Absorbable Suture Research Articles

Analysing inflammatory responses after mandibular third molar extraction: a comparison of suture-less and multiple suture techniques.

This study aims to compare the outcomes of suture-less and multiple suture closure methods on postoperative pain, swelling, and trismus, and associated complications. This prospective, randomized clinical trial was conducted at the Department of Oral & Maxillofacial Surgery, Goa Dental College & Hospital. Inclusion criteria encompassed subjects aged between 17 and 55 years, classified as American Society of Anaesthesiologists (ASA) I, with asymptomatic impacted third molars falling within the moderately difficult impaction range (Pederson's difficulty index: 5-7). Study excluded individuals classified as ASA II, III, or IV, those with known or suspected allergies to the anaesthetic solution, immunocompromised patients, and individuals taking medications that could affect healing. Pregnant or lactating females and those with a history of bleeding disorders were also excluded. Wound closure methods were compared: Group A underwent primary closure with silk sutures, while Group B had suture-less closure. Subjects were allocated to the specific groups using a simple randomization method. This involved using a lottery-based random sequence to assign each participant to either Group A or Group B. Pain intensity, facial swelling, and trismus were key outcomes. Secondary outcomes included lingual nerve sensation and postoperative complications. Demographics factors, surgical details, radiographic and perioperative data, and physiological parameters were considered. Non-parametric tests and parametric test (repeated measure ANOVA) were employed. Statistical significance was set at P < 0.05. Among 101 participants, both closure techniques exhibited similar outcomes in pain, swelling, and lingual nerve function. However, suture-less closure resulted in significantly less trismus and fewer cases of delayed wound healing. Suture-less method after surgical removal of third molar may reduce trismus compared to multiple sutures. While pain, swelling, and lingual nerve function management were comparable.

Case Report: Abdominal Wall Abscess as First Clinical Sign of Jejunal Perforation After Blunt Abdominal Trauma

AimTo discuss extended retrorectal abscess secondary to blunt abdominal trauma as a cause of abdominal wall (AW) infection and impairment.MethodsAccording to the CARE checklist, we describe a rare case of blunt abdominal trauma with late diagnosis of jejunal perforation with an abscess that extensively dissected the retromuscular space.ResultsA 65 years-old female patient experienced multiple traumas after a traffic collision. Ten days after admission, the patient presented with swelling in the right abdomen. CT scan showed localised pneumoperitoneum and extensive collection affecting the right retrorectal space, reaching the ribs and preperitoneal space. Urgent laparotomy was performed and jejunal perforation with biliary peritonitis and extraperitoneal extension with dissection of the right retrorectal space were found. Intestinal resection with anastomosis was then performed. Exhaustive lavage of the cavity and retromuscular space with debridement of the necrotic posterior rectus lamina was required. Retrorectal drainage was placed. Primary closure of the aponeurosis was achieved using a small-bites technique with a slowly absorbable monofilament suture. Due to the weakness of the abdominal wall, an absorbable biosynthetic mesh impregnated with gentamicin was placed onlay. Negative pressure therapy was applied to the closed wound. Patient received antibiotics and CTs showed favourable evolution. No infectious complications or incisional hernia were reported after 12 months of follow-up.ConclusionNo cases of blunt trauma causing extensive AW infection have been reported in the literature. Whilst rare, this should be considered in traumatic patients. Our experience shows that they can be managed with surgical drainage and absorbable meshes can be considered in cases of fascial loss.

Clinical application of reconstruction of pelvic floor with pedunculated omentum flap combined with basement membrane biological products in pelvic exenteration with sacrococcygeal bone

