Conventional Suture Research Articles

Comparative Evaluation of the Aesthetic Outcomes of Octyl-2-Cyanoacrylate Skin Adhesive and Ethilon Suture in Maxillofacial Surgery - A Randomised Clinical Study.

Wound closure methods have evolved, attributed to the armamentarium including the synthetic sutures, staples, surgical adhesive tapes and, most recently, the cyanoacrylate tissue adhesives. Cyanoacrylates have shown promising results in terms of aesthetic outcomes in other fields of surgery. The aim of this study is to compare the aesthetic value of Dermabond over Ethilon suture when used in case of facial surgical incisions. The purpose of this study was to demonstrate the efficacy of Dermabond for wound closure in the head-and-neck region. This study involved 20 subjects undergoing maxillofacial surgery. In 10 subjects, skin closure was done with conventional suturing (Ethilon) and other 10 subjects with tissue glue (2-octyl cyanoacrylate). Observations regarding skin closure time and scar assessment were made, and their results were compared. The mean time for closure in the Dermabond group was 217.2 ± 42.0 s and for Ethilon suture group was 383.3 ± 140.2 s. Dermabond was significantly better than Ethilon sutures at both 1 month and 3 months with P = 0.001 and P < 0.001, respectively. For Dermabond, the average score improved from 8.2 ± 2.5 at 1 month to 6.1 ± 1.6 at the 3rd month. The improvement was statistically significant (P = 0.001) for Ethilon sutures; the average score improved from 12.0 ± 1.2 at 1 month to 10.2 ± 2.0 at 3rd month. The improvement was statistically significant (P = 0.038). Adhesive glue appears to be superior to conventional suturing in clean elective surgeries. It is a safe and effective method of skin closure with less operative time and better cosmesis of the scar.

Comparison of bone tacks and sutures in free gingival graft procedures a clinical study

Objective The aim of the present study was to compare the efficacy of bone tacks and sutures in free gingival graft FGG stabilization during gingival augmentation procedures. Materials and Methods Twelve subjects participated in this study. One site in each subject was randomly assigned into each of the following experimental groups. In the test group, the FGG was stabilized with bone tacks whereas FGG procedure with conventional sutures was performed in the control group. Clinical parameters assessed were the width of keratinized gingiva and plaque index PI scores at baseline 1 month and 3 months. Surface shrinkage SS was recorded at 15 days 1 month and 3 months. Early wound healing score EHS was recorded postoperatively after an interval of 1 week. Results Bone tacks stabilized with FGG were effective in increasing the width of the keratinized gingiva but did not show any added advantage over sutures with no statistical difference between both groups p0.49. In both groups there was similar SS EHS and PI scores with no statistical significance difference between them p1.00. Conclusion This trial was conducted over a period of 3 months and it was observed that bone tacks can be used to stabilize the FGG during mucogingival procedures.

Biomechanical evaluation of the ST-knot: A new suture for flexor tendon repair

PurposeAlthough tendon lacerations are common, there is currently no consensus on choice of suture. Easy and fast sutures that impart enough strength to allow mobilization are needed. This study compared the ex vivo biomechanical strength (force required to create a 2 mm tendon gap) of a novel suture (ST-knot) with that of a conventional suture (double Kessler). Materials and methodsForty fresh deep flexor tendons from porcine forelimbs were used. Both repaired tendon ends were mounted on standard traction jaws of an axial traction machine at an initial distance of 40 mm for all tendons. A high-definition camera was used to determine the force forming a 2 mm gap. Ten tendons in group 1 (ST-knot) and 10 in group 2 (double Kessler) were prepared with PDS 4.0 (single thread for Kessler, double thread for ST-knot). Tendons in groups 3 (ST-knot) and 4 (double Kessler) were repaired with PDS 1.0 using the same principle. ResultsThere was no significant difference in the force required to form a 2 mm tendon gap between groups 1 and 2, and this trend was identical when using a stronger thread in groups 3 and 4. The maximum force before rupture, mode of repair failure, stress and stiffness were also comparable, with no significant differences between groups 1 and 2, or between groups 3 and 4. ConclusionsThe ST-knot showed comparable results to the double-Kessler knot, whichever the thread used. Because it involves fewer steps than conventional techniques and is easy to perform, the ST-knot may offer a therapeutic solution, particularly in complex trauma with multiple tendon injury.

