Suture Material Research Articles

Assessment of Mechanical Properties and Antimicrobial Effects of Hyaluronic Acid Coating on Absorbable Suture Material: An In-vitro Study

Introduction: The use of absorbable suture materials in surgical procedures is a critical aspect of wound closure and tissue repair. In recent years, there has been growing interest in exploring the potential benefits of incorporating Hyaluronic Acid (HA), a naturally occurring biopolymer, into these sutures. By shedding light on the interactions between HA and absorbable sutures, the present study seeks to provide valuable insights that could enhance the quality of surgical wound management. Aim: To assess the mechanical properties and antimicrobial effects of HA-coated and uncoated absorbable suture material. Materials and Methods: The in-vitro study was conducted at Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India in a year 2022. A total of 70 samples of HA-coated and uncoated Vicryl 4-0 suture material were tested for tensile strength using an Instron machine. An anti-bacterial effect against Pseudomonas aeruginosa and Streptococcus mutans was assessed using a Mueller Hinton agar (MHA) plate, and the zone of inhibition was measured. Additionally, both the uncoated and HA-coated Vicryl 4-0 suture materials were analysed under the Scanning Electron Microscope (SEM) to determine the surface characteristics. An independent t-test was used to compare the tensile strength of coated and uncoated suture materials. Results: The mean tensile strength of uncoated and HAcoated suture material was 6.47±0.23 MPa and 3.78±1.02 MPa, respectively. The difference between both groups was statistically significant (p<0.05). For Pseudomonas aeruginosa and Streptococcus mutans, the zone of inhibition was 8.0±0.5 mm in diameter and 9±0.5 mm in diameter, respectively, around coated Vicryl 4-0 suture material, whereas no zone of inhibition was observed for both Pseudomonas aeruginosa and Streptococcus mutans around uncoated suture material. SEM analysis showed superior surface characteristics of HA-coated suture thread when compared to uncoated suture thread. Conclusion: HA-coated suture material does not exhibit superior tensile strength when compared to the uncoated suture material. However, HA-coated suture material has potent antibacterial effects against Pseudomonas aeruginosa and Streptococcus mutans. Additionally, SEM analysis showed improved surface characteristics in favour of the coated suture material.

Repercussions of perineal repair using surgical glue or suture thread on postpartum outcomes: A controlled randomized clinical trial in São Paulo, Brazil.

The type of perineal repair can have significant long-term effects on various functions in a woman's postpartum life. The aim was to compare urinary incontinence (UI), women's satisfaction, pelvic floor muscle strength (PFMS), and sexual function according to the type of perineal repair (surgical glue or suture thread) during the first eight months after normal childbirth. A controlled randomized clinical trial of 133 primiparous women undergoing perineal repair during birth with surgical glue or sutures, evaluated during labor and monitored up to 8 months postpartum, from March 2017 to September 2018, in the city in São Paulo, Bazil. Descriptive and inferential analyses were carried out. A total of 133 women were included in the study, 111 (83.5%) were assessed between 10 to 20 days postpartum, 121 (91.0%) between 50 to 70 days, and 54 (40.6%) between 6 to 8 months. There were no significant differences for UI concerning the type of repair; however, there was a significant difference concerning the postpartum period (p=0.031), with a higher prevalence at two months. Most women reported satisfaction, with the highest levels reported two months after birth (p=0.019). For PFMS, the mean of the glue and suture groups were 32.4 cmH2O and 27.4 cmH2O, but not significant. Women in the glue group showed higher mean values in all sexual function domains but without significance. Surgical glue showed good aesthetic and functional results in the perineum at eight months postpartum.