Objective: To introduce the experience of reconstructing the pelvic floor with a pedicled large omental flap combined with a basement membrane biological mesh in combined pelvic organ resection for locally advanced or locally recurrent rectal cancer combined with sacrococcygeal resection, and to discuss the feasibility, safety, and near-term therapeutic efficacy of this technique. Methods: For patients with sacrococcygeal resection of combined pelvic organs, a basement membrane mesh was used to rebuild the pelvic floor with a pedicled greater omentum flap to isolate the abdominopelvic cavity. The main operation was to pull the greater omentum, which preserved the double vascular arches, to the pelvic floor to cover the pelvic floor, and then the mesh was used to cover the posterior peritoneal defect and pelvic inlet with absorbable sutures of 2-0 or thicker. Results: In this study, a retrospective cohort study was used to collect clinical data through the China Rectal Cancer Combined Pelvic Organs Resections Case Database. Twenty patients with locally advanced or locally recurrent rectal cancer without extra-pelvic metastasis or only oligometastases underwent combined pelvic organ and sacrococcygeal resection in the Department of Anal and Intestinal Surgery of the Second Affiliated Hospital of the Naval Military Medical University during the period of July 1, 2022, to June 30, 2023, and 10 patients underwent simple basement membrane resection with a simple basement membrane. Among them, the pelvic floor were reconstructed by basement membrane mesh alone in 10 cases (mesh only group), and 10 cases were reconstructed the pelvic floor by pedicled large omental flap combined with basement membrane mesh (omental flap-combined mesh group). The recent outcomes of the two groups of patients were studied comparatively. Comparison of baseline data and intraoperative conditions between the two groups showed no statistically significant differences (all P>0.05); the drain removal time in the omental flap-combined mesh group was 26.7 (19-42) days, which was shorter than that in the mesh only group, which was 40.4 (24-56) days (U=4.125, P=0.001); The empty pelvis healing time in the omental flap-combined mesh group was 29.4 (23~43) days, which was shorter than that of 42.2 (27~58) days in the mesh-only group (U=4.043, P=0.001); the differences were all statistically significant. The postoperative complication rate of grade ≥III in the omental flap-combined mesh group was 1/10, which was lower than that of 6/10 in the mesh-only group; the difference was not statistically significant when comparing the two groups (P = 0.057). Follow-up ended on 09/30/2023, with a median follow-up of 9.5 (3-15) months in 20 patients, and all 20 cases survived during the follow-up period, with no tumor recurrence at the surgical site. Conclusion: In locally advanced or locally recurrent rectal cancer undergoing combined pelvic organ resection with sacrococcygeal, compared with reconstruction of the pelvic floor by basement membrane mesh alone, reconstruction of the pelvic floor and isolation of the abdominopelvic cavity by a pedicled greater omentum flap combined with a basement membrane mesh is safe and feasible.

Hyperglycemia Exacerbates Periodontal Destruction via Systemic Suppression of Regulatory T Cell Number and Function.

Diabetes is a significant risk factor that exacerbates the pathological progression of periodontal disease. In recent years, attention has focused on the effect of regulatory T cells (Tregs), which play a central role in immune tolerance, on inflammatory processes in periodontal tissue, suggesting a link with diabetes-associated periodontitis. In this study, we examined the dynamics of Tregs in periodontal tissue of mice with streptozotocin (STZ)-induced hyperglycemia. Eleven-week-old male C57BL/6J mice were divided into four treatment groups: Untreated (C group), ligature placed around the maxillary second molars with silk sutures (PD group), intraperitoneal administration of STZ (HG group), and ligature placed after STZ administration (PHG group). Establishment of hyperglycemia was assessed 14 days after STZ administration, and ligation was performed 7 days later. After another 7 days of ligation, the mice were euthanized. The right side of the maxilla was observed histopathologically, whereas the palatal gingiva on the left side of the maxilla was analyzed genetically, and the microstructure of the alveolar bone was also assessed. In addition, lymphocytes from peripheral blood, spleen, and periodontal tissue were analyzed using flow cytometry. In bone structure analyses, alveolar bone height, bone volume/tissue volume (BV/TV), and bone mineral density (BMD) were lower in the PHG group than the PD group. In the gingival tissue, expression of the Foxp3 gene was up-regulated in the PHG group compared with the C group, and IL-17a was up-regulated in the PHG group compared with the PD group. Flow cytometry analyses showed that the number of Tregs (CD4+CD25+Foxp3+ cells) in the blood and gingival tissue was significantly higher in the PD and PHG groups than the C group. The number of CD4+CD25-Foxp3+ cells, which are reportedly functionally attenuated as Tregs, was increased in blood of the PHG group. Immunofluorescence staining of periodontal tissue showed that the number of CD25+Foxp3+ cells was significantly increased only in the PD group, whereas a trend toward an increased number of CD25-Foxp3+ cells was observed in the PHG group. The present study showed that STZ-induced hyperglycemia numerically and functionally attenuates Tregs in a mouse model of experimental periodontitis. Furthermore, impaired immune tolerance capacity appears to be involved in exacerbating inflammation and bone destruction in periodontal tissue.

