Polyamide Sutures Research Articles

A randomized clinical study comparing Trupler skin stapler and Trulon polyamide suture in post-surgical skin closure during orthopaedic and open abdominal surgeries

A randomized clinical study comparing Trupler skin stapler and Trulon polyamide suture in post-surgical skin closure during orthopaedic and open abdominal surgeries

Evaluating and Comparing the Tensile Strength and Clinical Behavior of Monofilament Polyamide and Multifilament Silk Sutures: A Systematic Review

Objective: This systematic review was carried out with the primary objective of verifying which suture (polyamide or silk) of two non-resorbable suture materials with different structures had better/greater tensile strength/resistance to tension, thereby presenting better mechanical behavior. The secondary objective was to verify which one had better performance. The null hypothesis was that both types of sutures had the same behavior. Methods: This systematic study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. The focused clinical question was: “In patients that underwent oral surgery treatment (P), is there significantly higher tensile strength/resistance for silk sutures (I) or for polyamide sutures (C) when comparing the outcomes (O)?”. The bibliographic search was conducted on ScienceDirect, B-On, and PubMed/MedLine between March and May 2023. The following MeSH terms were defined: sutures, breaking strength, tensile strength, oral surgery, and dentistry, which were articulated and combined using Boolean operators. There were restrictions, such as articles published in Portuguese, Spanish, or English between 1 January 2018 and 3 April 2023. The quality assessment involved the use of the Joanna Briggs Institute (JBI) checklist for RCTs and the QUIN tool (Quality Assessment Tool For In Vitro Studies) for in vitro assays. Results: Ten articles were included in this review (eight in vitro studies and two RCTs). For the RCTs, there were moderate and high levels of bias, whereas in the in vitro studies, three were classified as having a high risk of bias and five as moderate risk. The results proved that suture thread with a monofilament polyamide physical structure causes a less inflammatory reaction owing to less bacterial retention and capillarity, while multifilament sutures, such as silk, have superior mechanical characteristics. Regarding hydration, the evidence demonstrated that the preservation and stability of mechanical properties lacked uniformity. Otherwise, hyaluronic acid (HA) presents a promising solution with the same characteristics and antibacterial capabilities. Conclusion: It was possible to reject the null hypothesis that both types of sutures had the same behavior and result. It was proven by the results above that sutures with a monofilament polyamide physical structure cause a less inflammatory reaction owing to less bacterial retention and capillarity. In contrast, multifilament sutures (silk) have superior mechanical characteristics. Regarding hydration using chlorohexidine in surgical sites, the evidence demonstrated in the preservation and stability of mechanical properties lacks uniformity and congruence. However, HA seems to present a promising option with the same characteristics and antibacterial capabilities.

Intraluminal Suture Placement for Management of Hypotony After Glaucoma Drainage Device Surgery.

Intraluminal 3-0 Supramid stent placement can be an effective long-term solution for hypotony after glaucoma drainage device surgery. This procedure may obviate the need for conjunctival dissection. In some cases, additional procedures are required. To describe the utility of implantation of a multifilament polyamide suture (Supramid) in the tube lumen to reverse hypotony after glaucoma drainage device (GDD) surgery. Patients who underwent tube revision with intraluminal placement of a 3-0 Supramid stent, with or without external ligature, to manage hypotony following GDD surgery between January 2010 and October 2020. Resolution of hypotony was defined as IOP >5mm Hg and the absence of hypotony-related structural abnormalities. Overall success was the absence of failure criteria (IOP ≤5mm Hg, >21mm Hg, or <20% reduction below baseline IOP after 3 months for 2 consecutive study visits; additional glaucoma surgery; or loss of light perception), with or without adjunctive ocular hypotensive therapy. Nine eyes of 9 patients underwent placement of a 3-0 Supramid stent with a resolution of hypotony in all eyes with a mean follow-up duration of 33.3 ±24.0 months. Overall success was achieved in 7 of 9 eyes. Four eyes required intervention after stent placement: 1 eye required selective laser trabeculoplasty followed by replacement of the original stent with a shorter 3-0 Supramid suture and external ligature; 1 eye underwent revision for tube exposure; and 2 eyes underwent laser suture lysis to release an external suture ligature. In cases of hypotony after GDD, particularly when it is desirable to reduce the extent of additional conjunctival dissection, intraluminal placement of a 3-0 Supramid stent via an intracameral approach can be an effective long-term solution. Postoperative adjustments were required in many cases.

