Suture Removal Research Articles

Comparison of the effectiveness of different corneal curvature measurement methods for IOL implantation in traumatic aphakic eyes with corneal injury.

To assess the refractive outcomes of secondary intraocular lenses (IOL) in patients with traumatic aphakic eyes with corneal penetrating injury and compare different corneal curvature measurement methods. Patients with unilateral penetrating eye injuries underwent corneal wound repair and cataract extraction, followed by secondary IOL implantation. Corneal curvature measurements were taken on the contralateral healthy eye (Group A), from the affected eye before removing corneal sutures (Group B), or after suture removal (Group C). The refractive outcomes were compared among the three groups. The study included 261 eyes. The Mean Absolute Error (MAE) in Group C (0.99 ± 0.85 D) was significantly smaller than that in Group A (1.87 ± 1.71 D) and Group B (1.37 ± 1.20 D) (both P < 0.001). Moreover, the percentage of eyes with IOL prediction errors within ± 0.50 D in Group C (40%) was higher than that in group A (21.7%) (OR = 2.364, 95%CI: 1.272-4.392, P = 0.006) and group B (28.0%) (OR = 1.714, 95%CI: 0.948-3.099, P = 0.073), and the percentage of eyes with IOL prediction errors within ± 1.0 D in Group C (90.9%) was higher than that in group A (67.9%) (OR = 4.758, 95%CI: 2.131-10.626, P < 0.001) and group B (75.0%) (OR = 3.370, 95%CI: 1.483-7.660, P = 0.003) as well. In traumatic aphakic eyes with corneal sutures, IOL power calculation based on the corneal curvature of the injured eye after removing the corneal sutures yields the best refractive outcomes.

Randomised controlled trial of resorbable versus non-resorbable sutures for lacerations of the face (TORN Face)

Facial lacerations are commonly encountered in emergency departments and require effective management to optimise aesthetic outcomes. Non-resorbable sutures are traditionally favoured for their tensile strength and minimal inflammatory response, despite the inconvenience of the required follow up for removal. This single-centre, single-blinded randomised controlled trial aimed to compare the clinical efficacy and cost-effectiveness of resorbable (Vicryl Rapide) versus non-resorbable (Ethilon) sutures for the closure of facial lacerations in adults. Between November 2021 and February 2023, 200 adult patients presenting with facial lacerations were randomly allocated to either resorbable or non-resorbable sutures. Outcomes assessed included aesthetic results via the Visual Analogue Scale (VAS) and Hamilton Scar Scale, patient-reported satisfaction using the Patient Scar Assessment Questionnaire (PSAQ), complication rates, and cost analysis. No significant differences were found in mean VAS scores between the two groups in both modified intention-to-treat and per-protocol analyses. The majority of patients reported high satisfaction levels. Early complication rates were significantly higher in the non-resorbable group at the one-week follow up, with no long-term differences noted. Preliminary cost analysis indicated a more than five-fold cost saving with resorbable sutures. Resorbable sutures provide a viable and cost-effective alternative to non-resorbable sutures for adult facial lacerations, with comparable aesthetic outcomes and patient satisfaction. Their use could reduce healthcare burdens by eliminating the need for follow-up suture removal, supporting broader adoption in clinical practice.

Сравнительный анализ рефракционных и функциональных результатов имплантации торической интраокулярной линзы с механизмом формирования волнового фронта при хирургическом лечении катаракты у пациентов после сквозной кератопластики

