Vicryl Rapide Research Articles

521. SHORT-TERM PROPHYLACTIC STENTING FOR HIGH-RISK ESOPHAGEAL ANASTOMOSIS: A CASE SERIES

Abstract Background Anastomotic leak after esophagectomy is a cause of major morbidity, increases surgical mortality and can affect long-term survival outcomes. Early recognition and treatment of anastomotic leaks has greatly improved the rescue rates for this catastrophic complication. However, for some patients, successful rescue is not sufficient to prevent major morbidity and worse long-term outcomes. Prevention of esophageal anastomotic leaks would benefit these patients. Prophylactic stenting after esophagectomy can be one of the tools used in addition to all other factors that are implemented to improve surgical outcomes in this complex cohort of patients. Methods We present a series of seven patients who underwent esophagectomy for malignant disease at our institution. They had insertion of prophylactic esophageal stents at the time of esophagectomy due to a combination of patient factors and intraoperative complications. All anastomoses were carried out using the modified Orringer technique of linear stapled esophagogastric anastomosis. All patients underwent insertion of an 18mm diameter, fully covered EGIS (S&G Biotech, Korea) esophageal stent with antireflux valve. This was fixed to the esophagus / gastric tube using two 2-0 Vicryl Rapide (Polyglactin 910) sutures. The stents were removed endoscopically between postoperative day 14 and 28. Results None of the seven patients who underwent prophylactic esophageal stenting had any clinical or radiological evidence of anastomotic leak. In one patient, at the time of stent removal, a possible anastomotic defect was noted but it was not possible to enter the cavity. A new stent was inserted, and the patient was clinically observed. He remained clinically well throughout. Another patient developed a severe hospital acquired pneumonia requiring ventilatory support without evidence of anastomotic leak. Median length of stay was 13 days. There was no mortality within 90 days of surgery. Conclusion Short term prophylactic esophageal stenting is possible and safe. The technique of stent fixation and early removal helps to mitigate the risks of stent migration and erosion. In our small series, the stents were effective in preventing anastomotic leaks with no stent related complications. This provides optimism for patients and surgeons that morbidity from anastomotic leaks can be minimised, enabling patients to recover from surgery and proceed to adjuvant treatment if indicated. The safety profile of prophylactic esophageal stents should be investigated further and both short- term and long-term outcomes compared to current standards of care by randomised studies.

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.

SUTURE CHOICE IN CARPAL TUNNEL SURGERY: A RANDOMIZED CONTROLLED TRIAL

ObjectiveCarpal tunnel release surgery is a commonly performed procedure for alleviating symptoms of median nerve compression and restoring hand function. With pressure on theatre time these procedures are now commonly performed in a step-down out-patient facility under local anaesthetic. The choice of suture for skin closure in this procedure can impact the quality of wound healing, patient outcomes and the follow-up required however the question of the best type of suture remains unanswered. The purpose of this study was to compare the outcomes of absorbable and non-absorbable sutures using a randomised control trial design.MethodsEighty patients diagnosed with bilateral carpal tunnel syndrome were enrolled and underwent outpatient carpal tunnel release surgery under local anaesthetic in a staged fashion. Random number generation was used to assign each hand to receive interrupted nylon or Vicryl Rapide sutures. Pre-operative data collection included patient demographics, ASA, inflammatory conditions, smoking status as well as a Boston Carpal Tunnel Questionnaire (BCTQ) for each hand. Patients were followed up at 2 and 6 weeks after each operation and the BCTQ was repeated along with the Patient and Observer Scar Assessment Scale and the VAS score for wound discomfort. This study has approval from the DHB ethics committee, Local Iwi, HDC and ANZ Clinical Trials:ACTRN12623000100695.ResultsStatistical analysis assessed patient preference and the scores between the groups. Multi-variate analysis was performed to assess the factors that may be contributing to patient choice.ConclusionInsights into patient preference and clinical outcomes associated with absorbable sutures and non-absorbable sutures in the setting of out-patient surgery are discussed.

Comparison of the Efficacies of Vicryl Rapide and Prolene Sutures in Transcolumellar Incision.

