Barbed surgical sutures have attracted worldwide attention in recent years. The plurality of barbs projecting out and penetrating into surrounding tissue eliminates the need for tying a knot. In the current study,nylo...Barbed surgical sutures have attracted worldwide attention in recent years. The plurality of barbs projecting out and penetrating into surrounding tissue eliminates the need for tying a knot. In the current study,nylon and polypropylene( PP) barbed sutures with two different barb geometries designed to anchor in porcine skin and tendon tissues were fabricated by a specially designed mechanical cutting machine. The tensile properties were compared between the barbed and unbarbed control sutures. The in vitro tissue anchoring ability was measured by two tissue /suture pullout tests,one for skin and the other for tendon tissue. Regardless of the type of tissue,the PP barbed suture with its higher modulus had a superior anchoring ability. Given the same suture material,improved anchoring performance was shown in tendon tissue.展开更多
Nonylphenol (NP) is the final degradation product of alkylphenol polyethoxylates (APEs), which are widely present in plastics, papers, pulp, detergents, pesticides, herbicides, paints and cosmetics. It is estimate...Nonylphenol (NP) is the final degradation product of alkylphenol polyethoxylates (APEs), which are widely present in plastics, papers, pulp, detergents, pesticides, herbicides, paints and cosmetics. It is estimated that annual global production of APEs is about 500000 t, 60% of which eventually ends up in aquatic ecosystems primarily via wastewater (So16 et cd., 2000). NP is resistant to biodegradation and persistent in the environment (Arukwe et al., 2000).展开更多
A 27-year-old man with recurrent right lower quadrant pain was admitted to our hospital. Ultrasonography and computed tomography examination of the abdomen revealed a target sign in the ascending colon, which was comp...A 27-year-old man with recurrent right lower quadrant pain was admitted to our hospital. Ultrasonography and computed tomography examination of the abdomen revealed a target sign in the ascending colon, which was compatible with the diagnosis of cecal intussusception. The intussusception was spontaneously resolved at that time, but it relapsed 6 mo later. The patient underwent a successful colonoscopic disinvagination; there was no evidence of neoplastic or inflammatory lesions in the colon and terminal ileum. The patient underwent laparoscopic surgery for recurring cecal intussusception. During laparoscopy, we observed an unfixed cecum on the posterior peritoneum(i.e. a mobile cecum). Thus, we performed laparoscopic appendectomy and cecopexy with a lateral peritoneal flap using a barbed wound suture device. The patient's post-operative course was uneventful, and he continued to do well without recurrence at 10 mo after surgery. Laparoscopic cecopexy using a barbed wound suture device is a simple and reliable procedure that can be the treatment of choice for recurrent cecal intussusception associated with a mobile cecum.展开更多
The development of an efficient technology for removing fine particles in flue gas is essential as the haze is becoming more and more serious.To improve agglomeration effectiveness of fine particles,a dual zone electr...The development of an efficient technology for removing fine particles in flue gas is essential as the haze is becoming more and more serious.To improve agglomeration effectiveness of fine particles,a dual zone electric agglomeration device consisting of a charging chamber and an agglomeration chamber with bipolar barb electrodes was developed.The bipolar barb electric agglomerator with a polar distance of 200 mm demonstrates good agglomeration effectiveness for particles with a size less than 8.0μm under applied AC electric field.An optimal condition for achieving better agglomeration effectiveness was found to be as follows:flue gas flow velocity of3.00 m/s,particle concentration of 2.00 g/m^3,output voltage of 35 kV and length of the barb of16 ram.In addition,4.0-6.0μm particles haste the best effectiveness with the variation of particle volume occupancy of-3.2.展开更多
