing in one study. Two studies associated with the creation of an intercostal muscle flap prior to the insertion of a rib retractor to be associated with significantly reduced postoperative pain. One study described a novel 'edge-closure' technique, comparable to the closure with intracostal sutures without drilling, to be superior to conventional closure with pericostal sutures. Postoperative pain is a significant issue faced by thoracic surgeons both in-hospital and in the longer term where patients may complain of chronic thoracotomy pain. We would therefore recommend that some form of intercostal nerve protection be implemented during thoracotomy opening and closure.
Visagan, Ravindran; McCormack, David J.; Shipolini, Alex R.; Jarral, Omar A.
We present the design for an absorbing metamaterial (MM) with near unity absorbance A(omega). Our structure consists of two MM resonators that couple separately to electric and magnetic fields so as to absorb all incident radiation within a single unit cell layer. We fabricate, characterize, and analyze a MM absorber with a slightly lower predicted A(omega) of 96%. Unlike conventional
N. I. Landy; S. Sajuyigbe; J. J. Mock; D. R. Smith; W. J. Padilla
Assessment of surgical sutures POLYMED® by intracutaneous irritation test in rabbits
The aim of the present study was to evaluate local irritant effects to rabbit skin following a single application of test samples of non-sterile polyamide non-absorbable surgical sutures POLYMED®. The polar and nonpolar extracts were prepared by using saline solution and olive oil, respectively, after sinking the materials tested (2.0 g) in 10 ml of the corresponding liquid. Incubation was carried out at the temperature of 37 °C for 72 h. The saline solution and pure olive oil, which had no contact with the materials tested, were used as negative control samples and were incubated under the same conditions as above. Assessments of the extracts from each material were conducted on 2 albino rabbits of the New Zealand breed. On the back of each animal, 5 intracutaneous injections of the extract tested and 5 injections of the control solution, each of 0.2 ml, were carried out. The degree of irritation was scored at 4, 24, 48, 72 hours after injection and no skin changes were found. The intracutaneous irritation index (III) was calculated and yielded 0.0. Hence it was concluded that under the experimental conditions the extracts of the material tested, i.e. non-sterile polyamide non-absorbable surgical sutures POLYMED®, were 'non-irritant' to the skin of rabbits when compared with the respective control groups. The experimental procedure was conducted according to ISO10993-10.
Danchev, Nikolai
Comparing historical catch rates of American shad in multifilament and monofilament nets: A step toward setting restoration targets for Virginia stocks
Recreational and commercial harvest of American shad Alosa sapidissima in the Virginia waters of the Chesapeake Bay and its tributaries has been prohibited since 1994. The Atlantic States Marine Fisheries Commission Shad and River Herring Management Plan requires that Virginia develop restoration targets for its shad populations, but estimates of their sizes are not available and there is little information about historic population levels. Thus, establishing restoration targets based on population size is problematic. A current spawning stock monitoring program yields catch rate information that can be compared with historic catch rate information recorded in commercial fishery logbooks from the 1950s and the 1980s. However, multifilament gill nets were used in the 1950s and monofilament nets were used in the 1980s (as well as in the current monitoring program). A Latin square design was employed to test the differences in relative fishing power of the two gear types over 2 years of seasonal sampling on the York River, Virginia. Estimates are that the monofilament nets are roughly twice as efficient as the multifilament nets. Reported catch rates in the 1950s and 1980s are roughly equivalent. However, when adjustments are made for the differences in fishing gear, catch rates for the 1950s are twice as high as those during the 1980s. These results provide valuable information for setting restoration targets for Virginia stocks of American shad. ?? Copyright by the American Fisheries Society 2006.
Maki, K. L.; Hoenig, J. M.; Olney, J. E.; Heisey, D. M.
Safety Pin Suture for Management of Atonic Postpartum Hemorrhage
Objective. To assess the efficacy of a new suture technique in controlling severe resistant uterine atonic postpartum hemorrhage. Patients and Methods. This is a retrospective observational study that included thirteen women with uterine atony and postpartum bleeding that did not react to usual medical management. All these women underwent compressing vertical suture technique in which the anterior and posterior walls of the uterus were attached so as to compress the uterus. The suture is transfixed at the uterine fundus, thus eliminating the risk of sutures sliding off at the uterine fundus (safety pin suture). Results. safety pin uterine compression suture was a sufficient procedure to stop the bleeding immediately in 92.2% of the women. None of the women developed complications related to the procedure. Conclusion. A new safety pin suture is a simple and effective procedure to control bleeding in patients with treatment-resistant, life-threatening atonic postpartum hemorrhage with the advantage of eliminating the risk of the sutures sliding off at the uterine fundus.
Mostfa, Ali Abdelhamed M.; Zaitoun, Mostafa M.
Electrospun Drug-Eluting Sutures for Local Anesthesia
We have developed a local anesthetic-eluting suture system which would combine the function and ubiquity of the suture for surgical repair with the controlled release properties of a biodegradable polymeric matrix. Drug-free and drug-loaded poly(lactic-co-glycolic acid) (PLGA) sutures were fabricated by electrospinning, with or without the local anesthetic bupivacaine. The tensile strength of the electrospun sutures decreased as drug content increased, but strains remained relatively similar across all groups. Sutures released their entire drug payload over the course of 12 days and maintained approximately 12% of their initial tensile strength after 14 days of incubation in vitro. In a rat skin wound model, local analgesia was achieved 1 day after surgery and lasted approximately 1 week in 90% of treated animals (n = 10, p < 0.05), and all wounds were able to heal normally without the need for further reinforcement. The sutures caused tissue reaction in vivo that was comparable to that seen with a commercially available suture composed of PLGA. Such sutures may enhance perioperative analgesia and mitigate the need for standard postoperative opioid analgesics.
Weldon, Christopher B.; Tsui, Jonathan H.; Shankarappa, Sahadev A.; Nguyen, Vy T.; Ma, Minglin; Anderson, Daniel G.; Kohane, Daniel S.
Strabismus surgery: adjustable sutures—good for all?
Aims The role of adjustable sutures in strabismus surgery has mainly been limited to conditions like dysthyroid restrictive myopathy, blow-out fractures of orbit, aberrant regeneration of nerves, and certain other long-standing and complicated squints. In this clinical study, an attempt has been made to analyse the efficacy of adjustable sutures in squint surgery as a routine procedure. We also studied
A Tripathi; R Haslett; I B Marsh
A biomechanical comparison of suture constructs used for coracoclavicular fixation.
There is no consensus regarding surgical treatment for severely dislocated acromioclavicular joints. Although many treatments are suture-based, the suture materials and resulting suture-bone constructs have been subjected to limited systematic evaluation. This study identifies the strongest and least deforming suture construct among those commonly used for such repairs. Each suture-based repair was tested on a simulated clavicle and coracoid process with the skeletal components distracted until the suture failed to obtain tensile strength. Additional groups of sutures were subjected to cyclic loading to determine resistance to deformation. Panacryl braid had significantly greater tensile strength than all other constructs: Polydioxanone (PDS) braid, Mersilene tape, and Ethibond #5. Deformation after cyclic loading of Panacryl braid, PDS braid, and two strands of Mersilene tape was significantly less than that of the other constructs. A bioabsorbable suture loop, such as Panacryl, can act as a temporary internal splint, maintaining acromioclavicular joint reduction long enough for ligamentous healing during rehabilitation, and can avoid complications associated with permanent fixation materials. Panacryl braid deserves serious consideration for coracoclavicular fixation because of its strength, resistance to deformation, and bioabsorbable properties. PMID:14577722
Wickham, M Quinn; Wyland, Douglas J; Glisson, Richard R; Speer, Kevin P
Arthroscopic transosseous suture anchor technique for rotator cuff repairs.
The skin is incised 1 to 2 cm distal to the lateral portal. A transosseous tunnel is created through the greater tuberosity by a sharp penetrator, entering 1.5 to 2 cm distal to the top of the greater tuberosity. The penetrator exits medially, between the tip of the greater tuberosity and the articular surface of the humeral head, in the middle of the footprint. The first anchor, a 5-mm Spiralok (DePuy Mitek, Norwood, MA) is placed at the penetrator's exit site on the footprint. Using a specially designed suture leader, the lateral limb of the suture in the anchor, which passes through the previously created transosseous tunnel, is taken from the anchor and pulled out. The other suture end is passed through the supraspinatus tendon. The second suture, placed superficially in the anchor, is passed from the anchor through the supraspinatus tendon, as a mattress suture. If more anchors are required, the procedure should be repeated. The transosseous suture limb and the suture limb that is passed through the supraspinatus tendon are tied through the lateral portal. The knot tying is then performed with a sliding Delimar knot. The mattress suture, passing through the supraspinatus tendon, is tied through the anterior lateral portal. The knot tying procedure is repeated depending on the number of anchors. PMID:16651169
Cicak, Nikola; Klobucar, Hrvoje; Bicanic, Goran; Trsek, Denis
Sidewinder retention sutures for closure of the abdominal wall.
Reported herein, a technique of sutures placement that avoids certain objections to the traditional style of retention sutures is described. It is particularly useful in patients undergoing repeated laparotomy and in patients whose wounds are closed in a layered manner and who are at high risk for dehiscence. PMID:2525819
Rappaport, W D; Putnam, C
Surgeon Evaluation of Suture and Endo-Mechanical Products
Background. Surgeons select medical instruments without comparative performance data. This analysis seeks to determine if suture and endo-mechanical products made by different vendors have equivalent performance profiles or are clearly distinguished by physicians on different dimensions. Materials and methods. A sample of 45 surgeons evaluated eight vendors of five categories of suture and endo-mechanical products: clip appliers, staplers, trocars, needles
Lawton R. Burns; J. Andrew Lee; Eric T. Bradlow; Anthony Antonacci
Strain in the Braincase and Its Sutures During Function
The skull is distinguished from other parts of the skeleton by its composite construction. The sutures between bony elements provide for interstitial growth of the cranium, but at the same time they alter the transmission of stress and strain through the skull. Strain gages were bonded to the frontal and parietal bones of miniature pigs and across the interfrontal, interparietal and coronal sutures. Strains were recorded 1) during natural mastication in conjunction with electromyographic activity from the jaw muscles and 2) during stimulation of various cranial muscles in anesthetized animals. Vault sutures exhibited vastly higher strains than did the adjoining bones. Further, bone strain primarily reflected torsion of the braincase set up by asymmetrical muscle contraction; the tensile axis alternated between +45° and ?45° depending on which diagonal masseter/temporalis pair was most active. However, suture strains were not related to overall torsion but instead were responses to local muscle actions. Only the coronal suture showed significant strain (tension) during jaw opening; this was caused by the contraction of neck muscles. All sutures showed strain during jaw closing, but polarity depended on the pattern of muscle usage. For example, masseter contraction tensed the coronal suture and the anterior part of the interfrontal suture, whereas the temporalis caused compression in these locations. Peak tensile strains were larger than peak compressive strains. Histology suggested that the skull is bent at the sutures, with the ectocranial surface tensed and the endocranial surface predominantly compressed. Collectively, these results indicate that skulls with patent sutures should be analyzed as complexes of independent parts rather than solid structures.
Herring, Susan W.; Teng, Shengyi
Meso-Tethyan oceanic sutures and their deformation
NASA Astrophysics Data System (ADS)
On the basis of comparative stratigraphie and paleontologic analysis, supported by some key paleomagnetic data and interpretations, it is shown that during the Mesozoic and the Cenozoic the Eurasian continent grew by accretion of microcontinents. These microcontinents separated basins with oceanic crust from the main ocean. During the Late Cretaceous and the early Cenozoic the collision of the microcontinents with Eurasia resulted in the closure of the basins, and Meso-Tethyan oceanic sutures originated. In the region under consideration, from the Carpathians to Tibet, there are two main Meso-Tethyan sutures: the Carpathian-Lesser Caucasus and the Afghan-Tibet suture. The above-mentioned main structures also had branches, which remained as sutures of small basins: the Kamennopotock, Interpontide, Nain-Baft basins and others. In the West Carpathians the Carpathian-Lesser Caucasus suture is overlain by a widespread Gemeric-Tatric allochton. From the West Carpathians the suture passes through the Pannonian basin into the Vardar ophiolite zone and farther to the ophiolites of the Izmir-Ankara zone. Being displaced along the North Anatolian right-lateral strike-slip fault, the main suture passes from the Eastern Pontides into the Lesser Caucasus, where it is marked by ophiolites of the Amasia area, the Shirak, Bozum and Zangezur ridges. Sunsequently, it can be observed through the Iranian Qara Dagh mountains to Lake Urumiyeh and the North Anatolian strike-slip fault. Being again shifted along the strike-slip fault, the Carpathian-Lesser Caucasus Meso-Tethyan suture ends in the Western Zagros near the Cenozoic Neo-Tethyan suture. The Afghan-Tibet Meso-Tethyan suture is situated in the Pamirs in the Rushan-Pshart zone. The east prolongation of the suture has been displaced along the Pamir-Karakorum right-lateral strike-slip fault in Tibet. West of the Pamirs this suture is also displaced along strike-slip faults and continues in the Farahrud zone in Afghanistan, and than passes through the Zabol-Baluch and Daz Murian ophiolite zones and approaches the Neo-Tethyan suture. The paleomagnetic data allow us to reconstruct the location of those sutures in the Late Cretaceous-early Cenozoic. If one compares the present position of the Carpathian-Lesser Caucasus and Afghan-Tibet Meso-Tethyan sutures with the Late Cretaceous-early Cenozoic reconstructions of these sutures it is possible to trace the inner deformation of the Alpine belt. According to these data, the Carpathian-Lesser Caucasus suture moved northwards over 1200 km ahead of the Arabian-Turkish syntaxis with the displacement direction across the fold belt. At the border of the Dinarides and Hellenides, the displacement decreases to 400-500 km, and its direction is along the fold belt. The amplitude of the suture displacement increases in the Pannonian region and again decreases towards the Eastern Alps. The displacement of the Afghan-Tibet suture was > 2000 km during the Alpine deformation. A great ensemble of Cenozoic nappes, folds and structural arcs of the Pamir-Punjab and Arabian-Turkish syntaxes and Carpathian loop is the result of lateral shortening of the Alpine belt through the collision.
Burtman, V. S.
Mesenteric suture granuloma caused by retained fragments of suture material in a girl who had a laparotomy 12 years previously.
The authors report a case of a mesenteric suture granuloma in a 12 year-old-girl who had a small bowel resection for a complicated intussusception at the age of 5 months. At later exploration a whitish round tumor located on the anti-mesenteric side of the intestine was found. Several small intestinal loops also abutted on the tumor. Pathologic examination showed fibrosis and a granuloma containing linear colored braided suture material with multinucleated giant cell. As mesenteric suture granulomas have a complex appearance and mimic a soft tissue tumor during imaging, it is important for a surgeon to know about this condition and to consider the history of previous surgery when evaluating the images of patients presenting with an abdominal or pelvic mass. Suture granulomas separate from previous suture sites have not been described in the literature. PMID:23331835
Jung, Eunyoung; Park, Woo-Hyun; Choi, Soon-Ok
Posterosuperior suture granuloma impingement after arthroscopic SLAP repair using suture anchors: a case report
Arthroscopic refixation of the glenoid labrum has become a standard treatment of type II SLAP lesions although postoperative\\u000a results are not uniformly good due to factors which are yet unclear. We present the case of an active overhead athlete with\\u000a an intraarticular posterosuperior impingement syndrome arising from a suture granuloma formation complicating the postoperative\\u000a course after arthroscopic SLAP repair. The
Adeleke Ifesanya; Markus Scheibel
Platelike Dynamic Vibration Absorber.
National Technical Information Service (NTIS)
The patent application describes platelike dynamic vibration absorbers for providing vibration suppression. Optimum values of their tuning and damping are specified. The dynamic absorbers are comprised either of a circular or an annular damped plate that ...
J. C. Snowdon
Infrared Saturable Absorber Devices.
National Technical Information Service (NTIS)
Gaseous saturable absorbers are studied. These absorbers are used for mode-locking of infrared lasers, particularly CO2. Nonlinear-optical coefficients and transition moments were measured. Detectors for infrared radiation were also studied. Mechanisms of...
S. E. Schwarz
NASA Technical Reports Server (NTRS)
Compact, inexpensive clamp for flexible cables or rigid tubes absorbs vibrations and other motion. It accomodates wide range of dimensions, and saves space by eliminating pigtails or bellows commonly used to absorb linear movement or vibrations
Abbott, J. R.; Valencia, B., Jr.
Sutures in the Altaids: Implications for Continental Suturing and Growth (Invited)
NASA Astrophysics Data System (ADS)
Ophiolites and melanges are remnants of vanished oceans in orogenic belts; therefore they are very important for defining sutures. However, as illustrated in the Altaids ophiolitic fragments can be formed at different tectonic settings. Some ophiolites in the Altaids may be substrate of oceanic island arcs or accreted fragments, such as those in Kazakhstan and East Junggar. Others are mainly melanges and mostly occur as blocks or slices in accretionary prisms, such as those in the southern Chinese Altay and southern Tianshan. Ages of ophiolites and melanges should be used to constrain the existence time of ancient oceans, which predate the accretionary process after their emplacement. These ophiolitic fragments or melanges do not necessarily represent real sutures. Ages of some ophiolitic fragments and melanges in Central Asia such as those in the Tianshan predate accretion/collision event and the incorporation of these ophiolitic fragments into accretionary complexes may reflect merely different phases of accretion instead of closure of a major ocean. Major oceans or real sutures can only be recognized by paleogeographical separation of typical faunas and/or floras as many orogenic systems contain archipelagos with second-hand ocean basins, a tectonic scenario similar to the present-day SE Asia. Paleomagnetic data and tectonic analysis enable us to conduct palinspastic reconstructions and can help define real sutures, such as the one in the Southern Tianshan as a main cryptic plane separating the Tarim craton to the south and the accretionary collages to the north from the late Paleozoic to the early Triassic. During most of the Paleozoic time, the Siberia Craton was distributed in the northwest and the Tarim Craton was in the southeast, while the Kazakhstan arc chain was in the west. The active margin of the Siberia Craton had wide accretionary complexes and accreted intra-oceanic arcs and terranes, the Kazakhstan arc chain was characterized by multiple subductions, while the northern margin of the Tarim Craton remained mostly a passive margin. The multiple convergence and accretion among these orogenic systems generated huge orogenic collages in the late Paleozoic and even early Triassic, in which two types of amalgamation happened: (1) orthogonal interactions and oroclinal stacking of the Kazakhstan composite arc chain, and (2) parallel collision of the Altai, East Junggar, and Tianshan arcs. Complicated orogensis may shed light on a better understanding of orogenic suturing and continental growth. Acknowledgements: NSFC (41230207, 41190070, 41190075)
Xiao, W.
A shock absorbing subassembly, for use in an oil well drilling string above a drilling bit to absorb and reduce bit induced vibration and impact loads, wherein a shock absorber element is provided which includes at least one set of ring springs. The ring springs comprise alternating closed outer rings and closed inner rings with tapered contact surfaces on the outer and inner rings.
Zabcik, C.J.
Randomized Comparison of Nylon Versus Absorbing Polyglactin 910 for Fascial Closure in Caesarean Section
Background: Regardless of numerous advances in surgical techniques, selection of the best technique to sew up wounds and the best suture material are still controversial. Several postoperative complications, including wound infection, stitched wound, chronic incision pain, wound dehiscence and hernia stitches result from many factors such as used suture material. Objectives: The aim of the present study was to investigate the complications of pfannenstiel incision and nylon/ polyglactin 910 sutures utilization in patients undergoing c-section cesarean. Patients and Methods: This clinical trial was conducted on 120 women who underwent caesarean section at Imam-Ali hospital in Zabol, Iran. In this study, patients were equally divided into two groups of 60 people (50% in nylon suture and 50% in polyglactin 910 sutures). Patients of the two groups were investigated by a gynecologist 24-48 hours after the operation, a week later and on the sixth month of surgery. Moreover, time of wound dehiscence and treatment duration, the level of sinus infection, chronic incision pain and incision hernia were studied. The results were analyzed by SPSS software. P ? 0.05 was considered as statistically signi?cant. Results: One hundred and twenty patients undergoing a cesarean section at Imam-Ali hospital in Zabol were recruited into the study, 60 in the Nylon group and 60 in Polyglactin 910group. Our data demonstrated a statistically higher incidence of suture sinus and chronic incision pain in the nylon group (P < 0.05). No statistically signi?cant difference in wound stitch and incision hernia was demonstrated between the suture groups. Conclusions: The results of our trial did not demonstrate a significant difference between absorbing polyglactin 910 (PDS) and nylon regarding incision hernia, wound infection and wound dehiscence. However, subjects sutured with PDS were less likely to experience chronic incision pain and wound stitch. Therefore, PDS appears to be the optimal choice for fascial closure after cesarean section.
Rezaie Kahkhaie, Kolsoum; Rezaie Keikhaie, Khadije; Shahreki Vahed, Aziz; Shirazi, Mahboobeh; Amjadi, Nooshin
Teaching basic video skills as an aid in laparoscopic suturing
Background There is a perception among surgeons that performing laparoscopic suturing is unduly difficult. The purpose of this study\\u000a is to document a program which aides in learning laparoscopic suturing.\\u000a \\u000a \\u000a \\u000a Methods Fourteen volunteer medical students without prior experience were taught laparoscopic suturing. Videoscopic pelvitrainers\\u000a were utilized for a 2-h training session. Extracorporeal and intracorporeal knot tying was demonstrated utilizing a three-throw\\u000a square
J. K. Champion; J. Hunter; T. Trus; W. Laycock
Reflection-diffraction seismic pattern at crustal suture zones
NASA Astrophysics Data System (ADS)
Seismic reflection profiling across strong dip (more than 25°) suture zones between different crustal terranes or provinces reveals a distinct seismic reflectivity pattern of dipping reflections and associated diffractions. Suture zones in areas dominated by thin-skinned tectonics do not show this pattern. Profiles from southern Germany (Deutsches Kontinentales Reflexionsseismisches Programm), Great Britain (British Institutions Reflection Profiling Syndicate) and North America (Consortium for Continental Reflection Profiling and U.S. Geological Survey) crossing major sutures are examined with respect to dipping reflections in the upper crust and accompanying diffractions in the lower crust. The strong resemblance of seismic patterns suggests a similar origin for these structures.
Sadowiak, P.; Wever, Th.
Scleral necrosis secondary to nonabsorbable suture following ptosis surgery.
We report a unique case of persistent scleral ulceration in a 68-year-old woman who developed eye redness, pain, and photophobia 2 days following external levator advancement with nonabsorbable suture. Slit-lamp biomicroscopy revealed an area of scleral ulceration superonasal to the limbus. The patient was treated with 6 months of topical steroids with some improvement in her condition but without complete resolution. An exposed suture or foreign body was never directly visualized; however, a mobile nodule was noted upon palpation of the eyelid. Subsequent surgical eyelid exploration revealed a retained polypropylene suture, which was dissected free and removed. Postoperatively, the area of scleral ulceration resolved completely. PMID:23274808
Meghpara, Beeran; Lee, Seongmu; Yen, Michael T
Barbed sutures for aesthetic facial plastic surgery: indications and techniques.
This article describes the indications and techniques related to the use of barbed sutures in facial aesthetic plastic surgery. The principle applications for barbed sutures in facial aesthetic plastic surgery are those involving lifts of the brow, midface, and the lower face and neck. Usually all three areas require surgical maneuvers to create a harmonious rejuvenation. Regardless of where in the face bidirectional barbed sutures are planned, five essential steps are needed: (1) making the incision or incisions, (2) dissecting soft tissue, (3) proximal anchoring, (4) deploying threads, and (5) molding soft tissue. PMID:18558239
Paul, Malcolm D
21 CFR 878.4494 - Absorbable poly(hydroxybutyrate) surgical suture produced by recombinant DNA technology.
Code of Federal Regulations, 2010 CFR
...recombinant deoxyribonucleic acid (DNA) technology. The device is intended for use in general soft tissue approximation and ligation. (b) Classification . Class II (special controls). The special control for this device is the FDA guidance...
21 CFR 878.4494 - Absorbable poly(hydroxybutyrate) surgical suture produced by recombinant DNA technology.
Code of Federal Regulations, 2010 CFR
...recombinant deoxyribonucleic acid (DNA) technology. The device is intended for use in general soft tissue approximation and ligation. (b) Classification . Class II (special controls). The special control for this device is the FDA guidance...
Composition for absorbing hydrogen
A hydrogen absorbing composition is described. The composition comprises a porous glass matrix, made by a sol-gel process, having a hydrogen-absorbing material dispersed throughout the matrix. A sol, made from tetraethyl orthosilicate, is mixed with a hydrogen-absorbing material and solidified to form a porous glass matrix with the hydrogen-absorbing material dispersed uniformly throughout the matrix. The glass matrix has pores large enough to allow gases having hydrogen to pass through the matrix, yet small enough to hold the particles dispersed within the matrix so that the hydrogen-absorbing particles are not released during repeated hydrogen absorption/desorption cycles.
Heung, L.K.; Wicks, G.G.; Enz, G.L.
Quantitative Analysis of Developmental Process of Cranial Suture in Korean Infants
Objective The purpose of this study was to elucidate the anatomical development of physiologic suture closure processes in infants using three dimensional reconstructed computed tomography (CT). Methods A consecutive series of 243 infants under 12 months of age who underwent three dimensional CT were included in this study. Four major cranial sutures (sagittal, coronal, lambdoidal and metopic suture) were classified into four suture closure grades (grade 0=no closure along the whole length, grade 1=partial or intermittent closure, grade 2=complete closure with visible suture line, grade 3=complete fusion (ossification) without visible suture line), and measured for its closure degree (suture closure rates; defined as percentage of the length of closed suture line divided by the total length of suture line). Results Suture closure grade under 12 months of age comprised of grade 0 (n=195, 80.2%), grade 1 (n=24, 9.9%) and grade 2 (n=24, 9.9%) in sagittal sutures, whereas in metopic sutures they were grade 0 (n=61, 25.1%), grade 1 (n=167, 68.7%), grade 2 (n=6, 24%) and grade 3 (n=9, 3.7%). Mean suture closure rates under 12 months of age was 58.8% in metopic sutures, followed by coronal (right : 43.8%, left : 41.1%), lambdoidal (right : 27.2%, left : 25.6%) and sagittal sutures (15.6%), respectively. Conclusion These quantitative descriptions of cranial suture closure may help understand the process involved in the cranial development of Korean infants.
Sim, Sook Young; Kim, Sun Yong
Silicone oil retention sutures in aphakic eyes with iris loss.
Silicone oil (SO) is a long-term intraocular tamponade used for a variety of retinal disorders. In aphakic eyes with an intact iris, the use of an inferior peripheral iridectomy prevents SO prolapse into the anterior chamber, thereby preventing glaucoma and keratopathy. We have developed a technique for preventing SO from entering the anterior chamber in aphakic eyes with iris loss. The technique involves placing 10-0 prolene sutures (SO retention sutures) across the anterior chamber to simulate an iris diaphragm. The sutures act as a barrier between the SO and aqueous, preventing SO-corneal contact. Images of this phenomenon were obtained by high-frequency ultrasound biomicroscopy with patients in the supine position. Silicone oil retention sutures may be an effective means to prevent SO-corneal touch in aphakic eyes with iris loss. PMID:21149785
Gentile, Ronald C; Eliott, Dean
Adjustable sutures in eyelid surgery for ptosis and lid retraction.
New techniques are described and illustrated for ptosis and lid retraction surgery in which the sutures holding the upper eyelid position are adjustable postoperatively. In the anterior approach, the sutures pass from the levator muscle through the anterior surface of the tarsal plate at the position of the skin crease and are tied at the skin crease incision. In the posterior approach, the sutures pass from the levator muscle through the cut upper edge of the tarsal plate and are tied at the position of the desired skin crease. The techniques allow the lid height to be adjusted for over and undercorrection medially, centrally, laterally, or overall if required, thereby achieving the optimal surgical result without altering the position of the skin crease. Suture adjustment is a simple procedure and is recommended at 24 hours. Images
Collin, J R; O'Donnell, B A
21 CFR 878.5010 - Nonabsorbable polypropylene surgical suture.
Code of Federal Regulations, 2013 CFR
... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.5010 Nonabsorbable polypropylene surgical suture. (a)...
21 CFR 878.4495 - Stainless steel suture.
Code of Federal Regulations, 2013 CFR
... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4495 Stainless steel suture. (a) Identification. A stainless steel...
21 CFR 878.5020 - Nonabsorbable polyamide surgical suture.
Code of Federal Regulations, 2013 CFR
... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.5020 Nonabsorbable polyamide surgical suture. (a) Identification....
21 CFR 878.5030 - Natural nonabsorbable silk surgical suture.
Code of Federal Regulations, 2013 CFR
... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.5030 Natural nonabsorbable silk surgical suture. (a) Identification....
Efficacy and Complications of Releasable Suture Trabeculectomy and Standard Trabeculectomy
Purpose: To compare the efficacy and complications of releasable suture trabeculectomy and standard trabeculectomy. Patients and Methods: Sixty-four patients with uncontrolled glaucoma despite maximally tolerated medical therapy were included in a prospective,\\u000a comparative, randomized clinical study. Standard trabeculectomy was performed on the 32 patients (Group 1) by one ophthalmologist\\u000a and releasable suture trabeculectomy was also performed on the 32 patients
Tulay Simsek; Mehmet Citirik; Aygen Batman; Seda Mutevelli; Orhan Zilelioglu
[Aorto-iliac microbridge by continuous suture in the rat].
We have performed micro-anastomoses by continuous suture technic: --circular suture of an aorta with 9/0 and with 10/0 Vicryl three (90% permeability); --next we performed an aortic-iliac bypass thanks to a carotid graft (70% permeability). The verification was carried out by injection of the complete arterial system with solidifying agent, and we obtained an arterial fitting after corrosion by the mean of hydrochloric acid. PMID:6759961
Berthelot, J L; Hureau, J
Strength of sliding knots in multifilament resorbable suture materials.
Experimental laboratory study was made to test the knot integrity of identical, non-identical and parallel sliding knots, with three and five throws, made with synthetic resorbable multifilament suture materials. The knots were made with Novosyn (polyglactin 612), Safil (polyglycolic acid), Vicryl (polyglactin 612) and Vicryl plus (polyglactin 910 + triclosan), all with suture size: 3-0 USP. Per material 10 knots for every kind of knot were tested in a tensiometer, resulting in a total of 240 tests. Sliding knots with three throws were compared with the five throw sliding knots, and a comparison of the loop-holding capacities (LHC) of the different suture materials was made. Differences in suture material, knot type, and number of throws in the knot had a remarkable effect on knot performance. Adding two extra throws to a three throw non-identical or parallel sliding knot resulted in significantly more reliable knots (P?0.05). In identical sliding knots, this effect was not seen, but these knots showed low LHCs, indicating poor knot reliability. Compared to the other suture materials, Safil showed significantly lower LHCs. Most of the mean LHCs of the various knots with Vicryl, Vicryl Plus or Novosyn were not statistically different from each other. Identical sliding knots appeared to be very unreliable, especially when made with three throws. Non-identical and parallel slipknots with five throws demonstrated superior knot integrity compared with the same knot types with three throws. Safil had inferior knot properties as compared to the other materials, but Vicryl, Vicryl Plus and Novosyn behaved virtually the same. The type of knot and the use of different suture materials have important influence on the integrity of the knot. A high knot reliability is nowadays all the more important because of the frequent use of resorbable suture materials. The suture gradually loses strength during the resorption process, so that an extra margin of safety neutralizes the effect of this process. PMID:23144642
van Leeuwen, Nourah; Trimbos, J Baptist
Single suture laparoscopic tubal re-anastomosis.
The goal of this article is to report our experience and review recent articles obtained for laparoscopic tubal sterilization reversal. The technique we describe is 'single suture laparoscopic tubal re-anastomosis'. This technique is simple and atraumatic and requires only one stitch in the tube. After preparing the tube stumps and bringing the edges of the mesosalpinx together, laparoscopic anastomosis is achieved by one stitch placed at '12 o'clock' on the antimesial edge of the tube. Between May 1994 and June 1997 we operated on 32 patients using this technique and carried out 48 tubal sterilization reversals. For the patients who underwent postoperative hysterosalpingography during the first or second month after the operation, the rate of patency was 87.5% (42/48). The overall intrauterine pregnancy rate was 53.1% (17 out of 32 patients). The overall delivery rate was 40.6% (13 out of 32 patients). The intrauterine pregnancy rate for the 17 patients who were aged 38 years or under was 58.8% (10 out of 17 patients). Laparoscopic tubal sterilization reversal is feasible with a simplified technique. Review of the publications concerning laparoscopic microsurgical tubal anastomosis confirms satisfactory fertility results. The surgeon should be experienced in microsurgical tubal anastomosis by laparotomy as well as operative laparoscopic procedures. PMID:9719882
Dubuisson, J B; Chapron, C
The iris cerclage suture for permanent mydriasis: a running suture technique.
Permanent mydriasis can be a disabling condition. The author describes an iris cerclage running suture technique for the treatment of permanent mydriasis caused by diffuse iris sphincter damage. A long, curved transchamber needle on 10-0 polypropylene is passed in and out of the anterior chamber through limbal paracentesis openings while weaving the needle through the iris near the pupillary margin to form the cerclage. The technique minimizes stretching and distortion of the iris and creates a pupil that is precisely sized and rather round. PMID:9854714
Ogawa, G S
Scar tissue orientation in unsutured and sutured corneal wound healing.
AIMS--This study aimed to evaluate stromal wound healing morphology in short term unsutured compared with sutured corneal wounds, to define regional variation in healing within radial keratotomy wounds. METHODS--Stromal scar tissue orientation (fibroblast and collagen fibre orientation) was analysed in unsutured and adjacent sutured keratotomy wounds in monkeys, 2 to 9 weeks after surgery, using light and transmission electron microscopy. RESULTS--At 2 to 4 weeks, scar tissue orientation was transverse to the wound edge in unsutured wounds, but sagittal in sutured wounds. At 5 to 9 weeks, a reorientation of scar tissue sagittal to the wound was seen in the unsutured wounds, proceeding from the posterior to anterior wound regions. In sutured wounds, a scar tissue reorientation transverse to the wound was seen, proceeding from the anterior wound region in a posterior direction. CONCLUSIONS--Within the same cornea, sutured and unsutured wounds showed opposite patterns of healing. Sutured wounds initially healed more slowly, but obtained pseudolamellar continuity over time. In contrast, healing of unsutured wounds was characterised by an early approximation towards lamellar repair that was followed by an ineffective reorganisation of the scar. This latter pattern of healing, that may be associated with a variable weakening of the wound, may relate to the clinical findings of unpredictability and/or progression of refractive effect following radial keratotomy. Images
Melles, G R; Binder, P S; Beekhuis, W H; Wijdh, R H; Moore, M N; Anderson, J A; SundarRaj, N
Surgical Suturing of Articular Cartilage Induces Osteoarthritis-Like Changes
Introduction In clinical tissue-engineering-based approaches to articular cartilage repair, various types of flaps are frequently used to retain an implanted construct within the defect, and they are usually affixed by suturing. We hypothesize that the suturing of articular cartilage is associated with a loss of chondrocytes from and osteoarthritis-like changes within the peri-sutural area. Materials and Methods We established a large, partial-thickness defect model in the femoral groove of adult goats. The defects were filled with bovine fibrinogen to support a devitalized flap of autologous synovial tissue, which was sutured to the surrounding articular cartilage with single, interrupted stitches. The perisutural and control regions were analyzed histologically, histochemically and histomorphometrically shortly after surgery and 3 weeks later. Results Compared to control regions, chondrocytes were lost from the perisutural area even during the first few hours of surgery. During the ensuing 3 weeks, the numerical density of cells in the perisutural area decreased significantly. The cell losses were associated with a loss of proteoglycans from the extracellular matrix. Shortly after surgery, fissures were observed within the walls of the suture channels. By the third week, their surface density had increased significantly and they were filled with avascular mesenchymal tissue. Conclusions The suturing of articular cartilage induces severe local damage, which is progressive and reminiscent of that associated with the early stages of osteoarthritis. This damage could be most readily circumvented by adopting an alternative mode of flap affixation, such as glueing with a biological adhesive.