Properties, Production, and Recycling of Regenerated Cellulose Fibers: Special Medical Applications.

Regenerated cellulose fibers are a highly adaptable biomaterial with numerous medical applications owing to their inherent biocompatibility, biodegradability, and robust mechanical properties. In the domain of wound care, regenerated cellulose fibers facilitate a moist environment conducive to healing, minimize infection risk, and adapt to wound topographies, making it ideal for different types of dressings. In tissue engineering, cellulose scaffolds provide a matrix for cell attachment and proliferation, supporting the development of artificial skin, cartilage, and other tissues. Furthermore, regenerated cellulose fibers, used as absorbable sutures, degrade within the body, eliminating the need for removal and proving advantageous for internal suturing. The medical textile industry relies heavily on regenerated cellulose fibers because of their unique properties that make them suitable for various applications, including wound care, surgical garments, and diagnostic materials. Regenerated cellulose fibers are produced by dissolving cellulose from natural sources and reconstituting it into fiber form, which can be customized for specific medical uses. This paper will explore the various types, properties, and applications of regenerated cellulose fibers in medical contexts, alongside an examination of its manufacturing processes and technologies, as well as associated challenges.

Management of Sacrocolpopexy Mesh Complications-A Narrative Review and Clinical Experience from a Large-Volume Center.

Despite the reputation of sacrocolpopexy as a highly durable reconstructive surgery for pelvic organ prolapse, mesh-related complications remain a significant deterrent for patients. This review discusses the incidence, presentation, diagnosis, management and prevention of sacrocolpopexy mesh complications. We reviewed the literature on sacrocolpopexy focusing on long-term mesh complications and their management. As the literature is not specifically robust, we also give our recommendations based on experience from a large-volume center. Intraoperative videos and images are provided to illustrate findings and management techniques. Sacrocolpopexy mesh complications include vaginal mesh exposure; bladder or bowel erosions; inflammatory and infectious conditions including spondylodiscitis; and mesh-related pain. Presentation ranges from overt symptoms such as mesh palpated in the vagina to insidious-like spondylodiscitis manifesting as back pain and malaise. Diagnosis relies on methodical history taking, review of operative reports, and a physical examination, with office-based endoscopy studies and imaging as indicated. Various management options have been described in the literature. We recommend an expectant approach for asymptomatic patients; For symptomatic vaginal exposure, we encourage removal of entire mesh arm(s) via an abdominal approach; however, many prefer to utilize a transvaginal or partial excisional approach first. Spondylodiscitis is managed with long-term antibiotics and often requires mesh removal. Prevention strategies include using a lightweight polypropylene mesh attached to well- vascularized vaginal walls, avoiding direct placement on any sutured vaginotomy or cystotomy. Delayed absorbable monofilament suture is non-inferior to permanent suture. Sacrocolpopexy mesh complications can be challenging to diagnose and manage. Symptomatic cases often require a proactive approach; listening to patients when they describe persistent symptoms with postoperative onset; a low threshold for further evaluation; and upfront discussion of management options.

Clinical Management of Uterine Prolapse in a Multiparous Persian Cat: A Case Report

This case report deals with the clinical management of uterine prolapse in a 3.5 years old Persian cat with the history of prior parturition. The prolapsed mass was displaying congestion, enlargement, edema and mild straining with no lacerations or injuries. After thorough cleaning, reduction of edema and antiseptic dressing, the prolapsed uterus was repositioned properly. Purse string suture was applied to prevent reoccurrence. The queen showed good response to the manual correction, with no complications. This report demonstrates effective clinical management of postpartum uterine prolapse by manual repositioning in a queen cat avoiding surgical intervention.

