[A detail of the practical technic of Halban's fascia suture in anterior colpoperineorraphy].
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This paper documents the differences among 8 monofile sutures in important functions such as linear tensile strength, bending stiffness, knot security and irreversible elongation. The results show that two materials (Prolene and Gore-Tex) do not seem to be as suitable as the other materials for long-term tensile loads. The lowest bending stiffness was that of Seralon. The highest knot security can already be reached with three loops of Novafil. Novafil has also got the highest maximal elongation. The knowledge of the different applications of suture materials tested in important practical functions, is the supposition to the right and secure use of suture materials.
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A new instrument was developed for passing and holding sutures during the replacement of a bone flap. The new device is a simple straight aluminum shaft, 6 cm in length and 0.7 mm in diameter with a groove on both ends for holding the suture. The shaft can be easily bent with the fingers to attain the desired curve and more suitable manipulation. Passing the shaft through the straight hole in the cranium or the cranial flap was very easy and convenient. No dural damage occurred during 80 procedures using this shaft. No needle holder or forceps for temporary clipping sutures were necessary, which reduced the operative time and mental and physical burden on the operator and the nurses. The mean time per hole with our instrument (45.8 +/- 9.2 sec) was significantly shorter compared to conventional methods with a circular needle, needle holder, and many forceps for temporary clamping of sutures (65.6 +/- 13.2 sec).
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Cutaneous surgery requires more than technical skill. A thorough understanding of instrumentation, suture material, sterile technic, and wound dressings is also imperative. This article will organize, primarily by pictorial essay, the often-neglected subject of surgical dressings. The principals and theory of dressings, the materials available to construct them, and the specific technics for tailoring them to difficult anatomic sites will be presented.
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In order to cover the defect of the oral mucosa temporarily, we used lyophilized porcine skin (LPS) in 10 cases. The use of LPS seemed to be effective from the following points of view; alleviation of postoperative pain and as a protection against exogenous irritants. A fixation method, that is, a continuous locked suture, was devised technically to prevent the LPS from tearing by suturing. With this simple method, the patient maintained good oral hygiene and had only a slight discomfort. Histological examination using Japanese white rabbits showed no apparent difference in wound healing between this method and interrupted suture with tie-over compression. Re-epithelialization of the wound in the non-dressed (control) group was recognized earlier than that in the LPS-covered group.
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In rotator cuff repairs, it is often necessary to pass 2 tails of 2 sutures through 1 transosseous hole to maximize the number of sutures per hole. We report on a simple technique with a double-loop suture thread that allows the passing of more than 1 suture limb through the same hole. This simple device, the simple suture shuttle, used in cuff repairs in combination with the modified Mason-Allen suture technique, significantly reduces the difficulty of passing more than 1 suture tail through a single bone tunnel. By reducing the number of bone tunnels, the weakening of a bone that might not be very strong is kept to a minimum. The Simple Suture Shuttle can also be used to pass more sutures through a given number of transosseous holes.
The Authors have developed an instrumentation suitable for suture line tension measuring during plastic operations for large incisional hernias. A full description is given of the measuring technique and of the original instrumentation, including two steel bars called "fachiri" and an electric measuring system with strain gauges. With the employment of this technique, relaxing incisions of the muscle aponeurosis can be reduced to the minimum. Being the suture line tension one of the most important causes of relapsing, the Authors believe that this technique provides a sure advantage for the long term results of plastic operations.