Hunziker, Ernst B.; Stahli, Alexandra
Age estimation by multidetector CT images of the sagittal suture.
Closure of cranial sutures progresses with age; therefore, macroscopic assessment of cranial sutures has been used as one method of age estimation. Postmortem computed tomography (PMCT), which many forensic medical departments and institutes have begun to adopt, has the potential to simplify the gathering of information from cranial sutures for both surface and cross-sectional evaluation. To examine the feasibility of age estimation by cross-sectional multidetector computed tomography images of the sagittal suture, PMCT findings of 125 subjects of known age and sex were retrospectively reviewed. The sagittal suture was divided into four segments, and 20 cross-sectional slices from each segment were analyzed. These slices were each categorized by visual evaluation into one of the seven stages defined by Harth et al. according to the degree of closure. The mean stage value of 20 slices was calculated for each segment. We were able to evaluate cross-sectional images of the sagittal suture by PMCT, and a positive correlation between age and closure degree was observed. Despite the prediction interval achieved with this method not being superior to traditional macroscopic or flat-panel CT assessment, multidetector CT is a potentially useful tool, in conjunction with other methods, for age estimation, particularly in adult females and in cases where only a skull is the sole remain. PMID:23760604
Chiba, Fumiko; Makino, Yohsuke; Motomura, Ayumi; Inokuchi, Go; Torimitsu, Suguru; Ishii, Namiko; Sakuma, Ayaka; Nagasawa, Sayaka; Saitoh, Hisako; Yajima, Daisuke; Hayakawa, Mutsumi; Odo, Yuriko; Suzuki, Yoichi; Iwase, Hirotaro
Chronic Loading of Polypropylene Sutures: Implications for Breakage after Carotid Endarterectomy
This study compared the breaking force of acutely and chronically loaded 6-O and 5-O polypropylene sutures. It also examined the effect of graded injuries on those sutures. Studies were performed on 134 6-O and 5-O polypropylene sutures subjected to acute loads, 312 6-O and 5-O sutures subjected to chronic loads, and 377 6-O sutures subjected to quantitative "pinches" with DeBakey
Philip B. Dobrin
Biomechanical testing of a new knotless suture anchor compared with established anchors for rotator cuff repair.
Various suture anchors are available for rotator cuff repair. For arthroscopic application, a knotless anchor was developed to simplify the intra-operative handling. We compared the new knotless anchor (BIOKNOTLESStrade mark RC; DePuy Mitek, Raynham, MA) with established absorbable and titanium suture anchors (UltraSorbtrade mark and Super Revo 5mmtrade mark; ConMed Linvatec, Utica, NY). Each anchor was tested on 6 human cadaveric shoulders. The anchors were inserted into the greater tuberosity. An incremental cyclic loading was performed. Ultimate failure loads, anchor displacement, and mode of failure were recorded. The anchor displacement of the BIOKNOTLESStrade mark RC (15.3 +/- 5.3 mm) after the first cycle with 75 N was significantly higher than with the two other anchors (Super Revo 2.1 +/- 1.6 mm, UltraSorb: 2.7 +/- 1.1 mm). There was no significant difference in the ultimate failure loads of the 3 anchors. Although the Bioknotlesstrade mark RC indicated comparable maximal pullout strength, it bares the risk of losing contact between the tendon-bone-interface due to a significantly higher system displacement. Therefore, gap formation between the bone and the soft tissue fixation jeopardizes the repair. Bioknotlesstrade mark RC should be used in the lateral row only when a double row technique for rotator cuff repair is performed, and is not appropriate for rotator cuff repair if used on its own. PMID:18396417
Pietschmann, Matthias F; Froehlich, Valerie; Ficklscherer, Andreas; Wegener, Bernd; Jansson, Volkmar; Müller, Peter E
Percutaneous suture of acute Achilles tendon rupture. A study of 60 cases.
Conservative treatment of Achilles tendon ruptures may lead to re-rupture. Open surgical repair entails a risk of skin necrosis or infection. Several percutaneous techniques have been used, such as Tenolig or Achillon, but these techniques are costly and may be marred by wound healing problems. Ma and Griffith described a technique for percutaneous repair which left the suture and the knot under the skin, thus reducing the risk for infection. From January 2001 to September 2006, we used this percutaneous treatment for 60 acute ruptures of tendo Achillis. The repair was made under local anaesthesia, using a single or double absorbable suture. Postoperative care was 3 weeks immobilistion in a non-weight bearing cast in equinus position, followed by another 3 weeks in a cast with the ankle at 90 degrees and progressive weight bearing. Mean followup was 19 months. Complications were 2 re-ruptures at 2 and 5 months respectively, 1 infection in a patient who presented with re-rupture after a previous surgical treatment, and 1 Achilles tendonitis. There was no sural nerve lesion. Mean time to return to working activities was 85 days; mean time to return to sports activities was 5 months. Clinical results were good with no loss in range of motion. This low-cost technique appeared as an interesting alternative to surgical or conservative treatment, providing strong repair with a low complication rate. PMID:20503951
Rouvillain, Jean-Louis; Navarre, Thomas; Labrada-Blanco, Octavio; Garron, Emmanuel; Daoud, Wael
Methods for absorbing neutrons
A conduction cooled neutron absorber may include a metal matrix composite that comprises a metal having a thermal neutron cross-section of at least about 50 barns and a metal having a thermal conductivity of at least about 1 W/cmK. Apparatus for providing a neutron flux having a high fast-to-thermal neutron ratio may include a source of neutrons that produces fast neutrons and thermal neutrons. A neutron absorber positioned adjacent the neutron source absorbs at least some of the thermal neutrons so that a region adjacent the neutron absorber has a fast-to-thermal neutron ratio of at least about 15. A coolant in thermal contact with the neutron absorber removes heat from the neutron absorber.
Guillen, Donna P. (Idaho Falls, ID); Longhurst, Glen R. (Idaho Falls, ID); Porter, Douglas L. (Idaho Falls, ID); Parry, James R. (Idaho Falls, ID)
Externally tuned vibration absorber
A vibration absorber unit or units are mounted on the exterior housing of a hydraulic drive system of the type that is powered from a pressure wave generated, e.g., by a Stirling engine. The hydraulic drive system employs a piston which is hydraulically driven to oscillate in a direction perpendicular to the axis of the hydraulic drive system. The vibration absorbers each include a spring or other resilient member having one side affixed to the housing and another side to which an absorber mass is affixed. In a preferred embodiment, a pair of vibration absorbers is employed, each absorber being formed of a pair of leaf spring assemblies, between which the absorber mass is suspended.
Vincent, Ronald J. (Latham, NY)
Craniosynostosis of Coronal Suture in Twist1+/? Mice Occurs Through Endochondral Ossification Recapitulating the Physiological Closure of Posterior Frontal Suture
Craniosynostosis, the premature closure of cranial suture, is a pathologic condition that affects 1/2000 live births. Saethre-Chotzen syndrome is a genetic condition characterized by craniosynostosis. The Saethre-Chotzen syndrome, which is defined by loss-of-function mutations in the TWIST gene, is the second most prevalent craniosynostosis. Although much of the genetics and phenotypes in craniosynostosis syndromes is understood, less is known about the underlying ossification mechanism during suture closure. We have previously demonstrated that physiological closure of the posterior frontal suture occurs through endochondral ossification. Moreover, we revealed that antagonizing canonical Wnt-signaling in the sagittal suture leads to endochondral ossification of the suture mesenchyme and sagittal synostosis, presumably by inhibiting Twist1. Classic Saethre-Chotzen syndrome is characterized by coronal synostosis, and the haploinsufficient Twist1+/? mice represents a suitable model for studying this syndrome. Thus, we seeked to understand the underlying ossification process in coronal craniosynostosis in Twist1+/? mice. Our data indicate that coronal suture closure in Twist1+/? mice occurs between postnatal day 9 and 13 by endochondral ossification, as shown by histology, gene expression analysis, and immunohistochemistry. In conclusion, this study reveals that coronal craniosynostosis in Twist1+/? mice occurs through endochondral ossification. Moreover, it suggests that haploinsufficiency of Twist1 gene, a target of canonical Wnt-signaling, and inhibitor of chondrogenesis, mimics conditions of inactive canonical Wnt-signaling leading to craniosynostosis.
Behr, Bjorn; Longaker, Michael T.; Quarto, Natalina
Lateral meniscus allograft transplantation: an arthroscopically-assisted single-incision technique using all-inside sutures with a suture hook.
We present an arthroscopically-assisted single-incision technique using all-inside sutures with a suture hook in the lateral meniscus allograft transplantation. Although this technique is technically demanding, it provides vertically oriented and secure sutures with good tissue approximation without the accessory skin incision. PMID:23328984
Lee, Su-Chan; Chang, Woo-Hyuk; Park, Seung-Jun; Kim, Tae-Ho; Sung, Byung-Yoon
Disposable circumcision suture device: clinical effect and patient satisfaction
In our experience patients undergoing circumcision are mostly concerned about pain and penile appearances. We conducted a prospective randomized trial to assess the benefits of a new disposable circumcision suture device (DCSD). A total of 942 patients were equally divided into three groups (conventional circumcision, Shang ring and disposable suture device group). Patients in the DCSD group were anesthetized with compound 5% lidocaine cream, the others with a 2% lidocaine penile block. Operation time, intra-operative blood loss, incision healing time, intra-operative and post-operative pain, the penile appearance and overall satisfaction degree were measured. Operation time and intra-operative blood loss were significantly lower in the Shang ring and suture device groups compared to the conventional group (P < 0.001). Intra-operative pain was less in the suture device group compared with the other two groups (P < 0.001); whereas post-operative pain was higher in the conventional group compared to the other two groups (P < 0.001). Patients in the suture device (80.57%) and Shang ring (73.57%) groups were more satisfied with penile appearances compared with the conventional circumcision group (20.06%, P < 0.05). Patients in suture device group also healed markedly faster than the conventional group (P < 0.01). The overall satisfaction rate was better in the suture device group (78.66%) compared with the conventional (47.13%) and Shang ring (50.00%) groups (P < 0.05). The combination of DCSD and lidocaine cream resulted in shorter operation and incision healing times, reduced intra-operative and post-operative pain and improved patient satisfaction with the cosmetic appearances.
Lv, Bo-Dong; Zhang, Shi-Geng; Zhu, Xuan-Wen; Zhang, Jie; Chen, Gang; Chen, Min-Fu; Shen, Hong-Liang; Pei, Zai-Jun; Chen, Zhao-Dian
Force-Induced Craniosynostosis in the Murine Sagittal Suture
BACKGROUND The etiology of non-syndromic craniosynostosis remains elusive. While compressive forces have been implicated in premature suture fusion, conclusive evidence of force-induced craniosynostosis is lacking. The purpose of this study was to determine if cyclical loading of the murine calvarium could induce suture fusion. METHODS Calvarial coupons from post-natal day 21, B6CBA wild-type mice (n = 18) were harvested and cultured. A custom appliance capable of delivering controlled, cyclical, compressive loads was applied perpendicular to the sagittal suture within the coupon in vitro. Nine coupons were subjected to 0.3g of force for 30 minutes each day for a total of 14 days. A control group of nine coupons was clamped in the appliance without loading. Analysis of suture phenotype was performed using alkaline phosphatase and H&E staining techniques, as well as in situ hybridization analysis using Bone Sialoprotein (BSP). RESULTS Control group sagittal sutures—which normally remain patent in mice—showed their customary histological appearance. In contradistinction, sagittal sutures subjected to cyclic loading showed histological evidence of premature fusion (craniosynostosis). In addition, alkaline phosphatase activity and BSP expression was observed to be increased in the experimental group when compared to matched controls. CONCLUSIONS An in vitro model of forced-induced craniosynostosis has been devised. Premature fusion of the murine sagittal suture was induced with the application of controlled, cyclical, compressive loads. These results implicate abnormal forces in the development of non-syndromic craniosynostosis, which supports our global hypothesis that epigenetic phenomena have a crucial role in the pathogenesis of craniosynostosis.
Oppenheimer, Adam J.; Rhee, Samuel T.; Goldstein, Steven A.; Buchman, Steven R.
Advanced neutron absorber materials
A neutron absorbing material and method utilizing rare earth elements such as gadolinium, europium and samarium to form metallic glasses and/or noble base nano/microcrystalline materials, the neutron absorbing material having a combination of superior neutron capture cross sections coupled with enhanced resistance to corrosion, oxidation and leaching.
Branagan, Daniel J. (Idaho Falls, ID); Smolik, Galen R. (Idaho Falls, ID)
NASA Technical Reports Server (NTRS)
The goal of this program was a comprehensive multiwavelength study of absorption phenomena in active galactic nuclei (AGN). These include a variety of associated absorption systems: X-ray warm absorbers, X-ray cold absorbers. UV absorbers with high ionization lines, MgII absorbers, red quasars and BALQSOs. The aim is to determine the physical conditions in the absorbing outflows, study their inter-relations and their role in AGN. We designed several observing programs to achieve this goal: X-ray spectroscopy, UV spectroscopy, FLAY spectroscopy and X-ray imaging. We were very successful towards achieving the goal over the five year period as shown through following observing programs and papers. Copies of a few papers are attached with this report.
Mathur, Smita
Multispectral metamaterial absorber.
We present the simulation, implementation, and measurement of a multispectral metamaterial absorber (MSMMA) and show that we can realize a simple absorber structure that operates in the mid-IR and terahertz (THz) bands. By embedding an IR metamaterial absorber layer into a standard THz metamaterial absorber stack, a narrowband resonance is induced at a wavelength of 4.3 ?m. This resonance is in addition to the THz metamaterial absorption resonance at 109 ?m (2.75 THz). We demonstrate the inherent scalability and versatility of our MSMMA by describing a second device whereby the MM-induced IR absorption peak frequency is tuned by varying the IR absorber geometry. Such a MSMMA could be coupled with a suitable sensor and formed into a focal plane array, enabling multispectral imaging. PMID:24690713
Grant, J; McCrindle, I J H; Li, C; Cumming, D R S
Comparison of suture material and technique of closure of subcutaneous fat and skin in caesarean section
Background: A large number of women undergo caesarean section throughout the world. These women pass through a period of post operative pain and a morbidity period. These women translate into a substantial portion of population and hence there is a load on the financial resources of healthcare system. Use of the appropriate technique to approximate the wound after caesarean section would not only avoid financial load but also help in early recovery of the patient. Aim: The aim of this study is to compare the effects of alternative techniques for closure of subcutaneous fat and skin on maternal health and use of healthcare resources in caesarean section. Materials and Methods: Patients undergoing Caesarean section were divided in two groups of one thousand patients each. Patients with hematological disorders or a malignancy, diabetes, septicemia or chorioamnionitis were excluded from the study. In all the patients, after stitching the uterus, the rectus sheath was stitched with thread vicryl No.1 (synthetic absorbable braided sutures with polyglycolic acid, polycaprolactone and calcium stearate coating), using a round body needle. Then the patients were divided into two groups. In group I, vicryl No.1 thread used in stitching of the rectus sheath was continued into the skin with application of subcuticular stitches, after securing the edges with a knot. In group II, after stitching the rectus sheath with vicryl No. 1, the thread was cut and interrupted sutures were applied in subcutaneous fat with thread vicryl No. 2. Skin was stitched with subcuticular stitches using proline 2, a non-absorbable propylene suture. The two groups of patients were observed for the duration of surgery, post-operative pain in stitches, patient satisfaction about removal of stitches, evidence of wound infection or seroma, and cosmetic results. Results: It was noted that the duration of surgery in group I was on average 7.5 minutes less as compared to the duration in group II. Patients in group I were more satisfied with the results of the surgery and were relieved to know that their stitches did not need to be removed. Conclusion: Although no difference was found in the rates of wound infection and formation of scar tissue between the group I and group II, the duration of surgery was less and the patients were more satisfied in group I.
Islam, Aliya; Ehsan, Ambreen
The efficacy of a single continuous nylon suture for control of post keratoplasty astigmatism.
PURPOSE: Post operative adjustment of a single continuous suture is an effective means of reducing post keratoplasty astigmatism. This study evaluates post keratoplasty keratometry following suture adjustment with an adjusted suture in place and after the suture is removed. METHODS: Average keratometric astigmatism was measured over 24 months time in 26 patients with an adjusted continuous suture and 24 patients with a continuous suture that was not adjusted. Average keratometry in 43 patients with an adjusted continuous suture was compared with 37 patients with combined continuous and interrupted sutures. Finally, suture out astigmatism in 19 adjusted patients was compared to six patients with no adjustment. RESULTS: There was an increase in average corneal astigmatism over two years of 2.2 diopters in the adjusted group and 1.7 diopters in the non-adjusted group with sutures in place. One year following surgery, average keratometry flattened from 47.5 to 42.9 diopters in the adjusted continuous group and from 47.0 to 46.0 diopters in the group with combined continuous and interrupted sutures. Following suture removal, average astigmatism in patients who had suture adjustment was 4.4 diopters +/- 2.5 diopters (range 1-10 diopters), and 6.01 diopters (range 4-7) in the non-adjusted group. CONCLUSIONS: Average post keratoplasty astigmatism increases after a continuous suture is adjusted but the increase is comparable to patients with acceptable astigmatism who do not require adjustment. More progressive corneal flattening over 12 months time is seen with a continuous suture than which combined sutures. Average suture out astigmatism was 4.0 diopters following suture adjustment, compared to an average of 8.4 diopters prior to adjustment. Images FIGURE 1 FIGURE 2 FIGURE 3 FIGURE 4 FIGURE 7A FIGURE 7B
Van Meter, W
A generalized mechanical model for suture interfaces of arbitrary geometry
NASA Astrophysics Data System (ADS)
Suture interfaces with a triangular wave form commonly found in nature have recently been shown to exhibit exceptional mechanical behavior, where geometric parameters such as amplitude, frequency, and hierarchy can be used to nonlinearly tailor and amplify mechanical properties. In this study, using the principle of complementary virtual work, we formulate a generalized, composite mechanical model for arbitrarily-shaped interdigitating suture interfaces in order to more broadly investigate the influence of wave-form geometry on load transmission, deformation mechanisms, anisotropy, and stiffness, strength, and toughness of the suture interface for tensile and shear loading conditions. The application of this suture interface model is exemplified for the case of the general trapezoidal wave-form. Expressions for the in-plane stiffness, strength and fracture toughness and failure mechanisms are derived as nonlinear functions of shape factor ? (which characterizes the general trapezoidal shape as triangular, trapezoidal, rectangular or anti-trapezoidal), the wavelength/amplitude ratio, the interface width/wavelength ratio, and the stiffness and strength ratios of the skeletal/interfacial phases. These results provide guidelines for choosing and tailoring interface geometry to optimize the mechanical performance in resisting different loads. The presented model provides insights into the relation between the mechanical function and the morphological diversity of suture interface geometries observed in natural systems.
Li, Yaning; Ortiz, Christine; Boyce, Mary C.
Mechanical Behavior of Bio-inspired Model Suture Joints
NASA Astrophysics Data System (ADS)
Suture joints of varying degrees of geometric complexity are prevalent throughout nature as a means of joining structural elements while providing locally tailored mechanical performance. Here, micromechanical models of general trapezoidal waveforms of varying hierarchy are formulated to reveal the role of geometric complexity in governing stiffness, strength, toughness and corresponding deformation and failure mechanisms. Physical constructs of model composite suture systems are fabricated via multi-material 3D printing (Object Connex500). Tensile tests are conducted on samples covering a range in geometry, thus providing quantitative measures of stiffness, strength, and failure. The experiments include direct visualization of the deformation and failure mechanisms and their progression, as well as their dependence on suture geometry, showing the interplay between shear and tension/compression of the interfacial layers and tension of the skeletal teeth and the transition in failure modes with geometry. The results provide quantitative guidelines for the design and tailoring of suture geometry to achieve the desired mechanical properties and also facilitate understanding of suture growth and fusion, and evolutionary phenotype.
Li, Yaning; Lin, Erica; Ortiz, Christine; Boyce, Mary
Recognizing surgeon's actions during suture operations from video sequences
NASA Astrophysics Data System (ADS)
Because of the shortage of nurses in the world, the realization of a robotic nurse that can support surgeries autonomously is very important. More specifically, the robotic nurse should be able to autonomously recognize different situations of surgeries so that the robotic nurse can pass necessary surgical tools to the medical doctors in a timely manner. This paper proposes and explores methods that can classify suture and tying actions during suture operations from the video sequence that observes the surgery scene that includes the surgeon's hands. First, the proposed method uses skin pixel detection and foreground extraction to detect the hand area. Then, interest points are randomly chosen from the hand area so that their 3D SIFT descriptors are computed. A word vocabulary is built by applying hierarchical K-means to these descriptors, and the words' frequency histogram, which corresponds to the feature space, is computed. Finally, to classify the actions, either SVM (Support Vector Machine), Nearest Neighbor rule (NN) for the feature space or a method that combines "sliding window" with NN is performed. We collect 53 suture videos and 53 tying videos to build the training set and to test the proposed method experimentally. It turns out that the NN gives higher than 90% accuracies, which are better recognition than SVM. Negative actions, which are different from either suture or tying action, are recognized with quite good accuracies, while "Sliding window" did not show significant improvements for suture and tying and cannot recognize negative actions.
Li, Ye; Ohya, Jun; Chiba, Toshio; Xu, Rong; Yamashita, Hiromasa
Selective laser vaporization of polypropylene sutures and mesh
NASA Astrophysics Data System (ADS)
Complications from polypropylene mesh after surgery for female stress urinary incontinence (SUI) may require tedious surgical revision and removal of mesh materials with risk of damage to healthy adjacent tissue. This study explores selective laser vaporization of polypropylene suture/mesh materials commonly used in SUI. A compact, 7 Watt, 647-nm, red diode laser was operated with a radiant exposure of 81 J/cm2, pulse duration of 100 ms, and 1.0-mm-diameter laser spot. The 647-nm wavelength was selected because its absorption by water, hemoglobin, and other major tissue chromophores is low, while polypropylene absorption is high. Laser vaporization of ~200-?m-diameter polypropylene suture/mesh strands, in contact with fresh urinary tissue samples, ex vivo, was performed. Non-contact temperature mapping of the suture/mesh samples with a thermal camera was also conducted. Photoselective vaporization of polypropylene suture and mesh using a single laser pulse was achieved with peak temperatures of 180 and 232 °C, respectively. In control (safety) studies, direct laser irradiation of tissue alone resulted in only a 1 °C temperature increase. Selective laser vaporization of polypropylene suture/mesh materials is feasible without significant thermal damage to tissue. This technique may be useful for SUI procedures requiring surgical revision.
Burks, David; Rosenbury, Sarah B.; Kennelly, Michael J.; Fried, Nathaniel M.
Cauterization technique for suture erosion in transscleral fixation of intraocular lenses.
Transscleral suturing is a commonly applied technique to fix intraocular implants in the sulcus. A major problem after transscleral implantation is suture erosion that normally happens in the late post-surgery period and may result in an increased incidence of endophthalmitis. Here we describe an original cauterization method by using a glass rod to melt the exposed suture end without damaging the suture knot in the sclera to avoid suture exposure in sclera-fixed IOL implantation. This is a simple, quick and effective technique that can be performed without conjunctiva incisions and will help to reduce suture erosion related complications. PMID:24392344
Hu, Xu-Ting; Zhang, Zong-Duan; Zhou, Rong; Pan, Qin-Tuo
Internal absorber solar collector
Thin solar collecting panels are described made from arrays of small rod collectors consisting of a refracting dielectric rod lens with an absorber imbedded within it and a reflecting mirror coated on the back side of the dielectric rod. Non-tracking collector panels on vertical walls or roof tops receive approximately 90% of solar radiation within an acceptance zone 60.degree. in elevation angle by 120.degree. or more in the azimuth sectors with a collector concentration ratio of approximately 3.0. Miniaturized construction of the circular dielectric rods with internal absorbers reduces the weight per area of glass, plastic and metal used in the collector panels. No external parts or insulation are needed as heat losses are low due to partial vacuum or low conductivity gas surrounding heated portions of the collector. The miniature internal absorbers are generally made of solid copper with black selective surface and the collected solar heat is extracted at the collector ends by thermal conductivity along the absorber rods. Heat is removed from end fittings by use of liquid circulants. Several alternate constructions are provided for simplifying collector panel fabrication and for preventing the thermal expansion and contraction of the heated absorber or circulant tubes from damaging vacuum seals. In a modified version of the internal absorber collector, oil with temperature dependent viscosity is pumped through a segmented absorber which is now composed of closely spaced insulated metal tubes. In this way the circulant is automatically diverted through heated portions of the absorber giving higher collector concentration ratios than theoretically possible for an unsegmented absorber.
Sletten, Carlyle J. (106 Nagog Hill Rd., Acton, MA 01720); Herskovitz, Sheldon B. (88 Hammond St., Acton, MA 01720); Holt, F. S. (46 Emerson Rd., Winchester, MA 01890); Sletten, E. J. (Chestnut Hill Rd. R.F.D. Rte. #4, Amherst, NH 03031)
NASA Technical Reports Server (NTRS)
The removal of bile acids and cholesterol by polymeric absorption is discussed in terms of micelle-polymer interaction. The results obtained with a polymer composed of 75 parts PEO and 25 parts PB plus curing ingredients show an absorption of 305 to 309%, based on original polymer weight. Particle size effects on absorption rate are analyzed. It is concluded that crosslinked polyethylene oxide polymers will absorb water, crosslinked polybutadiene polymers will absorb lipids; neither polymer will absorb appreciable amounts of lipids from micellar solutions of lipids in water.
Marsh, H. E., Jr.; Wallace, C. J.
Suture fixation technique for posterior chamber intraocular lenses.
We describe a modified method for scleral fixation of posterior chamber intraocular lenses (IOLs). A double-armed, 10-0 polypropylene (Prolene) suture on a curved long needle is passed through a groove in the sclera and retrieved within the barrel of a bent 25-gauge needle through the opposite groove. Double transscleral passages enable 4-point fixation and provide better stability and centration. Knots are buried completely in the scleral groove. In a series of 10 cases, the IOLs were well centered, no sutures protruded from the scleral groove, and the vision in all eyes improved. In 1 case, a ciliary hemorrhage occurred during insertion of the 25-gauge needle, but the bleeding stopped after ocular pressure reform. This technique is easy to perform, improves centration and stability of the IOL, and avoids suture exposure. PMID:15210214
Lin, Chang-Ping; Tseng, Han-Yi
Suture techniques for tendon repair; a comparative review
Summary Over the past five decades we have seen numerous iterations of suture repair methods for tendon. The pursuit of the ultimate repair has led to many repair methods being described. This comprehensive compilation of the suture repair techniques will describe the factors that affect repair success, including repair strength, gapping resistance, glide and rehabilitation. Different approaches to rejoining severed tendons will be critiqued on their biomechanical ability to improve tendon repair strength, maintaining glide, reducing tendon damage, and minimising adhesion formation. It is important to highlight how the suture repairs have evolved and improved but also review how they may contribute to their own trauma. The apparent paradox between providing mechanical strength and minimising adhesions require refinements in the field to improve on functional outcomes.
Rawson, Shelley; Cartmell, Sarah; Wong, Jason
Arthroscopic disc repositioning and suturing: a preliminary report.
Eight patients (11 joints) underwent arthroscopic disc repositioning and suturing. Disc displacement was established by physical examination, magnetic resonance imaging (MRI), and diagnostic arthroscopy. Postoperative MRIs were taken at varying intervals between 1 day and 6 months. In all 11 joints, either partial improvement or normal disc position was observed arthroscopically. In 9 of the 11 joints, either partial improvement or normal position was observed on the postoperative MRIs. It is concluded that posterior disc repositioning and suturing is an achievable goal of temporomandibular joint arthroscopy. PMID:1593316
McCain, J P; Podrasky, A E; Zabiegalski, N A
Preparation of scaffolds based on bulky sutures for cell therapy
NASA Astrophysics Data System (ADS)
Scaffold for cell therapy was prepared with poly (lactide-co-glicolide, PLA/PGA (10:90). By using melt-spinning and draw texturing process, we could prepare microfibrous bulky suture which had heterogeneous macropore. Microfibrous structure has great potentiality as biomimicking architecture for cell growth and maintaining cell functions. The result of cell seeding showed that pore size, pore distribution, and fiber fineness of sutures were suitable as a biocompatible scaffold in vitro for NIH 3T3 Fibroblast cell. Also, we expect that prepared scaffold for cell-therapy will provide numerous benefits as a noninvasive alternative for tissue engineering applications.
Park, Young Hwan; Chun, Heung Jae; Kim, Sung Jin
Low Frequency Vibration Absorber.
National Technical Information Service (NTIS)
This patent application discloses a mounting assembly for absorbing low frequency vibrational energy as produced by a source and isolating a base member therefrom. The mounting assembly includes a central metallic ring, non-metallic foam rings located on ...
N. J. Dubois B. G. Gauthier
Radar Absorbing Material Design.
National Technical Information Service (NTIS)
Low observable platforms have extremely low radar cross section specifications that cannot be achieved by shaping alone. The application of radar absorbing material is necessary, in which case the appropriate constitutive parameters and thickness must be ...
C. K. Yuzcelik
Histologic evaluation of absorbable and non-absorbable barrier coated mesh secured to the peritoneum with fibrin sealant in a New Zealand white rabbit model
Purpose The purpose of this study is to evaluate the histologic response to fibrin sealant (FS) as an alternative fixation method for laparoscopic ventral hernia repair. Methods One non-absorbable barrier mesh (Composix™) and three absorbable barrier meshes (Sepramesh™, Proceed™, and Parietex™ Composite) were used for the study, with uncoated macroporous polypropylene mesh (ProLite Ultra™) as the control. Three methods of fixation were used: #0-polypropylene suture? FS (ARTISS™, Baxter Healthcare Corp.), FS alone (ARTISS™), or tacks alone (n = 10 for each group). Two pieces of mesh (of dimensions 4 × 4-cm) were secured intraperitoneally in 75 New Zealand white rabbits. After 8 weeks, hematoxylin and eosin (H&E)-stained specimens were evaluated for host tissue response. Statistical significance (P < 0.05) was determined using a one-way analysis of variance (ANOVA) with Fisher's least significant difference (LSD) post hoc test. Results Composix™ with FS only showed significantly greater cellular infiltration than with suture? FS (P = 0.0007), Proceed™ with FS only had significantly greater neovascularization than with suture? FS (P = 0.0172), and ProLite Ultra™ with suture? FS had significantly greater neovascularization than with tacks only (P = 0.046). Differences due to mesh type showed that Composix™ exhibited less extensive cellular infiltration (P ? 0.0032), extracellular matrix (ECM) deposition, and neovascularization, and demonstrated less inflammatory cells and more fibroblasts compared to the other meshes (P < 0.05). Conclusions FS did not have a significant histologic effect compared to tacks when utilized for the fixation of mesh to the peritoneum of New Zealand White rabbits. However, the mesh type did have a significant histologic effect. The permanent barrier mesh (Composix™) was associated with less histologic incorporation than absorbable barrier and macroporous meshes, as evidenced by lower levels of cellular infiltration, ECM deposition, and neovascularization, independent of the fixation method used.
Jenkins, E. D.; Melman, L.; Desai, S.; Deeken, C. R.; Greco, S. C.; Frisella, M. M.; Matthews, B. D.
Review of Radar Absorbing Materials.
National Technical Information Service (NTIS)
Radar is a sensitive detection tool and since its development, methods for reducing microwave reflections have been explored. Radar absorbers can be classified as impedance matching or resonant absorbers. Radar absorbing materials are made from resistive ...
P. Saville
[Subluxation of scleral-fixated PC IOL caused by polypropylene suture degradation--case report].
The purpose of the study is to evaluate factors related to late-onset of lens subluxation in transscleral sutured posterior chamber IOL. We report a child, which required surgical treatment for dislocation of a scleral-sutured PC IOL. 11 years earlier the secondary lens implantation with scleral fixation was performed in 4 years old boy. The first surgical procedure included an anterior victrectomy and suturing a single- piece PMMA IOL under the scleral flaps with a 10-0 polipropylene suture. The second--included explantation of the dislocated lens. Optic and scanning electron microscopy was used to analyze the surface of the explanted remnants of the breakage suture. Microscopic findings indicate that the late suture breakage and subluxation of suture-fixated PC IOL was due to the degradation of polypropylene suture. PMID:19673444
Kanigowska, Krystyna; Gra?ek, Miros?awa; Czarnowska, Elzbieta; Zajaczkowska, Agnieszka
Palatine sutures as age indicator: a controlled study in the elderly.
Vault sutures have proven their low reliability for estimating age at death in individual forensic science cases. We broke down the palatine sutures of 134 skulls (with known sex and age at time of death) into 15 subparts and 5 stages of fusion to obtain a mean coefficient of obliteration (Cp) which was then linked to five age classes. We completed this study with multiple regression equations of total palatine suture scores. We compared our results with those obtained using the Mann method on the one hand and classically segmented and scored ectocranial suture age determination methods on the other. Palatine sutures generally do not estimate age at death any better than cranial vault sutures. Despite the partly subjective aspect of suture study, palatine suture observation contributes additional information to age-range estimation, especially in old and very old subjects where other methods lose their effectiveness. PMID:20002267
Beauthier, Jean-Pol; Lefevre, Philippe; Meunier, Maurice; Orban, Rosine; Polet, Caroline; Werquin, Jean-Pierre; Quatrehomme, Gérald
A safety technique for Mitek anchor suture rupture: a useful trick.
We propose that the simple method of passing an extra suture through the Mitek anchor eyelet before bony insertion provides a safety net against failure of the preloaded suture and gives extra strength to the core repair. PMID:21802866
Othman, Diaa; Le Cocq, Heather; Majumder, Sanjib
Cases of difficult suture removal following the McDonald procedure.
Abstract We examined the clinical significance of difficult suture removal following the McDonald procedure. We examined 117 patients following the McDonald procedure with a singleton pregnancy who delivered at ?34 weeks of gestation. Difficult suture removal was defined as when spinal anesthesia was required for suture removal. Seven patients (6.0%) were defined as involving difficult suture removal. The cervical length in the difficult-removal-group was significantly shorter than that in the easy-removal-group at suture removal (p?=?0.04). If the cervical length was shorter than 20?mm, the odds ratio for difficult suture removal was 9.0 (95% CI 1.6-49, p?=?0.01). The progression of cervical ripening following the McDonald suture may be associated with an increased risk of difficult suture removal. PMID:24106791
Suzuki, Shunji
In vivo cranial suture function and suture morphology in the extant fish Polypterus: implications for inferring skull function in living and fossil fish.