Study on needle stick injuries during surgery and blunt needle use for reducing occupational exposure and hygiene benefits.

The conventional round suture needle poses a significant risk of needle stick injuries among surgical physicians, identified as a global occupational hazard by the World Health Organization, increasing hospital costs and exposure to bloodborne pathogens. While novel blunt suture needles have shown promise in reducing these risks, their adoption is limited domestically, prompting a study to compare their efficacy against traditional sharp needles in reducing needle stick injuries among surgical physicians. To investigate suture needle stick injuries among surgical doctors during operations and assess the application effectiveness of a novel blunt suture needle. A total of 106 surgical department physicians from March 2021 to February 2023 participated in the study. After completing a questionnaire survey on suture needle injuries during surgery, the participants were divided into two groups. Over a 6-month intervention period, the control group used regular round needles while the study group utilized novel blunt suture needles. Subsequently, suture needle injury incidence rates and economic hygiene benefits were compared between the two groups. The suture needle injury questionnaire survey showed that over the past 6 months, among 106 surgical department physicians, 20 needle stick injuries occurred, yielding an incidence rate of 18.87%. The highest incidence (65.00%) was during suturing incisions longer than 10 cm, primarily when visibility was poor (70.00%). Surgeons linked most injuries (60.00%) to prolonged surgical duration causing fatigue. Although 85.00% detected injuries within 1 minute, only 40.00% were reported, often due to perceived reporting complexity. Following intervention, the study group had significantly fewer injuries per surgery and lower occupational exposure costs compared to the control group (p< 0.05). Surgical department physicians commonly sustain suture needle injuries while suturing incisions of 5-10 cm length under poor visibility, exacerbated by prolonged surgical duration. Despite detecting most injuries within 1 minute, only 40% are reported. The implementation of novel blunt suture needles significantly decreases injury rates, resulting in reduced occupational exposure costs and favorable safety and economic hygiene outcomes.

Application of Polylactic Acid in Clinical Medicine

Polylactic acid (PLA), a bio-based and biodegradable material, shows significant potential in environmental protection and clinical medicine. Derived from renewable resources, PLA's biodegradability reduces long-term environmental pollution by allowing it to decompose rapidly under specific conditions. This review explores PLA's applications in clinical medicine, emphasizing its mechanical properties, biocompatibility, and controlled degradation rates. The study covers PLA's extensive use in drug delivery systems, absorbable sutures, and tissue engineering scaffolds, highlighting its compatibility with human tissues and low immunogenicity. Research methods and designs, including in vitro and in vivo experiments, are discussed to evaluate PLA's efficacy and safety. The challenges of high production costs and specific degradation conditions are also addressed. Future research directions include developing new catalysts to improve synthesis efficiency and exploring renewable raw materials to reduce costs and environmental impact. As global awareness of sustainable development grows, the demand for PLA and other degradable plastics is expected to increase, expanding their applications in various fields. In conclusion, PLA offers substantial advantages in reducing reliance on fossil fuels and mitigating environmental pollution, while providing innovative solutions in the medical field. Technological advancements and increased production are anticipated to lower costs, making PLA more economically competitive and accelerating its application in both environmental protection and clinical medicine.

Is Half a Century-Based Suturing Pattern Worth the Upgrade? Evaluating a Novel Suturing Technique: Knot Less is More.

The aesthetic outcomes of wise pattern-based breast reduction and mastopexy procedures are significantly influenced by the final scar quality, which is directly impacted by the suturing technique. Over the past century literature on suture placement has remained limited, with little advancement in tissue approximation methods. The success of conventional suturing depends on the surgeon's skills and expertise and the selection of suture material. Proper deep placement of absorbable sutures is essential to reduce risks; in fact, incorrect placement can lead to complications such as poor scar quality and negative psychological effects on the patient, and occasionally more severe issues like delayed wound healing. Our experience with a running suturing technique for wise pattern-based mammoplasty indicates that reducing the number of knots can lead to a better overall experience for both the patient and the surgeon. This technique may improve aesthetic results, decrease complications, and streamline the surgical process.Level of Evidence IV 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 .