Pain scores and functional outcomes of patients with shoulder labral repair using all-suture anchors versus conventional anchors.

The purpose of this study was to compare PROMs in patients undergoing anterior glenoid labral repair using all-suture versus conventional anchors. We hypothesized PROMs would be similar between groups. We performed a retrospective review of the Arthrex Global Surgical Outcomes System (SOS) database, querying patients who underwent arthroscopic glenoid labral repair between 01/01/2015 and 12/31/2020. Patients aged 18-100, who had isolated glenoid labrum repair with at least 12-month follow-up were included. The visual analog pain scale (VAS), Western Ontario Shoulder Instability Index, Veteran's RAND 12-items health survey, single assessment numeric evaluation and the American Shoulder and Elbow Surgeons score (ASES) were compared preoperatively, 3months, 6months, 1year and 2years postoperatively in patients who received all-suture anchors versus conventional anchors in the setting of anterior glenoid labrum repair. Our primary aim was comparison of PROMs between patients receiving all-suture versus conventional suture anchors. Secondarily, a sub-analysis was performed comparing outcomes based on anchor utilization for patients with noted anterior instability. We evaluated 566 patients, 54 patients receiving all-suture anchors and 512 patients receiving conventional anchors. At two-year follow-up there was no significant difference between the two groups in PROMs. In a sub-analysis of isolated anterior labrum repair, there was an improvement in ASES (P = 0.034) and VAS (P = 0.039) with the all-suture anchor at two-year follow-up. All-suture anchors provide similar or superior pain and functional outcome scores up to 2years postoperatively compared to conventional anchors. As all-suture anchors gain popularity among surgeons, this is the largest scale study to date validating their use in the setting of glenoid labrum repair. Institutional Review Board (IRB): IRB202102550.

Reduction in drain-related adverse events using the barbed suture method for chest tube wound closure.

A chest tube is usually placed in patients undergoing general thoracic surgery. Although the barbed suture method has been introduced for chest tube wound closure, its superiority to the conventional suture methods for drain management remains unclear. The study aimed to determine whether the barbed suture method could reduce drain-related adverse events compared to the conventional method. We retrospectively reviewed the medical records of patients who underwent general thoracic surgery between January 2021 and December 2022, 1year before and after the introduction of the barbed suture method at our institution. Patients who underwent the barbed suture or conventional method were included. Univariate and multivariate analyses of drain-related adverse events were performed. Of the 250 participants, 110 and 140 underwent the barbed suture method and conventional suture method, respectively. The univariate analysis showed that a higher body mass index, preoperative malignant diagnosis, lobectomy, longer operative time, larger tube size, longer chest drainage duration, surgical complications, and conventional method were risk factors for drain-related adverse events. The multivariate analysis showed that the barbed suture method was a protective factor against drain-related adverse events (odds ratio 0.267; 95% confidence interval 0.103-0.691; P = 0.007). The barbed suture method could reduce drain-related adverse events compared to the conventional method. Therefore, it might be a potential standard method for chest tube wound closure in patients undergoing general thoracic surgery.

Clinical outcomes of arthroscopic all-inside anterior talofibular ligament suture augmentation repair versus modified suture augmentation repair for chronic ankle instability patients

BackgroundTo compare the clinical efficacies of arthroscopic anterior talofibular ligament suture augmentation repair and modified suture augmentation repair in patients with chronic ankle instability (CAI).MethodsFrom October 2019 to August 2020, 100 patients with CAI were enrolled after propensity score matching analysis and observed for two years. Among them, 50 underwent modified suture augmentation repair and the other 50 underwent suture augmentation repair. The clinical efficacies of CAI treatments were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) clinical rating scale, visual analog scale (VAS), and anterior drawer test scores.ResultsThe postoperative AOFAS score of the modified suture augmentation repair group (83.8 ± 11.3) was significantly higher than that of the suture augmentation repair group (76.3 ± 11.3; P = 0.001). The VAS (P = 0.863) and anterior drawer test (P = 0.617) scores were not significantly different between the two treatment groups.ConclusionBoth the modified suture augmentation repair and suture augmentation repair demonstrated good clinical efficacies. The AOFAS score of the modified suture augmentation repair group was superior to that of the conventional suture augmentation repair group. Thus, modified suture augmentation repair is a feasible and practical surgical technique for CAI treatment.

