Effect of interrupted suture and continuous suture on perineal rehabilitation of parturients: a Meta-analysis / 中国实用护理杂志

Objective:To explore the effect of perineal lateral incision and continuous suture of deep and superficial Ⅱdegree laceration on postoperative perineum rehabilitation of parturients.Methods:Randomized controlled trials of intervention effects on postoperative maternal wound rehabilitation using continuous sutures and interrupted sutures of mucosal, muscle, and skin layers after perineal lateral resection and Ⅱdegree lacerations were searched in Cochrane Library, PubMed, Medline, Embase, Science direct, China Biology Medicine, China National Knowledge Infrastructune, Wanfang Database, VIP Database. The retrieval time limit was from database establishment to October 1, 2020. using RevMan 5.3 software for statistical processing.Results:After searching and screening, 12 articles were finally included. The total sample size was 2 827 cases. After the two groups used different suture techniques, the results of Meta analysis showed that the pains ( MD=1.02, 95% CI=1.02-1.06), the suture time ( MD=-4.59, 95% CI=-7.29 - -1.91) and the healing condition ( MD=-0.55, 95% CI=-0.71 - -0.39) of the two groups were compared, the differences were significant (all P<0.01). Conclusions:In the suture of perineal lateral incision and Ⅱdegree laceration, continuous suture technique is used to suture the mucosal layer, muscle layer, and cortex, which can reduce the suture time, reduce the pain of the parturient, and is beneficial to the healing of the wound. It can be clinically based on the parturient. It can be used in accordance with the neatness and depth of the mouth and the needs of the parturient.

Clinical comparative observation of continuous and interrupted suture of omentopexy in laparoscopic sleeve gastrectomy / 国际外科学杂志

Objective:To compare the safety of continuous suture and interrupted suture in Laparoscopic Sleeve Gastrectomy and Omentopexy.Methods:The retrospective study include 121 patients who underwent Laparoscopic Sleeve Gastrectomy and Omentopexy in the Department of Obesity and Metabolic Surgery of the First Affiliated Hospital of Jinan University from January 2019 to March 2020.Among the 121 patients, 40 were males and 81 females, with an average age of (30.17±10.16) and (27.10±11.03), respectively. Among them, 70 patients used continuous suture during OP (continuous suture group), and 51 patients used intermittent suture (interrupted suture group). The operation time, intraoperative blood loss, postoperative pain score, postoperative complications were compared between the two groups. Normally distributed measurement data were measured as (mean ± standard) deviation ( Mean± SD), and t test was used to count the comparison between the two groups. The χ2 test was used to compare the measurement data between groups. The rank data used Wilconxon rank sum test. Results:(1) Intraoperative conditions: the operative time and intraoperative blood loss in the continuous suture group were (124.89±37.69) min and (7.3±2.5) mL, respectively. In the interrupted suture group, the above indexes were (124.80±35.53) min and (7.0±2.5) mL, respectively. There was no significant difference between the two groups ( t=0.012, 0.709, P>0.05). (2) Postoperative conditions: postoperative pain score and postoperative hospital stay in the continuous suture group were: mild pain in 45 cases, moderate pain in 25 cases, painless and severe pain in 0 cases, (9.3±3.2) d, respectively. In the interrupted suture group, the above indicators were 39 cases of mild pain, 12 cases of moderate pain, 0 cases of painless and severe pain, (8.7±2.1) d, and there was no statistical significance between the two groups ( Z=-1.431, P>0.05, t=1.149, P>0.05). In the continuous suture group, postoperative abdominal distension occurred in 8 cases, nausea and vomiting in 32 cases, gastroesophageal reflux in 17 cases by upper digestive tract imaging, contrast agent slowly passed through the residual stomach/anastomotic site in 14 cases, gastric volvulus in 6 cases, and no postoperative infection or anastomotic leakage occurred. In the interrupted suture group, the above indexes were 10 cases, 25 cases, 14 cases, 10 cases, gastric volvulus in 1 cases, and no postoperative infection or anastomotic leakage occurred. There was no significant difference in the above indicators between the two groups ( χ2=1.559, 0.010, 0.155, 0.003, 1.308, P>0.05). Conclusions:In laparoscopic sleeve gastrectomy and omentopexy, there is no significant difference between the continuous suture and interrupted suture in terms of operation time, intraoperative blood loss and postoperative complications. The surgeon can choose a suitable suture method based on his own judgment and experience.