<b><br>Introduction:</b> Septorhinoplasty aims to enhance nasal function and appearance. This common but complex procedure has demonstrated advancements with both open and endonasal approaches. The selection of sutures can impact patient comfort and scar outcomes, presenting both advantages and disadvantages.</br> <b><br>Aim:</b> This study was conducted to compare the cosmetic outcomes of the use of absorbable polyglactin 910 (PG) (Vicryl Rapide 5/0; Ethicon Inc.) and nonabsorbable polypropylene (PP) (Prolene 5/0; Ethicon Inc.) in open septorhinoplasty in terms of surgical scarring.</br> <b><br>Methods:</b> The sample of this prospective, randomized, single-blind study consisted of 42 patients who underwent open septorhinoplasty. The patients were randomized into the vicryl rapide (n = 16) and prolene (n = 26) suture groups. The groups were comparatively evaluated by two surgeons in terms of surgical scarring, pigmentation, level difference, indentation, and general appearance based on patient photographs taken in the 2nd week, 6th weeks and 12th week post-op.</br> <b><br>Results:</b> The mean age of the vicryl rapide and prolene groups was 26.9 5.7 years and 24.6 3.9 years, respectively. There was no significant difference between the groups in any of the parameters investigated within the scope of the study in postoperative week 2, 6, and 12 (P > 0.05). On the other hand, intragroup analyses revealed that suture scar significantly decreased in the vicryl rapide group in the 6th and 12th weeks compared to the 2nd week (P < 0.05), while no significant difference was observed in the prolene group in the suture scars in week 6 and 12 compared to week 2 (P > 0.05).</br> <b><br>Conclusions:</b> Inverted V trans-columellar incisions sutured with rapidly absorbable suture material resulted in significantly less suture discomfort and did not significantly increase the risk of postoperative infection compared to nonabsorbable suture material. However, there was no significant difference between the two suture materials in terms of scar appearance.</br&gt.

Comparison of Vicryl Rapide Versus Chromic Catgut for Episiotomy Repair

A significant proportion of women benefit from episiotomy, but it’s also associated with short and long-term postpartum morbidities like perineal pain due to lacerations and scar formation after repair. The current study was designed to rule out the variations regarding pain and analgesia requirement. Objective: To evaluate outcome of vicryl rapide sutures versus chromic catgut sutures for episiotomy repair in terms of pain and analgesia requirement. Methods: In this randomized control trial from March to September 2021, a total of 206 females (103 in each group) were enrolled and the data was collected after taking informed consent. Episiotomy in all females was done by a single senior consultant. Subjects were randomly assigned one of two sutures. In Group-A females were managed by vicryl rapide 2-0 (36mm, 1/2circle double reverse cutting and round bodied needle) females. in group-B were managed by chromic catgut 1.0 (30 mm, 0.5 circle round bodied needle). Both groups were compared in terms of pain and analgesic requirement. Results: Comparison of pain in vicryl rapide sutures versus chromic catgut after repair of episiotomy showed that 32.0% (n=33) in Group-A and 49.5% (n=51) in Group-B had pain after 48 hours (p value = 0.01). Analgesia requirement at day 7 was recorded in 20.4% (n=21) in Group-A and 66.0%(n=68) in Group-B (p = <0.000). Conclusions: We concluded that vicryl rapide has a better outcome as compared with chromic catgut in repair of episiotomy in terms of pain and analgesic requirements.

Comparison of Wound Outcomes for Absorbable versus Non-absorbable Suture after Carpal Tunnel Release

