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1.
Rev. bras. ortop ; 57(3): 496-501, May-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1388022

ABSTRACT

Abstract Objective To evaluate the results obtained from the surgical treatment of malleolar ankle fractures associated with distal tibiofibular syndesmosis (DTFS) injury submitted to conventional surgical procedure for fracture fixation and DTFS fixation by suture button (SB). Methods Forty-nine patients were retrospectively evaluated, with a mean age of 45 years old and a mean follow-up of 34.1 months. Clinical and functional evaluation was based on the visual analogue scale (VAS) and on the American Foot and Ankle Society Score (AOFAS) for ankle and hindfoot, return to routine activities, and return to sport. Results The postoperative mean AOFAS and VAS were, respectively, 97.06 (confidence interval [CI 95%: 95.31-98.81] and 0.16 [CI 95% 0,04 - 0,29]. All patients returned to previous daily activities, and only 12 showed some residual symptom. There was no postoperative instability in any patient. Forty-six patients returned to sports activities and, of these, only 1 did not return to the level prior to the injury. Only two patients presented SB-related alterations. There was no report of dissatisfaction. Conclusion In malleolar fractures of the ankle with DTFS injury, the fixation of syndesmosis with SB demonstrated excellent postoperative results. Level of Evidence IV, retrospective case series.


Resumo Objetivo Avaliar os resultados obtidos do tratamento cirúrgico das fraturas maleolares do tornozelo associadas a lesão da sindesmose tibiofibular distal (STFD) submetidas a procedimento cirúrgico convencional de fixação da fratura e fixação da STFD pelo suture button (SB). Métodos Avaliou-se retrospectivamente 49 pacientes com uma média de idade de 45 anos e seguimento médio de 34,1 meses. A avaliação clínica e funcional foi baseada na escala visual analógica (EVA) e na escala American Foot and Ankle Society Score (AOFAS, na sigla em inglês) para tornozelo e retropé, retorno às atividades da rotina e retorno ao esporte. Resultados As médias pós-operatórias das escalas AOFAS e EVA foram, respectivamente, 97,06 (índice de confiança [IC 95%: 95,31 - 98,81] e 0,16 [IC 95% 0,04 - 0,29]. Todos os pacientes retornaram às atividades prévias do cotidiano, sendo que apenas 12 apresentaram algum sintoma residual. Não se verificou instabilidade pós-operatória em nenhum paciente. Ao todo, 46 pacientes retornaram às atividades desportivas e, destes, apenas 1 não retornou ao nível prévio à lesão. Apenas dois pacientes apresentaram alterações relacionadas ao SB. Não houve relato de insatisfação. Conclusão Em fraturas maleolares do tornozelo com lesão da STFD, a fixação da sindesmose com o SB demonstrou excelentes resultados pós-operatórios. Nível de Evidência IV, série de casos retrospectiva.


Subject(s)
Humans , Male , Female , Outcome Assessment, Health Care , Aftercare , Ankle Fractures/surgery , Ankle Fractures/rehabilitation , Ankle Joint/surgery
2.
Rev. bras. ortop ; 57(3): 524-528, May-June 2022. graf
Article in English | LILACS | ID: biblio-1388021

ABSTRACT

Abstract The first meniscal suture was performed in 1885 and took about a century to become popular. Currently, all-inside meniscal repair devices are widely used. However, this technique presents the disadvantage of being a method dependent on specific devices, presenting a higher cost than other techniques. This high cost limits the use of such a technique in many locations. The objective of the present technical note is to describe a microinvasive meniscal suture technique as a modification of the all-inside technique, using a disposable 40 x 12 mm procedure needle. The authors believe that the proposed modification to the technique can make it more popular, enabling the use of the microinvasive technique in places with limited resources.


Resumo A primeira sutura meniscal foi realizada em 1885 e levou cerca de um século para tornar-se popular. Atualmente, os dispositivos de reparo meniscal all-inside são amplamente utilizados. Contudo, esta técnica apresenta a desvantagem de ser um método dependente de dispositivos específicos, apresentando um custo superior aos de outras técnicas. Este valor elevado limita o uso de tal técnica em muitos locais. O objetivo da presente nota técnica é descrever uma técnica de sutura meniscal microinvasiva, como uma modificação da técnica all-inside, utilizando uma agulha descartável de procedimento de 40 x 12 mm. Os autores acreditam que a modificação proposta para a técnica pode torná-la mais popular, possibilitando o uso da técnica microinvasiva em locais com recursos limitados.


Subject(s)
Humans , Arthroscopy , Suture Techniques , Minimally Invasive Surgical Procedures , Tibial Meniscus Injuries/surgery
3.
Article in Chinese | WPRIM | ID: wpr-934087

ABSTRACT

Clinical data of 62 patients with gastrointestinal submucosal tumors (diameter ≥1 cm) who were treated with kissing suture by single-channel endoscope after endoscopic full-thickness resection (EFR) in the First Affiliated Hospital of Zhengzhou University from February 2017 to May 2019 were analyzed retrospectively to evaluate the clinical value of kissing suture technique by single-channel endoscope in defect closure after EFR. All the post-EFR defects were successfully closed (100%). No postoperative anastomotic leakage or other serious complications occurred. The mean maximum diameter of lesions was 3 cm (ranged 1-7 cm), and 13 (21%) of them were greater than or equal to 5 cm.The mean number of clips used was 25.7 (ranged 7-78). The mean procedure time was 168 min (ranged 44-300 min), and the mean suture time was 63 min (ranged 13-211 min). The mean postoperative hospital stay was 7 days (ranged 4-12 days). Endoscopic reexamination 3-6 months after operation showed that all wounds healed well. Kissing suture method by single-channel endoscope is a safe, effective, easy and feasible for closing gastrointestinal defect after EFR.