Abstract Comparative analysis of the refractive and functional results of toric intraocular lens with wavefrontshaping mechanism implantation during the surgical treatment of cataracts in patients after penetrating keratoplasty. D.A. Khvan, , G.A. Fedyashev Pacific State Medical University Ministry of Health of Russia, Vladivostok, Russian Federation Primorskii center of eye microsurgery, Vladivostok, Russian Federation Relevance. This study presents a comparative analysis of the effectiveness of toric intraocular lens (IOL) with a wavefront shaping mechanism implantation in cataract surgical treatment in patients after penetrating keratoplasty (PKP). Purpose. To evaluate the effectiveness of toric IOL with a wavefront shaping mechanism implantation in cataract surgical treatment in patients after PKP. Material and methods. This prospective study included 65 patients (65 eyes) who underwent cataract surgery after prevous PKP (the time after removal of corneal sutures averaged 1.4±0.8 years). In the 1st group of patients (34 patients, 34 eyes) the AcrySof IQ Toric IOL was implanted, in the 2nd group – the AcrySof IQ Vivity IOL (31 patients, 31 eyes). In both groups, IOL power was calculated at a target refraction of (–) 0.5 D. The observation period was up to 6 months. Results. In all groups, there was a significant (p&lt;0.001) improvement in uncorrected (UCVA) and best-corrected visual acuity (BCVA) on the first day, after 1, 3 and 6 months. In 1st group, by the 6th month of observation, there was a tendency towards a slight significant (relative to the 3rd month) decrease in UCVA of 0.134±0.1 (p=0.019). In 2nd group, UCVA was significantly (p&lt;0.001) higher than in 1st group at all periods of postoperative follow-up and was 0.075±0.063 before surgery (in 1st group 0.053±0.029), on the first day after surgery 0.348± 0.139 (in the 1st group 0.097±0.05), 1st month 0.516±0.144 (in the 1st group 0.133±0.076), 3rd month 0.642±0.143 and by the 6th month 0.642±0.139 (in 1st group 0.16±0.1 and 0.134±0.1, respectively). Statistically significant (p=0.03) differences were obtained when comparing the error of the spherical equivalent of refraction (SE) from the expected result in the 1st and 2nd groups (1.22±0.875 and 0.76±0.582, respectively) during the observation period up to 6 months. Conclusion. AcrySof IQ Vivity Toric IOL implantation during the cataract surgical treatment in patients with previous keratoplasty allows to obtain significantly higher postoperative UCVA, due to more accurate access to target refraction, which confirmed by a significantly lower spherical equivalent error. Key words: wavefront, cataract, penetrating keratoplasty, EDOF, Vivity

Fast absorbing gut sutures in dermatologic surgery: a systematic review and meta-analysis.

Fast gut cutaneous sutures have become more prominent due to their low tissue reactivity, rapid absorption, and elimination of suture removal visits. It is not known how fast gut sutures compare to other closure modalities. A comprehensive literature review was conducted to identify randomized controlled trials comparing fast gut sutures to alternative closure methods during dermatologic surgery. Data collected included patient and physician assessed cosmetic outcome as well as standardized complication rates. Six studies were included in final analysis and reported on 208 patients. Fast gut sutures were associated with lower physician opinions of final scar when compared to polypropylene sutures (SMD 0.438; 95% CI 0.082 to 0.794). No differences existed between physician opinion of fast gut sutures and cyanoacrylate tissue adhesive (SMD -0.024; 95% CI -0.605 to 0.556). Complications with fast gut suture placement were rare, and included infection, dehiscence, and hematomas. Fast gut sutures were less likely to experience wound dehiscence than tissue adhesive (p = 0.01). If no contraindications to polypropylene sutures exist, they may provide superior cosmetic outcomes compared to fast gut sutures. Further research is required to better quantify cosmetic outcomes and optimal use of fast gut sutures.

Accuracy of Intraocular lens power calculation in pediatric traumatic cataract.

To evaluate the prediction error (PE) in pediatric traumatic cataract surgery involving primary or secondary intraocular lens implantation (IOL) and the factors affecting it. Retrospective data of unilateral traumatic cataract eyes of children aged ≤16 years were collected between February 2019 and March 2022 at a tertiary eye care hospital. Absolute PE was calculated by deducting the target refraction from the observed refraction at 6 weeks postsurgery following suture removal. Simulated PE was calculated in eyes with corneal scar replacing the affected eye keratometry (K) with the K of the fellow eye and standard K (44D) and was then compared with absolute PE. Fifty children with a mean age of 9.5 years (2-16 years) were included. Mean absolute PE was 1.63 ± 1.8D (0 to 9D). Absolute PE was not affected by the age at surgery, method of biometry, duration of injury, type of cataract surgery, position of IOL, and preoperative keratometry. The absolute PE was affected by axial length (AXL) being <1.5D in AXL of 22.73 ± 0.84 mm, <1.5-2D in AXL of 22.07 ± 0.61 mm, and >2D in AXL of 22.01 ± 0.74 mm (P = 0.039) in univariate analysis. In multivariate analysis, none of the factors affected the absolute PE. In 34 eyes with corneal scar, higher variability in PE was observed. The standard K resulted in greater simulated PE as compared to the affected eye average K in eyes with scar involving the visual axis. Absolute PE following pediatric traumatic cataract was studied. It was higher in shorter AXLs. In corneal scar involving the visual axis, using the fellow eye K yielded lesser simulated PE as compared to standard K.