Continuous Suture Technique for Aortic Valve Replacement in Patients with Severe Aortic Valve Stenosis / 日本心臓血管外科学会雑誌

<b>Objective</b> : The aim of the present study is to show the continuous suture technique in which the aortic valve replacement can be safely performed to insert prosthetic valves of an appropriate size in patients with aortic stenosis associated with a small annulus. <b>Patients and Methods</b> : Thirteen patients with severe aortic valve stenosis (aortic valve area <1.0 cm²) underwent aortic valve replacement with the continuous suture technique using three 2/0 non-absorbable monofilament polypropylene sutures. Transthoracic echocardiogram was performed before and after surgery in all patients to determine how large a prosthetic valve could be used compared to the preoperative annular size. <b>Results</b> : The mean size of the prosthetic valve implanted was 23.3 mm, while the preoperative mean value of aortic annulus was 21.7 mm. The 19 mm size prosthetic valves were never used even when the preoperative aortic annular diameter was less than 19 mm (in 2 patients). The duration of procedure time was adequate and the post-operative echocardiography showed excellent results with good prosthetic valve function and no adverse events. <b>Conclusions</b> : Using our continuous suture technique, prosthetic valves of an appropriate size can be safely and effectively inserted at an aortic position in patients with severe aortic stenosis.

Influence analysis of full-thickness continuous suture method and layer interrupted suture method in emergency abdominal operation closure / 中国医师进修杂志

Objective To assess the influence of full-thickness continuous suture method and layer interrupted suture method in emergency abdominal operation closure.Methods Two hundred and thirtyseven patients of emergency abdominal operation were divided into full-thickness continuous suture method group (145 cases) and layer interrupted suture method group (92 cases) according to the suture method.The rate of incision liquefaction and infection,time of incision suture were compared between the 2 groups,the patients with incision liquefaction and infection were given bacterial culture.Results The time of incision suture in full-thickness continuous suture method group was significantly shorter than that in layer interrupted suture method group [(18.37 ± 7.42) min vs.(25.92 ± 5.79) min],there was statistical difference (P ＜0.01).There were no statistical differences in the rate of incision liquefaction and infection,the rate of incision primary healing between the 2 groups (P ＞ 0.05).In full-thickness continuous suture method group,the rate of incision liquefaction and infection in median incision was significantly lower than that in rectus abdominis incision [18.58％ (21/113) vs.31.25％ (10/32)],the rate of incision primary healing was significantly higher than that in rectus abdominis incision [81.42％ (92/113) vs.68.75％ (22/32)],there were statistical differences (P ＜ 0.05).In layer interrupted suture method group,there were no statistical differences in the rate of incision liquefaction and infection,the rate of incision primary healing between median incision and rectus abdominis incision [33.33％ (23/69) vs.26.09％(6/23),66.67％ (46/69) vs.73.91％ (17/23),P ＞ 0.05].The rate of incision liquefaction and infection in median incision of full-thickness continuous suture method group was significantly lower than that in median incision of layer interrupted suture method group,and the rate of incision primary healing was significantly higher than that in median incision of layer interrupted suture method group,there were statistical differences (P ＜ 0.05).There were no statistical differences in the rate of incision liquefaction and infection,the rate of incision primary healing in rectus abdominis incision between the 2 groups (P ＞ 0.05).The bacterial culture result in patients with incision liquefaction and infection showed positive was in 26 cases,in full-thickness continuous suture method group was in 10 cases (6.90％,10/145),in layer interrupted suture method group was in 16 cases (17.39％,16/92),there was statistical difference (P ＜0.05).The mostly bacterial of infection was Escherichia coli.Conclusions The full-thickness continuous suture in median incision can shorten operative time and reduce the rate of incision liquefaction and infection in emergency abdominal operation.Suture technique has important impact on incision healing.

