New dedicated blunt straight needles and sutures for uterine compression sutures: a retrospective study and literature review

Shinya Matsuzaki,Satoshi Nakagawa,Masayuki Endo,Satoko Matsuzaki,Aiko Kakigano,Kazuya Mimura,Tatsuya Miyake,Tadashi Kimura,Takuji Tomimatsu,Tsuyoshi Takiuchi,Yutaka Ueda

doi:10.1186/s12893-019-0495-7

Abstract

BackgroundWe developed a dedicated blunt straight needle with No. 2 polydioxanone sutures (2-Monodiox®) for uterine compression sutures (UCSs) and aimed to assess the outcomes and complication rates of UCSs for postpartum hemorrhage by comparing with commercially available needle and suture types.MethodsA retrospective analysis was performed between January 2010 and February 2018. During the study period, two types of commercially available sutures and 2-Monodiox® were used. PubMed, MEDLINE, and Scopus databases were searched for English articles published between January 1997 and May 2017 using search terms related to the suture and needle types for UCSs to discuss the dedicated needles and sutures for UCS.ResultsThe analysis included 47 cases of UCSs for the uterine body with three suture types (No. 0 polydioxanone, 7 cases; No. 1 poliglecaprone 25, 21 cases; and No. 2 polydioxanone, 19 cases). B-Lynch suture using No. 0 sutures was associated with a significantly lower uterine preservation rate than those with Nos. 1 and 2 sutures (42.9% vs. 95.2 and 89.5%, respectively; p < 0.01). A modified Hayman suture technique was performed using 2-Monodiox® sutures, which achieved a similar uterine preservation rate compared with B-Lynch suture using No. 1 poliglecaprone 25 sutures. No patients developed severe complications. The literature review showed that no dedicated sutures have developed for UCSs. Three dedicated needles for UCSs have been developed, and 2-Monodiox® is the first dedicated blunt straight needle for UCSs.ConclusionOur data showed that No. 0 sutures should not be used for B-Lynch suture. The uterine preservation rate is similar for 2-Monodiox® with modified Hayman suture and No. 1 poliglecaprone 25 sutures with B-Lynch suture, without the occurrence of severe complications.

Highlights

We developed a dedicated blunt straight needle with No 2 polydioxanone sutures (2-Monodiox®) for uterine compression sutures (UCSs) and aimed to assess the outcomes and complication rates of Uterine compression suture (UCS) for postpartum hemorrhage by comparing with commercially available needle and suture types
Key message Our dedicated blunt straight needle with No 2 polydioxanone sutures (2-Monodiox®) could perform modified Hayman suture with similar uterine preservation rate performed with B-Lynch technique with No 1 sutures
We considered that using a straight needle was not necessary for UCSs when performing the B-Lynch technique; the Hayman, Cho, and MY techniques have been performed using a straight or liver needle in previous studies, and these procedures may be more accessible once a straight blunt needle is developed [25,26,27]

Summary

Introduction

We developed a dedicated blunt straight needle with No 2 polydioxanone sutures (2-Monodiox®) for uterine compression sutures (UCSs) and aimed to assess the outcomes and complication rates of UCSs for postpartum hemorrhage by comparing with commercially available needle and suture types. Studies about dedicated needles and sutures for UCSs are limited, and the differences in the efficacies of a needle and sutures have not been. Our study focused on the efficacy of needles and sutures for UCSs. First, we show detailed information about our dedicated blunt straight needle with No 2 polydioxanone sutures (2-Monodiox®, Alfresa Pharma Co., Osaka, Japan) specially made for UCSs. Our study is the first report of 2-Monodiox® for UCS. The efficacy of different needles and sutures for UCSs used at our institution were compared

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