Application of"Hong's One Stitch Method"in pancreaticoduodenectomy / 沈阳医学院学报

Objective:To investigate the effect of Hong's One Stitch Method in pancreaticoduodenectomy(PD).Methods:A total of 40 patients who underwent PD in our hospital from Jan 2021 to Dec 2022 were divided into two groups according to random number table method,with 20 patients in each group.The control group was treated with end to end pancreatojejunal anastomosis,and the observation group was treated with"Hong's One Stitch Method".The perioperative indicators,complications,secondary surgery,mortality and quality of life were compared between the two groups.Results:The pancreatoenteroanastomosis time,operation time and hospitalization time in the observation group were shorter than those in the control group,and the incidence of pancreatic fistula was lower than that in the control group(P＜0.05).There were no significant differences in intraoperative blood loss,pancreatic biochemical leakage,bile fistula,hemorrhage,localized abdominal infection,gastric emptying obstruction,pulmonary infection,secondary surgery and mortality between the two groups(P＞0.05).The mental health score,emotional function score,social function score,energy score,general health status score,body pain score,and physiological function score in the observation group were higher than those in the control group(P＜0.05).Conclusion:In PD surgery,the application of"Hong's One Stitch Method"to perform pancreatoenterostomy is beneficial to shorten the pancreatoenterostomy time,operation time and hospitalization time,accelerate the postoperative recovery,reduce the incidence of pancreatic fistula,and improve the quality of life of patients.

Cervical leiomyomas: a surgeon抯 challenge

Leiomyoma are benign uterine tumors of unknown etiology. Only 5% of the cases are cervical and are usually single. Extraperitoneal leiomyomas leads to pressure symptoms. They may be submucosal, intramural or sub-serosal type. Anterior cervical fibroids are the most common. Central cervical fibroids are described as 揟he Lantern on the dome of St. Paul抯�. A retrospective clinical study of 6 cervical fibroids operated in the department of Obstetrics and Gynecology, in a tertiary care hospital in Mumbai for a period of 24 months from March 2021 to February 2022. Patients were studied with respect to clinical profiles, pre-operative investigations, intra- operative surgical challenges and post-operative surveillance. In our study we observed that cervical fibroids were most commonly diagnosed in the age group of 40-50 years, and most commonly in women of second parity. The most common presenting symptom was pain in abdomen. All patients underwent hysterectomy (abdominal or vaginal), wherein 16% of them required blood transfusion. The largest cervical fibroid operated was 20 x 12 x 10 cm in size with uterus corresponding to 22 weeks of gestation. Excision of cervical fibroids is a challenging procedure due to its close proximity to ureters. It is only with experience and with fine surgical skills that a good patient outcome can be achieved. Even after advent of various alternative management options, surgery remains the mainstay of treatment and is still a surgeon抯 nightmare.

Four-stitch cholangiojejunostomy / 中华肝胆外科杂志

Objective:To evaluate the clinical application efficacy of four-stitch cholangiojejunostomy.Methods:Of 38 patients who received four-needle biliary and enterointestinal anastomosis in the Department of Hepatobiliary Surgery, Yuebei People's Hospital Affiliated to Shantou University Medical College from November 2016 to April 2020 were included, and the diseases, surgical methods and postoperative complications of four-needle biliary and enterointestinal anastomosis were analyzed.Results:There were 26 males and 12 females with an average of 57.3(44-77) years. Among 38 patients, there were 12 hilar cholangiocarcinoma patients, 10 pancreatic head cancer, 9 duodenal papillary cancer, 4 intrahepatic and extrahepatic bile duct stones, 1 pancreatic cystic adenoma, 1 gastric cancer invading pancreatic head and 1 gallbladder carcinoma. The procedure included pancreatoduodenectomy in 20, radical resection of hilar cholangiocarcinoma in 12, hepatectomy with biliary-enteric anastomosis in 4, radical resection of gastric cancer combined with pancreaticoduodenectomy in 1, radical resection of gallbladder carcinoma in 1. One, two and three ductal openings were anastomosed in 27, 7 and 4 patients, respectively. 10 patients have bile duct diameter <6 mm. Postoperative anastomotic leakage occurred in 1, and all patients were received followed-up visit for 2 months to 4 years without anastomotic stenosis.Conclusion:Four-stitch cholangiojejunostomy is simple, safe, effective, and convenient for small biliary ductal surgeries.

