scholarly journals Suture-Tool: A Mechanical Needle Driver for Standardized Wound Closure

2019 ◽  
Vol 44 (1) ◽  
pp. 95-99
Author(s):  
Gabriel Börner ◽  
Agneta Montgomery
Keyword(s):  
Medical Technology ◽  
Wound Closure ◽  
Suture Line ◽  
Fascial Closure ◽  
High Quality ◽  
Burst Abdomen ◽  
Incision Length ◽  
Needle Driver ◽  
Mechanical Suture ◽  
Suture Device

Abstract Introduction A laparotomy is commonly required to gain abdominal access. A safe standardized access and closure technique is warranted to minimize abdominal wall complications like wound infections, burst abdomen and incisional hernias. Stitches are recommended to be small and placed tightly, obtaining a suture length-to-incision length (SL/WL) ratio of ≥ 4:1. This can be time-consuming and difficult to achieve especially following long trying surgical procedures. The aim was to develop and evaluate a new mechanical suture device for standardized wound closure. Methods A mechanical suture device (Suture-tool) was developed in collaboration between a medical technology engineer team with the aim to achieve a standardized suture line of high quality that could be performed speedy and safe. Ten surgeons closed an incision in an animal tissue model after a standardized introduction of the instrument comparing the device to conventional needle driver suturing (NDS) using the 4:1 technique. Outcome measures were SL/WL ratio, number of stitches and suture time. Results In total, 80 suture lines were evaluated. SL/WL ratio of ≥ 4 was achieved in 95% using the Suture-tool and 30% using NDS (p < 0,001). Number of stitches was similar. Suture time was 30% shorter using the Suture-tool compared to NDS (2 min 54 s vs. 4 min 5 s; p < 0.001). Conclusions The mechanical needle driver seems to be a promising device to perform a speedy standardized high-quality suture line for fascial closure.

scholarly journals A clinical study of continuous and interrupted fascial closure in emergency midline laparotomy at a tertiary care centre

2017 ◽  
Vol 4 (6) ◽  
pp. 2014
Author(s):  
Rahul D. Kunju ◽  
Vinayak Thakkannavar ◽  
Shrivathsa Merta K. ◽  
Sachin H. G. ◽  
Allen Netto ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Wound Infection ◽  
Wound Closure ◽  
Tertiary Care ◽  
Fascial Closure ◽  
Emergency Laparotomy ◽  
Closure Technique ◽  
Burst Abdomen ◽  
Midline Laparotomy ◽  
Laparotomy Wound

Background: Commonest approach in emergency open abdominal surgeries remains to be midline laparotomy because it is simple, saves time and causes minimal blood loss. Optimal technique for laparotomy wound closure has been a topic of debate since long. Risk factors for development of incisional hernia and burst abdomen are wound infection, systemic illnesses of patient and closure technique. Factors related to patients like age, gender, body mass index (BMI), systemic illnesses are not modifiable when an emergency laparotomy is the only option. Hence closure technique is one factor where surgeon has total control, which can bring down the incidence of burst abdomen and incisional hernias.Methods: Prospective study conducted in 150 patients who underwent emergency midline laparotomy from December 2014 to February 2016 in Krishna Rajendra Hospital attached to Mysore Medical College and Research Institute, Mysore, Karnataka, India with 6 months’ follow-up after surgery.Results: Most of patients in the study belonged to 30-40-year group and were males (78%). Gastrointestinal perforation peritonitis (52%) was the single most common indication for emergency midline laparotomy. In the continuous and interrupted groups, post-operative wound infection was found in 54.6% and 34.6%, wound dehiscence was found in 16% and 6.6% and incisional hernia in 14.4% and 4% respectively.Conclusions: Interrupted suturing is superior to continuous technique in emergency midline laparotomy wound closure in terms of complications and post-operative morbidity.

scholarly journals Stapling technology with triple-row and enhanced staple configurations evaluated in a series of 124 consecutive laparoscopic vertical gastrectomies

