Polyglactin Suture Research Articles

Adjustable flanged technique for secondary implantation of four-point scleral‑fixated posterior chamber intraocular lenses using two parallel 6−0 polyglactin sutures

ObjectiveTo assess the efficacy and safety of using the adjustable flanged technique for secondary implantation of four-point scleral‑fixated posterior chamber intraocular lenses with two parallel 6−0 polyglactin sutures.MethodsTwo parallel 6−0 polyglactin sutures were passed separately through the two haptics on the horizontal line of the 4-haptic IOL. The four externalized sutures were then trimmed and cauterized to form flanges. The best corrected visual acuity, intraocular pressure, and complications in all patients were observed and recorded.ResultsThe flanged technique using two parallel 6−0 polyglactin sutures was applied to 14 aphakic eyes. The average preoperative best corrected visual acuity was 1.00 ± 0.88 LogMAR (Snellen 20/200), which improved to 0.42 ± 0.38 LogMAR (Snellen 20/48) at the final follow-up (P = 0.004). None of the patients experienced vitreous hemorrhage, low intraocular pressure, or issues with exposed or broken sutures.ConclusionThe simplicity of the technique, along with its ability to accommodate adjustments post-implantation, allows for optimal positioning and reduces risks like IOL tilt or dislocation. Overall, this is a promising approach to secondary IOL implantation, with potential benefits for both patient outcomes and surgical efficiency.

Comparison of the Incidence of Surgical Site Infection in Abdominal Wound Closure: Antibiotic-Coated Polyglactin 910 Suture Versus Polyglactin Suture With Local Infiltration of Antibiotic Along the Incision Line.

Aim and objectives The purpose of this study is to compare the incidence of surgical site infection (SSI) rates in abdominal wound closure utilizing antibacterial-coated(triclosan-coated) suture material versus conventional suture material with subcutaneous antibacterial infiltration along the incision line. Materials and method This prospective and comparative (randomized, non-blinded clinical trial) was conducted at the Postgraduate Department of Surgery, Swaroop Rani Nehru Hospital, associated with Motilal Nehru Medical College, Prayagraj, India. The sample size was calculated to be one hundred. The patients in Group A underwent laparotomy using polyglactin 910 coated with triclosan. The patients in Group B underwent normal suture closure and local infiltration of broad-spectrum antibiotics (1 gram of ceftriaxone in 10 ml distilled water, along with the incision). Results There was no discernible difference between the various groups onpostoperativeday (POD) 14, 21, and 30. In Group A, 100.0% of individuals had healed wound status (POD 30). Group B had healed wound status among the 96.0% of members (POD 30). Twenty percent of the people in Group A had SSI whereas 38.0% of the participants in Group B had SSI. There was no discernible difference between the two groups regarding the distribution of culture (χ² = 7.741, p = 0.127). Conclusion Triclosan-coated sutures are more effective than subcutaneous antibiotic infiltration along the incision line in lowering the frequency of SSI during primary laparotomy wound closure.

Autologous Pericranium Graft for Necrotizing Scleritis.

The purpose of this study was to describe the clinical outcome of scleral staphyloma secondary to necrotizing scleritis treated with autologous pericranial grafting. A 63-year-old woman with necrotizing scleritis and choroidal protrusion underwent homologous scleral grafting, which failed. The patient's medical management was optimized for control of her systemic inflammation, and she underwent a second surgery consisting of autologous pericranium grafted to the parietal region. A 3- × 2-cm tissue patch was harvested and sutured over the staphyloma borders with 8/0 polyglactin sutures. Complete re-epithelialization was observed at 3 weeks, the graft was well integrated, and no signs of inflammation were observed at 18 months. The pericranium offers a viable alternative for scleral thinning because of necrotizing scleritis.

Post-urethroplasty complications in hypospadias repair: a systematic review and meta-analysis comparing polydioxanone and polyglactin sutures

BackgroundPolyglactin (PG) and polydioxanone (PDS) sutures are extensively used based on the surgeon’s preference. The development of post-reconstruction urethrocutaneous fistula (UCF) is variably attributed to the choice of suture material...

