Fibrin seal—An alternative to suture repair in experimental pulmonary surgery

1986 ◽  
Vol 40 (4) ◽  
pp. 340-345 ◽  
Author(s):  
Jacob Bergsland ◽  
Thomas Kalmbach ◽  
Daya Balu ◽  
Mary J. Feldman ◽  
Joseph A. Caruana ◽  
...  
Keyword(s):  
Suture Repair ◽  
Pulmonary Surgery ◽  
Fibrin Seal

scholarly journals The ‘wave sign’ in hip arthroscopy: a systematic review of epidemiological factors, current diagnostic methods and treatment options

2020 ◽  
Author(s):  
Jason Derry Onggo ◽  
James Randolph Onggo ◽  
Mithun Nambiar ◽  
Andrew Duong ◽  
Olufemi R Ayeni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Protective Factor ◽  
Treatment Options ◽  
Arthroscopic Surgery ◽  
Classification Systems ◽  
Diagnostic Methods ◽  
Suture Repair ◽  
Significant Heterogeneity ◽  
Epidemiological Factors

ABSTRACT This study aims to present a systematic review and synthesized evidence on the epidemiological factors, diagnostic methods and treatment options available for this phenomenon. A multi-database search (OVID Medline, EMBASE and PubMed) was performed according to PRISMA guidelines on 18 June 2019. All studies of any study design discussing on the epidemiological factors, diagnostic methods, classification systems and treatment options of the wave sign were included. The Newcastle–Ottawa quality assessment tool was used to appraise articles. No quantitative analysis could be performed due to heterogeneous data reported; 11 studies with a total of 501 patients with the wave sign were included. Three studies examined risk factors for wave sign and concluded that cam lesions were most common. Other risk factors include alpha angle >65° (OR=4.00, 95% CI: 1.26–12.71, P=0.02), male gender (OR 2.24, 95% CI: 1.09–4.62, P=0.03) and older age (OR=1.04, 95% CI: 1.01–1.07, P=0.03). Increased acetabular coverage in setting of concurrent cam lesions may be a protective factor. Wave signs most commonly occur at the anterior, superior and anterosuperior acetabulum. In terms of staging accuracy, the Haddad classification had the highest coefficients in intraclass correlation (k=0.81, 95% CI: 0.23–0.95, P=0.011), inter-observer reliability (k=0.88, 95% CI: 0.72–0.97, P<0.001) and internal validity (k=0.89). One study investigated the utility of quantitative magnetic imaging for wave sign, concluding that significant heterogeneity in T1ρ and T2 values (P<0.05) of acetabular cartilage is indicative of acetabular debonding. Four studies reported treatment techniques, including bridging suture repair, reverse microfracture with bubble decompression and microfracture with fibrin adhesive glue, with the latter reporting statistically significant improvements in modified Harris hip scores at 6-months (MD=19.2, P<0.05), 12-months (MD=22.0, P<0.05) and 28-months (MD=17.5, P<0.001). No clinical studies were available for other treatment options. There is a scarcity of literature on the wave sign. Identifying at risk symptomatic patients is important to provide prompt diagnosis and treatment. Diagnostic techniques and operative options are still in early developmental stages. More research is needed to understand the natural history of wave sign lesions after arthroscopic surgery and whether intervention can improve long-term outcomes. Level IV, Systematic review of non-homogeneous studies.

scholarly journals All-Inside Double-Sided Suture Repair for Longitudinal Meniscal Tears

2021 ◽  
Author(s):  
Constant Foissey ◽  
Mathieu Thaunat ◽  
Jean-Marie Fayard
Keyword(s):  
Suture Repair ◽  
Meniscal Tears

scholarly journals HEMORRHAGE FROM FIBRINOLYSIS IN PULMONARY SURGERY

1956 ◽  
Vol 32 (4) ◽  
pp. 548-554
Author(s):  
William Walker ◽  
Eugene G. Laforet
Keyword(s):  
Pulmonary Surgery

Bone suture anchor repair and functional outcome of a triceps tendon rupture, a rare clinical entity

2021 ◽  
Vol 14 (7) ◽  
pp. e241773
Author(s):  
Pieter Willem Johannes Lozekoot ◽  
Juul Jeanne Wilhelmus Tegels ◽  
Raoul van Vugt ◽  
Erik Robert de Loos
Keyword(s):  
Tendon Rupture ◽  
Suture Repair ◽  
Bone Anchor ◽  
Rare Injury ◽  
Accident And Emergency ◽  
Active Range Of Motion ◽  
Triceps Tendon Rupture ◽  
Elbow Function ◽  
Triceps Tendon ◽  
Anchor Suture

Triceps tendon rupture is rare and easily missed on presentation. A 58-year-old man was seen in our accident and emergency department with an inability to extend his right elbow against gravity after he fell. Ultrasound and MRI confirmed the suspected diagnosis of a traumatic triceps tendon rupture and excluded additional injuries. Surgical repair was carried out by a bone anchor suture reinsertion of the tendon to the olecranon. After 2 weeks of cast immobilisation, an early active range of motion (ROM) rehabilitation schedule was followed, resulting in excellent elbow function at 12 weeks postoperatively.In conclusion, it is important to suspect this rare injury and use additional studies to confirm the diagnosis of triceps tendon rupture. Also, good clinical outcome with regards to function can be achieved using bone anchor suture repair and an early active ROM rehabilitation schedule.

scholarly journals Case report: direct suture repair of inferior vena cava to rescue a stab patient with hepatic and caval injury through left hepatectomy and total vascular exclusion