4.
Article in Chinese | WPRIM | ID: wpr-932329

ABSTRACT

Objective:To compare the mid-to long-term clinical outcomes between suture anchor and simple suture for acute injury to lateral ankle ligament (cauda equina tear near the insertion).Methods:This retrospective study included 146 patients (professional and semi-professional athletes) who had been treated for acute injury to lateral ankle ligament (cauda equina tear near the insertion) at Department of Sports Medicine, The Third Hospital Affiliated to Peking University from June 2007 to May 2017.They were 101 males and 45 females, with an age of (27.1±10.3) years (from 12 to 62 years). Depending on ligament repair techniques, the patients were divided into a suture anchor group of 81 cases subjected to reconstruction of the torn ligament with a 1.8 mm suture anchor, and a simple suture group of 65 cases subjected to direct suture of the torn ligament with a braided thread. The 2 groups were compared in terms of visual analog scale (VAS) pain scores, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores and Tegner scores at preoperation and the last follow-up, time and level of postoperative motion recovery, proportion of limited joint motion, incidence of re-sprain and patient satisfaction.Results:There was no significant difference in the preoperative general data between the 2 groups, showing they were comparable ( P>0.05). The mean follow-up duration was (46.1±14.1) months (from 36 to 132 months). The VAS pain score, AOFAS ankle-hindfoot score and Tegner score at the last follow-up were significantly improved than those before operation in all the patients ( P<0.05). Postoperatively, there was no significant difference between the 2 groups in VAS pain score, AOFAS ankle-hindfoot score, Tegner score, incidence of re-sprain or proportion of limited joint motion ( P> 0.05). The suture anchor group was significantly better than the simple suture group in the level of postoperative motion recovery (92%±13% versus 89%±13%) and time of postoperative motion recovery [(4.2±1.1) months versus (4.6±1.0) months] ( P<0.05). Conclusions:Ligament repair, either by suture anchor or by simple suture, is a reliable procedure for patients with high sports demands after severe acute injury to the lateral ankle ligament. Compared with simple suture, suture anchor may accelerate postoperative motion recovery to the pre-injury level.

5.
Article in Chinese | WPRIM | ID: wpr-931676

ABSTRACT

Objective:To investigate the efficacy of laparoscopic myomectomy with a baseball-style suture technique in the treatment of hysteromyoma.Methods:Sixty patients with hysteromyoma who received treatment in the Department of Obstetrics and Gynecology, The Second People's Hospital of Hefei, China between July 2018 and July 2020 were included in this study. They were randomly assigned to observation and control groups with 30 patients per group. The observation group was subjected to laparoscopic myomectomy with a baseball-style suture technique. The control group was given laparoscopic myomectomy with a continuous suture technique. Intraoperative indices and postoperative complications were compared between the two groups.Results:Operative time in the observation group was significantly shorter than that in the control group [(98.06 ± 35.41) minutes vs. (119.39 ± 33.65) minutes, t = 2.39, P < 0.05]. Intraoperative blood loss in the observation group was significantly less than that in the control group [(28.33 ± 9.56) mL vs. (46.17 ± 13.08) mL, t = 6.36, P < 0.05]. The percentage of intraoperative needle-hole bleeding in the observation group was significantly lower than that in the control group [16.67% (5/30) vs. 46.67% (14/30), χ 2 = 6.23, P < 0.05). The time to anal exhaust and the time to drainage in the observation group were (19.21 ± 5.77) hours and (59.07 ± 18.85) hours, respectively, which were significantly shorter than (25.39 ± 9.65) hours and (77.22 ± 27.07) hours in the control group ( t = 3.01, 3.02, both P < 0.05). The incidence of postoperative fever in the observation group was significantly lower than that in the control group [3.33% (1/30) vs. 26.67% (8/30), χ 2 = 4.70, P < 0.05]. Conclusion:Laparoscopic myomectomy with a baseball-style suture technique is highly effective on hysteromyoma. It can improve the safety of operation and has a great clinical value.