The bleeding mother and her baby: a study to determine the fetomaternal outcome in cases of placenta previa

Background: Placenta previa is one of the major causes for obstetric hemorrhagic morbidity and mortality with increasing incidence in recent times. This study aims at determining risk factors, maternal and fetal outcome associated with placenta previa.Methods: This was an observational, retrospective study conducted at a tertiary care hospital in Mumbai from May 2017 to March 2020. A total of 102 women with placenta previa during the study period were included, their case records critically analyzed to identify risk factors, maternal outcome in relation with blood transfusion required, ICU admission, obstetric hysterectomy and fetal outcome pertaining to prematurity, asphyxia and mortality.Results: A total of 102 patients were analyzed. Placenta previa was more common in >26 years of age, multipara (64.7%), with previous history of caesarean sections (21.5%) and previous curettage (11.7%), 44.2% babies born were preterm, 4.4% stillbirths and 8.5% neonatal deaths. Maternal complications like antepartum hemorrhage was seen in 58.8% patients and postpartum hemorrhage in 33.3%, blood transfusion was required in only 18 patients post operatively, bladder rent was seen in 3 patients and there was no maternal mortality. 44 patients required uterine artery ligation, Ashok Anand stitch was taken in 37 patients, uterus compression sutures in 10, obstetric hysterectomy in 7 patients and internal iliac artery ligation in 2 patients.Conclusions: Early identification of women at risk, obstetric preparedness and simple techniques like uterine artery ligation, Ashok Anand stitch and uterine compression sutures can help in effectively reducing need for multiple blood transfusions and morbidity.

An in silico Analysis of Protein Targeted by Glycyrrhizin in Common Dental Pathogens

Glycyrrhizin is a phytocompound which is derived from Glycyrrhiza glabra. It is used in treating the upper respiratory tract disease like cough, bronchitis, laryngitis, sore throat, etc. It has various medicinal uses in rheumatism, peptic ulcers, asthma, allergies, and inflammation. Glycyrrhizin has been reported to possess antibacterial, antiviral, antioxidant, anti inflammatory properties. In view of the above facts, the present in silicostudy was designed to demonstrate the molecular mechanism underlying the antimicrobial activity of glycyrrhizin against common dental pathogens such as Streptococcus mutans, Porphyromonas gingivalis, Treponema denticola, Enterococcus faecalisandTannerella forsythia.The STITCH tool was used to identify the drug-protein interaction. The functional class of the protein was deduced using VICMPred, followed by the identification of epitopes on the virulence factors using BepiPred. Further, the subcellular location of the virulence factors were also studied using PSORTb software. The computational analysis performed identified several virulence factors viz., short chain dehydrogenase/reductase family oxidoreductase of Treponema denticola and D-mannonate oxidoreductase of Tannerella forsythiawhich were found to interact with glycyrrhizin. Interestingly, phosphopyruvate hydratase was found to be the protein present in all the five genera was shown to interact with glycyrrhizin. Thus the present study reveals the target proteins on the dental pathogens which were shown to interact with glycyrrhizin. Furthermore,experimental validation of the resultsare warranted to provide substantial details on the anti-microbial activity of glycyrrhizin against common dental pathogens

