Suture Removal Research Articles

Coated sutures for use in oral surgery: a comprehensive review.

Clinicians have access to a variety of suture materials for effective wound repair. Recent studies have suggested utilizing coatings on sutures to enhance their properties. Literature indicates that such coatings may improve the tensile strength of sutures and augment their antimicrobial capabilities. Various materials, including zinc oxide (ZnO) nanoparticles, silver nanoparticles, and antimicrobial agents, have been investigated. This study aims to elucidate the materials utilized for coating sutures, identify the types of sutures employed, and detail the properties imparted by each coating. A systematic search was conducted in the Scopus, Web of Science, and PubMed databases using the keywords "coat*," "sutures," and "oral surgery." 20 articles met the inclusion criteria and were incorporated into this review. The literature is sparse regarding comparative studies on sutures with specific coatings. Triclosan-coated sutures have not shown a significant reduction in microbial load in oral surgery. However, silver nanoparticle coatings have been effective in reducing wound contamination. Antiseptic-coated silk sutures demonstrated significantly lower microbial colonization compared to controls. Notably, sutures with lycopene coatings did not exhibit superior antimicrobial or mechanical properties to uncoated sutures. ZnO nanoparticle-coated silk fibers displayed higher tensile strength than their uncoated counterparts. Other coatings, such as silicone or wax, have been developed to reduce suture friction. In oral surgery, the effectiveness of coatings remains limited, potentially due to the high microbial load present in the anatomical region. Many coated materials are available for use in oral surgical sutures, but further research is necessary. Timely removal of sutures is recommended to minimize the risk of surgical wound infections, along with maintaining good oral hygiene.

Endophthalmitis Following Delayed Gore-Tex Suture Rotation: A Lesson in Suture Management.

To highlight occurrence and management of an important surgical complication. Retrospective case review. A 35-year-old Caucasian female with a history of crystalline lens dislocation secondary to Marfan Syndrome was referred for management of chronically exposed Gore-Tex suture knots following AKREOS 4-point fixation six years prior. The initial surgery was reportedly complicated by hypotony leading to multiple attempted wound revisions. Ultimately, the patient remained with chronically exposed suture knots. Upon referral to our practice, the knots of the left eye were rotated into the eye, leading to endophthalmitis refractory to two rounds of intravitreal antibiotics. Infection was controlled only after removal of all preexisting hardware, suggesting colonization of the suture material. In the other eye, the decision was made to remove all preexisting sutures and re-fixate the initial lens using new suture. The patient achieved 20/20 vision in both eyes with implantation of a new secondary IOL in one eye and with removal of all preexisting sutures in the other eye. This report highlights a case of endophthalmitis following delayed rotation of exposed suture. Based on the outcome of this case, the importance of avoiding suture exposure is highlighted, and options to manage chronically exposed suture are discussed.

Transconjunctival correction of involutional entropion: A video demonstration.

