Suture Techniques: Techniques for securing together the edges of a wound, with loops of thread or similar materials (SUTURES).Sutures: Materials used in closing a surgical or traumatic wound. (From Dorland, 28th ed)Cranial Sutures: A type of fibrous joint between bones of the head.Cosmetic Techniques: Procedures for the improvement or enhancement of the appearance of the visible parts of the body.Dermatologic Surgical Procedures: Operative procedures performed on the SKIN.Tensile Strength: The maximum stress a material subjected to a stretching load can withstand without tearing. (McGraw-Hill Dictionary of Scientific and Technical Terms, 5th ed, p2001)Hernia, Ventral: A hernia caused by weakness of the anterior ABDOMINAL WALL due to midline defects, previous incisions, or increased intra-abdominal pressure. Ventral hernias include UMBILICAL HERNIA, incisional, epigastric, and spigelian hernias.Polypropylenes: Propylene or propene polymers. Thermoplastics that can be extruded into fibers, films or solid forms. They are used as a copolymer in plastics, especially polyethylene. The fibers are used for fabrics, filters and surgical sutures.Tendons: Fibrous bands or cords of CONNECTIVE TISSUE at the ends of SKELETAL MUSCLE FIBERS that serve to attach the MUSCLES to bones and other structures.Cadaver: A dead body, usually a human body.Wound Healing: Restoration of integrity to traumatized tissue.Infarction, Middle Cerebral Artery: NECROSIS occurring in the MIDDLE CEREBRAL ARTERY distribution system which brings blood to the entire lateral aspects of each CEREBRAL HEMISPHERE. Clinical signs include impaired cognition; APHASIA; AGRAPHIA; weak and numbness in the face and arms, contralaterally or bilaterally depending on the infarction.Suture Anchors: Implants used in arthroscopic surgery and other orthopedic procedures to attach soft tissue to bone. One end of a suture is tied to soft tissue and the other end to the implant. The anchors are made of a variety of materials including titanium, stainless steel, or absorbable polymers.Biomechanical Phenomena: The properties, processes, and behavior of biological systems under the action of mechanical forces.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.Leiomyoma: A benign tumor derived from smooth muscle tissue, also known as a fibroid tumor. They rarely occur outside of the UTERUS and the GASTROINTESTINAL TRACT but can occur in the SKIN and SUBCUTANEOUS TISSUE, probably arising from the smooth muscle of small blood vessels in these tissues.Myoma: A benign neoplasm of muscular tissue. (Stedman, 25th ed)Uterine Myomectomy: Surgical removal of a LEIOMYOMA of the UTERUS.Uterine Neoplasms: Tumors or cancer of the UTERUS.Laparoscopy: A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy.Gynecologic Surgical Procedures: Surgery performed on the female genitalia.Iris: The most anterior portion of the uveal layer, separating the anterior chamber from the posterior. It consists of two layers - the stroma and the pigmented epithelium. Color of the iris depends on the amount of melanin in the stroma on reflection from the pigmented epithelium.Defibrillators, Implantable: Implantable devices which continuously monitor the electrical activity of the heart and automatically detect and terminate ventricular tachycardia (TACHYCARDIA, VENTRICULAR) and VENTRICULAR FIBRILLATION. They consist of an impulse generator, batteries, and electrodes.Prostheses and Implants: Artificial substitutes for body parts, and materials inserted into tissue for functional, cosmetic, or therapeutic purposes. Prostheses can be functional, as in the case of artificial arms and legs, or cosmetic, as in the case of an artificial eye. Implants, all surgically inserted or grafted into the body, tend to be used therapeutically. IMPLANTS, EXPERIMENTAL is available for those used experimentally.Radio Frequency Identification Device: Machine readable patient or equipment identification device using radio frequency from 125 kHz to 5.8 Ghz.Electromagnetic Radiation: Waves of oscillating electric and MAGNETIC FIELDS which move at right angles to each other and outward from the source.Pacemaker, Artificial: A device designed to stimulate, by electric impulses, contraction of the heart muscles. It may be temporary (external) or permanent (internal or internal-external).Iris Diseases: Diseases, dysfunctions, or disorders of or located in the iris.Rotator Cuff: The musculotendinous sheath formed by the supraspinatus, infraspinatus, subscapularis, and teres minor muscles. These help stabilize the head of the HUMERUS in the glenoid fossa and allow for rotation of the SHOULDER JOINT about its longitudinal axis.Arthroscopy: Endoscopic examination, therapy and surgery of the joint.Tenodesis: Fixation of the end of a tendon to a bone, often by suturing.Shoulder Joint: The articulation between the head of the HUMERUS and the glenoid cavity of the SCAPULA.Viscosupplements: Viscoelastic solutions that are injected into JOINTS in order to alleviate symptoms of joint-related disorders such as OSTEOARTHRITIS.Infusions, Intralesional: The administration of medication or fluid directly into localized lesions, by means of gravity flow or INFUSION PUMPS.Hernia, Hiatal: STOMACH herniation located at or near the diaphragmatic opening for the ESOPHAGUS, the esophageal hiatus.Acellular Dermis: Remaining tissue from normal DERMIS tissue after the cells are removed.Hernia, Inguinal: An abdominal hernia with an external bulge in the GROIN region. It can be classified by the location of herniation. Indirect inguinal hernias occur through the internal inguinal ring. Direct inguinal hernias occur through defects in the ABDOMINAL WALL (transversalis fascia) in Hesselbach's triangle. The former type is commonly seen in children and young adults; the latter in adults.Surgical Mesh: Any woven or knit material of open texture used in surgery for the repair, reconstruction, or substitution of tissue. The mesh is usually a synthetic fabric made of various polymers. It is occasionally made of metal.Herniorrhaphy: Surgical procedures undertaken to repair abnormal openings through which tissue or parts of organs can protrude or are already protruding.Anastomosis, Surgical: Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end, or side-to-side.Lymph Node Excision: Surgical excision of one or more lymph nodes. Its most common use is in cancer surgery. (From Dorland, 28th ed, p966)Pelvic Neoplasms: Tumors or cancer of the pelvic region.Colectomy: Excision of a portion of the colon or of the whole colon. (Dorland, 28th ed)Aortic Aneurysm, Abdominal: An abnormal balloon- or sac-like dilatation in the wall of the ABDOMINAL AORTA which gives rise to the visceral, the parietal, and the terminal (iliac) branches below the aortic hiatus at the diaphragm.Blood Vessel Prosthesis Implantation: Surgical insertion of BLOOD VESSEL PROSTHESES to repair injured or diseased blood vessels.Endovascular Procedures: Minimally invasive procedures, diagnostic or therapeutic, performed within the BLOOD VESSELS. They may be perfomed via ANGIOSCOPY; INTERVENTIONAL MAGNETIC RESONANCE IMAGING; INTERVENTIONAL RADIOGRAPHY; or INTERVENTIONAL ULTRASONOGRAPHY.Blood Vessel Prosthesis: Device constructed of either synthetic or biological material that is used for the repair of injured or diseased blood vessels.Fascia: Layers of connective tissue of variable thickness. The superficial fascia is found immediately below the skin; the deep fascia invests MUSCLES, nerves, and other organs.Postpartum Hemorrhage: Excess blood loss from uterine bleeding associated with OBSTETRIC LABOR or CHILDBIRTH. It is defined as blood loss greater than 500 ml or of the amount that adversely affects the maternal physiology, such as BLOOD PRESSURE and HEMATOCRIT. Postpartum hemorrhage is divided into two categories, immediate (within first 24 hours after birth) or delayed (after 24 hours postpartum).Directories as Topic: Lists of persons or organizations, systematically arranged, usually in alphabetic or classed order, giving address, affiliations, etc., for individuals, and giving address, officers, functions, and similar data for organizations. (ALA Glossary of Library and Information Science, 1983)Medical Illustration: The field which deals with illustrative clarification of biomedical concepts, as in the use of diagrams and drawings. The illustration may be produced by hand, photography, computer, or other electronic or mechanical methods.Uterine Inertia: Failure of the UTERUS to contract with normal strength, duration, and intervals during childbirth (LABOR, OBSTETRIC). It is also called uterine atony.Oxytocics: Drugs that stimulate contraction of the myometrium. They are used to induce LABOR, OBSTETRIC at term, to prevent or control postpartum or postabortion hemorrhage, and to assess fetal status in high risk pregnancies. They may also be used alone or with other drugs to induce abortions (ABORTIFACIENTS). Oxytocics used clinically include the neurohypophyseal hormone OXYTOCIN and certain prostaglandins and ergot alkaloids. (From AMA Drug Evaluations, 1994, p1157)Labor Stage, Third: The final period of OBSTETRIC LABOR that is from the expulsion of the FETUS to the expulsion of the PLACENTA.Misoprostol: A synthetic analog of natural prostaglandin E1. It produces a dose-related inhibition of gastric acid and pepsin secretion, and enhances mucosal resistance to injury. It is an effective anti-ulcer agent and also has oxytocic properties.

