A new myocardial pacemaker lead (sutureless).
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Contrast-enhanced 16-slice multi-detector row spiral computed tomography (MDCT) has been shown to be useful for non-invasive visualization of aortocoronary bypass grafts (CABG). This new-generation scanner could be a good alternative to the common invasive coronary angiography. In this article, we report a patient operated on with the St. Jude Medical, Inc, Symmetry Bypass System (Aortic Connector System [ACS]) and subsequently studied by MDCT.
OBJECTIVE: To study the quality of scars following the use of butyl cyanoacrylate to close the skin during cleft lip repair. DESIGN: Nonrandomized prospective study. SETTING: Tertiary care hospital. PATIENTS: Patients (n = 104) with cleft lip and palate in combination of various degrees of cleft with the age group ranging from 3 months to 5 years. INTERVENTIONS: Use of butyl cyanoacrylate to close the skin during cleft lip repair after inserting dermal stitches with delayed absorbable sutures. RESULTS: None of the 104 patients required revision of the vertical scar, which was excellent in nature. No patients had complications such as wound infection, dehiscence, nasal obstruction, or eyelid adhesion. CONCLUSIONS: Quality of the scar following the closure of skin of cleft lip repair using butyl cyanoacrylate was considered excellent.
A technique designed to utilize the autogenous free gingival graft without the use of sutures was demonstrated. Necessary objectives were maintained but achieved without unnecessarily piercing the graft, and in less time. The only variance in results would be due to the underlying physical properties of the recipient site. This new approach to grafting avoids the cyanoacrylate from getting between the graft and recipient site, therefore acting as a foreign body. Also shown was the complete coverage of a denuded root surface by this technique using a free autogenous gingival graft. This technique enables the surgeon to achieve the results of a predictable technique (autogenous free gingival graft) even more predictably simple.
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A technique for repair of traumatic iridodialysis that avoids the need for iris sutures is described. Following a limbal peritomy, sclerostomy sites level with the iris base are created at each clock hour of the iridodialysis using a microvitreoretinal blade. Vitreoretinal forceps passed through these ports are used to incarcerate the peripheral iris. No suture material is used to secure the iris. The conjunctiva is closed with absorbable sutures. The technique is suitable for use in simple iridodialysis repair and in conjunction with intraocular procedures.
The case history of a sixty-two-year-old lady, who presented with a bleb in the upper part of her left eye following cataract surgery was studied. The patient had no prior history of any glaucoma surgery. Gonioscopy revealed fishmouthing of the internal aspect of the scleral tunnel incision. The diagnosis of post-cataract filtering bleb was made which was managed by resuturing the wound. This case highlights the use of gonioscopy to visualise and evaluate the internal wound and discusses intraoperative recognition of internal leak and its management with horizontal sutures.
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Attempts to find alternatives to sutured vascular reconstruction techniques has continued for decades and include various forms of rings, tubes, endoluminal stents as well as gluing or welding techniques of large vessel anastomoses. One recently introduced technique uses nonpenetrating titanium clips for everted vessel approximation and closure. Experimental work on their use in various types of large vessel repairs and reconstructions has shown that the clips are easily applied with a short learning curve, create good conditions for vessel wall healing without causing excessive inflammation or fibrosis, and are considerably faster to apply when compared to standard suture techniques. Although there are some clinical reports of defective clipped closures causing postoperative bleeding complications, they are rare and most probably related to technical errors in applying the clips. The main disadvantages of the clips include the limited experience of their applicability in atherosclerotic vessels, lack of long term follow-up and cost. Potentially, the clips could be useful in the repair of multiple vascular injuries, in vessel repair or ligation performed in confined spaces, and in vascular procedures requiring the shortest possible cross-clamping time. Future applications could include endoscopic procedures as well as the use of a one-shot device which simultaneously applies up to a dozen clips to symmetrically everted and approximated vessel edges.
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A platelet-fibrinogen-thrombin mixture utilizing autologous platelets was studied for its potential as a corneal adhesive. In the rabbit it demonstrated sufficient adhesive properties to allow 50 per cent of lamellar keratoplasties (autotransplants) to remain in place without the use of sutures. The mixture retains significant adhesive properties for four to six days. It is simple to prepare and apply. It also appears nonantigenic and nontoxic to the cornea; it does not incite inflammation, nor interfere with corneal clarity or the regrowth of corneal epithelium.
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The aim of our study was experimental and clinical assessment of bifurcated grafts with ring on its main branch made of the same polyester as the prosthesis. This type of prosthesis facilitates quick anastomosis with the aorta through tying the aortic wall on the ring using a polyester tape. Experimental studies carried out on 18 pigs demonstrated good healing up of such a graft. The prosthesis was used for surgery in 8 patients with abdominal aneurysm which required clamping the aorta above renal arteries. The prosthesis was found to facilitate and accelerate making the proximal anastomosis, diminish the amount of blood loss, and reduces the time of the surgery, especially the time necessary for clamping the aorta above renal arteries which prevents renal ischaemia.