Prolene Suture Research Articles

SCLERAL SUTURE FIXATION FOR DISLOCATED SILICONE PLATE HAPTIC INTRAOCULAR LENS.

To describe results in two cases of a dislocated silicone plate haptic intraocular lens managed with vitrectomy and repositioning with scleral suture fixation. Small case series. Two patients presenting with dislocated silicone plate haptic intraocular lens underwent a 23-gauge vitrectomy with a "handshake" maneuver to pass a 9-0 prolene suture through the positioning holes to allow scleral fixation. Best-corrected visual acuity was returned to predislocation Level 2 and 8 months after the vitrectomy. Silicone plate haptic intraocular lens can be managed with scleral suture fixation using this adapted technique, avoiding removal and exchange techniques. These are the first reported cases of silicone plate haptic intraocular lens managed with scleral suture repositioning.

Microbiological Evaluation of Four Different Suture Materials Used for the Surgical Removal of Impacted Lower Third Molars: A Single-Center Prospective Comparative Study.

Introduction Sutures play a crucial role in the postoperative healing process, as they help approximate wound edges, promote hemostasis, and support tissue healing. The oral cavity harbors a diverse microbial population, and oral surgical procedures can introduce potential pathogens into the surgical site. Understanding the impact of suture material on wound infection rates and the colonization of potentially harmful microorganisms is vital for improving patient outcomes. This study was aimed to evaluate and compare the microbiological properties of prolene, vicryl plus, monocryl, and silk sutures used after the surgical removal of impacted lower third molars. Materials and methods A total of 40 patients requiring surgical extraction of impacted lower third molars wereassigned to four groups: prolene, vicryl plus, monocryl, and silk sutures. Surgical extraction of impacted toothwas done, and wound was sutured with the abovementioned four different materials in four groups, respectively. After seven days, the sutures were removedand sent to the microbiology lab for colony count assessment. Total microbial colony count, streptococcus count, and lactobacillus count were assessed.Data was analyzed using IBM SPSS Statistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, New York, United States) with p-values less than 0.05 considered as statistically significant. The one-way analysis of variance (ANOVA) and post-hoc Tukey test were done to compare intergroup relations. Results The microbiological evaluation of the sutures revealed significant differences in bacterial colonization among the four groups. More bacterial quantitieswere found in the silk group followed by the monocryl, vicryl plus, and prolene groups in the descending order. Prolene demonstrated the lowest incidence of bacterial growth (p<0.001) compared to vicryl plus, monocryl, and silk sutures.Bacterial colony count was highest in the silk group. The predominant bacterial species found in all groups were Streptococcus viridans, Staphylococcus aureus, and Lactobacillus. Conclusion It was found that prolene and vicryl plus sutures exhibited superior microbiological properties compared to monocryl and silk sutures when used for the surgical removal of impacted lower third molars. The lower incidence and less quantityof bacterial colonization on prolene sutures suggest their potential for reducing the risk of postoperative infection; hence, these sutures can be preferred for oral surgical procedures.

Ultrasound-Guided Epigastric Hernia Repair in the Pediatric Population: One Institution's Experience and Outcomes.

Introduction: Epigastric hernia repair is a common procedure performed on pediatric patients. These hernias have been demonstrated to be readily identified by ultrasound. This manuscript describes and assesses a novel technique in which ultrasound is used to identify and repair the hernias in a minimally invasive manner. Methods: A retrospective chart review evaluates all the ultrasound-guided epigastric hernia repairs done with prolene suture at one institution over 20 months. Operative details and postoperative complications were compared to patients who underwent traditional open epigastric hernia repair at the same institution during the same time frame. Results: Thirty-two pediatric patients underwent epigastric hernia repair between May 2021 and December 2022. Thirteen (41%) underwent the ultrasound-guided technique with prolene suture and using only a meniscus needle and no incision. Nineteen (59%) underwent standard open repair. There were no recurrences or postoperative complications in either group. The average operative time for the ultrasound hernia repair was 24.4 minutes, which was shorter than the average operative time of 33.6 minutes for the open repair (P = .08). In 3 ultrasound cases (23%), an additional epigastric hernia that had not been clinically apparent was identified and simultaneously repaired. Conclusions: Ultrasound-guided epigastria hernia repair is a feasible alternative to traditional open repair. It has a comparable safety and efficacy profile, has a short operative time, and has the advantages of being minimally invasive and having the ability to identify and repair concurrent epigastric hernias.

