Suture Materials and Technics, Possible Cause for C-Section Scar Defect

With the increasing number of births by Caesarean section a new pathology has made its presence felt, linked to the scarring of the low uterine transverse incision. It was found that after the birth by caesarean section some patients presented postmenstrual prolonged bleeding, spotting, pelvic pain and infertility. First described in 1995, the isthmocele is a healing defect in the anterior wall of the lower uterine segment at the caesarean hysterotomy site. This faulty scarring could be attributed to physiological peculiarities of the patient, to the suturing technique or ascribed to tissue reaction specifically to the type of suture material used. We found that it may be a correlation between the suture materials used and the appearance of the isthmocele. There are no large studies that asses the long-term outcome of C-section scar on prolonged menstrual bleeding, spotting and infertility and no comparison on the rate of appearance of this pathology by account of the suture material.

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IMPACT OF TIME TO REPERFUSION ON MICROVASCULAR FUNCTION AND LONG-TERM OUTCOME AFTER PRIMARY ANGIOPLASTY FOR FIRST ANTERIOR WALL MYOCARDIAL INFARCTION

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(11)61045-0 ◽

2011 ◽

Vol 57 (14) ◽

pp. E1045

Author(s):

Takefumi Takahashi ◽

Yoshikazu Hiasa ◽

Shin-ichiro Miyazaki ◽

Shinobu Hosokawa ◽

Koichi Kishi ◽

...

Keyword(s):

Myocardial Infarction ◽

Primary Angioplasty ◽

Anterior Wall ◽

Microvascular Function ◽

Term Outcome ◽

Long Term Outcome ◽

Anterior Wall Myocardial Infarction

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Predictors of Mortality in Primary Surgical Repair of Postinfarction Ventricular Septal Defects: The Leipzig Experience

The Heart Surgery Forum ◽

10.1532/hsf.3803 ◽

2021 ◽

Vol 24 (3) ◽

pp. E522-E529

Author(s):

Maximilian Vondran ◽

Jens Garbade ◽

Sven Lehmann ◽

Johannes Laessing ◽

Mahmoud Sleiman Wehbe ◽

...

Keyword(s):

Cardiogenic Shock ◽

Surgical Repair ◽

Survival Rates ◽

Surgical Techniques ◽

Mattress Suture ◽

Term Outcome ◽

Long Term Outcome ◽

Surgical Closure ◽

Materials Used

Background: A postinfarction ventricular septal defect (pVSD) as a complication of acute myocardial infarction (AMI) is associated with high mortality. This retrospective, single-center study aimed to identify predictors of early and long-term outcomes in patients undergoing primary surgical repair of pVSD managed by various surgical techniques. Methods: We reviewed data from 77 consecutive patients who underwent primary surgical repair after pVSD in our institution. Prospectively collected demographic and perioperative data were analyzed retrospectively. Predictors of 30-day mortality and long-term outcome were assessed. Results: pVSD was anterior in 45 patients (58.4%) and posterior in 32 (41.6%). Buttressed mattress suture (n = 9, 11.7%), simple single septal patch (n = 34, 44.2%), simple double septal patch (n = 2, 2.6%), sandwich double patch (n = 1, 1.3%), and the infarct exclusion technique (n = 31, 40.3%) were performed for surgical closure. Fifty-three patients (68.8%) had preoperative cardiogenic shock. The 30-day mortality was 42.8% (33 patients). Independent risk factors of 30-day mortality were duration between AMI and surgery <7 days (odds ratio [OR] 5.229, P = .011), preoperative absence of diuretics (OR 6.913, P = .005), and preoperative cardiogenic shock (OR 3.558, P = .011). Cumulative survival rates at 1, 5, and 10 years were 57.1%, 57.1%, and 31.2%, respectively. Conclusion: In pVSD, the 30-day mortality remains high, and preoperative cardiogenic shock significantly influenced mortality in our study. None of the surgical techniques or materials used in our investigation influenced the outcome.

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Vaginal delivery compared with caesarean section in early preterm breech delivery: a comparison of long term outcome

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.1999.tb08303.x ◽

1999 ◽

Vol 106 (5) ◽

pp. 486-491 ◽

Cited By ~ 43

Author(s):

Hans Wolf ◽

Arty H. P. Schaap ◽

Hein W. Bruinse ◽

Hetty Smolders-de Haas ◽

Ingrid Ertbruggen ◽

...

Keyword(s):

Caesarean Section ◽

Vaginal Delivery ◽

Term Outcome ◽

Long Term Outcome ◽

Breech Delivery

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Mechanical testing of orthopaedic suture material and a crimp clamp system for the extracapsular stabilisation of canine cruciate-deficient stifles

Veterinární Medicína ◽

10.17221/6467-vetmed ◽

2012 ◽

Vol 57 (No. 11) ◽

pp. 597-602 ◽

Cited By ~ 2

Author(s):

V. Ledecky ◽

D. Knazovicky ◽

M. Badida ◽

L. Dulebova ◽

M. Hluchy ◽

...

Keyword(s):

Suture Material ◽

Cruciate Ligament ◽

Joint Stability ◽

Suture Materials ◽

Cranial Cruciate Ligament ◽

Stifle Joint ◽

Medial Rotation ◽

Materials Used ◽

Knot Security

The cranial cruciate ligament (CCL) provides cranio-caudal stability, prevents hyperextension and constrains medial rotation of the tibia in the canine stifle joint and CCL rupture is the leading cause of hind leg lameness in dogs. Treatment of CCL rupture aims to resolve lameness caused by joint instability and provide good long-term function of the affected hind limb. The extracapsular technique is one of the most popular methods to restore joint stability. The technique involves a suture loop that is placed around the lateral fabella and through the tibial tuberosity. The ideal suture material should be strong, aseptic, easily handled, inexpensive, and provide excellent knot security and knot compactness. A critical property of the loop is the application of either a knot or crimp to maintain the tension on the loop. There is a variety of orthopaedic suture materials used for the extracapsular technique. Our aim was to compare the mechanical properties of four commercially available materials in pure tension. The materials tested were monofilament nylon leader (MNL) 100 lb, MNL 80 lb, Supramid and Silon. Our second objective was to compare the interoperator variability of applying either a knot or a crimp to secure the suture loop. Ultimate tensile strength was greatest with MNL 100 lb (373 N) followed by MNL 80 lb (285 N), Supramid (160 N) and Silon (103 N). Based on our results, we conclude that MNL 100 lb and MNL 80 lb are mechanically superior to Silon and Supramid. Our study also shows significant effects for the operator and method of loop fixation (P < 0.0001). Intraoperator differences were also found to be significant, for operator 1 (P < 0.0001), for operator 2 (P < 0.001) and operator 3 (P < 0.01). Our findings indicate that MNL is most suitable orthopaedic material and that loop fixation should remain the method of choice for surgeons treating CCL.

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