Comparing the Tolerability of a Novel Wound Closure Device Using a Porcine Wound Model.

Objective: To compare the tolerability and mechanical tensile strength of acute skin wounds closed with nylon suture plus a novel suture bridge device (SBD) with acute skin wounds closed with nylon suture in a porcine model. Approach: Four Yucatan pigs each received 12 4.5 cm full-thickness incisions that were closed with 1 of 4 options: Suture bridge with nylon, suture bridge with nylon and subdermal polyglactin, nylon simple interrupted, and nylon simple interrupted with subdermal polyglactin. Epithelial reaction, inflammation, and scarring were examined histologically at days 10 and 42. Wound strength was examined mechanically at days 10 and 42 on ex vivo wounds from euthanized pigs. Results: Histopathology in the suture entry/exit planes showed greater dermal inflammation with a simple interrupted nylon suture retained for 42 days compared with the SBD retained for 42 days (p < 0.03). While tensile wound strength in the device and suture groups were similar at day 10, wounds closed with the devices were nearly 8 times stronger at day 42 compared with day 10 (p < 0.001). Innovation: A novel SBD optimized for cutaneous wound closure that protects the skin surface from suture strands, forms a protective bridge over the healing wound edges, and knotlessly clamps sutures. Conclusion: This study suggests that the use of a SBD increases the tolerability of nylon sutures in porcine acute skin wound closures allowing for prolonged mechanical support of the wound. For slow healing wounds, this may prevent skin wound disruption, such as edge necrosis and dehiscence.

Exclusion and control: patterns aimed at limiting the influence of faculty of color.

This article reports on findings from a grounded theory study of the experiences of faculty of color (FOC) in predominantly Euro-American schools of nursing. Findings indicate that a dominant group sometimes referred to as the "Good Old Girls" posed a major barrier to change. To maintain the status-quo, the Good Old Girls used their influence to subject FOC to Patterns of Exclusion and Control with the goal of controlling the influence of FOC. This occurred through parallel and interrelated exclusion and control subprocesses. Exclusion and control strategies threatened FOC's success in academe while simultaneously jeopardizing their well-being. The exclusion strategies FOC experienced included Invalidation of Sense of Self, Othering, and Unequal Standards and Access to Resources. The control strategies included Insincerity and Putting You in Your Place. We describe each of these processes in detail and end with a discussion of the implications of our findings for educational practice.