Correction of curvature in single stage hypospadias repair with foreskin reconstruction

Many surgeons offer foreskin reconstruction (FR) as a routine part of hypospadias repair. We present a step-by-step video of the procedure of Tubularised Incised Plate (TIP) repair, FR and dorsal plication through a ventral skin incision. A ventral incision is made between the inner preputial mucosa and the outer skin extending below the meatus. Ventral degloving is carried out. The dissection is extended laterally around the corporal bodies. The point of maximal curvature (PMC) is marked on the dorsal midline. A vertical incision is made and closed transversely with 5-0 prolene suture in a Heineke- Mikulicz fashion. Urethroplasty is performed in 2 layers using 7-0 polydioxanone (PDS). Spongioplasty and ventral dartos are used as barrier layers. Glansplasty is performed in 2 layers.FR is carried out in 3 layers. Curvature correction is key to good outcome. Dorsal degloving can be achieved through a ventral incision allowing exposure of the dorsal midline for plication sutures. The patient had good cosmetic and functional outcome at 1 month follow up. FR can be safely performed during TIP repair for distal hypospadias repair. Curvature of less than 30° can be corrected through a ventral incision only.

Estrogen and testosterone supplementation improves tendon healing and functional recovery after rotator cuff repair.

Failure of healing after rotator cuff repair (RCR) is common. The purpose of the current study was to evaluate the effect of systemic estrogen or testosterone supplementation on tendon healing after RCR. Seventy-two adult male mice were utilized for all experiments. The supraspinatus tendon was transected and repaired with 6-0 Prolene suture on the left shoulder of 51 animals. Mice were segregated into three groups postoperative: (1) vehicle group (VG; n = 18), (2) estrogen group (EST; n = 17), and (3) testosterone group (TST; n = 16). An unrepaired control group (unrepaired, n = 21) did not have surgery. Utilizing these animals, histological analysis, activity testing, biomechanical testing and RNA sequencing (RNA-seq) was performed. At 8 weeks post-RCR, TST, and EST supplementation improved the overall histologic structure of the repaired enthesis site. No differences in ultimate failure loads or stiffness were detected between VG, EST, and TST groups after biomechanical testing. RCR caused a reduction in wheel activity compared to unrepaired controls and supplementation with TST restored wheel activity. RNA-seq analysis indicated that estrogen and testosterone regulated different pathways associated with enthesis healing, including a suppression of inflammatory signaling. Supplementation with sex hormones improved the structure of the repaired tendon enthesis and significantly regulated expression of diverse pathways regulating multiple biological processes. Testosterone administration following RCR restored wheel activity without having a detrimental impact on biomechanical strength. Future human studies of sex hormone supplementation after RCR are warranted as supplementation in an animal model may improve tendon enthesis healing.

Endoilluminator-assisted management of acute hydrops in pellucid marginal corneal degeneration (PMCD) with compression sutures and intracameral perfluropropane (C3F8)

In this case, a male in his 30s presented to the clinic with blurring of vision, sudden whiteness, and pain in the left eye for 10 days. All preliminary examinations were recorded. He was a known case of Pellucid marginal corneal degeneration (PMCD). Clinical examination revealed corneal edema due to acute hydrops. Anterior segment optical coherence tomography (OCT) showed increased corneal thickness and a large descemets detachment. Endoilluminator-assisted compression sutures were placed along with intracameral C3F8 gas. As the tear was large, a 10-0 prolene suture was used instead of the conventional 10-0 nylon. This is the first case in literature in which acute hydrops in PMCD was managed with compression sutures (10-0 prolene) along with the injection of intracameral perfluropropane (C3F8) with the help of intraoperative use of endoilluminator.

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.

Modified Miller banding technique for ischemia in native fistulae

Treating upper limb ischemia or dialysis access-associated steal syndrome (DASS) is controversial. Many treatments have been described for this pathology; one of the techniques of preference in our institution is banding with the technique described by Miller et al. of minimally invasive endoluminal-assisted limited ligation revision (MILLER), in which we have modified to avoid the intercurrences it causes. Four cases of stage II steal are presented in which the Miller technique is performed in which, instead of banding with a 2-0 Prolene suture, it is surrounded with a 1 cm wide PTFE segment. An angioplasty balloon is used to calibrate the desired diameter of the banding, and a Doppler ultrasound is performed to evaluate the flow before and after the procedure, as in the Miller technique. The procedure allowed ischemia to be resolved, and the fistulas were found to be permeable without evidence of the complications usually described.