Incisional hernias in patients with aortic aneurysmal disease: the importance of suture technique. (1/1368)

OBJECTIVE: To study the rate of incisional hernia at 12 months in patients undergoing abdominal aortic aneurysm repair compared with others undergoing other surgery through midline incisions. METHODS: A prospective study of 1023 patients, 85 of these with aneurysmal disease. Wounds were continuously closed and the suture technique was monitored by the suture length to wound length ratio. RESULTS: Wound incisions were longer and operations lasted longer in aneurysm patients than in others. Incisional hernia was less common if closure was with a suture length to wound length ratio of at least four. Wounds were closed with a ratio of four or more in 39% (33 of 85) of aneurysm patients and in 59% (546 of 923) of others (p < 0.01). In aneurysm patients no wound dehiscence was recorded, the rate of wound infection was low and incisional hernia occurred in the same amount as in others. CONCLUSIONS: It is concluded that the rate of incisional hernia is similar in patients with abdominal aortic aneurysmal disease and others. Wounds are closed with a less meticulous suture technique in aneurysm patients.  (+info)

Zernike representation of corneal topography height data after nonmechanical penetrating keratoplasty. (2/1368)

PURPOSE: To demonstrate a mathematical method for decomposition of discrete corneal topography height data into a set of Zernike polynomials and to demonstrate the clinical applicability of these computations in the postkeratoplasty cornea. METHODS: Fifty consecutive patients with either Fuchs' dystrophy (n = 20) or keratoconus (n = 30) were seen at 3 months, 6 months, and 1 year (before suture removal) and again after suture removal following nonmechanical trephination with the excimer laser. Patients were assessed using regular keratometry, corneal topography (TMS-1, simulated keratometry [SimK]), subjective refraction, and best-corrected visual acuity (VA) at each interval. A set of Zernike coefficients with radial degree 8 was calculated to fit two model surfaces: a complete representation (TOTAL) and a representation with parabolic terms only to define an approximate spherocylindrical surface (PARABOLIC). The root mean square error (RMS) was calculated comparing the corneal raw height data with TOTAL (TOTALRMS) and PARABOLIC (PARABOLICRMS). The cylinder of subjective refraction was correlated with the keratometric readings, the SimK, and the respective Zernike parameter. Visual acuity was correlated with the tilt components of the Zernike expansion. RESULTS: The measured corneal surface could be approximated by the composed surface 1 with TOTALRMS < or = 1.93 microm and by surface 2 with PARABOLICRMS < or = 3.66 microm. Mean keratometric reading after suture removal was 2.8+/-0.6 D. At all follow-up examinations, the SimK yielded higher values, whereas the keratometric reading and the refractive cylinder yielded lower values than the respective Zernike parameter. The correlation of the Zernike representation and the refractive cylinder (P = 0.02 at 3 months, P = 0.05 at 6 months and at 1 year, and P = 0.01 after suture removal) was much better than the correlation of the SimK and refractive cylinder (P = 0.3 at 3 months, P = 0.4 at 6 months, P = 0.2 at 1 year, and P = 0.1 after suture removal). Visual acuity increased from 0.23+/-0.10 at the 3-month evaluation to 0.54+/-0.19 after suture removal. After suture removal, there was a statistically significant inverse correlation between VA and tilt (P = 0.02 in patients with keratoconus and P = 0.05 in those with Fuchs' dystrophy). CONCLUSIONS: Zernike representation of corneal topography height data renders a reconstruction of clinically relevant corneal topography parameters with a marked reduction of redundance and a small error. Correlation of amount/axis of refractive cylinder with respective Zernike parameters is more accurate than with keratometry or respective SimK values of corneal topography analysis.  (+info)

Pseudoaneurysm of the vertebral artery. (3/1368)

