PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “SUTURE TECHNICS”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources
PubMed1978

Single-layer anastomosis of the colon. A review of 165 cases.

One hundred sixty-five patients undergoing elective colorectal or colonic anastomoses with a one-layer technic are presented. One death from suture line dehiscence was noted, and the overall mortality was 2.4 per cent. The usual technic for esophagogastrointestinal suturing in French surgical centers is described and the importance of suture technic in the etiology of anastomotic leaks is discussed.

Adult↗
PubMed2003

Use of suturing as a measure of technical competence.

There is an ongoing demand for surgeons to demonstrate that they can operate well, maintain their performance, and deliver acceptable results. Currently, surgeons are assessed by a series of subjective and peer-reviewed interviews, but at no stage is the objective assessment of surgical competence measured. The authors have introduced an objective test of suturing skill as one of an array of tests used to assess technical ability. A range of surgeons with differing surgical skill was tested. The candidates were asked to suture a 4-cm wound on a latex skin pad. They were videotaped during the procedure and were scored by four independent observers using the Objective Structured Assessment of Technical Skill scoring system. Their movements were also monitored using an electromagnetic tracking system. Forty-three plastic surgeons and 46 general surgeons were divided into four groups, depending on grade, and were assessed. The difference in scores among the plastic surgeons gave a value of p < 0.001, whereas the general surgeons gave a value of p = 0.001. However, when similar grade but different specialties were compared, plastic surgeons scored significantly higher (down to senior house officer [resident year 1-2] level; mean p value = 0.019). Interrater reliability was also high (Cronbach alpha = 0.89). This task has shown that technical ability can be assessed objectively. The task has also been shown to exhibit face, construct, and concurrent validity. This has important implications for the future of surgical training in that it allows one to identify whether the fundamentals of surgical technique have been passed on to the trainee and to monitor their progress continually. It also may be used in revalidation of surgeons.

Clinical Competence↗
PubMedDate not supplied

Suture suspension platysmaplasty for neck rejuvenation revisited: technical fine points for improving outcomes.

BACKGROUND: The suture suspension platysmaplasty technique for neck rejuvenation was introduced more than 13 years ago. Over the years and after a large number of procedures performed for all classes of neck deformities, a number of technical fine points evolved that resulted in even more aesthetically pleasing and predictable results. These technical fine points are presented in detail, and their direct anatomic effects are analyzed. Finally, the points that constitute the youthful neck are redefined with detailed schematic presentation. ANATOMIC CONSIDERATIONS: All aspects of neck rejuvenation with the suture suspension platysmaplasty are analyzed, with a focus on the changes that occur in terms of the following six key anatomic points: cervicomental angle depth, mandibular border definition, mandibular angle definition, labiomandibular fold prominence (jowling), mental prominence, and neck width. TECHNICAL FINE POINTS: Additional technical fine points have evolved over the past 13 years to optimize the results and produce a more natural appearing and aesthetically pleasing neck: the "angle loop" of the suspension sutures, anatomic suction-assisted lipectomy using appropriate cannulas, application of moderate tension to the interlocking suspension suture to avoid the "overcorrected neck," imbrication of the midline platysma, conservative skin excision, and augmentation of the chin to increase the depth of the cervicomental angle. CONCLUSION: The interlocking suture technique, by creating an artificial permanent "ligament" under the mandible, corrects the anatomic components of the neck (points 1 to 6) with excellent long-term outcomes and patient satisfaction rates. The additional technical fine points have made the aesthetic results more natural and pleasing, while making the technique more simple, safe, and reproducible.

Female↗
PubMed2001

Ergonomic principles of task alignment, visual display, and direction of execution of laparoscopic bowel suturing.

BACKGROUND: Laparoscopic suturing is technically a demanding skill in laparoscopic surgery. Ergonomic experimental studies provide objective information on the important factors and variables that govern optimal endoscopic suturing. Our objective was to determine the optimum physical alignment, visual display, and direction of intracorporeal laparoscopic bowel suturing using infrared motion analysis and telemetric electromyography (EMG) systems. METHODS: Ten surgeons participated in the study; each sutured 50-mm porcine small bowel enterotomies toward and away from the surgeon in the vertical and horizontal bowel plane with either isoplanar (image display corresponds with actual lie of the bowel) or nonisoplanar (bowel displayed horizontally but mounted vertically in the trainer and vice versa) display. The end points were the placement error score, execution time, leakage pressure, motion analysis, and telemetric EMG parameters of the surgeon's dominant upper limb. RESULTS: Suturing was demonstrably easier in the vertical than in the horizontal plane, resulting in a better task quality (placement error score, p < 0.0001; leakage pressure, p < 0.005) and shorter execution time (p < 0.05). Nonisoplanar display of the surgical anatomy degrades performance in terms of both task efficiency and task quality. On motion analysis, a wider angle of excursion and lower angular velocity were observed during the vertical suturing with isoplaner display. Compared to horizontal suturing, supination at the wrist was significantly greater during vertical than horizontal suturing (p < 0.05). Within each category (vertical vs horizontal suturing), the direction of suturing (toward/away from the surgeon) did not influence the extent of pronation/ supination at the wrist. In line with the degraded performance, significantly more muscle work was expended during horizontal suturing. This affected the forearm flexors (p < 0.05), arm flexors and extensors (p < 0.005 and p < 0.05, respectively), and deltoid muscles (p < 0.005) and was accompanied by significantly more fatigue in the related muscles. Small bowel enterotomies sutured toward the surgeon in both the vertical and the horizontal planes exhibited less placement error score than when sutured away from the surgeon, with no significant difference in the motion analysis and EMG parameters. CONCLUSIONS: Optimal laparoscopic suturing (better task quality and reduced execution time) is achieved with vertical suturing toward the surgeon with isoplanar monitor display of the operative field. The poorer task performance observed during horizontal suturing is accompanied by more muscle work and fatigue, and it is not improved by monitor display of the enterotomy in the vertical plane.

Animals↗
PubMed1998

Single-layer closure of a bladder laceration during laparoscopy. A case report.

BACKGROUND: The increase in complex laparoscopic surgery has led to an increase in bladder injuries. Two-layer laparoscopic closure has been described but is technically difficult. CASE: A bladder laceration was sustained during laparoscopic removal of an ovarian cyst with lysis of omental adhesions. A single-layer closure using laparoscopically assisted suturing resulted in a good outcome. CONCLUSION: Case reports demonstrate that two-layer closure of the bladder using laparoscopic suturing is technically feasible but may be beyond the capabilities of many laparoscopic surgeons. This case demonstrates that single-layer closure may give good results.

Adult↗