Prospective, multi-centric, international, single-arm, cohort study to assess a synthetic polyamide suture material in oral surgery to close the mucosa - MUCODA study.

ObjectivesThe aim was to collect different clinical parameters systematically and proactively regarding safety, effectiveness, and performance of a nylon monofilament suture under routine clinical practice for oral surgery. MethodsThe study design was prospective, bicentric, international, single-armed, and observational. A non-absorbable suture was applied to close the mucosa after different dental surgical interventions. Main objective was the incidence of combined postoperative complications until suture removal. The 95 % Confidence Interval (Agresti-Coull method) was used to prove the non-inferiority with a pre-specified upper margin of 21.9 %. Secondary variables were intraoperative suture handling, patient pain and satisfaction, wound healing, aesthetic appearance, and bacterial contamination. Results105 patients were enrolled. Complication rate was low (1.9 %), 2 swellings occurred. Pain was present for 1.61 days ± 1.42 after various dental interventions with an average pain level of 20.98 ± 22.60 (VAS). Patients with impacted third molar extraction showed the longest pain duration (6 days) combined with the highest mean pain level of 35.33 ± 30.45 (VAS). Intraoperative suture handling was very good to excellent. Suture removal was done after an average duration of 7.56 ± 2.09 days. Patient's satisfaction was high, and an excellent wound healing was reported by the dentists. Aesthetic appearance only performed in implant patients was rated by oral surgeons with an average of 96.19 ± 3.79 points [min. 80 – max. 100] at 5 months postoperatively. Thread bacterial analysis showed that F. nucleatum was the most present species. ConclusionsOur findings indicate that the non-absorbable, nylon-based monofilament suture used is safe and quite suitable for oral mucosal closure after various dental surgical interventions such as tooth extraction, implant placement and impacted third molar extraction. Clinical significanceThis study showed the safe use of a non-absorbable, nylon-based monofilament suture for different oral surgical interventions under daily routine clinical practice.

Comparative experimental study of biomechanical features of suture materials in tendon repair

Introduction Many different suture configurations and pathomorphology of tendon repair have been described for tendon repair over the past 20 years. However, the biomechanical properties of suture material at primary flexor tendon repair have not been sufficiently explored. A cyclic loading test is performed to evaluate the performance of the different sutures under repeated loading conditions simulating dynamic conditions in postoperative rehabilitation procedures.The objective was to compare the strength of suture materials under cyclic loading on a biological model of a tendon.Material and methods Eighty porcine digital flexor tendons were examined in a pilot study. The sutured tendons were tested with a universal testing machine. Tendon repair was produced using polypropylene in group I, braided polyamide suture in group II, complex polytetrafluoroethylene thread in group III and a thread of superelastic titanium nickelide in group IV. The standard Chang protocol was used for cyclic loading.Results The percentage of intact sutures was 25 % in group I and in group II, 80 % in group III and 85 % in group IV after completing the entire load cycle. A pairwise comparison showed suture disruption being more common for group I and group II as compared to group III and group IV. Irreversible gap was more common for group 1 as compared to group IV. Neither knot ruptures nor tissue cutting were seen in the groups.Discussion The topic of biomechanical properties of suture material remains poorly understood. Although static load testing is commonly used in current experimental studies and cyclic testing is suitable for simulating postoperative conditions. The search continues for the “ideal” suture material for flexor tendon repair to prevent tears and retain tensile properties until the repair reaches strength.Conclusion The threads of polytetrafluoroethylene and nickelide-titanium showed the best biomechanical properties for tendon repair in the form of linear strength, good elasticity and low plasticity of the suture material. There were no significant differences between polypropylene and braided polyamide threads.

