Biomedical subjects

L A Israelsson

Publications and source records attributed to L A Israelsson.

21 records · Page 2Linked to original sources

PubMed1994

Closure of midline laparotomy incisions with polydioxanone and nylon: the importance of suture technique.

The healing of midline laparotomy incisions closed with a continuous suture of nylon or second-generation polydioxanone was evaluated in a randomized clinical trial. The effect of suture technique, reflected in the suture length to wound length ratio, was also assessed. All patients who underwent abdominal surgery through a midline incision were included except those with incisional hernia after previous midline operation. Wound dehiscence occurred in five (0.6 per cent) of 813 patients and wound infection in 73 (9.0 per cent). These rates were similar for both suture materials, as were those for the development of suture sinus and prolonged postoperative wound pain. Incisional hernia 12 months after surgery was found in 49 (15.1 per cent) of 325 wounds sutured with polydioxanone and in 50 (15.7 per cent) of 318 closed with nylon (P = 0.91). There was a significant correlation between the hernia rate and the suture to wound length ratio for both materials (P < 0.001). These results indicate that suture of midline laparotomy wounds is as safe with polydioxanone as it is with nylon. Incisional hernia is associated more with suture technique than with the material used.

Female↗

PubMed1993

Suture length to wound length ratio and healing of midline laparotomy incisions.

The effect of suture length to wound length ratio on the healing of midline laparotomy wounds closed with a continuous suture was evaluated in a prospective clinical trial. All patients undergoing abdominal procedures through a midline incision were included except those with an incisional hernia after previous midline operation. The total incidence of wound infection was 36 of 454 patients (7.9 per cent) and wound dehiscence requiring reoperation occurred in three patients (0.7 per cent). Incisional hernia was found in 18.7 per cent of 363 patients alive 12 months after surgery. Multivariate analysis identified the suture length to wound length ratio, age and major wound infection as independent risk factors for the development of hernia, which occurred in 9.0 per cent of patients when the suture length to wound length ratio was > or = 4 and in 23.7 per cent (P = 0.001) when it was < 4. The suture length to wound length ratio is an important parameter for healing of midline incisions closed with a continuous suture technique. The incidence of incisional hernia is lower when such wounds are sutured with a ratio > or = 4.

Adult↗

PubMedDate not supplied

Physical properties of self locking and conventional surgical knots.

OBJECTIVE: To assess some of the physical properties of three types of self locking knots and two types of conventional surgical knots. DESIGN: Experimental in vitro study. OUTCOME MEASURES: Knot efficiency (knot strength: suture strength ratio), slippage, and volume. MATERIALS: Test knots tied with the suture materials polyglactin, polydioxanone and nylon in USP sizes 1,2/0, and 4/0. RESULTS: Self locking knots performed significantly better (p < 0.01) than conventional knots in all combinations of material and size, except for 4/0 nylon. Efficiency of the self locking knots tied with the monofilament polydioxanone and nylon ranged from 0.88-0.96. With the multifilament polyglactin, it ranged from 0.71-0.90, and it increased proportionally with the thickness of the material. The mean efficiency of the conventional knots was 0.51 (0.06) for polyglactin, and 0.70 (0.17) for the monofilament materials. The self locking knots did not slip. The conventional starting knot often slipped partly, but came undone only when the conventional terminating knot was tied with monofilament material. The self locking knots were significantly smaller than the conventional knots. CONCLUSION: Self locking knots are safer than conventional surgical knots, and considerably smaller.

Humans↗