6.
Article in Chinese | WPRIM | ID: wpr-931165

ABSTRACT

Objective:To investigate the application value of Prolene thread-needle continuous suture method in pancreaticojejunostomy pancreaticoduodenectomy.Methods:The clinical data of 80 patients with preoperative diagnosis of periampullary tumors undergoing pancreaticoduodenectomy who were admitted to Shanxian Central Hospital of Heze City from January 2017 to December 2020 were selected. According to the different methods of anastomosis, 80 patients were divided into A group and B group, each group with 40 patients, the patients in A group were performed pancreatic duct-mucosal anastomosis and the patients in B group were performed Prolene thread-needle continuous suture. The preoperative clinical data, operation-related data, postoperative complications in two groups were compared.Results:There were no statistically significant differences between the two groups in clinical data such as gender, age, albumin level, pancreatic duct diameter, combined underlying diseases, preoperative bilirubin, admission symptoms, preoperative biliary drainage and tumor location ( P>0.05).The operation time, intraoperative blood loss, postoperative drainage, operation durationand postoperative hospital stay in B group were lower than those in A group : (353.64 ± 95.28) min vs. (395.38 ± 110.29)min, (330.19 ± 100.27) ml vs. (397.43 ± 105.97) ml, (330.57 ± 110.68) ml vs. (376.18 ± 94.73) ml, (20.74 ± 8.08) min vs. (31.06 ± 7.83) min, (18.72 ± 6.02) d vs. (23.79 ± 7.41) d, the differences were statistically significant ( P<0.05). The incidence of complications such as pancreatic leakage, pancreatic fistula, abdominal infection, lung infection, biliary fistula and delayed gastric emptying in B group were lower than those in A group : 10.0%(4/40) vs. 20.0%(8/40), 7.5%(3/40) vs. 20.0%(8/40), 2.5%(1/40) vs. 12.5%(5/40), 0 vs. 7.5%(3/40), 5.0%(2/40)vs. 17.5%(7/40), 7.5%(3/40) vs. 17.5%(7/40), the differences were statistically significant ( P<0.05). Conclusions:Prolene thread-needle continuous suture method in pancreaticojejunostomy pancreaticoduodenectomy has the characteristics of simple operation, effective shortening of operation time, reliable anastomosisand can reduce the risk of postoperative pancreatic fistula complications.

7.
Article in Chinese | WPRIM | ID: wpr-928259

ABSTRACT

OBJECTIVE@#To investigate the clinical effect of scar tissue suture at the broken end of Achilles tendon after gastrocnemius aponeurosis release in the treatment of chronic Achilles tendon rupture.@*METHODS@#The clinical data of 17 patients with old achilles tendon rupture treated from January 2017 to December 2019 were analyzed retrospectively, including 15 males and 2 females, aged 26 to 53 years with an average of (35.2±11.6) years old, and the time from injury to operation was 37 to 92 days with an average of (49.3±13.3) days. Myerson's classification included 6 cases of typeⅡ and 11 cases of typeⅢ. The defect of the broken end of Achilles tendon was 2 to 5 cm with an average of(4.1±1.5) cm after partial scar tissue was removed. All patients were treated with gastrocnemius aponeurosis, appropriate excision of scar tissue at the broken end of Achilles tendon and direct suture. The continuity and healing of Achilles tendon were evaluated by color Doppler ultrasound 3 months after operation. The ankle plantar flexor strength was measured by ankle plantar flexor strength tester before operation and 1 year after operation. American Orthopaedic Foot and Ankle Society ankle hindfoot score (AOFAS) and Achilles tendon rupture score were used before operation and 1 year after operation Achilles tendon total fracture score (ATRS) was used to evaluate the clinical rehabilitation of Achilles tendon rupture.@*RESULTS@#All patients were followed up for 12 to 18 months with an average of(13.6±1.8) months. The surgical incision healed in stageⅠ. Color Doppler ultrasound showed good continuity of Achilles tendon, local Achilles tendon slightly thickened and irregular fiber direction. The ankle plantar flexor force (92.2±3.9) N at 1 year after operation was significantly higher than that before operation (29.5±4.2) N (P<0.05);One year after operation, the AOFAS(91.20±3.30) was significantly higher than that before operation (42.20±4.40)(P<0.05);the ATRS (90.70±3.00) was significantly higher than that before operation(40.00±2.90)(P<0.05).@*CONCLUSION@#The gastrocnemius aponeurosis release combined with scar suture of Achilles tendon end is an effective technique for the treatment of chronic Achilles tendon rupture, avoid injury to hallux flexor longus or flexor digitorum longus, with the plantar flexor muscle strength of the ankle was recovered well, is an effective method to treat chronic Achilles tendon rupture.


Subject(s)
Achilles Tendon/surgery , Adult , Aponeurosis , Cicatrix , Female , Humans , Male , Middle Aged , Retrospective Studies , Rupture/surgery , Sutures , Treatment Outcome , Young Adult
8.
Rev. bras. ginecol. obstet ; 43(9): 655-661, Sept. 2021. tab
Article in English | LILACS | ID: biblio-1351776

ABSTRACT

Abstract Objective To describe the clinical experience with the B-Lynch technique in the management of postpartum hemorrhage as well as the factors related to the indication of the technique and to present the success rates of the application of the B-Lynch technique. Methods Observational, retrospective, cross-sectional, and analytical study. Patient data was obtained through the study of medical records. The study population comprised of patients who underwent hemostatic suture using the B-Lynch technique, including 104 patients within the period from January 1, 2005, to December 31, 2019. Results Of the total of 104 patients, 82.7% did not present any complications. Blood transfusion and intensive care unit admission were the most prevalent complications, with 13.5% and 15.4%, respectively. Only 1% of the patients had puerperal and surgical site infections. The factors most related to the application of the technique were the presence of previous cesarean section (30.8%), use of oxytocin (16.3%), and pre-eclampsia (11.6%). Puerperal hysterectomy was performed in 4.8% of the patients due to failure of the method. Conclusion The clinical experience with the B-Lynch technique was satisfactory since it presented few complications, with excellent results in hemorrhagic control. Previous cesarean section, the use of oxytocin, and preeclampsia stood out as factors related to the indication of the application of the technique, and the success rate in controlling postpartum hemorrhage was 95.2%.