2019 ◽  
Vol 6 (6) ◽  
pp. 1857
Author(s):  
Alessandro Bianchi ◽  
Alberto Pagan-Pomar ◽  
Marina Jimenez-Segovia ◽  
Carla Soldevila-Verdeguer ◽  
Jaume Bonnin-Pascual ◽  
...  
Keyword(s):  
Staple Line ◽  
Suture Line ◽  
Clinical Results ◽  
Anthropometric Parameters ◽  
Surgical Time ◽  
Vertical Gastrectomy ◽  
Gastric Leakage ◽  
Mechanical Suture ◽  
Group 2 ◽  
Group 1

Background: Laparoscopic sleeve gastrectomy (LSG) is a procedure frequently used to treat morbid obesity, due to its simplicity compared to other bariatric techniques. However, LSG can lead to serious complications, such as gastric leakage and bleeding from the staple line. To reduce these complications, seroserosal reinforcement of the mechanical suture line after gastrectomy is generally recommended. In recent decades, studies have focused on the safety of anastomosis with staples, especially compared to manual sewing techniques. Since studies on the improvement of stapling technology are limited, this study arises to compare the clinical results of staple line oversewing versus stapling technology with triple-row and enhanced staple configurations in laparoscopic sleeve gastrectomy.Methods: A retrospective review from a prospectively maintained database of 124 laparoscopic vertical gastrectomies performed at single centre between March 2010 and December 2016. Patients were divided into two groups, with comparable anthropometric parameters and inclusion criteria. Seroserosal reinforcement was used in the first group, and stapling technology with triple-row and enhanced staple configurations in the second. Rates of anastomotic leakage, bleeding, reoperation, and 30-day mortality were compared.Results: In Group 1 the average surgical time was 125 min, whereas in Group 2 it was 87 min. No differences were found between the two groups regarding leakage or bleeding of the staple line.Conclusions: The use of triple-row stapling devices during laparoscopic vertical gastrectomy enables surgical time to be reduced. Further high-quality studies to evaluate the efficacy and effectiveness of stapling technology with triple-row and enhanced staple configurations are needed.

Vacuum-Assisted Wound Closure Achieves Early Fascial Closure of Open Abdomens after Severe Trauma

2003 ◽  
Vol 55 (6) ◽  
pp. 1155-1160 ◽  
Author(s):  
James W. Suliburk ◽  
Drue N. Ware ◽  
Zsolt Balogh ◽  
Bruce A. McKinley ◽  
Christine S. Cocanour ◽  
...  
Keyword(s):  
Wound Closure ◽  
Severe Trauma ◽  
Fascial Closure

scholarly journals Evaluation of abdominal wound closure using continuous versus interrupted sutures in patients of perforation peritonitis

2021 ◽  
Vol 8 (3) ◽  
pp. 844
Author(s):  
Arnab Mohanty ◽  
Yoel Dewa Paljor ◽  
Rajeev Sharma
Keyword(s):  
Wound Closure ◽  
Critical Role ◽  
Wound Dehiscence ◽  
Fascial Closure ◽  
New Delhi ◽  
Abdominal Wound ◽  
Hollow Viscus ◽  
Single Centre Study ◽  
Perforation Peritonitis ◽  
Group B

Background: The type of wound closure plays a critical role in patients of perforation peritonitis, since many of these patients also have poorly controlled co-morbidities and risk factors for wound dehiscence. Though many studies have evaluated abdominal wound closures in the elective scenario, similar studies in the emergent scenario are rather scarce. Hence, we have dealt with this issue in patients presenting with hollow viscus perforation peritonitis.Methods: This was a prospective randomized case control single-centre study with 120 patients performed at St. Stephen’s Hospital, New Delhi, India between February 2016 and January 2019. These patients were randomized divided into two groups; group A comprising those patients in whom, the abdominal wound was closed with continuous sutures, and group B comprising those in whom it was closed with interrupted sutures. Informed consent was taken from all the patients. A detailed proforma included all parameters. Follow up was conducted at 2, 4, 6 and 12 weeks from the date of surgery. Data analysis was done using S.P.S.S. version 17.Results: The time taken for continuous suture fascial closure was significantly less than the interrupted technique. There were no significant differences in other parameters, immediately or on follow-up.Conclusions: The continuous method of abdominal closure was faster than interrupted suturing on account of the use of only two terminal knots, this difference being statistically significant. The outcomes were comparable to other studies that have dealt with this issue in elective surgeries.