Clinical study of modified continuous single straight needle suture in the treatment of early traumatic ciliary body detachment / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the clinical effect of modified continuous single straight needle suture in the treatment of early traumatic ciliary body detachment.<p>METHODS: Totally 25 patients with cyclodialysis associated with macular edema were retrospectively analyzed during 2017-2018. The range of cycloidalysis was determined by ultrasound biomicroscopy(UBM)and the level of macular edema was observed by optical coherence tomography(OCT)before surgery. In the closed state of the eyeball, the modified continuous single-straight needle suture method was used for suture repair, and mydriasis and corticosteroid drugs were applied to control inflammation. Visual acuity and intraocular pressure were observed after operation. Ciliary body reduction was observed by UBM, OCT was used to observe the recovery of macular edema.<p>RESULTS: Three months after the operation, all the ciliary body detachment of 25 patients were restored, the intraocular pressure returned to normal, the vision was improved, and the macular edema disappeared.<p>CONCLUSION:It is a minimally invasive, safe and effective operation method to suture ciliary body detachment with single straight needle under the closed state of vitreous body cavity and anterior chamber.

History-indicated transvaginal cerclage: results from a single-centre

Background: Cervical incompetence occasionally results in mid-trimester pregnancy loss, preterm labour and increased foetal morbimortality. History-indicated cerclage is proposed when obstetric history suggests cervical incompetence. The aim of this study was to evaluate the maternal-foetal outcomes following prophylactic cervical cerclage.Methods: Retrospective study reviewing data of all women undergoing transvaginal history-indicated cerclage from January 1st, 2008 to December 31th, 2017 at Centro Hospitalar Universitário do Algarve - Faro. Primary outcome: gestational age <37weeks at birth. Secondary outcomes: neonatal morbimortality and intensive care unit (NICU) admission and maternal morbidity. Data were analyzed with IBM SPSS Statistics 23.Results: A total of 12 history-indicated cerclages were performed (9 women). At first cerclage, mean maternal age, gestity, parity and live children were 27.6, 2.44, 1.11 and 0.78 (87.7% preterm), respectively. At cerclage placement, mean gestational age and cervical length were 16.1 weeks and 27.5mm. Average hospital admission was 10.7 days. In all cases McDonald technique was performed. Four hospital readmissions occurred for threatened labour. Mean gestational age at cerclage removal was 36.9 weeks (83.3% in ambulatory) and 38.9 at delivery. Average time between cerclage removal and labour was 14.5 days. Spontaneous onset of labour occurred in 75% and vaginal delivery in 83.4%. There were no reports of preterm birth, foetal admission to NICU or maternal complications. Mean number of live children after procedure was 1.58.Conclusions: Prophylactic cervical cerclage seems to improve pregnancy outcome with minimal maternal risks. However, our data suggest over inclusion of women, with unnecessary procedures, emphasizing the importance of re-evaluating inclusion criteria.

Stitch less, clip less, three ports laparoscopic cholecystectomy: experience of 300 cases

Background: 300 cases of cholelithiasis were operated by stitch less, clip less, three ports laparoscopic cholecystectomy at Maxx lyfe Hospital, near Bathindi morh, Sunjwan road, Jammu with effect from August 2017 to May 2019. The outcome measures in the form of safety of the technique, postoperative pain, need of postoperative analgesia, number of OT assistants needed, duration of hospital stay, recovery and return to routine work, cosmetic satisfaction of the patient were taken into consideration and were found to be better than in conventional four ports technique of laparoscopic cholecystectomy.Methods: In three port laparoscopic cholecystectomy, first 10 mm umbilical, second 5 mm subxyphoid and third 5 mm subcostal ports are used and telescope is passed into the peritoneal cavity through the umbilical port. Retraction of the gallbladder is done by the long grasping forceps through the 5 mm subcostal port, whereas dissection is accomplished through the subxyphoid port. The gallbladder is retrieved through the subxyphoid port.Results: Mean operative time was 40 minutes and mean duration of postoperative stay in the hospital was 18 hours. Days to return to normal activity was 4 days at an average.Conclusions: The 3-port laparoscopic cholecystectomy  technique is safe and has better outcomes in the form of less postoperative pain, less duration of hospital stay, early return to routine work and more cosmetic satisfaction as compared to the conventional 4-port technique, with no obvious increase in bile duct injuries and it can be a viable alternative in the field of minimally invasive surgery.