Resumo Objetivo Descrever a experiência clínica com a técnica de B-Lynch no manejo da hemorragia pós-parto e os fatores relacionados à indicação da técnica bem como apresentar as taxas de sucesso da aplicação da técnica de B-lynch. Métodos Estudo observacional, retrospectivo, de corte transversal e analítico. Os dados foram obtidos por estudo de prontuário. A população do estudo foi constituída de pacientes submetidas à sutura hemostática com a técnica de B-Lynch, sendo incluídas 104 pacientes dentro do período de 01 de janeiro de 2005 a 31 de dezembro de 2019. Resultados Do total de 104 pacientes, 82,7% não apresentaram qualquer complicação. A transfusão de sangue e a internação na UTI foram as complicações mais prevalentes, com 13,5% e 15,4%, respectivamente. Apenas 1% teve infecção puerperal e do sítio cirúrgico. Os fatores mais relacionados com a aplicação da técnica foram a presença de cesárea anterior (30,8%), uso de ocitocina (16,3%) e pré-eclâmpsia (11,6%). A histerectomia puerperal foi realizada em 4,8% das pacientes por falha do método. Conclusão A experiência clínica com a técnica de B-Lynch foi satisfatória, pois apresentou poucas complicações, com excelentes resultados no controle hemorrágico. A cesárea anterior, o uso de ocitocina e a pré-eclâmpsia se destacaram como fatores relacionados à indicação da aplicação da técnica. A taxa de sucesso avaliada foi de 95,2%.


Subject(s)
Humans , Female , Pregnancy , Postpartum Hemorrhage/surgery , Cesarean Section/adverse effects , Cross-Sectional Studies , Retrospective Studies , Suture Techniques
9.
Rev. chil. ortop. traumatol ; 62(1): 19-26, mar. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1342598

ABSTRACT

OBJETIVO:Comparar el promedio de curva de presión de contacto y el porcentaje de presión de contacto residual final en la interfase tendón-huella de una reparación transósea (TO) realizada con nudos cruzados y una configuración Mason-Allen modificada (MAM). MÉTODOS: Se utilizaron ocho hombros de cordero para simular una rotura de manguito rotador. Se midió la presión con un sensor digital. Se registró la presión basal durante la aplicación de carga cíclica y al final de la intervención. Se compararon dos reparaciones: dos túneles TOs con nudos cruzados (TOCs) (n » 4) y dos puntos MAMs (n » 4) utilizando suturas MaxBraid #2 (Zimmer Biomet, Warsaw, IN, EEUU). Se realizaron 1.000 ciclos, con una frecuencia de 2 Hz y una carga de 30 N. Se utilizó el test de t de Student, y se consideraron significativos valores de p < 0,05. RESULTADOS: El promedio de curva de presión de contacto en las piezas que fueron reparadas con suturas TOCs fue de 86,01 8,43%, mientras que con MAM fue de 73,28 12,01% (p < 0,0004). El promedio del porcentaje residual al final del ciclado fue de 71,57% para suturas TOCs y de 51,19% para MAM (p < 0,05). CONCLUSION: La reparación TOC presenta mayor promedio de curva de presión de contacto y mayor porcentaje de presión de contacto residual final en la interfase tendón-huella que la reparación con sutura MAM luego de carga cíclica estandarizada, lo que podría traducirse en una mejor cicatrización del tendón. NIVEL DE EVIDENCIA: Estudio de ciencia básica.


OBJECTIVE: To compare the average contact pressure curve and the percentage of final residual contact pressure at the tendon-footprint interphase of a transosseous (TO) repair performed with crossover sutures or a modified Mason-Allen (MMA) configuration. METHODS: Eight lamb shoulders were used to simulate a rotator cuff tear. The pressure was measured with a digital sensor. The baseline pressure was recorded during the application of the cyclic load and at the end of the intervention. Two repairs were compared: 2 crossover TO (CTO) sutures (n » 4) and 2 MMA sutures MMA (n » 4), using MaxBraid #2 (Zimmer Biomet, Warsaw, IN, US) sutures. A thousand cycles were performed, with a frequency of 2 Hz and a 30-N load. The Student t-test was used, and significance was set at p < 0.05. RESULTS: The average contact pressure curve was of 86.01 8.43% for parts repaired with CTO sutures, and of 73.28 12.01% for those repaired with MMA sutures (p < 0.0004). The mean residual percentage at the end of cycling was of 71.57% for CTO sutures, and of 51.19% for MMA sutures (p < 0.05). CONCLUSION: The CTO repair shows a higher average contact pressure curve and a higher percentage of final residual contact pressure at the tendon-footprint interphase than the MMA suture repair after standardized cyclic loading, potentially resulting in improved tendon healing. LEVEL OF EVIDENCE: Basic Science Study.