Effects of over the lower edge of the tarsal joint continuous suture fixation combined with orbital entire complex on eyelid epicanthus / 中国基层医药

Objective To investigate the continuous suture through the lower edge of the tarsal joint fixation orbital reconstructive eyelid superfluous skin treatment efficacy.Methods 50 cases of abject epicanthus clinical data were retrospectively analyzed from June 2009 to June 2013 in our hospital by the hospital ethics committee approved,which had a total of 100 eyes.According to the numbering method,they were randomly divided into control group and observation group,each 50 cases.Control group was given through the lower edge of the tarsal continuous suture fixation,while the observation group was treated on the basis of control group combined with joint orbital entire complex treatment.Therapeutic effects were compared,pain,treatment before and after each measurement indicators and lower eyelid skin complications and so on.Results After treatment,the control group redundant lower eyelid skin correction,eyelash contact with the cornea and corneal epithelial healing of eye damage were respectively 39 (78.00％),10 (20.00％) and 43 (86.00％),while the observation group were 49 (98.00％),1 (2.00％) and 50 (100.00％),the above parameters were statistically significant differences (x2 =5.559,16.839,3.840,P ＜ 0.05,P ＜ 0.01) ; According to VAS pain score,VAS scores before and after treatment were statistically significant (t =5.271,12.593,P ＜0.05,P ＜ 0.01),and the observation group after treatment VAS scores after treatment compared with the control group,the difference was statistically significant(t =4.399,P ＜ 0.05) ; Before and after treatment from the eyelid folds distance,flat as the lower eyelid away from the eye position,head lower eyelid skin flap in eyelid,head tilt eyelashes,inner canthal angle,outer canthal angle,inner canthal folds,palpebral fissure height,head of small tears on the pitch,orbicularis muscle eyelid width,eyelid orbicularis muscle thickness and orbital orbicularis muscle thickness differences were statistically significant,and the observation group after treatment with these indicators compared to the control group after treatment,the differences were statistically significant (t =4.292,5.828,4.135,5.099,4.723,5.002,6.717,8.092,7.038,8.056,3.129,7.043,P ＜ 0.05) ; the course of treatment in both groups would be lower eyelid retraction,ectropion and eyelid scar concurrent disease control group complication rate was 20.00％,which was significantly higher than that of the observation group(6.00％),the difference was significant statistical significance(x2 =13.283,P ＜ 0.01).Conclusion Over the lower edge of the tarsal joint continuous suture fixation treatment of orbital reconstructive eyelid superfluous skin effect is significant,with low complication rate,which is worth to be promoted in clinical and applied.

Study of patency rate in variable microvascular anastomosis

Several microvascular anastomotic techniques have been described with methodical effectiveness, patency rates, healing state of microscopic findings. This experimental study presents the comparison of three types of arterial microvascular anastomotic techniques: end-to-end(ETE) anastomosis, end-in-end(EIE) anastomosis, and continuous technique. Sixty male Sprague-Dawley rats, 60 femoral arteries were used for this study. Twenty rats per each technique were used and sacrificed at post-operation 1 day, 3 days, a week, 2 weeks for scanning electromicroscopic findings. The patency was monitored by miniDoppler throughout total experimental periods. The anastomotic time on each method was measured to compare the technical effectiveness. The final results were as follows: 1. The anastomotic time for the end-in-end technique was significantly shorter than another techniques. The average time for each technique was measured as 15 minutes on EIE technique, 20 minutes on continuous technique and 25 minutes on ETE technique. 2. The patency rate for the end-in-end technique at 2 weeks also was superior to another techniques. The patency rate for each technique was demonstrated as 90 % on EIE technique, 85 % on ETE technique and 80 % on continuous technique. 3. The scanning electromicroscopic findings on healing condition of vessel endothelium during the observation period showed that the end results of EIE technique, ETE technique and continuous technique in sequence were good. The end-in-end technique proved to be the superior with regard to anastomotic time and patency rate when compared to end-to-end technuqe, so EIE techniqe might be well available for the case of large discrepancy of vessel size. The patency rate, microscopic healing findings in continuous technique were seen as the lowest level among the three anastomotic techniques, therefore the application of continuous technique was recommended only on the inevitable case.

Operation Experience of Double Valve Replacment and Tricuspidplasty / 中国医师杂志

Objective To investigate the operation experience of reducing time of heart clamp in double valve replacement and tricuspidplasty in 66 patient. Methods From May 1999 to March 2003, 66 patients received mitral valve replacement(MVR), aortic valve replacement(AVR) and tricuspidplasty. Mitral valves were replaced by continuous suture. Aortic valves were replaced by continuous suture in 59 cases and interrupted suture in 7 cases. Results 132 artificial valves were grafted. The time of aortic clamp and pump was 34.5?4.3 minutes and 56.1?7.8 minutes respectively. There were no postoperative severe complications and death in all 66 cases in hospital. Conclusions Decreasing the time of aortic clamp and pump is good for myocardium protection and may reduce postoperative complications.