УСПЕШНАЯ ОТКРЫТАЯ РЕПОЗИЦИЯ ОСКОЛЬЧАТОГО ВНУТРИСУСТАВНОГО ПЕРЕЛОМА БОЛЬШЕБЕРЦОВОЙ КОСТИ С ПОСЛЕДУЮЩИМ ОСТЕОСИНТЕЗОМ ТИТАНОВОЙ ПЛАСТИНОЙ И ВИНТАМИ

Pilon fractures are intra-articular fractures of the distal tibial metaepiphysis account for about 1 % of all lower extremity fractures. A typical sign of a pilon fracture is a large number of fragments of bone structures in the injured area as a result of the impact of the talus on the tibia. The study aims to assess antiinflammatory and antibacterial therapy, timely pain relief for an injured patient, prevention of thromboembolic complications, aseptic dressings, and the patient’s movement as soon as feasible before the suture material is removed. The assessment was based on the data from the medical documentation of the trauma hospital, instrumental research, and the results of dynamic observation of surgery on open reduction of a comminuted intra-articular fracture of the tibia of the left leg, osteosynthesis with a titanium plate and screws performed under regional spinal anesthesia. In the early postoperative period, an integrated approach to rehabilitation therapy was used. Intra-articular injuries of the distal metaepiphysis of the tibia are one of the most burning issues in traumatology. This type of injury requires the active implementation of modern diagnostic methods and surgical treatment through the use of metal osteosynthesis techniques in various variations.

Modernization of an existing microwave installation for microwave processing of biological substrates

One of the urgent tasks for breeding and seed centers producing elite and superelite seeds is to reduce excess moisture, which leads to reduced storage, reduced efficiency of use, deterioration in the commercial quality of products after drying, and contributes to the rapid development of pathogenic pathogens that render grain unusable ( average losses of grain without drying are 15...18%). Existing methods of reducing seed moisture are the use of drying devices, the significant disadvantages of which are: high energy intensity, the use of diesel and gas fuels, which pollute the environment, and the high cost of installations, which increases the cost of the final product. It is proposed to develop an energy-saving technology to obtain agricultural products with improved qualities, expanding the functionality of the use of equipment both for seed production enterprises and agricultural enterprises, as well as for processing polycaproamide threads used as suture material in veterinary medicine. Ultrahigh-frequency electrotechnological installations, which use the energy of electromagnetic oscillations of ultrahigh frequency, can carry out thermal microwave modification of biological substrates and non-thermal microwave modification of polycaproamide threads. The paper presents an installation with a hybrid-type working chamber, in which thermal and non-thermal microwave modification of biological substrates and polycaproamide threads is simultaneously carried out. The presented installation is cheaper, it requires one rather than two microwave generators, and it occupies less space than two separate installations.

Effect of Thumari Malahara in The Management of Post-debridement Wound of Fournier’s Gangrene

Background: Despite improvements in surgical techniques, suture materials, and peri-operative care, acute wound failure or dehiscence remains a dreaded surgical complication. Factors contributing to wound failure include inadequate closure, local factors like infection, advanced age, obesity, malnutrition, and local surgical site infection or hematoma. Case details: A 59-year-old patient referred from Civil hospital to Shalya Tantra OPD seeking management of post debridement wound, on 15th day after secondary suture on debrided wound of Fournier’s Gangrene. Material and Methods: Sutures from the dehisced wound (8×4×2 cm³) were removed and wound management was done by daily dressing with Normal Saline and packed with Thumari Malahara until complete healing. Triphala Guggulu 1gram three times daily and Isabgol husk 2 tablespoonsful at bedtime with lukewarm water was given for one month. The assessment was done on every 7th day on subjective criteria like Varna (Colour of margin & surrounding skin), Srava (Discharge), Vedana (Pain) and granulation tissue and objective criteria as Unit Healing Time (UHT). Results and discussion: Unit healing time was 0.437 days/cm³ with significant decrease in amount of discharge, pain etc. The wound healed completely within 4 weeks of treatment. During follow up for 60 days, no recurrence was noticed. Thumari known as Securinega leucopyrus is a potential drug for wound healing. Thumari in a Malahara formulation further aids in wound healing by maintaining moist environment in wound and penetrating drugs to deeper tissue. Conclusion: This case demonstrates the significant wound healing effect of Thumari Malahara along with adjuvant Ayurveda medicines in the management of post debridement wound of Fournier’s Gangrene.