Subject(s)
Animals , Pressure , Suture Techniques , Rotator Cuff Injuries/surgery , Arthroscopy , Tendon Injuries/surgery , Sheep , Shoulder Injuries/surgery
10.
Article in Chinese | WPRIM | ID: wpr-909198

ABSTRACT

Objective:To systematically evaluate manual suture versus mechanical anastomosis in esophagojejunostomy, two methods of digestive tract reconstruction after laparoscopic total gastrectomy. Methods:A computer-based online search of PubMed, CBM, Wanfang database and CNKI database was performed to retrieve clinical studies related to manual suture (manual suture group) and mechanical anastomosis (mechanical anastomosis group) in esophagojejunostomy after laparoscopic total gastrectomy published between January 2015 and October 2020. The quality of eligible literature was evaluated and data were extracted for meta-analysis using Review Manager 5.4 software.Results:Four clinical studies involving 746 patients were included in the final analysis. Meta-analysis results revealed that there was no significant difference in operative time between manual suture and mechanical anastomosis methods [ MD = 8.32, 95% CI (-5.94, 22.57), P > 0.05]. The intraoperative blood loss in manual suture group was significantly less than that in mechanical anastomosis group [ MD = -9.54, 95% CI (-15.54, -3.55), P < 0.05]. The time to exhaust in the manual suture group was shorter than that in the mechanical anastomosis group [ MD = -0.38, 95% CI (-0.59, -0.18), P < 0.05]. The length of hospital stay in the manual suture group was less than that in the mechanical anastomosis group [ MD = -0.88, 95% CI (-1.23, -0.54), P < 0.05]. The incidence of anastomotic leakage in the manual suture group was significantly lower than that in the mechanical anastomosis group [ OR = 0.23, 95% CI (0.06, 0.93), P < 0.05]. The incidence of anastomotic stenosis in the manual suture group was significantly lower than that in the mechanical anastomosis group [ OR = 0.14, 95% CI (0.04, 0.54), P < 0.05]. Conclusion:After total gastrectomy, continuous suture of oesophago-jejuno ends with barbed threads under laparoscopy is safer and less expensive and needs less time to postoperative recovery and shorter length of hospital stay compared with mechanical anastomosis.

11.
Article in Chinese | WPRIM | ID: wpr-912655

ABSTRACT

Objective:To explore the training methods to improve the cosmetic suture technique of junior surgeons.Methods:The training course of cosmetic suture techniques was carried out for junior residents such as plastic surgery professional graduate students and standardized training residents, through the study of the basic knowledge of cosmetic suture and the practical training of minimally invasive principles, to help them master cosmetic suture techniques systematically for the need of future clinical practice. Compared with the level of operation skills before and after cosmetic suture training in different groups (graduate students of plastic surgery and other majors, standardized training residents of plastic surgery and other majors), the residents' performance had been significantly improved. The incisions healing after half a year follow-up in cases they sutured were observed.Results:After cosmetic suture training, the suture skills of the students were significantly improved, and there was a significant correlation with the time of clinical practice. The incidence of incisions inflammation and postoperative scar formation in the cases sutured by the students with practice for 6 months was significantly lower than those for 1 month (6.42% vs 21.67%, 1.13% vs 5.56% respectively).Conclusions:The training of cosmetic suture techniques is very important to improve the professional ability of junior residents in plastic and cosmetic surgery, and it needs a long time practice to master the suture skills.

12.
Article in Chinese | WPRIM | ID: wpr-888303

ABSTRACT

OBJECTIVE@#To observe and compare the clinical outcomes between arthroscopic modified Mason-Allen repair and suture-bridge repair for medium-size rotator cuff tears.@*METHODS@#From January 2017 to January 2018, 22 patients with medium-size rotator cuff tears underwent arthroscopic modified Mason-Allen repair. There were 9 males and 13 females with an average age of (57.14±10.26) years. From February 2018 to January 2019, 20 patients with medium-size rotator cuff tears underwent arthroscopic suture-bridge repair. There were 6 males and 14 females with an average age of (57.75±7.57) years. The preoperative and postoperative clinical function was assessed by American Shoulder and Elbow Surgeons (ASES) and Constant score system. The healing status of repaired rotator cuff was assessed using MRI.@*RESULTS@#All patients were followed up, and the duration ranged from 24 to 33 months, with a mean of (26.38±2.29) months. In modified Mason-Allen group, AS###ES score and Constant score increased from (45.22±7.58) and (58.72±9.26) preoperatively to (96.89±3.49) and (93.18± 3.20) postoperatively. In suture-bridge group, ASES score and Constant score increased from(47.33±7.50) and (60.05±11.76) scores to (97.58±3.43) and (93.85±3.15). There were no significant differences in ASES score and Constant score between the two groups before and after operation. There were no significant differences in rotator cuff healing between the two groups.@*CONCLUSION@#Both arthroscopic modified Mason-Allen and suture-bridge repair for treatment of medium-size rotator cuff tears could obtain good clinical outcomes, and there were no significant differences in clinical outcomes between the two techniques.


Subject(s)
Aged , Arthroscopy , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Rotator Cuff/surgery , Rotator Cuff Injuries/surgery , Suture Techniques , Sutures , Treatment Outcome
13.
Article in Chinese | WPRIM | ID: wpr-934463

ABSTRACT

Objective:To investigate the effect and necessity of aesthetic suture techniques training in improving the suture quality of non-plastic surgeons.Methods:The well-planned aesthetic suture techniques training programs were run in non-plastic surgery senior residents and attending surgeons at Peking University People's Hospital from January 2017 to January 2019. There were 120 senior residents and attending surgeons included (aged from 25-32 years, average 28.9 years, with 66 males and 54 females). Mixed teaching methods were used such as video shows, lectures, surgery live show and scenario simulation. Baseline tests were taken before the training. Suture quality tests were taken when the trainings came to the end. Self-assessments were carried out both before and after the trainings.Results:Eight rounds of aesthetic suture techniques training were accomplished and 120 trainees were included in all. One hundred and two trainees passed the test while eight failed, while 10 trainees were absent in some courses or the final test. The passing rate was 85.0%. The scales of suture tools and material selection, incision design, subcutaneous tissue suture quality, tension relaxation, aesthetic suture appearance, and flexibility of different suture techniques were sharply improved after the training in both subjective and objective assessments.Conclusions:The aesthetic suture techniques training is effective in improving the suture quality of non-plastic surgeons, which is worthy to generalize in resident training.

