Wound Suture Research Articles

Suturing techniques

The act of suturing wounds on the skin has been done for thousands of years. Closing dead space, supporting and strengthening wounds until healing increases their tensile strength, approximating skin edges for an esthetically pleasing and functional result, and minimizing the risks of bleeding and infection remain the primary goals of suture techniques, even though suture materials and techniques have changed. A well-planned closure or flap may have its post-operative appearance jeopardized if the wrong suture technique is used or if the procedure is not performed well. On the other hand, poor surgical skills cannot entirely be made up for by careful suturing. Poor incision placement with respect to relaxed skin tension lines, excessive removal of tissue, or inadequate undermining may limit the surgeon’s options in wound closure and suture placement. Gentle handling of the tissue is also important to optimize wound healing. The choice of suture technique depends on the type and anatomic location of the wound, thickness of the skin, degree of tension, and desired cosmetic result. Proper placement of sutures enhances the precise approximation of the wound edges, which helps minimize and redistribute skin tension. Wound eversion is essential to maximize the likelihood of good epidermal approximation. Eversion is desirable to minimize the risk of scar depression secondary to tissue contraction during healing. Usually, inversion is not desirable, and it probably does not decrease the risk of hypertrophic scarring in an individual with a propensity for hypertrophic scars. To maximize the esthetic and functional outcomes, dead space must be removed, natural anatomic shapes must be restored, and stitch marks must be minimized. This page describes the methods for placing sutures for different kinds of stitches, goes over why certain suture techniques are better than others and goes over the benefits and drawbacks of each suture technique. For the best possible closure of a wound, multiple suture techniques are frequently required. After reading this article, the reader ought to comprehend the basic techniques for inserting each type of suture as well as how and why specific sutures are selected.

029. Management of Injury to The Right Lung Due to Penetrating Trauma to The Chest: A Case Report

Background: Thoracic trauma is a significant cause of mortality, in fact, many patients with thoracic trauma die after reaching the hospital. However, many of these deaths can prevented with prompt diagnosis and treatment. Less than 10% of blunt chest injuries and only 15 to 30% of penetrating chest injuries require operative intervention. Most patients who sustain thoracic trauma can be treated by technical procedures within the capabilities of trained clinicians. Case: We reported a case of 44-year-old female having a penetrating wound in her left chest because of her ex-husband stabbed her with a knife. The patient felt pain and the vital signs were stable, from the physical examination there were no abnormalities found. The surgeons did anterior thoracotomy and evacuated the knife within 2 hours since the patient arrived in the ER, and turned out the knife injured the right lung and there was bronchopleural fistula appeared. The surgeons did repair of the fistula and debridement of the wound and primary suturing carried out. The patient discharged 3 days after hospitalized with good clinical condition. Conclusion: This case report presents a successful management of a stable patient with penetrating chest trauma.

Multifunctional Analgesic Sutures from Microfluidic Spinning Technology.

Sutures are the most commonly used wound repair method after surgery. However, addressing delayed recovery and pain management remains a significant challenge. Here, microfibers are developed from microfluidic spinning with long-lasting analgesia capabilities for sutures. By using a solvent extraction manner, the polycaprolactone (PCL) microfibers encapsulated with ropivacaine (ROP), a well-known analgesic, can be continuously obtained from microfluidics. The intrinsic property of PCL and the advantage of microfluidic spinning technique impart the microfiber with highly controlled morphologies, mechanical strengths, as well as drug release. After exploring their biocompatibility both at in vitro and in vivo levels, the microfibers are directly applied to wound suture. The results demonstrate the lasting analgesic effect of the microfiber on mice with incision pain, highlighting its potential as promising suture for post-surgery treatments. It is anticipated that the multifunctional analgesic sutures produced through microfluidic spinning will pave the way for utilizing fibers as effective sutures in clinical incision wound treatment.

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.

Penyuluhan Tentang Manajemen Nyeri Dengan Analgetik Narkotik Pada Pasien Pasca Anestesi Umum

Introduction: Pain is a form of sensory and emotional experience that is not unpleasant sensations associated with tissue damage or likely to occur tissue damage. Surgery or surgery is an invasive treatment action through incisions to open or display the part of the body to be dealt with and end with wound closure and suturing. With this surgery a person will experience pain both before and after surgery. One way to treat pain is using Post-surgical pain management techniques using pharmacological therapy. Opioids are a group of drugs that have properties like opium or morphine Objective: Service Activities to the Community (PKM) aims to help increase knowledge about the effects side effects of narcotic analgesics Method: This PKM is carried out by providing counseling education using leaflets and audio visuals for preoperative patients using general techniques anesthesia as many as 30 respondents. Result: level of knowledge about pain management with narcotic analgesics in patients after general anesthesia in the good category before administration education by 17%, Sufficient by 47%, Less by 37%, After providing education increased by 100%. Conclusion: After providing education, the respondent's level of knowledge increased by 100%.

