Experimental study on an alternative to suturing the laparotomy wound with a mesh thread

2021 ◽  
Vol 29 (2) ◽  
pp. 277-286
Author(s):  
Andrey V. Fedoseev ◽  
Tatiyana M. Cherdantseva ◽  
Alexander S. Inyutin ◽  
Iliya B. Glukhovets ◽  
Sergey N. Lebedev ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Negative Impact ◽  
Collagen Fibrils ◽  
Wound Complications ◽  
Suture Materials ◽  
White Line ◽  
Fully Integrated ◽  
Longitudinal Orientation ◽  
Laparotomy Wound ◽  
Mesh Endoprosthesis

BACKGROUND: Incisional ventral hernias (IVH) in abdominal surgery remain relevant because the frequency of their formation after laparotomy reaches 10%30.7%. AIM: This study aimed to develop a method for the primary closure of a laparotomy wound via mesh endoprosthesis, which is superior to laparorrhaphy with traditional suture materials in terms of morphophysical properties. MATERIALS AND METHODS: Laparorrhaphy with a mesh thread was developed (Patent for invention RUS No 2714439 02/14/2020) as an alternative to preventive prosthetics with narrow indications to avoid herniation. An experimental work was conducted to investigate the wound process in the suture area on days 14 and 60 and determine the effectiveness and safety of the proposed method. RESULTS: Video laparoscopy data showed that no cases of adhesions were observed between the internal organs and the area of laparorrhaphy on days 14 and 60 of the postoperative period. Defects in the area of the application of sutures on the aponeurosis of the white line were absent. In the wound, the mesh thread fully integrated into the regenerating tissue, including at the site of the knot. The tissue also grew through the meshed cells. On day 14, the strength of the regenerating tissue with the sutured mesh thread was greater than that sutured without it (11.198 1.499, p 0.01). This finding was confirmed by the larger area of granulations and fibrosis in cases of mesh suture than that of the checkerwise-reinforcing suture, suture with a mesh thread, and suture with a strip of mesh endoprosthesis. Another peculiarity of the connective tissue newly formed in the area of the mesh endoprosthesis in the form of the mesh thread was that collagen fibrils were arranged concentrically. By contrast, the mesh strip had collagen fibrils arranged in a longitudinal orientation parallel to the endoprosthesis. On day 60 of the experiment, all the series showed signs of maturation of the connective tissue in the form of the predomination of fibrils in cellular elements and their compaction. The area of fibrosis and granulations still prevailed in cases of the mesh suture, where neocollagenogenesis in the cells of the endoprosthesis was more pronounced than that after the application of a reinforcing suture, a mesh thread, and a strip of mesh endoprosthesis. CONCLUSION: The absence of wound complications and negative impact on the surrounding tissues indicated the safety of using the mesh suture. The strengthened characteristics associated with the peculiarities of the wound process showed that the mesh suture was effective in preventing the occurrence of postoperative hernia. Therefore, this method could be used in clinical practice.

Banded Structures in the Connective Tissue of Meningioma

1976 ◽  
Vol 34 ◽  
pp. 234-235
Author(s):  
C. N. Sun ◽  
H. J. White
Keyword(s):  
Connective Tissue ◽  
Osmium Tetroxide ◽  
Uranyl Acetate ◽  
Collagen Fibrils ◽  
Lead Citrate ◽  
Connective Tissues ◽  
Native Collagen ◽  
Routine Procedures

Previously, we have reported on extracellular cross-striated banded structures in human connective tissues of a variety of organs (1). Since then, more material has been examined and other techniques applied. Recently, we studied a fibrocytic meningioma of the falx. After the specimen was fixed in 4% buffered glutaraldehyde and post-fixed in 1% buffered osmium tetroxide, other routine procedures were followed for embedding in Epon 812. Sections were stained with uranyl acetate and lead citrate. There were numerous cross striated banded structures in aggregated bundle forms found in the connecfive tissue of the tumor. The banded material has a periodicity of about 450 Å and where it assumes a filamentous arrangement, appears to be about 800 Å in diameter. In comparison with the vicinal native collagen fibrils, the banded material Is sometimes about twice the diameter of native collagen.

MANAGEMENT AND OUTCOME OF ABDOMINAL WALL CLOSURE IN EMERGENCY LAPAROTOMY AT A TERTIARY CARE CENTRE

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Mohit Badgurjar ◽  
Poojan Thakor ◽  
Pankaj Saxena ◽  
Suman Parihar ◽  
Giriraj Prajapati ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Tertiary Care ◽  
Wound Complications ◽  
Emergency Laparotomy ◽  
Abdominal Wall Closure ◽  
Suture Materials ◽  
Tertiary Care Centre ◽  
Mass Closure ◽  
Continuous Methods ◽  
Closure Group

