Dacron Suture Research Articles

Intrusion of Dacron Sutures and A Recurrent Vitreous Hemorrhage: Rare Complication of Scleral Buckle

Intrusion of Dacron Sutures and A Recurrent Vitreous Hemorrhage: Rare Complication of Scleral Buckle

Intrusion of Dacron suture knot 15\u2009years after scleral buckling

BackgroundWe present a case of intrusion of a suture knot 15 years after scleral buckling surgery.Case presentationA 62-year-old woman with high myopia had undergone scleral buckling surgery in her left eye 15 years previously for rhegmatogenous retinal detachment. She recently displayed highly elevated intraocular pressure, with hyphema and vitreous hemorrhage. After the blood was cleared, a ring-shaped protrusion was noted around the equator of the eyeball, with a blue suture knot standing out on its surface and extending into the vitreous cavity at 5 o’clock. The suture knot was removed successfully. Mass spectrometry revealed that the material of the suture was polyethylene terephthalate, or Dacron. One week later, at the place where the suture knot had been located, the choroidal and retinal tissue disappeared and the silicone buckle remained an uncovered intrusion, whereas the rest of the retina was still attached.ConclusionsThe suture knot was possibly the one used to close the drainage port for subretinal fluid, which was covered by the encircling band. During the buckling procedure, covering a nonabsorbable suture, which is usually placed where the sclera is compromised by trauma or the surgical incision, with an encircling band may lead to the intrusion of the suture. Therefore, a soft absorbable suture may be preferable, if possible.

Purse-String Capsule Repair to Reduce Proximal Femoral Arthroplasty Dislocation for Tumor—A Novel Technique With Results

Hip joint dislocation is the most common complication after proximal femoral arthroplasty with a large endoprosthesis. Average dislocation rates are around 15%. In an attempt to decrease dislocations after proximal femoral arthroplasty for tumor resections, we devised a novel closure of the hip capsule. This technique uses a 3-mm cottony Dacron suture placed about the hip capsule in a circumferential, purse-string manner. Thirty-nine patients received hip hemiarthroplasty with purse-string capsular closure. Seven patients were lost to follow-up, leaving 36 patients available for analysis. One patient dislocated (2.8%). We believe this technique is useful in preventing dislocation in patients undergoing proximal femoral arthroplasty for oncologic disease.

Alternative AOAC Sporicidal Test Carrier for Evaluating Peracetic Acid-Based Sterilants (Modification of AOAC Official Method 966.04)

Dacron suture loops were demonstrated to be inert, consistent carriers in the presence of peracetic acid-based sterilants, whereas black silk sutures had a variable preparation process and interacted with peracetic acid. In addition, Dacron suture loops provided comparable spore loading to black silk suture loops and an HCI resistance of > or = 2 min. These results indicate that black silk suture loops are not appropriate carriers for assessing peracetic acid-based sterilants, and Dacron loops are an acceptable alternative. This finding is consistent with the Office of Science and Technology Laboratory (Center for Devices and Radiological Health) study which determined that "polyester suture material is a viable alternative to silk for the AOAC sporicidal test for liquid disinfectants."

Securing cochlear implants to the skull: Two alternate methods

In view of the various problems encountered with the traditional methods of securing cochlear implants--including dural tear and suture dissolution following infection--we devised two alternate methods of performing this procedure. We use a titanium mesh or a Gore-Tex patch secured with two 4-mm screws to fix the receiver to the skull. No patient who has undergone either of these procedures at our institution has experienced any of the complications that are associated with the older silk, nylon, and Dacron sutures. Moreover, our two alternate methods are less technically difficult and can be performed in a shorter period of time.

Use of Dacron as an Alternative Carrier for Evaluating Oxidizing Sterilants in the AOAC Sporicidal Test

The AOAC sporicidal method (966.04) recommends the use of porcelain penicylinders and black waxed silk sutures as carriers for demonstrating the sporicidal activity of sterilants. However, the silk carriers are not suitable for evaluating the sporicidal efficacy of oxidizing agents, and an inert polyester material (Dacron) is recommended as an alternative. Dacron provides an equivalent microbial and physical challenge to silk. Microbiologically, both materials demonstrated similar HCI resistance, which is required by the AOAC test, as well as equivalent spore loading and spore wash-off. Electron microscopy showed that both materials present the same braided microstructure, providing an equivalent physical challenge to the test sterilant. Dacron was more consistent than silk, and did not require extraction prior to spore loading. The extraction method for black waxed silk was variable and incomplete, which may compromise the activity of oxidizing sterilants and add to method variability. Silk was also structurally altered in the presence of oxidizing sterilants and increased sterilant degradation. Dacron did not affect the sterilant and was inert in the presence of oxidizing agents. Dacron sutures are proposed as inert alternatives to silk for evaluating the sporicidal efficacy of oxidizing agents.