Oral Mucocele in Pediatric Patient: A Case Report

Mucoceles can appear anywhere on the oral mucosa where there are minor salivary glands. Because the diagnosis is mostly clinical in character, it is important to appropriately do the anamnesis in order to look for any prior trauma. Extravasation and retention mucocele are the two main forms that can develop. Although retention mucoceles can appear anywhere, extravasation mucoceles typically occur on the lower lip. Histologically, mucoceles can be divided into extravasation types and retention types, with extravasation types being more prevalent. The extravasation mucocele, also known as a "mucous retention cyst," lacks an epithelial lining and a defined border. It is thought that trauma to a small salivary gland excretory duct causes an extravasation mucocele to occur. Saliva pools in the nearby submucosal tissue as a result of duct laceration, which causes edema. The obstruction of a minor salivary gland duct, frequently by a sialolith, periductal scarring, or tumor, results in the retention type mucocele. Saliva builds up and the duct enlarges due to the obstruction of salivary flow. A 9-year-old child arrived to Rumah Sakit Gigi dan Mulut Universitas Muhammadiyah Yogyakarta with his mother, complaining of a lump on his lower lip. Patient frequently bit his lips since the lump has been there for a few months. It did not hurt and occasionally grew in size. The lump bothered the patient. The dentist performed minor surgery to remove the mucocele. Minor surgery was performed with infiltration anesthesia around the mucocele and then used blade no. 15 for excision of the mucocele. For postoperative wounds, braided surgical sutured silk was used. Post-operative instructions were given, antibiotics and analgetic were prescribed. Patient was recalled after 1 week for the removal of sutures. No recurrence was seen after a follow up at 1 month and 3 months.International Journal of Human and Health Sciences Supplementary Issue 01: 2024 Page: S53

Intermittent sliding-lock-knot suture for limbal conjunctival autograft fixation in pterygium surgery: a technique note.

To report a technique used with intermittent sliding-lock-knot (ISLK) fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent (RI) fixation. Consecutive patients with primary pterygium who had undergone pterygium excision combined with limbal conjunctival autograft transplantation between March 2021 and March 2022 at our institute were retrospectively analyzed. Primary outcome measures were mean duration of surgery and suture removal, degree of conjunctival hyperemia on postoperative day 1, pain score at suture removal, postoperative symptoms at 6mo, including conjunctival hyperemia, foreign body sensation, and graft stability. Ninety-eight patients underwent monocular surgery and were divided into ISLK (51 eyes) and RI (47 eyes) groups according to the type of conjunctiva autograft fixation method planned. There was no significant difference in mean duration of surgery between the two groups (18.59±2.39min vs 18.15±2.20min, P=0.417); however, compared to the RI group, shorter suture removal times were observed in the ISLK group [0.58min (0.42-0.87) vs 3.00min (2.21-4.15), P<0.001]. The degree of conjunctival hyperemia on postoperative day 1 was milder in the ISLK group (P<0.001). Pain scores at suture removal were lower in the ISLK group than in RI group [1 (0-3) vs 2 (1-4), P<0.001]. Postoperative symptoms at 6mo were comparable between the groups (P=0.487), with no recurrence. ISLK is an innovative method for limbal conjunctival autograft fixation after pterygium excision. Compared to RI fixation, ISLK facilitates suture removal and reduces discomfort, with comparable surgery duration and less conjunctival hyperemia.