Pilonidal sinus hastalığında Rhomboid eksizyon ve Modifiye Limberg flep uygulanan hastalarda tek merkez klinik deneyiminin değerlendirilmesi

Aims: Pilonidal sinus disease (PSD) is a chronic inflammatory disease that is seen especially in young men, is often located in the sacrococcygeal region and negatively affects the quality of life and daily life of the person. In this study, we aimed to share our experience with the literature by examining our clinical approach and results in the patient group who underwent Modified Limberg flap technique electively in PSD.
 Methods: Patients who underwent elective modified Limberg flap application due to PSD in the general surgery clinic were included in the study. Demographic and clinical parameters of the patients were investigated retrospectively.
 Results: The mean age of 76 patients included in the study was 27.5±8.5 years (18-51 years). The median duration of hospitalisation was 2 days. The most commonly preferred prophylactic antibiotic at surgery was cefuroxime + metranidazole combination (60.5%) or cefuroxime alone (32.9%). Drain use was present in approximately 40% of the cases. Subcutaneous tissues were closed with a single layer of polyglactin suture in most cases (94.7%). During the median follow-up period of 12 months, postoperative recurrence was observed in only 6 cases (7.9%).
 Conclusions: Modified Limberg flap technique is a well-defined, safe and feasible surgical method. Since it is an effective off-midline technique, its application by experienced surgeons in complicated and recurrent cases in elective PSD surgery and its transfer to junior and resident surgeons will be effective in terms of moving away from midline techniques.

Comparative Analysis of Incisional Wound Closure Techniques in Plastic Surgery Practice Between Single Subcutaneous/Subdermal Continuous Polyglactin Suturing Versus Layer-By-Layer Continuous Suturing with Polyglactin Subcutaneous Suturing and Polypropylene Interrupted Skin Suturing: A Comprehensive Literature Review

Introduction: Wound closure technique has some variations in reconstructive and plastic surgery. The use of ideal suture material and technique for subcutaneous tissue closure is needed to be established in the current clinical practice to enhance the surgical outcome. Methods: This literature review was compiled using information from numerous open access web databases. Data were compiled and analyzed. Results and Discussions: In term of tensile strength, single layer subcutaneous suture with polyglactin has superior outcome than multi-layer suture combining polyglactin subcutaneous suture and polypropylene interrupted cutaneous suture. In aesthetic consideration, a single-layer subcutaneous closure has better outcome. Previous studies showed there were no significant difference between the two techniques in term of patients satisfaction. Conclusion: The single layer subcutaneous continuous suture with polyglactin and multiple layer subcutaneous suture with combining continuous polyglactin suture and polypropylene interrupted suture has each advantage and need to be considered by surgeon about the wound closure effect and long term prognostic such as cosmetic and satisfaction of the patient.

Lateral tarsal strip procedure: comparison of absorbable sutures and non-absorbable polypropylene suture. Does the suture type matter?

To determine whether the success and complication rates of the Lateral Tarsal Strip (LTS) Procedure, when treating involutional ectropion/entropion, is influenced by the use of suture when attaching the tarsal strip to the periosteum. Multi-centre retrospective comparative study of re-operation and complication rates (Recurrence, Dehiscence, Suture Infection, Granuloma, Haemorrhage, Residual-Lid Laxity, Suture Extrusion and Repeat Procedure) in LTS, between 01/01/2017 and 01/01/2022 who met the inclusion/exclusion criteria, for involutional ectropion/entropion using an absorbable polyglactin (vicryl) and non-absorbable polypropylene suture (prolene). 1079 operations in 891 patients (36% female, average age 81.4 years) were performed with an average follow-up of 1.785 years. 588 operations in 475 patients were performed using prolene whilst 491 procedures in 416 patients were performed using vicryl sutures. Of these, 61% were performed by a consultant surgeon in the prolene group compared to 49.7% in the vicryl group. Overall complication rates between prolene and vicryl were 24.7% and 29.7% (p = 0.061) respectively. Higher complication rates for post-operative residual lid laxity, granuloma and suture infection were greater in the vicryl group versus prolene (2.65% and 0.51% p = 0.004, 2.24% and 0.68% p = 0.03, 1.83% and 0.17% p = 0.007 respectively). Non-significant results for dehiscence or repeat procedures (2.24% and 2.21% p = 0.974, 6.72% and 9.01% p = 0.166 respectively). Both sutures are effective for the correction of involutional ectropion/entropion with LTS. Dehiscence and redo rates were not statistically significant. Nevertheless, the use of vicryl suture was found to be associated with a higher complication rate for: post-operative residual lid laxity, granuloma and suture infection.