Involution or aging is the most common cause of lower eyelid entropion (in-turning of eyelid margin) in the elderly population. Various pathomechanisms have been postulated for its occurrence. Aging leads to laxity of tissues and loss of muscle tone. Disinsertion/dehiscence of inferior retractors is considered as the major reason along with the loss of orbicularis muscle tone with or without over-riding of pre-septal fibers onto pretarsal fibers, and laxity of overall eyelid and/canthal tendons. The examination should focus on testing the above-mentioned predisposing factors. The clinical tests are as below. 1. Distraction/pinch test-This test is conducted to assess the overall eyelid laxity. The patient is asked to look in the primary gaze and the lower eyelid is pulled away from the globe. The distance between the pulled eyelid and the globe is measured in millimeters. The laxity is considered significant if the value is more than 6 to 8 mm, which varies according to the age of the patient. 2. Snapback test-This test is conducted to assess the tone of the orbicularis muscle. After doing the distraction test, leave the eyelid and check for its position in relation to the globe. If it snaps back immediately or follows a blink, then it is normal for an old patient. If on leaving the eyelid, it does not come in contact with the globe after blinking repeatedly, then the loss of tone is significant. 3. Medial canthal laxity-Pull the eyelid laterally and observe the shift of the puncta. Laxity is significant if the shift of puncta is 4 mm. 4. Lateral canthal laxity-Pull the eyelid medially and observe the shift of the lateral canthus. Laxity is significant if the shift of the lateral canthus is 4 mm. 5. Eyelid sagging/sclera show-The presence of the sclera due to eyelid sagging is suggestive of significant horizontal lid laxity. 6. Inferior retractor weakness-Inferior retractor weakness occurs because of its dehiscence or disinsertion. The presence of the following signs is suggestive of weakness, that is, higher eyelid resting in primary gaze, eyelid fails to retract on down gaze (normal excursion of the lower eyelid is 3-4 mm), increase in the depth of inferior fornix, and presence of white infratarsal band of retractors separated from the lower tarsal border by a pinkish orbicularis band. Surgical management of involutional entropion includes tackling the vertical component (inferior retractors reinsertion/plication or eyelid margin rotation surgery) with or without the horizontal component. Horizontal tightening (lateral tarsal strip procedure or full-thickness pentagon excision) is indicated in the presence of significant laxity of the overall eyelid and/or canthal laxity. Tackling both vertical and horizontal components gives the best long-term outcome. To highlight important surgical steps of transconjunctival correction of left eye involutional entropion in a 70-year-old patient. The video 1 shows the correction of involution entropion by horizontal tightening (lateral tarsal strip procedure) and vertical tightening (advancement and reattachment of inferior retractors on the anterior surface of the tarsus) by conjunctival approach. The limitations of the procedure are mainly that it needs surgical expertise and excessive skin excision if needed cannot be conducted. In our experience, skin excision is not needed in unilateral cases to avoid asymmetry. The suture removal especially at the eyelid margin should be removed at 2-3 weeks to provide a strong attachment of inferior retractors with the tarsal surface. Steps of transconjunctival correction of involutional entropion.Video Link:https://youtu.be/JVLi0PngKm4.

Impact of mitomycin C on surgical outcomes of PAUL glaucoma implant in neovascular glaucoma: 12-month follow-up results.

To evaluate the effectiveness of the PAUL Glaucoma Implant (PGI) and the adjunctive impact of intraoperative Mitomycin C (MMC) on surgical outcomes in patients with neovascular glaucoma (NVG). This retrospective, comparative study included NVG patients who underwent PGI implantation. The cohort was divided into two groups: Group 1 (PGI without MMC) and Group 2 (PGI with MMC). Inclusion criteria encompassed a minimum 12-month postoperative follow-up and preoperative light perception. Surgical success was defined as maintaining intraocular pressure (IOP) between 6-21 mmHg without additional surgical intervention from the third month to the end of the 12-month follow-up. Failure due to hypotony was defined as an IOP ≤5 mmHg. The study enrolled a total of eighty-one patients, with 40 patients in Group 1 and 41 in Group 2. There were no significant differences in the demographic data and baseline ocular characteristics between the groups. Group 1 required more medications at 1, 3, 6, and 12 months (p < 0.05 for all). Surgical success rates at 12 months were 85% for Group 1 and 87.8% for Group 2, with no statistically significant difference between the groups (p = 0.140). Group 2 demonstrated a lower frequency of additional glaucoma procedures (p = 0.003) and delayed ripcord suture removal (p = 0.0001). Incorporating MMC as an adjunct to PGI implantation may improve IOP control and decrease the requirement for additional medications and surgical interventions in NVG patients. However, there was no statistically significant difference between the two groups in terms of the surgical success criterion.

Effect of the prolene ripcord suture on the baerveldt tube position: A case study.

A 42 year old Afro-Caribbean man underwent Baerveldt Glaucoma Implant (BGI) surgery for silicone oil induced glaucoma. Three months following initial surgery, the 3-0 prolene ripcord suture was removed. Anterior segment OCT demonstrates the position of the intracameral portion of the tube before and after the 3/0 prolene stent suture (PSS) removal. Ex-vivo experiments further demonstrate the variation in tube position using straight vs curved segments of 3/0, 4/0 and 5/0 PSS passed through the BGI lumen. Glaucoma tube surgeons should consider how the rigid nature of the prolene stent suture could influence the position of non-valved tubes within the eye, both during tube implantation and after prolene suture removal.

Patient Satisfaction With Surgery of Basal Cell Carcinoma: Keep It Safe and Simple.