This study describes the mechanical role that cranial sutures play in fish during feeding. The long-term goal of our work is to establish relationships between suture form and function, so that functional inferences can be made from suture morphology in fossil taxa. To this end, strain gauges were surgically implanted across selected sutures in the skull roof of four individuals of Polypterus endlicherii. After surgery, bone and suture strains during feeding were recorded along with high-speed video of the feeding events. Each trial was designated as a suction feeding or biting on prey trial, and neurocranial elevation, hyoid position and gape were quantified to aid in interpreting the strain data. The strains due to suction feeding are different from those observed during biting. Suction feeding results in a fairly stereotyped strain pattern, with the interfrontal and frontoparietal sutures experiencing tension, while the interparietal suture is compressed. Biting causes much more variable strain patterns. However, both suction and biting result in compression in the back of the skull, and tension between the frontals. Peak strains, and the time at which they occur in the feeding cycle, were compared between suction and biting. In general, peak suture strains are higher during suction than during biting, but not all of these differences are significant. Peak suture and bone strains occur at or near maximum gape during both suction and biting, suggesting that these strains are caused by muscle contraction involved in mouth opening and closing. Micro-computed tomography (microCT) scans of the experimental specimens indicate that the interfrontal and frontoparietal sutures, typically loaded in tension, are less interdigitated in cross section than the interparietal suture, which experiences compression. This is consistent with published correlations of suture form and function in mammals, where interdigitated sutures indicate compression and lack of interdigitation is associated with tension. PMID:16709911
Markey, Molly J; Main, Russell P; Marshall, Charles R
In-the-bag scleral suturing of intraocular lens in eyes with severe zonular dehiscence
Purpose To compare the degree of tilt and decentration of an intraocular lens (IOL), refractive status, and prediction error between eyes that underwent trans-scleral suturing of the IOL within the capsular bag (in-the-bag scleral suturing) and eyes that underwent scleral suturing outside of the bag (out-of-the-bag scleral suturing) because of severe zonular dehiscence. Patients and methods Thirty eyes that underwent in-the-bag scleral suturing of an IOL and 38 eyes that underwent out-of-the-bag scleral suturing were recruited sequentially. The tilt and decentration of the IOL, anterior chamber depth, manifest refractive spherical equivalent (MRSE), prediction error, and incidence of complications were examined. Results The mean tilt angle and the decentration length of the IOL of the in-the-bag suturing group were significantly less than those of the out-of-the-bag suturing group (P=0.0003 in tilt and P=0.0391 in decentration), although the anterior chamber depth was similar. The mean MRSE and prediction error of the in-the-bag suturing group were less than those of the out-of-the-bag suturing group (P=0.0006 in MRSE and P=0.0034 in error). The incidence of vitreous loss was less in the in-the-bag suturing group than in the out-of-the-bag suturing group (20% vs63.2%, P=0.0009). Conclusions The tilt and decentration of the IOL after in-the-bag scleral suturing are significantly less than those after out-of-the-bag scleral suturing, which may lead to less MRSE and less prediction error. As the incidence of vitreous loss is less after in-the-bag scleral suturing, in-the-bag suturing is advantageous for eyes of younger patients and of less complicated cases.
Hayashi, K; Hirata, A; Hayashi, H
Barbed Suture for Vaginal Cuff Closure in Laparoscopic Hysterectomy
Background and Objectives: Our aim was to evaluate whether the use of barbed suture for vaginal cuff closure is associated with a decrease in postoperative vaginal bleeding compared with cuff closure with polyglactin 910 in patients who have undergone laparoscopic hysterectomy. Methods: We performed a cohort study of patients who underwent laparoscopic hysterectomy between January 2008 and July 2012 by the minimally invasive gynecologic surgery division of the Gynecology, Obstetrics and Human Reproduction Department at Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia. Results: A total of 232 women were studied: 163 were in the polyglactin 910 group, and 69 were in the barbed suture group. The main outcome, postoperative vaginal bleeding, was documented in 53 cases (32.5%) in the polyglactin 910 group and in 13 cases (18.8%) in the barbed suture group (relative risk, 0.57; 95% confidence interval, 0.34–0.9; P = .03). No statistically significant differences were found in other postoperative outcomes, such as emergency department admission, vaginal cuff dehiscence, infectious complications, and the presence of granulation tissue. Conclusion: In this study an inverse association was observed between the use of barbed suture for vaginal cuff closure during laparoscopic hysterectomy and the presence of postoperative vaginal bleeding.
Medina, Byron Cardoso; Riano, Giovanni; Hoyos, Luis R.; Otalora, Camila
Cranial suture biology and dental development: genetic and clinical perspectives.
Premature fusion of the calvarial bones at the sutures, or craniosynostosis (CS), is a relatively common birth defect (1:2000-3000) frequently associated with limb deformity. Patients with CS may present oral defects, such as cleft soft palate, hypodontia, hyperdontia, and delayed tooth eruption, but also unusual associations of major dental anomalies such as taurodontism, microdontia, multiple dens invaginatus, and dentin dysplasia. The list of genes that are involved in CS includes those coding for the different fibroblast growth factor receptors and a ligand of ephrin receptors, but also genes encoding transcription factors, such as MSX2 and TWIST. Most of these genes are equally involved in odontogenesis, providing a pausible explanation for clinical associations of CS with dental agenesis or tooth malformations. On the basis of the present knowledge on genes and transcription factors that are involved in craniofacial morphogenesis, and from dental clinics of CS syndromes, the molecular mechanisms that control suture formation and suture closure are expected to play key roles in patterning events and development of teeth. The purpose of this article is to review and merge the recent advances in the field of suture research at the genetic and cellular levels with those of tooth development, and to apply them to the dental clinics of CS syndromes. These new perspectives and future challenges in the field of both dental clinics and molecular genetics, more in particular the identification of possible candidate genes involved in both CS and dental defects, are discussed. PMID:17686002
De Coster, P J; Mortier, G; Marks, L A; Martens, L C
Angiogenesis and osteogenesis in an orthopedically expanded suture
NASA Technical Reports Server (NTRS)
The purpose of this study was to examine the angiogenic and the subsequent osteogenic responses during a 96-hour time-course after sutural expansion. Fifty rats were divided into: (1) a control group that received only angiogenic induction through injection of 5 ng/gm recombinant human endothelial cell growth factor (rhECGF); (2) an experimental group that received orthopedic expansion and rhECGF; (3) a sham group that received expansion and sodium chloride (NaCl) injection; and (4) a baseline group that received no expansion or injection. All rats were injected with 3H-thymidine (1.0 microCi/gm) 1 hour before death to label the DNA of S-phase cells. Demineralized sections (4 microm thick) were stained with hematoxylin and eosin. Angiogenesis and cell migration were analyzed with a previously established cell kinetics model. Analysis of variance was used to test the hypothesis that enhancement of angiogenesis stimulates reestablishment of osteogenic capability. Blood vessel number, area, and endothelial cell-labeled index significantly increased in experimental groups, but no difference was found between control and baseline groups. Labeled-pericyte index and activated pericyte numbers in the experimental group were also higher than in the sham groups. These results show that supplemental rhECGF enhances angiogenesis in expanded sutures but not in nonexpanded sutures. Data also suggest that pericytes are the source of osteoblasts in an orthopedically expanded suture.
Chang, H. N.; Garetto, L. P.; Potter, R. H.; Katona, T. R.; Lee, C. H.; Roberts, W. E.
Hemostatic suturing technique for uterine bleeding during cesarean delivery
Background: If medical management is unsuccessful in controlling postpartum hemorrhage, conservative surgical intervention or cesarean hysterectomy is required.Technique: Hemostatic multiple square suturing using a straight number 7 or number 8 needle and number 1 chromic catgut is a new surgical technique to approximate anterior and posterior uterine walls, especially in areas where there is heavy bleeding. It controls postpartum hemorrhage
Jin Ho Cho; Hye Sun Jun; Chung No Lee
Arthroscopic Rotator Cuff Repair Using a Suture Bridge Technique: Is the Repair Integrity Actually Maintained?
Background: Suture bridge repair has been recognized to have superior biomechanical characteristics, as shown in previous biomechanical studies. However, it is not clear whether the tendon heals better in vivo after suture bridge repair.Purpose: To evaluate the clinical results and repair integrity after arthroscopic rotator cuff repair using a suture bridge technique for patients with rotator cuff tears.Study Design: Case
Nam Su Cho; Bong Gun Lee; Yong Girl Rhee
Shape Memory Alloy Fixator System for Suturing Tissue in Minimal Access Surgery
A new technique for suturing human tissue is described in which tissue closure is achieved by means of small fixators made from shape memory alloy. The aim of the development is to provide an alternative to thread suturing in minimal access surgery, which is quicker and requires less skill to achieve the required suturing quality. The design of the fixators
W. Xu; T. G. Frank; G. Stockham; A. Cuschieri
[Twist-guided thread control: a technique for faster and atraumatic continuous sutures].
A simple technique by twisting the thread in clockwise or counter clockwise direction before tightening the suture can help to produce a regular vascular suture line. In a blinded experiment with 60 vascular anastomosis it was proved that the time needed for suture can be reduced by 15%, and that traumatic touch with surgical instruments can be diminished by 63%. PMID:15354249
Freudenberg, S; Rewerk, S; Bay, F; Schlüter, M; Weiss, C; Kerger, H
Biomechanical properties of superficial musculoaponeurotic system tissue with vs without reinforcement with poly-4-hydroxybutyric acid absorbable mesh.
IMPORTANCE It is unknown whether poly-4-hydroxybutyric acid (P4HB)-reinforced superficial musculoaponeurotic system tissue (SMAS) plication techniques will support SMAS imbrication and plication and potentially improve outcomes in rhytidectomy. OBJECTIVES To evaluate the biomechanical properties (tissue breaking strength, suture tearing force, and stress relaxation) of the SMAS with vs without reinforcement with P4HB absorbable mesh and to correlate these results with potential clinical applications. DESIGN, SETTING, AND SAMPLES In a cadaver study at an academic setting, 12 fresh frozen cadaver heads were used. Rhytidectomy incisions were made, and the SMAS was harvested and prepared for strength and stress testing using an Instron device. MAIN OUTCOMES AND MEASURES Tissue breaking strength and suture tearing force were analyzed. Stress relaxation test results were also assessed. The results of the SMAS samples alone were compared with those reinforced with P4HB absorbable mesh. RESULTS Overall, there were significant differences noted in tissue breaking strength and suture tearing force between the 2 groups. When the SMAS was reinforced with absorbable mesh, significant improvements were observed in tissue breaking strength (P?.001) and suture tearing force (P?.003). In addition, less variability was demonstrated in the maximum tensile load-bearing quality of the SMAS when the repair was reinforced with P4HB. CONCLUSIONS AND RELEVANCE Reinforcement with P4HB absorbable mesh improves tissue breaking strength and suture tearing force in cadaveric SMAS. It also reduces the variability in load vs displacement seen among samples tested. These data suggest that P4HB-reinforced SMAS imbrication would support higher loads and provide more consistent, long-lasting SMAS support among patients undergoing rhytidectomy. Further studies are needed to correlate these data with clinical outcomes in rhytidectomy. PMID:24676588
Angelos, Patrick C; Brennan, Tara E; Toriumi, Dean M
NASA Technical Reports Server (NTRS)
A tool to assist in the servicing of a shock absorber wherein the shock absorber is constructed of a pair of aligned gas and liquid filled chambers. Each of the chambers is separated by a movable separator member. Maximum efficiency of the shock absorber is achieved in the locating of a precise volume of gas within the gas chamber and a precise volume of liquid within the liquid chamber. The servicing tool of this invention employs a rod which is to connect with the separator and by observation of the position of the rod with respect to the gauge body, the location of the separator is ascertained even though it is not directly observable.
Koepler, Jack L. (Inventor); Hill, Robert L. (Inventor)
Unravelling the molecular control of calvarial suture fusion in children with craniosynostosis
Background Craniosynostosis, the premature fusion of calvarial sutures, is a common craniofacial abnormality. Causative mutations in more than 10 genes have been identified, involving fibroblast growth factor, transforming growth factor beta, and Eph/ephrin signalling pathways. Mutations affect each human calvarial suture (coronal, sagittal, metopic, and lambdoid) differently, suggesting different gene expression patterns exist in each human suture. To better understand the molecular control of human suture morphogenesis we used microarray analysis to identify genes differentially expressed during suture fusion in children with craniosynostosis. Expression differences were also analysed between each unfused suture type, between sutures from syndromic and non-syndromic craniosynostosis patients, and between unfused sutures from individuals with and without craniosynostosis. Results We identified genes with increased expression in unfused sutures compared to fusing/fused sutures that may be pivotal to the maintenance of suture patency or in controlling early osteoblast differentiation (i.e. RBP4, GPC3, C1QTNF3, IL11RA, PTN, POSTN). In addition, we have identified genes with increased expression in fusing/fused suture tissue that we suggest could have a role in premature suture fusion (i.e. WIF1, ANXA3, CYFIP2). Proteins of two of these genes, glypican 3 and retinol binding protein 4, were investigated by immunohistochemistry and localised to the suture mesenchyme and osteogenic fronts of developing human calvaria, respectively, suggesting novel roles for these proteins in the maintenance of suture patency or in controlling early osteoblast differentiation. We show that there is limited difference in whole genome expression between sutures isolated from patients with syndromic and non-syndromic craniosynostosis and confirmed this by quantitative RT-PCR. Furthermore, distinct expression profiles for each unfused suture type were noted, with the metopic suture being most disparate. Finally, although calvarial bones are generally thought to grow without a cartilage precursor, we show histologically and by identification of cartilage-specific gene expression that cartilage may be involved in the morphogenesis of lambdoid and posterior sagittal sutures. Conclusion This study has provided further insight into the complex signalling network which controls human calvarial suture morphogenesis and craniosynostosis. Identified genes are candidates for targeted therapeutic development and to screen for craniosynostosis-causing mutations.
Coussens, Anna K; Wilkinson, Christopher R; Hughes, Ian P; Morris, C Phillip; van Daal, Angela; Anderson, Peter J; Powell, Barry C
This patent describes a neutron irradiation environment of a water cooled and moderated reactor core a fuel assembly having a discrete annular burnable absorber rod, the rod being free of nuclear fuel material the rod comprising a first elongated hollow tube having opposed ends, a second elongated hollow tube having opposed ends. The first and second tubes are constructed of a zirconium material, the first and second tubes concentrically arranged about a common axis to provide a coextensive annular space therebetween and a path for the water through the first tube along the common axis. A sealing means seals the annular space at common opposed ends of the first and second tube and a hollow niobium tubular support is arranged within the annular space. The tubular support has an inner and outer surface, a layer of burnable neutron absorber material provided on at least a portion of one of the surfaces of the support the layer of the burnable neutron absorber material selected from the group of boron compounds consisting of boron carbide, boron nitride and zirconium diboride; and the layer of the burnable neutron absorber material having a thickness between 0.002 to 0.010 inches.
Chubb, W.
Absorbed dose water calorimeter
An absorbed dose water calorimeter that takes advantage of the low thermal diffusivity of water and the water-imperviousness of polyethylene film. An ultra-small bead thermistor is sandwiched between two thin polyethylene films stretched between insulative supports in a water bath. The polyethylene films insulate the thermistor and its leads, the leads being run out from between the films in insulated
The present invention is drawn to new classes of advanced neutron absorbing structural materials for use in spent nuclear fuel applications requiring structural strength, weldability, and long term corrosion resistance. Particularly, an austenitic stainless steel alloy containing gadolinium and less than 5% of a ferrite content is disclosed. Additionally, a nickel-based alloy containing gadolinium and greater than 50% nickel is also disclosed.
Mizia, Ronald E. (Idaho Falls, ID); Shaber, Eric L. (Idaho Falls, ID); DuPont, John N. (Whitehall, PA); Robino, Charles V. (Albuquerque, NM); Williams, David B. (Bethlehem, PA)
Method of making a burnable neutron absorber of boron carbide in a matrix of aluminum oxide. In the practice of this method, boron-carbide particles are coated with a pore former and then they are mixed in a slurry with aluminum oxide powder. When the slurry is subsequently dried and sintered, the pore former is burned out and a body is
B. M. Argall; P. J. Kuchirka; K. C. Radford
Solar Radiation Absorbing Material.
National Technical Information Service (NTIS)
Solar energy absorbing means in solar collectors are provided by a solar selective carbon surface. A solar selective carbon surface is a microporous carbon surface having pores within the range of 0.2 to 2 micrometers. Such a surface is provided in a micr...
J. M. Googin C. R. Schmitt J. M. Schreyer H. D. Whitehead
National Technical Information Service (NTIS)
The invention involves a shock absorber consisting of a cylindrical housing (containing a coaxially placed guide cylinder forming a working space equipped with by-pass apertures), a chamber (formed by the housing and the floating piston), and a working pi...
N. N. Rakhmanov
Lifetimes of Saturable Absorbers
THE use of saturable absorbers such as aluminium phthalocyanine for the passive Q-switching of ruby lasers1 raises the question of the lifetime of the active molecule. We have measured the lifetime of that state of aluminium phthalocyanine which corresponds to absorption at or near 6943 Ĺ. Similar data for magnesium phthalocyanine have been obtained, for comparison with literature values.
P. W. A. Bowe; W. E. K. Gibbs; J. Tregellas-Williams
Surgical suture assembled with polymeric drug-delivery sheet for sustained, local pain relief.
Surgical suture is a strand of biocompatible material designed for wound closure, and therefore can be a medical device potentially suitable for local drug delivery to treat pain at the surgical site. However, the preparation methods previously introduced for drug-delivery sutures adversely influenced the mechanical strength of the suture itself - strength that is essential for successful wound closure. Thus, it is not easy to control drug delivery with sutures, and the drug-delivery surgical sutures available for clinical use are now limited to anti-infection roles. Here, we demonstrate a surgical suture enabled to provide controlled delivery of a pain-relief drug and, more importantly, we demonstrate how it can be fabricated to maintain the mechanical strength of the suture itself. For this purpose, we separately prepare a drug-delivery sheet composed of a biocompatible polymer and a pain-relief drug, which is then physically assembled with a type of surgical suture that is already in clinical use. In this way, the drug release profiles can be tailored for the period of therapeutic need by modifying only the drug-loaded polymer sheet without adversely influencing the mechanical strength of the suture. The drug-delivery sutures in this work can effectively relieve the pain at the surgical site in a sustained manner during the period of wound healing, while showing biocompatibility and mechanical properties comparable to those of the original surgical suture in clinical use. PMID:23770220
Lee, Ji Eun; Park, Subin; Park, Min; Kim, Myung Hun; Park, Chun Gwon; Lee, Seung Ho; Choi, Sung Yoon; Kim, Byung Hwi; Park, Hyo Jin; Park, Ji-Ho; Heo, Chan Yeong; Choy, Young Bin
The global impact of sutures assessed in a finite element model of a macaque cranium.
The biomechanical significance of cranial sutures in primates is an open question because their global impact is unclear, and their material properties are difficult to measure. In this study, eight suture-bone functional units representing eight facial sutures were created in a finite element model of a monkey cranium. All the sutures were assumed to have identical isotropic linear elastic material behavior that varied in different modeling experiments, representing either fused or unfused sutures. The values of elastic moduli employed in these trials ranged over several orders of magnitude. Each model was evaluated under incisor, premolar, and molar biting conditions. Results demonstrate that skulls with unfused sutures permitted more deformations and experienced higher total strain energy. However, strain patterns remained relatively unaffected away from the suture sites, and bite reaction force was likewise barely affected. These findings suggest that suture elasticity does not substantially alter load paths through the macaque skull or its underlying rigid body kinematics. An implication is that, for the purposes of finite element analysis, omitting or fusing sutures is a reasonable modeling approximation for skulls with small suture volume fraction if the research objective is to observe general patterns of craniofacial biomechanics under static loading conditions. The manner in which suture morphology and ossification affect the mechanical integrity of skulls and their ontogeny and evolution awaits further investigation, and their viscoelastic properties call for dynamic simulations. PMID:20652940
Wang, Qian; Smith, Amanda L; Strait, David S; Wright, Barth W; Richmond, Brian G; Grosse, Ian R; Byron, Craig D; Zapata, Uriel
The mouse palate and its cellular responses to midpalatal suture expansion forces
Objectives To investigate the anatomy of the mouse palate, the midpalatal suture, and the cellular characteristics in the sutures before and immediately after midpalatal suture expansion. Material and Methods Wild-type C57BL/6 male mice, aged between 6 weeks and 12 months, were chosen for all the experiments. The complete palate of the non-operated group and the midpalatal suture expanded group at different ages was used for histological, micro-CT, immunohistochemistry, and sutural cell analyses. Results The current study documents precise morphological and histological characteristics of the mouse palatal sutures. In addition to the opening of the midpalatal suture caused by expansion, both transverse and interpalatine sutures were also seen to be affected. Cellular density was decreased in different types of sutures following application of mechanical force. Conclusions The detailed morphology and histology of the mouse palate and the cellular changes which occur following midpalatal suture expansion, as described here, will be helpful as a basis for further investigations of palatal suture tissue responses to mechanical force.
Katebi, N; Kolpakova-Hart, E; Lin, CY; Olsen, BR
Cranial sutures work collectively to distribute strain throughout the reptile skull
The skull is composed of many bones that come together at sutures. These sutures are important sites of growth, and as growth ceases some become fused while others remain patent. Their mechanical behaviour and how they interact with changing form and loadings to ensure balanced craniofacial development is still poorly understood. Early suture fusion often leads to disfiguring syndromes, thus is it imperative that we understand the function of sutures more clearly. By applying advanced engineering modelling techniques, we reveal for the first time that patent sutures generate a more widely distributed, high level of strain throughout the reptile skull. Without patent sutures, large regions of the skull are only subjected to infrequent low-level strains that could weaken the bone and result in abnormal development. Sutures are therefore not only sites of bone growth, but could also be essential for the modulation of strains necessary for normal growth and development in reptiles.
Curtis, Neil; Jones, M. E. H.; Evans, S. E.; O'Higgins, P.; Fagan, M. J.
[Meniscal sutures combined with the reconstruction of the anterior cruciate ligament. Comparative results between sutures of chronic and recent lesions: 102 cases].
The authors report the results of 102 meniscal sutures (53 lateral meniscus and 49 medial meniscus) done on 85 persons (86 knees) with laxity of the knee (54 acute laxities and 32 chronic laxities). All the sutures were done by posterior arthrotomy, while reconstruction of anterior cruciate ligament. Among the operations done on anterior cruciate ligaments, we find 45 reconstructions using MacIntosh procedure, 37 CHO method and 3 reconstructions using Lemaire procedure. 78 per cent of the sutures of the recent injuries were placed in a post-operative plaster cast, on the other hand, none of the chronic injuries was splinted. All the knees (except 1) were followed up within an interval of time of 1 year minimum to 4 years maximum. 3 sutures of fresh medial meniscus tear were reoperated on and one suture of old tear was reoperated. None of the lateral meniscus sutures, old or new was reoperated. 27 "objective" controls were done: 5 by arthrography, 4 by arthroscopy and 18 by magnetic resonance imaging (M.R.I.). Of the 18 controlled sutures by M.R.I., 13 (that is, 76, 5 per cent) presented a high signal as if they had a "wound" or persistent injury, this was found within a context of knees without any symptoms. Therefore the sutures of medial meniscus associated with laxity heal very well. It would be even better if they were in the chronic laxity stage (1 did not succeed out of the 22) than in the acute laxity stage (3 failures out of 27). The sutures of lateral meniscus healed very well in the chronic and in the old laxity stages (total success in both stages). The M.R.I controls for the 18 meniscus sutures presented the problem of the sutured meniscus future. PMID:2146710
Saragaglia, D; Tourne, Y; Chamseddine, A; Butel, J
Endoscope-assisted transscleral suture fixation of intraocular lenses.
We describe a new method for placing transscleral sutures when fixating posterior chamber intraocular lenses to the sulcus. An intraocular microendoscope with an 18 gauge probe is used for direct sulcus observation and needle position assessment. The straight needle of a 10-0 polypropylene suture and the tip of the probe are placed in a 16 gauge silicone rubber tube to hold them together. Fixing the needle to the endoscope allows a direct view of its tip and requires only one hand. The other hand is used to grasp the tip of the needle when it comes out under the scleral flap after passing through the sulcus. Assessment of needle position with an endoscope avoids surgically induced iris root or ciliary body damage. Fixing the needle to the endoscope simplifies the surgical technique. PMID:9041077
Jürgens, I; Lillo, J; Buil, J A; Castilla, M
CASE REPORT Pan-Suture Synostosis After Posterior Vault Distraction
Objective: Posterior vault remodeling by distraction osteogenesis is a relatively new technique used for initial correction of turribrachycephaly in children with bicoronal craniosynostosis. We present a new potential complication from this procedure; a case of pan-suture synostosis subsequent to posterior vault distraction. Methods: We report an infant girl who presented with bicoronal synostosis in the setting of Saethre-Chotzen syndrome. She underwent posterior vault distraction and was distracted a total of 34 millimeters, with successful osteogenesis at the site. Results: One year postoperatively, the patient was found to have incidental, asymptomatic pan-suture synostosis on computed tomography. Conclusions: To our knowledge, this is the first reported case of delayed craniosynostosis after posterior vault distraction in the literature. The possible pathogenesis and significance of this case are discussed with a review of the current literature.
Chu, Katrina F.; Sullivan, Stephen R.; Taylor, Helena O.
Arthroscopic Lateral Meniscus Root Repair With Soft Suture Anchor Technique
Meniscus root tear leads to circumferential hoop tension loss and increases femorotibial contact force, which causes irreversible cartilage degeneration. Biomechanical studies have shown that meniscus root repair provides better femorotibial contact force than meniscectomy. Many techniques for meniscus root repair have been published in recent years. The soft suture anchor is widely used in the glenoid labral repair. It is a small low-profile soft anchor. This article presents a new and simple technique of lateral meniscus root repair using the small soft anchor, which results in an anatomic and more vertical anchor position. It avoids instrument-related complications, such as cartilage delamination, material reaction, metal retention, and hard suture anchor pullout.
Prasathaporn, Niti; Kuptniratsaikul, Somsak; Kongrukgreatiyos, Kitiphong
Comparison of bursting pressure of sutured, stapled and BAR anastomoses.
The study was undertaken to compare anastomotic bursting pressure (ABP) of colorectal canine anastomoses using three different anastomotic techniques. Biofragmentable anastomotic ring (BAR), stapled, and sutured colon anastomoses were sequentially placed in each of 48 dogs following division of the colon at three equally spaced sites. Four groups of 12 dogs were sacrificed either on day 0, 3, 7, or 28 and ABP and bursting wall tension were determined. The data revealed that BAR anastomoses have the greatest strength on the day of surgery, sutured anastomoses are the strongest on the third day and all are comparable by the 7th day. Bursting pressures for all groups by day 28 approach normal colonic bursting pressure, with any differences likely to be a reflection of variation in anastomotic fibrosis and other factors. PMID:8492037
Bundy, C A; Jacobs, D M; Zera, R T; Bubrick, M P
Modified ab externo method for introducing 2 polypropylene loops for scleral suture fixation of intraocular lenses.
We describe a method that enables the introduction of 2 suture loops for scleral fixation of an intraocular lens (IOL) by a single ab externo procedure. A long needle carrying a polypropylene suture loop is inserted through the scleral fixation site and docked with a hollow needle inserted through the opposite fixation site. The hollow needle pulls the suture needle out, but the suture loop end is left external. Another polypropylene suture loop is placed through the first loop. As the first (leading) suture is pulled, the second (trailing) suture is drawn into the eye. The suture loops are retrieved through the main incision. The IOL haptics are secured with a polypropylene loop by cow hitches. After the IOL is placed in the eye, the sutures are fixated to the sclera. This technique enhances efficiency and control during the introduction of suture loops for scleral fixation of IOLs. PMID:23988241
Seki, Masaaki; Yamamoto, Susumu; Abe, Haruki; Fukuchi, Takeo
An adjustable medial orbital wall suture for third nerve palsy.
A 16-year-old girl presented with a large-angle exotropia due to congenital third nerve palsy. She had undergone recession/resection surgery as a child. A nasal transposition of the superior oblique and the lateral rectus produced some improvement but the result was still cosmetically unacceptable. Subsequent surgery to permanently secure the globe to the medial orbital wall using an intraoperatively adjustable nonabsorbable traction suture produced a satisfactory outcome. PMID:15498054
Mora, Justin
'Universal retraction suture' for the overprojecting nasal tip
Achieving a proper nasal tip projection is a crucial element of a successful rhinoplasty. A large number of correction methods and manoeuvres have been proposed in the medical literature as solutions for the prominent nasal tip, thus complicating the surgeon's strife to choose the ideal plan of action. In the present article, a single straight-forward technique, christened the 'universal retraction suture', is suggested to tackle the overprojecting tip in a simplified, controlled and efficient fashion.
Fanous, Nabil; Fanous, Amanda; Al-Sebeih, K; Cote, Valerie
Arthroscopic Suture Bridge Fixation of Tibial Intercondylar Eminence Fractures
Tibial intercondylar eminence fractures that are displaced and non-reducible require open or arthroscopically assisted repair. Ideally, fracture reduction and fixation would be performed with a technique that has low morbidity, allows easy visualization and reduction, provides firm fixation, does not violate the proximal tibial physis, avoids metal hardware, and does not require a second procedure for implant removal. The suture bridge technique, used in the shoulder for rotator cuff tears and greater tuberosity fracture repair, has the ability to produce high contact pressures with rigid fixation. We describe an all-inside and all-epiphyseal arthroscopic suture bridge technique for tibial intercondylar eminence fracture repair performed with PushLock anchors (Arthrex, Naples, FL). One or 2 anchors preloaded with No. 2 FiberWire (Arthrex) are placed in the posterior fracture bed, followed by fracture reduction. The suture limbs are shuttled through and around the anterior cruciate ligament and over the fracture fragment in crossing fashion and are secured by use of additional anchors placed at the anteromedial and anterolateral fracture margin. The anchors are placed obliquely to avoid the proximal tibial physis in the pediatric population. Anatomic reduction and secure fixation allow more aggressive rehabilitation and faster restoration of joint function.
Sawyer, Gregory A.; Hulstyn, Michael J.; Anderson, Brett C.; Schiller, Jonathan
IGF1R Variants Associated with Isolated Single Suture Craniosynostosis
The genetic contribution to the pathogenesis of isolated single suture craniosynostosis is poorly understood. The role of mutations in genes known to be associated with syndromic synostosis appears to be limited. We present our findings of a candidate gene resequencing approach to identify rare variants associated with the most common forms of isolated craniosynostosis. Resequencing of the coding regions, splice junction sites, and 5? and 3? untranslated regions of 27 candidate genes in 186 cases of isolated nonsyndromic single suture synostosis revealed three novel and two rare sequence variants (R406H, R595H, N857S, P190S, M446V) in insulin-like growth factor I receptor (IGF1R) that are enriched relative to control samples. Mapping the resultant amino acid changes to the modeled homodimer protein structure suggests a structural basis for segregation between these and other disease-associated mutations found in IGF1R. These data suggest that IGF1R mutations may contribute to the risk and in some cases cause single suture craniosynostosis.
Cunningham, Michael L.; Horst, Jeremy A.; Rieder, Mark J.; Hing, Anne V.; Stanaway, Ian B.; Park, Sarah S.; Samudrala, Ram; Speltz, Matthew L.
Biomechanics of the Rostrum and the Role of Facial Sutures
The rostrum is a large diameter, thin-walled tubular structure that receives loads from the teeth. The rostrum can be conceptualized both as a rigid structure and as an assemblage of several bones that interface at sutures. Using miniature pigs, we measured in vivo strains in rostral bones and sutures to gain a better understanding of how the rostrum behaves biomechanically. Strains in the premaxillary and nasal bones were low but the adjacent maxillary-premaxillary, internasal, and intermaxillary suture strains were larger by an order of magnitude. While this finding emphasizes the composite nature of the rostrum, we also found evidence in the maxillary and nasal bones for rigid structural behavior. Namely, maxillary strain is consistent with a short beam model under shear deformation from molar loading. Strain in the nasal bones is only partially supported by a long beam model; rather, a complex pattern of dorsal bending of the rostrum from incisor contact and lateral compression is suggested. Torsion of the maxilla is ruled out due to the bilateral occlusion of pigs and the similar working and balancing side strains, although it may be important in mammals with a unilateral bite. Torsional loading does appear important in the premaxillae, which demonstrate working and balancing side changes in strain orientation. These differences are attributed to asymmetrical incisor contact occurring at the end of the power stroke.
Rafferty, Katherine L.; Herring, Susan W.; Marshall, Christopher D.
NASA Technical Reports Server (NTRS)
Load attenuators for the Apollo spacecraft crew couch and its potential applications are described. Energy absorption is achieved through friction and cyclic deformation of material. In one concept, energy absorption is accomplished by rolling a compressed ring of metal between two surfaces. In another concept, energy is absorbed by forcing a plastically deformed washer along a rod. Among the design problems that had to be solved were material selection, fatigue life, ring slippage, lubrication, and friction loading.
Wesselski, C. J.; Drexel, R. E.
Evaluation of BioCorkscrew and Bioknotless RC suture anchor rotator cuff repair fixation: an in vitro biomechanical study
This in vitro biomechanical study used cadaveric specimens to compare the rotator cuff repair fixation provided by BioCorkscrew\\u000a and Bioknotless RC suture anchors. Three cm wide by 1-cm long full-thickness supraspinatus defects were repaired using either\\u000a two BioCorkscrew suture anchors with combined vertical and horizontal mattress sutures (n = 7) or three Bioknotless RC suture anchors with simple sutures (n = 7). Therefore, the
Jennifer Tucker Ammon; John Nyland; Haw Chong Chang; Robert Burden; David N. M. Caborn
Absence of endochondral ossification and craniosynostosis in posterior frontal cranial sutures of Axin2(-/-) mice.
During the first month of life, the murine posterior-frontal suture (PF) of the cranial vault closes through endochondral ossification, while other sutures remain patent. These processes are tightly regulated by canonical Wnt signaling. Low levels of active canonical Wnt signaling enable endochondral ossification and therefore PF-suture closure, whereas constitutive activation of canonical Wnt causes PF-suture patency. We therefore sought to test this concept with a knockout mouse model. PF-sutures of Axin2(-/-) mice, which resemble a state of constantly activated canonical Wnt signaling, were investigated during the physiological time course of PF-suture closure and compared in detail with wild type littermates. Histological analysis revealed that the architecture in Axin2(-/-) PF-sutures was significantly altered in comparison to wild type. The distance between the endocranial layers was dramatically increased and suture closure was significantly delayed. Moreover, physiological endochondral ossification did not occur, rather an ectopic cartilage appeared between the endocranial and ectocranial bone layers at P7 which eventually involutes at P13. Quantitative PCR analysis showed the lack of Col10?1 upregulation in Axin2(-/-) PF-suture. Immunohistochemistry and gene expression analysis also revealed high levels of type II collagen as compared to type I collagen and absence of Mmp-9 in the cartilage of Axin2(-/-) PF-suture. Moreover, TUNEL staining showed a high percentage of apoptotic chondrocytes in Axin2(-/-) PF-sutures at P9 and P11 as compared to wild type. These data indicated that Axin2(-/-) PF-sutures lack physiological endochondral ossification, contain ectopic cartilage and display delayed suture closure. PMID:23936395
Behr, Björn; Longaker, Michael T; Quarto, Natalina
Absence of Endochondral Ossification and Craniosynostosis in Posterior Frontal Cranial Sutures of Axin2?/? Mice
During the first month of life, the murine posterior-frontal suture (PF) of the cranial vault closes through endochondral ossification, while other sutures remain patent. These processes are tightly regulated by canonical Wnt signaling. Low levels of active canonical Wnt signaling enable endochondral ossification and therefore PF-suture closure, whereas constitutive activation of canonical Wnt causes PF-suture patency. We therefore sought to test this concept with a knockout mouse model. PF-sutures of Axin2?/? mice, which resemble a state of constantly activated canonical Wnt signaling, were investigated during the physiological time course of PF-suture closure and compared in detail with wild type littermates. Histological analysis revealed that the architecture in Axin2?/? PF-sutures was significantly altered in comparison to wild type. The distance between the endocranial layers was dramatically increased and suture closure was significantly delayed. Moreover, physiological endochondral ossification did not occur, rather an ectopic cartilage appeared between the endocranial and ectocranial bone layers at P7 which eventually involutes at P13. Quantitative PCR analysis showed the lack of Col10?1 upregulation in Axin2?/? PF-suture. Immunohistochemistry and gene expression analysis also revealed high levels of type II collagen as compared to type I collagen and absence of Mmp-9 in the cartilage of Axin2?/? PF-suture. Moreover, TUNEL staining showed a high percentage of apoptotic chondrocytes in Axin2?/? PF-sutures at P9 and P11 as compared to wild type. These data indicated that Axin2?/? PF-sutures lack physiological endochondral ossification, contain ectopic cartilage and display delayed suture closure.