Refractive Results of Successful Penetrating Keratoplasty, Intraocular Lens Implantation With Selective Suture Removal

The refractive outcome in 44 eyes that had combined penetrating keratoplasty and intraocular lens insertion, with at least 6 months follow-up, was analyzed. All patients were operated on by the same surgeon using two types of trephines in all but one eye, and one suturing technique with nylon or dacron sutures. The intraocular lens power was calculated using SRK II formula with an assumed average post-operative keratometry of 45 D. The first refraction showed that the mean spherical equivalent was -0.20 +/- 3.45 D, the mean refractive astigmatism was 5.11 +/- 2.48 D and the average keratometry had a mean of 44.42 +/- 3.19 D. Modulation of postoperative astigmatism was done by selective removal of tight interrupted sutures, taking out one suture or maximally two sutures per visit, based on refraction, keratometry, and keratography criteria. The total number of sutures removed had a mean of 2.5 +/- 2.2 with a mean total number of visits of 5.3 +/- 2.0. The interval between visits had a mean of 4.5 +/- 1.9 weeks and the total duration of the suture removal phase was about six months. At the end of the refractive rehabilitation period, 73% of cases had a spherical equivalent between +3.0 D and -3.0 D and 61% of cases had an average keratometry within 2.5 D from our assumed value of 45 D. The mean postoperative refractive astigmatism was 2.5 +/- 1.5; 55% of cases had 3.0 D or less of astigmatic error and 90% of cases were within 4.0 D of postoperative astigmatism.

A New Sling Material for Ptosis Patients

Patients with poor or total absence of levator function require correction of their ptosis by a sling procedure. The aim of the procedure is to utilize the action of the frontalis muscle, innervated by the seventh nerve, to mechanically raise the droopy eyelid. The most common materials used for the sling are autogenous or preserved fascia lata and synthetic products such as nylon or dacron sutures. We introduce a new material for the sling procedure--preserved placental umbilical vein modified for the use as a sling. Two cases are presented in which this material was used with excellent results.

A New Sling Material for Ptosis Patients

Patients with poor or total absence of levator function require correction of their ptosis by a sling procedure. The aim of the procedure is to utilize the action of the frontalis muscle, innervated by the seventh nerve, to mechanically raise the droopy eyelid. The most common materials used for the sling are autogenous or preserved fascia lata and synthetic products such as nylon or dacron sutures. We introduce a new material for the sling procedure--preserved placental umbilical vein modified for the use as a sling. Two cases are presented in which this material was used with excellent results.

Scanning electron microscopic study of Dacron degradation by ocular tissue extracts.

A scanning electron microscopic study showed that the surface of Dacron thread became significantly roughened after treatment with bovine iris-ciliary body extracts. The Dacron-degrading factor in the extract was nondialysable, heat-labile, and active at an acidic pH, suggesting that lysosomal enzymes may be a factor in this phenomenon. Bovine extracts from the iris, ciliary body, and sensory retina degraded the surface of Dacron most substantially, while the Dacron surface was moderately digested by extracts from the cornea and retinal pigment epithelium. Lenticular and choroidal extracts did not affect the Dacron surface. Possibly the factor that degrades Dacron may be different from that which affects nylon, and the Dacron suture may not be preferable for corneal surgery.

Biocidal Braided Sutures

Once sutures become contaminated it is difficult for local tissue defenses or antibiotics to eliminate the bacteria and prevent infection. Impregnation of sutures with antibiotics before implantation is one way to prevent bacterial seeding of the suture surface. In this study, braided silk and Dacron sutures were impregnated with the antibiotic complex, neomycin palmitate. Using our standard wound model in the mouse, the efficacy of these biocidal sutures was determined in the presence of Staphylococcus aureus, Escherichia coli, Proteus mirabilis, and Pseudomonas aeruginosa. Implantation of these biocidal sutures into tissue contaminated with 10(7) organisms resulted in substantially decreased numbers of bacteria as compared with that of tissue receiving control sutures. In most cases, the tissue bacterial counts in the presence of biocidal sutures were also considerably lower than that for similarly contaminated tissue without a suture. Consequently, the presence of the neomycin palmitate eliminated the infection-potentiating effect of the suture. The therapeutic benefit of the biocidal sutures was related to the dose of antibiotic complex and was not adversely affected by delaying suture implantation.