A Comparison of Efficacy of Autologous Platelet-rich Plasma and Conventional Sutures in Anchoring Split Skin Graft on Wounds

Abstract Context: Split thickness skin grafting (STSG) restores cutaneous cover over wounds thus protecting the underlying surface from contamination, fluid loss and stimulates healing. Autologous platelet rich plasma (PRP) provides a large number of platelets and high concentration of growth factors which promote overall uptake of STSG. Aims: The aim of this study was to assess the immediate, subsequent adhesion and final take of STSG with application of PRP over recipient site. Methods and Material: 1 year Randomised Control Trial where 80 wounds of various aetiologies were randomised into intervention group (n=40) which received PRP before placing STSG on recipient site and control group (n=40) in which the graft was fixed in place with sutures alone. Immediate graft adhesion and subsequent graft uptake were compared between the two groups and statistical analysis was done with: SPSS Version 20. Results: Irrespective of aetiology, and size, among a total of 80 wounds 87.5% grafts had adhered by 1st minute of application in the intervention group compared to nil in control group (p&lt; 0.0001). Graft uptake was assessed on first three consecutive dressings. There was significantly better graft uptake in intervention group compared to control group [third dressing uptake (98.29%, 93%, p&lt; 0.0001) respectively].Difference in seroma and haematoma formation were also compared between the two groups and found to be not significant. (p&gt;0.05) Conclusions: Application of topical PRP facilitates STSG uptake. It decreases operative time by decreasing mobility of graft over the wound bed. Thus, use of PRP improves outcome of split thickness skin graft in wounds of various aetiologies and we recommend use of the same at recipient site of STSG. CTRI/2021/06/034401

832 Trial of labor outcomes after knotless-barbed vs. conventional suture for closure of cesarean uterine incision

832 Trial of labor outcomes after knotless-barbed vs. conventional suture for closure of cesarean uterine incision

STAPLED FASCIAL CLOSURE VS. CONTINUOUS HAND-SEWN SUTURE: EXPERIMENTAL STUDY OF THE ABDOMINAL WALL ON PORCINE MODEL AND HUMAN CADAVER.

One of the primary complications associated with large incisions in abdominal surgery is the increased risk of fascial closure rupture and incisional hernia development. The choice of the fascial closure method and closing with minimal tension and trauma is crucial for optimal results, emphasizing the importance of uniform pressure along the suture line to withstand intra-abdominal pressure. To evaluate the resistance to pressure and tension of stapled and sutured hand-sewn fascial closure in the abdominal wall. Nine abdominal wall flaps from human cadavers and 12 pigs were used for the experimentation. An abdominal defect was induced after the resection of the abdominal wall and the creation of a flap in the cadaveric model and after performing a midline incision in the porcine models. The models were randomized into three groups. Group 1 was treated with a one-layer hand-sewn small bite suture, Group 2 was treated with a two-layer hand-sewn small bite suture, and Group 3 was treated with a two-layer stapled closure. Tension measurements were assessed in cadaveric models, and intra-abdominal pressure was measured in porcine models. In the human cadaveric model, the median threshold for fascial rupture was 300N (300-350) in Group 1, 400N (350-500) in Group 2, and 350N (300-380) in Group 3. Statistical comparisons revealed non-significant differences between Group 1 and Group 2 (p=0.072, p>0.05), Group 1 and Group 3 (p=0.346, p>0.05), and Group 2 and Group 3 (p=0.184, p>0.05). For porcine subjects, Group 1 showed a median pressure of 80 mmHg (85-105), Group 2 had a median of 92.5 mmHg (65-95), and Group 3 had a median of 102.5 mmHg (80-135). Statistical comparisons indicated non-significant differences between Group 1 and Group 2 (p=0.243, p>0.05), Group 1 and Group 3 (p=0.468, p>0.05), and Group 2 and Group 3 (p=0.083, p>0.05). Stapled and conventional suturing resist similar pressure and tension thresholds.

