ABSTRACT
PURPOSE: To assess the effect of cyanoacrylate glue on knot slippage and strength in vitro. METHODS: Ethibond 3/0 was tested using a tensile tester. A single drop of cyanoacrylate glue was applied to the knots. Seven knot configurations (10 samples each) were tested: (1) a surgeon's knot (S) plus 4 square throws (+4) without glue (control group), (2) S plus one square throw (+1) without glue, (3) S+1 with glue, (4) S with glue, (5) S+1 wet posttie without glue, (6) S+1 wet pre-tie without glue, and (7) S+1 wet pre-tie with glue. Wet sutures were immersed in normal saline for 24 hours prior to knot tying. Wet pre- and post-tie sutures were immersed for one minute prior to knot tying and tensile testing, respectively. Outcome measures were the mode of failure (knot slippage or suture snapping) and the ultimate tensile strength. RESULTS: All knots without glue failed owing to knot slippage, except for the controls, whereas all knots with glue failed owing to suture snapping. The ultimate tensile strength was significantly higher in knots with glue and controls than in knots without glue. The ultimate tensile strength did not differ significantly between S+4 without glue and S with glue (p=0.48), indicating that glue could reinforce knots and reduce the number of throws needed. Wet suture is protective against failure (p<0.01). CONCLUSION: Cyanocrylate glue may have clinical applications for flexor tendon repairs for which a reduced knot size is advantageous.
Subject(s)
Cyanoacrylates , Suture Techniques , Sutures , Materials Testing , Polyethylene Terephthalates , Tensile StrengthABSTRACT
Underwater noise from shipping is a growing presence throughout the world's oceans, and may be subjecting marine fauna to chronic noise exposure with potentially severe long-term consequences. The coincidence of dense shipping activity and sensitive marine ecosystems in coastal environments is of particular concern, and noise assessment methodologies which describe the high temporal variability of sound exposure in these areas are needed. We present a method of characterising sound exposure from shipping using continuous passive acoustic monitoring combined with Automatic Identification System (AIS) shipping data. The method is applied to data recorded in Falmouth Bay, UK. Absolute and relative levels of intermittent ship noise contributions to the 24-h sound exposure level are determined using an adaptive threshold, and the spatial distribution of potential ship sources is then analysed using AIS data. This technique can be used to prioritize shipping noise mitigation strategies in coastal marine environments.
Subject(s)
Environmental Monitoring/methods , Noise, Transportation/statistics & numerical data , Ships/statistics & numerical data , Acoustics , Animals , Ecosystem , Environment , Environmental Monitoring/instrumentation , Humans , Oceans and SeasABSTRACT
BACKGROUND: Not all patients gain the same degree of improvement from total hip replacement and the reasons for this are not clear. Many investigators have assessed predictors of general outcome after hip surgery. This study is unique in its quest for the predictors of the best possible early outcome. METHODS: We prospectively collected data on 1318 total hip replacements. Prior to surgery patient characteristics, demographics and co-morbidities were documented. Hip function and general health was assessed using the Harris Hip score (HHS) and the Short-Form 36 respectively. The HHS was repeated at three years. We took a maximal HHS of 100 to represent an excellent outcome (102 patients). Multiple logistic regression analysis was used to identify independent predictors of excellent outcome. RESULTS: The two strongest predictive factors in achieving an excellent result were young age and a high pre-operative HHS (p = 0.001). CONCLUSIONS: It was the young and those less disabled from their arthritis that excelled at three years. When making a decision about the timing of hip arthroplasty surgery it is important to take into account the age and pre-operative function of the patient. Whether these patients continue to excel however will be the basis of future research.
Subject(s)
Arthroplasty, Replacement, Hip/rehabilitation , Age Factors , Aged , Arthroplasty, Replacement, Hip/methods , Body Mass Index , Comorbidity , Disability Evaluation , Female , Humans , Male , Middle Aged , Preoperative Period , Prognosis , Prospective Studies , Severity of Illness Index , Sex Factors , Treatment OutcomeABSTRACT
We report a case of external iliac artery aneurysm rupture during removal of the acetabular component for septic loosening. Potentially fatal hemorrhage would have occurred if the risk had not been recognized, and the external iliac vessels exposed to gain vascular control before proceeding with implant removal. A review of the literature on vascular injury at revision hip surgery is presented.