Polypropylene mesh versus nylon mosquito net mesh for external abdominal hernias repair in cattle and buffaloes

Herein, the effectiveness of locally sourced and autoclaved nylon mosquito net mesh for the repair of external abdominal hernias was investigated. Eleven animals (7 cattle and 4 buffaloes) having hernial ring sizes of 8 to 30 cm in diameter were divided into two Groups 1 (5 animals) and Group 2 (6 animals). In Group 1, nylon mosquito net mesh was used, and in Group 2, polypropylene mesh was used for the repair of defects. The animals were sedated with xylazine HCl and given local anaesthesia during surgery. Over the external hernial sac, an elliptical skin incision was made. The internal hernial sac was bluntly dissected and freed down to the hernial ring. The internal hernial sac was opened, and the hernial ring was repaired with nylon mosquito net mesh or polypropylene mesh using the inlay technique. After hernioplasty, the sac and subcutaneous tissue were repaired with prolene suture material. The skin incision was closed with simple interrupted mattress sutures using monofilament polyamide suture material. Antibiotics and analgesics were given postoperatively, and povidone iodine was used to treat the suture line daily. The skin sutures were removed on the 10th to 15th postoperative day, depending upon the wound condition. Mild inflammatory swelling in Group 1 was observed at the incision line, which had completely subsided by the 15th postoperative day. The wounds healed by first intention in both groups. In any case, no recurrence was seen in a follow-up period of 3 months. Without clinical signs of wound dehiscence, infection, or recurrence, all animals recovered uneventfully.

Evaluating the Efficacy of Nikant Doxycycline Sutures in Reducing Surgical Site Infections Following Appendectomies

Background: In appendectomies, surgical site infections (SSIs) provide a serious post-operative issue. The purpose of this study was to compare the antimicrobial alternative Nikant doxycycline sutures to regular polyamide sutures in terms of how well they reduced the risk of SSIs. Materials and Methods: The 79 appendectomy patients were split into two groups for the study: the main group of 30 patients who used Nikant doxycycline sutures and the control group of 49 patients who received conventional polyamide sutures. A comprehensive questionnaire was employed to collect the data, and SPSS version 17 was used for analysis. A p-value of 0.05 or lower was deemed statistically significant. Results: Patients' rates of surgical site infections were 7.6%. Traditional polyamide sutures were utilised by patients with a 1.3 percent infection rate, but Nikant doxycycline sutures had a 6.3 percent infection rate. This distinction lacked statistical significance. Infected individuals were in the hospital longer than those who were not infected, and they were more likely to have peritonitis and necrotic appendicitis. Conclusion: According to our research, SSI rates were not significantly lower with Nikant doxycycline sutures than they were with conventional polyamide sutures. However, their use did not result in any further issues, suggesting that they might be a secure replacement for surgical suturing in appendectomies.

Intraoperative primary partial occlusion of the PreserFlo MicroShunt to prevent initial postoperative hypotony

PurposeThe aim of the underlying study was to present a new surgical method in PreserFlo MicroShunt surgery for glaucoma. A removable polyamide suture was placed into the lumen of the MicroShunt during implantation to prevent early postoperative hypotony.MethodsThirty-one patients undergoing stand-alone glaucoma surgery with implantation of a PreserFlo MicroShunt and an intraluminal occlusion were retrospectively reviewed and compared to a control group without occlusion. Inclusion criteria were diagnosis of primary open-angle glaucoma or secondary open-angle glaucoma due to pseudoexfoliation or pigment dispersion. Patients with a history of filtrating glaucoma surgery were excluded.ResultsIOP decreased from 26.9 ± 6.6 to 18.0 ± 9.5 mmHg at the first postoperative day after PreserFlo MicroShunt implantation. Postoperative removal of the occluding suture resulted in a mean IOP reduction in 11.1 ± 7.6 mmHg. Mean visual acuity was 0.43 ± 0.24 logMAR during the first postoperative examination. The interval with the occluding intraluminal suture in place varied from days to 2–3 weeks. Patients were followed up to 1 year.ConclusionImplantation of a PreserFlo MicroShunt combined with an intraluminal suture prevented postoperative hypotony in all patients. Mean postoperative pressure was reduced despite the occluding suture in place.

