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The authors have elaborated a sutureless method of closing the wound surface in order to preserve the renal parenchyma. They have used oxydized cellulose net (Surgicel) and tissue adhesive (Histoacryl-N-blau) to hold together the cut surface of the kidney at renal hypothermy (bench surgery) on dogs.
Sutureless end-to-end anastomosis of rat common carotid artery was carried out, low energy Nd-YAG laser being used thereby. An intraluminal-intervascular splint, made of water-soluble poval, was used for precise adaptation of the intimas. Neither stay suture nor glue was required. The patency rate of the anastomosed vessels, 24 hours after operation, was as high as 91%. The vessels were confirmed to be likewise patent on the 7th and 30th postoperative day. Complications such as pseudoaneurysm formation or stenotic change, were negligible. The fusion of the anastomosis with Nd-YAG laser was histologically proved to be satisfactory and the result of tensile strength test was excellent. Temperature at the anastomotic site during laser irradiation was measured, optimal energy for anastomosis determined and possible mechanism of vascular fusion by laser beam postulated. The major advantages of the laser technique combined with poval splint, such as rapidity, consistency and no residual foreign body (thread or adhesive), are discussed.
The authors have shown the possibility of the hermetization of the bronchial stump after resection of the lung through the use of osteocyanacrlic mass treated with ultrasound. A small number of clinical reservations, however does not allow to recommend the method for a broad use in the clinical practice. Nevertheless the authors believe the idea of ultrasound sutureless closure of the bronchial stump to be a promising one and needing further studies.
This report details our experience with 300 sutureless epicardial electrode implantations performed in the past 6 years. Indications for pacing, surgical approaches, implantation sites and complications are presented. The subxiphoid approach was valuable in obtaining safe, reliable, and long-term impulse generation. Complications have been few and of short duration. In general, pacing thresholds have been lower and sensitivity thresholds higher with left ventricular implantation than with right ventricular implantation. Endocarcial pacing is reserved for the very aged and debilitated patients, patients requiring implantation within 4 to 6 weeks of acute myocardial infarction, and for atrial or atrioventricular sequential pacing.
A sutureless technique of skin closure for the amputation stumps of patients with peripheral vascular disease is described. It offers less trauma to skin flaps, limits access to the wound by exogenous sources of bacterial contamination, and is very acceptable to the patient.
Op-Site skin closures, a new product for sutureless skin closure, were used on 100 patients undergoing a wide variety of major surgical procedures. The results showed that, provided that the underlying fat and muscle layers were closed meticulously to eliminate dead space, these skin closures maintained wound-edge apposition satisfactorily to produce an excellent cosmetic appearance to the final scar with the added advantages of a low incidence of infection, quicker application, and improved patient acceptability compared with conventional suturing techniques.
A new sutureless intraluminal graft has been developed with a ring made of a titanium-nickel shape-memory alloy. The diameter of the ring can be reversibly reduced by compression in 4 degrees C normal saline solution and recovers its original shape in 38 degrees C physiologic saline solution during insertion in the aorta. The new graft was implanted in nine dogs and was evaluated histologically and angiographically at various intervals from 15 to 90 days. No complications, such as dislodgment, aortic rupture, stenosis, or aneurysmal dilation, were observed. The component of the shape-memory ring allows the graft to be introduced and secured in place easily. The function of this ring is better than that of the rigid ring.
The results of 31 cases of sutureless esophagogastrostomy by intraluminal elastic circular ligation (IECL) with the biodegradable supporting tube were reported. The fate of the supporting tube could be tracked satisfactorily by X-ray. The tube-dislodge time was 15.03 +/- 2.23 days and unaffected by the size of supporting tube or the site of anastomosis. The supporting tube could be safely absorbed or partially discharged through the alimentary tract. IECL, with the merits of saving time, anastomosing tightly and leaving no suture materials in the anastomotic site, can be expected to further reduce the incidence of anastomotic leakage and provide references for other gastrointestinal anastomosis.
Pulmonary vein stenosis is a rare cardiac disease associated with a disastrous prognosis. Nowadays, it is more often a iatrogenic complication, following neonatal surgical repair of total anomalous pulmonary venous drainage (TAPVD). It is as well a native congenital anomaly. The responsible histologic lesion is an intimal hyperplasia that proliferates to involve the extracardiac segment of the pulmonary veins. This lesion tends to be extremely recurrent following surgical or angioplastic attempts. A new sutureless surgical technique, that tunelizes the pulmonary veins to the left atrium through the pericardium, is described. This method was successfully applied in a 2.5 years old child, presenting with bilateral stenosis of pulmonary veins, following neonatal repair of a TAPVD. The result, controlled 6 months later, by catheterization and angiography was judged satisfactory. This new technique, that has to be confirmed by a longer follow up, may provide a therapeutic answer to this challenging disease.
The idea of the sutureless anastomosis is not a new one, but only the introduction of the VALTRAC-BAR instrument made the wide clinical application possible. The authors have applied this instrument in the case of 32 patients in a two years period. It was used in intestinal procedures in 28, in gastric resection in 4 occasions, respectively. In one case spontaneously recovered stercoral fistula was observed. According to our experiences, the instrument can be used advantageously in preparing anastomoses in the gastrointestinal tract.
A 79-year-old hypertensive woman, with fusiform shaped atherosclerotic aneurysm in the descending thoracic aorta whose medial layer was maintained by an extensive solid calcium plate (porcelain aorta), was successfully treated using a sutureless intraluminal ringed graft. Spools of the ring were fixed by circumferential ligatures at both proximal and distal sites of anastomosis and a dilated segment of the aorta was replaced with the tube graft.
OBJECTIVE: To compare a biodendrimer adhesive with a conventional suture for repairing linear and stellate corneal lacerations. METHODS: A keratome knife was used to create 4.1-mm full-thickness linear incisions (n = 36) and 3 x 4-mm full-thickness stellate incisions (n = 25) in the central cornea of enucleated human eyes. The incisions were sealed with either a suture or the biodendrimer adhesive. The globes were inflated with balanced salt solution, and the increase in intraocular pressure was monitored via a cardiac transducer until fluid leaked from each eye. This intraocular pressure reading from the transducer was recorded at the sight of any leakage through the wound (leakage pressure). By using the Wilcoxon rank sum test, the median leakage pressure was compared for each closure method, separately for each wound group. By using the 1-sided 1-sample t test, each mean leakage pressure value was compared with 34 mm Hg, which is the intraocular pressure under certain stressful physiologic conditions (eg, coughing and the Valsalva maneuver). RESULTS: For globes that underwent a linear incision, the mean leakage pressure was 78.7 mm Hg for the sutured group and 109.6 mm Hg for the adhesive group. Globes that underwent a stellate incision had a mean leakage pressure of 57.8 mm Hg for the sutured group and 78.7 mm Hg for the adhesive group. All of these pressures showed a statistical significance from 34 mm Hg via a 1-sided 1-sample t test. CONCLUSIONS: The difference in leakage pressures for all 4 groups was statistically significant relative to 34 mm Hg. This suggests that either method of closure, adhesive or suture, can withstand physiologic increases in intraocular pressure postoperatively and that biodendrimer adhesives are able to seal large corneal lacerations.Clinical Relevance The use of biodendrimer adhesives to repair a corneal wound constitutes a viable alternative clinical procedure to conventional sutures.
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Explore the source record for details and available documents.