Intraoperative partial thickness compression suturing for descemet’s membrane detachment: A Novel technique

: To evaluate the efficacy of partial thickness transcorneal compression suturing with air desmetopexy in descemet’s membrane detachment (DMD) during cataract surgery: This is a retrospective review of records of patients who were managed for non-planar DMDs during phacoemulsification or small incision cataract surgery with partial thickness suturing with air descemetopexy in virgin eyes. : A total of fifteen cases were identified including 11 females and 4 males with average age of 67 years. All patients involved in the study underwent uneventful cataract surgery. All 15 cases involved in the study with DMD during cataract surgery were caused by intra-operative trauma during different instrumentations. Five cases had peripheral DMDs and ten cases had central DMDs. The average size of non-planar DMD was 4 mm. Ten cases had DMDs with scrolled margins. Eight patients achieved the best corrected visual acuity (BCVA) of 6/6 at the end of one month with clear corneas. Descemet’s membrane (DM) got completely attached at two weeks follow-up. The suture removal was done approximately after one month of follow-up. : Partial thickness transcorneal compression suturing with air desmetopexy in non-planar DMD is very helpful in recovering traumatic corneal edema during cataract surgery.

The Establishment of Calvarial Suture-Bony Composite Defects in Rats: A Standardized Model for Suture-Regenerative Therapy Investigation.

Large-scale calvarial defects often coincide with cranial suture disruption, leading to impairments in calvarial defect restoration and skull development (the latter occurs in the developing cranium). However, the lack of a standardized model hinders progress in investigating suture-regenerative therapies and poses challenges for conducting comparative analyses across distinct studies. To address this issue, the current protocol describes the detailed modeling process of calvarial suture-bony composite defects in rats. The model was generated by drilling full-thickness rectangular holes measuring 4.5 mm × 2 mm across the coronal sutures. The rats were euthanized, and the cranium samples were harvested postoperatively at day 0, week 2, week 6, and week 12. µCT results from samples collected immediately post-surgery confirmed the successful establishment of the suture-bony composite defect, involving the removal of the coronal suture and the adjacent bone tissues. Data from the 6th and 12th postoperative weeks demonstrated a natural healing tendency for the defect to close. Histological staining further validated this trend by showing increased mineralized fibers and new bone at the defect center. These findings indicate progressive suture fusion over time following calvarial defects, underscoring the significance of therapeutic interventions for suture regeneration. We anticipate that this protocol will facilitate the development of suture-regenerative therapies, offering fresh insights into the functional restoration of calvarial defects and reducing adverse outcomes associated with suture loss.

Topical lyophilized thrombin application improves wound healing for posterior spinal surgery

BackgroundThe erector spinae plane block (ESPB) was proposed as a part of the postoperative multimodal analgesic regimen to improve pain management after posterior spinal surgery. However, ESPB might cause more surgical incisional wound exudate and poor wound healing, which might be improved after topical lyophilized thrombin application. Materials and methodsWe performed a retrospective study on patients who received posterior spinal surgery between January 2018 and December 2021. These patients were assigned into three groups: group A (general anesthesia), group B (general anesthesia with ESPB), and group C (general anesthesia with ESPB and topical 1000-unit thrombin application). Postoperative outcomes, including times of dressing changes, duration of suture removal, and incisional wound healing, were compared among these groups. ResultsOur study included 89 patients, with 48, 20, and 21 patients in groups A, B, and C, respectively. Baseline demographics, height, weight, comorbidities, and operation duration were comparable among the three groups. Group B required statistically significantly more dressing changes and had a prolonged duration of suture removal than group A (9.4 ± 4.7 versus 6.5 ± 2.0 times, 16.2 ± 3.7 versus 14.2 ± 1.4 days, respectively), which could be statistically significantly improved after the thrombin application in group C. Group B also had more frequent poor wound healing (25.0 %), which could also be improved after the thrombin application (0.0 %). ConclusionsESPB could cause more dressing changes and poor surgical wound healing after posterior spinal surgery, which could be improved by topical lyophilized thrombin powder application.

Outcomes of deep anterior lamellar keratoplasty in eyes with healed hydrops - A retrospective interventional analysis.