Arthroscopic Fixation of Acute Large Bony Bankart with Suture-assisted Reduction and Screw Fixation - Surgical Technique.

Glenoid rim fractures with Bankart lesions are called bony Bankart lesions and are associated with persistent glenohumeral joint instability. Acute bony Bankart lesions can be treated by various arthroscopic techniques. Here, we present a technique of arthroscopic bony Bankart repair using suture-assisted reduction and screw fixation. The conventional suture anchor repair does not provide compression of the fractured fragment, and the bony piece may tilt because of the single-point fixation. This procedure can achieve firm compression between the bony fragments and prevent rotation of fragment during screw fixation to the glenoid. The capsular plication distributes the loads to the surrounding soft tissues. Hence, this procedure should be offered to all patients presenting acutely with a large bony Bankart of size >25% of glenoid width, as it is minimally invasive as well as provides excellent outcomes and anatomical union.

The Effect of Bidirectional Barbed Sutures on the Duration of Common Enterotomy Closure in Intracorporeal Anastomosis.

The adoption of intracorporeal anastomosis in minimally invasive surgery for colon cancer has gradually expanded owing to its many advantages. However, intracorporeal anastomosis has the disadvantage of a longer operative time than extracorporeal anastomosis. One reason that intracorporeal anastomosis takes longer to perform is the closure of the common enterotomy. The present study evaluated the effect of bidirectional barbed sutures on the duration of common enterotomy closure in intracorporeal anastomosis for minimally invasive colectomy. The time required for common enterotomy closure was measured with a simulator using an intestinal model. A two-layer suture with continuous full-thickness suture followed by a continuous serosal-muscular suture was adopted. The time required to close the common enterotomy using two unidirectional barbed sutures and one bidirectional barbed suture was measured five times each. The duration of common enterotomy closure using bidirectional barbed suture was significantly shorter than that using two conventional barbed sutures. Bidirectional barbed sutures are useful for closing the common enterotomy in intracorporeal anastomosis for minimally invasive colectomy.

A comparative study of cyanoacrylate-based tissue adhesive and surgical sutures on marginal flap stability following coronally advanced flap

IntroductionThe present study evaluated the biomechanical characteristics of cyanoacrylate-based tissue adhesive (TA) compared to surgical sutures in coronally advanced flap (CAF) procedures using an ex-vivo model.Material and methodsThirty-six half-pig mandibles were divided into three groups, n=12 each: (I) CAF fixed with sutures (sling and tag suture technique), (II) CAF fixed with TA, and (III) CAF fixed with sutures and TA. At mandibular premolars, gingival recession defects extending 3 mm apical to the cemento-enamel junction (CEJ) were created. CAF procedures were performed using a split-full-split approach, with coronal advancement of the flap to 1 mm above the marked CEJ and stabilization according to the respective groups I–III. Marginal flap stability against pull-of forces (maximum tensile force) was measured with a universal material testing machine until the CEJ became visible.ResultsThe comparison between groups I–III demonstrated a significantly increased maximum tensile force for the TA (II) compared to the suture group (I) (p<0.001). A significantly increased maximum tensile force was found for the suture and TA (III) compared to the suture group (I) (p<0.001). There was also a significantly increased maximum tensile force in the suture and TA (III) compared to the TA group (II) (p<0.001).ConclusionThe results suggest that cyanoacrylate-based TA can increase marginal flap stability compared to sutures in CAF procedures.Clinical relevanceCyanoacrylate-based TA can be considered a useful and valuable adjunct to conventional suturing techniques in periodontal plastic surgery, especially in cases where high flap stability is required. The results of this ex-vivo study can only be transferred to the clinical situation with limitations. Clinical long-term follow-up data must be generated.