Objective: Abdominal wall closure of an emergency laparotomy involves a great deal of consideration. An ideal laparotomy wound closure should be efficient. provide strength and serve as a barrier to infection. The aim of this study is to compare and evaluate the advantages of layered closure in comparison with the mass layered closure, the types of suture materials used in the closure, absorbable/nonabsorbable and its correlation with post operative complications such as wound sepsis, burst abdomen and incisional hernia. Methods: This prospective study was carried out over a period of 18 months enrolling a total of 90 patients split into two groups with group 1 undergoing mass closure using both interrupted and continuous methods and group 2 undergoing layered closure using both interrupted and continuous methods of suturing. Results: A higher rate of wound complications was noted in the layered closure group (37.7%) than the mass closure group (17%). Wound complications were also noted to be higher in closures done with prolene suture (37.7%) than PDS (20%). As far as techniques were concerned, interrupted and continuous suturing had a similar rate of complications. Of all the comorbidities, considered in the study, the highest rate of wound related complications were seen in patients with pulmonary complications (13.3%). Conclusion: Although the ideal way to close an abdomen post laparotomy has not yet been discovered, our study shows that mass closure with PDS suture to close the abdominal wall should be advocated as there is decreased early and late post operative wound complications Keywords: PDS.

MORPHOLOGICAL CHANGES OF COLLAGEN FIBRILS IN THE SUBSYNOVIAL CONNECTIVE TISSUE IN CARPAL TUNNEL SYNDROME

2006 ◽  
Vol 88 (4) ◽  
pp. 824-831
Author(s):  
JINROK OH ◽  
CHUNFENG ZHAO ◽  
MARK E. ZOBITZ ◽  
LESTER E. WOLD ◽  
KAI-NAN AN ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Connective Tissue ◽  
Carpal Tunnel ◽  
Morphological Changes ◽  
Collagen Fibrils ◽  
Tunnel Syndrome ◽  
Subsynovial Connective Tissue

Surgical Wound Complications after Knee Cruciate Ligament Reconstruction in Patients with Atopic Dermatitis

2020 ◽  
Author(s):  
Takuji Yokoe ◽  
Takuya Tajima ◽  
Nami Yamaguchi ◽  
Yudai Morita ◽  
Etsuo Chosa
Keyword(s):  
Atopic Dermatitis ◽  
Foreign Body ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Wound Complications ◽  
Surgical Wound ◽  
Barrier Dysfunction ◽  
Suture Materials ◽  
Cruciate Ligament Reconstruction ◽  
Foreign Body Reactions

AbstractAtopic dermatitis (AD), sometimes referred to as eczema, is a common skin disease, and skin barrier dysfunction and immunological disorders are well recognized. However, surgical wound complications after orthopaedic surgery in patients with AD have not been described. This study aimed to report four patients with AD who developed foreign body reactions to FiberWire sutures with or without surgical wound infection (SSI) after knee cruciate ligament reconstruction (CLR). The mean age was 19.8 (range, 16–25) years, and patients 1 and 3 underwent reconstructions of the posterior and anterior cruciate ligament, respectively. At a mean of 7.5 (range, 4–10) weeks postoperatively, discharge from the surgical wound at the tibial side of the fixed graft was identified. All patients were treated with continuous saline lavage and antibiotics; however, their wounds did not heal. Second-look arthroscopy and hardware removal were performed at a mean 12.2 (range, 9–15) months postoperatively. Proliferated granulation tissue surrounding the FiberWire was identified. Intraoperative wound cultures were negative in three of the four patients. Histological examination of the tissues adjacent to the FiberWire revealed a foreign body reaction. All wounds healed immediately after the second surgery. In addition to SSI, foreign body reactions are more likely to occur in patients with AD than in those without AD. Preoperative management of AD by dermatologists and consideration of appropriate suture materials are mandatory to reduce surgical wound complications after knee CLR in patients with AD.

scholarly journals A Sea-Cucumber Derived Novel Protein that Softens the Cell-Disrupted Catch Connective Tissue through Inhibiting the Interaction between Collagen Fibrils

2014 ◽  
Vol 106 (2) ◽  
pp. 733a
Author(s):  
Yasuhiro Takehana ◽  
Akira Yamada ◽  
Masaki Tamori ◽  
Tatsuo Motokawa
Keyword(s):  
Connective Tissue ◽  
Sea Cucumber ◽  
Collagen Fibrils ◽  
Novel Protein

Der Einfluß von D-Penicillamin auf den Gehalt einiger Organe an Spurenelementen sowie auf die mechanischen Eigenschaften von Kollagen / Trace Elements in Several Organs and Mechanical Properties of Collagen under the Influence of D-Penicillamin

1978 ◽  
Vol 33 (5-6) ◽  
pp. 346-358 ◽  
Author(s):  
H. Wesch ◽  
R. Jonak ◽  
H. Nemetschek-Gansler ◽  
H. Riedl ◽  
Th. Nemetschek
Keyword(s):  
Mechanical Properties ◽  
Trace Elements ◽  
Schiff Base ◽  
Connective Tissue ◽  
Functional Groups ◽  
Schiff Bases ◽  
Collagen Fibrils ◽  
Principal Effect ◽  
Tail Tendon ◽  
Cu Ions