Background and Hypothesis:Carpal tunnel release (CTR) is a common hand surgery procedure. Despite the large volume of CTRs performed worldwide (400,000-600,000 cases/year), there is no consensus as to the optimal suture material for incision closure. In this study, we sought to compare outcomes of absorbable and non-absorbable suture for skin closure after CTR. Our hypothesis was that that there is no statistically or clinically significant difference in wound-related outcomes between the cohorts.
 Project Methods:All patients who underwent primary open carpal tunnel release (CTR) at a large, public county hospital in Indianapolis, IN were identified by CPT code (64721). All patients were treated by one of two fellowship-trained hand surgeons. The most recent 50 patients treated between September 2022 and May 2023 by each surgeon were identified. Surgeon “A” uses 4-0 vicryl rapide for closures (absorbable). Surgeon “B” uses 4-0 nylon for closures (non-absorbable). Adverse events (AE) were defined as infection, dehiscence, or suture granuloma observed at any follow-up appointment. This study was approved by the Institutional Review Board.
 Results:100 patients were identified - 4 patients were lost to follow-up and were excluded from the study. Of the remaining 96 patients, 46 received absorbable suture and 50 non-absorbable suture. Of the 46 patients who received absorbable suture, 8 experienced AE (17.4%). None of the 50 patients who received non-absorbable suture experienced an AE. There was a statistically significant difference in AE between the absorbable and non-absorbable suture cohorts (p=0.002). Patients with absorbable suture averaged 1.61 follow-up appointments, whereas those with non-absorbable suture averaged 2.32 (p=.0008).
 Conclusion and Potential Impact:In this study, absorbable suture resulted in more wound-related complications after CTR. However, patients with non-absorbable suture had more post-operative follow-up appointments. These findings should be considered when selecting suture material for skin closure after CTR.

Effect of the absorption rate of suture material on oral mucosal scar formation: A triple-blind randomized controlled trial

IntroductionExtensive oral mucosal scar formation following LeFort-I osteotomy can pose patients with several scar-related complications in case of function as well as cosmesis. The present study aimed to evaluate the effect of the absorption rate of Vicryl Rapide and Vicryl on oral mucosal scar formation. Material and methodsIn a triple-blind randomized controlled trial study, Vicryl and Vicryl Rapide were used randomly for wound closure on the left and right sides of the LeFort-I incision line. Three maxillofacial surgeons evaluated mucosal scars on each side two and four months post-surgically using Mucosal Scarring Index (MSI). ResultsThe differences in the total scores of MSI between the Vicryl and Vicryl Rapide groups were not significant, neither in the anterior nor in the posterior areas (Paired t-test, df = 25, CI = 95 %, P-value >0.05). ConclusionThe results of the present study demonstrated that Vicryl Rapide is comparable to Vicryl suture material regarding the mucosal scar formation following LeFort-I osteotomy surgery; therefore, it could be considered for such oral surgical procedures.

The effect of myrrh and eugenol on resorption rate of different suture materials: an in vitro study

This in vitro study exposed common absorbable oral surgery sutures - Vicryl, Vicryl Rapide, chromic gut, and Monocryl in 3-0, 4-0, and 5-0 sizes - to preparations of myrrh, eugenol, chlorhexidine, and essential oils. Samples were immersed at 37°C and degradation assessed by time to complete absorption. Smaller sutures degraded faster, especially with constant oil exposure. Monocryl 5-0 was most rapid while chromic gut was most resilient. Myrrh and eugenol oils significantly accelerated absorption compared to controls. The findings demonstrate myrrh and eugenol oils substantially reduce oral suture longevity in vitro, particularly for synthetic monofilaments. This can optimize clinical recommendations on suture selection and natural medicine usage post-operatively based on their impacts on degradation rates.

Surgical adhesive glue to repair first-degree perineal tears in vaginal birth: A randomised controlled clinical trial

