Clinical effect of subcutaneous negative pressure suction with anti L incision in liver surgery / 局解手术学杂志

Objective To explore the clinical effect of subcutaneous negative pressure suction cosmetic suture with anti L incision in liver surgery.Methods A total of 140 patients who received liver surgery in general surgery department of our hospital from March 2015 to April 2016 were randomly selected,of which 70 cases received cosmetic suture with negative pressure drainage (observation group),the other 70 cases treated with conventional suture(control group).The repair times,the healing of the incision of two groups were observed and analyzed.Results Compared with the control group,the repair time and hospital stays of patients in observation group were significantly shorter than those of the control group,and the differences were statistically significant (P ＜ 0.01).Conclusion Cosmetic suture with negative pressure drainage is effective to shorten the repair time,reduce the incidence of incision fat liquefaction and infection,while ensuring the aesthetic level of the incision.

Focal cerebral ischemia model of middle cerebral artery in rabbits induced by the improved suture method / 中国脑血管病杂志

Objective To investigate the establishment of focal cerebral ischemia model in rabbits with the improved suture method.Methods A total of 45 healthy and clean adult New Zealand rabbits were divided into either a sham operation group (n =5) or a model group (n =40) using random number table method before modeling,and the sex was not limited.The self-made head ends of 2-0 fishing lines dipped in paraffin were used as the sutures.The external carotid artery was cut and inserted into a intracranial artery through the internal carotid artery and blocked the origin of middle cerebral artery.The neurological function score was performed after 6 h.The neurological deficit scores ≥2 was successful modeling.The rabbits were killed by anesthesia.The brain slices were stained with 2％ 2,3,5-triphenyl tetrazolium chloride solution.The infarct foci were observed.The diameters of suture head and the depth of suture insertion were compared in the model rabbits with successful modeling,failure,and death in the model group.Results There were 40 rabbits in the model group,six of them died,including 4 died of subarachnoid hemorrhage within 4 h after operation,and 2 died from anesthetic accident.The mortality rate was 15.0％.Seven rabbits failed,mainly because of cerebral vasospasm and the insertion depth of suture was insufficient.Twenty-seven had successful modeling,and the success rate was 67.5％.All the rabbits in the sham operation group survived.The diameter of the suture head and insertion depth in the successful modeling rabbits were compared with the death and failure outcome in rabbits.The difference was statistically significant (diameter:0.52 ± 0.14 mm vs.0.45 ±0.40 mm and 0.58 ±0.17 mm;depth:5.49 ±0.17 cm vs.6.04 ± 0.11 cm and 4.26 ±0.30 cm;all P ＜ 0.05).Conclusions The improved suture method can successfully prepare the focal cerebral ischemia model of middle cerebral artery in rabbits.The method is simple.Its repeatability and practicability are better.

A modified method for common carotid artery puncture in the establishment of a rat model of middle cerebral artery occlusion / 中国实验动物学报

Objective To compare the timeliness, success and mortality rates between the modified carotid artery puncture method ( MCAPM) and standard suture method ( SSM) in the establishment of rat model of a middle cerebral ar?tery occlusion ( MCAO) . Methods Thirty?two male rats were randomly and equally assigned into MCAPM group and SSM group. The MCAO models were established by inserting a thread into the common carotid artery ( CCA) . 24 h after modeling, the rats of the two groups were evaluated with Bederson neurological scores, and the modeling success rate and mortality rate were analyzed. Results The suture insertion times, success rates and mortality rates of the MCAPM vs. SSM groups were (82?3 ±17?4) s versus (164?6 ± 22?0) s (P0?05), and 6?25% versus 18?75% (P>0?05). Conclusions MCAPM can be used to establish the rat model of MCAO due to its simplicity, mild wound and feasibility.

Comparative study of inverting suture and 8-character-pattern suture after laparoscopic myomectomy / 局解手术学杂志

Objective To observe the effect analysis of inverting suture and 8-character-pattern suture after laparoscopic myomectomy for the operation and postoperative complications. Methods The data of of 142 patients with laparoscopic myomectomy were analyzed retro-spectively. According to the different suture methods,they were divided into inverting suture group (85 cases) with straight mattress inverting suture and 8-character-pattern suture group (57 cases). The operation time, intraoperative bleeding, postoperative complications between two groups were compared. Results The operation time and intraoperative bleeding of varus suture group were less than those of 8-character-pat-tern suture group, single tumor posterior uterine wall parts of operation time and intraoperative bleeding than patients with the anterior wall of the uterus and uterine bottom, 1 cases of pelvic related operation infection after operation in eight suture group,abdominal and pelvic mucosa adhesion in 2 cases,the complication rates between two groups were statistically difference (P<0. 05). Conclusion Laparoscopic myomec-tomy with direct mattress inverting suture can shorten operation time, play a good hemostasis in the operation and reduce the incidence of pel-vic infection and abdominal and pelvic mucosa adhesion.