Patient-reported outcomes are important quality indicators in dermatologic surgery. We performed a prospective cohort study to assess patient satisfaction with surgery of basal cell carcinoma (BCC) and identify patient-, tumor-, and treatment-related influencing factors. Patients who underwent BCC surgery at the Vivantes Skin Cancer Center in Berlin, Germany, rated global, cosmetic, and functional satisfaction on a visual analog scale from 0 (very dissatisfied) to 10 (very satisfied) at suture removal (T0) and three months after surgery (T1). Group differences were examined with the Kruskal-Wallis test and independent associations with linear regressions. Among 150 participants (41.3% females, mean age 75.3 years),82.7% had a BCC in the head/neck region. Reconstruction after micrographically controlled excision was performed most frequently with advancement or rotation flaps (52%), followed by linear closure (27.3%), transposition flaps (8.7%), and skin grafts (6%). Patient satisfaction was overall high (global: mean 8.5 (T0) and 8.3 (T1), cosmetic: 7.3 (T0) and 7.6 (T1), functional: 8.6 (T0) and 8.2 (T1)) and intercorrelated with physicians' satisfaction. Males and patients aged >75 years were significantly more satisfied with cosmetic and functional results. Poor health state, tumor localization on the nose, complications, pain, and prolonged wound healing were associated with lower satisfaction in most categories. Linear wound closure led to better global satisfaction than local flaps and skin grafts at T1. Patient satisfaction was related to inherent patient- and tumor-associated factors, reconstruction technique, and complications, aspects to be discussed during shared decision-making to reconcile patients' expectations with practicability.

Effect of selective suture removal on graft astigmatism after corneal transplantation in keratoconus

Background: Selective suture removal has been demonstrated to be effective in reducing post-keratoplasty astigmatism, while the remaining sutures are left in place. Existing studies typically focus on outcomes immediately after selective suture removal, without delving into the final suture-out keratometric astigmatism. Objectives: To examine the impact of selective suture removal on corneal graft astigmatism following keratoplasty in keratoconus and identify potential factors associated with the changes in graft astigmatism after suture removal. Design: Retrospective, comparative interventional case series. Methods: The study included 118 consecutive eyes of 118 cases that underwent corneal transplantation for keratoconus and had a keratometric astigmatism of ⩾4 D. One or two interrupted sutures corresponding to the steep meridian were removed per session. Patients were re-evaluated at 1 to 2-month intervals, repeating the procedure until achieving a keratometric astigmatism of &lt;4.0 D or no interrupted sutures remained in the steep meridian. Results: The mean recipient age was 28.4 ± 8.4 years. A total of 234 selective suture removals were performed, with a mean of 2.0 ± 1.1 removals per eye. Pre-suture removal keratometric astigmatism significantly decreased from 6.3 ± 2.0 D to 3.91 ± 2.23 D after the completion of selective suture removal ( p &lt; 0.001). This value was significantly increased to 5.45 ± 2.93 D after all suture removal ( p &lt; 0.001). Higher pre-suture removal astigmatism and deep anterior lamellar keratoplasty were associated with a more favorable response to selective suture removal. Conclusion: Selective suture removal effectively modifies graft curvature to reduce post-keratoplasty astigmatism in keratoconus patients. However, its efficacy markedly diminishes after all sutures are removed. This procedure is particularly effective in patients with higher pre-suture removal astigmatism and those undergoing deep anterior lamellar keratoplasty.

Impact of residual stromal thickness on the outcomes of manual deep anterior lamellar keratoplasty