Bioactive Suture with Added Innate Defense Functionality for the Reduction of Bacterial Infection and Inflammation.

Surgical site infections (SSI) are a clinical and economic burden. Suture-associated SSI may develop when bacteria colonize the suture surface and form biofilms that are resistant to antibiotics. Thrombin-derived C-terminal peptide (TCP)-25 is a host defense peptide with a unique dual mode of action that can target both bacteria and the excessive inflammation induced by bacterial products. The peptide demonstrates therapeutic potential in preclinical in vivo wound infection models. In this study, the authors set out to explore whether TCP-25 can provide a new bioactive innate immune feature to hydrophilic polyglactin sutures (Vicryl). Using a combination of biochemical, biophysical, antibacterial, biofilm, and anti-inflammatory assays in vitro, in silico molecular modeling studies, along with experimental infection and inflammation models in mice, a proof-of-concept that TCP-25 can provide Vicryl sutures with a previously undisclosed host defense capacity, that enables targeting of bacteria, biofilms, and the accompanying inflammatory response, is shown.

An Evaluation of the Tensile Strength of Polyglactin Sutures After Immersion in Different Herbal Mouthwashes: An In Vitro Study.

Background The process of suturing is essential to the healing of surgical wounds. Sutures on surgical wounds from fabric approximate ligament tissues, control haemorrhage, and assist the primary healing process in oral surgical procedures. The oral environment may cause the suture to lose its tensile strength, which causes tissue to open and spread infection. Different mouthwashes are recommended for effective oral hygiene maintenance postoperatively. Ideally, the use of mouthwashes should not alter the mechanical properties of suture materials. A suture material's tensile strength or ability to endure tension during knotting and long-term wound protection is measured. Aim The aim of the current study is to assess the tensile strength of polyglactin sutures following immersion inherbal mouthwashes. Methods Two commercially available synthetic braided polyglactin 910 absorbable sutures (Vicryl and Seamcryl) were chosen to assess their tensile strength following immersion in two kinds of herbal mouthwashes: nilavembu (Andrographis paniculata) silver nanoparticle mouthwash and clove-uni stevia mouthwash. The tensile strength of the sutures was evaluated using an ElectroPuls® E3000 (Instron, Norwood, MA, USA) universal testing machine. The data were transferred to IBM Statistical Package for Social Sciences (SPSS) software version 23.0 (IBM Corp., Armonk, NY, USA), wherein the tensile strength values of Vicryl and Seamcryl after immersion in two different mouthwashes compared with control were statistically analysed using a one-way analysis of variance (ANOVA) test. Results The tensile strength of Vicryl suture material was found to be higher in the clove-uni stevia mouthwash group than in the nilavembu silver nanoparticle mouthwash and control (p-value=0.000, which is statistically significant). The tensile strength of Seamcryl suture material was found to be higher in the clove-uni stevia mouthwash group than in the nilavembu silver nanoparticles mouthwash and control (p-value=0.001, which is statistically significant). Conclusion Nilavembu silver nanoparticle mouthwashes analysed in the present study decreased the tensile strength property of Vicryl suture material after immersion for 24 hours, whereas clove-uni stevia mouthwash was shown to increase the tensile strength of both Vicryl and Seamcryl suture materials. Therefore, the selection of suture material and the postoperative prescription of mouthwash should be considered for a better clinical outcome.