BackgroundPerineal tears in vaginal birth are highly prevalent and may be related to physical and psychological trauma. Surgical glues are an alternative repair method to avoid the pain that may be caused by perineal repairs with sutures. ObjectiveTo evaluate the effectiveness of surgical adhesive glue in reducing perineal pain when compared to sutures in first-degree perineal tears resulting from vaginal birth. DesignOpen-label parallel-group randomised controlled trial. SettingAn alongside birth centre in Sao Paulo, Brazil. Participants84 intrapartum women with first-degree perineal tears needing repair. MethodsIn the experimental group (n = 42), the perineal tears were repaired with Epiglu® surgical glue (ethyl-2-cyanoacrylate); in the control group (n = 42), the tears were repaired with Vicryl Rapide® (polyglactin 910) sutures. The primary outcome was the intensity of perineal pain after birth measured by a numeric pain rating scale ranging from 0 to 10 points. The secondary outcomes were healing, measured by the “Redness, Oedema, Ecchymosis, Discharge, and Approximation" scale; women's satisfaction with the perineal repair, measured by a visual analogue scale; and the time necessary to complete the repair. Data were collected during postpartum hospitalisation and 10–20 days after discharge, from December 2020 to May 2021. Data were analysed using bivariate analysis and linear models by intention-to-treat. Results36–48 h after birth, the mean of perineal pain was 0.2 (95% Confidence Interval [CI] 0.1–0.8) in the experimental group and 0.9 (95% CI 0.5–1.5) in the control group; the perineal healing score was 0.7 (95% CI 0.4–1.2) and 0.8 (95% CI 0.5–1.2), in the experimental and control groups, respectively; satisfaction was higher among women in the experimental group (88.1% versus 83.3% in the control group). After discharge, the mean of perineal pain was 0.1 (95% CI 0.0–0.5) in the experimental group and 1.4 (95% CI 0.8–2.2) in the control group; the perineal healing score was 0.0 (95% CI 0) and 1.0 (95% CI 0.7–1.3) in the experimental and control groups, respectively. Satisfaction was higher in the experimental group (94.9% versus 75.0%). The longitudinal analysis showed statistically significant differences between the groups regarding perineal pain and women's satisfaction. The average time necessary for perineal repair was 6.0 (95% CI 4.7–8.7) minutes in the experimental group and 9.7 (95% CI 8.3–11.5) in the control group (p < 0.001). ConclusionsSurgical glue resulted in less perineal pain, faster repair, and greater satisfaction than perineal sutures after birth. The healing process was similar in both cases. Tweetable abstractSurgical glue was less painful and promoted greater satisfaction after birth compared to sutures in women with first-degree perineal tears. RegistrationRegistered on The Brazilian Clinical Trials Registry number RBR-52y5tq (http://www.ensaiosclinicos.gov.br/rg/RBR-52y5tq/), on July 16, 2020. The first recruitment was on December 17, 2020.

Clinical equivalence of Trusynth fast® and Vicryl rapide® polyglactin 910 fast absorbing sutures on maternal morbidity experienced by women following episiotomy repair: a single-blind, randomized study

Background: Episiotomy procedure enlarges the vaginal outlet to facilitate childbirth. Polyglactin 910 fast-absorbing sutures are widely used for the repair of episiotomy because of their rapid absorption and less inflammatory response. This study was designed for subjective assessment of perineal pain post-episiotomy repair, with Trusynth Fast® and Vicryl Rapide® polyglactin 910 fast-absorbing sutures. Method: This was a single-blind, randomized, prospective study conducted between January 7, 2021 and July 14, 2021 across two centers in India. Primiparous or multiparous women (18—40 years), who required episiotomy during vaginal delivery were included, and either Trusynth Fast® (n=47) or Vicryl Rapide® (n=49) suture was used for their episiotomy repair. The primary endpoint, perineal pain was assessed with visual analogue scale at all follow-up visits. The secondary endpoints, quantity of local anesthesia, number of sutures used, time to repair episiotomy, intraoperative suture handling, analgesics used, early and late wound complications, wound re-suturing, time to complete healing, presence of residual sutures, return to sexual activity, dyspareunia, and adverse events were also recorded. Results: The study showed no significant difference in perineal pain between the two groups at any visit. A statistically significant difference (p&lt;0.05) in total score of episiotomy healing scale on day 2 (0.13±0.34 versus 0.35±0.56) and swelling on day 2 (8.51 versusversus 28.57%) was noted between Trusynth Fast® and Vicryl Rapide® group. Non-significant difference was observed between the groups regarding anesthesia, number of sutures, time to repair episiotomy, intraoperative suture handling, analgesics, puerperal fever, wound infection, dehiscence, hematoma, urinary incontinence, re-suturing, time to complete healing, return to sexual activity and dyspareunia. Conclusion: Trusynth Fast® suture is clinically equivalent to Vicryl Rapide® suture and can be used for episiotomy repair with minimal risk of perineal pain and wound complications. Clinical Trials Registry of India Registration: CTRI/2020/12/029925; Registered on December 18, 2020

A simple method to improve the antibiotic elution profiles from polymethylmethacrylate bone cement spacers by using rapid absorbable sutures