Mastectomy in ten mares: indications, surgical technique, complications, and long-term outcome.

To describe the indications for and surgical technique of mastectomy of mares and to describe the outcome of 10 mares that underwent mastectomy in a retrospective case series. 10 mares having disease of one or both mammary glands. Medical records (1995 to 2022) from 2 university teaching hospitals were searched to identify mares that had undergone unilateral or bilateral mastectomy. Data regarding history, signalment, diagnostic tests, preoperative treatment, surgical procedure, and postoperative management were reviewed. Follow-up information was obtained by interviewing the owners by telephone. One (n = 4 mares) or both mammary glands (6 mares) were excised for the following reasons: chronic bacterial mastitis (4), neoplasia (3), lymphangiectasia (1), pythiosis (1), and lymphoid hamartoma (1). None of the mares experienced intraoperative complications. The surgical site was closed primarily in 2 mares and left unsutured in 8 mares. Both sutured wounds developed a seroma, and 1 dehisced. The owners reported that the surgical wound, whether sutured or unsutured, was healed within 3 months. All mares returned to use for their intended purpose, but 3 mares were euthanized 2 to 4 years after surgery due to progression of disease. One mare drowned 1 year after discharge. Mastectomy can be an effective treatment for mares suffering from disease of one or both mammary glands when the mare is refractory to medical treatment.

A Prospective Randomized Controlled Study of Stratafix versus Standard-of-Care for Deep Tissue Closure in Orthopedic Surgery.

Orthopedic deep surgical incisions require the approximation of 1 or multiple tissue layers. This prospective randomized controlled study aimed to assess the usefulness and effectiveness of a barbed suture technique (Stratafix symmetric PDS plus) versus the conventional interrupted knotted suture technique for deep tissue closure in orthopedic surgery by comparing deep fascia suture time, relative cost, and wound-related complications. A total of 254 patients with deep surgical incisions who underwent orthopedic surgery between October 1, 2020, and June 30, 2021, were recruited. Their general characteristics (age, sex, weight, height, body mass index, American Society of Anesthesiologists physical status score, total operation time, and length of deep incision) and factors related to deep incision wounds (suture type and number, wound closure time, and operation site outcomes) were collected. The general characteristics did not differ between the Stratafix and conventional groups. There were no between-group differences observed in total operation time or total anesthesia time. The wound suture times differed significantly. In the conventional group, the suture time per unit length was lower in the group with the length of deep incision under 20 cm but did not differ significantly for each wound size. In the Stratafix group, the suture time per unit length was lower in the group under 15 cm, with the shortest time observed for 10-14.9 cm, followed by 5.0-9.9 cm and the group under 5 cm. The conventional group developed 4 cases of superficial wound infection or surgical wound necrosis. One case of protruded suture tap occurred in the Stratafix group. The average suture time per unit length increased for lengths under 5 cm as barbed sutures required more time from the start of the first suture to finish of the last suture. There was no significant benefit for very short suture length. One barbed suture material allows a suture of approximately 10-12 cm; sutures beyond that require more time because the surgeon has to start again. The Stratafix group used less suture material than the conventional group.

Open management of rectal wound after transanal endoscopic microsurgery: randomized prospective study