Mini-laparotomy in-situ pyeloplasty for repair of the ureteropelvic junction obstruction: Outcome of 150 cases.

To evaluate the functional and cosmetic outcomes of using the mini-laparotomy technique In Situ pyeloplasty to repair UPJ obstruction in young infants less than 6 months. Between January 2014 and March 2020, 150 young infants (less than 6 months) diagnosed with unilateral ureteropelvic junction obstruction (UPJO) and treated by mini-laparotomy In Situ pyeloplasty were included in this analysis. Once the UPJ has been identified, it was grasped by an Allis forceps for gentle traction. Two facing transverse incisions were made in the dilated pelvis facing the upper ureter. The transverse ureteric incision was then opened longitudinally. An anastomosis was done between the most dependent part of the lower lip of the pelvis and the apex of ureteric spatulation using 6/0 polyglactin (Vicryl®) sutures in the direction of "out-in-in-out." Follow-up was scheduled for 1 month and then every 3 months for a year with abdominal ultrasonography. DTPA was done for all patients 1 year after repair. The mean age was 3 ± 0.5 months, and the mean follow-up was 1.5 ± 0.3 years. Our technique was done in all included patients with a functional success of 96% (all patients restored normal function, and no obstruction was reported). Parents were satisfied with the cosmetic appearance of the wound in 91% of cases. Major complications occurred in 4% of cases. Successful repair of ureteropelvic junction obstruction in young infants can be achieved by using mini-laparotomy In Situ pyeloplasty technique with satisfactory functional and cosmetic outcomes.

A comparative study of assessing Inguinodynia in open inguinal hernia repair while fixing mesh with polyglactin sutures (Vicryl) Vs Polypropylene sutures (Prolene)

A comparative study of assessing Inguinodynia in open inguinal hernia repair while fixing mesh with polyglactin sutures (Vicryl) Vs Polypropylene sutures (Prolene)

(214) Female bmg Urethroplasty and 2nd Degree Vaginal Tear Repair

Abstract Introduction Pregnancy and childbirth bring biological, psychological, and social changes which may influence women's health. Objective Second degree tears are the most common type of tear. A female urethral stricture is a less common condition. Buccal mucosa graft (BMG) is widely used tissue for urethral stricture repair. Methods We present a 38-year old female who suffered a 9-year long history of urethral stricture disease and dyspareunia after two vaginal child births. The patient (pt) had urethral injury and 2nd degree tear in vaginal wall and pelvic muscle. Despite repeated attempts of urethral dilations, the stricture and the obstructive complaints persisted. Additionally, lack of sexual arousal and painful intercourses, affected the patient’s quality of life. The pt was treated with a dorsal onlay urethroplasty using a buccal mucosa graft, excision of vaginal wall scar, pelvic floor muscle repair, and repair of vaginal opening The surgery was carried out with a suprameatal approach. A semicircular incision was performed and the urethra was dissected from the ventral aspect of the clitoris with a sharp and blunt dissection up to the proximal part of stricture. Then, a dorsal sagittal incision is performed over the stricture and the BMG is sutured dorsally for the edges and quilted with 4.0 polyglactin sutures. A 16Fr Foley catheter was left in place for two weeks. Then, we performed hydrodissection of posterior vaginal wall, scar excision from episiotomy and 2nd degree tear, approximation of levator ani muscle, vaginal wall and opening repair. Results Two weeks after surgery the patient urinates without strain and with no post voiding residual urine. Uroflow 6 weeks after surgery showed Qmax of 28ml/sec and urethra was easily passable for 20Fr Nelaton catheter. Eight weeks after surgery the patient reported having a normal sexual life without pain and lack of sexual satisfaction Conclusions Female dorsal onlay urethroplasty and vaginal wall tear repair are feasible and give great functional and aesthetical results Disclosure No

A Novel Method to Fix Paediatric Mandibular Fracture using 2-0 Polyglactin Suture: A Technical Note.