The aim of the study was to analyze the techniques and outcomes of deep anterior lamellar keratoplasty (DALK) done in eyes with healed hydrops. Thirty-one eyes with paracentral scars following acute hydrops underwent DALK and were included in the study. Manual layer-by-layer dissection with stromal air injection was done in all cases, keeping dissection of the site of preexisting perforation to the end. Out of the 31 eyes, in 28 eyes, DALK could be completed, and in 3 eyes, procedure had to be converted to penetrating keratoplasty. Visual outcomes in all cases were good, with 26 out of 28 eyes (92.8%) achieving a best-corrected visual acuity (BCVA) of 6/12 or better. Preoperative mean BCVA of LogMAR 1.19 ± 0.27 improved to a postoperative mean BCVA of LogMAR 0.23 ± 0.08 (P < 0.00001). Postoperative mean refractive astigmatism at the last follow-up was -2.69 ± 0.82 D with postoperative a spherical equivalent of -2.31 ± 0.7 D. Complications included double anterior chamber in one eye and secondary angle closure in two eyes. Stromal rejection in one eye was managed with steroids and one eye with suture infiltrate needed selective suture removal. Layer-by-layer dissection with limited air injection into the stroma has shown good visual outcomes in patients undergoing DALK following healed hydrops, and DALK can very well be the primary treatment option even in such cases with a paracentral posthydrops scar.

Role of STIMULAN in chronic osteomyelitis-A randomised blinded study on 95 patients comparing 3 antibiotic compositions, bead quality, forming & absorption time

IntroductionChronic Osteomyelitis is a well-known clinical entity affecting patients holistically and presents with multiple treatment challenges. Local antibiotic delivery with biodegradable drug carriers has shown promising results. Materials and methodsProspective multicenter study performed at 2 centers from November 2021 to January 2023 on 95 osteomyelitis patients treated with surgical debridement & STIMULAN™ for local antibiotic delivery. Patients were randomized into 3 groups. Authors compared antibiotic combinations, bead quality, bead setting, and resorption time for calcium sulfate beads- STIMULAN™. Additionally, organisms isolated, WBC Turnover time, Hypersensitivity Reactions, Recurrence, and Revision Rates were documented. Results95 patients underwent surgical debridement and STIMULAN™ bead application for chronic osteomyelitis. The proximal 1/3rd tibia was commonly affected. The most common symptoms were sinus and pus discharge in 96.84 % & 86.31 % of patients respectively (p < 0.001). Staphylococcus aureus & MRSA were isolated in 37.8 % & 29.4 % of the patient's wound culture respectively. Bead setting time in Descending order was Group 3 > Group 2 > Group 1 (p < 0.001). Bead setting first in Group 1 followed by Group 3 & 2. On compression, Group-1 beads withstood maximum compression forces & had smooth even bead surfaces. On radiographs, 1/3rd bead volume in ascending order was Group 3 > Group 2 > Group 1 (p < 0.001). 2/3rd reduction in ascending order was Group 3 > Group 2 > Group 1. Complete bead absorption was earliest seen in Group 3 followed by Group 2 & Group 1 (p < 0.001). Recurrence in 2 patients (Group 2) at 6 weeks. Revision rate: 2.10 %. There were no incidences of hypersensitivity. Suture removal was done at 16 ± 2 days. ConclusionSTIMULAN™ combination with tobramycin, vancomycin, and gentamycin is stable, and forms uniform beads with predictable drug elution & bead resorption with negligible side effects. A mixture with higher liquid content sets later, forms softer beads, and resorbs earlier.

Horse owner perceptions of equine veterinary nursing roles in the United Kingdom.

Registered (equine) veterinary nurses (R(E)VNs) typically provide few client-facing services. Better utilising R(E)VN skills could help address workforce shortages, improve morale and benefit patient health. The aim of this study was to explore horse owner perceptions of R(E)VN roles. An online cross-sectional survey of horse owners gathered data on their understanding of R(E)VN roles, their experiences of R(E)VNs their openness to further R(E)VN services and perceived facilitators of and barriers to such services. Participants were recruited via practices, social media and snowball sampling. Descriptive analysis of the quantitative data and manifest content analysis of the qualitative data were conducted. Three hundred and forty-seven useable responses were received. Eighty-one percent (282/347) had heard the term R(E)VN. Most talked positively about their experiences with R(E)VNs. Eighty-seven percent (285/326) were open to an R(E)VN visiting their horse under the direction of a veterinary surgeon, with more than 90% being extremely or somewhat comfortable with R(E)VN visits for bandaging and suture removal. It is unclear how closely respondents' perceptions reflect those of the wider UK horse owner population. Horse owners appear to be open to further nursing services, with key procedures such as bandaging being a potential starting point. Understanding the career goals of the individual nurses and the needs of the practice will be key to the successful implementation of these services.