A new technology of knotless barbed surgical sutures has made its mark in cosmetic surgery around the world. Although this technology is still under development, it has been approved by the Federal Drug Administration...A new technology of knotless barbed surgical sutures has made its mark in cosmetic surgery around the world. Although this technology is still under development, it has been approved by the Federal Drug Administration in USA, and is now used for facelift and eyelid ptosis procedures. The objectives of this study were to review the different types of knotless sutures, assess the tissue holding capacity of barbed sutures and perform image analysis to better understand the mechanism of energy absorption by the barbs under loading by the forces of surrounding tissues. A two dimensional finite element analysis was also performed to identify the areas of stress concentration, which are the main precursors for the peeling of the barbs beyond the maximun tissue holding force for a particular polymer. It was found that barbed sutures exhibit tissue holding capacities comparable to that of knotted sutures. This technology needs to be investigated further so as to optimize the barb geometry for superior holding capacity in a variety of different tissues.展开更多
BACKGROUND Anastomotic leakage(AL) is a severe complication in rectal cancer surgery.Various methods, including intracorporeal reinforcing suturing, have been used to reduce the incidence of AL. However, little is kno...BACKGROUND Anastomotic leakage(AL) is a severe complication in rectal cancer surgery.Various methods, including intracorporeal reinforcing suturing, have been used to reduce the incidence of AL. However, little is known about the efficacy of staple-line reinforcement by barbed suture for preventing AL.AIM To evaluate the efficacy of staple-line reinforcement using barbed suture for preventing AL in laparoscopic surgery for rectal cancer.METHODS We retrospectively reviewed the clinical datum of 319 patients undergoing laparoscopic low anterior resection combined with double stapling technique between May 1, 2017 and January 31, 2021. All surgeries were performed by the same surgical team specializing in colorectal surgery. Patients were divided into two groups depending on whether they received reinforcing sutures. Patients’ baseline characteristics did not show any significant difference between the two groups. We analyzed patient-, tumor-, as well as surgery-related variables using univariate and multivariate logistic analyses.RESULTS There were 168 patients in the reinforcing suture group and 151 patients in the non-reinforcing suture group. AL occurred in 25 cases(7.8%). Its incidence was significantly higher in the non-reinforcing suture group than in the reinforcing suture group(4.8% vs 11.3%, P = 0.031). The multivariate analyses demonstrated that the tumor site, tumor size and presence of staple-line reinforcement were independent risk factors for AL. We divided these patients into two risk groups based on the combination of tumor site and tumor size. Patients without any risk factor were assigned to the low-risk group(n = 177), whereas those having one or two risk factors were assigned to the high-risk group(n = 142). In the high-risk group, the AL incidence considerably decreased in the reinforcing suture group compared with that in the non-reinforcing suture group(P = 0.038). Nonetheless, no significant difference was found in the low-risk group between the two groups.CONCLUSION Staple-line reinforcement by barbed suture may decrease the incidence of AL. A large-scale prospective randomized controlled trial is needed for evaluating the efficacy of staple-line reinforcement for preventing AL.展开更多
<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> The use of barbed suture in laparoscopic surgery is ...<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> The use of barbed suture in laparoscopic surgery is increasing ever since 2008. Published reports of use of unidirectional barbed suture for vaginal vault closure following total laparoscopic hysterectomy (TLH), indi</span><span style="font-family:Verdana;">cates it is safe. Despite of this many reports of adhesions and bowel obstruction </span><span style="font-family:Verdana;">are reported. This complication was never assessed in relation to amount of suture exposure at vaginal vault. We thought of quantifying the barbed suture exposure at vaginal vault and assess the risk of post-operative complications. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> The objective was to quantify the exposure of barbed suture at vaginal </span><span style="font-family:Verdana;">vault by adopting a uniform technique of vault suturing and assessing p</span><span style="font-family:Verdana;">ost</span><span><span style="font-family:Verdana;">operative risk related to adhesions at vaginal vault. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">In 30 pati</span></span><span style="font-family:Verdana;">ents who underwent TLH, a uniform new technique of vaginal vault closure using barbed suture was used and the portion of suture exposed at vaginal vault was quantified. The patients were followed up for a period of 6 months to assess post-operative risk of adhesions at vault and sequalae. </span><b><span style="font-family:Verdana;">Result:</span></b><span style="font-family:Verdana;"> Mean length of suture exposed was 2.64 ± 1.65 mm only. Suture exposure at vaginal vault was seen in 23 (76.67%) out of 30 patients. The suture was exposed on average at 1.57 ± 1.20 places at vaginal vault. </span><b><span style="font-family:Verdana;">Conclusion and Recommendations:</span></b><span style="font-family:Verdana;"> The study with an accepted relative error of 5% quantifies barbed suture exposure at vaginal vault. We had adopted a uniform new method of vaginal vault suturing to study and to quantify barbed suture exposure. It was observed that very minimal portion of suture was exposed at vaginal vault. It was exposed at only a couple of places at vaginal vault. Thus, decreasing suture exposure at vaginal vault will reduce its exposure related risk.</span></span></span></span>展开更多
Aim: The ideal flexor tendon repair should be reliable, simple and strong enough without impairing the tendon healing. Based on these requirements, we have imagined the use of a single barbed intra-tendinous suture fo...Aim: The ideal flexor tendon repair should be reliable, simple and strong enough without impairing the tendon healing. Based on these requirements, we have imagined the use of a single barbed intra-tendinous suture for stumps connection. The aim of our research is to quantify the stress that the suture and barbs should withstand in order to ensure perfect stumps connections. Methods: Seven different cross-section sutures were selected for the research study. One circular and 6 different elliptical shapes were defined according to the ratio of their minor and major axes (ρ = b/a). Barbs were designed with 3 different depths and 3 different cut angles. Thus, 9 different situations were considered for each suture geometry. Finally, 2 loading conditions were applied on each barb and tested in ANSYS Workbench using a finite element analysis technique. Results: Studies showed that a barbed suture with 0.18-mm depth, 150° cut angle and ρ = 3 produced the lowest stresses within the barb itself, while a barbed suture with 0.18-mm depth, 160° cut angle and ρ = 4 demonstrated lowest stress within the entire suture. Conclusion: The stress values in these two configurations are observed to be very close and both can fit a single barbed suture for tendon insertion and repair.展开更多
Aim: Use of barbed sutures for fiexor tendon repair is a promising technique. These sutures lie within the substance of the tendon, avoiding the need of external knots and so improving tendon gliding. The load is disp...Aim: Use of barbed sutures for fiexor tendon repair is a promising technique. These sutures lie within the substance of the tendon, avoiding the need of external knots and so improving tendon gliding. The load is dispersed equally along the length of the barbed suture, decreasing the possibility of rupture. The purpose of this article is to propose enhanced suture geometry by comparing different cross-sectional configurations, barb cut angles and cut depths using the finite element method. Methods: lnspired by the geometry of fiexor tendons, an elliptical cross-sectional wire was investigated. Mechanical behavior of five different aspect ratios (ρ = 1/3, 1/2, 1, 2, 3), three different cut angles (150°, 154°, 160°) and three cut depths (0.07-mm, 0.12-mm, 0.18-mm) were studied via extended finite element analysis using ABAQUS, for two different loading conditions: one to assess the strength of the suture and the second to evaluate the strength of a single barb. An extended finite element method has been implemented on ABAQUS to predict crack growth in viscoelastic material. Results: Based on these results, an elliptical suture having an aspect ratio of 1/2, 160° of cut angle, and 0.12-mm of cut depth is recommended. Conclusion: Barbed sutures are a good option for tendon repair. Our experiments assessed the mechanical performance of barbed sutures and suggested an optimized suture geometry for a single-stranded repair technique.展开更多