4 A Quantitative Image Analysis Study of Modified Kessler Extensor Repair

Abstract Aim The aims of this study were to compare and measure the amount of 4.0 Prolene suture material at the tendon repair site with 2 types of knot placement in a modified Kessler technique, as placement of suture knot can impact extensor tendon healing. Method Thirty-two extensor tendons of 2 fresh frozen cadaveric hands were divided and repaired using the modified Kessler technique with either intratendinous or extratendinous knot placement of a 4.0 Prolene suture. Tendon repairs were sectioned, and cross-sectional photographs were analysed using quantitative image analysis. Results Comparison of percentage change in tendon dimension surface area showed no significant difference (p = 0.4750) between intratendinous and extratendinous knot placement to demonstrate consistency of repair. Quantitative image analysis revealed suture material occupied a significantly (p = 0.0103) larger percentage of tendon cross sectional area in intratendinous than extratendinous knot placement. In both groups this represented &amp;lt;10% of the total cross-sectional area of the tendon at the repair site (7.49% vs 2.92%). There was no significant relation between digit, tendon or repair zone and percentage of repair zone occupied by suture material. Conclusions Intratendinous knot placement occupies a larger proportion of tendon cross sectional area than extratendinous knot placement, though this is still comparatively small when a 4’0 monofilament suture is used.

902 Systematic Review of Suturing Dermatotraction Techniques in Closing Fasciotomy Wounds

Abstract Aim A surgical patient post fasciotomy presents a challenge to restore cover of the muscle groups. The use of the suturing dermatotraction techniques presents a cheap and easy means of native cover. This systematic review of case series and case controls explored the trend of this technique including duration to delayed primary wound closure, complications and failure rates. Method A literature review was conducted on Medline, Embase and CINAHL yielding a combined total of 820 articles between 1946 and 18 June 2022. Human studies with suturing dermatotraction techniques were included. Twenty-one (21) studies reviewed met the criteria. Results The basic anatomy of the dermatotraction technique involves: An anchor point on the skin; A material for traction and a suture pattern. The Shoelace technique was the predominant suture pattern, with staples as skin anchor material and silastic vessel loops as traction sling used by 9 studies. Modifications of this method included use of intradermal prolene sutures and pediatric catheters. The shortest duration to skin apposition was 2 days and 113 days longest, with most mean closure rates at 7 days. This shoelace technique had fewer or no complications. Data showed superficial and early complications were more likely than deep or delayed complications. NPWT and skin graft salvaged few failed closures in 2 studies. Conclusions Most fasciotomy wounds closed with suturing techniques can expect to close within 7 days, with minimal complications. There are varying practices of traction rates, and this may account for the wide range to delayed primary closure.

CERCLAGE OUTCOME DEPENDING ON SUTURE MATERIAL CHOICE, EFFECTS ON BIRTH WEEK, INFANT WEIGHT, INTENSIVE CARE REQUIREMENT, AND INFECTION RATES

Aim: A preterm birth (PTB) is one that occurs before the full 37th week of pregnancy. Our theory is based on the possibility that braided mesh sutures made of Mersilene could lead to more complications and undesirable outcomes.&#x0D; Methods: There were 46 pregnant women who had cervical insufficiency. Mersilene sutures were used in 26 cases and prolene sutures in 20 cases. The cervical lengths were comparable.&#x0D; Results: Each case involved a pregnancy with a single fetus. Mersilene and prolene were the suture types in 26 cases and 20 cases, respectively. During the monitoring period, no problems, including infections, were noted.&#x0D; Conclusion: Prolene sutures appear to be related with decreased PTB and improved neonatal results, despite the fact that mersilene sutures are the conventionally chosen material for cerclage. Prolene sutures continue to offer an option to conventional mersilene sutures, notwithstanding the need for more thorough randomized clinical trials to identify any potential associations between suture material and cerclage outcomes.

Comparison of 2-Octyl Cyanoacrylate with Prolene (4-0) Sutures in Extra Oral Wound Closure.