Traditional suture tape versus multiple high-strength sutures for augmentation of anterior cruciate ligament primary repair: A time-zero biomechanical study

Background/objectiveDuring the initial stages of rehabilitation after anterior cruciate ligament (ACL) surgery, a pivotal role is played in ensuring effective recuperation and averting complications. An often-employed strategy to tackle ACL laxity during this period involves the incorporation of synthetic materials for reinforcement. The objective of this study is to compare the effectiveness of conventional suture tape and multiple high-strength sutures as augmentation techniques for ACL repair. MethodsTen preserved cadaveric knees embalmed using the Thiel method were segregated into two groups, each containing five knees. In one group, traditional suture tape was employed for augmentation, while the other group utilized multiple high-strength sutures. Each knee underwent a cyclic load of 1000 sine wave cycles, succeeded by an axial distraction load until failure ensued. The resultant displacement and ultimate load at failure were assessed to contrast the efficacy of the two augmentation techniques. ResultsThe group utilizing multiple high-strength sutures exhibited a significantly higher load to failure at time-zero (1690.7 N) compared to the suture tape group (987.6 N) (P = .003). Furthermore, the multiple high-strength sutures group demonstrated significantly reduced displacement after 1000 cyclic loads (6.6 mm) in comparison to the suture tape group (16.3 mm) (P < .001). ConclusionsMultiple high-strength sutures show better biomechanical properties for the augmentation of ACL repair at time-zero. Both suture tape and multiple high-strength sutures had ultimate load-to-failure values higher than the natural ACL loads. Therefore, these substances might serve as augmentation options to prevent the ACL's gradual elongation, a critical concern particularly in the initial stages of rehabilitation.

Comparing the biomechanical properties of conventional suture and all-suture anchors using patient-specific and realistic osteoporotic and non-osteoporotic phantom using 3D printing

Conventional suture anchors (CAs) and all-suture anchors (ASAs) are used for rotator cuff repair. Pull-out strength (POS) is an important factor that affects surgical outcomes. While the fixation mechanism differs between the anchor types and relies on the quality, few studies have compared biomechanical properties of anchors based on bone quality. This study aimed to compare the biomechanical properties of anchors using osteoporotic bone (OB) and non-osteoporotic bone (NOB) simulators. Humerus simulators were fabricated using fused deposition modeling of 3D printing and acrylonitrile butadiene styrene adjusting the thickness of cortical bone and density of cancellous bone based on CT images. Cyclic loading from 10 to 50 N, 10 to 100 N, and 10 to 150 N for 10 cycles was clinically determined at each anchor because the supraspinatus generates a force of 67–125 N in daily activities of normal control. After cyclic loading, the anchor was extruded at a load of 5 mm/min. Displacement, POS, and stiffness were measured. In OB simulators, CAs revealed bigger gap displacement than ASAs with cyclic loading of 10–150 N. ASA showed higher values for POS and stiffness. In NOB simulators, ASAs revealed bigger gap displacement than CAs with cyclic loading of 10–150 N. ASA showed higher values for POS and CA showed higher values for stiffness. POS of anchors depends on anchors ‘displacement and bone stiffness. In conclusion, ASA demonstrated better biomechanical performance than CA in terms of stability under cyclic loading and stiffness with similar POS in OB.

Mersilene tape versus conventional sutures in transvaginal cervical cerclage: a systematic review and meta-analysis

ObjectiveThis study aimed to assess the effectiveness of Mersilene tape versus alternative suture types in prolonging singleton pregnancies as well as other pregnancy and neonatal outcomes, in cases of history-, ultrasound-, and exam-indicated cervical cerclage.MethodsA systematic review was conducted to identify relevant studies comparing different suture types in cervical cerclage procedures. The primary outcome of interest was preterm birth (PTB) rate < 37, <35, < 28, and < 24 weeks. Statistical analyses were performed to determine the relationship between suture type and various outcomes.ResultsA total of five studies, including three randomized controlled trials (RCTs) and two retrospective studies, with a combined participation of 2325 individuals, were included. The pooled analysis indicated no significant association between suture type and PTB at less than 37 weeks of gestation (RR: 1.02, 95% CI: 0.65–1.60, p < 0.01, I2 = 74%). Women who received Mersilene tape had a higher risk of PTB at 34–37 weeks (RR: 2.62, 95% CI: 1.57–4.37, p = 0.69, I2 = 0%), but a lower risk of PTB at less than 34 weeks (RR: 0.43, 95% CI: 0.28–0.66, p = 0.66, I2 = 46%). No statistically significant differences were observed for PTB before 28 weeks (RR: 1, 95% CI: 0.65–1.53, p = 0.70, I2 = 0%), before 24 weeks (RR: 0.86, 95% CI: 0.60–1.23, p = 0.33, I2 = 0%), incidence of chorioamnionitis (RR: 0.97, 95% CI: 020-4.83, p < 0.01, I2 = 95%), neonatal intensive care unit (NICU) admission (RR: 0.79, 95% CI: 0.28–2.22, p = 0.08, I2 = 67%) and neonatal death (RR: 1.00, 95% CI: 0.42–2.35, p = 0.17, I2 = 48%).ConclusionOur findings suggest that Mersilene tape does not reduce the risk of PTB before 37, 28 or 24 weeks. We observed higher risk of preterm birth between 34 and 37 weeks with Mersilene tape but lower incidence before 34 weeks, a period with higher neonatal morbidity and mortality. Due to the limited number of studies, our results and their clinical significance should be interpreted with caution.