Comparison of Scar Quality using Polyglactin and Polyamide Suture Materials for Closure of Nasolabial Flap Donor Site Defects in Patients with Oral Submucous Fibrosis: A Research Protocol

Introduction: Scar formation is an unavoidable sequelae of any surgical procedure. The goal is to produce fine scars with the least complications. Literature mentions various surgical factors that may lead to better quality of scars, one of which is the type of suture material used. Few studies exist in the literature that have compared the quality of scars after placement of polyglactin and polyamide sutures. Additionally, no studies have been done to compare the quality of scars following reconstruction with nasolabial flaps in patients with oral submucous fibrosis. Need for the study: This study will help evaluate and establish the healing outcomes in nasolabial flaps in the form of scars after placing subcutaneous 4-0 polyglactin (VICRYL™ ETHICON) and 4-0 polyamide (ETILONTM ETHICON) sutures. This will eventually lead to minimal tissue reaction and more aesthetic scars with fewer complications. Aim: To evaluate and compare the quality of scars postreconstruction with nasolabial flaps with subcutaneous polyglactin sutures and subcutaneous polyamide sutures. Materials and Methods: This is a prospective randomised triple-blinded trial which will be conducted in the Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College and Hospital (SPDCH), Sawangi (Meghe), Wardha, India. The trial will take place from July 2023 to June 2024. A total of 15 subjects with grade C Oral and Submucous Fibrosis (OSMF), who will undergo fibrotomy followed by reconstruction of bilateral nasolabial flaps, will be enrolled in the trial. Suturing of one side of the flap will be done using 4-0 polyglactin (VICRYL™ ETHICON) suture subcutaneously, and the other side will use 4-0 polyamide (Ethilon™ ETHICON) suture subcutaneously. The scar tissues will be periodically evaluated at one week, one month, and three months postoperative period to assess the healing outcomes and overall aesthetic appearance using the Patient and Observer Scar Assessment Scale (POSAS) using Chi-square test and Student’s t-test.

Performance and Strength Characteristics of Suture Knots in Periodontal Microsurgery: An In Vitro Study.

This study is aimed to investigate the types of knot failure (untying or breaking) and the tension required to break different sutures diameters. One hundred and fifty knots were fabricated using polyamide sutures diameters of 6/0, 7/0, and 8/0. The studied knots were either squared or slipped with different numbers of throws (2, 3, 4, 5 and 6), and the following data were recorded: type of failure (untied or broken), number of throws, the tension required to untie or break each knot, slippage, and elongation of the knot. The knots were created in a standardized way. with a device and weights and then subjected to a controlled tension. The knots that got untied were: 1&#61;1, 1x1, 2&#61;1, and 2x1, whereas the remaining knots got broken. Notably, at least three throws were required to prevent untying, but separately, as in 1&#61;1&#61;1 or 1x1x1. The mean tension to break the knots of 6/0, 7/0, and 8/0 sutures were 3.1, 1.3, and 0.6 N, respectively (P < 0.05), and they were independent of the knot type. Results from this study demonstrated that the knots with geometries of 2&#61;2/2x2 and 1&#61;1&#61;1/1x1x1 were secure, and additional throws does not increase their security. Furthermore, tensile strength reduces with decreased suture size.

Re-inventing the straight incision with a single central suture in manual small-incision cataract surgery to minimize surgically induced astigmatism.

