Hysterography after cesarean section for evaluation of suturing technic.
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The course of regenerative processes was compared in rat sciatic nerve after its transection and anastomosis of the nerve. The nerves were united suturing the epineurium, laying sutures through the nerve trunk or were united with tissue adhesive. A comparison of the results of clinical, electromyographic and histological studies demonstrated a superiority of suturing through the epineurium over the remaining methods. Regeneration processes appeared in these cases earliest and in the end result these processes were most complete.
The aim of these examinations was a comparison of the tensile strength and the histology of single and two-layer sutured gastrotomies applied to rats. Independent of the applied suture material and suture technique all experiments resulted in the same tensile strength of the suture between the 5th and 7th postoperative day as in the control group. Differences of anastomotic dehiscence did not exist. The single-layer can be loaded as well as the two-layer suture. Any difference of the tensile strength of anastomosis depending on the suture material does not exist.
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During the last 10 years 268 laparotomies by a midline incision were performed. A high incidence of seromas, fistulas caused by suturing material and wound ruptures were observed. After finding only a small number of publications in the veterinary medicine about wound healing disturbances an analysis of the human medical literature was done. This induced the change of our surgical procedure and suturing technique: The midline incision and surgical management during the laparotomies in 14 horses suffering from colic were performed by a minimized trauma. The abdominal wall was closed layer by layer in the following manner: peritoneum by a running suture of catgut metric 5, linea alba by Sultan single sutures of polyglycolic acid material metric 5 (12 cases) or of polydioxanone metric 4 (2 cases), subcutaneous layer by a running suture of polyglycolic acid material metric 4, skin by single sutures of monofilamentous synthetic material metric 2. Thus, no complications in wound healing were observed in these 14 horses. Therefore, we recommend to prove the described surgical and suturing procedure by a larger number of horses undergoing a laparotomy by a midline incision.
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