Graft and Button Modification of Technique of Coracoclavicular Joint Reconstruction in Treatment of Chronic Type V Acromioclavicular Joint Dislocation: A Case Report

@#Treatment of chronic Rockwood’s type V Acromioclavicular (AC) joint dislocation remains controversial. We describe a surgical technique to reduce and maintain AC joint using a combination of gracilis autograft with GraftMax™ button (Conmed Inc, Utica, NY). Graft was prepared using running whip stitch technique with No. 5 Hi-Fi high strength suture (ConMed Linvatec, Largo, FL). Our technique reduces intraoperative clavicular and coracoid tunnel fracture and restores anatomical coracoclavicular ligament. At sixth week and third month postoperatively, the patient demonstrated good clinical and radiographic outcome.

Effect observation of lock stitch suture with bandage contact lens for pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the efficacy and characteristic of lock stitch suture with bandage contact lens for pterygium. <p>METHODS: A prospective randomized controlled double-blind study was conducted. Totally 140 cases(140 eyes)with pterygium were involved in the study from January 2014 to December 2015. All cases were randomly divided into two groups: 68 cases(68 eyes)in Group A received lock stitch suture, while 72 cases(72 eyes)in Group B received lock stitch suture with bandage contact lens. The postoperative reaction, effect, complications and so on were retrospectively analyzed between two groups. <p>RESULTS: One week later, the pain index scores at 1, 3 and 7d after surgery were 1.62±0.71, 0.83±0.52, 0.31±0.36 in Group A, and the pain index scores were 0.98±0.47,0.27±0.14, 0.12±0.21 in Group B, there were significant difference between the two groups(<i>t</i>=6.23, 8.56, 7.03, <i>P</i><0.05), and the difference were statistically significant within Group A and B(<i>F</i>=8.60, 13.60, <i>P</i><0.01); 4 of 68 eyes(5.9%)were recurrence after 1a in Group A and 4 of 72 eyes(5.6%)were recurrence in Group B, demonstrating no significant differences(<i>P</i>>0.05); 10 of 68 eyes(14.7%)with complications in Group A and 3 of 72 eyes(4.2%)with complications in Group B, demonstrating significant differences(<i>χ</i>2=4.61, <i>P</i><0.05). <p>CONCLUSION: A good result can be obtained by using the lock stitch suture with bandage contact lens in the treatment of pterygium. The lock stitch suture with bandage contact lens could significantly release pain response, it can significantly reduce the probability of the concurrent appearance.

A Modified Mac Suture Bridge Technique: Clinical and Radiological Outcomes of the Treatment of Rotator Cuff Tear with Poor Tissue Quality / 대한정형외과학회잡지

PURPOSE: Base on the concept of the Mac stitch, we designed the modified Mac-suture bridge technique to improve the outcome of arthroscopic repair of rotator cuff tear with poor tissue quality. Moreover, we evaluated both the radiological and clinical outcomes of the surgery to assess the effectiveness of the newly designed technique. MATERIALS AND METHODS: From January 2010 to December 2014, a total of 52 patients (25 males, 27 females) with rotator cuff tear, with poor tissue quality according to both radiological and intraoperative findings, who underwent arthroscopic rotator cuff repair using the modified Mac-suture bridge technique and followed-up for at least 1 year were included in this study. The mean patient age at the time of surgery was 60 years. The average follow-up period was 20 months. We evaluated the clinical outcomes by checking the range of motion and compared the following, both preoperatively and postoperatively: American Shoulder and Elbow Surgeon (ASES) score, University of California, Los Angeles (UCLA) score, Constant shoulder score (CSS), visual analogue scale (VAS). In addition, we analyzed 42 series of postoperative magnetic resonance imaging by using the Sugaya's classification for the evaluation of the repair integrity. RESULTS: All clinical scores showed significant improvement (ASES score improved from 56.75 to 83.44, UCLA score from 20.52 to 29.23, CSS from 64.04 to 80.90, and VAS from 6.17 to 1.62; p<0.001). The range of motion was also improved; forward flexion improved from 108° to 158°, abduction from 109° to 160°, external rotation from 27° to 50°, and internal rotation from 31° to 57° (p<0.001). Satisfactory radiologic results were noted on postoperative magnetic resonance imaging, consisting of 15 cases (35.7%) type I, 22 cases (52.4%) type II, 3 cases (7.1%) type III, 2 cases (4.8%) type IV, and no type V, according to the Sugaya's method. CONCLUSION: The modified Mac-suture bridge technique provided satisfactory results both radiologically and clinically for the treatment of rotator cuff tear with poor tendon tissue quality. It could possibly be a good alternative to previous techniques of arthroscopic repair.