To calculate the surgically induced astigmatism (SIA) in MSICS through a superiorly placed straight scleral incision closed with a single, central, perpendicular 10-0 polyamide suture and to document any suture-related complaints and complications. A retrospective, hospital-based study was carried out in 50 cases of uncomplicated senile cataract (&gt;50 year) with nuclear sclerosis ≥ grade 4, "with the rule" astigmatism who underwent MSICS through a superior, straight incision with a single, central, perpendicular 10-0 nylon suture. Patients with "against the rule" astigmatism, keratoconus, pre-existing corneal opacity, astigmatism &gt;2D, distorted or oblique mires, and previous ocular surgeries and unwilling to participate were excluded. The mean age of the patients was 64.81 + 2.824 years, with a male: female ratio of 1.38:1. The mean SIA at day 7, week 6, and 12 weeks was 0.539 + 0.118, 0.529 + 0.134, and 0.524 + 0.129, respectively. Only 6 patients (12%) complained of foreign body sensation. No patient developed any suture-related complications. SIA is significantly reduced in straight incision by applying a single, central, and perpendicular 10-0 polyamide suture, as compared to a straight incision without a suture.

Biomechanical Evaluation of a Novel Double-Strand (Looped) Polyamide Monofilament Suture for Canine Flexor Tendon Repair

Objective: Determine the influence of a novel looped polyamide suture on the biomechanical properties and gap formation of repaired canine flexor tendons. Study Design: Tendons were assigned to 3 groups (n=12/group). Following transection, tendons were repaired with a Kessler pattern using monofilament polypropylene, Kessler pattern using looped polyamide suture and a Kessler pattern using looped polyamide augmented with a continuous Epitendinous Suture (ES) representing groups 1, 2, and 3 respectively. Constructs were tested to simulate clinical failure. Yield, peak and failure loads, loads at -1 and 3mm gap formation and failure modes were analyzed. Results: Looped polyamide suture is equivalent to monofilament polypropylene using a Kessler core pattern. Looped polyamide suture augmented with a running ES significantly increased yield, peak and failure loads by 3.2x, 3.0x and 2.6x respectively, compared to core suture use alone. Use of an ES required significantly greater force to cause 3mm gap formation while reducing occurrence of gapping in tested constructs. Mode of failure differed among experimental constructs. Conclusion: Looped polyamide suture is equivalent to monofilament polypropylene in the same pattern. Our results support the addition of ES augmentation, a simple technique modification that demonstrates substantially improved repair strength while reducing the occurrence of gapping between tendon ends. Future in-vivo studies investigating effect of suture placement on tendinous healing, blood supply, and glide function are warranted.

A single-blind randomised controlled trial comparing clinical equivalence of Trulon® and Ethilon® polyamide sutures for the skin closure following laparotomy incisions

BackgroundLaparotomy is a common procedure to gain access to the peritoneal cavity, for obstetrics, gynecological, and digestive system-related surgeries. Wound infection is among other complications of laparotomy. This study compared the rate of wound infection post-laparotomy skin closure using Trulon® and Ethilon® polyamide sutures. MethodsThis multicentric, prospective, two-arm, parallel-group, randomized (1:1), single-blind study (CTRI/2020/09/027978) was conducted between January and July 2021, and included 102 women undergoing laparotomy-based obstetric/gynecological procedures. The primary endpoint, incidence of wound infection [superficial and deep surgical site infection(SSI)] occurring within 12 weeks of the surgery was compared between two treatment groups, Trulon® (n = 50) and Ethilon® (n = 52). The secondary endpoints, incidence of wound dehiscence, suture sinus, seroma, hematoma, skin disruption, suture loosening, re-suturing, duration of surgery, suture removal, hospital stay, intraoperative suture handling parameters, pain score, return to normal day-to-day activities, modified Hollander cosmesis score, subject satisfaction score, and adverse events were also evaluated. ResultsNon-significant differences were observed in the incidence of SSI, wound dehiscence, suture sinus, seroma, hematoma, skin disruption, suture loosening, re-suturing, intraoperative handling parameter (except ease of passage), operative time, hospital stay, suture removal duration, pain score, time to return to day-to-day activities, modified Hollander cosmesis score, and subject satisfaction score between the two groups. ConclusionTrulon® and Ethilon® polyamide sutures are clinically equivalent. For abdominal skin closure following laparotomy both the sutures deliver a lower chance of infection, minimal pain, higher satisfaction, and cosmesis score. Registration of researchThis trial is registered prospectively at Clinical Trial Registry of India (CTRI Reg. No: CTRI/2020/09/027978; Registered on: 23/09/2020).