Wound closure after total knee replacement: Comparison between staples and sutures

2021 ◽  
Vol 38 (ICON-2022) ◽  
Author(s):  
Mansoor Ali Khan ◽  
M. Waseem Memon ◽  
Amin Chinoy ◽  
Salman Javed ◽  
Rahil Barkat ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Wound Closure ◽  
P Value ◽  
Incision Length ◽  
Total Knee ◽  
The Mean ◽  
The Right

Background and Objective: Total Knee Arthroplasty is a commonly performed procedure for arthritic knees. Preventing complications is of utmost importance for good functional outcomes and preventing morbidity. Wound closure after the procedure is as important as the replacement aspect of surgery.The objective of this study was to provide subjective and objective evidence of better closure technique and material; we conducted the study so that the outcome of TKA can be further improved. Methods: We conducted a randomized trial at The Indus Hospital, Karachi, from December 2018 to June 2020. All patients from age 40 to 70 years who underwent total knee arthroplasty were included in the study. The wound of one knee was closed with Polypropylene (Prolene) sutures, and the other with staples. The wound was assessed independently by two assessors using Hollander’s score; lower score means a worse outcome. All data was entered and analyzed using STATA version 16. Results: Thirty patients who underwent bilateral total knee replacement were included in the analysis, among which 71.8% were female. The average age of participants was 57.3 (± 7.5) years. The mean incision length on the right knee was 17.6 ± 1.1 cm, while on the left the incision length was 18.3 ± 1.2 cm. Overall, the mean Hollander score was significantly different among participants in the sutures and staples group in both the right (p-value=0.001) and left knees (p-value=0.001). The score was significantly higher in knees closed with sutures as compared to staples. Also, the mean Hollander score is significantly higher in females than males in both the right knee (B=0.56, p-value=0.049) and the left knee (B=0.38, p-value=0.044). Conclusion: The study has shown that Hollander’s score was significantly higher in knees closed with sutures as compared to the patients in whom staples were used for wound closure. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5782 How to cite this:Khan MA, Memon MW, Chinoy A, Javed S, Barkat R, Jiwani A. Wound closure after total knee replacement: Comparison between staples and sutures. Pak J Med Sci. 2022;38(2):340-344. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5782 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Endoscopic endonasal suturing of dural reconstruction grafts: a novel application of the U-Clip technology

2008 ◽  
Vol 108 (2) ◽  
pp. 395-400 ◽  
Author(s):  
Paul Gardner ◽  
Amin Kassam ◽  
Carl Snyderman ◽  
Arlan Mintz ◽  
Ricardo Carrau ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Csf Leak ◽  
Endoscopic Endonasal ◽  
Tissue Graft ◽  
Needle Driver ◽  
Csf Leakage ◽  
Suture Device ◽  
Tissue Grafts ◽  
Graft Migration ◽  
Graft Reconstruction

✓ Cerebrospinal fluid (CSF) leakage following endoscopic endonasal skull base resection can be a significant problem. A method for securing tissue grafts is needed. In this paper the authors used an endonasal suturing device to secure the graft reconstruction following endonasal tumor resection. The U-Clip anastomotic device (Medtronic), developed for cardiovascular anastomoses, was used to secure the tissue graft to native dura. A specialized needle driver and hemoclip applier were used for the application and deployment of this device. No suture tying was necessary, facilitating its endonasal application. The graft was successfully secured in its desired position to native dura by using the U-Clip anastomotic device. The patient did not suffer a postoperative CSF leak, and postoperative imaging and endoscopy revealed that the graft was in a good position. There was no complication from the use of the device. The U-Clip anastomotic device can be used as a suture device during endonasal surgery. It may prevent tissue graft migration and help prevent CSF leakage.

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