14.
Article in Chinese | WPRIM | ID: wpr-879381

ABSTRACT

OBJECTIVE@#To compare therapeutic efficacy of modified single-needle arthroscopic repair technique and Fast-Fix technique in repairing longitudinal meniscus injuries.@*METHODS@#From July 2016 to July 2017, patients with longitudinal meniscus injuries who underwent meniscal repair surgery were retrospectively analyzed. Ninety-one patients treated with modified single-needle technique and 77 patients were treated with Fast-Fix technique, the average age were (26.7±7.6) and (27.9±6.1) years old respectively, the average lengths of follow-up were (32.5±9.2) and (33.2±11.9) months, respectively. Operation cost, suture time, intraoperative failure rate and postoperative failure rate were used as clinical outcomes, MRI of knee joint was used as main diagnosis and evaluation basis; 2000 IKDC subjective score, Lysholm score and Tegner activity scale were compared between two groups preoperatively, 12 months after operation and at the latest follow-up. Intraoperative and postopertaive complications were observed.@*RESULTS@#Compared with Fast-Fix group, patients in modified single-needle technique group had lower operation costs [(645.7±133.1 vs.(12 184.8±4 709.8), @*CONCLUSION@#Modified single-needle arthrscopicrepair technique could achieve the similar therapeutic efficacy as Fast-Fix technique, and it has advantageds of simple opertion and more economical. This study recommends clinical application of modified single-needle arthrscopic repair technique in treating meniscus injuries.


Subject(s)
Adult , Arthroscopy , Humans , Knee Injuries/surgery , Menisci, Tibial/surgery , Retrospective Studies , Suture Techniques , Tibial Meniscus Injuries/surgery , Treatment Outcome , Young Adult
15.
Article in English | LILACS, BBO | ID: biblio-1250445

ABSTRACT

ABSTRACT Objective: To compare and assess the primary and secondary closure techniques following extraction of impacted third molars for post-operative complications. Material and Methods: In total, 30 patients ranging between 18-30 years of age and of either sex who had bilaterally impacted mandibular third molars were randomly selected. Split mouth study method was used so that the participants served as their own control. Group 1 consisted of primary closure of left mandibular impacted third molars and Group 2 consisted of secondary closure of right mandibular impacted third molars. Basement evaluations were recorded for each patient along with subjective and objective evaluations for postoperative 7 days. Data analysis was carried out by SPSS 17.0 software using Mann-Whitney U test, Wilcoxon matched-pairs test and t-test. A p-value ≤ 0.05 was assigned as statistically significant. Results: When compared to group 1, group 2 revealed statistically less pain and swelling following the secondary closure of wound from day 1 to 7. There was a significant improvement in mouth opening in Group 2 at day 1 (p=0.0005) and at day 7 (p=0.00001). Conclusion: Secondary wound closure after disimpaction of mandibular third molar results in better postoperative recovery than primary closure.


Subject(s)
Humans , Male , Female , Adult , Postoperative Complications , Surgery, Oral , Trismus/pathology , Wound Closure Techniques/instrumentation , Molar, Third/anatomy & histology , Tooth Extraction , Tooth, Impacted , Wound Healing , Data Interpretation, Statistical , Suture Techniques/instrumentation , Statistics, Nonparametric , Diagnosis, Oral , India
16.
Journal of Chinese Physician ; (12): 882-885, 2021.
Article in Chinese | WPRIM | ID: wpr-909638

ABSTRACT

Objective:To design a laparoscopic suture guide set based on the principle that the ends of three struts on the arc of the same center, and to explore the rationality and practicability of the device by suture experiment in an isolated human kidney.Methods:⑴ The device was made. The three struts of the device were arranged on the fixed shaft in sequence. The function structure included the direction limitation device and the needle exit site locating device. The direction limitation device included the U-shaped end of the second strut and arc cylinder of the third strut. The needle exit site locating device was the Y-shaped end of the first strut. The ends of the three struts were on the same circular arc with the fixed axis as the center of the circle. When the long round needle of the same radian entered the curved cylinder (the first direction limitation device), it was restricted by the cylinder to travel to the U-shaped end of the second strut (the second direction limitation device), and was guided by the two devices to the Y-shaped end of the first strut (the needle exit site locating device). A built-in torsion spring clamped the kidney to fix the device. The design of the device was drawn into a 3D figure, printed by a metal 3D printer with titanium alloy, polished and then assembled into a finished product. ⑵ Experiment. Four kidneys of patients underwent retroperitoneal laparoscopic radical nephrectomy was cut open, and 8 needle insertion and exit points were designed along the long axis. The kidney sutured with conventional methods was set as the conventional group. Then the laparoscopic suture guide set was used to assist the suture, which was set as the guide group. For effective suture, the distance between the actual insertion point and the preset insertion point was less than 1.0 cm. If the distance was greater than 1.0 cm, re-suture rate and deviation distance were observed. The distance between the actual injection point and the preset injection point was less than 0.5 cm, which means the point is conformant, and the conformance rate was observed. Single needle suture time was observed in 2 groups.Results:In the experiment, 15 stitches deviated more than 0.5 cm, 10 stitches deviated more than 1.0 cm in the conventional group, the re-suture rate was 31.3%(10/32), the conformance rate was 53.1%(17/32), and the deviation distance was 0.6-1.15(0.41±0.48)cm. In the guide group, 5 stitches deviated more than 0.5 cm, 2 stitches deviated more than 1.0 cm, the re-suture rate was 6.3%(2/32), the conformance rate was 84.4%(27/32), and the deviation distance was 0.6-1.10(0.14±0.34)cm. There were statistically significant differences in the above indicators between the two groups ( P<0.05). The single stitch suture time in the conventional group ranged from 3-12(6.00±3.32)seconds, and that in the guide group ranged from 5-11(5.94±1.41)seconds. There was no significant difference in single stitch suture time between the two groups ( P>0.05). Conclusions:The structure design of laparoscopic suture guider is relatively reasonable. The device can ensure the direction of the surgical needle, reduce the number of times to adjust the surgical needle, and the needle position is accurate. It has a good auxiliary effect for suture in vitro, but the guider needs to be operated under laparoscopy to further verify its rationality and practicability.