Aim:The primary author previously described his technique for periareolar closure in mastopexy using a pinwheel interlocking purse string with absorbable barbed suture and now reports the results of a retrospective ph...Aim:The primary author previously described his technique for periareolar closure in mastopexy using a pinwheel interlocking purse string with absorbable barbed suture and now reports the results of a retrospective photometric analysis comparing this technique with the same closure using Gortex®suture.This study is designed to compare the degree of areolar widening and safety profile of using absorbable barbed sutures for periareolar closure versus permanent smooth suture.Methods:A retrospective chart review was conducted of all patients whose periareolar closures were performed using an interlocking purse-string technique over a 10-year period.Only patients undergoing circumvertical mastopexy were included.All had photometric evaluation and follow-up performed within 6-24 months.Results:In total,20 patients(40 areolas),which were closed with absorbable barbed suture,were analyzed photometrically.In this suture group,areola size increased a mean of 4.9%from baseline,and no complications(0%)were observed.This compared favorably with previously reported complication rates using permanent sutures and with a series of cases presented herein in which permanent smooth suture was used for purse string closure.The degree to which absorbable barbed suture controls areolar spread was shown to be significantly better than those where permanent smooth purse string techniques were employed.Conclusion:Circumvertical mastopexy closures using absorbable barbed suture was shown to be safe and effective and compared favorably to older techniques using permanent smooth suture for similar closures.This paper lends support to the safety of using absorbable barbed suture in circumareolar closures to limit areolar spread.展开更多
A new glacial history paradigm that describes huge and prolonged southwest-oriented meltwater floods flowing along the rising rim of a deep “hole” (which a large continental icesheet created and occupied) is used to...A new glacial history paradigm that describes huge and prolonged southwest-oriented meltwater floods flowing along the rising rim of a deep “hole” (which a large continental icesheet created and occupied) is used to explain previously unexplained or poorly explained central Pennsylvania Bald Eagle through valley region topographic map evidence. Pennsylvania’s Bald Eagle through valley as defined here extends in a northeast direction from near Altoona to near Williamsport along the Allegheny Front escarpment base and forms the boundary between the Appalachian Plateau to the northwest and the Ridge and Valley Province to the southeast. The Lycoming and Towanda Creek valleys follow a probable northeastern Bald Eagle through valley extension and a probable southern extension continues southward along the Allegheny Front base by crossing Juniata River tributary drainage basins to reach the Potomac River drainage basin. Landform features identified on topographic maps, which include through valleys (valleys crossing drainage divides), barbed tributaries, drainage route orientations, drainage route direction changes, water gaps, and gaps located along the Allegheny Front crest, are used to reconstruct how the Pennsylvania Susquehanna and Juniata River drainage systems developed. The resulting geomorphic history describes how massive southwest-oriented floods moving across what was probably a low relief and rising surface (now preserved if preserved at all by the region’s highest elevations) flowed to an actively eroding Potomac River drainage system before being captured and sometimes reversed first by Juniata River valley headward erosion, second by West Branch Susquehanna River valley headward erosion (to create northeast-oriented Bald Eagle Creek and the northeast-oriented West Branch Susquehanna River segment) and third by North Branch Susquehanna River valley headward erosion. This interpretation explains most if not all of the previously poorly explained and unexplained topographic map evidence.展开更多
文摘Barbed surgical sutures have attracted worldwide attention in recent years. The plurality of barbs projecting out and penetrating into surrounding tissue eliminates the need for tying a knot. In the current study,nylon and polypropylene( PP) barbed sutures with two different barb geometries designed to anchor in porcine skin and tendon tissues were fabricated by a specially designed mechanical cutting machine. The tensile properties were compared between the barbed and unbarbed control sutures. The in vitro tissue anchoring ability was measured by two tissue /suture pullout tests,one for skin and the other for tendon tissue. Regardless of the type of tissue,the PP barbed suture with its higher modulus had a superior anchoring ability. Given the same suture material,improved anchoring performance was shown in tendon tissue.