ПРИМЕНЕНИЕ ШОВНОГО МАТЕРИАЛА С АНТИБАКТЕРИАЛЬНЫМ ПОКРЫТИЕМ ПРИ РЕЗЕКЦИИ ТОНКОЙ И ТОЛСТОЙ КИШКИ

The study reviewed the scientific literature available on the CyberLeninka and eLIBRARY.RU electronic scientific libraries, as well as the PubMed database. The study focused on the use of suture material with antibacterial triclosan coating for small and large intestine resection; the reduction of the risk of surgical site infection during small and large intestine resection; the feasibility of using antibiotic therapy and the validity of combining the latter with systemic antibacterial therapy; and the prospects of developing a biologically active suture material.

Comparative study between polydioxanone 6.0 and polyglactin 6.0 suture material in distal hypospadias repair

Comparative study between polydioxanone 6.0 and polyglactin 6.0 suture material in distal hypospadias repair

Analysis of Surgical Suture Production Process Control Using Statistical Process Control (SPC) Methods

The medical industry currently has very high-quality standards for medical products such as surgical sutures. PT XYZ, as a well-known manufacturer in this industry, faces challenges in reducing the level of surgical suture product defects. This research focuses on the surgical suture production process produced by PT XYZ. One strategy to gain a competitive advantage is to continuously improve the quality of its products. This condition must be supported by the implementation of quality control in the process so that it can run well to produce products that have high competitiveness. The aim of this research is to analyze whether the surgical suture production process is statistically controlled or not and to analyze whether the production process meets the specified design or not. The data used in this research are secondary data and primary data. Primary data was obtained through direct observation and interviews, while secondary data was obtained from the internet, literature and journals. This research uses statictical process control (SPC) as an analysis tool by creating X and R control charts and analyzing process capabilities. The research results show that the control of the surgical suture production process is a reliable process. This is an indication that the process is under control or is not experiencing deviations. The process capability ratio shows that the process is said to be feasible and does not need to be improved. The process capability index shows that the process accuracy is good, which means that the process does not need to be improved.

Improving the Packaging Quality of Surgical Suture Products at PT. XYZ with the Application of the Six Sigma Method and Failure Mode Effect Analysis (FMEA)

The medical industry today upholds strict quality standards for medical products, including surgical sutures. PT XYZ, a leading manufacturer in this sector, faces challenges in mitigating surgical suture product defects. This research focuses on the packaging of surgical suture products produced by PT XYZ, with a focus on the production period from January to March. During this time period, there was a significant level of packaging production defects. The aim of future research is to improve the quality of packaging for surgical suture products. Specifically, it aims to identify the causes of defects in PT The Six Sigma method, using DMAIC, will be used in this research. The Define stage combines tools such as the Supplier, Input, Process, Output, and Customer (SIPOC) diagram, along with Critical to Quality (CTQ) identification. The Measure stage involves calculations using the P control chart, C control chart, DPMO, and sigma level. During the Analysis phase, a thorough analysis of the causes of failure is carried out using tools such as Pareto diagrams, fishbone diagrams, and Failure Mode Effects Analysis (FMEA). Moving to the Improve stage, FMEA identifies high-risk defects, including torn cartons, inconsistent colors, and damp cartons. Therefore, the proposed defect repair involves analysis of 5W 1H cartons. The results of the analysis provide alternative solutions such as increasing the frequency of replacing cutting tools on mold cutting machines, using cleaning aids on molding machines, and improving environmental monitoring SOPs in factories. An additional suggestion is to include antiseptic wet wipes in each carton of surgical suture products. After making improvements in the Improve stage, the final Control stage is carried out to assess the impact of the proposed changes on the company. The results show a positive impact, with an increase in the sigma value to 3.670.

