ABSTRACT
Paediatric age group is most vulnerable to trauma. Children often suffer facial injuries. Though many topical skin adhesives and strips are available in the market which have given excellent cosmetic results, deeper injuries especially along the lines of high tension need suturing both with buried and skin sutures. Different variety of sutures are available in the market which are used as per the choice of the surgeon. Children are more apprehensive when it comes to suture removal. So use of absorbable sutures in place of non-absorbable sutures in skin can save the children from this fear factor. MethodsA prospective study was done in the department of plastic surgery from May 2012 to Dec. 2013 with an objective of studying the outcome of plain catgut suture as skin sutures versus non-absorbable skin suture Nylon in facial trauma in the paediatric age group. Chromic catgut was used as buried suture in both groups. All the patients presenting in emergency department with facial trauma with age 10 years or less were included in the study. Skin sutures, where needed removal, were removed on 5th post-operative day followed by follow up on 7th post-operative day, 3rd month and 8th month during which cosmetic assessment of scar was done. 25 patients who presented first in emergency and fulfilled the study criteria were sutured with 5 - 0 chromic catgut buried sutures and skin suture used was 6 - 0 Nylon and this group was labelled group A. Next 25 patients who presented in emergency for suturing were sutured with 5 - 0 chromic catgut as buried and plain catgut as skin suture. This group was labelled as Group B. Cosmetic outcome was assessed on 7th post-operative day, 3rd month and 8th month by using Beusang E cosmetic scar assessment scale based on two parameters which included colour and texture of scar.1 Statistical analysis was done with continuous variables expressed as Mean ± S.D. and categorical variables were expressed as count (percentage). Chi-square was used to compare the categorical variables between groups or Fisher exact test was used. ResultsOn 7th post-operative day follow up, out of 50 patients, 25 patients (50 %) in whom nylon was used as skin suture, 4 patients (16 %) had mismatch of colour. All scars were smooth in texture. In rest 25 patients (50 %) in whom plain catgut was used as a skin suture, 1 (4 %) patient had mismatch of the colour. None of the patients had frank pus in both groups & hypertrophic scar was seen in one patient. On 3rd month follow up, Group A patients with nylon as skin suture, 1 (4 %) patient showed hypertrophic scar whereas in Group B (8 %) patients had hypertrophic scar. On 8th month follow up, both group A & B had colour mismatch of 12% with firm texture of scar in 8% patients. ConclusionsThere is no long-term differences in cosmetic outcomes and complication rates between absorbable catgut suture and commonly used nylon sutures in the repair of facial trauma in paediatric age groups. So, absorbable sutures are acceptable alternative to non-absorbable suture especially in paediatric age group, keeping in mind their apprehensive nature and fear of suture removal.
ABSTRACT
Background: Which are the different ways of stabilizing connective tissue grafts (CTGs) for root coverage and gingival augmentation by means of placement of sutures? There are various defined and undefined ways of stabilizing CTGs depending on experience and personal preferences. Most of the techniques profess use of absorbable sutures in separate interrupted fashion (sutures at the corners of the graft wherever possible). Aim: This paper describes a new suturing method, “the lingually-tied horizontal mattress contouring suture,” for stabilization of CTGs with or without epithelialized collar at the recipient site, for use with papilla retention and sparing techniques to treat marginal tissue recessions. Methods and Material: The suturing technique is described in detail. It can be indicated for good number of root coverage cases, with additional objectives of gingival augmentation, specifically developed for papilla sparing and papillary buccal de-epithelialization recipient site preparations. Results: Over a period of last 16 years this suturing technique showed promising results in terms of graft stabilization and survival. The main advantage of this technique lies in the use of cost-effective nonabsorbable sutures that usually retain some amount of tension on the soft tissues longer. Conclusion: The primary objective of the suturing technique, per se, is to stabilize the CTG firmly along the contours of the root surface and to expedite a very close adaptation to the interdental soft tissues as well. The secondary objective of the article or publication is to disseminate the knowledge acquired through long periods of performance and observation for the benefit of the periodontal community as whole. Further validation is advocated.
ABSTRACT
OBJECTIVES: The aim of the study was to compare wound healing complications following the use of either absorbable or non-absorbable sutures for skin closure in cleft lip repair. MATERIALS AND METHODS: This was a randomized controlled trial conducted at the Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi Araba, Lagos State, Nigeria. Sixty subjects who required either primary or secondary cleft lip repair and satisfied all the inclusion criteria were recruited and randomized into two groups (Vicryl group or Nylon group). The surgical wounds in all subjects were examined on 3rd, 7th, and 14th postoperative days (POD) for presence or absence of tissue reactivity, wound dehiscence, and local wound infection. RESULTS: Hemorrhage, tissue reactivity, wound dehiscence, and local wound infection were identified as wound healing complications following cleft lip repair. The incidence of postoperative wound healing complications on POD3 was 33.3%. Tissue reactivity was more common throughout the evaluation period with the use of an absorbable (Vicryl) suture compared to a non-absorbable (Nylon) suture, although the difference was statistically significant only on POD7 (P=0.002). There were no significant differences in the incidences of wound dehiscence and infection between the two groups throughout the observation period. CONCLUSION: There were no statistically significant differences in the incidences of wound dehiscence and surgical site wound infection following the use of either Vicryl or Nylon for skin closure during cleft lip repair. However, more cases of tissue reactivity were recorded in the Vicryl group than in the Nylon group on POD7. Particular attention must be paid to detect the occurrence of wound healing complications, most especially tissue reactivity, whenever a Vicryl suture is used for skin closure in cleft lip repair.