ObjectiveAntibiotic-loaded bone cement beads and spacers have been widely used for orthopaedic infection. Poor antibiotic elution is not capable of eradicating microbial pathogens and could lead to treatment failure. The elution profiles differ among different cement formulations. Although Simplex P cement has the least release amount, it is widely used due to its ready availability. Previous methods aiming to improve the elution profiles were not translated well to clinical practice. We sought to address this by using easily available materials to improve the elution profile of antibiotics from PMMA, which allows clinicians to implement the method intraoperatively.MethodsVancomycin was mixed with Simplex P cement. We used Vicryl Rapide sutures to fabricate sustained-release cement beads by repetitively passing the sutures through the beads and/or mixing suture segments into the cement formulation. Vancomycin elution was measured for 49 days. The mechanism of antibiotic release was observed with gross appearance and scanning electron microscopic images. The antimicrobial activities against MRSA were tested using an agar disk diffusion bioassay.ResultsPassing Vicryl Rapide sutures through cement beads significantly improved the elution profiles in the 7-week period. The increased ratios were 9.0% on the first day and 118.0% from the 2nd day to the 49th day. Addition of suture segments did not increase release amount. The Vicryl Rapide sutures completely degraded at the periphery and partially degraded at the center. The antibiotic particles were released around the suture, while antibiotic particles kept densely entrapped in the control group. The antimicrobial activities were stronger in passing suture groups.ConclusionPassing fast absorbable sutures through PMMA cement is a feasible method to fabricate sustained-release antibiotic bone cement. Intra-cement tunnels can be formed, and the effect can last for at least 7 weeks. It is suitable for a temporary spacer between two stages of a revision surgery.

Efficacy of Isoamyl 2-Cyanoacrylate Tissue Adhesive and 3-0 Vicryl Rapide Sutures in Impacted Mandibular Third Molar Surgery: A Comparative Study

Efficacy of Isoamyl 2-Cyanoacrylate Tissue Adhesive and 3-0 Vicryl Rapide Sutures in Impacted Mandibular Third Molar Surgery: A Comparative Study

Comparative study of surgical wound closure with nylon interrupted sutures and running subcuticular vicryl rapide suture after open release of the carpal tunnel.

BackgroundSurgical decompression of the carpal tunnel is considered the method of choice for its treatment with satisfactory results documented. Various methods and suturing materials have been used for closure of the surgical wound. In the present study, we compared interrupted mattress closure by means of nylon suture to running subcuticular closure with vicryl rapide suture. As far as we know, there is no similar study in the literature.MethodsA total of twenty patients were included in the study. Ten of them had their surgical wound closed with 3.0 nylon suture in an interrupted fashion and for the rest, a running subcuticular 3.0 vicryl rapide was used. All patients filled in a questionnaire about VAS perceived pain and a Quick DASH score sheet, preoperatively, at two and six weeks postoperatively. The cosmesis of the scar was assessed using the POSAS v2.0 system at two and six weeks after surgery and overall incidence of infections was noted as well.ResultsThere was no statistically important difference between the two groups of patients in regards to postoperative VAS pain levels at two and six weeks. Likewise, no statistically significant difference was evident as far as Quick DASH score, POSAS score and infections were concerned.ConclusionsOur results suggest that the use of running subcuticular vicryl rapide suture is an attractive alternative to interrupted nylon sutures for closure after open carpal tunnel decompression, lacking any significant drawbacks.Lay SummarySurgery for carpal tunnel decompression is considered the method of choice for its treatment with documented satisfactory results. Various methods and suturing materials have been used for closure of the surgical wound. In the present study, we compared the use of a non-absorbable suture, placed intermittently to an absorbable continuous intradermal suture. A total of twenty patients were included in the study. Half of them had their wound closed with the absorbable suture and the other half with the non-absorbable suture, as described above. All patients were evaluated as far as pain, scar characteristics, functional outcomes of the operated hand and incidence of infection, at two and six weeks after surgery. After analysis of the data, no significant differences were found between the two groups, suggesting that both of these techniques are equally safe and efficacious.