17.
Rev. bras. cir. plást ; 35(3): 283-287, jul.-sep. 2020. ilus
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1128037

ABSTRACT

Introdução: O facelift light apresenta uma padronização da técnica com o objetivo de tratar o terço inferior da face e o pescoço, com menores cicatrizes, plicatura do SMAS em todos os pacientes e utilização de pontos de adesão para redução de hematomas. O descolamento moderado permite um retorno mais rápido do paciente às suas atividades. Métodos: A cirurgia é feita após uma marcação prévia periauricular de todos pacientes, com a área a ser descolada e o desenho da pele a ser retirada. A anestesia é local e sedação, sem a necessidade de cortes no cabelo. É feito o descolamento dos retalhos, plicatura do SMAS, pontos de adesão nos retalhos anterior e posterior, além da sutura interna por planos e lipoaspiração do submento quando necessária. O curativo é compressivo sem a utilização de drenos. Resultados: Foram submetidos à ritidoplastia por essa técnica 185 pacientes a partir de 2014. Com a idade variando entre 31 e 84 anos, sendo a média de 55 anos. É feita drenagem linfática a partir de sete dias e com duas semanas observou-se uma redução considerável do edema. Conclusão: O facelift light é uma técnica eficaz, de simples execução, cicatrizes reduzidas e com poucas complicações, favorecendo o retorno precoce dos pacientes às suas atividades.


Introduction: Facelift light represents a technique standardization to treat face and neck lower third, with lesser scars, SMAS plication in all patients, and adhesion points to reduce bruises. Moderate detachment allows the patient to return to their activities faster. Methods: Surgery is performed after prior periauricular marking of all patients of the area to be detached and the skin's design to be removed. Anesthesia is local with sedation, and without the need for haircuts. Flap detachment, SMAS plication, adhesion points in the anterior and posterior flaps are performed, in addition to the internal suture by layers and liposuction of the subment when necessary. The dressing is compressive without using drains. Results: One hundred and eighty-five patients underwent rhytidoplasty using this technique since 2014. Their age varied between 31 and 84 years, with an average of 55 years. Lymphatic drainage is performed after seven days, and after two weeks, a considerable reduction in edema has been observed. Conclusion: Facelift light is a useful technique, simple to perform with reduced scarring and few complications, favoring the early return of patients to their activities.

18.
Rev. bras. ortop ; 55(4): 445-447, Jul.-Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1138052

ABSTRACT

Abstract Objective To evaluate the biomechanical properties of the "figure-of-eight" and Kessler suture techniques for tendons. Methods Flexor tendons of porcine fingers were divided into two groups with triple central "figure of eight" sutures (six passages) and Kessler sutures (two passages) associated with simple and continuous peripheral sutures, and submitted to continuous longitudinal mechanical tests, to obtain the mechanical properties of maximum load and energy at maximum load. Results The mean maximum load and energy at maximum load in the "figure-of-8" suture were of 63.4 N and 217.3 N.mm respectively; in the Kessler suture, the values were of 34.19 N and 100.9 N.mm respectively. The statistical analysis indicated that the "figure-of-eight" suture is mechanically superior to the Kessler technique. Conclusion Under the conditions of this experiment and in the flexor tendon of porcine fingers, the triple "figure-of-eight" suture (six passages) is more resistant than the Kessler suture (two passages). The "figure-of-eight" suture with six passages enables active movement in the immediate rehabilitation of the flexor tendon repair of the finger, with little risk of rupture or suture spacing.