INTRODUCTION: the wound following Transanal Endoscopic Microsurgery (TEM) is traditionally closed by suturing. However, some studies suggest that leaving the wound open after TEM might be a viable alternative. STUDY OBJECTIVE: to compare two methods of managing rectal wounds in patients after TEM. PATIENTS AND METHODS: patients were divided into 2 groups: the main group (open wound management) and the control group (suture wound management). The primary endpoint of the study was the morbidity rate. The secondary endpoints included the need and duration of antibacterial therapy, post-op hospital stay, the severity of the inflammatory response, the wound healing time and the quality of life. RESULTS: from November 2021 to November 2023, 177 patients were included in the randomized study: 68 in the open wound management group and 109 in the suture wound group. The analysis included 50 patients in eachgroup. It was found that the operation time in the main group was significantly shorter (30 (20; 40) minutes versus 55 (40; 60), p &lt; 0.0001). The infectious complications rate was lower in the open wound management group: 11/50 (22 %) versus 16/50 (32 %), p = 0.26; the postoperative bleeding rate was higher: 4/50 (8 %) versus 2/50 (4 %), p = 0.7. Post-op hospital stay did not differ: 6 (4;7) days versus 6 (5; 7), p = 0.22. The duration of antibiotic therapy for infectious complications was longer in the open wound management group: 6 (5;6) days versus 5 (5;6.5), p = 0.02. In the case of infectious complication the inflammatory response was higher in the group of the open wound management: white blood cell counts (15.9 (14.3; 19.5) × 109/L versus 13.1 (12; 15.6) × 109/L, p = 0.01) and temperature (38.6 ± 0.7 °C versus 38 ± 0.6 °C, p = 0.02). Wounds in both groups healed by the 30th day, and the quality of life did not differ between groups. CONCLUSION: the results of the randomized study demonstrated the efficacy and safety of open rectal wound management after TEM.

Pediatric facial trauma management: Emergency case in a toddler

Background: Facial soft tissue trauma cases are often encountered in the emergency room. Soft tissue trauma, especially to the face, is rarely life threatening. It varies in shape, size, and depth and can also affect surrounding organs. The treatment of soft tissue trauma can be complicated and may have a significant impact on facial function and, especially, facial aesthetics. Children are easily injured due to their active nature. Soft tissue trauma to the faces of toddlers is challenging even for experienced surgeons; however, wound debridement and suture management under general anesthesia should be considered. Purpose: The aim of this article is to deliver a thorough overview of the evaluation and treatment of soft tissue injuries in children, covering initial assessments, physical examinations, the application of antimicrobial therapies, and preparation for surgical procedures. Case: An 11-month-old girl went to the emergency department of Hasan Sadikin General Hospital, Bandung, with injuries to her left cheek and upper left lip sustained when she fell, and her face hit the edge of a cement pot at home. There was no history of unconsciousness, nausea and vomiting. The injury was diagnosed as vulnus laceratum of the left face and upper lip region. Case management: Emergency management was carried out by triage, Tetagam injection, and early wound debridement and suture under general anesthesia because the patient was uncooperative. Wounds on the face and lips were primary sutured layer by layer, returning the wound edges to their normal anatomical position. Conclusion: The management of facial soft tissue injuries in toddlers requires general anesthesia for adequate and accurate wound debridement and suture, so that functional and aesthetic effects can be satisfactorily obtained.

Objective Comparison of the First-Person-View Live Streaming Method Versus Face-to-Face Teaching Method in Improving Wound Suturing Skills for Skin Closure in Surgical Clerkship Students: Randomized Controlled Trial.

The use of digital online teaching media in improving the surgical skills of medical students is indispensable, yet it is still not widely explored objectively. The first-person-view online teaching method may be more effective as it provides more realism to surgical clerkship students in achieving basic surgical skills. This study aims to objectively assess the effectiveness of the first-person-view live streaming (LS) method using a GoPro camera compared to the standard face-to-face (FTF) teaching method in improving simple wound suturing skills in surgical clerkship students. A prospective, parallel, nonblinded, single-center, randomized controlled trial was performed. Between January and April 2023, clerkship students of the Department of Surgery, Pelita Harapan University, were randomly selected and recruited into either the LS or FTF teaching method for simple interrupted suturing skills. All the participants were assessed objectively before and 1 week after training, using the direct observational procedural skills (DOPS) method. DOPS results and poststudy questionnaires were analyzed. A total of 74 students were included in this study, with 37 (50%) participants in each group. Paired analysis of each participant's pre-experiment and postexperiment DOPS scores revealed that the LS method's outcome is comparable to the FTF method's outcome (LS: mean 27.5, SD 20.6 vs FTF: mean 24.4, SD 16.7; P=.48) in improving the students' surgical skills. First-person-view LS training sessions could enhance students' ability to master simple procedural skills such as simple wound suturing and has comparable results to the current FTF teaching method. Teaching a practical skill using the LS method also gives more confidence for the participants to perform the procedure independently. Other advantages of the LS method, such as the ability to study from outside the sterile environment, are also promising. We recommend improvements in the audiovisual quality of the camera and a stable internet connection before performing the LS teaching method.