Subject(s)
Cleft Lip , Hemorrhage , Hospitals, Teaching , Incidence , Nigeria , Nylons , Polyglactin 910 , Skin , Surgery, Oral , Sutures , Wound Healing , Wound Infection , Wounds and InjuriesABSTRACT
Rifaximin as a representative of the non-absorbable antibiotics,has special effects and wide application prospects in treatments of acute intestinal tract infections,irritable bowel syndrome,inflammatory bowel disease,diverticulosis of colon,hepatic encephalopathy and so on.This paper reviews the advances on clinical efficacy and safety of rifaximin to provide reference for clinical use.
ABSTRACT
This study was performed to compare the clinical effectiveness of two regenerative techniques for class II furcation involvements in human: a combination of bone grafts with PRP vs. GTR with bone grafts. The e-PTFE group was treated with non-absorbable membrane and bone grafts, the PRP group was treated with PRP and bone grafts Pocket depth, clinical attachment level, and gingival recession were measured at baseline and postoperative 6 months. Vertical and horizontal furcation depth were measured by re-entry surgeries at 6 months post-treatment Both groups were statistically analyzed by Wilcoxon signed Ranks Test & Mann-whitney Test using SPSS program (5% significance level). The results were as follows: 1. The change of pocket depth, clinical attachment level, vertical furcation depth and horizontal furcation depth in both groups was decreased significantly at 6 months than at baseline. (p<0.05) 2. The change of gingival recession in both groups was increased significantly at 6 months than at baseline. (p<0.05) 3. The change of alveolar crest absorption in both groups was increased at 6 months than at baseline but there were no statistically significant differences. 4. The change of pocket depth, clinical attachment level, vertical furcation depth and horizontal furcation depth in both groups was increased significantly at 6 months, but there were no statistically or clinically significant differences with both groups. 5. The change of gingival recession and alveolar crest absorption in both groups was increased at 6 months, but there were no statistically or clinically significant differences with both groups. In conclusion, the use of bone graft with PRP or GTR technique improved clinical index of the soft and hard tissue in mandibular class II furcation involvement but there were no statistically or clinically significant differences between bone graft with PRP and GTR technique.
Subject(s)
Humans , Absorption , Gingival Recession , Guided Tissue Regeneration , Membranes , Platelet-Rich Plasma , TransplantsABSTRACT
PURPOSE: The purpose of this study is to evaluate the effectiveness on decrease of the exposure rate of Medpor(R) implant (high-density porous polyethylene) when the suture material is left permanently without removal after continuous vertical suture of conjunctiva and Tenon's capsule with non-absorbable material, polypropylene suture (Prolene(R)). METHODS: We performed 66 cases of Medpor(R) orbital implantation in conjunction with enucleation, evisceration, or secondary orbital implantation between November 1997 and February 2002, and reviewed the charts of patients retrospectively. We divided 66 cases into 2 groups; One is Polypropylene group (P group, 30 eyes), in which conjunctiva and Tenon's capsules were sutured with double shoe string technique by 5-0 polypropylene sutures in one layer, and the other is control group (36 eyes), in which conjunctiva and Tenon's capsules were sutured by 5-0 polyglactin (Vicryl(R)) in separate layer, or Tenon's capsules were sutured by 5-0 Vicryl(R) and conjunctivae were 7-0 silk. We compared P group with control group with regard to the exposure rates, irritations, conjunctivitis and assessed covering of polypropylene suture by conjunctival epithelization. RESULTS: In control group, 5 of 36 eyes (13.8%) had the exposures of Medpor(R) implants, 21 eyes (58.3%) had the irritations, and 10 eyes had conjunctivitis. But, there was no exposure of Medpor(R) implants in all cases of P group, only two of 30 eyes had the irritations, and 3 eyes had conjunctivitis. There were significant differences between the two groups in the rates of exposure and irritations, but in the eyes with conjunctivitis, there was no significant difference between the two groups (Table 5, chi-square test). After 2 months of operation, the wound surfaces were smooth with complete covering of polypropylene suture by appropriate conjunctival epithelization. CONCLUSIONS: Continuous vertical suturing of conjunctiva and Tenon's capsule with non-absorbable polypropylene suture (Double shoestring technique) substantially reduced the exposure of Medpor(R) implant in addition to less inflammations, irritations and more comfortability. We concluded that the suture materials and methods must be considered as the important causes of exposure in enucleation or evisceration using proper Medpor(R) implant.