AIM: To report a systematic review of published randomized controlled trials(RCTs) investigating the role of absorbable suture(AS) against non-AS(NAS) used for the closure of surgical incisions.METHODS: RCTs investiga...AIM: To report a systematic review of published randomized controlled trials(RCTs) investigating the role of absorbable suture(AS) against non-AS(NAS) used for the closure of surgical incisions.METHODS: RCTs investigating the use of AS vs NAS for the closure of surgical incisions were statistically analysed based upon the principles of meta-analysis and the summated outcomes were represented as OR.RESULTS: The systematic search of medical literature yielded 10 RCTs on 1354 patients. Prevalence of wound infection(OR = 0.97; 95%CI: 0.56, 1.69; Z = 0.11; P = 0.92) and operative morbidity(P = 0.45) was comparable in both groups. Nonetheless, the use of AS lead to lower risk of wound break-down(OR = 0.12; 95%CI: 0.04, 0.39; Z = 3.52; P 【 0.0004).CONCLUSION: This meta-analysis of 10 RCTs demonstrates that the use of AS is similar to NAS for skin closure for surgical site infection and other operative morbidities. AS do not increase the risk of skin wound dehiscence,rather lead to a reduced risk of wound dehiscence compared to NAS.展开更多
Objective To observe the degradability of absorbable sutures in tendon grafts and the histology of tendon healing in a rabbit model.Methods Semitendinosus tendons were harvested from 15 healthy adult New Zealand rabbi...Objective To observe the degradability of absorbable sutures in tendon grafts and the histology of tendon healing in a rabbit model.Methods Semitendinosus tendons were harvested from 15 healthy adult New Zealand rabbits in this study.展开更多
Aim:Patients with cleft lip usually undergo multiple procedures that require hospitalization resulting in emotional stress to their family members.Young patients often require sedation or general anesthesia(GA)for sut...Aim:Patients with cleft lip usually undergo multiple procedures that require hospitalization resulting in emotional stress to their family members.Young patients often require sedation or general anesthesia(GA)for suture removal on a sensitive area to prevent disruption of the repair.In this study,we compared absorbable and nonabsorbable sutures for primary cleft lip repair.Methods:Patients with cleft lip who presented to Smile Train Unit,Child Hospital and Research Institute,Nagpur,India,were randomly assigned to two groups and underwent surgical repair using either Vicryl Rapid suture(Group 1)or Prolene suture(Group 2).Patients were followed up at 1 month,6 months,and 1 year.Photographs of the patients were obtained at these visits and rated using a validated 100-mm cosmesis visual analogue scale(VAS)by three people(social worker,surgeon,and patient’s mother).A VAS score of 15 mm or greater was considered as clinically important difference.Results:A total of 60 patients were enrolled in this study,and they were equally divided into two groups.There was no difference in age,race,sex,wound length,number of sutures,and layered repair rates between the groups.The average age of the patient was 3 months.There was no significant difference in the rates of infection which was 6%in this study,wound dehiscence,and hypertrophic scar formation.No significant difference was found in cosmetic outcome in both the mean VAS score of 90.3 in Group 1 and 91.7 in Group 2.Conclusion:Absorbable sutures are a viable alternative to nonabsorbable sutures in the repair of primary cleft lip repair.We prefer absorbable sutures because they do not require removal under GA or sedation.展开更多
AIM: To determine whether absorbable sutures or non-absorbable sutures are better in preventing surgical site infection (SSI), in this paper we discuss the results of a randomized clinical trial which examined the typ...AIM: To determine whether absorbable sutures or non-absorbable sutures are better in preventing surgical site infection (SSI), in this paper we discuss the results of a randomized clinical trial which examined the type of sutures used during hepatectomy. METHODS: All hepatic resections performed from January 2007 to November 2008 at the Department of Surgery at Iizuka Hospital in Japan were included in this study. There were 125 patients randomly assigned to an absorbable sutures (Vicryl) group or non-absorbable sutures (Silk) group. RESULTS: SSI was observed in 13.6% (17/125) patients participating in this study, 11.3% in the Vicryl group and 15.8% in the Silk group. Incisional SSI including superficial and deep SSI, was observed in 8% of the Vicryl group and 9.5% of the Silk group. Organ/ space SSI was observed in 3.2% of the Vicryl group and 6.0% of the Silk group. There were no significant differences, but among the patients with SSI, the period for recovery was significantly shorter for the Vicryl group compared to the Silk group.CONCLUSION: The incidence of SSI in patients receiving absorbable sutures and silk sutures is not significantly different in this randomized controlled study; however, the period for recovery in patients with SSI was significantly shorter for absorbable sutures.展开更多