Novel Treatment for the Prevention of Secondary Adhesions

Adhesion formation following surgical procedures poses a major clinical challenge, often leading to chronic pain, increased hospital readmissions, and substantial healthcare costs exceeding a billion dollars annually. Despite advancements in surgical techniques, minimally invasive approaches, and barrier methods, there is a lack of targeted research on preventing secondary adhesions after adhesiolysis. This study aims to bridge this gap in the literature by exploring novel treatment options. In our earlier research, alanyl-glutamine was shown to effectively prevent primary adhesions in a rat model involving polypropylene-type meshes, which are typically associated with severe adhesions despite their suitability for hernia repair. Building on these findings, we extended our investigation to determine if this treatment could also prevent secondary adhesions post-adhesiolysis. In this study, adhesions were induced in Wistar rats, followed by adhesiolysis and subsequent treatment with alanyl-glutamine. Six weeks posttreatment, the extent of adhesion formation was evaluated, revealing no adhesion formation. Our results demonstrate that alanyl-glutamine effectively prevents both primary and secondary adhesions in a rat model, highlighting its potential as a promising intervention to mitigate the adverse effects and complications associated with surgical adhesions.

Pioneering nanomedicine in orthopedic treatment care: a review of current research and practices.

A developing use of nanotechnology in medicine involves using nanoparticles to administer drugs, genes, biologicals, or other materials to targeted cell types, such as cancer cells. In healthcare, nanotechnology has brought about revolutionary changes in the treatment of various medical and surgical conditions, including in orthopedic. Its clinical applications in surgery range from developing surgical instruments and suture materials to enhancing imaging techniques, targeted drug delivery, visualization methods, and wound healing procedures. Notably, nanotechnology plays a significant role in preventing, diagnosing, and treating orthopedic disorders, which is crucial for patients' functional rehabilitation. The integration of nanotechnology improves standards of patient care, fuels research endeavors, facilitates clinical trials, and eventually improves the patient's quality of life. Looking ahead, nanotechnology holds promise for achieving sustained success in numerous surgical disciplines, including orthopedic surgery, in the years to come. This review aims to focus on the application of nanotechnology in orthopedic surgery, highlighting the recent development and future perspective to bridge the bridge for clinical translation.

Эффективность лекарственного препарата «Аргумистин®» при обработке операционного поля и швов после оперативного вмешательства

This paper presents the results of a study of the effectiveness of an antiseptic when treating the surgical field and sutures after surgery. It has been established that the antiseptic agent «Argumistin 0,005 %» has an equal degree of effectiveness compared to traditional methods of seam treatment. Complications when using the antiseptic were not recorded in any case, allergic reactions and signs of inflammation were also absent. Thus, this product can be recommended for use in veterinary clinics when treating sutures after surgical operations. It has been established that the antiseptic «Argumistin 0,005 %», along with a 0,01 % solution of chlorhexidine digluconate, effectively prevents the development of surgical infection when treating the surgical field, is well tolerated by animals, does not cause allergic reactions and the development of inflammation.

Comparison between four different suture configurations for rotator cuff repair: a biomechanical animal study.

The arthroscopic repair of a massive rotator cuff tear could be surgically challenging. There is a continuous argument regarding the best surgical technique and suture configuration used to treat massive rotator cuff tears. The purpose of this study was to assess the in vitro strength of the new double Mason-Allen suture and compare it to the commonly used other suture configurations. Twenty-five fresh sheep shoulders were randomly divided into five equal groups. Each group had their infraspinatus tendons cut and repaired with one of five suture configurations (simple, horizontal mattress, Mason-Allen, modified Mason-Allen, and double Mason-Allen) using Arthrex® 1.3mm suture tape. The specimens were fixed to the test apparatus through their scapulae and hung with the repair tape to Sartorius® precision balance with sequential load increments till failure. The load to failure was measured for each of the five suture configurations. Study data found the double Mason-Allen configuration to have the highest mean load to failure 423.30±23.05 (Newtons), followed by modified Mason-Allen, Mason-Allen, horizontal mattress, and simple suture respectively. The double Mason-Allen repair configuration has the highest load to failure compared to the other known suture configuration to repair rotator cuff tears.