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Reina Hirooka ◽  
Kyoji Ito ◽  
Nobuyuki Takemura ◽  
Fuminori Mihara ◽  
Norihiro Kokudo
Keyword(s):  
Inferior Vena Cava ◽  
Hepatic Resection ◽  
Inferior Vena ◽  
Vena Cava ◽  
Damage Control Surgery ◽  
Posterior Wall ◽  
Emergency Laparotomy ◽  
Suture Repair ◽  
Vascular Exclusion ◽  
Total Vascular Exclusion

Abstract Background The mortality of abdominal vena caval injuries is as high as 50–80%. Yet, there were few reports on how to repair injured inferior vena cava (IVC). This report presents a method of vena caval repair in a case of penetrating retrohepatic IVC injury, requiring hepatic resection and total vascular exclusion (TVE). Case presentation The patient was a 20-year-old man with a stab wound in the epigastrium. An emergency laparotomy was performed in the emergency room, and a stab incision on the left liver was detected. As the Pringle’s maneuver did not reduce bleeding, hepatic vein injury was suspected, and left hemihepatectomy was performed to confirm the bleeding point. After the hepatectomy, laceration was still evident deeper into the resection, and IVC injury was suspected. The bleeding was temporarily controlled by tentative hepatorrhaphy and gauze packing, and the initial damage control surgery was terminated. Definitive surgery was performed on the third postoperative day. The lacerated point was observed under TVE, and the laceration penetrated the retrohepatic IVC through its posterior wall. The slit of the posterior wall was sutured first, followed by suturing of the anterior wall of the IVC. Finally, the lacerated liver was closed with hepatorrhaphy. TVE was removed, and the massive bleeding was successfully controlled. Conclusion In severe liver injuries involving the retrohepatic IVC, hepatic resection and TVE may be useful for ensuring an optimized surgical field for repairing the injured IVC.

scholarly journals Rating the incidence of iatrogenic vascular injuries in thoracic and lumbar spine surgery as regards the approach: A PRISMA-based literature review

2021 ◽  
Author(s):  
Alice Giotta Lucifero ◽  
Cristian Gragnaniello ◽  
Matias Baldoncini ◽  
Alvaro Campero ◽  
Gabriele Savioli ◽  
...  
Keyword(s):  
At Risk ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Iliac Vein ◽  
Lumbar Spine Surgery ◽  
Common Iliac Vein ◽  
Suture Repair ◽  
Vascular Injuries ◽  
Mesh Terms ◽  
Thoracic And Lumbar Spine

Abstract Purpose To assess the rate, timing of diagnosis, and repairing strategies of vascular injuries in thoracic and lumbar spine surgery as their relationship to the approach. Methods PubMed, Medline, and Embase databases were utilized for a comprehensive literature search based on keywords and mesh terms to find articles reporting iatrogenic vascular injury during thoracic and lumbar spine surgery. English articles published in the last ten years were selected. The search was refined based on best match and relevance. Results Fifty-six articles were eligible, for a cumulative volume of 261 lesions. Vascular injuries occurred in 82% of instrumented procedures and in 59% during anterior approaches. The common iliac vein (CIV) was the most involved vessel, injured in 49% of anterior lumbar approaches. Common iliac artery, CIV, and aorta were affected in 40%, 28%, and 28% of posterior approaches, respectively. Segmental arteries were injured in 68% of lateral approaches. Direct vessel laceration occurred in 81% of cases and recognized intraoperatively in 39% of cases. Conclusions Incidence of iatrogenic vascular injuries during thoracic and lumbar spine surgery is low but associated with an overall mortality rate up to 65%, of which less than 1% for anterior approaches and more than 50% for posterior ones. Anterior approaches for instrumented procedures are at risk of direct avulsion of CIV. Posterior instrumented fusions are at risk for injuries of iliac vessels and aorta. Lateral routes are frequently associated with lesions of segmental vessels. Suture repair and endovascular techniques are useful in the management of these severe complications.

Fistulotomy with Primary Sphincter Repair in High Anal Fistula

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Tarek Youssef Ahmed ◽  
Mohab Gamal El-din Mustafa ◽  
Mohamed Elemam Elshawy ◽  
Modaser Hashim Abdelaziz
Keyword(s):  
Anal Fistula ◽  
Therapeutic Option ◽  
Chronic Phase ◽  
Sphincter Repair ◽  
Suture Repair ◽  
Anorectal Abscess ◽  
Success Rates ◽  
Immediate Reconstruction ◽  
Effective Therapeutic Option ◽  
Fistula Recurrence

Abstract Background Anal fistula is abnormal communication between the anal canal and the perianal skin or perineum or buttocks. Anal fistula is almost always a consequence of an anorectal abscess that was drained. While the abscess represents the acute phase of the disease, fistula represents the chronic phase as the fistulous pathway may persist in about 1/3 of cases. Aim of the Work In this study we will perform fistulotomy with primary sphincter repair in high cryptoglandular fistula with assessment of recurrence rate, incontinence rate and patient satisfaction according to pain score, wound healing, discharge and return to daily activity parameters. Methods This was prospective cohort study on 30 patients of high peri-anal fistulae and fistulotomy and reconstruction (primary suture repair) of anal sphincter was done., the patients were followed up 6 months postoperatively regarding their continence using Wexner score, recurrence, discharge and their return to work by scheduled outpatient clinical examination. Results Among 30 patients only three patients complaining usual incontinence mostly as post defecation soiling. Three patients reported anal fistula recurrence: One occurred at the 5th month, while the other two occurred at the 6th month after surgery. The procedure was well tolerated by the patients as most of them complaining only minimal pain and returned to work after two weeks without need of other stage like other procedures. Conclusion Fistulotomy with primary sphincter repair is an effective therapeutic option for patients with high anal fistula. Our study demonstrated that immediate reconstruction of the sphincters after fistulotomy achieved high success rates and low risk of postoperative fecal incontinence, compared to reported rates after simple fistulotomy.

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