Breve historia de las suturas mecánicas en la cirugía mundial y argentina / Brief history of mechanical sutures in global surgery and Argentina

Las suturas mecánicas son instrumentos que se utilizan en cirugía para permitir secciones de tejidos de manera rápida y segura. Su invención co- rresponde a los húngaros Victor Fischer y Hümer Hültl. En este artículo se describe su evolución a lo largo de la historia de la cirugía y se detalla su incursión en la cirugía argentina.

Thyroid surgery: use of ligasure vessel sealing system versus conventional knot tying method

The aim of this study was to compare the use of conventional knot tying vs. LigaSure Vessel Sealing System [Valley lab, Boulder, Colorado] in patients undergoing thyroid surgery. We hypothesized that the use of LigaSure would reduce the time of operation without more complications. This study was conducted in Endocrine Surgery Unit, Mansoura University Hospital on patients who underwent thyroid surgery from January 1, 2006 to December 31, 2006. 110 patients were operated upon by the same team of surgeons using conventional knot tying in 55 and LigaSure in 55 patients for hemostasis. The medical records of patients enrolled regarding age, sex, histopathological diagnosis, type of operation performed [lobectomy vs. subtotal thyroidectomy vs. total thyroidectomy]; the operation time, intraoperative blood loss, postoperative complications, length of incision, hospital stay and cost, as well as the postoperative pain and outcome were reviewed and compared. The two groups had nearly similar demographic data. We have noticed that patients in the LigaSure[TM] group had significant lower operating times [P = 0.000], lower intraoperative blood loss [P = 0.000], less postoperative pain and early pain-free return to normal activity and return to work [P = 0.0001]. LigaSure Vessel Sealing System was as safe as conventional knot tying method for thyroidectomy, with the benefit of a reduced operating time, decreased postoperative pain and early pain-free return to normal activity and return to work

randomized controlled trial comparing the use of prolene suture and nylon tape in modified Shirodkar operation: a clinical-microbiological study

A short cervix during pregnancy offers less resistance to ascending infection, which is related to the occurrence of preterm birth, preterm premature rupture of the membranes, and mid-trimester abortion. All these events significantly increase the incidence of perinatal mortality and morbidity. Cervical cerclage is a procedure used to increase the functional length of the cervix during pregnancy, by placement of a tape at the level of the internal os to support the cervical musculature. Much controversy is present about the value of cervical cerclage in improving perinatal outcome. The use of a braided synthetic material, that will significantly change the bacterial milieu in the upper vagina and cervix, might in itself play a role in promoting infection, and might contribute to this controversy. On the other hand, the use of a monofilament suture material as Prolene, might obviate the changes in the bacterial milieu of the high vagina after the procedure, and might help improve the perinatal outcome. To identify the microbiological changes of the cervico-vaginal flora in women undergoing modified Shirodkar operation using two different suture materials, and to compare the pregnancy outcomes as an indicator of operation effectiveness. A randomised controlled trail was conducted at Ain Shams University Maternity Hospital [ASUMH] from September 2000 through February 2002. Bacteriological indicators of infection [Number and type of colony forming units]; fetal salvage ratio; prematurity ratio. 44 Cases with clinical and/or dynamic ultrasonographic criteria of cervcial incompetence underwent cervical cerclage operation using either Prolene suture or Nylon-tape according to the modified Schirodkar technique. 4 cases dropped out. The rest [40 cases] were followed up till they ended their pregnancy spontaneously. Bacteriological swabs were obtained pre- and 4 weeks post operatively and aerobic and anaerobic cultures were performed and analysed. No difference was observed between the two groups in any of the major confounding variables. The Prolene group had statistically significantly less post-operative bacterial colonizaton compared to the Nylon-tape group. The Prolene group showed better fetal-salvage and prematurity ratois; the results reaching statistical significance. Elective cervical cerclage by modified Shirodkar technique at 12 to 18 weeks' gestation using Prolene suture improves the fetal salvage as well as the prematurity ratio in patients at risk of fetal wastage due to cervical incompetence. Prolene suture was statistically significantly superior to Nylon tape as regards the microbiological and perinatal outcome measures. Intervention on the basis of dynamic ultrasono graphic parameters was related to a better fetal survival outcome

Consideraçöes gerais em odontologia dos fios de sutura / Odontological General Considerations About Suture's thread

O autor após revisäo da literatura descreve as características dos numerosos tipos de fios de sutura; a sua classificaçäo e os aspectos mais importantes para a escolha do fio "ideal", quanto a reaçäo residual, propriedades dos fios, as regiöes e condiçöes para seu uso, bem como as consideraçöes entre os vários fios de sutura usados em odontologia