The study of without needle stitch closure in gynaecology cesarean section incision / 中国现代医生

Objective To study the clinical offect of without needle stitch closure in gynaecology cesarean section in-cision. Methods A total of 300 cases of cesarean section surgery (new lower uterine segment cesarean section) were randomly divided into, experimental group and the control group with 150 cases in each. Experimental group were giv-en needle suture closed incision of skin and the control group were given traditional needle suture skin incision. The time skin, the skin suture incision scar wound unit length, hospitalization days, primary healing of incision, increase of the number of cases and adverse reactions were compared. Results Needle without stitch machine skin incision was (2.71±0.96) seconds, hospitalization days was (5.06±0.31) days, the wound of scar width was (0.21±0.13) cm, which were significantly lower than that in the traditional needle stitch suture incision skin (5.87 ±1.62) seconds, hospitaliza-tion days (6.12±1.84) days, the wound of scar width (5.56±2.32) cm. The differences between the two groups were sta-tistically significant (P < 0.05). Two groups of wound were primary healing rate was 99.33%.Experimental group pa-tients postoperative day 1 incision, 1 case of itching, accounted for 0.7%, control group itching 3 cases, accounted 2.0%, compared two groups had no difference(P>0.05);only 3 days postoperatively itchy in 1 case. Conclusion Com-pared accounte dwith the traditional way, needle without stitch machine can shorten the skin incision, and significantly reduce the skin wound scar width. Which does not affect the primary healing of incision and less adverse reaction.

Modified Mason-Allen Suture Bridge Technique: A New Suture Bridge Technique with Improved Tissue Holding by the Modified Mason-Allen Stitch

We present a new method of suture bridge technique for medial row fixation using a modified Mason-Allen stitch instead of a horizontal mattress. Medial row configuration of the technique is composed of the simple stitch limb and the modified Mason-Allen stitch limb. The limbs are passed through the tendon by a shuttle relay. The simple stitch limb passes the cuff once and the modified Mason-Allen stitch limb passes three times which creates a rip stop that prevents tendon pull-out. In addition, the Mason-Allen suture bridge configuration is basically a knotless technique which has an advantage of reducing a possibility of strangulation of the rotator cuff tendon, impingement or irritation that may be caused by knot.

Easy and Fast Stitch out Method with a Traction Nylon in Pediatric Sutured Wound

PURPOSE: Except for continuous suture in skin layer, stitching out in facial laceration, we have to hold each knots up and cut the knots by No. 11 blade or small scissors. However, we often have difficulty in stitching out the knots on children who do not cooperate well. Therefore we introduce an easy and fast stitch out method of pediatric lacerations. METHODS: From January to May 2009, we studied 15 pediatric patients(mean age 5.6 years old) who had facial laceration on face or underwent any surgery on operation room. For easy stitch out, we left the one string of the first knot long enough to extend at the opposite end of laceration site. And then the extended string was fixed to skin using Steri-strip. Next we do simple interrupted suture including the extended traction nylon string inside the knot. Through this method, we can stitch out all knots simply by lifting up the traction nylon needless to hold the each knot one by one. RESULTS: Until stitching out, the traction nylon was just right position and there was no normal tissue injury during stitch out all knots. Patients were satisfied with the short stitch out time. CONCLUSION: By using the traction nylon on pediatric laceration suture, we can stitch out all the knots with no normal tissue injury in less time.

