A modified alar cinch suture technique

Abstract Background It is proposed a new running suture technique called Needle Adjustment Free (NAF) technique, or PAN suture. The efficiency and the safety were evaluated in laparoscopic partial nephrectomy. Methods This new running suture technique avoids the Needle Adjustment method used in traditional techniques. The new continuous suture technique (11 patients) was compared with the traditional continuous suture method (33 patients) used in both transperitoneal and retroperitoneal laparoscopic partial nephrectomy (LPN) in terms of suture time (ST), warm ischemia time (WIT), blood loss (BL), open conversion rate and post-op discharge time, post-op bleeding, post-op DVT, ΔGFR (affected side, 3 months post-op). Differences were considered significant when P < 0.05. Results ST in the PAN suture group was 30.37 ± 16.39 min, which was significant shorter (P = 0.0011) than in the traditional technique group which was 13.68 ± 3.33 min. WIT in the traditional technique group was 28.73 ± 7.89 min, while in the PAN suture group was 20.64 ± 5.04 min, P = 0.0028. The BL in entirety in the traditional technique group was 141.56 ± 155.23 mL, and in the PAN suture group was 43.18 ± 31.17 mL (P = 0.0017). BL in patients without massive bleeding in the traditional technique group was significantly greater than in the PAN suture group at 101.03 ± 68.73 mL versus 43.18 ± 31.17 mL (P = 0.0008). The open conversion rate was 0 % in both groups. There was no significant difference between the two groups in postoperative discharge time, post-op bleeding, post-op DVT, ΔGFR (affected side, 3 months post-op). Conclusions The NAF running suture technique, or PAN suture, leading to less ST, WIT and BL, which was shown to be more effective and safer than the traditional technique used for LPN. A further expanded research with larger sample size is needed.

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Outcomes of a new suture technique for the treatment of dislocated intraocular lenses: locked loop on the haptic

International Ophthalmology ◽

10.1007/s10792-021-01927-6 ◽

2021 ◽

Author(s):

Ugur Unsal ◽

Berkay Akmaz ◽

Deniz Kilic

Keyword(s):

Suture Technique ◽

Intraocular Lenses

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Non-pledget commissural suture technique to avoid atrioventricular block

General Thoracic and Cardiovascular Surgery ◽

10.1007/s11748-021-01605-5 ◽

2021 ◽

Vol 69 (5) ◽

pp. 906-908

Author(s):

Shingo Kunioka ◽

Kishu Fujita ◽

Shizuko Iwasa ◽

Hiroyuki Kamiya ◽

Kenji Yamazaki ◽

...

Keyword(s):

Atrioventricular Block ◽

Suture Technique

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Surgical Strategies to Promote Cutaneous Healing

Medical Sciences ◽

10.3390/medsci9020045 ◽

2021 ◽

Vol 9 (2) ◽

pp. 45

Author(s):

Ines Maria Niederstätter ◽

Jennifer Lynn Schiefer ◽

Paul Christian Fuchs

Keyword(s):

Wound Healing ◽

Wound Closure ◽

Chronic Wounds ◽

Treatment Algorithm ◽

Surgical Site Infections ◽

Repair Process ◽

Suture Technique ◽

The Body ◽

Wound Debridement ◽

Reconstructive Ladder

Usually, cutaneous wound healing does not get impeded and processes uneventfully, reaching wound closure easily. The goal of this repair process is to restore the integrity of the body surface by creating a resilient and stable scar. Surgical practice and strategies have an impact on the course of wound healing and the later appearance of the scar. By considering elementary surgical principles, such as the appropriate suture material, suture technique, and timing, optimal conditions for wound healing can be created. Wounds can be differentiated into clean wounds, clean–contaminated wounds, contaminated, and infected/dirty wounds, based on the degree of colonization or infection. Furthermore, a distinction is made between acute and chronic wounds. The latter are wounds that persist for longer than 4–6 weeks. Care should be taken to avoid surgical site infections in the management of wounds by maintaining sterile working conditions, using antimicrobial working techniques, and implementing the principles of preoperative antibiotics. Successful wound closure is influenced by wound debridement. Wound debridement removes necrotic tissue, senescent and non-migratory cells, bacteria, and foreign bodies that impede wound healing. Additionally, the reconstructive ladder is a viable and partially overlapping treatment algorithm in plastic surgery to achieve successful wound closure.

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Chemotherapy and Abdominal Wall Closure Technique Increase the Probability of Postoperative Ventral Incisional Hernia in Patients With Colon Cancer

The American Surgeon ◽

10.1177/00031348211011149 ◽

2021 ◽

pp. 000313482110111

Author(s):

David A. Santos ◽

Liangliang Zhang ◽

Kim-Anh Do ◽

Brian K. Bednarski ◽

Celia Robinson Ledet ◽

...

Keyword(s):

Body Mass Index ◽

Colon Cancer ◽

Adjuvant Chemotherapy ◽

Incisional Hernia ◽

Abdominal Wall ◽

Suture Technique ◽

Abdominal Wall Closure ◽

Clinical Predictors ◽

Closure Technique ◽

Ventral Incisional Hernia

Background Chemotherapy is associated with postoperative ventral incisional hernia (PVIH) after right hemicolectomy (RHC) for colon cancer, and abdominal wall closure technique may affect PVIH. We sought to identify clinical predictors of PVIH. Methods We retrospectively analyzed patients who underwent RHC for colon cancer from 2008-2018 and later developed PVIH. Time to PVIH was analyzed with Kaplan-Meier analysis, clinical predictors were identified with multivariable Cox proportional hazards modeling, and the probability of PVIH given chemotherapy and the suture technique was estimated with Bayesian analysis. Results We identified 399 patients (209 no adjuvant chemotherapy and 190 adjuvant chemotherapy), with an overall PVIH rate of 38%. The 5-year PVIH rate was 55% for adjuvant chemotherapy, compared with 38% for none (log-rank P < .05). Adjuvant chemotherapy (hazard ratio [HR] 1.65, 95% confidence interval [CI] 1.18-2.31, P < .01), age (HR .99, 95% CI .97-1.00, P < .01), body mass index (HR 1.02, 95% CI 1.00-1.04, P < .01), and neoadjuvant chemotherapy (HR 1.92, 95% CI 1.21-3.00, P < .01) were independently associated with PVIH. Postoperative ventral incisional hernia was more common overall in patients who received adjuvant chemotherapy (46% compared with 30%, P < .01). In patients who received adjuvant chemotherapy, the probability of PVIH for incision closure with #1 running looped polydioxanone was 42%, compared with 59% for incision closure with #0 single interrupted polyglactin 910. Discussion Exposure to chemotherapy increases the probability of PVIH after RHC, and non–short stitch incision closure further increases this probability, more so than age or body mass index. The suture technique deserves further study as a modifiable factor in this high-risk population.

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