Intravenous Sedation and Analgesia in a Pediatric Emergency Department: A Retrospective Descriptive Study.

Background Painful procedures in the pediatric emergency department often require the use of sedation and analgesia to ensure adequate pain control, a right of children and adolescents. This study aims to describe the procedural sedation and analgesia with intravenous medications performed in a pediatric emergency department. Methods This is a retrospective descriptive study of intravenous sedoanalgesia used in a pediatric emergency department of a level II district hospital in the Lisbon metropolitan area from October 2018 to December 2023. The type of intervention, drugs used, and adverse events were analyzed. Results A total of 615 patients were included in the study; 65.7% (n=404) were male with a median age of 6 years. The most frequently performed procedures were wound suturing (50.9%, n=313) and fracture reduction (36.3%, n=223). The drugs used for sedation and analgesia were ketamine (99.2%, n=610), midazolam (95.8%, n=589), propofol (1.6%, n=10), and morphine (0.5%, n=3). The majority of patients received midazolam and ketamine in association (93.8%, n=577). A total of 50 adverse events (8.1%) were recorded in 42 patients. The most frequent side effects were transient oxygen desaturation (2%, n=12), vomiting (1.5%, n=9), apnea/bradypnea (1%, n=6), and hallucinations (0.8%, n=5). The occurrence of adverse events was not dose-dependent (p >0.05). Respiratory complications resolved without requiring invasive interventions. Children were sedated by a pediatric intensivist in 68.1% (n=419), by a general pediatrician in 26.7% (n=164), and by a pediatric resident in 2% (n=12). Conclusions The results of this study demonstrate that intravenous sedoanalgesia, particularly the combination of ketamine and midazolam, is a safe method for sedation in pediatric patients, with a low rate of adverse events.

Prevention of the development of diastasis of the wound edges during two-stage breast reconstruction

The main problem of breast reconstruction after a mastectomy is the complete destruction of all structural elements of the breast and the lack of integumentary tissues that do not allow carrying out one-stage breast reconstruction. To solve this problem, usually performing a two-stage reconstruction, which today is the most commonly used method of breast reconstruction. The peculiarity of this method is that after removal of the expander, during the second stage of reconstruction, some retraction of the skin and a decrease in the area of the prepared skin cover are observed. Thus, after installing a permanent implant and suturing the surgical wound, the skin sheath is tightened around the installed endoprosthesis, while the greater the retraction of the skin, the more pronounced the tension appears and, accordingly, the load on the sutured wound increases. As a result, the risks of developing diastasis of the wound edges with the exposure of the endoprosthesis increase, which leads to the need to remove the implant. Therefore, when carrying out the second stage of breast reconstruction, a very important moment of the operation is the suturing of the postoperative wound, the competent implementation of which allows the prevention of implant extrusion.

Post-procedural infection rate after minor surgical procedures performed with and without sterile gloves: a systematic review and meta-analysis.

Post-procedural infection has been a top priority for the perioperative team. The use of sterile gloves to counter this became popular and was routinely used, but randomized studies have shown that the benefit that was thought to be added by the use of sterile gloves is insignificant and that not all procedures require the use of sterile gloves. Prospective protocol registration was and electronic databases were searched without using any search filters. Screening was performed by independent reviewers, and data was extracted from selected studies. Heterogeneity was assessed by the I2 test, and the effect model was chosen accordingly. The odds ratio was used as an effect measure as the variables in this study were dichotomous. Forest plots and funnel plots were used to give visual feedback. This meta-analysis included 14 comparative studies that involved a total of 12625 patients. Analysis of post-procedural infection outcome showed no significant difference between the procedure performed using sterile gloves and without using sterile gloves (OR: 0.88; 95% CI: 0.71-1.10; n=12625; I2=0%; P-value=0.26). Sensitivity analysis and subgroup analysis for randomized studies only, surgical site infection, and patients that did not receive prophylactic antibiotics showed no variations. The use of sterile gloves did not show any extra benefit for controlling infection during wound repair, excision and suturing, cystoscopy, and urinary catheterization. The use of sterile gloves does not have any extra benefit for preventing infections when minor surgical procedures are performed.

Tissue Adhesive versus Skin Suture plus Waterproof Wound Dressings for Carpal Tunnel Wound Closure: A Prospective Randomized Controlled Trial.