Suture Hemostasis - Conservative Management of Ectopic Pregnancy

<h3>Study Objective</h3> The conservation of fertility in spite of recurrent ectopic pregnancy in women who want to continue to have children. This procedure will allow for the regeneration of the tubal structure which will make future pregnancies possible and affordable when compared to other methods such as in vitro fertilization. <h3>Design</h3> Case Study, early first trimester diagnosis of ectopic pregnancy which includes ultrasound and serial serum B-hCG levels will lead to medical or surgical management of the ectopic pregnancy. <h3>Setting</h3> Hospital, operating room. <h3>Patients or Participants</h3> Case Study 28-yo Gravida 4 Para 2 with a previous salpingectomy for and ectopic gestation presents with a recurrent ectopic in her remaining fallopian tube and had failed medical management with methotrexate. She was offered conservative surgical management with suture hemostasis. <h3>Interventions</h3> At laparotomy (in this case) or laparoscopy the ectopic site was identified in the fallopian tube. Overlapping vicryl rapide sutures were placed proximal to the ectopic site and distal to it. An anterolateral incision was made in the ectopic site with removal of the products of conception. The site remained blood less, hemostasis of the surgical site was noted, peritoneal lavage performed and the abdomen closed in layers. <h3>Measurements and Main Results</h3> 1. Hemostatic suture placement. 2. Removal of the products of conception and confirmation of same on histopathology. 3. Hemostasis of the surgical site. 4. Confirmation of a tubal patency by a successful intrauterine pregnancy. <h3>Conclusion</h3> Suture hemostasis must be an option in ectopic pregnancy whether primary or recurrent since the method is cost effective and tubal patency can be confirmed in the post operative recovery phase. It allows for an additional conservative surgical option when hemostasis may be difficult using linear salpingostomy for larger ectopics leading to an unfortunate salpingectomy. A more extensive case series is recommended to further advance the technique and to note its potential benefits and drawbacks.

Polyglactin 910 (Vicryl Rapide) for Reducing Pain and Wounds Healing in Postpartum Perineum

Objective: The purpose of this study was to compare the use of polyglactin 910 (vicryrapide) and chromic catgut to perineal pain and healing wounds on postpartum.&#x0D; Method: This research is true experiment with a randomized controlled trial (RCT) and single-blind. The number of respondents pad this study of 40 respondents were divided into 20 respondents to the intervention group (vicrylrapide) and 20 respondents for the control group (chromic catgut). Data analysis using independent t-test.&#x0D; Results: Statistical test results using independent t-test for pain showed p = 0.035 &lt;0.05 and for wound healing showed p = 0.000 &lt;0.05 of a second can mean the results are there differences in the use of threads polyglactin 910 (vicrylrapide) and chromic catgut thread to perineal pain and healing wounds in the mother postpartum perineum.&#x0D; Conclusion: The use rapidevicryl thread to repair perineal perineum or stitches can reduce perineal pain and healing wounds better than the use of the chromic catgut thread.&#x0D; Keywords: chromic catgut, pain, polyglactin 910, rapide vicryl, wound healing of the perineum.&#x0D; &#x0D; Abstrak&#x0D; Tujuan: Untuk mengetahui perbandingan penggunaan polyglactin 910 (vicry rapide) dan chromic catgut terhadap nyeri dan penyembuhan luka perineum pada postpartum.&#x0D; Metode: Penelitian ini merupakan penelitian true experiment dengan randomized controlled trial (RCT) dansingle blind. Jumlah responden pada penelitian ini sebanyak 40 responden yang di bagi menjadi 20 responden untuk kelompok intervensi (vicryl rapide) dan 20 responden untuk kelompok kontrol (chromic catgut ). Analisis data menggunakan independent t-test.&#x0D; Hasil: Uji statistik menggunakan independent t-test untuk nyeri didapatkan hasil p=0,035&lt;0,05 dan untuk penyembuhan luka didapatkan hasil p=0,000&lt;0,05 dari kedua hasil tersebut dapat diartikan ada perbedaan penggunaan benang polyglactin 910 (vicryl rapide) dan benang chromic catgutterhadapnyeri perineum dan penyembuhan luka perineum pada ibu postpartum.&#x0D; Kesimpulan: Penggunaan benang vicryl rapide untuk perbaikan perineum atau penjahitan luka perineum dapat mengurangi nyeri perineum dan penyembuhan luka yang lebih baik dibandingkan dengan penggunaan pada benang chromic catgut.&#x0D; Kata kunci: chromic catgut, nyeri, penyembuhan luka perineum, polyglactin 910, vicryl rapide.