Reduction and stabilisation of fractures at the earliest is valuable in the paediatric age groups. This novel technique focuses on stabilisation of the fracture fragments using vicryl, which has an added advantage to conventional plating and wiring. This study aimed on a novel cost-effective technique of stabilising the paediatric mandibular fracture using 2-0 resorbable polyglactin 910 suture with minimal trauma to tooth buds and bone and adequate stability. After raising a full-thickness mucoperiosteal flap, the fracture segments are identified and reduced. 1.6mm drill bit is used to make holes through the buccal cortex on either side of the fractured segment in an anteroposterior direction. The patency of holes is checked by passing a long 26-gauge wire. The proximal end of the wire is bent into a loop, a 2-0 resorbable polyglactin suture (vicryl) is passed through this loop and the loop is pressed in place to lock the suture. The wire with the attached suture is pulled through the distal end. Once the suture is secure in place, the 26G wire is cut, and the two ends of sutures are knotted and stabilised. The mucoperiosteal flap is then closed. A novel method of stabilisation of paediatric fracture without hampering the tooth and jaw growth, especially in the financially unstable population. 2-0 polyglactin 910 suture is cost-effective, $2 US, compared to resorbable plates costing about $150 US, and easily available. Polyglactin 910 takes 40-60 days for resorption, and half-life tensile strength is 2 weeks; thus, it gives adequate stability and time for callus formation and does not damage the tooth buds or bone by cutting through them.

Conjunctival Foreign Body Granuloma after Pterygium Excision and Adaptation by Polyglactin Sutures

Abbreviations OD: oculus dexter (right eye) OS: oculus sinister (left eye) OU: oculus uterque (both eyes)

Transurethral ventral inlay buccal mucosa graft urethroplasty: technique and intermediate outcomes.

To outline our step-by-step surgical technique for a transurethral ventral buccal mucosa graft inlay urethroplasty to treat fossa navicularis and distal urethral strictures. The transurethral ventral inlay urethroplasty is accomplished in four steps. First, after obtaining proper exposure the cicatrice is excised via a transurethral ventral urethrotomy until the lumen is at least 24fr. Second, double arm 6-0 polydioxanone suture is used to deliver the triangular buccal mucosal graft to the proximal extent of the urethrotomy and secured externally. Third, the graft is secured to the meatus with 5-0 polyglactin sutures and additional 6-0 double arm polydioxanone sutures are used to quilt the graft for spread fixation. Finally, a 16fr silicone catheter is placed. Patients are discharged the same day and return for void trial after one week. A retrospective, single institution review was conducted to include all patients who underwent this procedure with a minimum of 1 year follow-up. Patients were analyzed for recurrences, and pre- and post-operative urine flow rates, post void residuals, and patient questionnaires were also reviewed. 44 patients met our inclusion criteria. Median surgical time was 120 minutes. At a mean follow up of 36 months (IQR 22-50) 95% of patients are patent without additional interventions. The 2 patients that did have stricture recurrence were found to have urethral stenosis that extended more proximally, and both were successfully treated with a dorsal onlay buccal urethroplasty. There were significant improvements in urine flow rate, post void residuals, international prostate symptom score and quality of life scores post operatively. There was no difference in post operative sexual function scores. This minimally invasive transurethral ventral urethroplasty has excellent intermediate term outcomes in terms of traditional objective measures of urethroplasty success and patient reported outcomes.