The popular wound closure methods for carpal tunnel decompression (CTD) include non-absorbable and absorbable sutures which have comparable results in clinical outcomes. However, these wound closure methods are recommended to keep a wound dry which may limit some ADLs. We conducted a prospective randomized controlled trial that compares clinical outcomes and cost-effectiveness in a skin closure following CTD between absorbable sutures plus a 2-octyl cyanoacrylate tissue adhesive (2OCA) versus non-absorbable skin sutures plus a waterproof dressing (NSPWD). We enrolled 120 patients undergoing CTD into two groups: 2OCA and NSPWD, with 60 patients in each group. Number of dressing changes, Quick DASH, pain VAS, cosmetic VAS, patient satisfaction VAS, and Hollander wound evaluation score, cost-effectiveness, and post-operative complications were collected at pre-operative period and two and six weeks post-operatively. Slightly better patient satisfaction VAS (7.9 vs 7.2, p=0.018) and cosmetic VAS (8.0 vs 7.2, p=0.025) were observed in 2OCA at 2 weeks. Meanwhile, NSPWD revealed lesser times of dressing change (Median, mode, IQR: 0/0/0 vs 2/3/2, p<0.001). The total wound-related costs include dressing change and suture removal cost ($15.9 for 2OCA vs $19.2 for NSPWD, p=0.002) although an initial wound-related cost in 2OCA was higher ($15.7/case vs $7.9/case, p<0.001). Our study revealed that the supplementary tissue adhesive to absorbable sutures following CTD could reduce total wound-related costs while clinical outcomes might not be considered clinically significant.

Comparison of the wound healing and complications of zipper type closure adhesive tape and stapler for surgical wound suture: A randomized control, single-centre, open-label trial.

Xkin closure is a newly developed medical suture device for lacerations and surgical wounds that can reduce scarring, pain and the risk of infection compared with conventional sutures or staplers. A randomized controlled study was performed to compare the wound healing effects and complications of Xkin closure with stapler closure. Fifty patients who underwent robot-assisted radical prostatectomy for prostate cancer were randomly assigned. Only the wound above the navel, which was extended to take out the prostate was targeted. The wound was examined at 2, 6 and 12 weeks after surgery, and the modified Vancouver Scar Scale (mVSS), scar height and side effects were assessed with a 3D skin analyser. Forty-six patients (23 Xkin, 23 Stapler) were analysed. The mVSS scores, vascularity and pliability were significantly lower in the Xkin group compared with the stapler group at the 12-week follow-up. No significant differences in the maximum peak and depth of the scars were detected between the two groups using 3D photographs at 12 weeks. Xkin is an effective wound closure method for improving scar outcomes. This method is expected to be widely used for surgical wounds and lacerations caused by trauma in daily life.

Asuhan Kebidanan Post Partum Fisiologi di Puskesmas Takalala

The postpartum period is the period after the birth of the placenta and lasts until the uterus regains its pre-pregnancy size known as the postpartum period. The postpartum period is the time after the placenta is born until the reproductive organs recover. That lasted for about six weeks. The aim of this research is to apply physiological post partum midwifery care to Mrs "R" on the 14th day at the Takalala Community Health Center. The care provided uses Varney's 7 Step Midwifery Care Management and forms of documentation via SOAP. The case study conducted on Mrs "R" explained that there were no difficulties when implementing Varney's 7 Step Midwifery Care Management approach. So, it makes it easier for caregivers to solve problems related to this. The form of midwifery care provided to Ny'R" includes taking anamnesis on the mother, carrying out a physical examination, and providing counseling to the mother and family, in this case to Ny"R: regarding the effective care of ruptured perineal suture wounds. This case study uses a descriptive observational method with a Continuity of Care approach. The subject is Mrs "R" post partum mother on day 14. How to collect anamnestic data, observation, examination and documentation. Next, compare the data obtained with existing theory.

Jugulocarotid Trauma in Civil Practice: About Three (3) Cases

Introduction: jugulocarotid trauma is rare and serious. They can be immediately life-threatening due to the impact of serious hemorrhage or obstruction of the upper airways. Objective: The objective of this work is to describe the clinical and therapeutic aspects of these lesions. Observations: The time taken to treat our patients was less than 12 hours in all our patients. A pressure dressing was placed in two patients. All our patients benefited from a preoperative assessment with Rh grouping and possibly a blood transfusion as needed. Exploratory cervicotomy was performed in all patients with, as appropriate, repair or ligation of the internal jugular vein and suture of the carotid wounds. All patients received antithrombotic treatment, antibiotic prophylaxis and analgesic treatment at the end of the procedure. The postoperative course was simple in all cases. Conclusion: vascular wounds of the neck constitute an emergency. Prehospital care is an essential step in the management of these lesions. Faced with massive hemorrhage, only immediate surgical exploration associated with resuscitation measures determines the survival of patients. In other cases, an imaging assessment may be necessary in stable patients.