Behr, Bjorn; Longaker, Michael T.; Quarto, Natalina
Bundles of Spider Silk, Braided into Sutures, Resist Basic Cyclic Tests: Potential Use for Flexor Tendon Repair
Repair success for injuries to the flexor tendon in the hand is often limited by the in vivo behaviour of the suture used for repair. Common problems associated with the choice of suture material include increased risk of infection, foreign body reactions, and inappropriate mechanical responses, particularly decreases in mechanical properties over time. Improved suture materials are therefore needed. As high-performance materials with excellent tensile strength, spider silk fibres are an extremely promising candidate for use in surgical sutures. However, the mechanical behaviour of sutures comprised of individual silk fibres braided together has not been thoroughly investigated. In the present study, we characterise the maximum tensile strength, stress, strain, elastic modulus, and fatigue response of silk sutures produced using different braiding methods to investigate the influence of braiding on the tensile properties of the sutures. The mechanical properties of conventional surgical sutures are also characterised to assess whether silk offers any advantages over conventional suture materials. The results demonstrate that braiding single spider silk fibres together produces strong sutures with excellent fatigue behaviour; the braided silk sutures exhibited tensile strengths comparable to those of conventional sutures and no loss of strength over 1000 fatigue cycles. In addition, the braiding technique had a significant influence on the tensile properties of the braided silk sutures. These results suggest that braided spider silk could be suitable for use as sutures in flexor tendon repair, providing similar tensile behaviour and improved fatigue properties compared with conventional suture materials.
Hennecke, Kathleen; Redeker, Joern; Kuhbier, Joern W.; Strauss, Sarah; Allmeling, Christina; Kasper, Cornelia; Reimers, Kerstin; Vogt, Peter M.
Shock absorber in Ignalina NPP.
National Technical Information Service (NTIS)
Theoretical calculation and experimental analysis of models of shock absorber in Ignalina NPP is presented. The results obtained from the investigation with model of shock absorber coincide with the theoretical calculation. (author). 2 figs., 3 refs. (Ato...
A. Bulavas J. Muralis
Corrosion resistant neutron absorbing coatings
A method of forming a corrosion resistant neutron absorbing coating comprising the steps of spray or deposition or sputtering or welding processing to form a composite material made of a spray or deposition or sputtering or welding material, and a neutron absorbing material. Also a corrosion resistant neutron absorbing coating comprising a composite material made of a spray or deposition or sputtering or welding material, and a neutron absorbing material.
Choi, Jor-Shan (El Cerrito, CA); Farmer, Joseph C. (Tracy, CA); Lee, Chuck K. (Hayward, CA); Walker, Jeffrey (Gaithersburg, MD); Russell, Paige (Las Vegas, NV); Kirkwood, Jon (Saint Leonard, MD); Yang, Nancy (Lafayette, CA); Champagne, Victor (Oxford, PA)
Corrosion resistant neutron absorbing coatings
A method of forming a corrosion resistant neutron absorbing coating comprising the steps of spray or deposition or sputtering or welding processing to form a composite material made of a spray or deposition or sputtering or welding material, and a neutron absorbing material. Also a corrosion resistant neutron absorbing coating comprising a composite material made of a spray or deposition or sputtering or welding material, and a neutron absorbing material.
Choi, Jor-Shan; Farmer, Joseph C; Lee, Chuck K; Walker, Jeffrey; Russell, Paige; Kirkwood, Jon; Yang, Nancy; Champagne, Victor
Machine for Testing Shock Absorbers.
National Technical Information Service (NTIS)
The machine is for testing shock absorbers used in tanks, personnel carriers, and like vehicles. A shock absorber is tested by mounting it on one end of a piston which is reciprocated by hydraulic fluid under pressure. The other end of the shock absorber ...
E. W. Posse C. E. Rutledge
Uterine Compression Sutures as an Effective Treatment for Postpartum Hemorrhage: Case Series
We evaluated the role of uterine compression sutures as a conservative treatment for postpartum hemorrhage (PPH) after failed medical treatment. We retrospectively reviewed the charts of all patients who delivered between 2003 and 2009 at a single tertiary care center and who underwent uterine compression sutures for PPH. Twelve women had uterine compression sutures for PPH. The mean age of the patients was 36.3 ± 5.2 years. The mean gestational age at delivery was 37.7 ± 2.0 weeks, and the average estimated blood loss was 2.1 ± 1.1 L. The mean procedure time to perform the uterine compression sutures was 9.3 ± 2.8 minutes. The success rate of compression sutures was 92% with only one failure resulting in a hysterectomy. Uterine compression sutures are an effective method for the treatment of PPH, thus avoiding hysterectomy and preserving potential fertility.
Al Riyami, Nihal; Hui, Dini; Herer, Elaine; Nevo, Ori
Acute Corneal Hydrops following Post-keratoplasty Suture Removal in Pellucid Marginal Degeneration
Purpose To report acute corneal hydrops following suture removal after penetrating keratoplasty (PK) in a case of pellucid marginal degeneration (PMD). Case report A young female underwent PK for corneal scarring in her left eye due to PMD; 8 months later the last sutures were removed. A few days following suture removal, the patient developed acute hydrops in the inferior aspect of the host-graft interface mostly in the recipient portion in the presence of a positive Seidel test. Review of the patient's records revealed suture tract leakage in the early postoperative period at the same location which had been significantly thin. The patient received conservative therapy leading to complete resolution of the condition. Conclusion Through and through suture bites in a mismatched host-graft interface can predispose the patient to acute hydrops in PMD when the sutures are removed during routine postoperative care.
Fallahi Motlagh, Behzad; Mortazavi, Seyed Zia
Orientation of late Precambrian sutures in the Arabian-Nubian shield
NASA Technical Reports Server (NTRS)
Recent tectonic models have resulted in conflicting descriptions of how the late Precambrian sutures of the Arabian-Nubian shield extend into northeast Africa. The Hamisana shear zone in northeastern Sudan is critical to this discussion because it truncates and disrupts two sutures, the Allaqi-Heiani and the Onib-Sol Hamed. Analysis of field structural data, Thematic Mapper imagery, and Rb-Sr and U-Pb geochronology suggests that the Allaqi-Heiani suture is the western extension of the Onib-Sol Hamed suture and that both make up the exposed parts of a far-traveled, polydeformed ophiolitic nappe complex. Subsequent deformation localized in the Hamisana shear zone disrupted this nappe and displaced the suture between 660 and 550 Ma during regional deformation associated with the Najd fault system. These results indicate that at least one suture extends westward into the interior of northern Africa.
Stern, Robert J.; Nielsen, Kent C.; Best, Eric; Sultan, Mohamed; Arvidson, Raymond E.
A simple, economical absorber utilizing a new principle of operation to achieve very low reradiation losses while generating temperatures limited by material properties of quartz is described. Its performance is analyzed and indicates approximately 90% thermal efficiency and 73% conversion efficiency for an earth based unit with moderately concentrated (~tenfold) sunlight incident. It is consequently compatible with the most economic of concentrator mirrors (stamped) or mirrors deployable in space. Space applications are particularly attractive, as temperatures significantly below 300 K are possible and permit even higher conversion efficiency. PMID:20134700
Powell, W R
Surgical sutures filled with adipose-derived stem cells promote wound healing.
Delayed wound healing and scar formation are among the most frequent complications after surgical interventions. Although biodegradable surgical sutures present an excellent drug delivery opportunity, their primary function is tissue fixation. Mesenchymal stem cells (MSC) act as trophic mediators and are successful in activating biomaterials. Here biodegradable sutures were filled with adipose-derived mesenchymal stem cells (ASC) to provide a pro-regenerative environment at the injured site. Results showed that after filling, ASCs attach to the suture material, distribute equally throughout the filaments, and remain viable in the suture. Among a broad panel of cytokines, cell-filled sutures constantly release vascular endothelial growth factor to supernatants. Such conditioned media was evaluated in an in vitro wound healing assay and showed a significant decrease in the open wound area compared to controls. After suturing in an ex vivo wound model, cells remained in the suture and maintained their metabolic activity. Furthermore, cell-filled sutures can be cryopreserved without losing their viability. This study presents an innovative approach to equip surgical sutures with pro-regenerative features and allows the treatment and fixation of wounds in one step, therefore representing a promising tool to promote wound healing after injury. PMID:24625821
Reckhenrich, Ann Katharin; Kirsch, Bianca Manuela; Wahl, Elizabeth Ann; Schenck, Thilo Ludwig; Rezaeian, Farid; Harder, Yves; Foehr, Peter; Machens, Hans-Günther; Egańa, José Tomás
Arthroscopic Posterior Stabilization of the Shoulder Using a Percutaneous Knotless Mattress Suture Technique
Posterior shoulder instability is far less common than anterior instability, and its arthroscopic treatment can be technically demanding. We describe a percutaneous arthroscopic technique for posterior shoulder stabilization using mattress sutures and knotless anchors. Spinal needles are used to pass the sutures percutaneously in a mattress fashion. Knotless anchors are used to secure the sutures under the labrum. These anchors can be used without cannulas, giving easier access to the posterior glenoid. This procedure is simple, cost-effective, and safe, avoiding the presence of both knots and suture strands in contact with the humeral head.
Tennent, Duncan; Concina, Chiara; Pearse, Eyiyemi
Effect of residents' previous laparoscopic surgery experience on initial robotic suturing experience.
Objective. To assess the impact of gynecology residents' previous laparoscopic experience on the learning curve of robotic suturing techniques and the value of initial structured teaching in dry lab prior to surgery. Methods. Thirteen gynecology residents with no previous robotic surgery experience were divided into Group 1, consisting of residents with 2 or fewer laparoscopic experiences, and Group 2, consisting of residents with 3 or more laparoscopic experiences. Group 1 had a dry-laboratory training in suturing prior to their initial experience in the operating room. Results. For all residents, it took on average 382 ± 159 seconds for laparoscopic suturing and 326 ± 196 seconds for robotic suturing (P = 0.12). Residents in Group 1 had a lower mean suture time than residents in Group 2 for laparoscopic suturing (P = 0.009). The residents in Group 2, however, had a lower mean suture time on the robot compared to Group 1 (P = 0.5). Conclusion. Residents with previous laparoscopic suturing experience may gain more from a robotic surgery experience than those with limited laparoscopic surgery experience. In addition, dry lab training is more efficient than hands-on training in the initial phase of teaching for both laparoscopic and robotic suturing skills. PMID:22973522
Kilic, Gokhan Sami; Walsh, Teresa M; Borahay, Mostafa; Zeybek, Burak; Wen, Michael; Breitkopf, Daniel
Effect of Residents' Previous Laparoscopic Surgery Experience on Initial Robotic Suturing Experience
Objective. To assess the impact of gynecology residents' previous laparoscopic experience on the learning curve of robotic suturing techniques and the value of initial structured teaching in dry lab prior to surgery. Methods. Thirteen gynecology residents with no previous robotic surgery experience were divided into Group 1, consisting of residents with 2 or fewer laparoscopic experiences, and Group 2, consisting of residents with 3 or more laparoscopic experiences. Group 1 had a dry-laboratory training in suturing prior to their initial experience in the operating room. Results. For all residents, it took on average 382 ± 159 seconds for laparoscopic suturing and 326 ± 196 seconds for robotic suturing (P = 0.12). Residents in Group 1 had a lower mean suture time than residents in Group 2 for laparoscopic suturing (P = 0.009). The residents in Group 2, however, had a lower mean suture time on the robot compared to Group 1 (P = 0.5). Conclusion. Residents with previous laparoscopic suturing experience may gain more from a robotic surgery experience than those with limited laparoscopic surgery experience. In addition, dry lab training is more efficient than hands-on training in the initial phase of teaching for both laparoscopic and robotic suturing skills.
Kilic, Gokhan Sami; Walsh, Teresa M.; Borahay, Mostafa; Zeybek, Burak; Wen, Michael; Breitkopf, Daniel
Use of Frost sutures in an orbital trauma patient with extensive conjunctival oedema and pseudoproptosis.
Frost sutures are temporary suspension sutures conventionally used in oculoplastics. The case is presented here of a patient with multiple orbital fractures who developed worsening conjunctival chemosis and pseudoproptosis. This patient was managed successfully with Frost sutures. To the best of the authors' knowledge, there is no documented use of Frost sutures in this type of case. It is emphasized that this technique should only be considered following rigorous exclusion of retrobulbar pathology and careful attention towards early detection of raised intraocular pressure. PMID:17391921
Krishnan, R; Izadi, S; Morton, C E; Marsh, I B
Arthroscopic Posterior Stabilization of the Shoulder Using a Percutaneous Knotless Mattress Suture Technique.
Posterior shoulder instability is far less common than anterior instability, and its arthroscopic treatment can be technically demanding. We describe a percutaneous arthroscopic technique for posterior shoulder stabilization using mattress sutures and knotless anchors. Spinal needles are used to pass the sutures percutaneously in a mattress fashion. Knotless anchors are used to secure the sutures under the labrum. These anchors can be used without cannulas, giving easier access to the posterior glenoid. This procedure is simple, cost-effective, and safe, avoiding the presence of both knots and suture strands in contact with the humeral head. PMID:24749039
Tennent, Duncan; Concina, Chiara; Pearse, Eyiyemi
Bilateral squamosal suture synostosis: A rare form of isolated craniosynostosis in Crouzon syndrome
Craniosynostosis is a pathologic condition which is characterized by the premature fusion of cranial sutures. It may occur alone or in association with other anomalies making up various syndromes. Crouzon syndrome is the most common craniosynostosis syndrome. Bicoronal sutures fusion is most commonly involved in Crouzon syndrome. There have only been a handful of cases of squamosal suture synostosis described in the surgery literature with the few ones described in Crouzon syndrome associated with other types of craniosynostosis. To the best of our knowledge, we are presenting the first case of isolated bilateral squamosal suture synostosis in a patient with Crouzon syndrome in a radiology journal with emphasis on its radiological appearance.
Tandon, Yasmeen K; Rubin, Michael; Kahlifa, Mohamed; Doumit, Gaby; Naffaa, Lena
'Suture-induced tear' after human meniscal allograft transplantation.
Meniscal allograft transplantation (MAT) is generally associated with good outcomes. However, the likelihood of a successful outcome is reduced by various complications, and a meniscal tear is one of the most common of these after MAT. Meniscal tears usually occur at the periphery of the meniscal allografts at the capsular junction or the posterior horn, and biomechanical factors, such as high contact stress areas, are possible causing mechanism. We encountered three unusual cases with multiple radial or horizontal tears possibly induced by the suture materials used for meniscus allograft fixation. PMID:19502064
Jung, Kwang Am; Lee, Su Chan; Hwang, Seung Hyun
Suture fixation of iris-claw intraocular lens.
We report a technique to surgically manage the damaged haptic of an iris-claw intraocular lens (IOL). An 89-year-old woman initially presented with a subluxated posterior chamber IOL that was exchanged for an Artisan iris-claw IOL. The IOL had been enclavated nasally and temporally, but it deenclavated nasally 4 weeks postoperatively. During surgery to reposition the IOL, 1 haptic of the nasal claw was seen to be damaged. It was sutured to the iris with 10-0 polypropylene using a CIF-4 needle. The postoperative outcome was good. Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned. PMID:22424806
Rai, Amandeep S; Varma, Devesh K; Ahmed, Iqbal Ike K
Bone suture in management of mandibular degloving injury.
Traumatic degloving injuries of the mandible are rare intraoral soft tissue traumas. A simple review of the medical literature shows that no article up to this date has reported the prevalence of the degloving injuries of the mandible. Moreover, the highest incidence of mandibular degloving injuries is reported in children and young adults. In this article, the author describes the mandibular degloving injury, characterized by the separation of periosteum and soft tissues of the anterior buccal side of the mandible, and the bone suture technique. This article outlines that a correct diagnostic assessment and appropriate treatment plan can reduce the complications after mandibular degloving injuries. PMID:24470849
Rahpeyma, Amin; Khajeahmadi, Saeedeh
Bone Suture in Management of Mandibular Degloving Injury
Traumatic degloving injuries of the mandible are rare intraoral soft tissue traumas. A simple review of the medical literature shows that no article up to this date has reported the prevalence of the degloving injuries of the mandible. Moreover, the highest incidence of mandibular degloving injuries is reported in children and young adults. In this article, the author describes the mandibular degloving injury, characterized by the separation of periosteum and soft tissues of the anterior buccal side of the mandible, and the bone suture technique. This article outlines that a correct diagnostic assessment and appropriate treatment plan can reduce the complications after mandibular degloving injuries.
Rahpeyma, Amin; Khajeahmadi, Saeedeh
Internal fixation strength of suture anchors--update 1997.
Two new areas of anchor development are biodegradable anchors and "mini" anchors. The group of biodegradable anchors tested include the Bio-Anchor, LactoSorb, Biofix, Bio-Statak, Mini Screw suture anchor, DePuy 4.5 molded, DePuy 4.5 machined, DePuy 3.5 machined, TAG Wedge 4, TAG Rod 2, TAG Wedge 3, TAG Wedge 2, and Stealth. "Mini anchors" have drill holes or minor diameters of < 2.2 mm. Those tested include the Mini Revo and Bio-Anchor, miniHarpoon, mini Mitek and Fast in 3, Statak 1.5 and 2.5, SB 2 and PeBA 3, Corkscrew 5, Corkscrew 3.5, and Fastak A2, Ogden 2.5, TAG Wedge 2, ROC 1.9, and Questus 2.5. Additional anchors tested that fit neither category include the Anspach, Questus 3.5 and 5.0, SB 3 and PeBA-C, Ogden 3.5, Fast in 4, Ultrafix, and the ROC 3.5, ROC 2.8, ROC 2.3, and ROC XS. An anchor comparison, using an established protocol in fresh porcine femurs, recorded failure strength, failure mode, eyelet size, minor and major diameters, and drill hole sizes. Except for the Bio-Anchor and TAG Wedge 2, biodegradable anchors tend to be larger to compensate for their lower strength relative to metal. Biodegradable screw anchors' predominant failure mode was eyelet cutout, whereas biodegradable nonscrew anchors failed to predominantly by anchor pullout. From an initial mechanical perspective, these biodegradable anchors perform acceptably. Both biodegradable and "mini" anchors include screw and nonscrew designs. As expected, screw designs perform well and generally fail at higher loads than nonscrew anchors. Although biodegradable anchors, as a group, are not as strong as metal anchors, they are stronger than the sutures for which they are designed. The move to smaller ("mini") and biodegradable anchors is supported by these data. Whether an anchor fails at twice the suture breaking strength or 10 times the suture breaking strength should make no difference. PMID:9195034
Barber, F A; Herbert, M A; Click, J N
Metamaterial electromagnetic wave absorbers.
The advent of negative index materials has spawned extensive research into metamaterials over the past decade. Metamaterials are attractive not only for their exotic electromagnetic properties, but also their promise for applications. A particular branch-the metamaterial perfect absorber (MPA)-has garnered interest due to the fact that it can achieve unity absorptivity of electromagnetic waves. Since its first experimental demonstration in 2008, the MPA has progressed significantly with designs shown across the electromagnetic spectrum, from microwave to optical. In this Progress Report we give an overview of the field and discuss a selection of examples and related applications. The ability of the MPA to exhibit extreme performance flexibility will be discussed and the theory underlying their operation and limitations will be established. Insight is given into what we can expect from this rapidly expanding field and future challenges will be addressed. PMID:22627995
Watts, Claire M; Liu, Xianliang; Padilla, Willie J
A solar energy absorbing panel is provided which may be integrally incorporated into a conventional building structure so that it does not protrude from the normal contour of the building , and which utilizes components of the building structure as a part of the collecting apparatus to thereby minimize the cost thereof. The panel is composed of a plurality of interconnected side-by-side, generally u-shaped sections, with the adjacent sides of adjacent sections forming parallel fins which facilitate transfer of heat to air passed therealong. Also, slot means are provided at one end edge of the panel which is adapted to receive the other end edge of another like panel therein, whereby the panels may be joined in an end-to-end arrangement.
McArthur, W.H.
Suturing techniques and postoperative management in penetrating keratoplasty in the United Kingdom
Aims To report on the suturing techniques and aspects of postoperative management in penetrating keratoplasty in the United Kingdom. Methods A postal questionnaire was sent to 137 ophthalmic consultants identified from a Royal College of Ophthalmology database as having a special interest in anterior segment surgery. The questionnaire surveyed surgeon preferences for surgical and suturing technique for penetrating keratoplasty surgery, and the postoperative care of corneal grafts. Results In all, 68% of questionnaires were completed and returned: 73% of respondents used a Flieringa ring or equivalent, 94% routinely used cardinal sutures, with 50.5% removing them at the end of the procedure. The most common suturing technique for routine penetrating keratoplasty was a single continuous suture (35%). In these cases, a 10/0 nylon suture was used by 89%. Sixty-six percent changed their technique in high-risk cases, 52% used a 3-1-1 knot, and 75% made a distinction between a reef and granny knot, with 76% using a reef. Thirty percent buried the knots within the donor material, and 29% within the host tissue. Twenty-five percent had no routine time for graft suture removal, but 41% removed them between 1 and 2 years post-surgery. After suture removal, 98% used steroids and 88% used topical antibiotics. Thirty-four percent stopped topical steroids before suture removal, with 38% stopping topical steroids more than 3 months prior to suture removal. Conclusion This survey demonstrates that there is considerable variation in suturing techniques and postoperative care for penetrating keratoplasty. These significant variations in practice need to be considered when interpreting outcomes and research.
Lee, Richard MH; Lam, Fook Chang; Georgiou, Tassos; Paul, Bobby; Then, Kong Yong; Mavrikakis, Ioannis; Avadhanam, Venkata S; Liu, Christopher SC
[Primary strength of conventional and alternative suture techniques of the rotator cuff. A biomechanical study].
The aim of this biomechanical study was to evaluate rotator cuff repair strength using different suture anchor techniques compared to conventional repair, taking into consideration the native strength of the supraspinatus tendon. Therefore, a defined defect of the supraspinatus was created in 50 freshly frozen cadaver specimen (group size n = 10; median age at death: 56 years). Five methods were employed for cuff repair: standard transosseous suture, modified transosseous suture with patch augmentation and three suture anchors (Acufex Wedge TAG, Acufex Rod TAG und Mitek GII). The maximum tensile load of the five techniques was: standard transosseous suture, 410 N; modified transosseous suture, 552 N; Wedge TAG, 207 N; Rod TAG, 217 N; Mitek GII, 186 N. The difference between the suture anchor and standard techniques were highly significant (P < 0.001). In this series, the Mitek Gll anchor showed the lowest anchor dislocation rate at 3% (n = 1). The Wedge TAG system had a dislocation rate of 27% (n = 8) and the Rod TAG system 43% (n = 13). Suture anchor techniques revealed about 20%, the standard technique 34% and its modification 60% of the hypothetically calculated native tendon strength. Compared to conventional transosseous suture techniques, the use of the suture anchors tested in this series does not significantly increase the primary fixation strength of rotator cuff repair. The metallic implant with two barbs (Mitek GII) seems to be superior to the polyacetal anchors when inserted into the spongiform bone of the greater tubercle. The considerably weaker repair strength needs to be taken into consideration in postoperative patient rehabilitation, especially after the use of suture anchors. PMID:11968555
Rickert, M; Witzel, U; Kölbel, R; Georgousis, H
New insights into the relationship between suture closure and craniofacial dysmorphology in sagittal nonsyndromic craniosynostosis
Premature closure of the sagittal suture occurs as an isolated (nonsyndromic) birth defect or as a syndromic anomaly in combination with other congenital dysmorphologies. The genetic causes of sagittal nonsyndromic craniosynostosis (NSC) remain unknown. Although variation of the dysmorphic (scaphocephaly) skull shape of sagittal NSC cases has been acknowledged, this variation has not been quantitatively studied three-dimensionally (3D). We have analyzed the computed tomography skull images of 43 infants (aged 0.9–9 months) with sagittal NSC using anatomical landmarks and semilandmarks to quantify and characterize the within-sample phenotypic variation. Suture closure patterns were defined by dividing the sagittal suture into three sections (anterior, central, posterior) and coding each section as 'closed' or 'fused'. Principal components analysis of the Procrustes shape coordinates representing the skull shape of 43 cases of NSC did not separate individuals by sex, chronological age, or dental stages of the deciduous maxillary first molar. However, analysis of suture closure pattern allowed separation of these data. The central section of the sagittal suture appears to be the first to fuse. Then, at least two different developmental paths towards complete fusion of the sagittal suture exist; either the anterior section or the posterior section is the second to fuse. Results indicate that according to the sequence of sagittal suture closure patterns, different craniofacial complex shapes are observed. The relationship between craniofacial shape and suture closure indicates not only which suture fused prematurely (in our case the sagittal suture), but also the pattern of the suture closure. Whether these patterns indicate differences in etiology cannot be determined with our data and requires analysis of longitudinal data, most appropriately of animal models where prenatal conditions can be monitored.
Heuze, Yann; Boyadjiev, Simeon A; Marsh, Jeffrey L; Kane, Alex A; Cherkez, Elijah; Boggan, James E; Richtsmeier, Joan T
Growth of cranial synchondroses and sutures requires polycystin-1
In vertebrates, coordinated embryonic and postnatal growth of the craniofacial bones and the skull base is essential during the expansion of the rostrum and the brain. Identification of molecules that regulate skull growth is important for understanding the nature of craniofacial defects and for development of non-invasive biologically based diagnostics and therapies. Here we report on spatially restricted growth defects at the skull base and in craniofacial sutures of mice deficient for polycystin-1 (Pkd1). Mutant animals reveal a premature closure of both presphenoid and sphenooccipital synchondroses at the cranial base. Furthermore, knockout mice lacking Pkd1 in neural crest cells are characterised by impaired postnatal growth at the osteogenic fronts in craniofacial sutures that are subjected to tensile forces. Our data suggest that polycystin-1 is required for proliferation of subpopulations of cranial osteochondroprogenitor cells of both mesodermal and neural crest origin during skull growth. However, the Erk1/2 signalling pathway is up-regulated in the Pkd1-deficient skeletal tissue, similarly to that previously reported for polycystic kidney.
Kolpakova-Hart, Elona; McBratney-Owen, Brandeis; Hou, Bo; Fukai, Naomi; Nicolae, Claudia; Zhou, Jing; Olsen, Bjorn R.
Acute skier's thumb repaired with a proximal phalanx suture anchor.
The purpose of this study was to determine the functional outcome of a surgical technique for the repair of injuries of the ulnar collateral ligament of the thumb. A 14-point questionnaire was developed to determine functional outcome after surgical repair of acute ulnar collateral ligament rupture. Early ulnar collateral ligament repair was performed on 58 patients with grade III sprains (complete rupture) of the ligament using a new technique that employs a suture anchor for fixation. Forty-five patients were interviewed at a minimum postoperative interval of 12 months and were included in this study. Forty-four patients (98%) believed they had a stable repair, were satisfied with their surgery, and would have it again if necessary. Forty-four patients (98%) were not hindered in their day-to-day activities and had a functional range of motion. Mild discomfort was felt by eight of our patients (17%), but only three patients (7%) had pain with activities. The average time to return to skiing was 1.7 days. The use of a suture anchor provided a strong and stable repair if the surgery was performed early. PMID:9784810
Zeman, C; Hunter, R E; Freeman, J R; Purnell, M L; Mastrangelo, J
Reflection measurements of microwave absorbers
NASA Astrophysics Data System (ADS)
A swept-frequency interferometer is described for making rapid, real-time assessments of localized inhomogeneities in planar microwave absorber panels. An aperture-matched exponential horn is used to reduce residual reflections in the system to about -37 dB. This residual reflection is adequate for making comparative measurements on planar absorber panels whose reflectivities usually fall in the -15 to -25 dB range. Reflectivity measurements on a variety of planar absorber panels show that multilayer Jaumann absorbers have the greatest inhomogeneity, while honeycomb absorbers generally have excellent homogeneity within a sheet and from sheet to sheet. The test setup is also used to measure the center frequencies of resonant absorbers. With directional couplers and aperture-matched exponential horns, the technique can be easily applied in the standard 2 to 40 GHz waveguide bands.
Baker, Dirk E.; van der Neut, Cornelis A.
Electrochemically regenerable carbon dioxide absorber
NASA Technical Reports Server (NTRS)
Preliminary designs were generated for two electrochemically regenerable carbon dioxide absorber concepts. Initially, an electrochemically regenerable absorption bed concept was designed. This concept incorporated the required electrochemical regeneration components in the absorber design, permitting the absorbent to be regenerated within the absorption bed. This hardware was identified as the electrochemical absorber hardware. The second hardware concept separated the functional components of the regeneration and absorption process. This design approach minimized the extravehicular activity component volume by eliminating regeneration hardware components within the absorber. The electrochemical absorber hardware was extensively characterized for major operating parameters such as inlet carbon dioxide partial pressure, process air flow rate, operational pressure, inlet relative humidity, regeneration current density and absorption/regeneration cycle endurance testing.
Woods, R. R.; Marshall, R. D.; Schubert, F. H.; Heppner, D. B.
Revisiting the Variscan transpressional tectonics in the Southwestern Iberian suture
NASA Astrophysics Data System (ADS)
The boundary between the Ossa-Morena Zone (OMZ) and the South Portuguese Zone (SPZ) in southwest Iberia is a Variscan collisional suture with transpressive left-lateral kinematics, contrasting with the dextral component that characterizes most of the Variscan convergence in other regions of the Orogen. Recent work including new structural and radiometric data has improved our knowledge on the geometry and timing of deformations affecting the OMZ/SPZ suture, which can be summarized as follows: Closure of the Rheic Ocean in Late Devonian time is attested by high-pressure and ophiolitic thin allochthonous units emplaced on the southern border of the OMZ. The kinematic interpretation of early stretching lineations and tectonic fabrics indicate that these units were emplaced in a tectonic regime of oblique left-lateral convergence. Transient transtension in Early Carboniferous time gave way to a narrow aisle of newly-formed oceanic-like crust just over the foregoing Rheic Ocean suture, accompanied by mafic magmatism intruded/extruded at both continental sides. Radiometric dating has yielded the same age of around 340 Ma for the oceanic-like mafic protholiths and their granulite/amphibolite facies tectonic fabric, thus indicating the very ephemeral life of the oceanic-like strip. Oblique convergence was resumed immediately after transtension, first causing northward obduction of the oceanic-like unit and north-verging folding in metasedimentary units of the southern border of the suture. Later on, a south-vergent regional fold was developed synchronous with left-lateral granulite-amphibolite facies shearing. Finally, shear deformation gave way to a low pitch stretching lineation, thrusting the OMZ over SPZ, concentrated on the southern limb of this regional fold and constituting a complex ductile 2-3 km-thick shear band evolving from amphibolite to greenschist facies, developing: (i) high-temperature greenschists at the southern border of the mafic oceanic-like unit, which propagated southwards progressively cooling to low-temperature greenschists; (ii) disruption of layers that produced small fishes of weakly deformed rocks, previously interpreted as sedimentary mélanges. Radiometric dating of acid volcanic rocks included in the low-grade shear zone has yielded an age of 337 Ma, putting an older limit to shearing. At late Variscan time, a brittle left-lateral shear band partially obliterated the previous syn-metamorphic shear zone. Oblique convergence propagated southwards across the SPZ in Late Carboniferous time, though lateral displacements decreased rapidly in favor of shortening. This deformation has been roughly modelled as a transpressional band characterized by 40% shortening and ?=1 shearing. An age of 330 Ma yielded by a deformed granite at the northern part of the SPZ probably indicates the arrival of deformation at that point, while stratigraphic data suggest that deformation reached SW Portugal at around 310 Ma. To conclude, the transpressive OMZ/SPZ boundary shows strain partitioning, with left-lateral displacements concentrated in ductile to brittle shear zones affecting the suture units, and moderately oblique shortening affecting a broad zone of the SPZ foreland.
Pérez Cáceres, Irene; Martínez Poyatos, David; Simancas, José Fernando; Azor, Antonio
Barbed Suture: A Review of the Technology and Clinical Uses in Obstetrics and Gynecology
Surgical knots are simply a necessary evil needed to anchor smooth suture to allow it to function in its role in tissue reapproximation. Surgical knots reduce the tensile strength of all sutures by thinning and stretching the material. The tying of surgical knots introduces the potential of human error and interuser variability. Knot-secured smooth suture must create an uneven distribution of tension across the wound with the higher tension burdens placed at the knots. Given the excessive relative wound tension on the knot and the reasonable concerns of surgeons for suture failure due to knot slippage, there is a natural tendency toward overcoming these concerns by over-tightening knots; however, tighter knots may be worse for wound healing and strength than looser knots. In minimally invasive laparoscopic surgeries, the ability to quickly and properly tie surgical knots presents a new challenge. In cases in which knot tying is difficult, the use of knotless barbed suture can securely reapproximate tissues with less time, cost, and aggravation. This article reviews the technology behind barbed sutures with a focus on understanding how they differ from traditional smooth sutures and how barbed sutures have performed in in vitro and animal model testing, as well as in human clinical trials.
Greenberg, James A; Goldman, Randi H
Antibacterial-Coated Suture in Reducing Surgical Site Infection in Breast Surgery: A Prospective Study
Background. To reduce the incidence of microbial colonization of suture material, Triclosan- (TC-)coated suture materials have been developed. The aim of this study was to assess the incidence of suture-related complications (SRC) in breast surgery with and without the use of TC-coated sutures. Methods. We performed a study on two consecutive periods: 92 patients underwent breast surgery with conventional sutures (Group 1) and 98 with TC-coated sutures (Group 2). We performed subgroups analyses and developed a model to predict SRC in Group 1 and tested its clinical efficacy in Group 2 using a nomogram-based approach. Results. The SRC rates were 13% in Group 1 and 8% in Group 2. We found that some subgroups may benefit from TC-coated sutures. The discrimination obtained from a logistic regression model developed in Group 1 and based on multifocality, age and axillary lymphadenectomy was 0.88 (95% CI 0.77–0.95) (P < 10?4). There was a significant difference in Group 2 between predicted probabilities and observed percentages (P < 10?5). The predicted and observed proportions of complications in the high-risk group were 38% and 13%, respectively. Conclusion. This study used individual predictions of SRC and showed that using TC-coated suture may prevent SRC. This was particularly significant in high-risk patients.
Laas, Enora; Poilroux, Cecile; Bezu, Corinne; Coutant, Charles; Uzan, Serge; Rouzier, Roman; Chereau, Elisabeth
Intracorporeal Suturing and Knot Tying Broadens the Clinical Applicability of Laparoscopy
Objective: As surgeons become more experienced with basic laparoscopic procedures like cholecystectomy, they are able to expand this approach to less common operations. However, without laparoscopic suturing skills, like those obtained with Nissen fundoplication, many operations cannot be completed laparoscopically. We present a series of 10 patients with less common surgical illnesses who were successfully treated with minimal access techniques and intracorporeal suturing. Methods: Over a 6-month period at 2 medical centers, 10 patients underwent operations with laparoscopic intracorporeal suturing and knot tying. Diagnoses included bowel obstruction due to gallstone ileus (n=1), perforated uterus from an intrauterine device (n=1), urinary bladder diverticulum (n=1), bleeding Meckel's diverticulum (n=3), and perforated duodenal ulcer (n=4). Results: Each patient was treated with standard surgical interventions performed entirely laparoscopically with intracorporeal suturing. No morbidity or mortality occurred in any patient due to the operation. Conclusions: Although each of these operations has been previously reported, as a series, they point out the importance of mastering laparoscopic suturing. Although devices are commercially available to facilitate certain suturing scenarios, we encourage residents and fellows to sew manually. We believe that none of these operations could have been completed as effectively by using a suture device. The ability to suture laparoscopically markedly broadens the number of clinical scenarios in which minimal access techniques can be used.
