Comparison of macroscopic one-layer over number 1 nylon suture vasovasostomy with the standard two-layer microsurgical procedure

Abstract OBJECTIVE To compare 3 anal purse-string suture techniques for resistance to leakage and to identify the suture technique requiring the fewest tissue bites to create a consistent leak-proof orifice closure. ANIMALS 18 large-breed canine cadavers. PROCEDURES 3 purse-string suture techniques (3 bites with 0.5 cm between bites [technique A], 5 bites with 0.5 cm between bites [technique B], and 3 bites with 1.0 cm between bites [technique C]) were evaluated. Each technique involved 2-0 monofilament nylon suture that was placed in the cutaneous tissue around the anus and knotted with 6 square throws. Standardized 2.0-cm-diameter circular templates with the designated bite number and spacing indicated were used for suture placement. Leak-pressure testing was performed, and the pressure at which saline was first observed leaking from the anus was recorded. The median and interquartile (25th to 75th percentile) range (IQR) were compared among 3 techniques. RESULTS Median leak pressure for technique A (101 mm Hg; IQR, 35 to 131.3 mm Hg) was significantly greater than that for technique C (19 mm Hg; IQR, 14.3 to 25.3 mm Hg). Median pressure did not differ between techniques A and B (50 mm Hg; IQR, 32.5 to 65 mm Hg) or between techniques B and C. CLINICAL RELEVANCE Placement of an anal purse-string suture prevented leakage at physiologic colonic and rectal pressures, regardless of technique. Placement of 3 bites 0.5 cm apart (technique A) is recommended because it used the fewest number of bites and had the highest resistance to leakage.

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Multiplanar Correction of the Lesser Digital Deviation and Indirect Plantar Plate Rupture Repair Using a Braided Polyethylene Nylon Suture: A Technique Guide

Foot & Ankle Specialist ◽

10.1177/1938640017724544 ◽

2017 ◽

Vol 10 (6) ◽

pp. 551-554 ◽

Cited By ~ 1

Author(s):

Cody D. Blazek ◽

Roberto A. Brandão ◽

Jeffrey M. Manway ◽

Patrick R. Burns

Keyword(s):

Sagittal Plane ◽

Digital Pathology ◽

Metatarsophalangeal Joint ◽

Metatarsal Head ◽

Foot And Ankle ◽

Dorsal Approach ◽

Plantar Plate ◽

Direct Repair ◽

Nylon Suture ◽

A New Technique

Forefoot and lesser digital pathology continues to be a challenging area of surgical correction for foot and ankle surgeons. Many techniques for the correction of digital deformities secondary to plantar plate rupture, regardless of planal dominance, have been described including direct repair and metatarsal shortening osteotomies for repair. The authors present a new technique for multiplanar correction of deformed lesser digits without direct repair of the plantar plate rupture utilizing a specialty suture. The technique utilizes a braided synthetic polyethylene Nylon suture, which has been traditionally used for open or arthroscopic shoulder labrum repair, for the stabilization of the lesser metatarsophalangeal joint. This novel technique guide for the correction of transverse and sagittal plane deformities of the digit at the metatarsophalangeal joint negates the need for a plantar incisional approach for plantar plate repair or metatarsal head osteotomy from a dorsal approach with augmented stabilization. Levels of Evidence: Level V: Expert opinion

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Dorsal stabilization of atlantoaxial subluxation using non-absorbable sutures in toy breed dogs

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-13-01-0009 ◽

2014 ◽

Vol 27 (01) ◽

pp. 62-67 ◽

Cited By ~ 6

Author(s):

A. Luján-Feliu-Pascual ◽

C. Font ◽

J. Mascort ◽

D. Sánchez-Masian

Keyword(s):

Suture Material ◽

Neurological Status ◽

Atlantoaxial Subluxation ◽

Functional Improvement ◽

Atlantoaxial Joint ◽

Dorsal Approach ◽

Nylon Suture ◽

Dorsal Stabilization ◽

Absorbable Sutures

Summary Objectives: To describe a novel dorsal technique for stabilization of atlantoaxial sub-luxation in toy breed dogs using 3-metric nylon suture. Study: Retrospective study. Animals: Fifteen toy breed dogs with a body weight of 2 kg or less with atlantoaxial subluxation. Materials and methods: The atlantoaxial joint of each dog was surgically stabilized through a dorsal approach by placing a double strand of non-absorbable, 3-metric, nylon suture material between the dorsal muscles of the atlanto-occipital and the atlantoaxial joint muscles. Pre- and postoperative neurological status, diagnostic imaging, and complications were reviewed. Clinical follow-up examination was performed at six months. For long-term assessment, a telephone follow-up was performed. Results: No intra-operative complications were observed. Functional improvement occurred in 12 dogs. One dog did not improve and four dogs required revision surgery. In two of those four cases, suture material breakage was proven and it was suspected in the other two. Two cases underwent a second dorsal approach with the same suture material and two cases underwent a ventral approach (transarticular fixation and multiple implants embedded with polymethylmethacrylate). Conclusions: Dorsal stabilization using 3-metric nylon may be adequate as a safe, effective, and simple alternative technique for atlantoaxial stabilization in toy breed dogs of ≤1.5 kg of weight, in which the use of ventral screws and pins is challenging.

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The Effect of Suture Materials on the Biomechanical Performance of Different Flexor Tendon Repairs and the Concept of Construct Efficiency

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s2424835518500285 ◽

2018 ◽

Vol 23 (02) ◽

pp. 243-247

Author(s):

Yoke Rung Wong ◽

Austin Mun Kitt Loke ◽

Shian Chao Tay

Keyword(s):

Tensile Strength ◽

Ultimate Tensile Strength ◽

Tensile Testing ◽

Flexor Tendon ◽

Experimental Results ◽

Suture Materials ◽

Nylon Suture ◽

Biomechanical Strength ◽

Repair Techniques

Background: To propose a new term (‘construct efficiency’) for the evaluation of multi strands flexor tendon repairs using different suture materials. Methods: A total of twenty specimens from 4-0 braided polyblend sutures (FiberLoop/FiberWire; Arthrex, Naples, FL) and 4-0 nylon sutures (Supramid Extra II; S. Jackson, Inc., Alexandria, VA) were subjected to tensile testing using Pneumatic Cord-and-Yarn Grips (Instron Corp., Canton MA, USA). The ultimate tensile strengths of the suture materials were measured. The expected repair strengths and construct efficiencies were computed based on the experimental results and from available literature on actual repair strengths of the 4-strand Becker, Cruciate repairs and 6-strand Tang, modified Lim-Tsai repairs. Results: The ultimate tensile strength of nylon suture was 15.4 ± 0.6N, lower than that of braided polyblend suture (45.3 ± 2.3N) with a difference of 194%. The construct efficiency of multi strand repairs varied with respect to different repair techniques and suture materials. It was found that the Becker repairs using FiberWire had the highest construct efficiency (55.7%) followed by the modified Lim-Tsai using Supramid (50.9%), Tang repair using Supramid (49.8%), Cruciate repair using Fiberwire (49.1%), and modified Lim-Tsai repair using FiberLoop (33.5%). Conclusions: The construct efficiency is more accurate in showing that, in terms of biomechanical strength, the use of FiberWire for the 4-strand Becker and Cruciate repair is more efficient than that of using FiberLoop for 6-strand modified Lim-Tsai repair.

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