Acromioclavicular joint reconstruction using Ethibond No. 5 Ortho Tape

Abstract Surgical reconstruction of acromioclavicular joint dislocation often requires exposure and instrumentation. This increases the chances of injury to the surrounding neurovascular structures. We present a safe, simple, and effective technique of primary fixation of Type 3 and Type 4 acromioclavicular joint dislocation, using a nonabsorbable suture material/ Ortho Tape, relying on the mechanical principles, without the need of any autograft or metal implants.

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...

Development of an Innovative Surgical Suture Material That Prevents the Formation of Arterial Thrombosis

Development of an Innovative Surgical Suture Material That Prevents the Formation of Arterial Thrombosis

Exogenous endophthalmitis caused by Citrobacter Koseri

Aims/Purpose: To present a case of exogenous endophthalmitis caused by Citrobacter Koseri.Methods: We present a 66‐year‐old man that works in an animal laboratory exercising their care, who came to the emergency department due to sudden loss of vision in his left eye. Using indirect ophthalmoscopy, we observed a dense hemovitreous that prevented visualization of the posterior structures. An ocular ultrasound was performed in which suggestive signs of retinal detachment are intuited, so we decided to perform an exploratory vitrectomy. During exploratory vitrectomy via pars plana, a dense fibrinoid vitreous was observed, with a tear at XIIh of more than 1 h in diameter. The vitrectomy was completed successfully after suturing the sclerotomies.Results: The postoperative period evolved adequately, but 3 days later, the patient presented to the emergency room with pain and severe ocular inflammation. On physical examination, he presented intense conjunctival hyperemia, signs of corneal melting, and increased ocular tone. Endophthalmitis was diagnosed and treatment was started with reinforced intravitreal and eye drops antibiotics and anti‐inflammatories. 24 h later, the patient went back with an extrusion of the lens that was sent to microbiological study. On physical examination, we observed corneal melting that produced complete corneal perforation with extrusion of purulent and vitreous material and an urgent evisceration was performed. Two days later, the microbiological samples confirmed the Citrobacter Koseri microorganism.Conclusions: Cases of exogenous endophthalmitis caused by Citrobacter are limited in the literature. In this case, exposed suture material and the epidemiological history of the patient were suspected as the source of infection. Despite early diagnosis and intensive treatment, the clinical course of Citrobacter endophthalmitis is very aggressive and has a poor visual prognosis. In our case it ended with evisceration.

Biomechanical Comparison of Banarji Knot with Various Sliding Locking Knots

Abstract Background: The most essential part of arthroscopic shoulder surgery is tying a secure knot. A knot should be a low profile, nonbulky, and more stable construct. In the present research, we have compared the biomechanical performance of the new sliding locking knot-the Banarji knot, with two different sliding locking knots: The Samsung Medical Centre (SMC) Knot and the Weston Knot. Methods: Two samples of arthroscopic sliding locking knot, Banarji knot with three and five half hitches were taken. They were named Banarji Knots 1 and 2 in the study. The SMC Knot and Weston Knot were taken for comparison with the Banarji Knot. All knots were prepared with high-strength suture material fiber wire (Arthrex, Naples, FL, USA) and were tested in Bose Testing Machine to evaluate the load to failure of knots taken in the research. The statistical significance was determined using a P = 0.05. Results: The maximum load to failure was higher with the Banarji Knot, and it showed significantly better performance when compared with other knots taken in this study. The maximum load to failure in Banarji Knot 1 was 23% and 17% higher than SMC Knot and Weston groups, respectively, and that for Banarji Knot 2 was 29% and 22% higher than SMC and Weston groups, respectively. Conclusion: The Banarji knot is a low-profile, stronger, and stable knot. The biomechanical properties of the Banarji knot were better, and the load to failure was superior to SMC and Weston Knot.