Blepharoptosis Correction with Stitch Method

There are various methods to correct mild ptosis and to make a double fold. However, all pre-existing methods have similar disadvantages, such as long-lasting swelling and down time. Recently, many patients prefer more convenient and minimal invasive methods with faster recovery. So we have devised a new technique to correct mild ptosis. Our technique is very similar to other non-incisional stitch methods. We try to correct ptosis through Muller's muscle tucking using the non-incisional stitch method. We think this method could be applied to mild degree ptosis. We hope to report the long-term follow up data of our cases and analysis with more efficient technique in the near future.

Minimal Stitch Canalicular Repair of Canalicular Lacerations

PURPOSE: To examine the results of minimal stitch on the restoration of tissue after canalicular laceration. METHODS: We have operated using sutures of tissues around canalicular laceration by inserting bicanalicular silicone stents and minimal horizontal mattress sutures with 8-0 Vicryl in cases of canalicular laceration instead of the existing method for the past 6 years. The ages of patients ranged from 2 to 76 years (average age 39.8+/-17.4 years), with most patients in their thirties (12 patients, 40%), 30 cases underwent canalicular repair with minimal stitch and bicanalicular silicone stent insertion within 24 hours after trauma. The silicone stent was removed 3 months after the operation if the patient did not complain of epiphroa while the canalicular remained open. RESULTS: Twenty-five eyes (83.3%) showed symptom improvement and good passage in lacrimal syringing test in 4~12 months (average: 6.8+/-2.2 months) of follow-up study. Complications included one case each of fistula formation, stent prolapse, and wound infection, and two cases of canalicular stenosis. CONCLUSIONS: We recommend this method because of its satisfying success ratio.

All Arthroscopic Repairs with Massive Cuff Stitch in Medium-sized Full Thickness Rotator Cuff Tears / 대한정형외과학회잡지

PURPOSE: We wanted to evaluate the usefulness of arthroscopic repair using the modified Mason-Allen Massive Cuff Stitch for medium sized full thickness rotator cuff tear. We verified the clinical results and evaluated the repair integrity after short term follow up. MATERIALS AND METHODS: Twenty-three cases of arthroscopically repaired full thickness tear of the rotator cuff of an estimated medium size were evaluated between December 2004 to May 2005. The average patient age was 54 years old (range: 43-69 years old), and the mean follow-up was 14 months (range: 12-17 months). We analyzed the results by paired t-test. The follow up MRIs were checked in 11 cases. RESULTS: The VAS pain score was improved from a preoperative average of 7.0 to a postoperative average of 0.9, the ADL was improved from 11.1 to 26.0 and the UCLA score was improved from 13.6 to 32.5 (all p<0.05). 91.3% showed an excellent or good result at the final follow-up. The satisfied rate was 95.7% (22 cases). There was re-rupture of the repaired rotator cuff in one out of 11 cases (9.1%). CONCLUSION: Arthroscopic repairs using a modified Mason-Allen Massive Cuff Stitch for full thickness rotator cuff tear of an estimated medium size showed good clinical outcomes.

