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PubMedDate not supplied

Technical description of the B-Lynch brace suture for treatment of massive postpartum hemorrhage and review of published cases.

Massive uncontrolled hemorrhage after childbirth is a leading cause of the pregnancy-related death and resulting morbidity. Uterine atony is the most common cause (75-90%) of primary postpartum hemorrhage. When simple massage of the uterus and uterotonics such as oxytocins, syntometrine and prostaglandins failed to manage this condition, various surgical solutions have been sought, including uterine artery ligation, more complicated stepwise devascularization of the uterus, internal iliac artery ligation and, ultimately, hysterectomy. All these procedures require above average surgical skill. In contrast, the B-Lynch suturing technique (brace suture) is particularly useful because of its simplicity of application, life saving potential, relative safety and capacity for preserving the uterus and subsequent fertility. The adequacy of haemostasis can be assessed both before and immediately after application of the suture. Only if it fails need other more radical surgical methods be considered. The special advantage of this innovative technique is that it presents an alternative to major surgical procedures for controlling pelvic arterial pulse pressure or hysterectomy. To date, this suturing technique, when applied correctly, has been successful with no problems and no apparent complications. This review provides an update on the B-Lynch brace suturing technique, including choice of suture material, use of the technique in early and late gestation, and comparison with other uterine compression surgical techniques. It also includes a comprehensive review and analysis of all published cases and their postoperative follow-up.

Female↗
PubMed1987

[Technical modification facilitating low colorectal anastomosis by mechanical suture].

The creation of a low colorectal anastomosis with an EEA or ILS stapler is considerably facilitated by the trans-suture anastomosis technique which avoids the sometimes difficult stage of distal purse. The crossing of circular and linear stapled closures has no untoward effect on the anastomosis. Our experience in 46 patients confirms that this technique is reliable.

Adult↗
PubMedDate not supplied

The development of suture anchors for use in soft tissue fixation to bone.

Soft tissue fixation to bone is a basic technique of orthopaedic surgery for which a multitude of devices have been developed. A new class of orthopaedic devices termed "suture anchors" has been developed to secure soft tissues to bone using suture material. The suture anchor is designed to allow quick and secure fixation without the need for extensive exposure. This device was tested using in vitro and in vivo models and found to be comparable with standard transosseous and two-pronged stable techniques. This device should prove useful in allowing the versatility of suture fixation of soft tissues to bone without the technical requirements of constructing transosseous suture tunnels.

Animals↗
PubMed1997

Reproducibility and reliability of middle cerebral artery occlusion using a silicone-coated suture (Koizumi) in rats.

The best technical approach to rat middle cerebral artery occlusion (MCAO) using a nylon-monofilament suture remains unsettled, regarding the usefulness of coated or uncoated sutures. Three investigators with different degrees of experience: A, well skilled; B, 2 years of experience; C, a novice with 6 months of experience, each subjected 10 Sprague-Dawley rats to permanent MCAO using low-viscosity silicone-coated sutures with a mean diameter 0.468+/-0.013 mm (mean+/-S.D.) at the tip and 0.361+/-0.013 mm in the body. Post-mortem corrected infarct size 24 h after MCAO was similar among the three investigators: A, 204.7+/-33.2 mm3; B, 212.6+/-42.8, and C, 195.9+/-44.4. The coefficient of variation was 16.2% to 22.7%, and 19.4% for the three investigators. This study suggests that experimental stroke with silicone-coated sutures (Koizumi's method) provides good reproducibility and reliability, among investigators of varying experience.

Animals↗
PubMed2002

Simplified arthroscopic suture passing using a suture loop.

Arthroscopic procedures for shoulder pathology are becoming more popular. Passing braided nonabsorbable suture for repair of intra-articular tissue can be technically difficult because advancing this suture through tissue is a 2-step process. The use of a suture loop with Spectrum suture hooks (Linvatec, Largo, FL) simplifies braided suture passing, and eliminates the use of expensive suture shuttles. This technique simplifies the use of nonabsorbable suture in arthroscopic shoulder procedures.

Arthroscopy↗