Delayed presentation of Wilkie’s syndrome after scoliotic curve correction surgery: a case report

BackgroundSuperior mesenteric artery (SMA) syndrome, also known as Wilkie’s syndrome, is a rare but serious complication following scoliosis correction surgery. It occurs as a result of mechanical compression of third part of duodenum between the SMA and aorta. This condition occurs most commonly in significantly underweight patients with deformities, and usually during the first week following spinal deformity corrective surgeries. The angle between the abdominal aorta and the SMA gets reduced following spinal lengthening during deformity correction surgery causing compression of third part of duodenum resulting in development of SMA syndrome.Case presentation.We present a case of 17-year-old male with congenital scoliosis with a 70-degree scoliotic curve who underwent spinal deformity correction surgery with posterior instrumented fusion. Post-operative course was uneventful and the patient was discharged after suture removal on post-operative day 15. The patient presented after 21-days of symptom onset on post-operative-day 51, with a 3 week history of post-prandial vomiting, abdominal pain and distension which resulted in rapid weight loss of 11 kg. A CT-angiogram showed obstruction at third part of duodenum. After reviewing clinical and radiological profile of the patient, a diagnosis of SMA syndrome was made. Conservative management was tried, but due to rapid deterioration of patient condition and symptoms of complete intestinal obstruction, the patient was treated surgically by gastro-jejunostomy and side-to-side jejuno-jejunostomy, which improved his condition.ConclusionSMA syndrome can occur much later than previously reported cases and with potentially life-threatening symptoms following scoliosis correction. Having a high index of suspicion, early recognition of condition and institution of appropriate treatment are essential to prevent occurrence of severe complications including risk of intestinal perforation and mortality. This case highlights management of delayed onset of SMA syndrome, with presentation further delayed after symptom onset, as is common in developing parts of the world, due to limited availability and accessibility of resources, and low socio-economic status of large segments of the population.

Application effects of armor chest straps in patients with sternal dehiscence after repair surgery

Objective: To investigate the application effects of armor chest straps in patients with sternal dehiscence after repair surgery. Methods: This study was a retrospective cohort study. The 11 patients who were admitted to the First Affiliated Hospital of Air Force Medical University (hereinafter referred to as the hospital) from March 2020 to March 2021 and used conventional chest straps after sternal dehiscence repair surgery were included in conventional chest strap group. The 12 patients who were admitted to the hospital from April 2021 to March 2022 and used armor chest straps after sternal dehiscence repair surgery were included in armor chest strap group. A special team for sternal dehiscence repair was set up, and the nurses in charge in the team instructed the patients in 2 groups on the correct abdominal breathing method, and the members of the surgical team performed the personalized surgery and wore the corresponding chest straps for the patients in 2 groups. The abdominal breathing frequency and chest breathing frequency on the first day after surgery were recorded. The pain intensity at 6, 24, 48, and 72 h after surgery was self-rated by the patients using numerical rating scale. The time of the first active cough and the time of wound healing after surgery were recorded. At postoperative suture removal, the cutting length of sutures induced by respiratory exercise was recorded. Whether there were complications such as redness, swelling, and exudation in flaps within 2 weeks after surgery were recorded, whether there were complications such as wound dehiscence or infection during follow-up of 3-12 months were recorded, and the incidence proportion of postoperative complications was calculated. At 6 months after surgery, the patients' scar status was evaluated by the Vancouver scar scale. Results: The abdominal breathing frequency of patients in armor chest strap group was (16.3±1.2) times/min on the first day after surgery, which was significantly higher than (5.3±1.4) times/min in conventional chest strap group (t=20.00, P<0.05), and the chest breath-ing frequency was (1.2±0.8) times/min, which was significantly lower than (12.4±1.5) times/min in conventional chest strap group (t=22.36, P<0.05). The pain intensity scores of patients in armor chest strap group at 6, 24, 48, and 72 h after surgery were significantly lower than those in conventional chest strap group (with t values of 15.07, 14.70, 13.66, and 11.03, respectively, P<0.05). The time of the first active cough and the time of wound healing after surgery of patients in armor chest strap group were significantly sooner than those in conventional chest strap group (with t values of 5.51 and 8.90, respectively, P<0.05). At postoperative suture removal, the cutting length of sutures induced by respiratory exercise of patients in conventional chest strap group was 2.0 (0, 5.0) mm, which was significantly longer than 2.0 (1.0, 2.0) mm in armor chest strap group (Z=4.10, P<0.05). There was no statistically significant difference in the incidence proportion of postoperative complications of patients between the 2 groups (P>0.05). At 6 months after surgery, the scar score of patients in armor chest strap group was 4.1±1.4, which was significantly lower than 5.6±1.4 in conventional chest strap group (t=2.71, P<0.05). Conclusions: The application of armor chest strap in patients with sternal dehiscence after repair surgery can increase the abdominal breathing frequency, reduce the wound cutting force, effectively relieve postoperative pain, increase the first active cough and wound healing speed, and alleviate postoperative scar proliferation, achieving good application effect.