To Compare the Clinical Outcomes Following Episiotomy Wound Repair Using Chromic Catgut versus Fast Absorbing Polyglactin 910

Episiotomy, a very common surgery in obstetrics meant to reduce difficulty during delivery of the baby can itself be the cause for distress if it lands up in complications. Many of these complications like pain and swelling in the wound, induration, urinary retention, feeling of uncomfortable stitches, wound dehiscence etc. are related to the type of suture used for repair. This study is aimed at comparing the clinical outcomes following episiotomy wound repair using the two commonly used absorbable sutures chromic catgut and fast absorbing polyglactin 910 (vicryl rapide). 200 patients were included in the study with half of them undergoing repair with chromic catgut and the remaining half with vicryl rapide. They were evaluated at 24-48 hrs, 3-5 days and at the end of 6 weeks. Factors considered were pain and swelling around episiotomy, need for analgesia, induration, feeling of uncomfortable stiches, wound dehiscence, wound healing etc. It was observed that Pain score and need for analgesia were significantly less in the vicryl rapide group at 24-48 hours and 3-5 days, as well as the patients with complaints of uncomfortable stitches (11% vs. 27%), wound indurations (11% vs. 23%), wound discharge (infection) (8% vs. 19%) and wound dehiscence (7% vs. 16% at 3-5 days and 8% vs. 16% at 6 weeks). Dyspareunia was also less in the vicryl rapide group (9% vs. 21%). Wound healing was also observed to be better in the vicryl rapide group than the other group. So it was concluded that fast absorbing polyglactin is a better suture for episiotomy wound repair than chromic catgut considering the lesser complications and better healing with it.

Wound dehiscence prevalence and relationship with prosthetic material extrusion in women underwent anterior colpotomy.

Aim:To assess the prevalence of anterior vaginal wall dehiscence in women who underwent anterior vaginal wall colpotomy for pelvic organ prolapse or stress urinary incontinence and to evaluate the influence of suture materials and techniques on wound dehiscence.Materials and Methods:This multicenter, prospective study enrolled naïve women for urogynecological surgery affected by anterior vaginal wall defect or stress urinary incontinence. Performed surgical procedures were anterior vaginal wall repair (AVWR) with native tissue (N-AVWR) or polypropylene mesh (M-AVWR), trans-obturator polypropylene in-out middle urethral sling (MUS). Used suture materials were Vicryl 2-0, Vicryl Rapide 2-0, and Monocryl 3-0. Suture techniques were running interlocking or interrupted. Follow-up was performed daily during hospitalization and in outpatient clinic after 10–14, 30 days, and after 3 months.Results:A total of 1139 patients were enrolled. AVWR were 790: 89.1% N-AVWR, and 10.9% M-AVWR. Polypropylene MUS were 349. Women with prosthetic implantation were 38.2%, while 61.8% had native tissue repair. Overall Vicryl was used in 53.9%, Vicryl Rapide in 37.4%, and Monocryl in 8.7%. Overall running interlocking sutures were 66.5%, while interrupted were 33.5%. Overall wound dehiscence prevalence was 0.9% (10/1139). Wound dehiscence rate of 0.6% (5/790) was documented in AVWR: 0.3% (2/704) in N-AVWR, and 3.5% (3/86) in M-AVWR. Among women underwent MUS, 1.4% (5/349) showed wound dehiscence. In patients who underwent prosthetic surgery, the overall dehiscence prevalence was 1.8% (8/435). A statistically significant higher rate of wound dehiscence was found in women with implanted prosthetic materials.Discussion:We reported for the first time the prevalence of wound dehiscence in females who underwent colpotomy for AVWR or MUS. Wound dehiscence occurrence was low, but non-negligible. We found that this complication was poorly associated to the suture methods and materials, while prosthetic material represented a risk factor for wound healing.