To compare the healing following various maxillofacial incisions using 2-octyl cyanoacrylate (2-OCA) and prolene (4-0) sutures. To evaluate the complications and aesthetic outcome of the incision wounds after closure using 2-OCA and prolene (4-0) sutures. The patient undergoing an extraoral incision was evaluated for pain, inflammation, infection, dehiscence, scar, and surface texture. In Group I, 15 patient incisions were closed with 2-OCA and in Group II, 15 patient incisions were closed with prolene (4-0) suture. A few patients experienced pain with Group I and then Group II, but infection, inflammation, and dehiscence were more in Group I than in Group II. A cosmetic outcome was higher in the cyanoacrylate group, and the surface texture was satisfying in the same group.

Minimally invasive approach for the management of tube–corneal touch in aniridic glaucoma

Aniridic glaucoma, with a prevalence of around 50% in aniridia patients, often requires surgical management with glaucoma drainage device implantation. It is associated with many complications related to the tube or plate. We present a case of tube endothelial touch in aniridic glaucoma where repositioning of the Ahmed glaucoma valve tube was performed using transcameral prolene suture fixation. The advantage of this technique is that it is minimally invasive and maintains the stability of the anterior chamber throughout the surgery.

Suturing Dermatotraction Techniques in Closing Fasciotomy Wounds: A Systematic Review.

A surgical patient post-fasciotomy presents a challenge to restore the cover of the muscle groups, and the use of the suturing dermatotraction techniques presents a cheap and easy means of native cover. This systematic review of case series and case-control study explored the trend of this technique, including duration of delayed primary wound closure, complications, and failure rates. A literature review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted on Medline, Embase, and Cumulative Index of Nursing and Allied Health Literature (CINAHL), yielding a combined total of 820 articles between 1946 and June 18, 2022. Human studies with suturing dermatotraction techniques were included. Sixteen (16) studies reviewed met the criteria. The basic anatomy of the dermatotraction technique involves an anchor point on the skin, a material for traction, and a suture pattern. The shoelace technique was the predominant suture pattern, with staples as skin anchor material/method and silastic vessel loops as traction sling used by 11 studies. Modifications of this method included the use of intradermal Prolene sutures and pediatric catheters. The shortest duration for skin apposition was two days, and the longest was 113 days. Complications were comparable to that of surgical wounds and thus may not be attributable to the technique itself. Studies reviewed showed that superficial and early complications were more likely than deep or delayed complications. Negative pressure wound therapy (NPWT) and skin graft salvaged a few failed closures in two studies. There are varying practices of tightening rates with reports ranging from daily to every 72 hours. The rate of tightening and disease burden may account for the wide range of reported delayed primary closure. Most of the studies reviewed closed fasciotomy wounds with this technique within an average of <10 days. It is relatively cheaper, carries a low morbidity burden, and has multiple reported successin the closure of fasciotomy wounds in this review and thus should have an increased adoption as a first approach in managing fasciotomy wounds, especially in low-income countries.

Economic Reliable Arthroscopic Technique for Reduction and Fixation of Acute Acromioclavicular Joint Dislocation

Separation of the acromioclavicular joint (ACJ) is a common orthopaedic injury among athletes involved in contact sports and victims of motor vehicle accidents. ACJ disruptions are common in athletes. Treatment is guided by the level of injury; grade 1 and 2 injuries are managed nonoperatively. Grades 4-6 are managed operatively, whereas grade 3 is an area of controversy. Several operative techniques have been described to restore anatomy and function. We present a technique that’s safe, economic, and reliable in the management of acute ACJ dislocation. It allows intra-articular glenohumeral assessment and relies on a coracoclavicular sling. This is an arthroscopic-assisted technique. It entails a small transverse or vertical incision over distal clavicle 2 cm away from ACJ, which enables us to reduce the ACJ and maintain reduction with a k-wire, checked by the C-arm. Diagnostic shoulder arthroscopy is then performed to assess the glenohumeral joint. The rotator interval is liberated and the coracoid base is exposed, and PROLENE sutures are then passed anterior to the clavicle medial and lateral to the coracoid. It is the used to shuttle polyester tape and ultrabraid as a sling under the coracoid. A tunnel is then made in the clavicle, then one end of suture is passed through the tunnel whereas the other end remains anterior. Several knots are made to ensure it is secured, then the deltotrapezial fascia is closed as a separate layer.