Rivas, Homero; Cacchione, Robert N.; Ferzli, George S.
Tissue-engineered Rabbit Cranial Suture from Autologous Fibroblasts and BMP2
Craniosynostosis is a congenital disorder of premature ossification of cranial sutures, occurring in one of approximately every 2500 live human births. This work addressed a hypothesis that a cranial suture can be tissue-engineered from autologous cells. Dermal fibroblasts were isolated subcutaneously from growing rabbits, culture-expanded, and seeded in a gelatin scaffold. We fabricated a composite tissue construct by sandwiching the
L. Hong; J. J. Mao
Suture Failure Causing Paravalvular Leak 20 Years after Mitral Valve Replacement
Every surgeon has encountered problems with a ruptured suture while pulling or knotting, but late fracture of the sutures is an uncommon cause of complications in surgical practice. In the literature, these rare events have presented with varied complications such as false aneurysm in vascular surgery and failure of anchorage in orthopedic surgery. In his medium term follow-up (eight years)
Mohamad N Bittar
Colonic anastomosis using the biofragmentable anastomotic ring and manual suture: a prospective, randomized study.
One hundred and fifty consecutive patients undergoing colonic surgery were randomized into two groups: 71 underwent hand-suture with a two-layer anastomosis of resorbable suture material (3/0 Dexon) and 79 were fitted with the biofragmentable anastomotic ring (Valtrac-BAR). Five patients, two treated using the BAR and three by suturing, developed anastomotic leakage which required a Hartmann-type reoperation. This was successful in four; one patient in the suture group died after reoperation. One patient who underwent suture had an early anastomotic stricture with fatal sequelae. Three other patients (one in the BAR group and two in the suture group) died after operation from other causes. Thus the mortality rate was 6 per cent in the suture group and 1 per cent in the BAR group. During follow-up, one patient in each group underwent reoperation for anastomotic stricture. Recovery of the gastrointestinal tract was similar in the two groups regarding duration of nasogastric drainage, intravenous fluid therapy and ileus. There was no difference between the groups in duration of hospital stay. The BAR seems to be a safe and reliable alternative to conventional suture anastomosis in colonic surgery. PMID:1611459
Gullichsen, R; Havia, T; Ovaska, J; Rantala, A
A mathematical model for mechanotransduction at the early steps of suture formation.
Growth and patterning of craniofacial sutures is subjected to the effects of mechanical stress. Mechanotransduction processes occurring at the margins of the sutures are not precisely understood. Here, we propose a simple theoretical model based on the orientation of collagen fibres within the suture in response to local stress. We demonstrate that fibre alignment generates an instability leading to the emergence of interdigitations. We confirm the appearance of this instability both analytically and numerically. To support our model, we use histology and synchrotron X-ray microtomography and reveal the fine structure of fibres within the sutural mesenchyme and their insertion into the bone. Furthermore, using a mouse model with impaired mechanotransduction, we show that the architecture of sutures is disturbed when forces are not interpreted properly. Finally, by studying the structure of sutures in the mouse, the rat, an actinopterygian (Polypterus bichir) and a placoderm (Compagopiscis croucheri), we show that bone deposition patterns during dermal bone growth are conserved within jawed vertebrates. In total, these results support the role of mechanical constraints in the growth and patterning of craniofacial sutures, a process that was probably effective at the emergence of gnathostomes, and provide new directions for the understanding of normal and pathological suture fusion. PMID:23516237
Khonsari, R H; Olivier, J; Vigneaux, P; Sanchez, S; Tafforeau, P; Ahlberg, P E; Di Rocco, F; Bresch, D; Corre, P; Ohazama, A; Sharpe, P T; Calvez, V
Repair of collateral ligament instability in 2 foals by using suture anchors.
Instability of the collateral ligaments of the carpal or metacarpophalangeal joint occurred in 2 foals. The instability was repaired using commercial suture anchors. In foals, commercial suture anchors combined with external coaptation can be used successfully to repair collateral ligament instability of the carpus or the metacarpophalangeal joint. Images Figure 1.
Rodgerson, D H; Spirito, M A
A mathematical model for mechanotransduction at the early steps of suture formation
Growth and patterning of craniofacial sutures is subjected to the effects of mechanical stress. Mechanotransduction processes occurring at the margins of the sutures are not precisely understood. Here, we propose a simple theoretical model based on the orientation of collagen fibres within the suture in response to local stress. We demonstrate that fibre alignment generates an instability leading to the emergence of interdigitations. We confirm the appearance of this instability both analytically and numerically. To support our model, we use histology and synchrotron X-ray microtomography and reveal the fine structure of fibres within the sutural mesenchyme and their insertion into the bone. Furthermore, using a mouse model with impaired mechanotransduction, we show that the architecture of sutures is disturbed when forces are not interpreted properly. Finally, by studying the structure of sutures in the mouse, the rat, an actinopterygian (Polypterus bichir) and a placoderm (Compagopiscis croucheri), we show that bone deposition patterns during dermal bone growth are conserved within jawed vertebrates. In total, these results support the role of mechanical constraints in the growth and patterning of craniofacial sutures, a process that was probably effective at the emergence of gnathostomes, and provide new directions for the understanding of normal and pathological suture fusion.
Khonsari, R. H.; Olivier, J.; Vigneaux, P.; Sanchez, S.; Tafforeau, P.; Ahlberg, P. E.; Di Rocco, F.; Bresch, D.; Corre, P.; Ohazama, A.; Sharpe, P. T.; Calvez, V.
Blood flow through sutured and coupled microvascular anastomoses: a comparative computational study.
This study uses computational fluid dynamics (CFD) to model blood flow through idealised sutured and coupled arterial anastomoses to investigate the affect of each technique on intravascular blood flow. Local flow phenomena are examined in detail to study characteristics that potentially initiate thrombus formation; for example, changes in velocity profile, wall shear stress (WSS), and shear strain rate (SSR). Idealised geometries of sutured and coupled anastomoses were created with dimensions identical to microvascular suture material and a commercially available coupling device using CFD software. Vessels were modelled as non-compliant 1 mm diameter ducts, and blood was simulated as a Newtonian fluid, in keeping with previous studies. All analyses were steady-state and performed on arteries. The sutured simulation revealed a reduced boundary velocity profile; high WSS; and high SSR at the suture sites. The coupled anastomosis simulation showed a small increase in maximum WSS at the anastomotic region compared to a pristine vessel, however, this was less than half that of the sutured model. The coupled vessel displayed an average WSS equivalent to a pristine vessel simulation. Taken together these observations demonstrate a theoretically more thrombogenic profile in a sutured anastomosis when compared to a coupled vessel. Data from simulations on a coupled anastomosis reveal a profile that is nearly equivalent to that of a pristine vessel. Based purely on the combination of less favourable flow properties shown using these idealised arterial models, the sutured method is potentially more thrombogenic than a coupled anastomosis. PMID:24731801
Wain, Richard A J; Whitty, Justin P M; Dalal, Milind D; Holmes, Michael C; Ahmed, Waqar
Responses of intramembranous bone and sutures upon in vivo cyclic tensile and compressive loading
Cranial vault and facial sutures interpose between mineralized bones of the skull, and may function analogously to appendicular and cranial base growth plates. However, unlike growth plates that are composed of chondrocyte lineage, cranial and facial sutures possess heterogeneous cell lineages such as mesenchymal cells, fibroblasts, and osteoblasts, in addition to vascular-derived cells. Despite recently intensified effort, the biological responses of intramembranous bone and sutures to mechanical loading are not well understood. This study was designed to investigate whether brief doses of tensile or compressive forces induce modeling and growth responses of intramembranous bone and sutures. In different groups of growing rabbits in vivo, cyclic tensile or compressive forces at 1 Newton and 8 Hz were applied to the maxilla for 20 min/d over 12 consecutive days. Computerized histomorphometric analyses revealed that the average sutural widths of both the premaxillomaxillary suture (PMS) and nasofrontal suture (NFS) loaded in either tension or compression were significantly higher than age- and sex-matched sham controls (P<0.01). The average cell density of tension- or compression-loaded PMS and NFS were significantly higher than sham controls (P<0.01). The average osteoblast occupied sutural bone surface loaded under tension was significantly higher than that of sham control (P<0.05). Interestingly, tensile loading significantly reduced the average osteoclast surface, in comparison to sham control (P<0.05). For the NFS, tensile loading significantly increased the average osteoblast occupied sutural bone surface, in comparison with that of sham control (P<0.05). Also for the NFS suture, compression significantly reduced the average sutural osteoclast surface in comparison with sham control (P<0.05). Taken together, the present data suggest that high-frequency cyclic forces in either tension or compression induce modeling and growth changes in cranial sutures. Due to the structural complexity of cranial vault and facial sutures, either tensile or compressive forces likely are transmitted as shear stresses and upregulate genes and gene products responsible for sutural growth.
Peptan, Alexandra I.; Lopez, Aurora; Kopher, Ross A.; Mao, Jeremy J.
The Mitek Mini G2 suture anchor: biomechanical analysis of use in the hand.
We inserted 36 Mitek Mini G2 suture anchors (Mitek Surgical Products, Westwood, MA) into various sites of 14 fresh cadaver hands. A single-strand 0-Ethibond suture (Ethicon, Sommerville, NJ) was threaded through each anchor, inserted into bone, and loaded to failure. In all cases, either the anchor pulled out (11 of 36) or the suture broke (25 of 36). No anchors fractured. We also measured the breaking strength of six types of suture material (without anchors) commonly used by hand surgeons; all failed at much lower loads than those generated in our anchor pullout model. We conclude that the Mitek Mini G2 suture anchor possesses sufficient pullout strength for tendon and ligament fixation in the hand, including the distal phalanx. PMID:8522761
Buch, B D; Innis, P; McClinton, M A; Kotani, Y
Decontamination of heavy metals-polluted soils remains one of the most intractable problems of cleanup technology. Currently available techniques include extraction of the metals by physical and chemical means, such as acid leaching and electroosmosis, or immobilization by vitrification. There are presently no techniques for cleanup which are low cost and retain soil fertility after metals removal. But a solution to the problem could be on the horizon. A small but growing number of plants native to metalliferous soils are known to be capable of accumulating extremely high concentrations of metals in their aboveground portions. These hyperaccumulators, as they are called, contain up to 1,000 times larger metal concentrations in their aboveground parts than normal species. Their distribution is global, including many different families of flowering plants of varying growth forms, from herbaceous plants to trees. Hyperaccumulators absorb metals they do not need for their own nutrition. The metals are accumulated in the leaf and stem vacuoles, and to a lesser extent in the roots.
Parry, J.
A novel suture-based method for efficient transplantation of stem cells.
Advances in regenerative medicine have improved the potential of using cellular therapy for treating several diseases. However, the effectiveness of new cellular therapies is largely limited by low cell engraftment and inadequate localization. To improve on these limitations, we developed a novel delivery mechanism using cell-seeded biological sutures. We demonstrate the ability of cell-seeded biological sutures to efficiently implant human mesenchymal stem cells (hMSCs) to specific regions within the beating heart; a tissue known to have low cell retention and engraftment shortly after delivery. Cell-seeded biological sutures were developed by bundling discrete microthreads extruded from extracellular matrix proteins, attaching a surgical needle to the bundle and seeding the bundle with hMSCs. During cell preparation, hMSCs were loaded with quantum dot nanoparticles for cell tracking within the myocardium. Each biological suture contained an average of 5903 ± 1966 hMSCs/cm suture length. Delivery efficiency was evaluated by comparing cell-seeded biological suture implantation with intramyocardial (IM) cell injections (10,000 hMSCs in 35 ?L) into the left ventricle of normal, noninfarcted rat hearts after 1 h. Delivery efficiency of hMSCs by biological sutures (63.6 ± 10.6%) was significantly higher than IM injection (11.8 ± 6.2%; p < 0.05). Cell-tracking analysis indicated suture-delivered hMSCs were found throughout the thickness of the ventricular myocardium: along the entire length of the biological suture track, localizing closely with native myocardium. These results suggest cell-seeded biological sutures can deliver cells to the heart more efficiently than conventional methods, demonstrating an effective delivery method for implanting cells in soft tissue. PMID:22961975
Guyette, Jacques P; Fakharzadeh, Michael; Burford, Evans J; Tao, Ze-Wei; Pins, George D; Rolle, Marsha W; Gaudette, Glenn R
Celastrol nanoparticles inhibit corneal neovascularization induced by suturing in rats
Purpose Celastrol, a traditional Chinese medicine, is widely used in anti-inflammation and anti-angiogenesis research. However, the poor water solubility of celastrol restricts its further application. This paper aims to study the effect of celastrol nanoparticles (CNPs) on corneal neovascularization (CNV) and determine the possible mechanism. Methods To improve the hydrophilicity of celastrol, celastrol-loaded poly(ethylene glycol)-block-poly(?-caprolactone) nanopolymeric micelles were developed. The characterization of CNPs was measured by dynamic light scattering and transmission electron microscopy analysis. Celastrol loading content and release were assessed by ultraviolet-visible analysis and high performance liquid chromatography, respectively. In vitro, human umbilical vein endothelial cell proliferation and capillary-like tube formation were assayed. In vivo, suture-induced CNV was chosen to evaluate the effect of CNPs on CNV in rats. Immunohistochemistry for CD68 assessed the macrophage infiltration of the cornea on day 6 after surgery. Real-time quantitative reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay were used to evaluate the messenger ribonucleic acid and protein levels, respectively, of vascular endothelial growth factor, matrix metalloproteinase 9, and monocyte chemoattractant protein 1 in the cornea. Results The mean diameter of CNPs with spherical shape was 48 nm. The celastrol loading content was 7.36%. The release behavior of CNPs in buffered solution (pH 7.4) showed a typical two-phase release profile. CNPs inhibited the proliferation of human umbilical vein endothelial cells in a dose-independent manner and suppressed the capillary structure formation. After treatment with CNPs, the length and area of CNV reduced from 1.16 ± 0.18 mm to 0.49 ± 0.12 mm and from 7.71 ± 0.94 mm2 to 2.29 ± 0.61 mm2, respectively. Macrophage infiltration decreased significantly in the CNP-treated corneas. CNPs reduced the expression of vascular endothelial growth factor, matrix metalloproteinase 9, and monocyte chemoattractant protein 1 in the cornea on day 6 after suturing. Conclusion CNPs significantly inhibited suture-induced CNV by suppressing macrophage infiltration and the expression of vascular endothelial growth factor and matrix metalloproteinase 9 in the rat cornea.
Li, Zhanrong; Yao, Lin; Li, Jingguo; Zhang, Wenxin; Wu, Xianghua; Liu, Yi; Lin, Miaoli; Su, Wenru; Li, Yongping; Liang, Dan
Effect of disagreement between refractive, keratometric, and topographic determination of astigmatic axis on suture removal after penetrating keratoplasty
BACKGROUND\\/AIMSPost-keratoplasty astigmatism can be managed by selective suture removal in the steep axis. Corneal topography, keratometry, and refraction are used to determine the steep axis for suture removal. However, often there is a disagreement between the topographically determined steep axis and sutures to be removed and that determined by keratometry and refraction. The purpose of this study was to evaluate
A R Sebai Sarhan; Harminder S Dua; Michelle Beach
Uterine artery suture: a preventive approach for pernicious placenta previa.
Pernicious placenta previa is an obstetric complication that results in a crisis situation for many patients. Most existing options deal with the problems after delivery leading to unfavorable outcomes. To circumvent this situation, a few preventive simple surgical options have been discussed in this paper. The highlight of the approach is the application of ascending uterine artery suture that drastically reduced the amount of bleeding as compared to that observed in regular surgeries. Combined with the placenta accrete location, wedge resection and 'patch' homeostasis of the serous membrane, the surgical modifications adopted effectively reduced the need for hysterectomy thus preserving the fertility of the patients for the future. Since fetuses were safely removed within 1-2 min, the Apgar scores of the neonates were also largely unaffected. PMID:23949849
Du, Xiaodong; Xie, Xiaoe; Wang, Yi
Single-incision laparoscopic splenectomy with innovative gastric traction suture.
Laparoscopic splenectomy is now the gold standard for patients with idiopathic thrombocytopenic purpura (ITP) undergoing splenectomy. There are a few reports in literature on single-incision laparoscopic (SIL) splenectomy. Herein, we describe a patient undergoing SIL splenectomy for ITP without the use of a disposable port device. We report a 20-year-old female patient with steroid-refractory ITP having a platelet count of 14,000/cmm who underwent a SIL splenectomy. Dissection was facilitated by the use of a single articulating grasper and a gastric traction suture and splenic vessels were secured at the hilum with an endo-GIA stapler. She made an uneventful postoperative recovery and was discharged on the second postoperative day. She is doing well with no visible scar at 8-month follow-up. PMID:21197246
Srikanth, G; Wasim, M D; Sajjad, A; Shetty, Neel
Subdermal placement of sutures in double eyelid surgery.
Increasing numbers of Asian patients of varying ethnicity are expressing preferences and expectations for a specific aesthetic appearance following double eyelid surgery. Those of Northern Mongolian ethnicity (Northern Chinese, Japanese, or Korean heritage) generally prefer a narrow crease, whereas those of Southern Mongolian ethnicity (Indonesian, Filipino, or Malaysian) prefer a wider fold. Older techniques performed until the mid-1990s resulted in a deep fold, giving the patients a more "Western" appearance. In this article, the author describes a modified technique of placing the suture in the subdermal layer, which allows for variety in the width of the fold, enabling the surgeon to retain anatomical aspects that are typical of each patient's ethnicity. With this technique, an Asian patient may now choose the width of fold that he or she prefers, resulting in a more ethnically natural look. PMID:23718979
Zubiri, Jesusito S
A double blind randomized controlled trial comparing primary suture closure with mesh augmented closure to reduce incisional hernia incidence
Background Incisional hernia is the most frequently seen long term complication after laparotomy causing much morbidity and even mortality. The overall incidence remains 11-20%, despite studies attempting to optimize closing techniques. Two patient groups, patients with abdominal aortic aneurysm and obese patients, have a risk for incisional hernia after laparotomy of more than 30%. These patients might benefit from mesh augmented midline closure as a means to reduce incisional hernia incidence. Methods/design The PRImary Mesh Closure of Abdominal Midline Wound (PRIMA) trial is a double-blinded international multicenter randomized controlled trial comparing running slowly absorbable suture closure with the same closure augmented with a sublay or onlay mesh. Primary endpoint will be incisional hernia incidence 2 years postoperatively. Secondary outcomes will be postoperative complications, pain, quality of life and cost effectiveness. A total of 460 patients will be included in three arms of the study and randomized between running suture closure, onlay mesh closure or sublay mesh closure. Follow-up will be at 1, 3, 12 and 24 months with ultrasound imaging performed at 6 and 24 months to objectify the presence of incisional hernia. Patients, investigators and radiologists will be blinded throughout the whole follow up. Disccusion The use of prosthetic mesh has proven effective and safe in incisional hernia surgery however its use in a prophylactic manner has yet to be properly investigated. The PRIMA trial will provide level 1b evidence whether mesh augmented midline abdominal closure reduces incisional hernia incidence in high risk groups. Trial registration Clinical trial.gov NCT00761475.
Triclosan-coated abdominal closure sutures reduce the incidence of surgical site infections after pancreaticoduodenectomy.
Abstract Background: Surgical site infection (SSI) is a serious complication after pancreaticoduodenectomy (PD). To prevent microbial colonization of suture material in operative wounds, triclosan-coated polyglactin sutures with antibacterial activity have been developed recently. Several clinical studies have shown that the use of such suture reduces SSIs in various operations, but its efficacy in PD has not been studied. We evaluated whether the incidence of SSI can be reduced when triclosan-coated sutures are used for abdominal incision closure after PD. Methods: This controlled clinical trial took place between December 2005 and February 2012 with a total of 198 consecutive patients who had undergone PD. The study group received triclosan-coated polyglactin 910 antimicrobial sutures between March 2009 and February 2012, and the control group received conventional wound closure between January 2005 and February 2009. We compared the rate and types of infections in the two groups. Results: In the study group, age, the incidence of diabetes mellitus, smoking history, and operating time were significantly greater than in the control group. The rates of SSI were 4.5% in the study group and 14.5% in the control group (p=0.037). Conclusions: The use of triclosan-coated sutures may help reduce the incidence of SSI after PD compared with conventional non-antibiotic sutures. PMID:24797228
Okada, Naoya; Nakamura, Toru; Ambo, Yoshiyasu; Takada, Minoru; Nakamura, Fumitaka; Kishida, Akihiro; Kashimura, Nobuichi
Biomechanical evaluation of a knotless barbed suture repair in a human achilles tendon rupture model.
Background. Knotless barbed sutures are seeing more common use in wound closures and small tendon repairs. The purpose of this study was to evaluate the strength and resistance to gap formation of these sutures in larger tendons, such as the Achilles, compared with conventional repair. Methods. Six matched pairs of fresh-frozen human cadaver Achilles tendons were transected to simulate a rupture. Six tendons were repaired using a double Bunnell over-the-top technique with Fiberwire, and the matched pairs were repaired using a double Bunnell knotless technique with barbed suture. The tendons were tested to failure and stiffness, peak failure load, percentage elongation, load at initial gap and load at 5-mm gap (clinical failure) were compared. Results. The mean peak failure load for the Fiberwire group (459 N) was significantly higher (P = .029) compared with the barbed suture group (184 N). Percentage elongation at peak load was significantly lower in the barbed suture group (P = .014), as was percentage elongation at initial gapping (P = .007) and percent elongation at 5 mm of gapping (P = .004). Conclusion. While the knotless barbed suture is attractive for its design and resistance to gap formation, low failure loads compared with conventional suture are concerning for large tendon repairs. Levels of Evidence: Therapeutic, Level IV: Bench testing. PMID:24686909
Kanz, Brian N; Morris, Randal P; Lewis, Taylor; Panchbhavi, Vinod K
Tissue Reactions to Various Suture Materials Used in Oral Surgical Interventions
A variety of suture materials are available for primary wound closure following oral surgical procedures. The aim was to review the tissue reactions to the various suture materials used in oral surgical interventions. Databases were searched using the following keywords: cotton, nylon, polyglecaprone 25, polytetrafluoroethylene (ePTFE), Polyglactin 910, polyglycolic acid (PGA), polylactic acid, silk, surgery, suture, and tissue reaction. Articles published only in English language were included. Seventeen studies were included. Two studies reported that polyglecaprone 25 had positive effects on wound-healing as compared to silk. Six studies reported that silk elicits more intense tissue inflammatory response and delayed wound healing as compared to other suture materials (including ePTFE, polyglecaprone-25, PGA, and nylon). Polyglactin 910 sutures were associated with the development of stitch abscess in one clinical study. Eight studies reported that tissue reactions are minimal with nylon sutures. Tissue reactions to suture materials used for oral surgical interventions may vary depending on the surface properties and bacterial adherence properties of the material.
Javed, Fawad; Al-Askar, Mansour; Almas, Khalid; Romanos, Georgios E.; Al-Hezaimi, Khalid
Absorbent product to absorb fluids. [for collection of human wastes
NASA Technical Reports Server (NTRS)
A multi-layer absorbent product for use in contact with the skin to absorb fluids is discussed. The product utilizes a water pervious facing layer for contacting the skin, overlayed by a first fibrous wicking layer, the wicking layer preferably being of the one-way variety in which fluid or liquid is moved away from the facing layer. The product further includes a first container section defined by inner and outer layer of a water pervious wicking material between which is disposed a first absorbent mass. A second container section defined by inner and outer layers between which is disposed a second absorbent mass and a liquid impermeable/gas permeable layer. Spacesuit applications are discussed.
Dawn, F. S.; Correale, J. V. (inventors)
B-Lynch suture technique to control postpartum hemorrhage in a patient with mullerian anomaly.
Congenital anomalies of the uterus may cause gynecologic, obstetric and fertility problems. Obstetrical complications are reported to occur more commonly with mullerian duct anomalies, such as postpartum hemorrhage (PPH). Uterine compression sutures may be effective in controlling PPH in these conditions as an alternative to hysterectomy, especially if the patient has a desire to conceive. As the shape of the uterus is changed in congenital malformation, the usage of compression sutures such as B-Lynch can be more difficult. In this study we report a case of PPH accompanying a large septae, treated with B-Lynch suture. A 24 year old, multigravid and nulliparous patient (G:3) was admitted to our clinic with vaginal bleeding and abdominal pain at 31 weeks of gestation. Emergency cesarean section was performed for abruptio placenta and PPH occurred subsequently. A deep uterine septum was revealed during operation. Intermittent fundal massage and intravenous uterotonics were used to improve uterine tonicity without any improvement. After the B-Lynch suture was performed, the bleeding diminished dramatically. As the shape of the uterus is changed in congenital malformation, the application of secondary interventions in postpartum hemorrhage can be more difficult. There can be slippage or overlapping of the suture while using a B-Lynch suture. Because the uterine shape is not completely distorted, patients with septate uterus can be candidates for a B-Lynch suture. There is no such reported case from the literature regarding efficacy of B-Lynch suture in mullerian anomalies. his case illustrates the potential benefits of B-Lynch compression suture in an uterus with mullerian anomalies. PMID:24591957
Boyar, Ibrahim Hakan; Boynukal?n, Fazilet Kübra; Boyar, Nuray; Vural, Mehmet
Ameloblastin Inhibits Cranial Suture Closure by Modulating Msx2 Expression and Proliferation
Deformities of cranial sutures such as craniosynostosis and enlarged parietal foramina greatly impact human development and quality of life. Here we have examined the role of the extracellular matrix protein ameloblastin (Ambn), a recent addition to the family of non-collagenous extracellular bone matrix proteins, in craniofacial bone development and suture formation. Using RT-PCR, western blot and immunohistochemistry, Ambn was localized in mouse calvarial bone and adjacent condensed mesenchyme. Five-fold Ambn overexpression in a K14-driven transgenic mouse model resulted in delayed posterior frontal suture fusion and incomplete suture closure. Moreover, Ambn overexpressor skulls weighed 13.2% less, their interfrontal bones were 35.3% thinner, and the width between frontal bones plus interfrontal suture was 14.3% wider. Ambn overexpressing mice also featured reduced cell proliferation in suture blastemas and in mesenchymal cells from posterior frontal sutures. There was a more than 2-fold reduction of Msx2 in Ambn overexpressing calvariae and suture mesenchymal cells, and this effect was inversely proportionate to the level of Ambn overexpression in different cell lines. The reduction of Msx2 expression as a result of Ambn overexpression was further enhanced in the presence of the MEK/ERK pathway inhibitor O126. Finally, Ambn overexpression significantly reduced Msx2 down-stream target gene expression levels, including osteogenic transcription factors Runx2 and Osx, the bone matrix proteins Ibsp, ColI, Ocn and Opn, and the cell cycle-related gene CcnD1. Together, these data suggest that Ambn plays a crucial role in the regulation of cranial bone growth and suture closure via Msx 2 suppression and proliferation inhibition.
Atsawasuwan, Phimon; Lu, Xuanyu; Ito, Yoshihiro; Zhang, Youbin; Evans, Carla A.; Luan, Xianghong
Impaired Posterior Frontal Sutural Fusion in the Biglycan/Decorin Double Deficient Mice
Biglycan (Bgn) and decorin (Dcn) are highly expressed in numerous tissues in the craniofacial complex. However, their expression and function in the cranial sutures is unknown. In order to study this, we first examined the expression of biglycan and decorin in the posterior frontal suture (PFS), which predictably fuses between 21–45 days post-natal and in the non-fusing sagittal (S) suture from wildtype (Wt) mice. Our data showed that Bgn and Dcn were expressed in both cranial sutures. We then characterized the cranial suture phenotype in Bgn deficient, Dcn deficient, Bgn/Dcn double deficient, and Wt mice. At embryonic day 18.5, alizarin red/ alcian blue staining showed that the Bgn/Dcn double deficient mice had hypomineralization of the frontal and parietal craniofacial bones. Histological analysis of adult mice (45–60 days post natal) showed that the Bgn or Dcn deficient mice had no cranial suture abnormalities and immunohistochemistry staining showed increased production of Dcn in the PFS from Bgn deficient mice. To test possible compensation of Dcn in the Bgn deficient sutures we examined the Bgn/Dcn double deficient mice and found they had impaired fusion of the PFS. Semi-quantitative RT-PCR analysis of RNA from 35 day-old mice revealed increased expression of Bmp-4 and Dlx-5 in the PFS compared to their non-fusing S suture in Wt tissues and decreased expression of Dlx-5 in both PF and S sutures in the Bgn/Dcn double deficient mice compared to the Wt mice. Failure of PFS fusion and hypomineralization of the calvaria in the Bgn/Dcn double deficient mice demonstrate these extracellular matrix proteoglycans could have a role in controlling the formation and growth of the cranial vault.
Wadhwa, Sunil; Bi, Yanming; Ortiz, Ana T.; Embree, Mildred C.; Kilts, Tina; Iozzo, Renato; Opperman, Lynne A.; Young, Marian F.
Acoustic performance of membrane absorbers
NASA Astrophysics Data System (ADS)
This paper is a report on the acoustic properties of absorbing elements, which consist of metal membranes and show good sound absorption at low and medium frequencies over more than one octave. The studies refer to the sound absorption coefficient and acoustic impedance at normal incidence of the sound waves. It is shown that the behavior of the absorbing element is mainly determined by a combination of Helmholtz resonance and plate resonance. The parameters of the separate resonators are determined both by theory and experiment and serve as input data for a simplified calculation model, which can be used as an auxiliary tool for designing membrane absorber silencers.
Frommhold, W.; Fuchs, H. V.; Sheng, S.
Self-Regulating Shock Absorber
NASA Technical Reports Server (NTRS)
Mechanical shock absorber keeps frictional damping force within tolerable limit. Its damping force does not increase with coefficient of friction between energy-absorbing components; rather, frictional damping force varies only slightly. Relatively insensitive to manufacturing variations and environmental conditions altering friction. Does not exhibit high breakaway friction and consequent sharp increase followed by sharp decrease in damping force at beginning of stroking. Damping force in absorber does not vary appreciably with speed of stroking. In addition, not vulnerable to leakage of hydraulic fluid.
Wesselski, Clarence J.
Suture Fixation Technique for a Single-piece Foldable Closed-loop Intraocular Lens
Purpose We describe a suture fixation technique for a single-piece foldable acrylic closed-loop intraocular lens (IOL) (C-flex™, Rayner). Methods In our experimental model analyzing the stability of acrylic haptics, we confirmed that the IOL could be in counterpoise without tilt using only a two-point fixation. This new surgical technique was performed in seven patients. Results The unique haptic design allows easy and secure suture fixation. The clinical outcomes were encouraging. Conclusions It is conceivable that better stabilization can be achieved by the broad arc of distal haptic-tissue contact, in addition to suture fixation, using our surgical technique with the C-flex™ IOL.
Park, Chang Hyun
Safety-basket suture for management of malpositioned posterior chamber intraocular lens.
The safety-basket suture technique is used during surgical management of a malpositioned or subluxated posterior chamber intraocular lens (IOL) in post-vitrectomy eyes. The purpose of the safety suture is to prevent posterior dislocation of the IOL during repositioning. The technique has been used in 32 cases to date with no occurrence of IOL posterior luxation. The only complication was transient vitreous hemorrhage in 2 eyes. This technique provides increased safety in the management of malpositioned IOLs and can be used for secondary IOL implantation by suture or intrascleral fixation. PMID:24160378
Masket, Samuel; Fram, Nicole R
Review in Sound Absorbing Materials
This article is a bibliographical revision concerning acoustic absorbing materials, also known as poroelastics. These absorbing\\u000a materials are a passive medium use extensively in the industry to reduce noise. This review presents the fundamental parameters\\u000a that define each of the parts comprising these materials, as well as current experimental methods used to measure said parameters.\\u000a Further along, we will analyze
X. Sagartzazu; L. Hervella-Nieto; J. M. Pagalday
Packed Alumina Absorbs Hypergolic Vapors
NASA Technical Reports Server (NTRS)
Beds of activated alumina effective as filters to remove hypergolic vapors from gas streams. Beds absorb such substances as nitrogen oxides and hydrazines and may also absorb acetylene, ethylene, hydrogen sulfide, benzene, butadiene, butene, styrene, toluene, and xoylene. Bed has no moving parts such as pumps, blowers and mixers. Reliable and energy-conservative. Bed readily adapted to any size from small portable units for use where little vapor release is expected to large stationary units for extensive transfer operations.
Thomas, J. J.; Mauro, D. M.
Absorber pin development in Europe
The neutron absorbing material chosen for the absorber elements of the European fast reactor (EFR) is boron carbide. Various pin designs are studied in Europe: (1) vented helium-bonded pins chosen for prototype fast reactor (PFR) control rods, (2) vented sodium-bonded pins chosen for the Phenix and Superphenix control rods, (3) vented shrouded sodium-bonded pins chosen for future loads of Superphenix
A. Languille; J. Escleine; B. Kryger; B. Munroe; B. Steinmetz
Countercurrent flow absorber and desorber
Countercurrent flow absorber and desorber devices are provided for use in absorption cycle refrigeration systems and thermal boosting systems. The devices have increased residence time and surface area resulting in improved heat and mass transfer characteristics. The apparatuses may be incorporated into open cycle thermal boosting systems in which steam serves both as the refrigerant vapor which is supplied to the absorber section and as the supply of heat to drive the desorber section of the system.
Wilkinson, William H. (Columbus, OH)
Tuned gyroscope with dynamic absorber
NASA Astrophysics Data System (ADS)
Dry tuned gyroscopes are subjected to random drift, noise, characteristically large transmissibility at structural resonance, bias shifts vs temperature, etc. The dynamic model of a tuned gyro is represented by a coupled multiple degree of freedom system, where bearing induced vibrational outputs pass through structural resonances. The article describes the application of the rotating dynamic vibration absorber, as a method of controlling the level of gyro structural radial and axial vibrations. By providing damping to the dynamic absorber, a system becomes less sensitive to tuning the resonant frequencies of the absorber system to the corresponding radial and axial gyro resonance frequencies. It significantly reduces rotor transmissibilities, keeps bias from shifting when bearing noise passes through resonances vs temperature, improves g and g-squared sensitivity, as well as the gyro's ability to withstand random vibration. Equations of motion of the gyro with the dynamic absorber, and the absorber separately from the gyro are derived. Theoretical and experimental data of the whole system and the absorber itself are discussed.
Strugach, M.
Polypropylene suture-guided valve tube for posterior chamber implantation in patients with pseudophakic glaucoma.
We describe a new surgical procedure for implanting a glaucoma drainage tube in the posterior chamber. A needle with a 10-0 polypropylene suture is introduced into the posterior chamber, and a 23-gauge needle is also introduced as the barrel on the polypropylene needle tip. After the 23-gauge needle is withdrawn from the posterior chamber, the polypropylene needle tip is pulled and the suture crosses the anterior and posterior chambers. A sliding knot is made around the drainage tube. The tube is pushed into the scleral tunnel and posterior chamber as the suture is pulled to position the tube. The knot is loosened and the suture removed from the eye by pulling from either side. This procedure is easy and effective for implanting a tube in the posterior chamber in pseudophakic eyes and is indicated after penetrating keratoplasty or in eyes with compromised endothelial function. PMID:19006725
Moreno-Montańés, Javier; Fantes, Francisco; García-Gómez, Pio
Arthroscopic Double-Locked Stitch: A New Technique for Suturing Rotator Cuff Tears
There are a number of reasons for failed rotator cuff tear repair. In such cases the suture-tendon interface seems to be the most vulnerable area, especially when tendon degeneration is present. We describe a new technique, the arthroscopic double-locked suture, that increases the tendon fixation and has the added benefit of being placed parallel to the blood vessels, therefore avoiding damage to the tendon vascularization. The suture may be achieved by use of knots or knotless anchors and suture passers, without the need for any additional instrumentation. The new technique is especially helpful in cases in which the tendon is retracted and degeneration is present, impeding the use of the double-row technique or its transosseous equivalents.