A Pilot Study to Determine the Effect of Individualized Enteral Nutrition Management Based on Prognostic Nutrition Index on Surgical Patients With Oral Malignancies

This study aimed to assess the effect of individualized enteral nutrition management based on the prognostic nutrition index (PNI) on surgical patients with oral malignancies. This quasi-experimental pilot study consecutively included patients diagnosed with oral malignancies who underwent radical surgery in Ningbo No. 2 Hospital between January 2020 and May 2023. The primary outcome was PNI. A total of 71 patients with oral malignancies were enrolled, and 35 patients received PNI-based individualized enteral nutrition management. The PNI group displayed significantly higher PNI than the routine enteral nutrition support group (1st week postoperatively: 39.86 ± 3.86 vs. 37.29 ± 4.23, p < 0.001. 2nd weeks postoperatively: 44.17 ± 4.36 vs. 40.72 ± 3.40, p < 0.001). The surgical suture removal time and length of hospital stay (both p < 0.001) in the PNI group were significantly shorter than in the routine enteral nutrition support group. At 1 month postoperatively, the PNI group had significantly higher scores of QoL (p = 0.002) than the routine enteral nutrition support group. The individualized enteral nutrition management based on the PNI could improve the nutritional status of postoperative patients with oral malignancy, which could facilitate postoperative rehabilitation and improve overall QoL.

A rare case of conjunctival granuloma in Aurolab aqueous drainage implant (AADI) with supramid

Conjunctival granuloma (CG) can be caused by a foreign body, surgically related inflammation, an allergen, an infectious organism, or as part of a systemic disease. We are reporting the first case of CG related to 5-0 prolene as supramid, which is used as an intraluminal stent in AADI to prevent hypotony. A 70-year-old female diagnosed with POAG in both eyes with posterior PCIOL on MMT with advanced disc damage and uncontrolled IOP in the right eye underwent AADI with supramid. The patient developed mild irritation and redness in RE in the fourth month of follow-up. On slit-lamp examination, there was localized CG at the end of the supramid tip. CG resolved with the removal of the supramid suture and medical treatment. Supramid-related CG is rare and generally causes non-fatal material-related hypersensitivity reactions that can be treated well with medications and removal of inciting factors.

THE USE OF PERIOSTEAL FLAP IN MANDIBLE PRIMARY RECONSTRUCTION AFTER SEGMENTAL RESECTION IN MEDICATION-RELATED OSTEONECROSIS PATIENT: CASE REPORT

Background: The treatment of medication-related osteonecrosis of the jaws is challenging. Mandible segmental resection is the main treatment method for advanced stage 2 and stage 3 medication- related osteonecrosis of the mandible. This brings to the large continuity defects of the mandible, decreasing the life quality of the patients. Method: In this study, a modified technique of mandible defect reconstruction, after segmental resection, with only a reconstruction plate, is described. In this technique, the periosteal flap is used for double-layer closure of the intraoral wound. Double-layer isolation of the reconstruction plate from the oral cavity prevents intraoral wound dehiscence and plate exposure. Also, for the bone fragments fixation, prebended 2.3mm reconstructive plate on the 3D-printed individual model of the patient’s mandible was used. The use of a prebended plate reduces the operation time and increases the precision of fixation of mandible fragments in the correct position. Results: After intraoral sutures removal on 14 days, there was a dehiscence of a few intraoral sutures on mucoperiosteal flaps. There was partial exposure of the periosteal flap, which secured the underlying reconstructive plate. Exposed periosteal flap spontaneously epithelialized during 1 month. The postoperative follow-up period was nine months. During this period no complications were noted Conclusion: Within the limitations of the study, this method can be used as an effective and predictable method for the primary reconstruction of the mandible with only a reconstruction plate in medication-related osteonecrosis of the jaws patients.