Aims/Purpose: To analyze how postoperative outcomes of manual deep anterior lamellar keratoplasty (DALK) are influenced by the thickness of the residual stromal bed of the recipient, and to explore predictive factors for this parameter.Methods: This is a retrospective case series of patients affected by keratoconus undergone manual DALK. Best spectacle‐corrected visual acuity (BSCVA) and tomographic parameters were evaluated preoperatively (T0) and postoperatively after complete suture removal (1 year, T1). The residual stromal bed of the recipient at T1 was assessed using the “flap thickness” module of CASIA SS‐1000 optical coherence tomography (Tomey, Tokyo, Japan). Measurements were performed at the center of the graft and at 12 peripheral points, 2 mm inside the margin of the corneal graft, along 6 different meridians equally spaced at 30 degrees. Then, mean peripheral thickness was calculated.Results: Data from 40 eyes undergone manual DALK were evaluated. BSCVA significantly improved at T1 (1.11 ± 0.55 LogMAR [95% CI, 0.94‐1.28] vs 0.17 ± 0.16 LogMAR [95% CI, 0.12‐0.22]). A significant linear correlation was found between postoperative BSCVA and the mean apical thickness of the residual stromal bed (72.85 ± 27.77 μm [95% CI, 64.24‐81.46]; r = 0.48, p = 0.002), but not with the mean peripheral thickness of the residual stromal bed (78.47 ± 25.32 μm [95% CI, 70.62‐86.31]; r = 0.28, p = 0.09). Multivariate regression analysis found mean posterior and anterior keratometry (K) readings of the axial power map to be the strongest predictive factors for the apical thickness of the residual stromal bed (R2 = 0.32, p &lt; 0.001).Conclusions: Postoperative BSCVA is significantly correlated with the apical thickness of the residual stromal bed. The preoperative mean posterior and anterior K readings may be predictors of the postoperative apical thickness of the residual stromal bed.

Cancellous bone harvesting from the distal radius for reconstruction of bone defects in the hand

Extraction of cancellous bone from the distal radius for reconstructive procedures on the hand. All reconstructive procedures on the hand for which acorticocancellous and/or vascularized bone graft or alarge amount of cancellous bone is not required. Acute distal radius fracture, osteosynthesis material embedded in the distal radius, e.g., after palmar plate osteosynthesis of adistal radius fracture, tumor in the distal radius. Removal of cancellous bone from the distal radius radially from the dorsal radial tuberosity via asmall bone window at the base of the second extensor tendon compartment. Wound dressing on the distal radius, elevation of the arm above heart level until swelling has subsided, first dressing change on postoperative day1 or 2,depending on the primary procedure on the hand, dressing until wound healing is complete, removal of the skin sutures around postoperative day14. In 2023, cancellous bone was harvested from the distal radius of 17patients for reconstructive procedures on the hand (6mediocarpal partial arthrodeses, 3acute fractures, 5delayed bone healings, 1pseudarthrosis, 2bone tumors). In all cases, the available amount of radius cancellous bone was sufficient, resulting in satisfactory healing. All patients complained of short-term, slight discomfort at the donor site for the first few days after surgery, which resolved completely. There were no complications at the donor site on the distal radius.

Early results of primary total hip arthroplasty performed in young adults at a regional Saudi-Arabian orthopedics center: a prospective observational study

Background. Younger patients undergoing primary total hip arthroplasty (THA) have different indications and outcomes than elderly patients. Furthermore, studies reporting the results of THA in young patients are scarce in our area. The aim of the study is to report the early experience and clinical results after total hip arthroplasty in patients ≤40 years old from a regional Saudi-Arabian hospital as a representative of the Arab (Middle Eastern) population. Methods. We conducted a prospective observational study over one year by following all patients (≤40 years) who underwent primary THA at a regional Saudi-Arabin orthopedics center. Twenty-five patients (a mean age of 31.60±6.07 years, and 14 (56%) were males) were eligible for final inclusion. The functional assessment was performed according to the Harris Hip Score (HHS), leg length discrepancy (LLD) was evaluated, and complications at any point were reported. Results. The commonest indication was advanced avascular necrosis (28%) followed by post-traumatic osteoarthritis (24%) and rheumatoid arthritis (24%). Cementless fixation was utilized in 20 (80%) THAs, and the bearing surface was either metal- or ceramic-on-polyethylene in 92% of THAs. After a mean follow up of 20.0±4.5 months, HHS improved from a pre-operative mean of 29.20±5.29 to 85.48±7.18 (p = 0.0001). Excellent and good results were reported in 84%. All working patients (52%) returned to their jobs after THAs. The leg length discrepancy improved significantly from a pre-operative mean of 2.12±1.01 cm to the last follow up mean of 0.72±0.4 cm, p = 0.0001. Two (8%) patients had superficial wound infections at the time of suture removal, which were treated successfully by daily dressing and antibiotics. None required revision. Conclusions. Primary total hip arthroplasty is the option for managing end-stage hip disease, even in younger patients when hip preservation surgeries are invalid. Our results showed improved functional outcomes and a return to pre-disease daily activities in most patients, with considerably lower complication incidence.