Refixation of osteochondral flake fractures after patellar dislocation-The parachute technique

Patellar dislocations are acommon occurrence in orthopedic practice, often accompanied by osteochondral fractures of the retropatellar cartilage surface, known as flake fractures, in up to 58% of cases. The parachute technique represents asimple and cost-effective surgical option aimed at restoring osteochondral integration and preserving native cartilage. Flake fracture of the patella with osteochondral fragments. Patella fracture. By utilizing transpatellar, absorbable sutures, astable osteochondral interface is achieved without penetrating the fragment itself. Postoperative treatment involves partial weight-bearing with amaximum of 20 kg for 6weeks in full knee extension. In addition, the range of motion of knee flexion is limited to30° and is increased by30° every 2weeks. To examine the short- to medium-term clinical outcomes, all patients with acute patellar dislocation treated using the parachute technique between 01/2012 and 11/2022 were included. Clinical outcomes were assessed using the visual analog scale (VAS), Tegner Activity Scale (TAS), Kujala Score, Knee Injury and Osteoarthritis Outcome Score (KOOS), and International Knee Documentation Committee (IKDC). Out of 20patients, 19 (10men, 11right-sided, 95% follow-up rate) could be recruited for postoperative evaluation. The average follow-up period was 62.5 ± 20.5 months. The clinical outcome scores yielded the following results: VAS 0.5 ± 1.6, TAS 5.8 ± 2.2, Kujala 89.4 ± 12.5, KOOS 87.8 ± 14.1, and IKDC 86.7 ± 14.3. Overall, 18patients (90.0%) expressed willingness to undergo the procedure again. At the time of follow-up, 19patients (95.0%) were satisfied with the surgical outcome. One patient (23-year-old man) required revision. None of the included patients suffered from the recurrence of patellar dislocation. In summary, the parachute technique demonstrated excellent clinical function in the short- to medium-term follow-up for acute patellar dislocation.

A novel solvent-extruded tacrolimus-eluting suture for attenuated inflammation and scarring in skin repair

This study aimed to design an absorbable suture that locally delivers the immunosuppressive agent, tacrolimus (FK506), to attenuate scar tissue formation by modulating inflammation. As the suture degrades, it releases FK506 directly into the repair site. The poly (l-lactide-co-caprolactone) (PLLA-PCL) polymer and 0.2 % wt FK506 were co-extruded using a solvent extrusion technique to generate the drug-eluting sutures. The properties of the generated sutures were assessed regarding FK506 release in vitro, wound closure in an in vivo murine model, murine skin histology for structural and inflammatory markers, and mechanical strength of both sutures and healed murine skin. The generated suture consistently released FK506 at ≤10 ng/day rates. Following annealing, the sutures retained 60 % of their anticipated tensile strength, exhibiting enhanced ductility. The histological examination and in vivo murine study indicated that wounds treated with FK506-eluting PLLA-PCL sutures produced a thinner epidermal layer, enhanced integrin β4 expression, increased keratinocyte presence, attenuated inflammation, and reduced scarring, demonstrating healed tissue improvements compared with those treated with the placebo, poly (glycolic-co-caprolactone) (PGCL), sutures. Mechanical evaluations of healed tissue indicated that drug-PLLA-PCL sutures did not reduce the mechanical strength of the skin compared to placebo PGCL sutures. The FK506-eluting PLLA-PCL sutures show promising results in advancing wound healing by offering targeted drug delivery. This innovative method can improve wound healing and provide a streamlined approach to scar management. Continued research, optimization, and broad-scale studies are needed to refine the manufacturing process and ensure that the properties of the suture meet clinical requirements.

Analysis of 398 cases of intradural spinal tumor resection with primary dural closure: surgical outcomes based on the suture material.