Prospective, multi-centric, international, single-arm, cohort study to assess a synthetic polyamide suture material in oral surgery to close the mucosa - MUCODA study.

ObjectivesThe aim was to collect different clinical parameters systematically and proactively regarding safety, effectiveness, and performance of a nylon monofilament suture under routine clinical practice for oral surgery. MethodsThe study design was prospective, bicentric, international, single-armed, and observational. A non-absorbable suture was applied to close the mucosa after different dental surgical interventions. Main objective was the incidence of combined postoperative complications until suture removal. The 95 % Confidence Interval (Agresti-Coull method) was used to prove the non-inferiority with a pre-specified upper margin of 21.9 %. Secondary variables were intraoperative suture handling, patient pain and satisfaction, wound healing, aesthetic appearance, and bacterial contamination. Results105 patients were enrolled. Complication rate was low (1.9 %), 2 swellings occurred. Pain was present for 1.61 days ± 1.42 after various dental interventions with an average pain level of 20.98 ± 22.60 (VAS). Patients with impacted third molar extraction showed the longest pain duration (6 days) combined with the highest mean pain level of 35.33 ± 30.45 (VAS). Intraoperative suture handling was very good to excellent. Suture removal was done after an average duration of 7.56 ± 2.09 days. Patient's satisfaction was high, and an excellent wound healing was reported by the dentists. Aesthetic appearance only performed in implant patients was rated by oral surgeons with an average of 96.19 ± 3.79 points [min. 80 – max. 100] at 5 months postoperatively. Thread bacterial analysis showed that F. nucleatum was the most present species. ConclusionsOur findings indicate that the non-absorbable, nylon-based monofilament suture used is safe and quite suitable for oral mucosal closure after various dental surgical interventions such as tooth extraction, implant placement and impacted third molar extraction. Clinical significanceThis study showed the safe use of a non-absorbable, nylon-based monofilament suture for different oral surgical interventions under daily routine clinical practice.

Evaluation and Surgical Outcomes of Primary Closure for Breast Abscess- 3 Year Experience in Rangpur Zone

Background: Breast abscesses are a common medical concern, often associated with pain, cost implications, and dressing-related complications. Managing breast abscesses presents an opportunity to optimize patient outcomes while streamlining healthcare resource utilization. This study aimed to evaluate the effectiveness of primary closure as a surgical approach for breast abscess management in a private practice setting, focusing on reducing hospital stays and associated costs, particularly improving patient compliance. Methods: This prospective study was conducted in private practice settings over three years, from July 2020 to June 2023. A total of 119 patients, comprising both acute (n=72) and chronic (n=47) breast abscess cases, were included in the study. The surgical procedures included incision, drainage, curettage, and primary closure using 16 FR/18 FR drains. Special measures included iodine irrigation, keeping drains for at least 7 days, suture removal on 10th-14th postoperative days, and administering antibiotics for up to 14 days. Follow-up appointments occurred after 3 weeks. Results: Among the 119 patients, 72 (60.5%) presented with acute breast abscesses, while 47 (39.5%) had chronic abscesses. All patients were discharged on the 2nd postoperative day. In cases of chronic breast abscess, drains were removed between 5-7 postoperative days, while in acute cases, drains were removed at the 10th postoperative day or upon suture removal. No suction drains were used. Over 95% of patients resumed breastfeeding shortly after surgery. Suture removal on the 10-12th postoperative days showed healthy wounds in 88 patients, minor wound gaps in 13 patients (requiring no further intervention), and secondary stitching in 10 patients. Ten patients experienced delayed abscess formations under the scar, necessitating drainage under local anesthesia and oral antibiotics. The most frequently isolated causative organism from pus was Staphylococcus aureus. .........