Miyazaki, Alberto N.; Zanella, Luiz A.Z.; La Salvia, Joao C.; Fregoneze, Marcelo; Santos, Pedro D.; da Silva, Luciana A.; Sella, Guilherme do Vall; Checchia, Sergio L.
Shape memory alloy fixator system for suturing tissue in minimal access surgery.
A new technique for suturing human tissue is described in which tissue closure is achieved by means of small fixators made from shape memory alloy. The aim of the development is to provide an alternative to thread suturing in minimal access surgery, which is quicker and requires less skill to achieve the required suturing quality. The design of the fixators is described in terms of the thermal shape recovery of shape memory alloy and a novel form of finite element analysis, which uses a nonlinear elastic element for the material property. Thermal analysis of the fixators and surrounding tissue is used to predict the temperature distribution during and after the application of electric current heating. This was checked in an in vitro experiment, which confirmed that deployment caused no detectable collateral damage to surrounding tissue. In vivo animal studies on the use of the shape memory alloy fixator for suturing tissue are ongoing to establish safety and healing effects. PMID:10548336
Xu, W; Frank, T G; Stockham, G; Cuschieri, A
An investigation of leakage tracts along stressed suture lines in phantom tissue.
Suturing is still one of the most important procedures used in trauma and surgery environments. It does however rely on piercing other wise healthy tissue. In doing so channels are opened which may act as conduits for bacteria to enter the body or to allow material such as blood or intestinal bacteria to leak from vessels. This work shows by means of finite element analysis and physical modelling through the use of a phantom that the tension in the suture has a direct bearing on the opening of these channels. It was found that for the phantom the channel cross-sectional area was approximately proportional to the applied tension and suture thread deflection. Leakage channels of up to 0.1mm(2) cross-section were achieved with suture tensions of 120 grammes force. Channels of this size are significantly larger than the bacteria suggesting transmission is theoretically possible. PMID:17137824
Thomson, G A
Arthroscopic double-locked stitch: a new technique for suturing rotator cuff tears.
There are a number of reasons for failed rotator cuff tear repair. In such cases the suture-tendon interface seems to be the most vulnerable area, especially when tendon degeneration is present. We describe a new technique, the arthroscopic double-locked suture, that increases the tendon fixation and has the added benefit of being placed parallel to the blood vessels, therefore avoiding damage to the tendon vascularization. The suture may be achieved by use of knots or knotless anchors and suture passers, without the need for any additional instrumentation. The new technique is especially helpful in cases in which the tendon is retracted and degeneration is present, impeding the use of the double-row technique or its transosseous equivalents. PMID:24904764
Miyazaki, Alberto N; Zanella, Luiz A Z; La Salvia, Joăo C; Fregoneze, Marcelo; Santos, Pedro D; da Silva, Luciana A; Sella, Guilherme do Vall; Checchia, Sergio L
Deformation and sedimentation along a developing terrane suture: Eastern Sunda forearc, Indonesia
NASA Astrophysics Data System (ADS)
The collision of the eastern Sunda arc with northwest Australia has resulted in the development of a suture between the Sumba ridge and Sawu-Timor terrenes along a zone of intraforearc convergence. The developing suture varies from the low-angle Sawu thrust, with attendant mud diapirs in the Sumba basin, to high-angle reverse faults near a basement: high of the underthrust Sumba ridge terrane. Bottom currents, associated with the flow of Pacific Ocean deep water into the Indian Ocean, have eroded the terrenes and subsequently deposited the detritus in an assemblage of contourites along the suture. This study reveals the high structural variability of a terrane suture and the oceanographic influence on trie deposition of overlap assemblages.
Reed, Donald L.; Silver, Eli A.; Prasetyo, Hardi; Meyer, Audrey W.
Deformation and sedimentation along a developing terrane suture: Eastern Sunda forearc, Indonesia
The collision of the eastern Sunda arc with northwest Australia has resulted in the development of a suture between the Sumba ridge and Sawu-Timor terranes along a zone of intraforearc convergence. The developing suture varies from the low-angle Sawu thrust, with attendant mud diapirs in the Sumba basin, to high-angle reverse faults near a basement high of the underthrust Sumba ridge terrane. Bottom currents, associated with the flow of Pacific Ocean deep water into the Indian Ocean, have eroded the terranes and subsequently deposited the detritus in an assemblage of contourites along the suture. This study reveals the high structural variability of a terrane suture and the oceanographic influence on the deposition of overlap assemblages.
Reed, D.L.; Silver, E.A.; Prasetyo, H.; Meyer, A.W.
Usefulness of an additional mattress suture for the extracranial drainage catheter.
In most intracranial surgery cases, a drain catheter is inserted to prevent the collection of the wound hematoma or seroma. A drain catheter is also inserted to drain the hematoma or the cerebrospinal fluid. The drain catheter itself does not cause complications; but many complications occur during its removal, such as hematoma, seroma, air collection and pseudomeningocele formation. To prevent these complications, neurosurgeons perform a suture on the catheter to remove the site. In this study, an additional horizontal mattress suture and an anchoring suture to the drainage catheter are proposed. This method maintains negative pressure in the catheter insertion site during the catheter removal, compresses the catheter tunnel site and attaches the external wounds strongly. The technique is easy and safe to perform, and does not require an additional suture to remove the catheter. PMID:24379957
Eom, Dong Woong; Kim, Jung Soo; Jeon, Kyoung Dong; Kim, Hoon; Choi, Byeong Sam
21 CFR 878.5000 - Nonabsorbable poly(ethylene terephthalate) surgical suture.
Code of Federal Regulations, 2013 CFR
... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.5000 Nonabsorbable poly(ethylene terephthalate) surgical suture. (a)...
Restoring the Labral Height for Treatment of Bankart Lesions: A Comparison of Suture Anchor Constructs
Purpose The purpose of this study was to evaluate glenoid labral heights before injury and after repair with 2 suture anchors: (1) traditional suture anchor secured with knots and (2) knotless suture anchor. Methods Ten matched pairs of human cadaveric glenoids were examined. In each specimen the labrum was detached from the 3-o'clock position to the 6:30 clock position on the anteroinferior glenoid, and labral repair was performed with either (1) traditional Bio-SutureTak suture anchors (n = 10) (Arthrex, Naples, FL) or (2) knotless PushLock suture anchors (n = 10, contralateral side) (Arthrex). By use of a 3-dimensional digitizer, the labral height, measured from the deepest point of the glenoid articular surface to the highest tip of the labrum, was measured in all specimens before injury and after repair at the 3:30, 4:30, and 5:30 clock positions. The degree of labral height increase was computed as a percent increase in labral height from before injury to after repair. Results Labral height increased significantly for all specimens from before injury (5.35 mm) to after repair (8.05 mm) (159.1% ± 13.7%, P < .0001). Increases in labral height from before injury to after repair were similar (P > .05) for Bio-SutureTak suture anchors (164.6% ± 18.7%, P < .0001) and PushLock suture anchors (153.6% ± 5.8%, P < .0001). The amount of labral height increase did not vary by anatomic location (157.0% ± 50.2%, 168.9% ± 51.0%, and 150.4% ± 35.2% at 3:30, 4:30, and 5:30, respectively; P = .46). Conclusions An increase in labral height can be achieved to create a significant height increase from before injury to after labral repair. The difference in labral height afforded by a traditional suture anchor and a knotless anchor is not statistically significant. Clinical Relevance Both traditional and knotless suture anchor constructs provide a reliable restoration of labral height in an acute Bankart model.
Slabaugh, Mark A.; Friel, Nicole A.; Wang, Vincent M.; Cole, Brian J.
Combined suture-in-needle and scleral tunnel technique for scleral fixation of intraocular lens.
We describe an intraocular lens (IOL) fixation technique that combines suture-in-needle and scleral tunnel techniques. A 10-0 polypropylene suture is inserted into the barrel of a 27-gauge sharp needle to tie the IOL haptic, and scleral tunnels are created to bury the knots for transscleral IOL fixation. The modification of the traditional scleral fixation technique simplifies the creation of a scleral covering and decreases harmful manipulations of the needle passing through the vitreous cavity. PMID:17662424
Han, Quanhong; Chu, Yanhua
Evaluation of sutures after immersion in nonalcoholic benzydamine hydrochloride mouthrinse by scanning electron microscopy
This study evaluated the surface integrity of sutures after immersion in mouthrinse or water, by scanning electron microscopy\\u000a (SEM) analysis. Pieces of resorbable suture remaining after oral surgery were immediately collected. Twelve pieces each of\\u000a catgut, chromed catgut, and polyglactin 910 were divided into four groups and immersed in pure mouthrinse, mouthrinse diluted\\u000a in water at 1:1 and 1:2, or
Gisele da Silva Dalben; Leda Aparecida Francischone; Paula Prieto-Oliveira; Alberto Consolaro
A single centre comparative study of laparoscopic mesh rectopexy versus suture rectopexy
AIM: The aim of our study is to compare the results of laparoscopic mesh vs. suture rectopexy. MATERIALS AND METHODS: In this retrospective study, 70 patients including both male and female of age ranging between 20 years and 65 years (mean 42.5 yrs) were subjected to laparoscopic rectopexy during the period between March 2007 and June 2012, of which 38 patients underwent laparoscopic mesh rectopexy and 32 patients laparoscopic suture rectopexy. These patients were followed up for a mean period of 12 months assessing first bowel movement, hospital stay, duration of surgery, faecal incontinence, constipation, recurrence and morbidity. RESULTS: Duration of surgery was 100.8 ± 12.4 minutes in laparoscopic suture rectopexy and 120 ± 10.8 min in laparoscopic mesh rectopexy. Postoperatively, the mean time for the first bowel movement was 38 hrs and 40 hrs, respectively, for suture and mesh rectopexy. Mean hospital stay was five (range: 4-7) days. There was no significant postoperative complication except for one port site infection in mesh rectopexy group. Patients who had varying degree of incontinence preoperatively showed improvement after surgery. Eleven out of 18 (61.1%) patients who underwent laparoscopic suture rectopexy as compared to nine of 19 (47.3%) patients who underwent laparoscopic mesh rectopexy improved as regards constipation after surgery. CONCLUSION: There were no significant difference in both groups who underwent surgery except for patients undergoing suture rectopexy had better symptomatic improvement of continence and constipation. Also, cost of mesh used in laparoscopic mesh rectopexy is absent in lap suture rectopexy group. To conclude that laparoscopic suture rectopexy is a safe and feasible procedure and have comparable results as regards operative time, morbidity, bowel function, cost and recurrence or even slightly better results than mesh rectopexy.
Sahoo, Manash Ranjan; Thimmegowda, Anil Kumar; Gowda, Manoj S
Clinical and experimental study of insufficiency of suture after treatment of injury of intestine
Summary Operations of intestine caused by abdominal injuries show a higher frequency of insufficiency of suture than the other operations\\u000a in the past 10 years. Insufficiency is more often found in injuries of upper intestine than lower or large bowel.\\u000a \\u000a Anemia, hypoproteinemia, liver and kidney insufficiency are showed in patients with insufficiency of suture of intestine caused\\u000a by hemorrahge, infection and
Saburo Awazu; Yukio Tsugu; Yutaka Kikuchi; Tadaaki Shiba
Deformation and sedimentation along a developing terrane suture: Eastern Sunda forearc, Indonesia
The collision of the eastern Sunda arc with northwest Australia has resulted in the development of a suture between the Sumba ridge and Sawu-Timor terranes along a zone of intraforearc convergence. The developing suture varies from the low-angle Sawu thrust, with attendant mud diapirs in the Sumba basin, to high-angle reverse faults near a basement high of the underthrust Sumba
Donald L. Reed; Eli A. Silver; Hardi Prasetyo; Audrey W. Meyer
Deformation and sedimentation along a developing terrane suture: Eastern Sunda forearc, Indonesia
The collision of the eastern Sunda arc with northwest Australia has resulted in the development of a suture between the Sumba ridge and Sawu-Timor terrenes along a zone of intraforearc convergence. The developing suture varies from the low-angle Sawu thrust, with attendant mud diapirs in the Sumba basin, to high-angle reverse faults near a basement: high of the underthrust Sumba
Donald L. Reed; Eli A. Silver; Hardi Prasetyo; Audrey W. Meyer
Suture Versus Tack Fixation of Mesh in Laparoscopic Umbilical Hernia Repair
Background and Objectives: Mesh fixation in laparoscopic umbilical hernia repair is poorly studied. We compared postoperative outcomes of laparoscopic umbilical hernia repair in suture versus tack mesh fixation. Methods: Patients who underwent laparoscopic umbilical hernia repair were separated by method of mesh fixation: sutures versus primarily tacks. Medical history and follow-up data were collected through medical records. The primary outcome of this study was the recurrence rates of hernias. Postoperative major and minor complications, such as surgical site infection, small-bowel obstruction, and seroma formation, were regarded as secondary outcomes. Additionally, a telephone interview was conducted to assess postoperative pain, recovery time, and overall patient satisfaction. Results: Eighty-six patients were identified: 33 in the suture group and 53 in the tacks group. The number of emergent cases was increased in the tacks group (6 vs 0; P = .022). Mean follow-up time was 2.7 years for both groups. Documented postoperative follow-up was obtained in 29 (90%) suture group and 31 (58%) tacks group patients. Hernia recurrence occurred in 3 and 2 patients in the sutures and tacks groups, respectively (P was not significant). No differences were found in secondary outcomes, including subjective outcomes from telephone interviews, between groups. Conclusions: There are no differences in postoperative complication rates in suture versus tack mesh fixation in laparoscopic umbilical hernia repair.
Kitamura, Riley K.; Choi, Jacqueline; Lynn, Elizabeth
Interplay of antibiotics and bacterial inoculum on suture-associated biofilms?
Background Biofilms are often antibiotic resistant, and it is unclear if prophylactic antibiotics can effectively prevent biofilm formation. Experiments were designed to test the ability of high (bactericidal) concentrations of ampicillin (AMP), vancomycin (VAN), and oxacillin (OXA) to prevent formation of suture-associated biofilms initiated with low (104) and high (107) numbers of Staphylococcus aureus. Materials and methods S. aureus biofilms were cultivated overnight on silk suture incubated in biofilm growth medium supplemented with bactericidal concentrations of AMP, VAN, or OXA. Standard microbiological methods were used to quantify total numbers of viable suture-associated S. aureus. Crystal violet staining followed by spectroscopy was used to quantify biofilm biomass, which includes bacterial cells plus matrix components. To observe the effects of antibiotics on the microscopic appearance of biofilm formation, biofilms were cultivated on glass slides, then stained with fluorescent dyes, and observed by confocal microscopy. Results In the presence of a relatively low inoculum (104) of S. aureus cells, bactericidal concentrations of AMP, VAN, or OXA were effective in preventing development of suture-associated biofilms. However, similar concentrations of these antibiotics were typically ineffective in preventing biofilm development on sutures inoculated with 107 S. aureus, a concentration relevant to contaminated skin. Confocal microscopy confirmed that bactericidal concentrations of AMP, VAN, or OXA inhibited, but did not prevent, development of S. aureus biofilms. Conclusion Bactericidal concentrations of AMP, VAN, or OXA inhibited formation of suture-associated biofilms initiated with low numbers (104), but not high numbers (107), of S. aureus cells.
Hess, Donavon J.; Henry-Stanley, Michelle J.; Wells, Carol L.
Full-thickness rotator cuff tears. A biomechanical comparison of suture versus bone anchor techniques.
We performed a biomechanical comparison of two rotator cuff repair techniques using fresh-frozen human cadavers. Nine pairs of cadaveric shoulders had standardized full-thickness tears made at the supraspinatus tendon insertion. One of each pair of the cadaveric shoulders was repaired by pulling the tendon into a bone trough in the humeral head using standard sutures. The remaining half of the pairs was repaired using anchor sutures. The repairs were tested using a servohydraulically operated material testing system. The anchor suture repair was significantly stronger than the standard suture technique irrespective of bone quality. Failure occurred predominantly through bone in the suture repairs and as a result of suture breakage in the anchor repairs. The anchors should be placed into the edge of the subchondral bone adjacent to the articular surface. The surgeon should direct the anchor so that the direction of the pull is approximately 90 degrees to the anchor, with the humerus at 30 degrees of abduction. PMID:8638752
Reed, S C; Glossop, N; Ogilvie-Harris, D J
Subsurface geometry of the Siletz-Klamath suture in southwest Oregon from mangnetotelluric imaging
NASA Astrophysics Data System (ADS)
Siletzia, a Paleocene to early Eocene basaltic seamount terrane, was sutured onto western North America in Eocene times and comprises the modern forearc basement throughout the Pacific Northwest. The suture zone is mostly obscured by the Cascades Arc. In southwest Oregon, however, it is preserved where previously accreted Mesozoic terranes in the Klamath Moutains overthrust Siletzia. The geometry of this suture at depth, however, is poorly constrained. In summer 2006, long-period (deep-crustal) and broadband (shallow-crustal) magnetotelluric (MT) data were collected along a 200-km profile stretching from the Pacific coast north of Coos Bay, OR to the California border south of Medford, OR, with an average site spacing of 4 km. South of the suture, the profile crosses Franciscan and Great Valley equivalents, arc lavas and sediments of the Western Klamath terrane, ophiolitic mélange of the Rattlesnake Creek terrane, and the Hayfork volcanic arc terrane, ending within the Condry Mountain Window. The data are in general agreement with the NW surface strike of the suture and the Klamath terranes. A smooth regularized two-dimensional inversion of the data resulted in a preliminary model extending to ~ 50 km depth which fits the data and is in accordance with observed surface geology. The imaged subsurface geometry of the Siletzia-Klamath suture is compared to previous potential-field modeling that suggested a thinning wedge of Silitzia has been thrust within the Klamath terranes.
Box, S.; Bedrosian, P. A.
A biomechanical comparison of EndoButton versus suture anchor repair of distal biceps tendon injuries.
The purpose of this study was to compare suture anchor and EndoButton repair of distal biceps injuries in a human bone-tendon model. Right and left arm repairs were alternately performed with either the EndoButton or 2 single-loaded 5-mm suture anchors. Each construct was cyclically loaded by use of a servohydraulic materials testing machine. Initial and final displacements were recorded. All repairs were then loaded to ultimate failure. Ten millimeters of displacement was designated the clinical failure point. The EndoButton group had more stiffness than the suture anchor group during initial cyclic loading (P = .01). There were no differences in final displacement measured after cyclic loading (2.06 mm for suture anchors and 2.58 mm for EndoButton). The EndoButton group had a 16% greater ultimate tensile load than the suture anchor group (274.77 N vs 230.06 N). The EndoButton group also had a 16% higher load to clinical failure (249.95 N vs 209.56 N). These differences were not statistically significant. The EndoButton and suture anchors provide comparable fixation strength for the repair and rehabilitation of distal biceps tendon ruptures. PMID:16831659
Spang, Jeffrey T; Weinhold, Paul S; Karas, Spero G
Suture-endobutton fixation of ankle tibio-fibular diastasis: a cadaver study.
Suture-Endobutton fixation is proposed as a minimally invasive, flexible fixation of ankle tibio-fibular diastasis, which would not require routine removal. This study tested the Suture-Endobutton construct in a cadaver syndesmosis injury model and compared this against A.O. syndesmosis screw fixation. Sixteen embalmed cadaver legs were used. Phase one consisted of placing the leg in a jig, generating an external rotation torque and measuring diastasis with increasing intraosseous membrane division. Phase two then compared the Suture-Endobutton construct vs. single four-cortex 4.5 mm A.O. screw fixation. Diastasis increased significantly with increasing intraosseous membrane division (p<0.001). No significant differences were seen in the mean rate of failure between the Suture-Endobutton and A.O. screw fixation. However, the Suture-Endobutton did give a significantly more consistent performance; the distribution of standard deviations for A.O. screw fixation was 0.64 mm higher than that for the Endobutton (95% C.I. 0.46 to 0.84). These results show that Suture-Endobutton fixation at least equals the performance of screw fixation and encourages clinical trials in ankle injuries with a syndesmosis diastasis. PMID:12627622
Thornes, Brian; Walsh, Alan; Hislop, Matt; Murray, Paraic; O'Brien, Moira
Arthroscopic reduction and fixation with suture-bridge technique for displaced or comminuted greater tuberosity fractures.
The arthroscopic suture-bridge technique (transosseous equivalent technique) was initially described for increasing the footprint size during arthroscopic rotator cuff repair. We describe a method in which the same principles are used to fix a displaced or comminuted greater tuberosity fracture. The technique involves reducing the displaced fragment with two medially placed, trans-tendinous anchors and compressing the greater tuberosity using the sutures from these medial anchors in two laterally placed anchors. The two medial anchors are inserted through the junction of the cuff and fragment. The anchor driver can be used as a joystick to reduce the fragment into position. One suture limb of each anchor is passed back through the tendon 5 mm from the original anchor insertion point in the tendon. With the scope in the subacromial space, the sutures from the medial anchors are tied in a mattress configuration. The four suture ends are passed distally over the greater tuberosity and incorporated into two PushLock anchors (4.5 mm; Arthrex, Naples, FL) using the suture-bridge technique. The postoperative rehabilitation protocol is similar to that for rotator cuff repairs. PMID:18657746
Song, Hyun Seok; Williams, Gerald R
Nonventing, Regenerable, Lightweight Heat Absorber
NASA Technical Reports Server (NTRS)
A lightweight, regenerable heat absorber (RHA), developed for rejecting metabolic heat from a space suit, may also be useful on Earth for short-term cooling of heavy protective garments. Unlike prior space-suit-cooling systems, a system that includes this RHA does not vent water. The closed system contains water reservoirs, tubes through which water is circulated to absorb heat, an evaporator, and an absorber/radiator. The radiator includes a solution of LiCl contained in a porous material in titanium tubes. The evaporator cools water that circulates through a liquid-cooled garment. Water vapor produced in the evaporator enters the radiator tubes where it is absorbed into the LiCl solution, releasing heat. Much of the heat of absorption is rejected to the environment via the radiator. After use, the RHA is regenerated by heating it to a temperature of 100 C for about 2 hours to drive the absorbed water back to the evaporator. A system including a prototype of the RHA was found to be capable of maintaining a temperature of 20 C while removing heat at a rate of 200 W for 6 hours.
Izenson, Michael G.; Chen, Weibo
Ultrastructure, Histochemistry, and Mineralization Patterns in the Ecdysial Suture of the Blue Crab, Callinectes sapidus
NASA Astrophysics Data System (ADS)
The ecdysial suture is the region of the arthropod exoskeleton that splits to allow the animal to emerge during ecdysis. We examined the morphology and composition of the intermolt and premolt suture of the blue crab using light microscopy and scanning electron microscopy. The suture could not be identified by routine histological techniques; however 3 of 22 fluorescein isothiocyanate-labeled lectins tested (Lens culinaris agglutinin, Vicia faba agglutinin, and Pisum sativum agglutinin) differentiated the suture, binding more intensely to the suture exocuticle and less intensely to the suture endocuticle. Back-scattered electron (BSE) and secondary electron observations of fracture surfaces of intermolt cuticle showed less mineralized regions in the wedge-shaped suture as did BSE analysis of premolt and intermolt resin-embedded cuticle. The prism regions of the suture exocuticle were not calcified. X-ray microanalysis of both the endocuticle and exocuticle demonstrated that the suture was less calcified than the surrounding cuticle with significantly lower magnesium and phosphorus concentrations, potentially making its mineral more soluble. The presence or absence of a glycoprotein in the organic matrix, the extent and composition of the mineral deposited, and the thickness of the cuticle all likely contribute to the suture being removed by molting fluid, thereby ensuring successful ecdysis.
Priester, Carolina; Dillaman, Richard M.; Gay, D. Mark
Coronal suture response to distraction osteogenesis in rabbits with delayed-onset craniosynostosis.
Recent studies have identified a subpopulation of persons with craniosynostosis who exhibit progressive or delayed-onset synostosis and mild cranial vault deformities. These persons may be good candidates for nonextirpation distraction osteogenesis. The present studies were designed to determine force-displacement parameters and assess the effects of distraction osteogenesis on coronal suture growth and morphologic characteristics in a rabbit model with congenital, delayed-onset craniosynostosis. Data were collected from a total of 178 rabbits: 71 normal controls; 16 normal controls with distraction; 72 with delayed-onset coronal suture synostosis; and 19 with delayed-onset coronal suture synostosis and distraction. At 10 days of age, all rabbits had amalgam markers placed on both sides of the coronal suture. In the force-displacement study, force-displacement distractors were placed across the coronal suture and distracted acutely for 1.0 mm at 42 days of age. Force-displacement curves for the coronal suture were best described by a third-order polynomial regression equation for both normal and synostosed groups. Significant differences (P < 0.05) were found in the mean force necessary to distract a normal suture 1 mm in distance (13.72 kg) compared with a suture with delayed-onset synostosis (48.39 kg). A significant (P < 0.05) relationship was also found between the extent of synostosis and the distractive force in rabbits with delayed-onset synostosis. In the distraction study, internal distractors were fixed across the coronal suture at 25 days of age and percutaneously and intermittently activated at an average of 0.11 mm/day for 42 days (4.54 mm total). Serial radiographs were taken at 10, 25, 42, and 84 days of age. Results revealed that rabbits with delayed-onset synostosis and distraction had significantly (P < 0.01) more coronal suture growth rates compared with rabbits with delayed-onset synostosis and no distraction. Coronal sutures were harvested at 84 days of age for qualitative histologic examination. Normal, distracted coronal sutures showed widened sutural ligaments and thin, active osteogenic fronts. In contrast, distracted coronal sutures from rabbits with delayed-onset synostosis showed narrowed sutural ligaments, thickened and blunt osteogenic fronts, and increased collagen and bony matrix deposition compared with controls. Results suggest that distraction osteogenesis without corticotomy may be a treatment alternative in persons with progressive, delayed-onset synostosis. However, these preliminary data also suggest that distractive forces may accelerate or stimulate osteogenesis differentially in persons with craniosynostosis, possibly through an underlying genetic disorder of bone and cytokine regulation. These differential osteogenic responses to distraction, if validated clinically, will need to be taken into account when planning distraction rate and rhythm protocols for patients with craniosynostosis. PMID:10388423
Losken, H W; Mooney, M P; Zoldos, J; Tschakaloff, A; Burrows, A M; Smith, T D; Cano, G; Arnott, R; Sherwood, C; Dechant, J; Cooper, G M; Kapucu, M R; Siegel, M I
Low temperature selective absorber research
NASA Astrophysics Data System (ADS)
Research carried out since 1979 on selective absorbers is surveyed, with particular attention given to the low-temperature coatings seen as promising for flat plate and evacuated tube applications. The most thoroughly investigated absorber is black chrome, which is highly selective and is the most durable low-temperature absorber. It is believed that other materials, because of their low cost and lower content of strategic materials, may eventually supplant black chrome. Among these candidates are chemically converted black nickel; anodically oxidized nickel, zinc, and copper composites; and nickel or other low-cost multilayer coatings. In reviewing medium and high-temperature research, black chrome, multilayer coatings and black cobalt are seen as best medium-temperature candidates. For high temperatures, an Al2O3/Pt-Al203 multilayer composite or the zirconium diboride coating is preferred.
Herzenberg, S. A.; Silberglitt, R.
Damage tolerant light absorbing material
A light absorbing article comprised of a composite of carbon-bonded carbon fibers, is prepared by: blending carbon fibers with a carbonizable organic powder to form a mixture; dispersing the mixture into an aqueous slurry; vacuum molding the aqueous slurry to form a green article; drying and curing the green article to form a cured article; and, carbonizing the cured article at a temperature of at least about 1000 C to form a carbon-bonded carbon fiber light absorbing composite article having a bulk density less than 1 g/cm[sup 3]. 9 figures.
Lauf, R.J.; Hamby, C. Jr.; Akerman, M.A.; Seals, R.D.
Damage tolerant light absorbing material
A light absorbing article comprised of a composite of carbon-bonded carbon fibers, prepared by: blending carbon fibers with a carbonizable organic powder to form a mixture; dispersing the mixture into an aqueous slurry; vacuum molding the aqueous slurry to form a green article; drying and curing the green article to form a cured article; and, carbonizing the cured article at a temperature of at least about 1000.degree. C. to form a carbon-bonded carbon fiber light absorbing composite article having a bulk density less than 1 g/cm.sup.3.
Lauf, Robert J. (Oak Ridge, TN); Hamby, Jr., Clyde (Harriman, TN); Akerman, M. Alfred (Knoxville, TN); Seals, Roland D. (Oak Ridge, TN)
Towards a viscoelastic model for the unfused midpalatal suture: development and validation using the midsagittal suture in New Zealand white rabbits.
Maxillary expansion treatment is a commonly used procedure by orthodontists to widen a patient's upper jaw. As this is typically performed in adolescent patients, the midpalatal suture, connective tissue adjoining the two maxilla halves, remains unfused. Studies that have investigated patient response to expansion treatment, generally through finite element analysis, have considered this suture to behave in a linear elastic manner or it was left vacant. The purpose of the study presented here was to develop a model that could represent the midpalatal suture's viscoelastic behavior. Quasilinear viscoelastic, modified superposition, Schapery's, and Burgers modeling approaches were all considered. Raw data from a previously published study using New Zealand White Rabbits was utilized for model parameter estimation and validation. In this study, Sentalloy(®) coil springs at load levels of 0.49N (50g), 0.98N (100g), and 1.96N (200g) were used to widen the midsagittal suture of live rabbits over a period of 6 weeks. Evaluation was based on a models ability to represent experimental data well over all three load sets. Ideally, a single set of model constants could be used to represent data over all loads tested. Upon completion of the analysis it was found that the modified superposition method was able to replicate experimental data within one standard deviation of the means using a single set of constants for all loads. Future work should focus on model improvement as well as prediction of treatment outcomes. PMID:23684080
Romanyk, D L; Liu, S S; Lipsett, M G; Toogood, R W; Lagravčre, M O; Major, P W; Carey, J P
Counterflow absorber for an absorption refrigeration system
An air-cooled, vertical tube absorber for an absorption refrigeration system is disclosed. Strong absorbent solution is supplied to the top of the absorber and refrigerant vapor is supplied to the bottom of the absorber to create a direct counterflow of refrigerant vapor and absorbent solution in the absorber. The refrigeration system is designed so that the volume flow rate of refrigerant vapor in the tubes of the absorber is sufficient to create a substantially direct counterflow along the entire length of each tube in the absorber. This provides several advantages for the absorber such as higher efficiency and improved heat transfer characteristics, and allows improved purging of non-condensibles from the absorber.
Reimann, Robert C. (Lafayette, NY) [Lafayette, NY
Knotless single-row rotator cuff repair: a comparative biomechanical study of 2 knotless suture anchors.
The purpose of this study was to compare the gap formation during cyclic loading, maximum repair strength, and failure mode of single-row full-thickness supraspinatus repairs performed using 2 knotless suture anchors with differing internal suture-retention mechanisms in a human cadaver model. Nine matched pairs of cadaver shoulders were used. Full-thickness tears were induced by detaching the supraspinatus tendon from the greater tuberosity. Single-row repairs were performed with either type I (Opus Magnum PI; ArthroCare, Austin, Texas) or type II (ReelX STT; Stryker, Mahwah, New Jersey) knotless suture anchors. The repaired tendon was cycled from 10 to 90 N for 500 cycles, followed by load to failure. Gap formation was measured at 5, 100, 200, 300, 400, and 500 cycles with a video digitizing system. Anchor type or location (anterior or posterior) had no effect on gap formation during cyclic loading regardless of position (anterior, P=.385; posterior, P=.389). Maximum load to failure was significantly greater (P=.018) for repairs performed with type II anchors (288±62 N) compared with type I anchors (179±39 N). Primary failure modes were anchor pullout and tendon tearing for type II anchors and suture slippage through the anchor for type I anchors. The internal ratcheting suture-retention mechanism of type II anchors may have helped this anchor outperform the suture-cinching mechanism of type I anchors by supporting significantly higher loads before failure and minimizing suture slippage, potentially leading to stronger repairs clinically. PMID:23937749
Efird, Chad; Traub, Shaun; Baldini, Todd; Rioux-Forker, Dana; Spalazzi, Jeffrey P; Davisson, Twana; Hawkins, Monica; McCarty, Eric
The electrical and sodium transport characteristics of sutured premalignant mouse colon.
Depolarization of the plasma membrane and increased sodium influx have both been suggested as mitogenic signals. Following bowel resection the intestinal suture line has been reported a fertile site for tumor recurrence. Whether alterations in cell surface signaling occur at suture lines has not been previously examined the electrical changes of sodium transport occurring at a suture line in an animal model of large bowel cancer. Forty-eight female CF1 mice underwent colotomies with repair utilizing silk or chromic sutures. Twenty-four mice underwent sham operations to serve as controls. The mice were injected subcutaneously with the carcinogen DMH (1,2-dimethylhydrazine) 20 mg/kg or an identical volume of 0.9% saline for 6 weeks and were sacrificed 1 week after the last injection. The sites of the sutured colotomies or a piece of distal colon from the sham-operated mice were mounted in a modified Ussing chamber and the electrical properties and unidirectional sodium fluxes were measured. The potential difference (pd) across the distal colon was not significantly different in any suture group compared to that in sham-operated controls when treated with saline (pd sham, -2.3 +/- 0.2 mV (mean +/- SEM); silk, -1.7 +/- 0.3 mV, chromic, -1.9 +/- 0.3 mV, P greater than 0.05, unpaired Student t test). The potential difference was significantly lowered in both suture groups compared to sham operated animals after treatment with DMH (pd sham, -2.6 +/- 0.3 mV; silk, -1.5 +/- 0.2 mV, P less than 0.05; chromic, -1.6 +/- 0.4 mV, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2755118
Davies, R J; Mier, L; Pempinello, C; Asbun, H; Funkhouser, W
Pericardial heterografts: a comparative study of suture pull-out and tissue strength.
The force required to pull sutures out of glutaraldehyde fixed bovine pericardium, for four different suture bites: 0.5 mm, 1 mm, 1.5 mm and 2.0 mm, was compared with the tissue strength. The mean suture pull-out force was significantly lower than the tissue strength for all bites, with a minimum value of 2.86 +/- 1.02 N for the 0.5 mm bite and a maximum value of 6.32 +/- 0.77 N for the 2.0 mm bite. The mean force which produced failure of the chemically modified pericardium was 15.49 +/- 8.48 N. The mean force at pull-out of the sutures lay on a regression line: force at failure = 1.68 + 2.25 x Bite. A video film of the experiments showed that the suture does not cut through the pericardium. It pulls a V-shaped band of collagen fibre bundles through the stationary pericardium. Eventually this band breaks away from the free edge of the tissue specimen. The specimens under uniaxial load failed by laminate debonding of two layers of tissue, rupture of the serosal surface layer followed by shear and fibre slippage. These results indicate that any suture which bears load, during the normal functioning of a heart valve substitute, will be a source of weakness, compared to the overall tissue strength. As a consequence the alignment/holding suture of the Standard Ionescu-Shiley valve and the modified stitch of the low profile valve are likely to be potential sites of fatigue failure. PMID:2755111
Trowbridge, E A; Lawford, P V; Crofts, C E
Oil and fat absorbing polymers
NASA Technical Reports Server (NTRS)
A method is described for forming a solid network polymer having a minimal amount of crosslinking for use in absorbing fats and oils. The polymer remains solid at a swelling ratio in oil or fat of at least ten and provides an oil absorption greater than 900 weight percent.