Effect of Epidermos Barrier Cream on Postoperative Parotidectomy Incision Scar.

Introduction: The modified Blair incision is commonly used for superficial and deep lobe lesions of the parotid gland. The most common complication of the parotidectomy procedure is the postoperative surgical scar. Epidermos barrier cream is a type of cream that helps in wound healing by covering the wound. Objective: The purpose of this study was to evaluate the effect of epidermos barrier cream on postoperative incision scars. Methods: Forty-six patients scheduled for surgery due to benign parotid masses were included in the study. Patients were called for a follow-up appointment to remove sutures 1 week after standard surgical intervention. In the study group, epidermos cream was used on the wound site until complete healing was achieved after suture removal, while wound healing in the control group was monitored without any medication. The patients were evaluated in the first, second, and fourth postoperative weeks using a wound site assessment questionnaire and surgical wound assessment for wound healing evaluation. Results: There were no statistically-significant differences between the groups in the evaluation results in the first week. On examination of the data in the second week, a difference was only observed in terms of the presence of hyperemia at the edges of the wound between the groups (P = .005), with no statistically-significant differences found in any other assessment tools. In the 4-week wound healing evaluation, a statistically-significant difference was observed in favor of the study group both in the patient's evaluation of the wound site (P < .001) and in the surgeon's evaluation of the wound site (P = .029). Conclusion: Epidermos cream was found to significantly improve postoperative scar healing in parotidectomy incisions considered challenging in terms of healing. Epidermos barrier cream was found to be beneficial for wound healing in wound sites.

Efficacy of Fibrin Sealant in Submental Liposuction: A Prospective Randomized Study.

The incidence rate of submental liposuction has been increasing in recent years. Although this procedure is relatively simple, serious complications, including fatalities, have been reported, primarily owing to intraoperative and postoperative bleeding. To enhance the safety of liposuction, we examined the efficacy of Beriplast® P (CSL Behring, Melbourne, Australia), a physiological tissue adhesive fibrin sealant, in reducing postoperative swelling. Swelling was measured using the image analysis software VECTRA® (Vectra AI, Inc., CA, USA). Twenty-nine cases of submental liposuction performed from February to August 2024 were analyzed for tissue volume changes immediately postoperatively and at the time of suture removal, comparing those who received the fibrin sealant to those who did not. The group using the fibrin sealant had significantly less postoperative swelling compared to the group that did not use the fibrin sealant (p<0.001). The fibrin sealant may be used to effectively suppress postoperative swelling, reducing the risk of complications and improving patient satisfaction, thereby enhancing the overall safety and effectiveness of cosmetic surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Assessment of a Non-Absorbable Monofilament Suture for Skin Closure in Adults and Paediatrics – Skinda, an International, Bi-Centric, Prospective Cohort Study

Each surgical incision has to be closed after surgery. Suture materials are mostly applied which differ in their filament structure, material composition, as well as in their absorption profile, and the choice of the suture material used for skin closure is mainly based on the surgeon´s preference. We designed a prospective, international, multicentric, single-arm, observational study to assess the clinical outcome of a non-absorbable monofilament nylon-based suture for skin closure with a comparison to historic data from the literature. In total, 115 patients were enrolled with an equally distribution of adults and paediatrics receiving a nylon-based suture material to close the skin. Different safety (wound dehiscence, surgical site infections, and adverse events) and effectiveness parameters (pain, wound healing, patient satisfaction, cosmetic result, intraoperative suture handling) were selected to judge the performance of the suture material. The assessment of patient satisfaction, wound healing, and handling properties of the suture was done using a Likert scale, whereas the Patient and Observer Scar Assessment Scale (POSAS) was chosen for aesthetic scar rating. The primary endpoint was a combined rate of wound dehiscence and surgical site infection occurring until suture removal. After discharge, the patients were examined at suture removal and the paediatric population received a further routinely 1-month post-surgery follow-up. Until suture removal, 2 surgical site infections (1.75%) occurred and one wound dehiscence was seen until 30 days postoperatively, indicating significant lower rates compared to historical data. Furthermore, good handling properties of the suture material as well as a high patient satisfaction combined with an excellent wound healing and cosmetic appearance were reported. Based on our findings, it can be concluded that a monofilament nylon-based suture material is an optimal choice for skin closure in adults as well as in children, and it represents an appropriate alternative to other devices, which are currently in utilization.