Pseudoaneurysms of the vertebral artery are rare. Their treatment depends on the location, size, cause, and coexisting injuries. The surgical management of a 22-year-old man who had a large pseudoaneurysm in the 1st portion of the right vertebral artery is described, and an additional 144 cases from the medical literature are briefly reviewed.  (+info)

Mesh-and-glue technique to prevent leakage of cerebrospinal fluid after implantation of expanded polytetrafluoroethylene dura substitute--technical note. (4/1368)

Expanded polytetrafluoroethylene (ePTFE) can be used as a dura substitute but is associated with leakage of cerebrospinal fluid (CSF) through the suture line. Fibrin glue alone may not prevent this problem. This new method for sealing the suture line in ePTFE membrane uses an absorbable polyglycoic acid mesh soaked with fibrinogen fluid placed on the suture line. Thrombin fluid is then slowly applied to the wet mesh, forming a large fibrin membrane reinforced by the mesh over the suture line. Only one of 33 patients in whom this technique was used had CSF leakage, whereas 12 of 59 patients in whom a dural defect was closed with ePTFE alone showed postoperative subcutaneous CSF collection (p < 0.05). Our clinical experiences clearly show the efficacy of the mesh-and-glue technique to prevent CSF leakage after artificial dural substitution. Mesh and glue can provide an adequate repair for small dural defect. The mesh-and-glue technique may also be used for arachnoid sealing in spinal surgery.  (+info)

Closure techniques for fetoscopic access sites in the rabbit at mid-gestation. (5/1368)

Operative fetoscopy may be limited by its relatively high associated risk of preterm prelabour rupture of membranes. The objective of this study was to study closure techniques of the access site for fetoscopy in the mid-gestational rabbit. A total of 32 does (288 amniotic sacs) at 22 days gestational age (GA; term = 32 days) underwent 14 gauge needle fetoscopy, by puncture through surgically exposed amnion. Entry site was randomly allocated to four closure technique groups: myometrial suture (n = 14), fibrin sealant (n = 15), autologous maternal blood plug (n = 13), collagen plug (n = 14); 16 sacs were left unclosed (positive controls), and the unmanipulated 216 sacs were negative controls. Membrane integrity, presence of amniotic fluid and fetal lung to body weight ratio (FLBWR) were evaluated at 31 days GA. Following fetoscopy without an attempt to close the membranes, amniotic integrity was restored in 41% of cases (amniotic integrity in controls 94%; P = 0.00001). When the access site was surgically closed, the amnion resealed in 20-44% of cases, but none of the tested techniques was significantly better than the others or than positive controls. Permanent amniotic disruption was associated with a significantly lower FLBWR in all groups. In conclusion, the rate of fetoscopy-induced permanent membrane defects in this model did not improve by using any of the closure techniques tested here.  (+info)

Everting suture correction of lower lid involutional entropion. (6/1368)

AIMS: To assess the long term efficacy of everting sutures in the correction of lower lid involutional entropion and to quantify the effect upon lower lid retractor function. METHODS: A prospective single armed clinical trial of 62 eyelids in 57 patients undergoing everting suture correction of involutional entropion. Patients were assessed preoperatively and at 6, 12, 24, and 48 months postoperatively. The main outcome variables were lower lid position and the change in lower lid retractor function. RESULTS: When compared with the non-entropic side, the entropic lid had a greater degree of horizontal laxity and poorer lower lid retractor function. These differences however, were not significant. At the conclusion of the study and after a mean follow up period of 31 months, the entropion had recurred in 15% of the patients. There were no treatment failures in the group of five patients with recurrent entropion. The improvement in lower lid retractor function after the insertion of lower lid everting sutures did not reach statistical significance. There was no significant difference between the treatment failure group and the group with a successful outcome with regard to: the degree of horizontal lid laxity or lower lid retractor function present preoperatively; patient age or sex; an earlier history of surgery for entropion. There was neither a demonstrable learning effect nor a significant intersurgeon difference in outcome. The overall 4 year mortality rate was 30%. CONCLUSIONS: The use of everting sutures in the correction of primary or recurrent lower lid involutional entropion is a simple, successful, long lasting, and cost effective procedure.  (+info)

Screw versus suture fixation of Mitchell's osteotomy. A prospective, randomised study. (7/1368)