Cerebrospinal fluid (CSF) leak after resection of intradural spinal tumors (IST) represents a significant postoperative challenge. Although various dura suture techniques and materials have been explored experimentally, direct clinical comparative studies are lacking. This study evaluated the effectiveness of specific suture materials in primary dural closure post-IST resection and identified associated risk factors for CSF leak. A retrospective review was conducted of patients who underwent IST resection surgery at a single institution from January 2012 to February 2021. Patients were categorized on the basis of the dura suture materials used. Eligibility for the study required a posterior midline surgical approach, primary dural closure after durotomy, and absence of closed-suction drainage. Of 398 patients who met the inclusion criteria, the overall CSF leak-related surgical complication rate was 4.27% (17/398). The sutures used were 6-0 Prolene for 163 patients and 5-0 silk for 235 patients. Significant differences were observed between the suture groups in the CSF leak rate (Prolene 1.8% vs silk 6.0%, p = 0.046), lumbar drainage insertion rate (Prolene 0.6% vs silk 4.3%, p = 0.031), and length of postoperative bed rest (Prolene 1.07 days vs silk 3.25 days, p < 0.001). Logistic regression analysis indicated a significant association of CSF leak with the use of 5-0 silk (OR 4.11, p = 0.006) and revision surgical procedures (OR 6.73, p = 0.001). Surgical complications related to CSF leaks were significantly lower with the use of 6-0 Prolene sutures compared to 5-0 silk sutures in primary dural closure after IST resection.

Novel Technique to Close Stellate Corneal Lacerations.

The study was performed to evaluate and optimize a novel technique to close stellate corneal lacerations in a wet laboratory environment. Twenty-one ex vivo porcine eyes with standardized, experimentally created stellate corneal lacerations were assigned to one of three surgical repair techniques. In Group 1 (n = 9), lacerations were closed with simple interrupted sutures only. In Group 2 (n = 7), a large-radius central purse string was used in addition to simple interrupted sutures. In Group 3 (n = 5), a small-radius central purse string was used in addition to simple interrupted sutures. Wound stability was assessed by determining the intraocular pressure (IOP) at which wound leak occurred. Group 3 eyes demonstrated a mean wound leak IOP of 56.1 mm Hg (range 32-90.3) compared with groups 1 and 2, which demonstrated mean wound leak IOPs of 6.4 mm Hg (range 1.9-19) and 13.3 mm Hg (range 2.8-31), respectively. These differences were highly statistically significant (P<0.002 and P<0.015, respectively, compared with Group 3). The use of a small-radius internal purse-string suture, when combined with simple interrupted sutures, produced a highly effective watertight closure in experimentally created stellate corneal lacerations, significantly outperforming approaches using only interrupted sutures or a large-radius purse string. The use of a small-radius purse-string suture should be considered for clinical use in the repair of stellate corneal lacerations.

Commentary Innovations in Tissue Regeneration and Wound Healing: A Comparative Study of Nigeria and South Africa

Tissue regeneration and wound healing represent critical areas in medical science, with significant advance-ments in recent years. These fields involve restoring damaged tissues and promoting recovery, which are essential for improv-ing patient outcomes and quality of life. Innovations such as biomaterials, stem cell therapy, advanced wound dressings, and regenerative medicine have significantly impacted these areas. This study provides a comparative analysis of innovations in tissue regeneration and wound healing in Nigeria and South Africa. The focus includes technological advancements, research contributions, and statistical data to highlight progress and challenges in both countries. Data from various healthcare institu-tions, research publications, and government reports form the basis of this analysis.Additionally, surgical innovations that minimize wound occurrence and improve wound healing, such as mini-mally invasive surgery, negative pressure wound therapy (NPWT), and the use of advanced suture materials, are transforming clinical outcomes in both Nigeria and South Africa. Minimally invasive techniques reduce tissue damage, leading to smaller wounds and faster recovery. NPWT has proven effective in managing chronic wounds and reducing infection rates, while an-timicrobial and absorbable sutures have lowered complications related to wound closure. Cold plasma therapy and stem cell applications are also emerging as promising approaches for chronic wound care and tissue regeneration. These innovations, coupled with the efforts in regenerative medicine and biomaterials, are providing both nations with effective tools to manage wound healing more efficiently. This comparative study aims to shed light on the current state of tissue regeneration and wound healing in these nations, offering insights into the advancements made, the effectiveness of various approaches, and the potential future devel-opments in this vital medical field.