COMPARISON TENSILE STRENGTH OF DIFFERENT SUTUR MATERIALS

Abstract Objectives: The purpose of this study is to compare the tensile strength of different types of surgical suture materials. Materials and Methods: Current study, the tensile strengths of 4 different suture materials made of different materials were compared. [(1-4/0 silk suture 2- 4/0 propylene suture 3-4/0 Polyamide suture 4- 4/0 Poly[Glycolide-Co-L-Lactide](90%:10%) (PGLA) suture)] The tensile strength of a total of 40 samples was calculated, with 10 samples in each group. In the study, the tensile strength of the sutures was calculated using a universal tester, the sutures were tightened to both poles of the test device and fixed with a distance of 15 mm between the poles, tensile force was applied so that both poles of the test device moved away from each other at a speed of 25cm/min until the sutures broke, and the force value of the sutures at the moment of brake was recorded in Newton units (N) as the tensile strength of suture.Statistical analysis of the data was evaluated by One-Way ANOVA and Tukey HSD tests. Results: In the statistical analysis of the tensile strength of the suture materials, the difference between the tension resistance of the PGLA and Polyamide suture was not statistically significant, but the difference between all other suture materials was statistically significant (p &amp;lt;0.05). Tensile strength of suture materials were determined as propylene, polyamide, pgla and silk suture, respectively. Conclusion:Within the limitation of this study.It has been stated that propylene suture may be more advantageous than PGLA, silk ,polyamide suture. Keywords: Sutures ,Tensile ,Break

Esthetic outcome of cleft lip repair with the use of tissue adhesive as opposed to suture for skin closure – A retrospective comparative study

Background: Suture removal in infants and children operated for cleft lip is one of the cumbersome task for the surgeons because of missing compliance. For this reason, tissue adhesives have gained popularity among the surgeons as well as the patients over the past two decades for skin wound closure. Although there are several published reports of case series using tissue adhesive for skin closure during cleft lip repair, very few have established its advantage over conventional suture technique. Objective: The objective of this study was to compare the esthetic outcome of skin closure in cleft lip repair with suture technique and tissue adhesive, with respect to the quality of scar. Methodology: A retrospective observational study was conducted by analyzing the photographic records of patients who underwent surgical repair of cleft lip between January 2015 and December 2017. The patients were divided into two groups, one for whom skin closure performed with 5-0 monofilament polyamide suture and the other with tissue adhesive. Esthetic outcome in terms of the quality of scar was assessed using a 5 point Likert's scale by 10 independent observers who remained blind of the surgeon performed the surgery, to reduce the assessor-related bias to minimum. The statistical analysis was performed using the SPSS version 27.0 and the difference between mean scores of both the groups was calculated. Results: A total of 70 patients were included in this study with 35 in each group. The mean follow-up period of adhesive and the suture group was 13.97 and 17.85 months, respectively. Overall mean of the total scores of the entire patient population was 3.92 (+/[FIGURE DASH]0.38). For the tissue adhesive group, the mean score was 3.88 (+/[FIGURE DASH]0.367) and for the suture group, the mean score was 3.96 (+/[FIGURE DASH]0.401). The difference between mean scores of individual parameters of both the groups as well as the difference between the overall mean scores of both the groups was not found to be statistically significant. Conclusion: The use of tissue adhesive for the closure of skin during cleft lip repair is as good as sutures, with respect to esthetic outcome of scar. Hence, any of these two techniques can be used for this purpose depending on the surgeon's preference.