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.

Clinical applications of buried-guiding-suture method in treatment of complications after nasal augmentation with silicone implant / 中华医学美学美容杂志

Objective To introduce a new method for the treatment of complications after nasal prosthesis.Methods 38 cases with complications after nasal prosthesis were treated by buried-guiding suture method.Results All the 38 patients with nasal prosthesis,such as skewed,floating and sinking mobile,entirely obtained good results.Conclusions The buried guiding suture method in the noninvasive and minimally invasive condition can make the prosthesis relative stability,make expanded extra cavity close adhesion,narrow,finally reaching the tightly wrapped.This method may provide an external force,so that the prosthesis oblique position is corrected,and maintained in a desired position,avoiding operation failure.The effect of this procedure is good,which is a clinical reference method.

Three level risk assessment for pancreatic fistula formation after distal pancreatectomy with a strategy for prevention.

Background: Distal pancreatectomy (DP) has a high post-operative morbidity predominantly due to pancreatic fistula though the mortality is very low. Data on distal pancreatectomy was reviewed to analyse the risk factors that contribute to this morbidity. Methods: Thirty three patients underwent distal pancreatectomy with sutured closure of the remnant, over a 5-year period between May 2006 and April 2011. Pancreatic fistula (PF) was defined according to the International Study Group on Pancreatic Fistula definition. Patient and surgical risk factors were subdivided as those reflecting a poorer pre-morbid status, those associated with increased complexity of surgery and those related to pancreas gland and were analyzed for incidence of pancreatic fistula. Results: Indications for DP included 16 (51.5%) pancreatic tumours, 13 (39.4%) chronic pancreatitis and 3 (9.1%) trauma. Spleen was preserved in 12 patients (36.4 %).There was no mortality while the morbidity rate was 45.5% (n=15). Incidence of pancreatic fistula was 30.3% (n=10); eight were grade A (80%) and two were grade C (20%). Incidence of clinically significant pancreatic fistulae was 6.1%. PF was significantly more common if the pancreatic duct was not identified (p=0.024) was significantly less with extensive peri-pancreatic adhesions (p=0.036). Conclusions: Identification and ligation of main pancreatic duct can help reduce the incidence of pancreatic fistulae. The identification of patients at high risk of developing a PF helps to implement prevention strategies.

Single needle running suture method for urethrovesical anastomosis during laparoscopic radical prostatectomy / 中华泌尿外科杂志

Objective To describe the single needle running suture method for the urethrovesi-cal anastomosis during laparoscopic radical prostatectomy(LRP). Methods Forty-five patients of prostate cancer underwent LRP with the single needle running suture method. The technique was initi-ated by performing a fixing suture at the posterior lip of bladder neck at 4 o' clock and tying the first knot. Another suture at the nearby position of the first suture was performed to leave the first knot outside. From 5 o' clock to 8 o' clock, sutures were performed every one o' clock to secure posterior approximation, then every two o'clock a suture. To avoid a loose anastomosis, lock sutures were per-formed every 3 sutures. After completing the full circumference, the needle was drawn at the 2 o' clock for the second knot. The needle was always driven full-thickness outside-in in the bladder neck and inside-out on the urethra. Any remaining leakage could be closed with additional interrupted su-tures. Results All urethrovesical anastomosis were completed successfully. The mean anastomosis time was 16 rain(from 12 to 25 min), and mean operative time was 132 rain (112 to 185 rain). The mean catheterization time was 9 d(7 to 14 d). Three temporal urinary leaks requiring prolonged cathe-terization were identified. Forty-four patients had total urinary control in 1 year postoperatively and no other short-term or persistent complication was found with a mean follow-up of 21 months. Conclu- sion The single needle running suture method could be a simple and safe method for urethrovesical anastomosis during LRP.

Double Eyelid Operation Using Continuous Buried Suture Method Avoiding Conjunctival Injury by a Newly Made Chalazion Forcep

Nowadays, nonincisional double eyelid operation is preferred by lots of patients and surgeons. There are a variety of suture methods but all the suture procedures-including continuous buried suture methods-in the literatures penetrate the conjunctivas. So due to the pain, surgeons had to infiltrate local analgesics into the conjunctiva. This horrifies the patients, gives pain, makes the eyelids and conjunctivas swollen, and sometimes interrupts the movements of the eyelids by affecting the levator palpabrae muscles. This condition could make the eyelid folds asymmetric. Authors changed the procedure by using a chalazion forcep with a small slit which allows the suture materials to get out and we could successfully perform the suture without penetrating the conjunctiva. So we could make double folds maintaining the patient's dynamic and static conditions very well since no direct local analgesics were needed for the conjunctivas, and the results were pretty satisfactory.