基金The Hi-Tech Research and Development Program (863) of China (No. 2001AA649040)
文摘Nonylphenol (NP) is the final degradation product of alkylphenol polyethoxylates (APEs), which are widely present in plastics, papers, pulp, detergents, pesticides, herbicides, paints and cosmetics. It is estimated that annual global production of APEs is about 500000 t, 60% of which eventually ends up in aquatic ecosystems primarily via wastewater (So16 et cd., 2000). NP is resistant to biodegradation and persistent in the environment (Arukwe et al., 2000).
文摘A 27-year-old man with recurrent right lower quadrant pain was admitted to our hospital. Ultrasonography and computed tomography examination of the abdomen revealed a target sign in the ascending colon, which was compatible with the diagnosis of cecal intussusception. The intussusception was spontaneously resolved at that time, but it relapsed 6 mo later. The patient underwent a successful colonoscopic disinvagination; there was no evidence of neoplastic or inflammatory lesions in the colon and terminal ileum. The patient underwent laparoscopic surgery for recurring cecal intussusception. During laparoscopy, we observed an unfixed cecum on the posterior peritoneum(i.e. a mobile cecum). Thus, we performed laparoscopic appendectomy and cecopexy with a lateral peritoneal flap using a barbed wound suture device. The patient's post-operative course was uneventful, and he continued to do well without recurrence at 10 mo after surgery. Laparoscopic cecopexy using a barbed wound suture device is a simple and reliable procedure that can be the treatment of choice for recurrent cecal intussusception associated with a mobile cecum.
基金supported by the Key Technology R&D Program of Hebei,China(No.13211207D)
文摘The development of an efficient technology for removing fine particles in flue gas is essential as the haze is becoming more and more serious.To improve agglomeration effectiveness of fine particles,a dual zone electric agglomeration device consisting of a charging chamber and an agglomeration chamber with bipolar barb electrodes was developed.The bipolar barb electric agglomerator with a polar distance of 200 mm demonstrates good agglomeration effectiveness for particles with a size less than 8.0μm under applied AC electric field.An optimal condition for achieving better agglomeration effectiveness was found to be as follows:flue gas flow velocity of3.00 m/s,particle concentration of 2.00 g/m^3,output voltage of 35 kV and length of the barb of16 ram.In addition,4.0-6.0μm particles haste the best effectiveness with the variation of particle volume occupancy of-3.2.
基金College of Textiles,North Carolina State University,USA
文摘A new technology of knotless barbed surgical sutures has made its mark in cosmetic surgery around the world. Although this technology is still under development, it has been approved by the Federal Drug Administration in USA, and is now used for facelift and eyelid ptosis procedures. The objectives of this study were to review the different types of knotless sutures, assess the tissue holding capacity of barbed sutures and perform image analysis to better understand the mechanism of energy absorption by the barbs under loading by the forces of surrounding tissues. A two dimensional finite element analysis was also performed to identify the areas of stress concentration, which are the main precursors for the peeling of the barbs beyond the maximun tissue holding force for a particular polymer. It was found that barbed sutures exhibit tissue holding capacities comparable to that of knotted sutures. This technology needs to be investigated further so as to optimize the barb geometry for superior holding capacity in a variety of different tissues.