High magnification versus optical magnification in hypospadias surgery: a randomized controlled trial

BackgroundHypospadias is the most common congenital abnormality of the urethra affecting live male births. The incidence is rising with the increasing pollution. During the last 50 years, developments in surgical instrumentation and optical systems allowed surgeons to increasingly undertake microsurgical procedures. Optical magnification is essential in pediatric surgery. Magnifying loupes are the most frequently used, although they often cause neck pain to the surgeon. Recent advances led to the development of a compact video microscope (VITOM; Karl Storz Endoscopy GmbH, Tuttlingen, Germany) that displays high-definition magnified images on a flat screen.ObjectiveEvaluate VITOM as a potential substitute for loupes in complex open pediatric procedures and explore VITOM as an effective intraoperative teaching modality for open surgery.MethodsFifty-two patients enrolled in our study were divided into two groups: Group A (26): high magnification was used either (VITOM Karl Storz Endoscopy GmbH, Tuttlingen, Germany) or (Surgical microscope, Carl Zeiss Microscopy GmbH), along with microsurgical instruments. Vicryl 8-0 suture was used for urethroplasty. Group B (26): patients were operated upon by conventional instruments (fine tip but not microsurgical instruments), sutures, and magnification (3.5×). Vicryl 6-0 suture was used for urethroplasty, with loupes-assisted magnification.ResultsMore complications were found in group B. Using VITOM was accompanied by less neck pain, enhanced visualization, and an enhanced teaching environment.ConclusionOperating with high magnification tools minimizes post-operative complications in hypospadias surgery. They enhanced identification of the penile anatomy and topography which facilitated reconstruction techniques as well as enhanced the comfort of the surgeon.Level of evidenceI.

Gap Resistance and Tensile Strength of a Q Suture Technique During Curved Loading: An ExVivo Porcine Flexor Tendon Study.

This study aimed to determine the mechanical properties of the double Q suture technique in angular motion and to compare the gap formation associated with tendon repairs during curved and linear loading. Eighty porcine flexor tendons were repaired with one of two 4-strand sutures: double Q suture or double modified Kessler plus peripheral running sutures. The repaired tendons were cyclically loaded sequentially against a pulley with a radius of 2.0, 1.5, and 1.0 cm or linearly without any pulleys. The number of tendons that formed an initial or 2-mm gap at the repair site during cyclic loading, the gap size between tendon ends when cyclic loading ended, and the ultimate strength were recorded. The gap at the repair site formed gradually from the dorsal to volar aspect during curved loading. No double Q repairs, but half of the double Kessler plus running suture repairs, formed an initial or 2-mm gap on the volar aspect during curved loading. The double Q group had a significantly smaller gap size on the dorsal aspect than the double Kessler plus running suture group at all three radii of curvature. The ultimate strength was similar between the two groups. There were no significant differences in linear motion between these two repairs. The double Q suture is superior to the conventional 4-strand tendon core suture plus running peripheral sutures in gap resistance in angular motion. This study provides insight into the formation of an unbalanced gap on the dorsal and volar aspects of tendon repair during curved loading. The double Q suture provides a simple and efficient option for flexor tendon repair considering the high risk of gap formation on the dorsal aspects of the tendon repair in angular motion.

Outcome Analysis of Total Thyroidectomy: Conventional Suture Ligation Technique vs Sutureless Technique.