Marsh, H. E., Jr. (inventor)
Specific Extra-Corporeal Absorbents.
National Technical Information Service (NTIS)
A number of new absorbent polymers for use in extra-corporeal loops (and also for possible use via ingestion) were prepared and studied. Attention was concentrated upon means for the removal of urea. Negative results were obtained in attempts to employ al...
H. P. Gregor J. S. Stamberg K. R. Brennen F. C. Chlanda C. Gryte
Tuned gyroscope with dynamic absorber
Dry tuned gyroscopes are subjected to random drift, noise, characteristically large transmissibility at structural resonance, bias shifts vs temperature, etc. The dynamic model of a tuned gyro is represented by a coupled multiple degree of freedom system, where bearing induced vibrational outputs pass through structural resonances. The article describes the application of the rotating dynamic vibration absorber, as a method
M. Strugach
Acceleration Sensitive Shock Absorber Valve.
National Technical Information Service (NTIS)
The patent describes a pressurized air-oil, telescopically configured, shock absorber of the type that may be incorporated in an aircraft landing gear or other devices subject to high structural stresses caused by high impact loadings. It consists of a su...
J. C. Brady K. J. Fewel
OVI Absorbers Over Cosmic Time
NASA Astrophysics Data System (ADS)
OVI absorption is observed in a wide variety of astrophysical environments (e.g. IGM, CGM, local ISM, HVC, DLA etc.). The high cosmic abundance of oxygen, high ionization potential (IP = 113.9 eV) and high oscillator strength of OVI 1031,1037 doublets make the OVI transition a useful and well-studied tracer of diffuse and/or high temperature regions of the Universe. We have built a sample of intervening OVI absorbers in the Lyman-alpha forest of 18 high redshift (z>2) UV bright QSOs, observed with the VLT/UVES. This is the largest sample of high-z OVI absorber observed with a high resolution spectrograph. In this talk, the author will present various results related to the high redshift IGM as probed by OVI absorbers and compare them to low redshift IGM studies. The gas that lies in the immediate vicinity of galaxies (i.e. so called CGM gas), on the other hand, is of great interest to study the gas flows in galaxies. Tracing inflow/outflow is essential for understanding formation and evolution of galaxies. In the last part of the talk, the author will highlight some of his recent studies on intermediate redshift (0.4 < z < 1.0) OVI absorption in MgII selected absorbers, which presumably trace the CGM environment.
Muzahid, Sowgat
Development and characterisation of silver-doped bioactive glass-coated sutures for tissue engineering and wound healing applications
A novel silver-doped bioactive glass powder (AgBG) was used to coat resorbable Vicryl® (polyglactin 910) and non-resorbable Mersilk® surgical sutures, thereby imparting bioactive, antimicrobial and bactericidal properties to the sutures. Stable and homogeneous coatings on the surface of the sutures were achieved using an optimised aqueous slurry-dipping technique. Dynamic mechanical analysis (DMA) was used to investigate the viscoelastic parameters of
J. J. Blaker; S. N. Nazhat; A. R. Boccaccini
An atraumatic suture technique for advancing the proximal end of a severed digital flexor tendon through the pulley system.
One may encounter difficulty in attempting to advance the proximal digital flexor tendon into the pulley system. The use of (1) a purse-string suture around the tendon end, and (2) simultaneous prolonged tension on both the purse-string and repair sutures may be helpful. Tension on the purse-string suture converts the shape of the tendon end from an accordion into a bullet, easing its entry into the pulley tunnel. PMID:3318645
Moss, R A
Mechanical properties of various suture materials and placement patterns tested with surrogate in vitro model constructs simulating laryngeal advancement tie-forward procedures in horses.
Objective-To compare the mechanical properties of laryngeal tie-forward (LTF) surrogate constructs prepared with steel fixtures and No. 5 braided polyester or braided polyethylene by use of a standard or a modified suture placement technique. Sample-32 LTF surrogate constructs. Procedures-Surrogate constructs were prepared with steel fixtures and sutures (polyester or polyethylene) by use of a standard or modified suture placement technique. Constructs underwent single-load-to-failure testing. Maximal load at failure, elongation at failure, stiffness, and suture breakage sites were compared among constructs prepared with polyester sutures by means of the standard (n = 10) or modified (10) technique and those prepared with polyethylene sutures with the standard (6) or modified (6) technique. Results-Polyethylene suture constructs had higher stiffness, higher load at failure, and lower elongation at failure than did polyester suture constructs. Constructs prepared with the modified technique had higher load at failure than did those prepared with the standard technique for both suture materials. All sutures broke at the knot in constructs prepared with the standard technique. Sutures broke at a location away from the knot in 13 of 16 constructs prepared with the modified technique (3 such constructs with polyethylene sutures broke at the knot). Conclusions and Clinical Relevance-Results suggested LTF surrogate constructs prepared with polyethylene sutures or the modified technique were stronger than those prepared with polyester sutures or the standard technique. PMID:24762024
Santos, Marcos P; Gutierrez-Nibeyro, Santiago D; Horn, Gavin P; Johnson, Amy J Wagoner; Stewart, Matthew C; Schaeffer, David J
Effects of suture position on left ventricular fluid mechanics under mitral valve edge-to-edge repair.
Mitral valve (MV) edge-to-edge repair (ETER) is a surgical procedure for the correction of mitral valve regurgitation by suturing the free edge of the leaflets. The leaflets are often sutured at three different positions: central, lateral and commissural portions. To study the effects of position of suture on left ventricular (LV) fluid mechanics under mitral valve ETER, a parametric model of MV-LV system during diastole was developed. The distribution and development of vortex and atrio-ventricular pressure under different suture position were investigated. Results show that the MV sutured at central and lateral in ETER creates two vortex rings around two jets, compared with single vortex ring around one jet of the MV sutured at commissure. Smaller total orifices lead to a higher pressure difference across the atrio-ventricular leaflets in diastole. The central suture generates smaller wall shear stresses than the lateral suture, while the commissural suture generated the minimum wall shear stresses in ETER. PMID:24211894
Du, Dongxing; Jiang, Song; Wang, Ze; Hu, Yingying; He, Zhaoming
Mandibular form in a rabbit model of familial nonsyndromic coronal suture synostosis.
Nonsyndromic coronal suture synostosis produces predictable and well-documented morphologies of the cranial vault with anteroposterior growth restrictions and mediolateral compensatory growth. The potential effects of nonsyndromic coronal suture synostosis on mandibular form are not as clear, however. This study was designed to evaluate whether coronal suture synostosis is associated with alterations in mandibular form by using a familial rabbit model of coronal suture synostosis. To assess this potential relation, the following hypothesis was tested: mandibular form in rabbits with coronal suture synostosis is significantly (P < 0.05) different from that seen in normal rabbits. The cleaned and dried mandibles of 33 adult New Zealand white rabbits were used (12 from normal rabbits, 13 from rabbits with delayed-onset synostosis, and 8 from rabbits with complete coronal suture synostosis). Seven anatomical landmarks on the mandible were located and digitized in three dimensions: anterior molar on the alveolus, posterior molar on the alveolus, coronoid process, anterior pole of the condyle, condylar process, angular process, and mandibular angle. To describe the mandibular condyle, the distance from the anterior pole to the posterior pole of the condyle was measured with digital sliding calipers, as was the distance between the medial and lateral poles. A shape ratio was then created using the dividend of these sums. Statistical analyses of mean form differences between mandibles were executed using Euclidean distance matrix analysis. Statistical analyses of the mandibular condyle linear and shape measurements were analyzed using one-way ANOVA in the three groups. Results showed that complete coronal suture synostosis is associated with significant (P < 0.05) differences in mandibular form compared with that of normal rabbits but that mandibular form in rabbits with delayed-onset synostosis does not differ from that of normal rabbits (P > 0.05). In particular, distances involving the coronoid process in rabbits with coronal suture synostosis were significantly different, paralleling previous work in human patients with coronal synostosis. There are no intrinsic condylar linear or shape differences between any of these groups, however. The form difference noted is most likely secondary to the synostosed coronal suture and may reflect alterations in the cranial base or masticatory musculature in this rabbit model. PMID:12000881
Burrows, Anne M; Cole, Theodore M; Mooney, Mark P; Smith, Timothy D; Losken, H Wolfgang; Siegel, Michael I
[Study of new blended chemical absorbents to absorb CO2].
Three kinds of blended absorbents were investigated on bench-scale experimental bench according to absorption rate and regeneration grade to select a reasonable additive concentration. The results show that, among methyldiethanolamine (MDEA) and piperazine (PZ) mixtures, comparing MDEA : PZ = 1 : 0.4 (m : m) with MDEA : PZ = 1 : 0.2 (m : m), the absorption rate is increased by about 70% at 0.2 mol x mol(-1). When regeneration lasting for 40 min, regeneration grade of blended absorbents with PZ concentration of 0.2, 0.4, and 0.8 is decreased to 83.06%, 77.77% and 76.67% respectively while 91.04% for PZ concentration of 0. MDEA : PZ = 1 : 0.4(m : m) is a suitable ratio for MDEA/PZ mixtures as absorption and regeneration properties of the blended absorbents are all improved. The aqueous blends with 10% primary amines and 2% tertiary amines could keep high CO2 absorption rate, and lower regeneration energy consumption. Adding 2% 2-Amino-2-methyl-1-propanol (AMP) to 10% diethanolamine (DEA), the blended amine solvents have an advantage in absorption and regeneration properties over other DEA/AMP mixtures. Blended solvents, which consist of a mixture of primary amines with a small amount of tertiary amines, have the highest absorption rate among the three. And mixed absorbents of secondary amines and a small amount of sterically hindered amines have the best regeneration property. To combine absorption and regeneration properties, blends with medium activator addition to tertiary amines are competitive. PMID:18290495
Wang, Jin-Lian; Fang, Meng-Xiang; Yan, Shui-Ping; Luo, Zhong-Yang; Cen, Ke-Fa
The Effect of Different Suture Removal Time Intervals on Surgical Wound Healing
INTRODUCTION: This study was carried out to compare the effect of different suture removal time on surgical wound healing. MATERIALS AND METHODS: Twenty-one male albino rabbits were used. Under general and local anesthesia a moucoperiosteal rectangular flap was raised in each animal and then repositioned and sutured. The animals were randomly divided into three experimental groups of seven animals each. In group I and II the sutures were removed after 3 and 5 days respectively and were followed up for 7 and 14 days after surgery. In group III the sutures were removed after 7 days and were followed up for 14 days after surgery. Tissue reactions were observed and recorded using inflammation and gingival indexes at 7 and 14 days after surgery in all three groups. Inflammation and gingival indexes were analyzed by Kurskal Wallis, Firedman and Wilcoxone tests. RESULTS: Results showed that inflammation index was significantly different with two other groups at the day 7 after surgery (P<0.008). Gingival index in group II was significantly different from two other groups at the day 14 (P<0.028); however, there was no significant difference between group II and III at the same interval. CONCLUSION: Based on result of this study, 5 days was recognized to the best time interval for suture removal in comparison with two other time intervals.
Parirokh, Masoud; Asgary, Saeed; Eghbal, Mohammad Jafar
Suture of the right internal jugular vein catheter in a mitral valve replacement: a case report
Introduction Central venous catheterization can be necessary for patients undergoing a cardiac operation. Accidental suturing of the catheter to the heart is a rare complication that is difficult to correct; excessive traction force on the central venous catheter can lead to heart breakage or even death. Case presentation We describe the case of a 56-year-old Han Chinese woman who was scheduled to undergo mitral valve replacement. The central venous catheter placed into her right internal jugular vein was accidentally sutured to the left atrial suture line during the operation. The stuck catheter was successfully removed without having to perform a cardiopulmonary bypass. Conclusions Attaching a catheter to the heart by cardiac sutures can occur when the tip of the catheter locates directly above the atrial-caval junction. Care should be taken when closing the cephalad end of a left atrial incision in a mitral valve replacement. Although rare, accidental suturing of the central venous catheter must be kept in mind, and an approach should be chosen to remove the catheter that best avoids additional insult to the heart function.
Laparoscopic technique and safety experience with barbed suture closure for pelvic cavity after abdominoperineal resection
Background Between April 2005 and December 2012, we performed laparoscopic colorectal resection with regional lymph node dissection on 273 cases of colorectal cancer patients. However, Laparoscopic rectal cancer surgery requires a high degree of skill. Any surgeon who is going to embark on these difficult resections should have at a minimum laparoscopic suturing skills in order to be able to close the peritoneal defect. Methods In laparoscopic surgery for rectal cancer, the intracorporeal suture technique required to close the pelvic cavity is very difficult. Barbed sutures have recently been proposed to facilitate laparoscopic suturing. Two patients with rectal cancer who underwent laparoscopic abdominoperineal resection (APR) with intracorporeal closure of the pelvic cavity from September to October 2012 were enrolled in this study. Results We present our initial experience of two consecutive cases of intracorporeal closure of the pelvic cavity by totally laparoscopic APR. After clinical follow-up, the two patients have no complaints and have shown no signs of recurrence. Conclusions We hypothesized that barbed sutures could potentially improve the efficiency of intracorporeal closure of the pelvic cavity after laparoscopic APR. Further, we expect that use of the V-Loc™ will reduce intra-operative stress on the endoscopic surgeon.
Foreign body granulomatous reaction associated with polyethelene 'Fiberwire(®)' suture material used in Achilles tendon repair.
Repair of acute Achilles tendon rupture is a common procedure. There are many accepted surgical techniques; suture selection is largely due to surgeon preference. We present a case report of a granulomatous reaction to suture material following Achilles tendon repair. 'Fiberwire(®)' is an increasingly popular suture material for the repair of tendons and ligamentous structures; the polyethelene braided structure with silicone and polyester coating provides high tensile strengths and good handling characteristics. Eight months following uneventful Achilles tendon repair surgery in an otherwise fit and well patient, pain, swelling and loss of function was noted. She required revision surgery with debridement and reconstruction of the tendo Achillis with flexor hallucis longus tendon transfer. Histology revealed a granulomatous reaction with giant cell response surrounding sections of the suture. Both the silicone coating of Fiberwire(®) and polyethylene core have the potential to cause a severe granulomatous reaction. We would advise caution in the use of this suture for tendo Achillis repair, and use the readily available alternatives. PMID:24796842
Ollivere, Ben J; Bosman, Hilary A; Bearcroft, Philip W P; Robinson, Andrew H N
The Effect of the Trabecular Microstructure on the Pullout Strength of Suture Anchors
This study investigates how the microstructural properties of trabecular bone affect suture anchor performance. Seven fresh-frozen humeri were tested for pullout strength with a 5 mm Arthrex Corkscrew in the greater tuberosity, lesser tuberosity, and humeral head. Micro-computed tomography analysis was performed in the three regions of interest directly adjacent to individual pullout experiments. The morphometric properties of bone mineral density (BMD), structural model index (SMI), trabecular thickness (TbTh), trabecular spacing (TbS), trabecular number (TbN), and connectivity density were compared against suture anchor pullout strength. BMD (r = 0.64), SMI (r = -0.81), and TbTh (r = 0.71) showed linear correlations to the pullout strength of the suture anchor with p-values < 0.0001. A predictive model was developed to explain the variances in the individual BMD, SMI, and TbTh correlations. The multi-variant model of pullout strength showed a stronger relationship (r = 0.86) compared to the individual experimental results. This study helps confirm BMD is a major influence on the pullout strength of suture anchors, but also illustrates the importance of local microstructure in pullout resistance of suture anchors.
Yakacki, Christopher M.; Poukalova, Mariya; Guldberg, Robert E.; Lin, Angela; Saing, Minn; Gillogly, Scott; Gall, Ken
Creep rupture behavior of polypropylene suture material and its applications as a time-release mechanism
The controlled failure of polypropylene (PP) sutures is studied via creep rupture tests. From plots of log time (tB) vs. stress (sigma), linear relationships are generated over the failure times of 1-1000 h. Results show that as a function of stress, the time dependence varies with irradiation dose (15, 20, 25, and 50 Mrad), irradiation atmosphere (air and vacuum), suture diameter (7-0, 6-0, 5-0, and 4-0), and test temperature (26 and 37 degrees C). For a given stress, the time to failure is least for the greatest dose in the presence of air and at the highest temperature. When suture loops are wrapped around a small wire sheave, however, failure occurs in the largest suture as much as two decades sooner than the smallest suture studied. Within the limitations stated herein, they are independent of test method, loop diameter, aging, and humidity. Consequently, after irradiation in vacuum and postirradiation heat treatment, the processed material may be stored at room temperature for at least 1 month. Such materials are advocated when the time release of a dental or medical device is required, for example, in the self-activating cleft palate appliance.
Kusy, R.P.; Whitley, J.Q.
Upper Mantle Structure Around the Trans-European Suture Zone
NASA Astrophysics Data System (ADS)
The Trans-European Suture Zone (TESZ) is the transition between old Proterozoic lithosphere in Northern and Eastern Europe and the younger Phanerozoic lithosphere in Central and Western Europe. The presented study is a part of the PASSEQ 2006-2008 project which is linked to the TOR project realized during 1996-1997. The PASSEQ and the TOR projects aimed to study the lithosphere and asthenosphere structure around the TESZ, but the latter was focused on the northwestern part of the TESZ between Sweden and Denmark - Germany, while the PASSEQ project was focused on the TESZ mainly beneath Poland. During the PASSEQ project 139 short-period and 49 broadband temporary seismic stations were deployed along the transect stretching from Germany throughout Czech Republic and Poland to Lithuania. The array recorded continuous seismic data from May, 2006 to June, 2008. In our study we used data of all available PASSEQ seismic stations and seismic stations of the national seismological networks of the participating countries and compiled a data set of teleseismic P-wave arrivals. The full data set consists of 8308 manually picked arrivals. Due to limited computational power we used the data of the highest quality only, i.e. 6008 picks. The non-linear teleseismic tomography algorithm TELINV was used to obtain the model of P-wave velocity perturbations in the upper mantle around the TESZ. We recovered the upper mantle structure from 70 km down to 350 km in the study area. The results show ±6.5 % P-wave velocity variations compared to the IASP91 velocity model. We found higher velocities beneath the old East European Craton (EEC) east of the TESZ and lower ones beneath the younger Western Europe west of the TESZ. The thickest litosphere was found beneath the EEC (Lithuania) where the higher velocities continue to about 300 km or even more. To the west of the TESZ under the Variscides the average depth of the lithosphere-asthenosphere boundary (LAB) is about 100 km. The TESZ appears as an intermediate tectonic structure between the EEC and Western Europe, with the asthenospere at a depth of 150-180 km. The LAB in the northern part of the TESZ has a shape of the ramp dipping NE direction at an angle of about 30 degrees. In the southern part of the TESZ the LAB is shallower, most probably due to younger tectonic settings.
Janutyte, Ilma; Majdanski, Mariusz; Voss, Peter H.; Kozlovskaya, Elena
Novel High Efficient Coatings for Anti-Microbial Surgical Sutures Using Chlorhexidine in Fatty Acid Slow-Release Carrier Systems
Sutures can cause challenging surgical site infections, due to capillary effects resulting in bacteria permeating wounds. Anti-microbial sutures may avoid these complications by inhibiting bacterial pathogens. Recently, first triclosan-resistances were reported and therefore alternative substances are becoming clinically relevant. As triclosan alternative chlorhexidine, the "gold standard" in oral antiseptics was used. The aim of the study was to optimize novel slow release chlorhexidine coatings based on fatty acids in surgical sutures, to reach a high anti-microbial efficacy and simultaneously high biocompatibility. Sutures were coated with chlorhexidine laurate and chlorhexidine palmitate solutions leading to 11, 22 or 33 µg/cm drug concentration per length. Drug release profiles were determined in aqueous elutions. Antibacterial efficacy against Staphylococcus aureus was assessed in agar diffusion tests. Biocompatibility was evaluated via established cytotoxicity assay (WST-1). A commercially triclosan-containing suture (Vicryl Plus), was used as anti-microbial reference. All coated sutures fulfilled European Pharmacopoeia required tensile strength and proved continuous slow drug release over 96 hours without complete wash out of the coated drug. High anti-microbial efficacy for up to 5 days was observed. Regarding biocompatibility, sutures using 11 µg/cm drug content displayed acceptable cytotoxic levels according to ISO 10993-5. The highest potential for human application were shown by the 11 µg/cm chlorhexidine coated sutures with palmitic acid. These novel coated sutures might be alternatives to already established anti-microbial sutures such as Vicryl Plus in case of triclosan-resistance. Chlorhexidine is already an established oral antiseptic, safety and efficacy should be proven for clinical applications in anti-microbial sutures.
Obermeier, Andreas; Schneider, Jochen; Wehner, Steffen; Matl, Florian Dominik; Schieker, Matthias; von Eisenhart-Rothe, Rudiger; Stemberger, Axel; Burgkart, Rainer
New modified iris suture technique for pupillary dilation in aphakic eyes during vitreoretinal surgery.
To describe a modified simple iris suture for pupillary dilation technique during vitrectomy in cases with a miotic pupil. Four translimbal incisions were created with a sharp straight blade at 1:30, 10:30, 4:30, and 7:30 o'clock, respectively. The straight needle of 10-0 polypropylene suture and a Sinskey IOL hook was used to displace the pupillary margin toward the limbus. In 3 cases, four sutures caused a 6-mm to 9-mm square-shaped pupil, and the pupil was allowed to return to a smaller size at the end of the operation. It is simple and may reduce postoperative complications. PMID:22553592
Han, Feng-Mei; Han, Quan-Hong; Chu, Yan-Hua
Use of Mitek anchoring for Bankart repair: A comparative, randomized, prospective study with traditional bone sutures.
The most common type of shoulder instability is posttraumatic anterior instability. Treatment is surgical. Of the several procedures used, the standard one is Bankart repair. However, this procedure is technically demanding. To simplify it a suture anchor such as Mitek anchors may be used. A prospective randomized study was conducted to compare Mitek anchors with bone sutures. The results showed that Mitek anchors shorten surgical time by making reattachment of the capsule easier. Shoulder muscle strength, range of motion, and frequency of recurrence were equally good in the anchor group and bone suture group. A roentgenographic method allowed exact measurement of placement of the anchors. This method showed at 2-year follow-up evaluation that the anchors were still in the anterior glenoid. No metal-related complications are found at the 2-year follow-up evaluation. PMID:22958842
Norlin, R
A new technique of internal suture mastopexy for mild to moderate breast ptosis
BACKGROUND: Current mastopexy techniques rely on incisions on the breast to correct ptosis. Trading a ptotic breast for a visibly scarred breast can be a difficult choice. OBJECTIVE AND METHODS: A technique of internal suture mastopexy that consists of plicating sutures placed in the superficial fascia of the breast from the deep surface is presented. The procedure leaves no scar on the breast and may be safer than other techniques when combining mastopexy with augmentation. RESULTS: The senior author has performed this procedure on over 120 patients, with a mean follow-up of two years. Patients and the surgeon have expressed satisfaction with the procedure. CONCLUSION: Based on this experience with over 120 patients, the authors believe that internal suture mastopexy is an effective alternative in selected patients.
Mahabir, Raman Chaos; Zamboni, William A
Suture-bridge subscapularis tendon repair technique using low anterior portals.
A suture-bridge technique has been introduced to facilitate fixation procedures and to achieve increased holding strength in posterosuperior rotator cuff. Based on biomechanical studies, this technique has been suggested as an effective method that could optimize rotator cuff tendon-footprint contact area and mean pressure, as well as holding strength. In this technique, the suture-bridge creation is adapted for arthroscopic subscapularis repair to attain the ideal cuff integrity and footprint restoration. To obtain enough working portals and space, two accessory portals were made on the anterior aspect of the shoulder and use an elevator to retract the conjoined tendons and deltoid muscle. This technique could be useful for the repair of subscapularis tears, which are not easily approached using other arthroscopic techniques. From a biomechanical point of view, the subscapularis tendon could be restored more ideally using the suture-bridge technique. PMID:20890701
Park, Jin-Young; Park, Jun-Suk; Jung, Jae-Kyung; Kumar, Praveen; Oh, Kyung-Soo
Ultrasonography in the evaluation of midpalatal suture in surgically assisted rapid maxillary expansion.
Surgically assisted rapid maxillary expansion (SARME), which combines orthodontics and surgery, is a well-established therapy for transverse maxillary hypoplasia in adults after sutural closure or completion of skeletal maturation. X-rays are usually the preferred monitoring technique for this treatment. Recently, ultrasound scanning has been used successfully in the follow-up of patients undergoing distraction osteogenesis. In this study, ultrasonography (US) was used in the evaluation of bone callus formation in the midpalatal suture in 3 patients undergoing SARME. For each patient, US was performed immediately after active expansion, at 2 and 4 months of the expansion period, at the removal of the expander 6 months later, and at 2 months after expander removal. The results indicated that US might be a useful and accurate method to assess bone fill in the midpalatal suture in patients undergoing SARME. However, further studies are necessary to clarify the US scores in a larger patient group undergoing SARME. PMID:22948650
Sumer, A Pinar; Ozer, Mete; Sumer, Mahmut; Danaci, Murat; Tokalak, Fuat; Telcioglu, N Tuba
NASA Astrophysics Data System (ADS)
In a recent work, Y. D. Chong [Phys. Rev. Lett.0031-900710.1103/PhysRevLett.105.053901 105, 053901 (2010)] proposed the idea of a coherent perfect absorber (CPA) as the time-reversed counterpart of a laser, in which a purely incoming radiation pattern is completely absorbed by a lossy medium. The optical medium that realizes CPA is obtained by reversing the gain with absorption, and thus it generally differs from the lasing medium. Here it is shown that a laser with an optical medium that satisfies the parity-time (PT) symmetry condition ?(-r)=?*(r) for the dielectric constant behaves simultaneously as a laser oscillator (i.e., it can emit outgoing coherent waves) and as a CPA (i.e., it can fully absorb incoming coherent waves with appropriate amplitudes and phases). Such a device can thus be referred to as a PT-symmetric CPA laser. The general amplification or absorption features of the PT CPA laser below lasing threshold driven by two fields are determined.
Longhi, Stefano
Transcaruncular medial canthal tendon plication with lower eyelid suture sling in facial nerve palsy.
Abstract Purpose: To report a technique for correcting lower eyelid punctal ectropion with an inferiorly displaced or retracted medial eyelid due to facial nerve palsy, by extending a suture sling along the pre-tarsal lower eyelid when performing transcaruncular medial canthal tendon plication. Methods: Single-centre retrospective, non-comparative review of patients with facial nerve palsy who underwent medial canthal tendon plication with lower eyelid suture sling (MCT suture sling). Outcome measures included: the presence of lower eyelid ectropion, medial eyelid height, punctal position, inferior marginal reflex distance (MRD) and inferior scleral show measured both pre-operatively and at the last follow-up visit. Results: Thirty-three patients with facial nerve palsy with a mean age of 59, underwent MCT suture sling for lagophthalmos and/or ectropion. Then, 66% (21/32) of cases had punctal ectropion pre-operatively and 9% (3/32) had punctal ectropion at the last follow-up. Medial eyelid height was deemed to improve in 66% (21/32) of cases at the last follow up visit. Follow-up was mean 13.5 months. Six (18%) patients were deemed failures due to inferior MRD and inferior scleral showing worse than pre-operative measurements. Discussion: We report a technique for incorporating a suture sling to transcaruncular-approach MCT plication when the medial canthus has retracted or descended thus requiring support and a posterior vector. It avoids rounding of the medial canthal angle that may occur with traditional medial canthoplasty. Transcaruncular MCT plication is well described. Incorporating a suture sling to potentially reduce single point-fixation cheese-wiring and early dehiscence is minimally invasive, non-excisional and repeatable. PMID:24568677
Sira, Mano; Norris, Jonathan H; Nduka, Charles; Malhotra, Raman
Suture zones of the Urals as integral prospective ore-bearing tectonic structures
NASA Astrophysics Data System (ADS)
Rift-related (1.2 Ga) and collision (380-240 Ma) suture zones of the Urals are described. The riftrelated suture zones comprise an ultramafic-gabbro complex with titanomagnetite mineralization, an ultramafic complex with chromite mineralization, and a complex of alkali granitoids with rare-metal (including REE) mineralization accompanied by K-feldspathites, albitites, and calcite metasomatic rocks. The collision suture zones are distinguished by early collision granitoids specialized for tungsten (scheelite) and gold, as well as by raremetal granites and such derivatives of them as pegmatite and greisen with rare-metal and colored-stone mineralization. The suture zones are characterized by long-term (up to 80 Ma or more) continuous-discontinuous periods of ore deposition; heterogeneous sources of ore matter and ore-bearing fluids; a polyelemental composition of lithogeochemical halos and an integral mineral composition of altered wall rocks; and the occurrence of mafic, intermediate, and felsic dikes at large gold deposits, as well as wide variations in PT parameters of the ore-forming process: T = 620-150°C and P = 3.2-0.6 kbar. Collision played a dual role in ore formation. On the one hand, collision led to deformation and metamorphism of precollision massive sulfide deposits and, to a lesser degree, Au-bearing Fe and Cu skarn and porphyry copper deposits, and, on the other hand, to the formation of new gold, rare-metal, quartz, colored-stone, talc, muscovite, and noble serpentine deposits. As a rule, this polygenetic mineralization differs in age and is related to collision volcanic and plutonic complexes. This diversity can be a good basis for metallogenic analysis, forecasting, and prospecting of various metallic deposits and industrial minerals. Polygenetic mineralization of various age known in suture zones is accompanied by integral lithogeochemical and metasomatic halos characterized by a continuous-discontinuous history. The complexity of ore mineralization and often nonlinear metallogeny increase the practical value of suture zones.
Koroteev, V. A.; Sazonov, V. N.; Ogorodnikov, V. N.; Polenov, Yu. A.
Sutural expansion using rigidly integrated endosseous implants: an experimental study in rabbits.
Rigidly integrated implants offer great promise for orthodontic and orthopedic anchorage in the oral and midfacial regions. Rigid anchorage can be used to control unwanted tooth movement, provide abutments in edentulous arches, and open the vertical dimension of occlusion. To evaluate the use of endosseous implants in the midface region, two flanged titanium implants were placed on either side of the midnasal suture of 18 New Zealand White rabbits. The rabbits were divided into an unloaded control and two experimental groups. One experimental group was loaded at 1 Newton (N) and the other at 3 N. All rabbits were euthanized after 12 weeks of loading. Stereologic point-hit and line-intercept methods were used to analyze microradiographic and multiple fluorochrome histology of the suture. All implants remained stable during the loading period. The distance between the implants increased significantly in the loaded groups compared with the control, and was significantly higher in the 3 N group than in the 1 N group. Percent bone volume was significantly decreased, while the percent suture volume tended to be increased in the loaded groups. Mineral apposition and bone formation rates at the sutural surfaces were increased in the loaded groups (P < 0.05), but did not differ between loaded groups. These results indicate that relatively low loads (1 or 3 N) applied to rigidly integrated endosseous implants across an unfused suture are satisfactory for achieving expansion under the conditions of this study. The 3 N load resulted in slightly more expansion, but did not affect the rate of bone formation at the suture. PMID:9267577
Parr, J A; Garetto, L P; Wohlford, M E; Arbuckle, G R; Roberts, W E
Impact of delirium and suture-less securement on accidental vascular catheter removal in the ICU.
The objectives were to describe the incidence of accidental vascular catheter removal (AVCR) in an Australian Intensive Care Unit (ICU) and evaluate whether the fixation method or patient delirium increased the risk of AVCR. This prospective observational study was based in a tertiary level ICU between April 2011 and October 2012. All vascular catheters were secured either by sutures or by a suture-less securement device (STATLOCK(™), Bard Medical, Covington, GA, USA) as per the treating clinician. Data were obtained from bedside nursing staff, with daily screening for delirium completed by the ICU medical team using the Confusion Assessment Method-ICU. 2361 patients were admitted during this period with 1032 patients screened and data available for 322 patients (452 vascular catheters). AVCR occurred in 15 patients (16 vascular catheters) (5.0%) with an incidence of AVCR of 2.77 per 100 catheter-days. Delirious patients were 13-fold more likely to have an AVCR event (odds ratio=13.3; 95% confidence interval 4.36, 40.52; P <0.0001). There was a non-significant trend to an increase in AVCR when using the suture-less securement device (odds ratio=2.6; 95% confidence interval 0.87, 7.8; P=0.09) but delirious patients were no more likely to have an AVCR episode when a suture-less securement device was used (P=0.95). In this study the use of suture-less securement did not seem to increase the risk of AVCR. However, there was a non-significant trend towards increased AVCR when using suture-less securement devices, which may reflect a ß error. PMID:24967762
Sundararajan, K; Wills, S; Chacko, B; Kanabar, G; O'Connor, S; Deane, Am
Modified Mason-Allen Suture Bridge Technique: A New Suture Bridge Technique with Improved Tissue Holding by the Modified Mason-Allen Stitch
We present a new method of suture bridge technique for medial row fixation using a modified Mason-Allen stitch instead of a horizontal mattress. Medial row configuration of the technique is composed of the simple stitch limb and the modified Mason-Allen stitch limb. The limbs are passed through the tendon by a shuttle relay. The simple stitch limb passes the cuff once and the modified Mason-Allen stitch limb passes three times which creates a rip stop that prevents tendon pull-out. In addition, the Mason-Allen suture bridge configuration is basically a knotless technique which has an advantage of reducing a possibility of strangulation of the rotator cuff tendon, impingement or irritation that may be caused by knot.
Lee, Bong Gun; Cho, Nam Su
Identifying the ciliary sulcus for suturing a posterior chamber intraocular lens by transillumination.
We describe herein a technique for locating the ciliary sulcus for suturing a posterior chamber intraocular lens. Transscleral illumination with a light-guide fiber placed underneath the iris reveals the ciliary sulcus as a bright area near the limbus, and it allows for a straight needle with 10-0 polypropylene fiber to be easily inserted through the sulcus after making two pairs of radial scleral incisions to fixate the 10-0 polypropylene fiber. We think that this procedure can minimize complications of suturing a posterior chamber intraocular lens and shorten the operation time. PMID:8155042
Horiguchi, M; Hirose, H; Koura, T; Satou, M
Prolonged bleeding due to a medicinal leech bite: another treatment method, primary suture
Medicinal leeches have been used in the treatment of many diseases for thousands of years. A 25-year-old man presented to our emergency department with bleeding from right and left side of his neck. He had applied leeches10 h previously to both sides of his neck to treat acne. The bleeding was not controlled by applying pressure with sterile gauze upon the wounds. Homeostasis was achieved by primary suture under local anaesthesia. Prolonged bleeding can be seen following medical leech application. In such cases, bleeding can be controlled by primary suture.
Zengin, Suat; Yarbil, Pinar; Kilic, Hasan; Al, Behcet
The "Flying Swan" Technique: A Novel Method for Anterior Labral Repair Using a Tensioned Suture Bridge
Arthroscopic labral repair is an effective technique for most cases of traumatic shoulder instability. However, patients with anterior labroligamentous periosteal sleeve avulsion lesions frequently have multiple episodes of subluxation or dislocation and a high recurrence rate after surgery, even with modern methods of labral repair. One reason may be failure of biological healing of the labrum due to an inadequate "footprint" of contact between the capsulolabral tissue and the glenoid bone. We have developed a technique that facilitates a tensioned suture bridge between suture anchors that may improve the results of labral repair in patients with anterior labroligamentous periosteal sleeve avulsion lesions.
Alexander, Susan; Wallace, Andrew L.
Early visual rehabilitation following keratoplasty using a single continuous adjustable suture technique.