DORSAL Plication Technique for the Treatment of Congenital Ventral Penile Curvature: Long-Term Outcomes of 72 Cases

A total of 78 patients aged 11 to 17 years were diagnosed with congenital ventral penile curvature and underwent surgery with the dorsal plication technique between 2005 and 2014. To investigate the long-term outcomes of 72 patients who underwent dorsal penile plication for the treatment of congenital ventral penile curvature without hypospadias. In all cases, the intervascular space between the deep dorsal vein and dorsal artery was dissected, and tunical plication was carried out with non-absorbable 3-0 polyamide sutures and the complication and satisfaction rates of the patients were determined in the postoperative seventh year. At the final postoperative follow-up, the patients' satisfaction with the operation was found to be 95.8%. Shortening of the penis (0.5-1 cm) in five cases, recurrence with less than a 20-degree curvature in two cases, palpable sutures in two cases was observed and no patients reported erectile dysfunction. The limitations of our study can be considered as the absence of pharmacological erection in the preoperative evaluation, failure to evaluate penile length at the last postoperative follow-up due to the continued development of the penis, inability to evaluate erectile function at the beginning, postoperative erectile capacity being assessed in only some of the operated cases, all operations being performed by a single surgeon in the same center, and the absence of standardized questionnaires for postoperative satisfaction or adverse events. According to the results of this study, dorsal plication is a relatively simple method with a low risk and high success rate for the treatment of congenital ventral penile curvatures.

Randomized Controlled Trial Comparing Nylon and Chromic Gut Sutures After Minor Hand Surgery

We sought to compare overall satisfaction with treatment and satisfaction with initial wound healing after closure of office hand and upper extremity surgery wounds using polyamide compared to Chromic gut sutures. We compared 62 patients randomized to polyamide suture closure of an office hand and upper extremity incision (mostly carpal tunnel release and trigger finger release) to 50 patients closed with Chromic gut suture. Patients rated overall treatment satisfaction, satisfaction with initial healing, pain intensity, and upper extremity-specific activity tolerance. Accounting for potential confounding in multivariable linear and logistic regression analysis, we found the following: (1) overall satisfaction with care was unrelated to suture type; (2) satisfaction with initial wound healing and appearance was lower among people with no other comorbidities, but unrelated to suture type; (3) there were no factors independently associated with pain intensity; and (4) excisional biopsy was associated with greater activity tolerance. Our findings suggests that Chromic sutures are a viable alternative to polyamide sutures after office hand surgery, provided that the care team anticipates and develops strategies for concerns that may arise if the sutures take an extended period to fall off. Therapeutic II.

Microbial Adherence of three different suture materials in patients undergoing periodontal flap surgery. A clinical &amp; microbiological study

proliferation of microbes to the parts open to the oral cavity. Hence, microbial colonization on various intraoral suture materials from patients undergoing periodontal flap surgery and its impact on healing of gingival tissues was&#x0D; compared.&#x0D; Patients and Methods: During periodontal flap surgery, three different suture materials (silk, polyamide, &amp; vicryl) were used in 25 patients. Eight days postoperatively, the sutures were removed, and adhered micro-organisms were counted by culturing on nutrient agar.&#x0D; Additionally clinical parameters, bleeding on probing and papillary position to assess healing were recorded to baseline, at 2 weeks, 4 weeks, and 6 weeks.&#x0D; Wilcoxon signed ranks test was used for statistical analysis.&#x0D; Results: Mean CFU’s for silk, polyamide and vicryl sutures were 6.239 ±1.476 X 108, 2.425 ± 1.010 X 108, 4.431 ± 1.069 X 108.&#x0D; There was no inter-group statistical difference in the clinical parameters i.e. bleeding on probing, papillary position at all time periods (p&gt;0.05).&#x0D; There was a significant statistical improvement in bleeding on probing in all the three groups from base line (p&lt;0.05).&#x0D; Conclusions: The results of the present study demonstrated that bacteria have different affinity towards different suture materials. Monofilament polyamide suture adhered the least amount of bacteria, followed by multifilament vicryl suture, while silk adhered maximum amount of bacteria.&#x0D; There was no statistically significant difference in the healing of gingival tissues in between all the three groups.&#x0D; Keywords: Monofilament sutures, Multifilament sutures, Colony forming units, Periodontal flap surgery&#x0D;