Total thyroidectomy is a common surgical procedure in endocrine surgery. However, it carries potential complications such as damage to the recurrent laryngeal nerve, permanent hypoparathyroidism, and bleeding. Methods: A prospective study was conducted at the Professorial Surgical Unit, Jaffna Teaching Hospital, involving consecutive patients who underwent total thyroidectomy. Patients with certain conditions were excluded from the study. The data collected were analyzed using IBMSPSSStatistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, New York, United States). This study included 59 patients who had total thyroidectomy from January 2018 to January 2021 at the Professorial Surgical Unit, Jaffna Teaching Hospital. Of these, 45 underwent conventional suture ligation (CSL), and 17 had a sutureless (SL) technique. Mean ages were 44±12.47 years (range: 23 to 68) for CSL and 47.63±13.37 years (range: 27 to 73) for SL. Operative time was 2.16 ± 0.32 hours for CSL and 1.56 ± 0.49 hours for SL. Intraoperative and postoperative bleeding occurred in 2.38% of CSL cases but not in SL. Postoperative hypocalcemia was 7.14% for CSL and 5.88% for SL. Postoperative stays averaged 3.83 ± 1.56 days for CSL and 3.41 ± 1.62 days for SL. The study found that the operative time differed significantly between the suture and SL techniques. However, there was no statistically significant difference in postoperative drainage volume or postoperative complications. The SL technique was shown to be superior to the conventional suture ligation technique for total thyroidectomy. It resulted in shorter operative time, reduced intraoperative bleeding, lower incidence of postoperative drainage, fewer postoperative voice changes, and shorter hospital stays. Therefore, the SL technique was deemed safe, efficient, and effective for total thyroidectomy compared to the conventional suture ligation technique.

C-Reactive Protein and Serum Amyloid-A Response to N-butyl Cyanoacrylate-based Sutures in Sahel Goats

The use of biomaterials as suture materials triggering less acute phase response to tissue damage for cutanuous wounds closure has been the goal of numerous researchers. The introduction of Cyanoacrylate into clinical practice is of keen interest which could be an alternative to conventional suture materials. This study focused on monitoring responses to tissue damage elicited by Cyanoacrylate and Nylon based suture materials for wound closure. Ten apparently healthy male goats (Bucks) with mean age of 9.7±1.33 months and mean weight 13.2±1.31 kg were randomly separated into two groups A &amp; B of five (5) bucks each. Incisions made in Group A were closed using N-butyl Cyanoacrylate while nylon was used in group B. Blood samples were taken before the procedures and after at 0, 5, 8, 24, 48 and 72 h for estimation of serum C-Reactive Protein (CRP) and Serum Amyloid-A (SAA). Results indicated that Nylon based suture material triggered early and significant tissue damages based on serum CRP elevated levels while serum SAA levels were comparable when nylon and N-butyl cyanocarylate were used as suture materials for wound closures.

Comparison of outcome of conventional suture ligation versus ligasure vessel sealing in patients undergoing total thyroidectomy for multinodular goiter.

Objective: To compare the results of Ligasure versus conventional suture ligation for thyroidectomy for multinodular goiter in terms of mean operative time and post-operative drain output volume. Study Design: Comparative Prospective study. Setting: Department of General Surgery, Mayo Hospital Lahore. Period: 1st April 2020 to 31st March 2021. Material &amp; Methods: After approval from the Institutional review board of King Edward medical university, a sample of 140 patients was obtained. Patients were divided into 2 groups, Group A and Group B. Group A patients underwent total thyroidectomy with Ligasure vessel sealing while Group B patients underwent total thyroidectomy with conventional suture ligation. Operative time and post-operative drain volume were measured and documented. The P-value of ≤ 0.05 was considered significant. Results: The average age of the patients was 36.04 ± 9.78 years with minimum and maximum ages being 18 &amp; 61 years respectively. The mean surgery time was 137.80 ± 26.21 minutes in group A while in group B the mean surgery time of the patients was 164.91 ± 31.94 minutes (P-value= &lt;0.001). The mean post-op drain volume in group A was 91.28 ± 7.82 ml, almost similar to group B patients i: e 70.28 ± 4.33 ml (P-value=0.14). Conclusion: Ligasure vessel sealing is significantly better than conventional suture ligation in terms of mean surgery duration but there is no difference in post-operative drain volume in both groups.