Polyglactin 910 versus irradiated polyglactin 910 for subcuticular closure in elective surgeries: a randomized double-blind study

Background: All suture materials are treated as foreign bodies and bring out a reaction in the tissues. The severity and duration of response depends on the type of suture material used. The choice of suture material is based on the concept that it should provide adequate tensile strength across the wound until tissue tensile strength has adequately developed, approximation of the epithelial portion has occurred and that the suture material should be absorbed after serving its function. this study was done to compare irradiated polyglactin 910 (Vicryl Rapide) versus polyglactin 910 (Vicryl) for subcuticular skin closure in patients of elective surgeries and to note post-operative wound inflammation, pain, dehiscence and quality of scar.Methods: 60 consecutive patients undergoing elective surgeries in department of surgery SGRD hospital were taken up for the study from April 2020 to June 2020. After randomization the subjects were divided into two groups. Subcuticular skin closure at the end of surgery was done using a 3-0 polyglactin 910 in group A and 3-0 irradiated polyglactin 910 in group B with cutting needle in both groups. Postoperatively the wound was inspected on day 3, 5, 7 and again 3 weeks after surgery.Results: Postoperatively the wounds were observed for the signs of inflammation and infection. Each was given a wound score according to scoring system. Statistical analysis by SPSS 17.0 software and chi-square test. Irradiated polyglactin 910 showed less inflammation, pain and dehiscence along with good quality of scar as compared to polyglactin 910 on comparison.Conclusions: It was concluded that irradiated polyglactin 910 was a better choice for suture material than polyglactin 910 for subcuticular skin closure in terms of postoperative pain, wound dehiscence and quality of scar.

COMPARATIVE STUDY OF EPISIOTOMY REPAIR: CHROMIC CATGUT AND VICRYL RAPIDE

Background: Prevalence of the episiotomy varies around the world depending on whether it is used as a routine or a restricted procedure. The rates are still higher in developing countries, like ours, since the use of restricted episiotomy is not being practiced widely in primigravidas.&#x0D; Methods: In our randomized comparative study of 222 women who were admitted to the Department of Obstetrics and Gynaecology, SMS Medical College Jaipur, the enrolled women were divided into 2 groups. In Group-A: Vicrylrapide (polygalactin-910) suture material was used in 111 patients and in Group-B chromic catgut suture material was used in another 111 patients, for repair of episiotomies.&#x0D; Results: In our present study in vicryl rapide group at 24-48 hrs pain was present in 49.55% of patients, redness was found in 8.10% of patients, swelling was found in 3.60% patients and analgesic used by 72.97% of patients. In chromic group at 24-48 hrs pain was present in 69.36% of patients, redness was found in 21.62%, swelling was found in 7.20% and analgesic was used by 89.18% of patients.&#x0D; Conclusion: Our study recommends use of vicryl rapide for episiotomy repair in the care of parturient women.&#x0D; Keywords: Complication, Chromic Catgut, Vicryl Rapide, Episiotomy

Photographic assessment of postsurgical facial scars epidermally sutured with rapidly absorbable polyglactin 910 or nylon: A randomized clinical trial

Surgeonsuse absorbable and nonabsorbable sutures for epidermal wound closure. No large, randomized studies have compared the effect of these suture types on facial scar appearance. To assess postsurgical facial scar appearance using either rapidly absorbable polyglactin 910 or nylon for epidermal closure. Randomized, blinded, split-scar clinical trial. A total of 105 patients with facial wounds resulting from Mohs micrographic surgery excisions were randomly assigned for epidermal closure with rapidly absorbable 5-0 polyglactin 910 (Vicryl Rapide) on one half of the repair and 5-0 nylon (Ethilon) on the other half. Two physicians (1 dermatologist and 1 plastic surgeon), unaware of the original suture location, examined photographs of each healed wound at 6months after surgery and graded the appearance of each half of the scar using the visual analog scale, wound evaluation scale, and Stony Brook Scar Evaluation Scale. At 6months, there was no significant difference in the combined mean (standard deviation) visual analog scale scores (83.1 [14.2] and 83.0 [13.7]), Stony Brook Scar Evaluation Scale scores (4.3 [0.9] and 4.4 [0.9]), or wound evaluation scale scores (5.3 [1.1] and 5.2 [1.1]) for rapidly absorbable polyglactin 910 versus nylon (P=.72, .57, and .21, respectively). Single institution. Both rapidly absorbable polyglactin 910 and nylon sutures placed through the epidermis resulted in an equivalent photographic appearance of facial scars at 6months after surgery.