Resumo Objetivo Avaliar as propriedades biomecânicas dos pontos de sutura tendinosa em "oito" e de Kessler. Métodos Tendões flexores dos dedos de membros superiores de porcos foram divididos em dois grupos com suturas triplas centrais em "oito" (seis passagens) e de Kessler (duas passagens) associadas a suturas periféricas contínuas simples, e submetidos a ensaios mecânicos longitudinais contínuos, obtendo-se as propriedades mecânicas de carga máxima e de energia na carga máxima. Resultados As médias da carga máxima e da energia na carga máxima na sutura em "8" foram de 63,4 N e 217,3 Nmm, respectivamente; na sutura de Kessler, os valores foram de 34,19 N e 100,9 Nmm, respectivamente. A análise estatística indicou que o ponto em "oito" é superior mecanicamente ao ponto de Kessler. Conclusões Nas condições deste experimento e no tendão flexor de dedo de membro superior de porcos, o triplo ponto em "oito" (seis passagens) é mais resistente do que o ponto de Kessler (duas passagens). O triplo ponto em "oito", com seis passagens, permite movimentação ativa na reabilitação imediata de reparo de tendão flexor de dedo de membro superior com pouco risco de ruptura ou espaçamento na sutura.


Subject(s)
Swine , Tendon Injuries , Biomechanical Phenomena , Suture Techniques , Orthopedic Procedures , Upper Extremity , Finger Injuries
19.
Chinese Journal of Orthopaedics ; (12): 154-159, 2020.
Article in Chinese | WPRIM | ID: wpr-868958

ABSTRACT

Objective To explore the clinical effects of Nice knot combined with elastic compress and stretch in treating skin and soft tissue defect.Methods From August 2017 to April 2019,a total of 23 patients,10 males and 13 females,aged 36.5±5.3 years (range 26-76 years),were retrospectively analyzed.The defect size was 60±5.3 cm2 (28-96 cm2).Under local anesthesia,the wound was debrided thoroughly,sutured and fixed by Nice knot.The wound was fixed by elastic dressing and traction.The wound was retracted every 3 days during dressing change.The wound healing grade,healing rate,healing time,and postoperative Vancouver Scar Scale (VSS) were observed and recorded.Results All operations were performed successfully in the debridement room.The operation time was 42±10.5 min (range 30-50 min),intraoperative bleeding 30±2.5 ml (range 20-60 ml),and the operation cost 180±11.5 RMB (range 160-240 RMB).Twenty patients were followed up for 4±2.5 months (range 3-6 months).The wound healing rate of 23 patients was 50%±3.5% (range 40%-56%).For the 20 patients,the wound healing rate was 65%±4.3% (range 53%-75%),74%±4.5% (range 65%-80%),83%±1.8% (range 76%-85%),90%±1.6% (range 84%-95%) and 95%±3.5% (range 94%-98%) at 3,6,9,12 and 15 days,respectively.The wound healing rate of 20 patients was 100% at the 42nd days of follow-up.Wound healing rate of Grade A and grade B was 95% (19/20) with scar VSS score 4(3,6).The excellent and good rate of grade B was 80% (16/20).Two cases were sutured and fixed with Nice knot after 10 days because of the partial loss of the sutures.One case was treated with vacuum sealing drainage (VSD) on-line junction because infection was not completely controlled.Local infection was controlled and the wound was contracted by Nice junction at 1 week.Conclusion The treatment of skin and soft tissue defect with Nice combination with elastic dressing and traction has the advantages of simple operation,low operation condition,short operation time,less bleeding,low cost,high wound healing grade and healing rate,suitable for basic level hospital application and promotion.

20.
Chinese Journal of Orthopaedics ; (12): 154-159, 2020.
Article in Chinese | WPRIM | ID: wpr-799740

ABSTRACT

Objective@#To explore the clinical effects of Nice knot combined with elastic compress and stretch in treating skin and soft tissue defect.@*Methods@#From August 2017 to April 2019, a total of 23 patients, 10 males and 13 females, aged 36.5±5.3 years (range 26-76 years), were retrospectively analyzed. The defect size was 60±5.3 cm2 (28-96 cm2). Under local anesthesia, the wound was debrided thoroughly, sutured and fixed by Nice knot. The wound was fixed by elastic dressing and traction. The wound was retracted every 3 days during dressing change. The wound healing grade, healing rate, healing time, and postoperative Vancouver Scar Scale (VSS) were observed and recorded.@*Results@#All operations were performed successfully in the debridement room. The operation time was 42±10.5 min (range 30-50 min), intraoperative bleeding 30±2.5 ml (range 20-60 ml), and the operation cost 180±11.5 RMB (range 160-240 RMB). Twenty patients were followed up for 4±2.5 months (range 3-6 months). The wound healing rate of 23 patients was 50%±3.5% (range 40%-56%). For the 20 patients, the wound healing rate was 65%±4.3% (range 53%-75%), 74%±4.5% (range 65%-80%), 83%±1.8% (range 76%-85%), 90%±1.6% (range 84%-95%) and 95%±3.5% (range 94%-98%) at 3, 6, 9, 12 and 15 days, respectively. The wound healing rate of 20 patients was 100% at the 42nd days of follow-up. Wound healing rate of Grade A and grade B was 95% (19/20) with scar VSS score 4(3, 6). The excellent and good rate of grade B was 80% (16/20). Two cases were sutured and fixed with Nice knot after 10 days because of the partial loss of the sutures. One case was treated with vacuum sealing drainage (VSD) on-line junction because infection was not completely controlled. Local infection was controlled and the wound was contracted by Nice junction at 1 week.@*Conclusion@#The treatment of skin and soft tis sue defect with Nice combination with elastic dressing and traction has the advantages of simple operation, low operation condition, short operation time, less bleeding, low cost, high wound healing grade and healing rate, suitable for basic level hospital application and promotion.

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