Comparison of Corneal Astigmatism after Keratolasty with 3 Kinds of Suture Techniques

In order to evaluate the comparison of corneal astigmatism after keratoplasty with 3 kinds of suture techniques, penetrating keratoplasty was performed in 25 patients(25 eyes) with different suture techniques, single continuous(group I, N=7), interrupted(II, N=7), and combined sutures(III, N=11) with 10-0 nylon. In group I, suture control was made from postoperative 1 month and selective suture removal was done in group II and III. The corneal astimatism was analyzed prospectively with corneal topography more than 1 year in all except 2 patients. The amout of corneal astigmatism in group I, II and III at postoperatie 1 month was 2.12D, 3.14D and 3.08D respectively (P>0.05, Kruskal-Willis test) and showed marked reduction upon postoperative 3 months. At postoperative 1 year, corneal astigmatism of each group was 2,62D, 1.49D and 2,18D respectively(P>0.05). The corneal astigmatism between keratoconus and other corneal disorders was not statistically ignificant. Interrupted suture induced least corneal astigmatism after keratoplasty compared to other suture methods even if there was no statistical significance.

Astigmatism after Penetrating Keratoplasty According to Suture Methods

A large amount of corneal astigmatism after penetrating keratoplasty is a common problem. The purpose of this study was to find out which is the best suture method to minimize the postoperative corneal astigmatism. Among 35 eyes there were 7 eyes in interrupted suture group, 14 eyes in continuous suture group, and 14 eyes in combined suture group. In order to minimize postoperative astigmatism selective suture removal was done in interrupted suture group or combined suture group, and suture tension adjustment was made in continuous suture group. At postoperative 20 months the mean astigmastism was 5.97D in interrupted suture group, 3.66D in continuous suture group and 2.87D in combined suture group, respectively. There was no statistical significance. In spite of statistical insignificance, the astigmatism of continuous or combined suture group after penetrating keratoplasty was smaller than that of interrupted suture group after penetrating keratoplasty.

Long-Term Follow-up Study after Superficial Temporal Artery-Middle Cerebral Artery Anastomosis plus Encephalomyosynangiosis for Moyamoya Disease

During the period from March 1990, through September 1993, 11 patients with moyamoya disease underwent superficial temporal artery(STA)-to-middle cerebral artery(MCA) anastomosis and encephalomyosynangiosis(EMS) bilaterally. The mean follow-up period was 30.6 months(range 17 to 42 months). The most frequent computed tomographic findings were intraventricular hemorrhage in adult patients and cortical infarction in pediatric patients. In all of the patients, confirmatory diagnosis could be made by angiography, and all had typical angiographic finding of moyamoya disease. According to angiographic classification by Suzuki, the most frequent phase was stage three. A modified continuous suture technique was used during anastomosis. The advantages of this microvascular suture technique are saving time for the surgical procedure, lessening bleeding from the anastomotic site and the ease and safety with which anastomosis can be achieved in the deep cranial cavity. Postoperatively, follow-up angiography was taken between 1 year and 2 years after operation. The angiography revascularization rate was 100%, excellent in 6, and good in 5. The typical postoperative angiography findings are as follows : 1) reduction of moyamoya vessels, 2) normalization or improvement of abnormal posterior circulation, 3) visualization of MCA territory through MCA-STA bypass, and 4) dilatation of STA. There were no major complication in patients with surgery, and no poor outcomes. These results indicate that the STA-MCA anastomosis and EMS in moyamoya disease can normalize cerebral circulation and reduce repeat ischemic attack and repeated bleeding.

The Use of Partial Continuous Sutures in Circumcision / 대한비뇨기과학회지

The skin of the penis is characterized by looseness and absence of adipose tissue, and the subcutaneous superficial blood vessels are easily recognized. We have tried preliminary ligation of these subcutaneous blood vessels at about 0.5cm proximal to incision line previous to the application of Gomco Clamp to prevent postoperative bleeding and to make good landmark for incision. This technique was applied in 34 cases and excellent results were obtained in all cases. We have experienced postoperative bleeding in pretty mant cases of circumcision especially in cases of Gomco Clamp applied.