Evaluation of the efficacy of upper eyelid gold implant surgery in the treatment of lagophthalmos

Material and method: The study included 12 eyes of 12 patients, comprising 5 men and 7 women, with an average age of 55 years. Surgeries were performed on 6 right upper eyelids and 6 left upper eyelids affected by lagophthalmos due to various causes. The average duration of symptoms before surgery was 3 years and 6 months. Patients were eligible for surgery at least 6 months after the onset of paralysis. During the qualification examination, the weight of the implant was estimated using steel trial weights attached to the skin of the upper eyelid, and 0.2 g was added to this measured weight to determine the final implant weight. All patients underwent gold implant insertion into the upper eyelid, with the implants fixed to the tarsal plate using absorbable sutures to prevent prosthesis migration. Special attention was paid to precise layered tissue suturing. Subsequent ophthalmological examinations were conducted at various intervals post-surgery to evaluate the outcomes. Results: Complete eyelid closure was achieved in 50% of the cases, while 100% of the patients reported subjective satisfaction with the surgical outcomes. The patients’ quality of life improved by an average of 85%. The average frequency of using moisturizing eye drops decreased from 7 times daily to 2 times daily. Improvement in the ocular surface condition was noted in all patients. Conclusions: Gold implant insertion into the upper eyelid facilitates improvement in eyelid function and ocular surface condition, significantly enhancing the quality of life for patients with paralytic lagophthalmos.

A reduced graphene oxide-coated conductive surgical silk suture targeting microresistance sensing changes for wound healing

Conventional sutures used in surgical procedures often lack the capability to effectively monitor physical and chemical activities or the microbial environment of surgical wounds due to their inadequate mechanical properties, insufficient electrical accuracy and unstability. Here, we present a straightforward layer-by-layer coating technique that utilizes 3-glycidoxypropyltrimethoxysilane (CA), graphene oxide (GO), and ascorbic acid (AA) to develop conductive silk-based surgical sutures (CA-rGSFS). The CA-rGSFS feature a continuous reduced graphene oxide (rGO) film on their surface, forming robust hydrogen bonds with silk fibroin. The reduction process of rGO is confirmed through Raman analysis, demonstrating an enhanced D peak to G peak ratio. Notably, the CA-rGSFS exhibit exceptional mechanical properties and efficient electron transmission, with a knot-pull tensile strength of 2089.72 ± 1.20 cN and an electrical conductivity of 130.30 ± 11.34 S/m, respectively, meeting the requirements specified by the United States Pharmacopeia (USP) for 2-0 sutures. These novel CA-rGSFS demonstrate the ability to accurately track resistance changes in various fluid environments with rapid response, including saline, intestinal, and gastric fluids. The suture also retains remarkable stretchablility and stability even after enduring 3000 tensile cycles, highlighting their potential for precise surgical site monitoring during the wound healing process.

An Assessment and Comparison of Adverse Effect Rates in Differing Absorbable Thread Lift Suture Materials.

Thread lifting, a minimally invasive alternative to facial rhytidectomy, has shifted from using nonabsorbable to absorbable sutures. Although many thread lift options exist, the impact of these different properties on complication rates remains unclear. To systematically compare thread lift complication rates across different suture materials, textures, fixation methods, and lift locations. A systematic review was conducted through February 2024, following PRISMA guidelines, using multiple databases. The study focused on absorbable sutures, excluding nonabsorbable materials. Statistical analysis used Chi-Square tests with Bonferroni correction. Nineteen studies, encompassing 1,406 patients, met inclusion criteria. A total of 876 complications were reported. Ecchymosis (19.49%), swelling (16.79%), and tenderness (9.96%) were the most frequent complications, while hematoma (0.64%), paresthesia (1.14%), and infection (2.49%) were least frequent. Complications varied significantly among the studied factors. Swelling and ecchymosis were more associated with polycaprolactone sutures, barbed threads, and midface lifts. Barbed threads were associated with more complications than smooth or coned threads, as were floating threads compared with fixed threads. Variations in thread lift suture materials and fixation technique were associated with different complication rates. Thread lifts using absorbable sutures exhibited complication rates under 5%, suggesting a generally favorable safety profile.