V09-07 HOW TO USE A MESH SLING SAFELY AFTER THE POST-VESICOVAGINAL FISTULA REPAIR REPAIR PATIENT WITH STRESS URINARY INCONTINENCE

You have accessJournal of UrologyCME1 Apr 2023V09-07 HOW TO USE A MESH SLING SAFELY AFTER THE POST-VESICOVAGINAL FISTULA REPAIR REPAIR PATIENT WITH STRESS URINARY INCONTINENCE Micheal Breen Tamatave, Madagascar, Ly Hoang Roberts, and Larry Sirls Micheal Breen Tamatave, MadagascarMicheal Breen Tamatave, Madagascar More articles by this author , Ly Hoang RobertsLy Hoang Roberts More articles by this author , and Larry SirlsLarry Sirls More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003317.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Patients with complicated obstetric fistulas may have stress urinary incontinence (SUI) after vesicovaginal fistula repair (VVF), especially if the urethra in involved. Various techniques to treat post-VVF SUI have low success rates or is technically challenging due to thin and scarred peri-urethral tissue. We describe a technique to place a midurethral mesh sling outside of the pre-existing vaginal mucosa. METHODS: With the patient in dorsal lithotomy under spinal anesthesia, a foley catheter is placed into the bladder and the labial majora is retracted for adequate exposure. A rectangular area of the same size as the mesh sling (3x1cm) at the midurethra is marked. A number 15 scalpel is used to incise the vaginal mucosa at the marked lines, and Metzenbaum scissors are used to dissect and mobilize the edges. The dissection is then carried out laterally to be behind the inferior pubic bone. This is done on both sides. The island of vaginal mucosa is then superficially scored using low power bovie cauterization to allow for mesh adhesion and tissue ingrowth. The mesh is sutured to the island of skin using a 3-0 Chromic or vicryl suture at the mesh edges in 4 areas. 0- prolen sutures are then placed on each lateral edge of the mesh in a running stitch. The Metzenbaum scissors are then used to enter into the endopelvic fascia behind the pubic bone to develop the retropubic space. Next, a suprapubic incision is made 1cm cranial to the pubic bone down to the rectus fascia. The Stamey needle is passed in a top-down approach approximately 2cm from midline and end delivered into the vaginal incision. To check for bladder perforation, a metal catheter is placed into the bladder and swept laterally to evaluate for any metallic noise indicative of contact. The prolene suture is passed up to the suprapubic incision and the same is done contralaterally. Bladder is backfilled with sterile saline with methylene blue by gravity and foley removed. Sutures are tied together midline with the sling tension adjusted while patient performs a Valsalva. Suprapubic incision is then closed in multiple layers. The vaginal incision is closed with mobilization of the proximal vaginal mucosa and reapproximation to the distal edge. For larger incisions, a Singapore flap can be done for adequate coverage. RESULTS: Successful managment of SUI. CONCLUSIONS: For challenging cases of SUI after a post-VVF repair, this technique can be an option. Further investigation is needed for clinical outcomes. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e839 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Micheal Breen Tamatave, Madagascar More articles by this author Ly Hoang Roberts More articles by this author Larry Sirls More articles by this author Expand All Advertisement PDF downloadLoading ...

Double flanged prolene intrascleral fixation of Cionni capsule tension ring

Background Transconjunctival intrascleral fixation using double flanged prolene suture was used for scleral fixation of intraocular lenses (IOLs), Cionni capsule tension ring, and Ahmed segment. This technique carries the risk of flange exposure with subsequent hypotony and inflammation. Aim This study aimed to evaluate the efficacy of combining the Hoffman pocket with the traditional technique of Cionni ring scleral fixation in the prevention of flange exposure. Patients and methods This is a prospective study that included nine cases in which scleral fixation of the Cionni ring was indicated to treat severe zonular dialysis due to pseudo-exfoliation syndrome. The patients were followed up on the first day, after 1 week, and monthly for 6 months. During each postoperative visit, slit lamp biomicroscopy was performed to evaluate the status of the cornea, IOL centration, and position of the prolene flanges. Uncorrected visual acuity and best-corrected visual acuity were recorded. Results The mean best-corrected visual acuity improved significantly from 0.21±0.1 preoperatively to 0.76±0.24, 6 months postoperatively (P=0.0056). In all cases, the IOLs were well-centered and stable all through the postoperative follow-up period which ranged from 6 to 8 months (mean=6.9±0.66 months). No hypotony or endophthalmitis were reported. Conclusion The use of the Hoffman pocket to bury the terminal flanged ends of prolene sutures proved to be an efficient method to decrease the risk of conjunctival erosion and flange exposure.