Double Eyelid Operation in Middle-aged Women by Buried Suture Method

Double eyelid operation is the most common cosmetic surgery in Asian. There are two procedures for the double eyelid operation: one is an incision method and the other is a suture(non- incision) method. The latter is classified into two categories: stitch method and buried suture method. The popular indications for the non-incision method are listed below (1) A dislike is shown for a procedure that may possibly leave conspicuous scars. (2) The relaxation of the skin and orbicular oculi muscle is not strong, and they retain some tension. (3) The deposition of subcutaneous fat is not very heavy. (4) A wide double eyelid line is not desired. (5) A weak double eyelid line is already present. So the plastic surgeon generally offer the incision method when the patient is older than the age of 35. But rarely aged woman wants the double eyelid operation by non-incision method because of short recovery time and less scar. From December 1999 to June 2003, we performed the double eyelid operation by non-incision method in 22 patients who are older than the age of 40 with selective indications. 16 patients (72.73%) were satisfied with their aesthetic results.

Double Eyelid Operation using Subconjunctival Buried Suture Method

Double eyelid operation is one of the most common aesthetic surgical procedure performed in Korea. In correlation with the cultural background and social changes, most patients prefer a nonincision method rather than an incision method at the present. Forty-two consecutive patients were operated on for creation of double eyelids, with the subconjunctival buried suture method through conjunctival approach, from June of 1999 to September of 2000. The choice of procedure was based on the age of the patient and the amount of subcutaneous fat and redundant skin. This method was especially advisable if the young patient wants not to leave any visible scar and rapid recovery. The follow-up period ranged from two months to one year. Of forty-two patients undergoing this procedure, three patients(7.1%) required reoperation because of asymmetry, disappearance of fold, and irrtation respectively. This method is similar to various ordinary nonincisional methods previously described except for subconjunctival buried suture. But authors could obtain better cosmetic result with the advantage of shorter operation time, less morbidity, no scarring, and natural look earlier in the appropriate candidates.

Various clinical applications of the continuous buried suture method: non-incision double eyelid operation

The double eyelid operation is one of the most common cosmetic surgery performed in orientals, and there are numerous studies about surgical procedures of that. In the case of appropriate candidates, the non-incision technique makes excellent cosmetic results, with the advantages of shorter operating time, less morbidity, less pain, no scarring and easy revision of shape. But, usually the non-incision technique is recommended in the cases with thin upper eyelid, small amount of orbital fat, less redundant skin of upper eyelid and in whom a wide fold is not desired so on. Therefore, the disadvantages of this method are that it cannot be applied to all patients. The postoperative complications are disappearance or faded fold, formation of cyst or lumps, asymmetry etc. and the incidence of these complications is slightly higher than those of the incisional method. In this study, the double eyelid operation using the continuous buried suture method was performed in 210 patients for formation of double eyelid from Jan. 1993 to Dec. 1995. In conclusion very good results can be obtained by the continuous buried suture method even in the cases of puffy upper eyelid. This method can make a double eyelid shape in the fashion the patient wants and can be a new indication for correction of unilateral double eyelid. This method is safe, satisfactory and take shorter postoperative recovery time and it can reduce the incidence of postoperative complications.

Pull - out Strength of Different Multiple Suturing Method of the Cruciate Ligament / 대한정형외과학회잡지

The aim of this study was to measure the immediate pull-out strengths by increasing the number of suture loops and to compare the immediate pull-out strengths of three different suturing techniques. In one group, the number of suture loops increased from 2 to 9 and the suturing technique of multiple loops through the proximal ligament stumps was used. The other group, the three different techniques were transverse, vertical, and criss-cross suture. The ultimate strength for the 2 loops was 16.62 (+/-6.7)N, for the 3 loops was 34.45 (+/-12.5)N, for the 4 loops was 54.80 (+/-17.7)N, for the 5 loops was 74.30 (+/-21.4)N, for the 6 loops was 102.49 (+/-13.5)N, for the 7 loops was 105.05 (+/-24.8)N, for the 8 loops was 129.50 (+/-76.1)N, for the 9 loops was 229.50 (+/-48.7)N. The transverse suture had a mean ultimate strength of 47.38 (+/-14.8)N, where-as the vertical suture failed at 76.94 (+/-26.4)N and the criss-cross suture at 101.82 (+/-25.7)N. Consequently, their strength can be improved by increasing the number of loops and we suggest that the criss-cross suture technique is reliable method for clinical use, because of high failure strength and wider apposition area of bone to ligament.