Incisional Negative Pressure Wound Therapy Versus Primary Wound Suturing after Intestinal Ostomy Closure: A Systematic Review and Meta-Analysis.

Objective: Wound infection after intestinal ostomy closure is a very common postoperative complication. An alternative to primary wound suturing by single sutures or purse string sutures (PSS) is applying incisional negative pressure wound therapy (iNPWT). The aim of the following systematic review and meta-analysis was to assess and compare clinical outcomes in patients after PSS and iNPWT use. Approach: The aim of the study was to find relevant clinical data comparing outcomes of iNPWT and primary wound closure after intestinal ostomy closure. The search was conducted using the MEDLINE/PubMed, ScienceDirect, EMBASE, Scopus, Cochrane Controlled Register of Trials, SciELO, and Web of Science databases and took place up to November 12, 2022. The authors did not use date or language filters. Statistical analysis was performed using Review Manager 5.4 (The Cochrane Collaboration, 2020, London, UK). The authors conducted a meta-analysis of the following four parameters: wound healing time (WHT), surgical site infections (SSIs), complications, and length of hospital stay (LOS). Odds ratios (OR) and inverse variance (IV) were generated with 95% confidence intervals (CI). The meta-analysis was registered in the International Prospective Register of Systematic Reviews database under registration number CRD42023391640. Results: The analysis revealed that the iNPWT group and the control group did not differ significantly with regard to the WHT parameter (Z = 2,73; p = 0.006; χ2 = 0.37, df = 1, p = 0.54, I2 = 0%). Meta-analysis of SSI incidence revealed a significant difference favoring the iNPWT group over the observational group (OR = 0.42; 95% CI = 0.25-0.72; p = 0.002; I2 = 14%). Patients included in the iNPWT group had a significantly lower pooled incidence of overall complications than the observational group (OR = 0.52; 95% CI = 0.35-0.77; p = 0.001, I2 = 71%). Subgroup analysis limited to randomized studies also presented significant differences favoring the iNPWT group over the observational group (OR = 0.27; 95% CI = 0.14-0.52; p < 0.001, I2 = 67%). Our analysis showed that LOS did not differ significantly between the groups treated with and without iNPWT (IV = 0.19; 95% CI = -0.66 -1,04; p = 0.76, I2 = 0%). In addition, subgroup analysis of randomized studies also did not present a significant difference (IV = 0.25; 95% CI = -0.80 -1,30; p = 0.33, I2 = 10%). Innovation: This study shows that the use of iNPWT can reduce the risk of SSIs with other complications, such as wound hematomas, wound seromas, wound dehiscence, fistulas, and ileus, in patients undergoing intestinal ostomy closure without extended hospital stay. Conclusions: Use of iNPWT can be considered in postoperative care after elective ostomy closure to decrease the rate of the most common complications after ostomy closure.

The Degradation of Absorbable Surgical Threads in Body Fluids: Insights from Infrared Spectroscopy Studies.

This study investigates the degradation of six different types of absorbable surgical threads commonly used in clinical practice, focusing on their response to exposure to physiological fluids. The threads were subjected to hydrolytic and enzymatic degradation in physiological saline, bile, and pancreatic juice. Our findings demonstrate that bile and pancreatic juice, particularly when contaminated with bacterial strains such as Escherichia coli, Klebsiella spp., and Enterococcus faecalis, significantly accelerate the degradation process. Using Fourier-transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and tensile strength testing, we observed distinct differences in the chemical structure and mechanical integrity of the sutures. Principal component analysis (PCA) of the FTIR spectra revealed that PDS threads exhibited the highest resistance to degradation, maintaining their mechanical properties for a longer duration compared with Monocryl and Vicryl. These results highlight the critical role of thread selection in gastrointestinal surgeries, where prolonged exposure to bile and pancreatic juice can compromise the suture integrity and lead to postoperative complications. The insights gained from this study will contribute to improving the selection and application of absorbable threads in clinical settings.