In-situ flanged intrascleral fixation of dislocated foldable intraocular lens

Purpose The aim of this study was to investigate the efficacy of in-situ transconjunctival scleral fixation of dislocated one-piece foldable intraocular lens (IOL) with flanged prolene 6/0 suture. Patients and methods The study included seven eyes of seven patients with dislocated IOL. A 6/0 prolene suture was threaded into a 30-G needle that was then passed transconjunctively. The needle was passed through the optic–haptic junction of the luxated IOL. The prolene was then retrieved through the corneal tunnel. Two central and two scleral bulbs (flanges) were created by heating the ends of the prolene suture. Results The best-corrected visual acuity was significantly improved from 0.16±0.05 preoperatively to 0.62±0.08 3 months postoperatively (P=0.006). There were nonsignificant IOP elevation and endothelial cell loss (P&gt;0.05). All cases had well-centered IOL. No postoperative complications such as vitreous hemorrhage, macular edema, retinal detachment, or endophthalmitis were recorded. Conclusion In-situ transconjunctival scleral fixation of foldable one-piece IOLs is a safe effective technique for fixing dislocated IOLs.

A PROSPECTIVE STUDY TO COMPARE CONTINUOUS VERSUS INTERRUPTED SUTURE IN PREVENTION OF BURST ABDOMEN

Aims And Objectives: The present study was undertaken to assess theproportion of burst abdomen in post midline laparotomy patient usinginterruptedXsuturesversuscontinuoussuturetechniqueinsheathclosure. Materials And Methods: A total of 50 patients undergoing midlinelaparotomyinemergencysettings,fromtheDepartmentofGeneralSurgery, Gadag Institute of Medical Sciences, Gadag, whose satisfying inclusion and exclusion criteria after takingwritten and informed consent were divided in to two groups of 25 each.In group A closure was performed using No.1 prolene suture, usinginterrupted X type, and in group B closure was done by continuousmethod,andthesepatients werefollowedupin thepostoperativeperiod. Results: Patients were followed up in the early post operative periodand regular follow up. 3 of the patients developed wound dehiscence, incontrastwithcontrolgroupinwhich9patientsdevelopedburstabdomen. 1 of our patients from the study group developed incisionhernia,7 from control group developed incision hernia. In the presentstudy 22patientsin whom interruptedXsuturingwasdonehadanormal wound healing compared to 16 patients with continuous group.5 patients from the interrupted group had a prolonged hospital staycomparedto11patientsfromthecontinuousgroup.Therefore,Interrupted X suturing technique overweighs the disadvantages of thecontinuoussuturingtechnique.Hencethetechniqueshouldbeconsidered. Conclusion:HenceInterruptedXsutureisbetterthancontinuoussheathclosureinpreventionofburstabdomen.

Which suture is ideal for abdominal fascial closure: polydioxanone or polypropylene?

Background: A secured fascial closure with appropriate suture material is an integral step to prevent complications in laparotomy. A costly post-operative complication is wound dehiscence which manifests as incisional hernia as a delayed complication. The present study compared prolene and polydioxanone (PDS) sutures in patients undergoing midline closure after emergency exploratory laparotomy with the aim to evaluate wound outcome after the use of either of the sutures. Methods: Sixty-six patients undergoing emergency laparotomy were randomly divided into two groups: group A (PDS) and B (prolene). Wound complications were evaluated for each patient in terms of wound pain, wound discharge, burst abdomen, stitch sinus, stitch granuloma and incisional hernia. Results: Wound pain was observed more in prolene group, p&lt;0.05 till 3rd post-op day. Wound discharge, wound dehiscence and burst abdomen were more in prolene group, but the difference was statistically insignificant (p&gt;0.05). Six patients developed incisional hernia, out of which 5 had prolene, (p&gt;0.05). Similar statistically insignificant difference was found with stitch granuloma and stitch sinus. Conclusions: Till date there is lack of agreement about the ideal suture for abdominal fascial closure. Present study concluded that any suture material is equally effective for abdominal fascial closure since there are many other factors contributing towards wound complications.