Suture Material as a Factor in the Occurrence of Anastomotic False Aneurysms

False aneurysm formation is a well-recognized late complication of prosthetic graft insertion. Despite the fact that other etiologic factors may be involved, the behavior of the suture material remains of central importance. In a retrospective review of 1,330 peripheral vascular cases, we found 26 cases involving a total of 39 false aneurysms, or an incidence of 2% (26/1,330). Twenty-four of these were directly attributable to failure of the monofilament plastic suture or silk suture material. Braided Dacron suture was used in the original anastomosis in another seven cases, and in these instances the false aneurysms were not related to suture failure but were association with such factors as previous endarterectomy, failure of arterial wall, and chronic hypertension. None of the 39 aneurysms was secondary to infection or trauma. These results emphasize the importance of using a braided, nonabsorbable suture material to ensure the continued integrity of an anastomosis involving prosthetic grafts.

An in vivo study of the dimensional changes of the aortic valve leaflets during the cardiac cycle

The reported systolic enlargement of the aortic root in the adult, and the resultant sharing of leaflet stress with the aortic wall, could explain the longevity of aortic leaflets. Previous studies of the aortic root have been confined to the excised specimen; this study, however, was undertaken to determine the in vivo dynamic relationship between leaflet motion and aortic root expansion. In each of nine adult dogs, we attached four Dacron sutures to appropriate parts of the leaflet and commissures to connect them to linear displacement transducers during right heart bypass. Changes in leaflet length during the cardiac cycle were measured. Diastolic leaflet lengths were measured from silicone rubber casts made at 80 mm. Hg. Histologic evaluation was performed to provide a structural basis for understanding the in vivo measurements of changes in leaflet length. The results indicate that, during the cardiac cycle, changes in leaflet length are less than 2 percent. This observation, which is supported histologically by the orientation of collagenous fibers, suggests that the leaflets resist repeated lengthening and shortening. The date support the hypothesis that the entire aortic root plays a critical role in the opening and closing of the normal aortic valve and that the leaflets sustain less stress than has been postulated previously.

Silastic tracheal bifurcation prosthesis with subterminal Dacron suture cuffs

Silastic tracheal bifurcation prosthesis with subterminal Dacron suture cuffs

Tensile strength of arterial prosthetic anastomoses

A method of accurately measuring the tensile strength of an arterial prosthetic anastomosis is described. By performing one anastomosis with an absorbable suture and the other with a Dacron suture, the contribution of fibrous tissue ingrowth and encapsulation was separately measured 4.5 months following implantation and was found to be only one-half as strong as the permanently sutured anastomosis. We concluded from the study that a permanent suture was ultimately the most important factor in anastomotic tensile strength because of the two-fold increase in tensile strength over fibrous tissue alone, and the fact that the anastomosis with permanent sutures was stronger than the artery itself. When the graft was removed no collagenase was found at the anastomosis, suggesting that collagen at the graft-artery interface is relatively stable and that little or no collagen turnover is taking place.

Clinical evaluation of dacron suture material.

Dacron is a polymer of ethylene glycol and terephthalic acid. A number of experimental studies have demonstrated that it has good qualities for suture material and synthetic grafts.1-5It has greater tensile strength than silk or cotton, does not lose strength upon sterilization, and causes minimal tissue reaction. This report concerns its use as suture material in 747 operative cases. The sutures employed were closely braided, dyed with D and C green No. 6, and sterilized by electron sterilization.* There was no conscious case selection. The clinical material constitutes consecutive cases treated in the general surgical and cardiovascular sections and a substantial number in the thoracic section. There were 162 cardiac operations. Approximately half were open procedures employing total cardiopulmonary bypass. The remainder were closed procedures, such as mitral valvulotomies, division and suture of patent ductus arteriosus, repair of coarctation of the aorta, pulmonary valvulotomies, banding of the pulmonary

Tissue Response to Orlon and Dacron Sutures

Tissue Response to Orlon and Dacron Sutures

Tissue response to orlon and dacron sutures; a comparison with nylon, cotton, and silk.

Tissue response to orlon and dacron sutures; a comparison with nylon, cotton, and silk.