Facelift Skin Flap Redraping: The Seven Key Steps

Although techniques for SMAS dissection and manipulation are numerous in the literature, the topics of skin flap vectoring and redraping are often overlooked. In this article, the authors detail a systematic method of skin flap vectoring and redraping to achieve consistent results. 1. SET THE APPROPRIATE VECTOR The principle of differential vectoring relies on treating the face and neck as separate anatomic subunits. These subunits are delineated by the axis of the mandibular border at the level where it intersects the lobule. The neck subunit is redraped in a direction parallel to the mandibular border. (See Video 1 [online], which displays the appropriate vector of skin flap redraping for the face and neck subunits, the fixation of the postauricular flap, and the subsequent excision of scalp flap redundancy.) The facial subunit follows a more horizontal vector with a slight superior shift equaling the width of one tragus. {"href":"Single Video Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"Video 1.","caption":"This video displays the appropriate vector of skin flap redraping for the face and neck subunits, the fixation of the postauricular flap, and the subsequent excision of scalp flap redundancy.","object-id":[{"pub-id-type":"doi","id":""},{"pub-id-type":"other","content-type":"media-stream-id","id":"1_na5x2j06"},{"pub-id-type":"other","content-type":"media-source","id":"Kaltura"}]} 2. POSTAURICULAR FIXATION The postauricular skin flap is superimposed over the apex of the postauricular incision where it departs transversely to the scalp. It is split at the area of overlap and temporarily secured with a staple (Video 1). Splitting the flap separates it into two areas of redundancy: the scalp portion containing the hair-bearing portion, and the retroauricular portion along the sulcus. The scalp flap redundancy is excised, and the hair-bearing portion is closed with staples, aligning the apex of the incision first to prevent a dog-ear, followed by precise realignment of the hairline. 3. PERILOBULAR EXCISION The retroauricular flap redundancy is then carefully excised at the retroauricular sulcus. (See Video 2 [online], which displays the key steps of retroauricular excision, helical root fixation, preauricular trimming, and temporal skin excision.) Maintaining redundancy at the otobasion inferius is preferable when nearing the lobule, which often reveals less perilobular redundancy than originally anticipated. {"href":"Single Video Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"Video 2.","caption":"This video displays the key steps of retroauricular excision, helical root fixation, preauricular trimming, and temporal skin excision.","object-id":[{"pub-id-type":"doi","id":""},{"pub-id-type":"other","content-type":"media-stream-id","id":"1_rt7hnjna"},{"pub-id-type":"other","content-type":"media-source","id":"Kaltura"}]} 4. HELICAL ROOT FIXATION The preauricular skin flap is redraped along the previously discussed vector, split to the point where the superimposed flap overlaps the helical root, and temporarily secured with a staple (Video 2). This again creates two flaps of redundancy: a temporal portion and a preauricular portion. 5. PREAURICULAR TRIMMING AND TEMPORAL EXCISION The preauricular redundancy is carefully trimmed, respecting the intricate contours of the peritragal region (Video 2). The senior author uses a free-hand approach to resect the obvious redundancy and performs further refinement of the tragal borders during closure. Alternatively, the flap can be split at the upper and lower tragal borders in a tailor-tacking fashion. The temporal skin excess is then resected. 6. CLOSURE Three key fixation sutures are placed at the preauricular and postauricular incisions. (See Video 3 [online], which demonstrates placement of the three key sutures when closing the preauricular and postauricular incisions.) The most critical are the tension offloading sutures at the tragus and lobule. A 5-0 Polyglactin suture is placed just superior to the tragus to prevent tragal deformity. At the lobule, another suture is placed either through the perichondrium of inferior conchal bowl or through Lore’s fascia to prevent traction on lobule.1,2 {"href":"Single Video Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"Video 3.","caption":"This video displays the placement of the three key sutures when closing the preauricular and postauricular incisions.","object-id":[{"pub-id-type":"doi","id":""},{"pub-id-type":"other","content-type":"media-stream-id","id":"1_2ajtejq3"},{"pub-id-type":"other","content-type":"media-source","id":"Kaltura"}]} 7. LOBULE INSET The lobule is released from the underlying fascia, allowing for the skin flap to be interposed beneath it. This affords the ability to leave more tissue redundancy without creating fullness, while also avoiding a pixie-ear deformity. The lobule is retropositioned 30 degrees posterior to the axis of the mandibular border, or 15–20 degrees posterior to the long axis of the ear, and inset with 5-0 Nylon.3 (See Video 4 [online], which demonstrates the process of ear lobule inset.) {"href":"Single Video Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"Video 4.","caption":"This video demonstrates the process of ear lobule inset.","object-id":[{"pub-id-type":"doi","id":""},{"pub-id-type":"other","content-type":"media-stream-id","id":"1_qxciwgw1"},{"pub-id-type":"other","content-type":"media-source","id":"Kaltura"}]}

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.