Abstract The content of trace elements in several organs of rats under the influence of D-penicillamine (D-PA) was investigated by the neutronactivation-analysis. It could be shown an diminution of Cu, and Co under D-PA-treatment, the content of Fe, Mn, Rb and Zn was not influenced. The investigat­ ed organs didn’t show any submicroscopic alterations under D-PA. On isolated collagen fibrils of tail tendon was seen a significantly diminuition of E-moduls. In accordance with Siegel the principal effect of D-PA is thought to block the synthesis of functional groups from Schiff-base crosslink precursors but not to inhibit lysyloxidase by loss of Cu-ions of connective tissue. The thermostability of D-PA influenced fibrils is changed in stretched state only and will be due to the lack of crosslink Schiff-bases; where as the shrinking point of not stretched fibrils shows only aging dependent changes.

scholarly journals Expert System in Accuracy to Identify Gingivitis in Humans Using the Certainty Factor Method

2020 ◽  
pp. 97-103
Author(s):  
Cyntia Lasmi Andesti ◽  
Sumijan Sumijan ◽  
Gunadi Widi Nurcahyo
Keyword(s):  
Connective Tissue ◽  
Medical Records ◽  
Negative Impact ◽  
Dental Health ◽  
The Body ◽  
Certainty Factor ◽  
Know How ◽  
Factor Method ◽  
Accuracy Level ◽  
Processing Steps

Gingivitis is a common inflammatory disease of the gums, which is a condition where bacteria develop in the mouth that causes damage to the connective tissue cells that are attached to the teeth. Lack of awareness in caring for teeth will have a negative impact not only on dental health but also on the health of the body. At present many people do not know how to accurately identify gingivitis in humans so that the condition is worsened and can even cause the paralysis of the existing connective tissue. This study aims to determine the level of accuracy in identifying gingivitis by using the Certainty Factor method precisely and accurately. The data processed in this study are fifty data sourced from expert interviews at Rahmatan Lil Alamin Clinic, Padang Indonesia. There are several types Symptoms refer to gingivitis in humans. The data is obtained from the results of medical records of patients who carry out examinations in the clinic. The data will be processed to identify the type of gingivitis based on the direction of the expert. The processing steps are solving rules, determining the weight value of each symptom and calculating the Certainty Factor value. The results of the processing were continued by calculating the level of accuracy. The results of the testing of this method were that 96% of them had gingivitis, the type most often suffered by marginal gingivitis patients. Based on the signs entered by the user. The results of this test have been able to specifically identify gingivitis, using the Certainty Factor method, the results of the accuracy level obtained are quite accurate and can be recommended to help dentists improve their accuracy in identifying gingivitis in humans.

scholarly journals Effect of intra-abdominal hypertension on the strength of the postoperative scar of a laparotomic wound

2020 ◽  
Vol 24 (2) ◽  
pp. 223-226
Author(s):  
I. K. Morar
Keyword(s):  
Mechanical Strength ◽  
Negative Impact ◽  
Abdominal Cavity ◽  
Study Groups ◽  
Laboratory Animals ◽  
Abdominal Pressure ◽  
Abdominal Hypertension ◽  
Laparotomy Wound ◽  
The Impact ◽  
Postoperative Scar

Annotation. One of the main factors of postoperative eventration is intra-abdominal hypertension, which occurs in various surgical pathologies of the abdominal cavity. Despite the presence of a large number of scientific papers on the negative effect of intra-abdominal hypertension on the morphological state of granulation tissue in the area of the laparotomy wound, there are no publications on the impact on the strength of the postoperative scar. Therefore, the study aimed to investigate in an experiment on small laboratory animals the effect of intra-abdominal hypertension on the mechanical strength of the postoperative scar of a laparotomy wound. The experiment was performed on 120 laboratory rats, which underwent a median laparotomy and brought together the edges of the musculoaponeurotic layer of the anterior abdominal wall with simple nodal sutures. The main group consisted of 72 animals who developed intra-abdominal hypertension by inserting a container (condom) with a certain amount of Furacilin into the abdominal cavity. The comparison group consisted of 48 animals who had an empty condom inserted into the abdominal cavity after laparotomy. The mechanical strength of the postoperative scar of the laparotomy wound was determined by the method of G. V. Petrovich (2010) on the 1st, 3rd, and 5th day after the creation of intra-abdominal hypertension, by measuring the level of intra-abdominal pressure at the time of rupture of the postoperative scar of the laparotomy wound. Statistical analysis of the results was performed using Microsoft Excel spreadsheets and a package of statistical processing software PAST. Differences between study groups were determined using Mann-Whitney criteria. The results of the study indicate that the created intra-abdominal hypertension leads to a decrease in the mechanical strength of the postoperative scar of the laparotomy wound. The degree of the negative impact of intra-abdominal hypertension on the strength of the postoperative scar is inversely proportional to the level of intra-abdominal pressure.

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