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At least 289 records · Page 16Linked to original sources
PubMed1998

[Proximal median and ulnar resections. Results of primary and secondary repairs].

PURPOSE OF THE STUDY: Recovery after median and ulnar nerve proximal repair is widely appreciated. The place and time for secondary functional reconstruction remains controversial. MATERIAL AND METHOD: From January 1983 to January 1990, 66 patients suffering from proximal injury of the median or ulnar nerves underwent nerve repair. Forty-five patients had a postoperative follow-up of more than 24 months: 24 isolated ulnar nerve lesions, 12 isolated median nerve lesions, and 9 combined median and ulnar nerve lesions. Ten patients were given a primary microsurgical nerve suture in our department. Thirty-eight patients underwent a delayed or secondary nerve repair of one or both nerves: 8 secondary nerve sutures, and 35 nerve grafts in 31 patients. RESULTS: Muscular strength, sensitivity, motion, and pain were better after primary nerve sutures (when technically possible) or after shortly delayed secondary sutures, although 40 per cent of patients treated with nerve grafts get final "good" or "very good" results. The time between the injury and nerve repair was the most significant prognosis factor. Results of ulnar nerve repairs at the elbow were statistically better with anterior transposition as compared to in situ repairs (p < 0.005). Fourteen patients required secondary functional reconstruction. Tendon transfers were performed at least 24 months after nerve repair. DISCUSSION: Nerve repair of proximal lesion to the median or ulnar nerves depends on the type of injury, but is advised even when delayed. Residual deficit following nerve repair should require functional transfers depending on hand sensitivity and extrinsic function.

Adolescent↗
PubMed2004

[Technical improvement of mechanical suture of bronchial stumps in pneumonectomy].

OBJECTIVE: To prevent or reduce such postoperative complications of pneumonectomy as bronchopleural fistula and promote the curative effect of the surgery by improving the technique for handling the bronchial stumps. METHODS: In 107 patients, bronchial stapler was adopted for closure of the bronchial stump and pneumonectomy was subsequently performed on the side of the staples. A 1-0 polyester suture was used to for suture in the shape of "U" deep in the mechanical suture on the bronchial stump. The postoperative complications were observed. RESULTS: The operations were performed easily and the bronchial stumps were short and sutured firmly. No fluid retention or granuloma occurred in the stumps after the operation, nor were the complications such as intractable cough and infection of thoracic cavity observed. No bronchopleural fistula was found in these patients. CONCLUSION: This new method is safe and effective for treatment of the bronchial stumps.

Adolescent↗
PubMed1987

[Anal fistula: value of the fistulectomy technic combined with endoanal suture using chromium catgut. Reflections apropos of 25 cases].

Results of treatment of 25 cases of anal fistula demonstrate that these lesions can be treated by combined fistulectomy and endoanal suture whatever their anatomic type, if the technique is carried out patiently and strictly. It ensures successful relief in 100% of cases of fistula treated by first intention. Satisfactory results were obtained after recovery surgery in 3 of 5 cases (60%) the 2 patients failing to respond having been treated by Arnous' method. Its advantage is total conservation of anal sphincter, avoiding postoperative sphincteric complications and other local sequelae.

Catgut↗
PubMed1983

[Intestinal anastomosis using the invagination technic without intestinal wall sutures in small animals].

After resection of a part of the ileac section of the gut, end-to-end anastomosis was performed in fifteen healthy test dogs and two cats by the method of the invagination of the cranial segment of the gut into the caudal segment without gut wall suture. Healing was controlled in several time intervals after operation (by clinical and histopathological examination). The main advantage of this technique is the speed and easiness of operation and a small tissue reaction with the formation of a minimum amount of adhesions, combined with the fact that by this method the passage of the intestines is not reduced. On the basis of the results and literary data, this technique is recommended for clinical use mainly in those cases when, owing to an alteration of the general health state, minimum time is left for an operation and, thereby, for a narcosis. However, the course of healing should be further studied in patients with an indication of enterectomy.

Animals↗
PubMed1995

Intrauterine repair of surgically created defects in mice (lip incision model) with a microclip: preamble to endoscopic intrauterine surgery.

We compared the difference between a nonpenetrating silver microclip and suture on wound healing, inflammatory response, and application time in the repair of surgically created standardized unilateral cleft lip type defects in fetal mice. Excellent lip continuity and dermal reconstitution were achieved by both methods of repair. Furthermore, collagen accumulation did not occur. Occasional mononuclear cells were seen around sutured repairs in contrast to microclipped repairs. The most significant difference, however, was in application time with the microclip requiring an average of 7 seconds (+/- 2) compared to 90 seconds (+/- 15) for suture. We conclude that the microclip offers distinct advantages for intrauterine cleft lip repair: (1) nonpenetrating tissue approximation; (2) less inflammatory response than suture; (3) technically more rapid and less difficult to apply than suture; and (4) can be utilized more readily than suture for endoscopic approaches limiting the risks of fetal surgery for both the mother and the fetus.

Animals↗
PubMed1996

The effect of chordal replacement suture length on function and stresses in repaired mitral valves: a finite element study.

BACKGROUND AND AIMS OF THE STUDY: Replacement of ruptured mitral valve chordae using expanded polytetrafluoroethylene (ePTFE) sutures is becoming an increasingly utilized repair technique. However, setting the proper length of the replacement suture is technically challenging, and the effect of a non-optimal suture length is undefined. The purpose of this study was to assess how varying the length of replacement sutures affects mitral valve function and stresses. MATERIALS AND METHODS: We employed a finite element model of the mitral valve used extensively in our laboratory. Seven different valve conditions were simulated using this model: (i)normal valve, (ii) chordal rupture without repair, and (iii-iv) chordal replacement using ePTFE sutures that were equal in length to the replaced chordae (equal length), 10% longer (Long10), 3% longer (Long3), 3% shorter (Short3), and 10% shorter (Short10) than the replaced chordae. Each model was loaded to physiologic pressures. RESULTS: Both the Long10 and chordal rupture models achieved complete valve closure, but chordal stresses were nearly double normal values. The Long3 model also demonstrated complete valve closure, but chordal stresses were increased to only one-third more than normal. Using sutures equal to or shorter than the length of the replaced chordae prevented complete valve closure, and produced stress concentrations at the anterior leaflet free edge. The resulting gaps and stress concentrations were most significant in the Short10 model and least significant in the equal length model. CONCLUSIONS: These models demonstrate that replacement sutures equal to, or slightly longer than the replaced chordae optimize function and stresses in the repaired valve.

Biomechanical Phenomena↗
PubMedDate not supplied

Anastomosis.

Esophageal anastomosis is still associated with a high rate of complications even though they have decreased considerably in recent years. Anastomotic leaks are more frequent in the neck than in the chest, and related mortality rate is not different. The leakage incidence does not depend on suture materials or on technical modalities used to perform the anastomosis. In fact, there is no difference between the leakage rate when comparing manual and mechanical anastomoses. The leak incidence after both mechanical and manual anastomoses is much higher in collective reviews than in reports coming from leading centers. "Frequent" esophageal surgeons can learn from their previous experience and therefore avoid technical errors, whereas "causal" esophageal surgeons do not have this opportunity. Performing an esophageal anastomosis is a technical matter, and suture healing is independent of the patient's biologic situation. Anastomotic fibrotic strictures are frequent after both manual and mechanical anastomoses, and most can be avoided by meticulous suturing technique.

Anastomosis, Surgical↗