Removal of aqueous humor and conjunctival compression sutures for a dysesthesic filtering bleb: A surgical technique and case report.

To present a novel surgical technique for the treatment of a steep-walled filtering bleb following an Ahmed glaucoma valve implant. The primary aim was to alleviate the patient's discomfort and address associated corneal thinning, complications that can arise from this condition. Case report and surgical technique. This case report describes a 29-year-old female who developed a dysesthesic filtering bleb following the implantation of a glaucoma drainage device. The employed surgical technique to address this complication involved the drainage of aqueous from the bleb using a 30-G needle, which effectively reduced its height. Subsequently, a compression suture was applied to maintain an appropriate bleb size. With the presented surgical technique, the ultimate control of an overhigh filtering bleb associated to a glaucoma drainage device was possible. Following the procedure, the patient's symptoms and the corneal thinning linked to the bleb's excessive size were successfully managed. Furthermore, the anatomy of the filtering bleb was preserved, and an optimal intraocular pressure outcome was achieved. The removal of aqueous and the application of a compression suture are two surgical techniques traditionally used for managing the hypertensive phase of glaucoma drainage devices and for alleviating discomfort from blebs after classical filtering surgery, respectively. In the case presented, the combination of these two techniques effectively reduced the size of an excessively high filtering bleb associated with a glaucoma drainage device. This approach successfully resolved the patient's discomfort and corneal issues related to this complication.

Risk factors for poor outcomes in adult patients with lip through-and-through wounds

BackgroundRisk factors associated with infection and traumatic lacerations affecting the face are still not fully understood. This study investigated risk factors for poor outcomes in adult patients with through-and-through lip wounds who underwent debridement and suturing. MethodsPatients with through-and-through lip wounds who underwent debridement in our emergency department between January 1, 2017, and December 31, 2021, were included. The effects of gender, age, wound age (time from injury to wound closure), antibiotic application, injury mechanism, diabetes, wound length, wound cleanliness, peripheral tissue damage, and postoperative wound blood scab on the poor outcome rate were assessed for all patients. Poor outcome was analyzed based on atraumatic wound dehiscence before suture removal, pus in the wound, and unhealed oral wounds with a length >1 cm or deeper than the muscle layer 5–6 days after surgery. ResultsA total of 728 cases were included, with a poor outcome rate of 20.88 %. The univariable analysis showed that the proportion of poor outcomes was significantly associated with male gender, age (65–79 years old), bicycle/electric bicyble, antibiotic use, wound length of 4–8 cm, wound contamination, peripheral tissue damage, and scabs. Binary logistic analysis showed that the proportion of poor outcomes was significantly associated with older age (65–79 years old), wound length of 4–8 cm, peripheral tissue damage and wounds covered by scabs. In the binary logistic regression analysis, poor outcomes were not associated with gender, injury mechanism, wound contamination or the use of antibiotics. ConclusionOur findings provide valuable information on the risk factors for poor outcomes in adult patients with lip through-and-through wounds who underwent debridement and suturing.

Endoscopic Techniques in Sagittal Synostosis Correction: A Systematic Review and Meta-Analysis.

Scaphocephaly is a craniofacial deformity caused by the premature fusion of the sagittal suture, which can affect skull growth and shape. For decades, surgical treatment or craniosynostosis has involved open procedures, ranging from the removal of a single suture to complex cranial remodeling techniques with large skin incisions. Since the 1990s, endoscopic approaches have emerged as potentially less invasive options. This study aimed to evaluate the efficacy of and differences between endoscopic scaphocephaly correction techniques. A comprehensive search was conducted on PubMed, Embase, Web of Science, and Scopus for clinical trials and observational studies analyzing endoscopic correction of scaphocephaly and describing the procedure. The outcomes analyzed included pre- and postoperative cephalic indexes, operation time, blood loss, number of transfusions, complications, and subgroup analysis. Thirty-two studies involving 1566 patients (mean age at the time of surgery: 3.3 months) were included. Overall, the cephalic index showed a significant increase in the mean difference of 7.58 (95% CI 6.35-8.80; P < .01), and when analyzed by subgroups based on the size of the removed strip (≤2 and >2 cm), there was no significant difference in the cephalic index. In addition, the analysis of lateral osteotomies showed no difference in CI between the subgroups. Our results suggest that less invasive techniques, involving smaller incisions and excisions, can achieve comparable success with traditional techniques. These findings have significant implications for clinical practice, underscoring the importance of exploring less invasive options for scaphocephaly correction to improve patient outcomes and reduce morbidity.