We measured postkeratoplasty visual acuity, refraction, retinoscopy, keratometry, and corneal topography in 105 patients, in 33 of whom an adjustable continuous technique had been used, and in 72 of whom a standard technique (in which the continuous suture was not adjusted) had been used. In the eyes in which the sutures were adjusted (within 6 weeks following surgery), acuity improved (preadjustment mean, 20/205; postadjustment mean, 20/100), and astigmatism decreased (preadjustment mean, 8.41 diopters; postadjustment mean, 2.22 D). Visual acuity and astigmatism in the control group were unchanged at the same point after surgery. PMID:2057184
Temnycky, G O; Lindahl, K J; Aquavella, J V; Erdey, R A
Selective suture ligation of the dorsal vein complex during robot-assisted laparoscopic radical prostatectomy.
Technique for apical dissection and control of the dorsal vein complex (DVC) during robot-assisted laparoscopic radical prostatectomy (RALP) affects blood loss, apical positive margins, and recovery of urinary control. Over the past 7 years, our technique for apical dissection has been spurred by the overarching goal of minimizing injury to the rhabdosphincter to improve urinary continence, evolving from stapling to suture ligation of the DVC before bladder neck dissection to an athermal DVC division followed by selective suture ligation (DVC-SSL) before RALP anastomosis. Assessment of patient-reported quality of life outcomes demonstrates earlier recovery of continence with DVC-SSL. PMID:23146080
Carter, Stacey C; Konijeti, Ramdev; Hu, Jim
Suture Granuloma Showing False-Positive Findings on FDG-PET.
We report a case of a 33-year-old male with a mixed germ-cell testicular tumor. Postoperative follow-up FDG-PET revealed concentration of FDG in the left inguinal area which is not tumor metastasis or local recurrence but suture reactivity granuloma. In this paper, we reviewed suture granulomas associated with false-positive findings on FDG-PET after surgery. If FDG-PET will be used more frequently in the future, it will be necessary to refrain from using silk thread in order to prevent any unnecessary surgery. PMID:23762743
Takahara, Kohei; Kakinoki, Hiroaki; Ikoma, Saya; Udo, Kazuma; Tobu, Shohei; Satoh, Yuji; Tokuda, Yuji; Noguchi, Mitsuru; Aoki, Shigehisa; Uozumi, Jiro
Proterozoic sutures and terranes in the southeastern Baltic Shield interpreted from BABEL deep seismic data
A hitherto unknown terrane and its bounding sutures have been revealed\\u000a by a combined study of normal-incidence and wide-angle seismic data\\u000a along the BABEL profile in the Baltic Sea. This Intermediate Terrane is\\u000a situated between a Northern Terrane of Svecofennian age and a\\u000a Southwestern Terrane of Gothian age. It is delimited upwards by two\\u000a low-angle and oppositely dipping sutures and
T. Abramovitz; A. Berthelsen; H. Thybo
Multiband Metamaterial Absorber at Terahertz Frequencies
NASA Astrophysics Data System (ADS)
We propose a multi-band metamaterial absorber operating at terahertz frequencies. The design, characterization, and theoretical calculation of the high performance metamaterial absorber are reported. The multi-band metamaterial absorber consists of two metallic layers separated by a dielectric spacer. Theoretical and simulated results show that the metamaterial absorber has four distinct absorption points at frequencies 0.57 THz, 1.03 THz, 1.44 THz and 1.89 THz, with the absorption rates of 99.9%, 90.3%, 83.0%, 96.1%, respectively. Two single band metamaterial absorbers and a dual band metamaterial absorber on the top layer are designed. Some multi-band absorbers can be designed by virtue of combining some single band absorbers. The multiple-reflection theory is used to explain the absorption mechanism of our investigated structures.
Xu, Zong-Cheng; Gao, Run-Mei; Ding, Chun-Feng; Zhang, Ya-Ting; Yao, Jian-Quan
Optical strain measurement and tear-out behavior of sutured porcine small intestine tissue using a standarized procedure
Some of the major complications leading to high morbidity and mortality rates in intestine surgery are caused by anastomotic insufficiencies. As the suture represents a crucial factor for the successful treatment of intestine anastomosis, it is of critical importance to investigate the tearing of sutured tissue. The goal of this study consists in examining the tear-out characteristics of stitched porcine
Kathrin Gester; Carolin Gabler; Klaus-Thilo von Trotha; Nick Butz; Ulf P. Neumann; Thomas Schmitz-Rode; Ulrich Steinseifer
Histopathological effect of low?level laser therapy on sutured wounds of the teat in dairy cattle
Perforating wounds were made on the cranial surface of 32 teats in eight dairy cattle. The teats were distributed into eight groups with four kinds of suture patterns. The used suture patterns were Gambee in Groups A and E, continuous 2?layer (Cushing for submucosal layer, continuous horizontal mattress for intermediate layer and skin) in Groups B and F, separated 2?layer
S. M. Ghamsari; K. Taguchi; N. Abe; J. A. Acorda; H. Yamada
An introduction to Radar Absorbent Materials (RAM)
The electromagnetic principles of radar absorbent materials are summarized. The fundamental theory of electromagnetic wave propagation in media and at the interfaces between different media is reviewed, and approaches to absorber design are described. The types of materials required and the techniques for measuring their electromagnetic properties and the performance of the finished absorber are outlined. A means of designing
P. G. Lederer
Waveguide characterization of flexible absorbing material
Among the materials with adequate performance to be used as radar absorbing material (RAM), the conducting polymers have been under intensive study due to their excellent potential for application in electromagnetic interference and microwave absorption areas, replacing conventional absorbing materials. The aim of this work is to present electromagnetic characterization of the flexible radar absorbing material at microwave frequency range
L. C. Folgueras; R. Faez; M. C. Rezende
Optimization of ramified absorber networks doing desalination
An iterated function system is used to generate fractal-like ramified graph networks of absorbers, which are optimized for desalination performance. The diffusion equation is solved for the boundary case of constant pressure difference at the absorbers and a constant ambient salt concentration far from the absorbers, while constraining both the total length of the network and the total area of
Martin S. Singleton; Gregor Heiss; Alfred Hübler
Electromagnetic scattering by pyramidal and wedge absorber
Electromagnetic scattering from pyramidal and wedge absorbers used to line the walls of modern anechoic chambers is measured and compared with theoretically predicted values. The theoretical performance for various angles of incidence is studied. It is shown that a pyramidal absorber scatters electromagnetic energy more as a random rough surface does. The apparent reflection coefficient from an absorber wall illuminated
Brian T. Dewitt; Walter D. Burnside
Graphene saturable absorbers for VECSELs
NASA Astrophysics Data System (ADS)
We report mode-locking of an optically pumped VECSEL using a graphene-based saturable absorber mirror (GSAM). Self-starting and stable modelocked operation is demonstrated with 473 fs pulses at 1.5 GHz repetition rate and 949 nm center wavelength. Wavelength tuning is achieved over a 46 nm bandwidth. We discuss the mirror design, the fabrication of the GSAMs, and give an outlook on further optimization of the design, including dielectric top coatings to protect the graphene and to increase the flexibility in the design.
Wittwer, V. J.; Zaugg, C. A.; Sun, Z.; Popa, D.; Milana, S.; Kulmala, T. S.; Sundaram, R. S.; Mangold, M.; Golling, M.; Lee, Y.; Ahn, J. H.; Keller, U.; Ferrari, A. C.
Porcelain enamel neutron absorbing material
A porcelain enamel composition as a neutron absorbing material can be prepared of a major proportion by weight of a cadmium compound and a minor proportion of compounds of boron, lithium and silicon. These compounds in the form of a porcelain enamel coating or layer on several alloys has been found to be particularly effective in enhancing the nuclear safety of equipment for use in the processing and storage of fissile material. The composition of the porcelain enamel coating can be tailored to match the coefficient of thermal expansion of the equipment to be coated and excellent coating adhesion can be achieved.
Iverson, Daniel C. (Aiken, SC)
Experiments on a bubble absorber
Experiments are carried out on a bubble absorber, operating as part of a vapor absorption refrigeration system working with HCFC22-DMF to obtain heat and mass transfer and pressure drop data. The results are evaluated to obtain the dependence of absorption process on different parameters. Experimental data are compared with the numerical correlation relating Sherwood number., Reynolds number, Schmidt number and length to diameter ratio developed earlier by the authors. Also the experimental pressure drop is compared with the pressure drop obtained from other well known classical correlations and the numerical model.
Sujatha, K.S.; Mani, A.; Murthy, S.S.
Mulitlayered Nanostructured Broad Band Absorber
NASA Astrophysics Data System (ADS)
Wasted energy in the form of heat is perhaps the largest source of lost energy making many power systems inefficient. Systems designed to convert heat into useful energy need a method of collecting the heat. We previously described a multilayer design with successive thin metallic and dielectric (non-metal and transparent) layers, where each successive metallic layer absorbs a small fraction of the radiation. However, the regular thickness of the dielectric layer causes reflection peaks, or regions where no absorption occurs. In this work we describe a similar design where we eliminated the undesirable reflection peaks using varying thicknesses of the dielectric layer.
Corrigan, Timothy; Ide, Benjamin
Porcelain enamel neutron absorbing material
A porcelain enamel composition as a neutron absorbing material can be prepared of a major proportion by weight of a cadmium compound and a minor proportion of compound of boron, lithium and silicon. These compounds in the form of a porcelain enamel coating or layer on several alloys has been found to be particularly effective in enhancing the nuclear safety of equipment for use in the processing and storage of fissile material. The composition of the porcelain enamel coating can be tailored to match the coefficient of thermal expansion of the equipment to be coated and excellent coating adhesion can be achieved. 2 figs.
Iverson, D.C.
Graphene based salisbury screen for terahertz absorber
NASA Astrophysics Data System (ADS)
A graphene-based, multiband absorber operating in terahertz (THz) frequency range was demonstrated. Graphene film was transferred onto the top of a flexible polymer substrate backed with a gold reflector. The graphene acts as a resistive film that partially attenuates and reflects THz waves. The destructive interference between THz waves reflected from graphene and backside reflector gives rise to perfect absorbance at multiple frequencies. To enhance the absorbance on/off ratio (AR), the conductivity of graphene was varied using a chemical doping method. The resulting p-doped, graphene-based THz absorber exhibited absorbance at maxima and AR higher than 0.95 and 25 dB, respectively.
Min Woo, Jeong; Kim, Min-Sik; Woong Kim, Hyun; Jang, Jae-Hyung
Triclosan-coated sutures do not reduce leg wound infections after coronary artery bypass grafting
OBJECTIVES Leg wound infection is a common complication after coronary artery bypass grafting (CABG). Suture contamination has been suggested as a mechanism of surgical site infections. Vicryl Plus® is a polyglacitin suture coated with the antiseptic chemical substance Triclosan, which has been shown to inhibit the growth of Staphylococcus aureus in vitro. The first aim of the present study was to compare Vicryl Plus with conventional Vicryl® sutures with regard to leg wound infections following CABG. The second aim was to examine patient- and operative characteristics, which are assumed to predict leg wound infections. METHODS After statistical calculations a priori, 328 CABG patients were prospectively randomized to leg wound closure with Vicryl Plus (164 patients) or conventional Vicryl sutures (164 patients). Incidences of leg wound infection and predictors of infection related to patient- and operative characteristics were examined. RESULTS The incidence of leg wound infections was 10.4% (17/163) in the Vicryl group, and 10.0% (16/160) in the Vicryl Plus group (P = 1.00). Patients with leg wound infections had increased body mass index and prolonged extracorporeal circulation and aortic clamping time compared with patients without infections. CONCLUSIONS In the present study, we report for the first time that Vicryl Plus did not reduce the incidence of leg wound infections in patients undergoing CABG. Obesity and prolonged time of extracorporeal circulation were both associated with the increased risk of infections. Currently, the clinical role and indication for the use of Vicryl Plus have yet to be defined.
Seim, Bj?rn Edvard; T?nnessen, Theis; Woldbaek, Per Reidar
Biomechanical evaluation of a veterinary suture anchor in the canine cadaver pelvis and femur.
A commercially available veterinary suture anchor was tested in the acetabula and femurs of canine cadavers. Size #2 suture anchor constructs were compared to a traditional screw and Teflon spiked washer constructs in a model of coxofemoral luxation repair. The screw/washer constructs failed at a higher maximum load than the #2 anchor constructs. In the acetabulum, significant differences in strength were also found in the position of the implant and in the direction of pull. The constructs in a more caudal position, and constructs pulled 90 degrees to the axis of insertion, failed at higher loads. The predominant mode of failure of the constructs was a suture failure. In the femur, size #5 suture anchors were used in a model of cranial cruciate ligament repair and collateral ligament repair. The anchor constructs failed predominantly by anchor pull-out in the distal femur. The constructs pulled 90 degrees to the axis of insertion were stronger than construcs pulled at 0 degrees to the axis of insertion. Varying the location of the implant in the femur did not affect the maximum load to failure. PMID:16594214
Singer, M J; Pijanowski, G; Wiley, R; Johnson, A L; Siegel, A M
Significantly Reducing Post-Tonsillectomy Haemorrhage Requiring Surgery by Suturing the Faucial Pillars: A Retrospective Analysis
Background The tonsillectomy is one of the most frequently performed surgical procedures. Given the comparatively frequent postsurgical bleeding associated with this procedure, particular attention has been paid to reduction of the postoperative bleeding rate. In 2006, we introduced routine suturing of the faucial pillars at our clinic to reduce postoperative haemorrhage. Methods Two groups from the years 2003–2005 (n?=?1000) and 2007–2009 (n?=?1000) have been compared. We included all patients who had an elective tonsillectomy due to a benign, non-acute inflammatory tonsil illness. In the years 2007–2009, we additionally sutured the faucial pillars after completing haemostasis. For primary haemostasis we used suture ligation and bipolar diathermy. Results The rate of bleeding requiring second surgery for haemostasis was 3.6% in 2003–2005 but only 2.0% in 2007–2009 (absolute risk reduction 1.6% (95% CI 0.22%–2.45%, p?=?0.04)). The median surgery time—including adenoidectomy and paracentesis surgery—increased from 25 to 31 minutes (p<0.01). Conclusions We have been able to substantiate that suturing of the faucial pillars nearly halves the rate of postoperative haemorrhage. Surgery takes 8 minutes longer on average. Bleeding occurs later, mostly after 24 h. The limitations of this study relate to its retrospective character and all the potential biases related to observational studies.
Senska, Gotz; Schroder, Hilal; Putter, Carolin; Dost, Philipp
Arachnoid Membrane Suturing for Prevention of Subdural Fluid Collection in Extracranial-intracranial Bypass Surgery
Objective Water-tight closure of the dura in extracranial-intracranial (EC-IC) bypass is impossible because the superficial temporal artery (STA) must run through the dural defect. Consequently, subdural hygroma and subcutaneous cerebrospinal fluid (CSF) collection frequently occur postoperatively. To reduce these complications, we prospectively performed suturing of the arachnoid membrane after STA-middle cerebral artery (STA-MCA) and evaluated the clinical usefulness. Materials and Methods Between Mar. 2005 and Oct. 2010, extracranial-intracranial arterial bypass (EIAB) with/without encephalo-myo-synangiosis was performed in 88 cases (male : female = 53 : 35). As a control group, 51 patients (57 sides) underwent conventional bypass surgery without closure of the arachnoid membrane. Postoperative computed tomography (CT) scan was performed twice in three days and seven days later, respectively, for evaluation of the presence of subdural fluid collection and other mass lesions. Results The surgical result was excellent, with no newly developing ischemic event until recent follow-up. The additional time needed for arachnoid suture was five to ten minutes, when three to eight sutures were required. Post-operative subdural fluid collection was not seen on follow-up computed tomography scans in all patients. Conclusion Arachnoid suturing is simple, safe, and effective for prevention of subdural fluid collection in EC-IC bypass surgery, especially the vulnerable ischemic hemisphere.
Kim, Gun Woo; Kim, Tae Sun; Moon, Hyung Sik; Jang, Jae Won; Seo, Bo Ra; Lee, Jung Kil; Kim, Jae Hyoo; Kim, Soo Han
Percutaneous Retrieval of a Central Venous Catheter Sutured to the Wall of the Right Atrium
A transjugular central venous catheter was inadvertently sutured to the wall of the right atrium in a 63-year-old female during coronary bypass surgery. Using two nitinol Goose Neck snares via a transfemoral and a transjugular approach the catheter was severed into two pieces and retrieved percutaneously.
Neuerburg, Joerg-M.; Guenther, Rolf W. [Department of Diagnostic Radiology, University of Technology Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany); Chalabi, Khaled [Department of Vascular and Thoracic Surgery, University of Technology Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany); Hunter, David [Department of Radiology, Fairview-University Medical Center, 420 Delaware Street S.E., Box 292, Minneapolis, MN 55455 (United States)
Single-incision repair of acute distal biceps ruptures by use of suture anchors.
The purpose of this study is to report the results of a single limited-incision technique for repair of acute distal biceps ruptures by use of suture anchors. Sixty consecutive patients underwent distal biceps repair after an acute rupture between January 1997 and January 2001 by use of a limited antecubital incision and suture anchors. Fifty-three patients could be evaluated at a mean follow-up of 38.1 months. A limited transverse incision was made in the antecubital fossa. The retracted biceps tendon end was identified, retrieved, and lightly debrided. Two suture anchors were placed in the radial tuberosity, and the tendon was reapproximated. Final follow-up consisted of physical examination, radiographs, and Andrews-Carson elbow score tabulations. According to the Andrews-Carson scores, there were 46 excellent and 7 good results. In 2 patients, heterotopic ossification developed that resulted in a mild loss of forearm rotation and mild pain. In 1 patient, a temporary radial nerve palsy developed, which resolved completely within 8 weeks. Repair of acute distal biceps tears via a limited antecubital incision and suture anchors is a safe, effective technique. PMID:16963286
John, Chris K; Field, Larry D; Weiss, Kenneth S; Savoie, Felix H
Evaluation of patients undergoing rotator cuff suture with the modified mason-allen technique
OBJECTIVE : The purpose of this study was to clinically evaluate patients who underwent Arthroscopic Rotator Cuff Repair (RC) using the Modified Manson-Allen technique. METHODS : We evaluated 79 patients who underwent shoulder arthroscopy. The lesions were repaired using the modified Mason-Allen suture between 2003 and 2009, divided by Cofield classification and clinically evaluated by the scoring system of the University of Los Angeles (UCLA) in the pre- and postoperative periods. RESULTS : The evaluation of lesion sizes showed 7 small lesions (<1cm), 55 average lesions (1-3cm) and 17 large lesions (3-5cm), and in this last group there were 5 reruptures and the patients were reoperated by the same technique. Comparing the pre (14.1) and postoperative (32.6) values by UCLA system there was a significant improvement of score (142.3%), regardless of lesion size. The modified Mason-Allen suture provided satisfactory clinical results, regardless of lesion size, similar to those found in literature. The rerupture rate was high in large lesions. New suture techniques have been developed with the aim of reducing the incidence of rerupture. CONCLUSION : The modified Mason-Allen suture technique provided clinical improvement, regardless of lesion size. Level of Evidence IV, Cases Series.
Porto, Fernanda de Marchi Bosi; Alves, Marcelo Wiltemburg; de Andrade, Andre Luis Lugnani
Valve-sparing aortic root remodeling with reinforcement of the proximal aortic suture-line.
Valve-sparing aortic root remodeling is associated with the risk of bleeding from the proximal aortic-graft suture line and subsequent annular dilation leading to aortic valve failure. Herein we describe a simple technique that may be used in valve-sparing root operations to prevent bleeding and improve annular stability. PMID:19740295
Calcaterra, Domenico; Garcia, Lisardo; Panos, Anthony; Salerno, Tomas A; Ricci, Marco
Effect of the suture on the durability of bovine pericardium used in cardiac bioprostheses.
Our study of the different biomaterials used in the construction of biological cardiac prostheses has shown it to be of vital importance that the physical properties of the tissue and of the suture that anchors it to the rigid polymeric support are compatible. By means of dynamic tests, we have determined the fatigue curve in sutured bovine pericardial tissue, expressed by the equation log y = 1.27 +/- 0.18 (0.26 +/- 0.05) log t, where y is the initial fatigue stress (MPa) and t is the time (min) it takes to achieve permanent deformation of the tissue. By applying this correction, we determine a set of values for stress-time which, when compared with those obtained with a non-sutured sample, reveal a significant fall in this ratio and, thus, a decrease in the durability. The use of suture threads of lesser elasticity than the pericardium may play an important role in reducing the durability of the bioprosthesis constructed with these materials. PMID:8199289
García Paez, J M; Carrera San Martín, A; Jorge-Herrero, E; Millán, I; Navidad, R; Candela, I; García Sestafe, J V; Castillo-Olivares, J L
Knee immobilization on meniscal healing after suture: an experimental study in sheep.
Immobilization and nonweightbearing may influence the healing of sutured meniscal lesions in the avascular zone. In 12 sheep, 3 to 4 months of age, a 0.5-cm longitudinal lesion was made in the middle segment and posterior portion of the medial meniscus of the left knee in the avascular zone. The lesion was sutured immediately. The knees of six sheep were immobilized with a monolateral external fixator, which crossed the knee, and the knees in the other six sheep were not immobilized. The animals were sacrificed 6 weeks after the operation. Specimens from the anterior meniscus were used for histologic and vascular studies, and the posterior meniscus was used for mechanical testing. Repair was observed in two of 12 sheep in the form of fibrous tissue. Fibrochondrocytes and synovial cells were involved. Meniscal fibrochondrocytes from the nearest meniscal tissue, synovial cells from the femoral and tibial meniscal surfaces, and fibroblastic cells migrating through the suture channel provide cell access to the meniscus lesion. Sutured menisci, immobilized or not, support less than 50% of a normal load and are mechanically weak. PMID:11937886
Guisasola, Ińigo; Vaquero, Javier; Forriol, Francisco
Geochemistry, provenance and stratigraphic age of metasedimentary rocks from the eastern Vardar suture zone, northern Greece
Uppermost Palaeozoic and Mesozoic sediments from the Vardar suture zone in northern Greece record a cycle of Neotethyan oceanic basin opening and closure and their analysis places tight constraints on the geotectonic evolution of the area. The oldest post-Carboniferous sedimentary unit in the study area is the Examili Formation, which comprises mainly metaarkoses and metaquartzites, and was deposited in an
Guido Meinhold; Dimitrios Kostopoulos; Thomas Reischmann; Dirk Frei; Marcelle K. BouDagher-Fadel
Use of a sponge stopper for placement of urethrovesical anastomotic sutures after radical prostatectomy or enterocystoplasty.
Vesicourethral anastomosis during radical retropubic prostatectomy or enterocystoplasty is often difficult because of poor visualization and collapse of the urethral stump. We have attempted to use a sponge stopper to facilitate urethral suture placement for vesicourethral anastomosis. The technique for use of a sponge stopper is described. PMID:9609646
Muraishi, O; Tokue, A
Hereditary premature closure of a coronal suture in the Abraham Lincoln family.
The most easily recognized facial features of unilateral premature closure of a coronal suture in the skull are an upward arching of the superior orbital rim and a smaller face on the involved side. Photographs indicate that at least 9 individuals over 5 generations of the Abraham Lincoln family showed this anomaly. PMID:23856133
Fishman, Ronald S
Comparison of Tensile Strength of Wounds Closed by Sutures and Cyanoacrylates.
National Technical Information Service (NTIS)
Skin incisions closed by 3 homologous alpha-alkyl cyanoacrylates were compared with sutured control wounds in rat skin with respect to tensile strength at 6 different times (postoperation days 1, 4, and 7 and postoperation weeks 4,8, and 16). The data ind...
P. B. Lamborn H. B. Solouay T. Matsumoto G. V. Aaby
Torn discoid lateral meniscus treated using partial central meniscectomy and suture of the peripheral tear
We present the cases of 5 patients with a torn discoid lateral meniscus treated using partial central meniscectomy in conjunction with the suture repair of the tear. The patients were 4 boys and 1 girl with a mean age of 15.4 years (range, 11 to 17). Preoperatively, all patients complained of knee pain during daily or sports activities. At the
Nobuo Adachi; Mitsuo Ochi; Yuji Uchio; Masakazu Kuriwaka; Rikuo Shinomiya
Suture Anchors and Tacks for Shoulder Surgery, Part 1 Biology and Biomechanics
The development and successful clinical application of suture anchors and tacks have revolutionized the surgeon's ability to secure soft tissues to bone via open or arthroscopic surgical techniques. When used carefully and with proper technique, these devices provide viable options for the repair and reconstruction of many intra-articular and extra-articular abnormalities in the shoulder, including rotator cuff tears, shoulder instability,
Edward G. McFarland; Hyung Bin Park; Ekavit Keyurapan; Harpreet S. Gill; Harpal S. Selhi
Suture-related urolithiasis following repair of inadvertent prostatectomy in a dog
A 10-month-old male chow chow mixed breed dog was presented for anuria secondary to inadvertent prostatectomy performed during unilateral cryptorchidectomy. Surgical repair was successfully performed; however, this resulted in suture-associated urolith formation 3 months later, requiring a second surgical intervention and urethrostomy.
Puttick, Jennifer L.; Sereda, Colin W.
Trans-anal reinforcing sutures after double stapling for lower rectal cancer: report of two cases.
To safely avoid the construction of a covering stoma in patients with advanced lower rectal cancer undergoing laparoscopy assisted colorectal surgery (LACS), we added circumferential manual reinforcing sutures via the transanal approach at the site of mechanical anastomosis. In June 2008, LACS was performed for a tumor of 6 cm in longer diameter in the Rb region of the lower rectum approximately 5 cm from the anal verge. After intraperitoneal coloproctal anastomosis was performed in the pelvis by the double stapling technique (DST), reinforcement was provided by manual trans-anal suturing (trans-anal reinforcing sutures: TARS). A covering stoma was constructed because this was a high-risk case. Complications such as mild wound infection and stoma trouble occurred, and the patient was discharged after conservative therapy. In June 2008, LACS was performed for a tumor of 5 cm in longer diameter in the Ra region of the lower rectum approximately 7 cm from the anal verge. After intraperitoneal colorectal anastomosis was performed in the pelvis by DST, TARS were added to avoid a covering stoma. Minor leakage occurred postoperatively, but this was controlled conservatively and the patient was discharged. In patients having surgical treatment of advanced lower rectal cancer, good results were obtained by adding circumferential reinforcing sutures via the trans-anal approach at the site of ultra-low anastomosis after DST. PMID:19148504
Mukai, Masaya; Fukasawa, Maki; Kishima, Kyoko; Iizuka, Shin-Ichi; Fukumitsu, Hiroshi; Yazawa, Naoki; Tajima, Takayuki; Nakamura, Masato; Makuuchi, Hiroyasu
A model of suture-induced urolithiasis with urographic control in the bladder of the rat.
The characteristics of a model of urolithiasis in the bladder of male Wistar rats were evaluated. Two techniques were compared: one knot of suture material through the bladder wall, or 15-throw knots inside the bladder. Rats were randomly assigned to one of six groups, according to the technique and suture material used (polyester, silk, or chromic catgut). An excretory urogram was performed at days 30, 60, and 90. At the moment of positive radiographic diagnosis, animals were sacrificed and stones were obtained. All rats were sacrificed at day 90 regardless of the x-ray results. Variables evaluated were average days to a positive urogram, average weight of all uroliths, and percentage of animals developing urolithiasis throughout the study. There were no statistical differences between groups for the average weight of stones, which ranged from 0.008 to 1.502 g for individual cases. All three materials were more lithogenic with the 15-throw knot inside technique. No significant differences were detected for lithogenesis criteria between suture materials. X-ray dispersion spectroscopy evidenced calcium phosphate composition of two stones from chromic catgut, and magnesium phosphate composition of two stones from chromic catgut, two from silk, and two from polyester. Neo-epithelization over the suture was confirmed microscopically in bladders with the one-throw technique. We conclude that (1) this is an effective model of urolithiasis, with predictability in time, composition, and amount of stone formation; (2) the presence of more suture material inside the bladder is more lithogenic; and (3) excretory urograms are highly sensitive and specific for the noninvasive diagnosis of bladder urolithiasis. PMID:10501079
Portilla, E; Ramos, A; Ramos, L; de Buen, N; García, D; Rodríguez-Reynoso, S; Larios, F; Terán, C
Potential field modelling of the Baltica Avalonia (Thor Tornquist) suture beneath the southern North Sea
NASA Astrophysics Data System (ADS)
Magnetic anomaly maps of the Trans-European Suture Zone (TESZ) highlight the contrast between the highly magnetic crust of Baltica and the less magnetic terranes to the SW of the suture. Although the TESZ is imaged on gravity maps, anomalies related to postcollisional rifting and reactivated rift structures tend to dominate. Seismic and potential field data have been used to construct 2 {1}/{2}-D crustal models along three profiles crossing the Baltica-Avalonia suture in the southern North Sea (SNS). The first of these models lies along a transect assembled from reflection line GECO SNST 83-07 and refraction profile EUGENO-S 2; the other two models are coincident with MONA LISA profiles 1 and 2. Additional structural information and density information for the cover sequence is available from released wells, while magnetic susceptibility values are compatible with values measured from borehole core samples. Magnetic anomalies related to the suture are interpreted as due to magnetic Baltican basement of the Ringkřbing-Fyn High dipping SW beneath nonmagnetic Avalonian basement underlying the western part of the SNS. Low-amplitude, long-wavelength magnetic anomalies occurring outboard of the suture are interpreted as due to a mid-crustal magnetic body, possibly a buried magmatic complex. This might represent the 'missing' arc related to inferred southward subduction of the Tornquist Sea, or an exotic element emplaced during the collision between Avalonia and Baltica. The present model supports an imbricated structure within Baltica as indicated by the latest reprocessing of the MONA LISA seismic data.
Williamson, J. P.; Pharaoh, T. C.; Banka, D.; Thybo, H.; Laigle, M.; Lee, M. K.
Mesozoic ophiolites, sutures, and arge-scale tectonic movements in Afghanistan
NASA Astrophysics Data System (ADS)
The tectonic history of Afghanistan appears to be the result of successive accretion of fragments of Gondwana to the active margin of Laurasia since the end of the Paleozoic. The margin, in Afghanistan, lies along the present Herat and Panjshir faults, south of Hindu Kush, swings around the central Pamirs and can presumably be traced along the present western Altyn Tagh and Kunlun faults in Tibet. North of this boundary, Paleozoic rocks have been deformed in the Upper Paleozoic, whereas south of it, there is no trace of the Hercynian orogeny. The first collision of Gondwanian fragments with Laurasia probably occurred in the early Mesozoic along the Hindu Kush and Kunlun. To the south, ophiolites along the Panjao and Pangong-Nu Chiang sutures (respectively in central Afghanistan and central Tibet) testify for another suturing event in the Upper Jurassic or Lower Cretaceous. The Indus-Tsangpo suture between India and Tibet corresponds, in eastern Afghanistan, to two ophiolite subbelts, near Kabul and Khost. Both ophiolite complexes have been emplaced between Maestrichtian and Lower Eocene by choking of two northward-dipping subduction zones. After complete contact between the Indian and Asian continents was achieved, presumably in the end of Eocene, the penetration of India into Asia caused large-scale intra-continental shortening. A large part of the shortening was accommodated by strike-slip faulting along Mesozoic and more ancient sutures. Central Afghanistan, in particular, was extruded to the west along the Herat suture by the protrusion of the Pamir wedge. It subsequently collided with the Lut block.
Tapponnier, Paul; Mattauer, Maurice; Proust, François; Cassaigneau, Christian
Comparison of the 20-Gauge Conventional Vitrectomy Technique with the 23-Gauge Releasable Suture Vitrectomy Technique
Purpose To compare the efficacy of the transconjunctival releasable suture technique for pars plana vitrectomy using 23-gauge (23G) instruments versus the conventional 20-gauge (20G) technique. Methods A retrospective and interventional case series was consecutively performed for 199 eyes of the 192 patients that were a part of this study. Clinical data were reviewed retrospectively regarding the operation time, preoperative and postoperative intraocular pressure, visual acuity and astigmatism for 54 consecutive patients who received a 23G releasable suture vitrectomy and for 98 consecutive patients who received a 20G conventional vitrectomy during the period between April 2007 and September 2010. Results Mean operation time based on the operation record was 88.5 ± 20.1 minutes in the 23G releasable suture vitrectomy group and 102.1 ± 23.1 minutes in the 20G conventional vitrectomy group, respectively (p = 0.01). The last best-corrected visual acuity (BCVA) was significantly better than the preoperative BCVA in both patient groups (p = 0.01, p = 0.01). The 23G releasable suture group showed less surgically induced astigmatism than the 20G conventional vitrectomy group. Vitreous bleeding was observed to be in 6 eyes (5.9%) in the 23G group, and in 8 eyes (8.2%) in the 20G group. In addition, ocular hypertension was noted to be in 3 eyes (3.0%) in the 23G group, and 6 eyes (6.1%) in the 20G group. No serious complications such as postoperative hypotony or endophthalmitis were observed in either group. Conclusions The 23G releasable suture technique is as effective as the 20G conventional technique and offers several advantages.
Kim, In Geun; Lee, Soo Jung
Oxalate: Effect on calcium absorbability
Absorption of calcium from intrinsically labeled Ca oxalate was measured in 18 normal women and compared with absorption of Ca from milk in these same subjects, both when the test substances were ingested in separate meals and when ingested together. Fractional Ca absorption from oxalate averaged 0.100 +/- 0.043 when ingested alone and 0.140 +/- 0.063 when ingested together with milk. Absorption was, as expected, substantially lower than absorption from milk (0.358 +/- 0.113). Nevertheless Ca oxalate absorbability in these women was higher than we had previously found for spinach Ca. When milk and Ca oxalate were ingested together, there was no interference of oxalate in milk Ca absorption and no evidence of tracer exchange between the two labeled Ca species.
Heaney, R.P.; Weaver, C.M. (Creighton Univ., Omaha, NE (USA))
Optimum orientation of absorber plates
Long-term analyses are presented to predict the optimum tilt angle of an absorber plate at any surface azimuth angle {gamma}. The analyses include the effects of number of glass covers, latitude angle, monthly average clearness index, month, and ground reflectivity. The effects of each of these parameters on the optimum tilt of a south-facing surface are studied. Two numerical correlations, for ground reflectivity equal 0.2 and 0.7, are developed to predict the monthly optimum tilt of a surface. The two correlations are used to predict the optimum tilt of a surface over any specified period of time that extends from one month up to several months or a year. The analyses are also extended to predict the optimum tilt angle and azimuth angles of surfaces exposed to shading by surrounding objects. Illustrative examples are presented to demonstrate the application of the analyses.
Elsayed, M.M. (King Abdulaziz Univ., Jeddah (Saudi Arabia))
Modeling the Absorbing Aerosol Index
NASA Technical Reports Server (NTRS)
We propose a scheme to model the absorbing aerosol index and improve the biomass carbon inventories by optimizing the difference between TOMS aerosol index (AI) and modeled AI with an inverse model. Two absorbing aerosol types are considered, including biomass carbon and mineral dust. A priori biomass carbon source was generated by Liousse et al [1996]. Mineral dust emission is parameterized according to surface wind and soil moisture using the method developed by Ginoux [2000]. In this initial study, the coupled CCM1 and GRANTOUR model was used to determine the aerosol spatial and temporal distribution. With modeled aerosol concentrations and optical properties, we calculate the radiance at the top of the atmosphere at 340 nm and 380 nm with a radiative transfer model. The contrast of radiance at these two wavelengths will be used to calculate AI. Then we compare the modeled AI with TOMS AI. This paper reports our initial modeling for AI and its comparison with TOMS Nimbus 7 AI. For our follow-on project we will model the global AI with aerosol spatial and temporal distribution recomputed from the IMPACT model and DAO GEOS-1 meteorology fields. Then we will build an inverse model, which applies a Bayesian inverse technique to optimize the agreement of between model and observational data. The inverse model will tune the biomass burning source strength to reduce the difference between modelled AI and TOMS AI. Further simulations with a posteriori biomass carbon sources from the inverse model will b