Biomechanical Analysis of Zone 2 Flexor Tendon Repair With a Coupler Device Versus Locking Cruciate Core Suture

To compare flexor tendon repair strength and speed between a tendon coupler and a standard-core suture in a cadaver model. In 5 matched-pair fresh cadaver hands, we cut the flexor digitorum profundus tendon of each finger in zone 2 and assigned 20 tendons to both the coupler and the suture groups. Coupler repair was with low-profile stainless steel staple plates in each tendon stump, bridged by polyethylene thread. Suture repair was performed using an 8-strand locking-cruciate technique with 4-0 looped, multifilament, polyamide suture. One surgeon with the Subspecialty Certificate in Surgery of the Hand performed all repairs. Via a load generator, each flexor digitorum profundus was loaded at 5 to 10 N and cycled through flexion just short of tip-to-palm and full extension at 0.2 Hz for 2,000 cycles to simulate 6 weeks of rehabilitation. We recorded repair gapping at predetermined cycle intervals. Our primary outcome was repair gapping at 2,000 cycles. Tendons that had not catastrophically failed by 2,000 cycles were loaded to failure on a servohydraulic frame at 1 mm/s. Tendon repair gapping was similar between coupled and sutured tendons at 2,000 cycles. Tendons repaired with the coupler had higher residual load to failure than sutured tendons. Mean coupler repair time was 4 times faster than suture repair. Zone 2 flexor repair with a coupler withstood simulated early active motion in fresh cadavers. Residual load to failure and repair speed were better with the coupler. This tendon coupler may eventually be an option for strong, reproducible, rapid flexor tendon repair.

Stapler versus polyamide sutures for skin closure for sternal wounds in coronary artery bypass graft surgery - our experience.

IntroductionPatients undergoing coronary artery bypass graft surgery constitute a large population of patients with anatomically similar incisions created under similar circumstances.AimOur study aimed at analysing and comparing rates of surgical site infections (SSIs) at the sternotomy sites based on the material used for skin closure of the sternal wound with special emphasis on presence of risk factors such as diabetes (glycated haemoglobin (HbA1c) > 9) and obesity (body mass index (BMI) > 30 kg/m2) in the 2 respective groups.Material and methodsThis is a retrospective observational study. A total of 864 patients were included in the study. The patients were grouped into 2 groups depending on the sternal wound closure strategy used. One group consisted of patients in whom polyamide sutures were used for skin closure, while the other group comprised patients in whom skin staples were used for skin closure. Incidence of sternal wound SSIs in both groups was noted. Co-morbid conditions such as diabetes mellitus (with HbA1c > 9) and obesity (BMI > 30 kg/m2) were noted and analysed as contributory factors for SSIs.ResultsGroup A comprised 432 patients out of whom 42 (9.72%) had sternal wound SSIs. Group B comprised the other 432 patients of whom only 20 (4.62%) developed sternal wound SSIs. Co-morbid conditions were analysed in each group. Group A showed SSI in 22/64 (34.3%) diabetic patients, 6/28 (21.8%) obese patients and 16/22 (72.72%) with diabetes and obesity. Group B showed SSIs in 6/56 (10.715) diabetics, 4/26 (6.01%) obese and 4/24 (16.67%) with diabetes and obesity.ConclusionsBy pairing staples and sutures, we observed a significantly lower incidence of total wound complications with suture than with staple closure.