Clinical Application of Skin Wound Adhesive (Glue) in Skin Incisions

Objective: To explore the clinical application of skin wound adhesive (glue) in skin incisions. Methods: Data from 46 patients who underwent surgery in our hospital between June 2024 and August 2024 were collected, focusing on breast surgery incisions as the study subject, with follow-up observations conducted for 1–2 weeks. Results: All incisions healed well without splitting, allergic reactions, or infections, and no adverse reactions were observed. Conclusion: The application of skin wound adhesive (glue) in breast surgery incisions is effective and safe; the adhesive process is convenient for external body incisions, eliminates the need for suture removal, shortens patient surgery and hospital stays, and reduces incision infection risk, resulting in satisfactory incision healing outcomes.

Machine learning methods to identify risk factors for corneal graft rejection in keratoconus

Machine learning can be used to identify risk factors associated with graft rejection after corneal transplantation for keratoconus. The study included all keratoconus eyes that underwent primary corneal transplantation from 1994 to 2021. Data relating to the recipient, donor, surgery, and postoperative course that might be associated with the occurrence of a graft rejection reaction were compiled. This study used five supervised learning algorithms including artificial neural network, support vector machine, gradient boosting, extra trees classifier, and random survival forests to select the most predictive factors for graft rejection. A total of 1214 consecutive eyes of 985 keratoconus patients were included in the study, and the technique of keratoplasty included penetrating keratoplasty in 574 eyes (47.3%) and deep anterior lamellar keratoplasty in 640 eyes (52.7%). The overall prevalence of first graft rejection was 28.1%. All five models had similar ability in identifying predictive factors for corneal graft rejection. Technique of keratoplasty was associated with an increased risk of graft rejection in all models. Other identified risk factors included patient age, keratoplasty in the fellow eye, donor age, graft endothelial cell density, duration of corticosteroid application, time from keratoplasty to complete suture removal, and suture-associated complications. It is advisable that in the absence of any contraindication, post-transplant keratoconus eyes receive a low dose topical corticosteroid until all sutures are removed.

Evaluation of Bone Supported Ultra Lock Ezy Bar versus Erich Arch Bar for the Treatment of Mandibular Fractures

ABSTRACT Introduction: Maxillofacial trauma treatment involves maxillomandibular fixation. Despite reduced need for post-operative MMF with plating devices, temporary intraoperative MMF is still necessary for proper tooth positioning. The aim of this research is to evaluate the cost-effectiveness, impact on patient gingival health, glove perforation, and time required for utilizing the Ultra Lock Ezy Bar compared to Erich’s Arch Bar. Methods: Ten patients with mandibular fractures were randomly split into two groups for treatment: Group A (study) and Group B (control). Group A received treatment with an Ultra Lock Ezy Bar and screws, while Group B received treatment using an Erich’s Arch Bar and wires. Follow-ups were done for suture removal, wound healing, and evaluations on gingival index, glove perforations, and treatment times. Results: In application time, group A had mean of 44.00 ± 3.391 and group B had 90 ± 9.354, with no significant difference. Neither group showed significant mean differences in removal time. Group B had statistically significant glove perforation (4.80 ± 0.837) compared to 0 in group A. Pre-operative gingival index comparison showed significance. After four weeks, group B’s mean index was 1.720 ± 0.2387 and group A’s was 1.120 ± 0.2049 with no statistical distinctions. Conclusion: To sum up, the randomized control experiment produced convincing results when comparing Erich’s Arch Bar with Ultra Lock Ezy Bar for mandibular fixation in ten patients. With notably quicker application and removal times, no glove perforations, and comparable gingival health immediately following surgery, Ultra Lock Ezy Bar showed clear benefits.

Post-operative Hypotony And Choroidal Effusion Following Cataract Surgery Suture Removal

Ocular hypotony can occur for a variety of reasons, including but not limited to ocular inflammation, glaucoma filtration surgery, or trauma...