The Use of Barbed Sutures in Total Hip Arthroplasty: A Systematic Review on Clinical-Surgical Outcomes, Costs, and Complications.

Total hip arthroplasty is among the most successful procedures in orthopaedic surgery. As the total number of total hip arthroplasties is constantly rising and it is expected to further increase, efforts oriented to optimise surgical pathways are investigated, aiming to reduce complications and diminish costs. The wound suturing phase is one of the steps that may be addressed. Barbed sutures have proved to reduce surgical times and enhance suture stability, then reducing wound-related complications in many surgical fields. The evidence on the use of this technology in total hip arthroplasty is still sparse, and its effect on patient outcomes and costs must still be clarified. A systematic search of studies published from 1 January 2000 to 1 March 2023 was performed. Two authors independently reviewed the literature available in eight electronic databases to identify papers eligible for inclusion. A total of nine studies investigating 6959 procedures on 6959 patients were included in the final analysis. Five studies were randomised controlled trials, and the overall quality of studies ranged from moderate to high. The mean age of patients ranged from 43.8 to 70 years. BMI ranged from 25 to 31.9 kg/m2. The mean follow-up of studies ranged from 3 to 6 months. Evidence included in the systematic review suggested that the use of barbed sutures is associated with lower suturing times, complication rates, and overall costs when compared to the use of traditional suturing techniques. II, systematic review of level I and II studies.

Powerful Antibacterial for Wound Healing using Betel Leaf Extract

This study investigates the antibacterial properties of betel leaf (Piper Betle L) extract on suture wound infections caused by Staphylococcus aureus. Using 25 Webster mice divided into five groups, the research compared the healing effects of 5%, 10%, and 15% betel leaf extract against a control group and a gentamicin antibiotic group over 8 days. Results, measured with the REEDA scale, indicated that the 15% extract was most effective, achieving optimal healing by the eighth day. These findings suggest that betel leaf extract, particularly at higher concentrations, could serve as a potent alternative to traditional antibiotics for treating bacterial wound infections. Highlights: 15% Extract Most Effective: Achieved complete healing by eighth day. Comparative Study: Betel leaf extract vs. control and gentamicin. Antibacterial Alternative: Potential for treating bacterial wound infections. Keywords: Betel leaf extract, Piper Betle L, wound infection, Staphylococcus aureus, antibacterial

Surgical treatment of pilonidal disease - Short-term follow up results of minimally invasive pit-picking surgery versus radical excision without suturing: A prospective randomised trial

BackgroundIn this study we compared the potential benefits of surgical treatments for chronic symptomatic pilonidal disease (PD) - minimally invasive pit-picking surgery and radical excision without wound suturing. Materials and methodsA total of 100 adult patients with chronic symptomatic PD were enrolled in this study at the Kaunas Hospital of the Lithuanian University of Health Sciences. They were randomly divided into two groups: pit-picking surgery (n = 50) and radical excision with open healing (n = 50). Recurrent PD patients were not excluded. The comparison of the techniques was based on pain within the first postoperative week, failed surgery rates, and wound healing time. Additionally, pain levels at different time intervals following the treatment, analgesic consumption, and time off work, were assessed and compared. ResultsA total of 89 patients (89 %) were available for follow-up after 6 months. Pain levels the first postoperative week were significantly lower in the pit-picking group compared to the radical excision group, with median scores of 10.0 and 20.0, respectively (p = 0.002). The complete wound healing time was longer in the radical excision group (60 days) versus the pit-picking group (17 days), with a significant difference noted (p = 0.00). No significant difference was observed between the type of surgery and the rate of failed surgery, with 5 (11.9 %) cases in the pit-picking group and 4 (8.5 %) in the radical excision group. ConclusionBased on our short-term findings, minimally invasive pit-picking surgery is a better option regarding pain, wound healing time and failed surgery rate. In cases where this approach is not suitable, other alternatives should be contemplated, as radical surgery without wound suturing should not be employed as a treatment method for PD. Additionally, the relationship between PD and recurrence rates should be investigated further.