The comparison of interrupted and continuous suturing technique in Snodgrass urethroplasty in patients with primary hypospadias: A systematic review and meta-analysis

Hypospadias is among the common congenital anomalies in boys. Snodgrass urethroplasty is one of the most popular techniques for correcting distal and mid hypospadias. Although there is consensus among pediatric surgeons on using absorbable sutures for urethroplasty, there are no established guidelines about the suturing techniques (interrupted suturing [IS] or continuous suturing [CS]) for neourethra creation in Snodgrass urethroplasty. This analysis aims to compare the reported outcomes of both the urethroplasty suturing techniques. This systematic review and meta-analysis was conducted as per the preferred reporting items for systematic review and meta-analyses guidelines. A systematic, detailed search was carried out by the authors in the electronic databases - MEDLINE, PubMed Central, Scopus, Google Scholar, and Clinical Trial Registry. Studies were selected and compared based on primary outcomes - development of urethrocutaneous fistula (UCF), meatal stenosis, and secondary outcomes - wound infection, urethral stricture, and operative time. Statistical analysis was performed using a fixed-effect model, pooled risk ratio, and I2 heterogeneity. Five randomized studies with a total of 521 patients met our inclusion criteria. Pooled analysis for total complications, UCF, meatal stenosis, and wound infection showed no significant difference between the CS and IS groups. Subgroup analysis of patients with the use of polyglactin sutures showed a decrease in total complications and UCF in the IS group. There is no difference in total complication rates among the CS and the IS group with the use of absorbable sutures in Snodgrass urethroplasty; however, there is a decrease in the incidence of total complications and UCF in the IS group when polyglactin was preferred over polydioxanone suture for urethroplasty.

Case Study: Removal of Calculi in The Bladder using Cystotomy Method in Female Pomeranian Mix Pekingese Dog at Winadi Vet Animal Clinic Malang

Urolithiasis is a disease caused by calculi, crystals, or excessive sediment in the urinary tract, which is generallycomposed of one or more types of minerals such as struvite, calcium oxalate, calcium phosphate, uric acid, andcystine.A10-year-oldfemalePomeranianmixPekingesedogwasreferredtoWinadiVetAnimalClinicMalangwith clinical signs of dysuria, strangury, and hematuria. The physical examination findings were lethargy, caudalabdominal pain, and bladder distension. Radiological examination results indicated distension in the urinarybladder containing two stones occupying withclearmarginsand radiopaque-likeopacity,withlengths of3.44cmand 3.35 cm, respectively. Cystotomy to remove the calculi was performed by incision on the midline.The urinary bladder was closed using a two-layer closure suture type, the first layer used simple interrupted, andthe second layer used simple continuous suture with 3-0 polyglactin (Vicryl®) suture. The animal recovered onthefourteenth day aftersurgery

A hyperplastic growth of lip

A 25- year-old systemically healthy female patient reported with an aesthetic complaint due to a growth in the corner of right upper lip present for 2 months. Clinical examination revealed a solitary spherical-shaped bright red fibrous overgrowth measuring 4x4 mm involving the mucocutaneous line of upper lip (Figure 1A & B). On palpation, it was non tender, smooth in texture, and soft in consistency. Based on the signs and symptoms, a provisional diagnosis of fibroma was made with a differential diagnosis of pyogenic granuloma. After obtaining written informed consent, the lesion was excised in totowith 1 mm of healthy margin by performing two elliptical incisions (Figure 1C). The biopsied tissue was fixed in 10% formalin and sent for histopathological examination. Double-layered microsurgical suturing was done with 7-0 polyglactin suture (Figure 1D) followed by superficial suturing of the wound margins (Figure 1E). Postoperative instructions were given and analgesics were prescribed, as and when required. Healing was uneventful and sutures were removed at 10 days follow-up (Figure 1F). A good cosmetic outcome and high patient satisfaction was achieved at 3 months (Figure 1G & H).