A Study on the Criteria for Lateral Retinacular Release in Total Knee Arthroplasty: The No Thumb Technique with One Stitch Method

PURPOSE: This study was performed to determine new criteria for performing lateral retinacular release (LRR) without having a detrimental effect on patellar tracking. MATERIALS AND METHODS: For 17 patients who underwent bilateral TKAs, LRR was not performed at one side (A) due to improvement of patellar tracking after deflation of tourniquet although maltracking existed with the inflation of tourniquet. At the other side (B), LRR was not performed either because patellar tracking improved with one stich method although maltracking existed regardless of tourniquet status. We measured the lateral patellar tilt angle (LPTA) of each side inthose 17 patients after 1 year after TKAs and compared them. We also surveyed the incidence of LRR in 225 primary TKAs with the staged method of patellar tracking evaluation during the same period. RESULTS: The average LPTA was 3.4degrees at side (A) and 4.6degrees at side (B) respectively. There was no significant difference in LPTA between side (A) and side (B) (p=0.337). From the survey for incidence of LRR in 225 primary TKAs during the same period, LRR was not required in 19% of patients showing good patellar tracking with inflation of tourniquet, 58% of patients showing improved patellar tracking after deflation of tourniquet and 21% of patients showing improved patellar tracking by one stitch method regardless of tourniquet status. Consequently, only 2% of patients required LRR in primary TKA. CONCLUSION: One stitch method under the deflation of tourniquet in evaluating process of patellar tracking during primary TKAs is supposed to be very effective and to reduce the incidence of LRR to only 2% without influencing the LPTA.

Clinical study on "one-stitch anastomosis through the skin" repair of canalicular laceration / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate the efficacy and safety of "one-stitch anastomosis through the skin" repair of canalicular laceration.METHODS:The data of 32 cases (32 eyes) of canalicular laceration who underwent repair of lacerated canaliculi with one-stitch anastomosis through the skin were retrospectively reviewed, inferior canalicular laceration in 29 patients,superior canalicular laceration in 1 patient, 2 cases involving both the inferior and superior canalicular laceration. All the operations were performed under surgical microscope, 5-0 silk sutures were used and silicone tube of 0.8mm diameter was employed in intubation. The stents were left in place for 3 months postoperatively and then removed. The follow-up period was 1 to 36 months.RESULTS: In 32 patients, 28 (88%)patients were cured entirely, 3 (9%)patients were meliorated, and 1 (3%)patient had no effects. A total of 29 patients complied with scheduled follow up 1-36 months (average 12 months) after stent removal, and 3 patients were lost in follow-up. All the patients had got good recovery of eyelid laceration with no traumatic deformity in eyelid and canthus.CONCLUSION: In "one-stitch anastomosis through the skin"repair of canalicular laceration, the cut ends could be anastomosed directly,for there was no suture remained in the wound permanently, so there was no suture-related granuloma which might cause obstruction or stenosis of canaliculi. It was simple, economical ,effective and safe.

The Effect of Nonincisional Double Fold Formation Using Three Small Incisions, Two-stitch Method

PURPOSE: The aim of this study was to analyze the effects of using the nonincisional, double fold formation method with three small incisions and two-stitches. METHODS: This study included 39 patients who underwent double eyelid operation by a nonincisional technique and who were followed up for more than 6 months. On the desired double eyelid line, three points 6 mm apart were marked and three stab incisions made. A small amount of subcutaneous tissue was removed through the incisions, and orbital fat was removed through the lateral wound site-if necessary. Using double-armed 7-0 nylon or prolene, two buried sutures of 6 mm width were made. Sixteen patients also underwent surgery for epiblepharon, and three patients with unilateral double eyelid due to trauma had a contralateral eyelid operation for asymmetry correction. Five patients also had epicanthoplasty. RESULTS: Two patients lost their folds completely and reoperations were performed. Two patients showed cysts due to suture material and so the suture knots were removed; the double fold remained afterwards, so no other procedures were needed. In one case, the suture was seen subcutaneously, so suture removal and reoperation were performed. CONCLUSIONS: To minimize double fold loss, which is a disadvantage of the nonincisional double fold formation technique, we removed a portion of pretarsal tissue, muscle, and/or orbital fat and made two wide slings. Also, we corrected asymmetry due to traumatic unilateral double eyelid and epicanthal fold. In conclusion, we expect that our method could extend the applicability of nonincisional double fold formation.