Background The primary objective of this multicenter post-market study was to compare the cosmetic outcome of triclosan-coated VICRYL＊ Plus sutures with Chinese silk sutures for skin closure of modified radical maste...Background The primary objective of this multicenter post-market study was to compare the cosmetic outcome of triclosan-coated VICRYL＊ Plus sutures with Chinese silk sutures for skin closure of modified radical mastectomy. A secondary objective was to assess the incidence of surgical site infection （SSI）.Methods Patients undergoing modified radical mastectomy were randomly assigned to coated VICRYL＊ Plus antibacterial （Polyglactin 910） suture or Chinese silk suture. Cosmetic outcomes were evaluated postoperatively at days 12 （±2） and 30 （±5）, and the evidence of SSI was assessed at days 3, 5, 7, 12 （±2）, 30 （±5）, and 90 （±7）. Cosmetic outcomes were independently assessed via visual analogue scale （VAS） score evaluations of blinded incision photographs （primary endpoint） and surgeon-assessed modified Hollander Scale （mHCS） scores （secondary endpoint）. SSI assessments used both CDC criteria and ASEPSIS scores.Results Six Chinese hospitals randomized 101 women undergoing modified radical mastectomy to closure with coated VICRYL＊ Plus suture （n=51） or Chinese silk suture （n=50）. Mean VAS cosmetic outcome scores for antibacterial suture （67.2） were better than for Chinese silk （45.4） at day 30 （P 〈0.0001））. Mean mHCS cosmetic outcome total scores, were also higher for antibacterial suture （5.7） than for Chinese silk （5.0） at day 30 （P=0.002）.Conclusions Patients using coated VICRYL＊ Plus suture had significantly better cosmetic outcomes than those with Chinese silk sutures. Patients using coated VICRYL＊ Plus suture had a lower SSI incidence compared to the Chinese silk sutures, although the difference did not reach statistical significance. （ClinicalTrials.gov NCT 00768222）展开更多
Aim:The primary author previously described his technique for periareolar closure in mastopexy using a pinwheel interlocking purse string with absorbable barbed suture and now reports the results of a retrospective ph...Aim:The primary author previously described his technique for periareolar closure in mastopexy using a pinwheel interlocking purse string with absorbable barbed suture and now reports the results of a retrospective photometric analysis comparing this technique with the same closure using Gortex®suture.This study is designed to compare the degree of areolar widening and safety profile of using absorbable barbed sutures for periareolar closure versus permanent smooth suture.Methods:A retrospective chart review was conducted of all patients whose periareolar closures were performed using an interlocking purse-string technique over a 10-year period.Only patients undergoing circumvertical mastopexy were included.All had photometric evaluation and follow-up performed within 6-24 months.Results:In total,20 patients(40 areolas),which were closed with absorbable barbed suture,were analyzed photometrically.In this suture group,areola size increased a mean of 4.9%from baseline,and no complications(0%)were observed.This compared favorably with previously reported complication rates using permanent sutures and with a series of cases presented herein in which permanent smooth suture was used for purse string closure.The degree to which absorbable barbed suture controls areolar spread was shown to be significantly better than those where permanent smooth purse string techniques were employed.Conclusion:Circumvertical mastopexy closures using absorbable barbed suture was shown to be safe and effective and compared favorably to older techniques using permanent smooth suture for similar closures.This paper lends support to the safety of using absorbable barbed suture in circumareolar closures to limit areolar spread.展开更多
文摘AIM: To report a systematic review of published randomized controlled trials(RCTs) investigating the role of absorbable suture(AS) against non-AS(NAS) used for the closure of surgical incisions.METHODS: RCTs investigating the use of AS vs NAS for the closure of surgical incisions were statistically analysed based upon the principles of meta-analysis and the summated outcomes were represented as OR.RESULTS: The systematic search of medical literature yielded 10 RCTs on 1354 patients. Prevalence of wound infection(OR = 0.97; 95%CI: 0.56, 1.69; Z = 0.11; P = 0.92) and operative morbidity(P = 0.45) was comparable in both groups. Nonetheless, the use of AS lead to lower risk of wound break-down(OR = 0.12; 95%CI: 0.04, 0.39; Z = 3.52; P 【 0.0004).CONCLUSION: This meta-analysis of 10 RCTs demonstrates that the use of AS is similar to NAS for skin closure for surgical site infection and other operative morbidities. AS do not increase the risk of skin wound dehiscence,rather lead to a reduced risk of wound dehiscence compared to NAS.
文摘Objective To observe the degradability of absorbable sutures in tendon grafts and the histology of tendon healing in a rabbit model.Methods Semitendinosus tendons were harvested from 15 healthy adult New Zealand rabbits in this study.