We studied prospectively 30 patients who had a Mitchell's osteotomy secured by either a suture followed by immobilisation in a plaster boot for six weeks, or by a cortical screw with early mobilisation. The mean time for return to social activities after fixation by a screw was 2.9 weeks and to work 4.9 weeks, which was significantly earlier than those who had stabilisation by a suture (5.7 and 8.7 weeks, respectively; p < 0.001). Use of a screw also produced a higher degree of patient satisfaction at six weeks, and an earlier return to wearing normal footwear. The improvement in forefoot scores was significantly greater after fixation by a screw at six weeks (p = 0.036) and three months (p = 0.024). At one year, two screws had been removed because of pain at the site of the screw head. Internal fixation of Mitchell's osteotomy by a screw allows the safe early mobilisation of patients and reduces the time required for convalescence.  (+info)

Increase in orthotopic murine corneal transplantation rejection rate with anterior synechiae. (8/1368)

PURPOSE: To evaluate the immunologic effect of anterior synechiae (AS) in a murine model of corneal transplantation. METHODS: Orthotopic penetrating keratoplasty with 12 interrupted sutures was performed on C57BL/6 donor mice and BALB/c recipient mice without AS (AS- group). In contrast to suturing in the AS- group, 3 of the 12 sutures were placed to create AS (AS+ group). The average graft opacity scores and rejection rates of both groups were compared. Cytotoxic T-lymphocyte (CTL) reactions and delayed hypersensitivity (DH) were evaluated 3 weeks after transplantation. Corneal cytokine expression was evaluated. RESULTS: The opacity scores of the AS+ group were consistently greater than those of the AS- group, and the rejection rate of the AS+ group was significantly greater than that of the AS- group (86% versus 54%, P = 0.03). The AS+ group had significantly higher CTL activity compared with the AS- group. There was no significant difference in DH between the two groups. The cytokine expression pattern in the AS+ group became similar to that of the AS- group in which the grafts were rejected. CONCLUSIONS: These findings indicate that AS impairs ocular immune privilege by mediating CTL activity, but without intensifying the DH response. Therefore, AS is a critical risk factor in allograft rejection in a murine model of corneal transplantation.  (+info)

  • Simple interrupted suturing is still a preferred technique when you want the most meticulous repair, but when dealing with less cosmetic areas, I like this technique as it is involves less knot tying and gets the job done a lot faster without sacrificing much in terms of wound appearance. (
  • Could you also just end these sutures with a simple surgeons knot correct or using the needle driver similar to interrupted sutures, just treating the loop as string #2? (
  • The first requirement is to possess a suture kit that includes, at least, the basic tools of a needle holder, toothed tissue forceps (with or without a skin hook), fine suture scissors and adequate suturing material. (
  • So as not to traumatize the tissue, I like to cut at each individual loop and then remove small pieces of thread as you would simple interrupted sutures. (
  • This is preferable to cutting at intervals and pulling The suture through, which has the potential to injure tissue as you pull. (
  • 1) Suture method is where a tissue-scaffold was implanted by suturing its border to the external oblique muscle, 2) Control method is where a tissue-scaffold was implanted without any suturing or support, 3) Frame method is where a tissue-scaffold was attached to a circular frame composed of polycaprolactone (PCL) biomaterial and placed subcutaneously. (
  • Macroscopically, tissue-scaffold degradation with the suture method and tissue-scaffold folding with the control method were observed after 4 weeks. (
  • The surgical approach used for the frame technique was found to be the best methodology for in vivo evaluation of tissue engineered acellular scaffolds, where the frame method did not compromise mechanical strength, but it reduced inflammation significantly. (
  • H&E staining showed progressive cell repopulation over the course of the experiment in all groups with acute and chronic inflammation observed in suture and control methods throughout the duration of the study. (
  • Immunohistochemistry quantification of CD3, CD 31, CD 34, CD 163, and αSMA showed a statistically significant differences between the suture, control and frame methods (P (
  • TEM analysis showed an increase in inflammatory cells in both suture and control methods following implantation. (
  • Specific tumour features (i.e. size, hilar location, anatomical complexity, nearness to renal sinus and/or urinary collecting system), surgeon's experience, robot‐assisted technology, as well as the aim of reducing warm ischaemia time and the amount of devascularized renal parenchyma preserved represented the key factors driving the evolution of the renorrhaphy techniques during MIPN over the past decade. (