Ramón Castroviejo (1904–1987): The father of the modern corneal transplantation

Ramón Castroviejo Briones was born in 1904 in Logroño, Spain. He received his medical education at the University of Madrid, where he graduated in 1927. In 1929, he received a fellowship to work as assistant in the Ear, Nose, and Throat Hospital and College of Chicago. In 1930, he passed his American Board Examination and returned to Europe to visit the centers where keratoplasty was a fact. He visited the University eye clinics of Madrid, Paris, Vienna, Berlin, and Prague. When he returned to the United States, Castroviejo had a clear idea of what was being done in Europe and what he hoped to achieve. William L. Benedict had offered him a research fellowship at the Mayo Clinic, in Rochester, Minnesota, which Castroviejo accepted. In 1932, Dr. Maynard C. Wheeler granted Castroviejo a Research Fellowship at the new Eye Institute of the College of Physicians and Surgeons of Columbia University. He moved to New York, where he continued his research in animals in the Eye Institute of the Columbia Presbyterian Medical Center, and was an early developer of techniques for transplanting corneal tissue from the eyes of those who had just died to damaged eyes of the living. While not being the first to successfully graft human cornea, he improved the technique of the operation in the 1930s and 1940s, prompting the worldwide adoption of corneal transplantation as a standard way to deal with severe corneal pathology. His keratoplasty technique, creating a rectangular rather than circular “window” in the cornea, was the secret to his successful transplants, and remained standard until more efficient suture materials became available. The surgeon described this technique in 1937 to the American College of Surgeons. He contended that rectangular windows gave better results than the circular ones that had been tried earlier, since their edges could be fitted better to merge with and become a living part of the rest of the eye. Although the medical community was slow to recognize his successes, Castroviejo was eventually lauded for his sight‐saving corneal tissue transplant techniques, which he continued to refine and teach for many years. Castroviejo also promoted the donation of corneal tissue in the United States and designed numerous ophthalmic instruments, including the Castroviejo needle holder ‐an instrument used in eye, dental and other forms of microsurgery‐ Castroviejo callipers and corneal scissors. He became the director of Ophthalmology at St. Vincent's Hospital before he opened his own hospital when he bought the Hammond House in New York. After closing his private hospital he retired as clinical professor of the University of New York and moved permanently to Madrid, where he founded the Instituto Castroviejo, at the Complutense University of Madrid, and organized the Spanish Eye Bank, maintaining extensive clinical activity whenever his health permitted. Ramón Castroviejo died in 1987, at the age of 82, and is widely recognized as one of the 10 most influential people in ophthalmology of the 20th century.

A Janus adhesive hydrogel sheet for preventing postoperative tissue adhesion of intestinal injuries.

Although adhesive hydrogels represent an alternative to surgical sutures for non-invasive tissue wound sealing, those with indiscriminate adhesion fail to hold wounds while inhibiting postoperative tissue adhesion, thus limiting their application in intestinal repair. In this study, an asymmetric adhesive hydrogel sheet composed mainly of polyacrylic acid (PAA) and gelatin (GA) that can be wet-adhered to the surface of intestinal tissue was developed. One side of the GA-PAA hydrogel sheet was complexed with polyvinyl alcohol (PVA), which shielded the excess adhesion based on a physical barrier. Both sides of the PVA/GA-PAA hydrogel showed distinct adhesive and antiadhesive properties. Intriguingly, the anti-adhesive side showed significant anti-adhesion toward specific proteins. The results of animal experiments showed that the PVA/GA-PAA hydrogel could firmly adhere to the intestine to stop leakage and prevent post-operative tissue adhesion two weeks after surgery. The hematoxylin and eosin (H&E) staining results showed that the damaged intestinal serosa was repaired without tissue adhesion. It is believed that the controllable adhesion of the adhesive hydrogel offers better prospects for intestinal repair.