文摘Aim:Patients with cleft lip usually undergo multiple procedures that require hospitalization resulting in emotional stress to their family members.Young patients often require sedation or general anesthesia(GA)for suture removal on a sensitive area to prevent disruption of the repair.In this study,we compared absorbable and nonabsorbable sutures for primary cleft lip repair.Methods:Patients with cleft lip who presented to Smile Train Unit,Child Hospital and Research Institute,Nagpur,India,were randomly assigned to two groups and underwent surgical repair using either Vicryl Rapid suture(Group 1)or Prolene suture(Group 2).Patients were followed up at 1 month,6 months,and 1 year.Photographs of the patients were obtained at these visits and rated using a validated 100-mm cosmesis visual analogue scale(VAS)by three people(social worker,surgeon,and patient’s mother).A VAS score of 15 mm or greater was considered as clinically important difference.Results:A total of 60 patients were enrolled in this study,and they were equally divided into two groups.There was no difference in age,race,sex,wound length,number of sutures,and layered repair rates between the groups.The average age of the patient was 3 months.There was no significant difference in the rates of infection which was 6%in this study,wound dehiscence,and hypertrophic scar formation.No significant difference was found in cosmetic outcome in both the mean VAS score of 90.3 in Group 1 and 91.7 in Group 2.Conclusion:Absorbable sutures are a viable alternative to nonabsorbable sutures in the repair of primary cleft lip repair.We prefer absorbable sutures because they do not require removal under GA or sedation.
文摘AIM: To determine whether absorbable sutures or non-absorbable sutures are better in preventing surgical site infection (SSI), in this paper we discuss the results of a randomized clinical trial which examined the type of sutures used during hepatectomy. METHODS: All hepatic resections performed from January 2007 to November 2008 at the Department of Surgery at Iizuka Hospital in Japan were included in this study. There were 125 patients randomly assigned to an absorbable sutures (Vicryl) group or non-absorbable sutures (Silk) group. RESULTS: SSI was observed in 13.6% (17/125) patients participating in this study, 11.3% in the Vicryl group and 15.8% in the Silk group. Incisional SSI including superficial and deep SSI, was observed in 8% of the Vicryl group and 9.5% of the Silk group. Organ/ space SSI was observed in 3.2% of the Vicryl group and 6.0% of the Silk group. There were no significant differences, but among the patients with SSI, the period for recovery was significantly shorter for the Vicryl group compared to the Silk group.CONCLUSION: The incidence of SSI in patients receiving absorbable sutures and silk sutures is not significantly different in this randomized controlled study; however, the period for recovery in patients with SSI was significantly shorter for absorbable sutures.
文摘Background The primary objective of this multicenter post-market study was to compare the cosmetic outcome of triclosan-coated VICRYL＊ Plus sutures with Chinese silk sutures for skin closure of modified radical mastectomy. A secondary objective was to assess the incidence of surgical site infection （SSI）.Methods Patients undergoing modified radical mastectomy were randomly assigned to coated VICRYL＊ Plus antibacterial （Polyglactin 910） suture or Chinese silk suture. Cosmetic outcomes were evaluated postoperatively at days 12 （±2） and 30 （±5）, and the evidence of SSI was assessed at days 3, 5, 7, 12 （±2）, 30 （±5）, and 90 （±7）. Cosmetic outcomes were independently assessed via visual analogue scale （VAS） score evaluations of blinded incision photographs （primary endpoint） and surgeon-assessed modified Hollander Scale （mHCS） scores （secondary endpoint）. SSI assessments used both CDC criteria and ASEPSIS scores.Results Six Chinese hospitals randomized 101 women undergoing modified radical mastectomy to closure with coated VICRYL＊ Plus suture （n=51） or Chinese silk suture （n=50）. Mean VAS cosmetic outcome scores for antibacterial suture （67.2） were better than for Chinese silk （45.4） at day 30 （P 〈0.0001））. Mean mHCS cosmetic outcome total scores, were also higher for antibacterial suture （5.7） than for Chinese silk （5.0） at day 30 （P=0.002）.Conclusions Patients using coated VICRYL＊ Plus suture had significantly better cosmetic outcomes than those with Chinese silk sutures. Patients using coated VICRYL＊ Plus suture had a lower SSI incidence compared to the Chinese silk sutures, although the difference did not reach statistical significance. （ClinicalTrials.gov NCT 00768222）
文摘Aim:The primary author previously described his technique for periareolar closure in mastopexy using a pinwheel interlocking purse string with absorbable barbed suture and now reports the results of a retrospective photometric analysis comparing this technique with the same closure using Gortex®suture.This study is designed to compare the degree of areolar widening and safety profile of using absorbable barbed sutures for periareolar closure versus permanent smooth suture.Methods:A retrospective chart review was conducted of all patients whose periareolar closures were performed using an interlocking purse-string technique over a 10-year period.Only patients undergoing circumvertical mastopexy were included.All had photometric evaluation and follow-up performed within 6-24 months.Results:In total,20 patients(40 areolas),which were closed with absorbable barbed suture,were analyzed photometrically.In this suture group,areola size increased a mean of 4.9%from baseline,and no complications(0%)were observed.This compared favorably with previously reported complication rates using permanent sutures and with a series of cases presented herein in which permanent smooth suture was used for purse string closure.The degree to which absorbable barbed suture controls areolar spread was shown to be significantly better than those where permanent smooth purse string techniques were employed.Conclusion:Circumvertical mastopexy closures using absorbable barbed suture was shown to be safe and effective and compared favorably to older techniques using permanent smooth suture for similar closures.This paper lends support to the safety of using absorbable barbed suture in circumareolar closures to limit areolar spread.