基金Supported by Science and Technology Development Project of Jilin Province,China,No. 2020SCZT079。
文摘BACKGROUND Anastomotic leakage(AL) is a severe complication in rectal cancer surgery.Various methods, including intracorporeal reinforcing suturing, have been used to reduce the incidence of AL. However, little is known about the efficacy of staple-line reinforcement by barbed suture for preventing AL.AIM To evaluate the efficacy of staple-line reinforcement using barbed suture for preventing AL in laparoscopic surgery for rectal cancer.METHODS We retrospectively reviewed the clinical datum of 319 patients undergoing laparoscopic low anterior resection combined with double stapling technique between May 1, 2017 and January 31, 2021. All surgeries were performed by the same surgical team specializing in colorectal surgery. Patients were divided into two groups depending on whether they received reinforcing sutures. Patients’ baseline characteristics did not show any significant difference between the two groups. We analyzed patient-, tumor-, as well as surgery-related variables using univariate and multivariate logistic analyses.RESULTS There were 168 patients in the reinforcing suture group and 151 patients in the non-reinforcing suture group. AL occurred in 25 cases(7.8%). Its incidence was significantly higher in the non-reinforcing suture group than in the reinforcing suture group(4.8% vs 11.3%, P = 0.031). The multivariate analyses demonstrated that the tumor site, tumor size and presence of staple-line reinforcement were independent risk factors for AL. We divided these patients into two risk groups based on the combination of tumor site and tumor size. Patients without any risk factor were assigned to the low-risk group(n = 177), whereas those having one or two risk factors were assigned to the high-risk group(n = 142). In the high-risk group, the AL incidence considerably decreased in the reinforcing suture group compared with that in the non-reinforcing suture group(P = 0.038). Nonetheless, no significant difference was found in the low-risk group between the two groups.CONCLUSION Staple-line reinforcement by barbed suture may decrease the incidence of AL. A large-scale prospective randomized controlled trial is needed for evaluating the efficacy of staple-line reinforcement for preventing AL.
文摘<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> The use of barbed suture in laparoscopic surgery is increasing ever since 2008. Published reports of use of unidirectional barbed suture for vaginal vault closure following total laparoscopic hysterectomy (TLH), indi</span><span style="font-family:Verdana;">cates it is safe. Despite of this many reports of adhesions and bowel obstruction </span><span style="font-family:Verdana;">are reported. This complication was never assessed in relation to amount of suture exposure at vaginal vault. We thought of quantifying the barbed suture exposure at vaginal vault and assess the risk of post-operative complications. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> The objective was to quantify the exposure of barbed suture at vaginal </span><span style="font-family:Verdana;">vault by adopting a uniform technique of vault suturing and assessing p</span><span style="font-family:Verdana;">ost</span><span><span style="font-family:Verdana;">operative risk related to adhesions at vaginal vault. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">In 30 pati</span></span><span style="font-family:Verdana;">ents who underwent TLH, a uniform new technique of vaginal vault closure using barbed suture was used and the portion of suture exposed at vaginal vault was quantified. The patients were followed up for a period of 6 months to assess post-operative risk of adhesions at vault and sequalae. </span><b><span style="font-family:Verdana;">Result:</span></b><span style="font-family:Verdana;"> Mean length of suture exposed was 2.64 ± 1.65 mm only. Suture exposure at vaginal vault was seen in 23 (76.67%) out of 30 patients. The suture was exposed on average at 1.57 ± 1.20 places at vaginal vault. </span><b><span style="font-family:Verdana;">Conclusion and Recommendations:</span></b><span style="font-family:Verdana;"> The study with an accepted relative error of 5% quantifies barbed suture exposure at vaginal vault. We had adopted a uniform new method of vaginal vault suturing to study and to quantify barbed suture exposure. It was observed that very minimal portion of suture was exposed at vaginal vault. It was exposed at only a couple of places at vaginal vault. Thus, decreasing suture exposure at vaginal vault will reduce its exposure related risk.</span></span></span></span>
文摘Aim: The ideal flexor tendon repair should be reliable, simple and strong enough without impairing the tendon healing. Based on these requirements, we have imagined the use of a single barbed intra-tendinous suture for stumps connection. The aim of our research is to quantify the stress that the suture and barbs should withstand in order to ensure perfect stumps connections. Methods: Seven different cross-section sutures were selected for the research study. One circular and 6 different elliptical shapes were defined according to the ratio of their minor and major axes (ρ = b/a). Barbs were designed with 3 different depths and 3 different cut angles. Thus, 9 different situations were considered for each suture geometry. Finally, 2 loading conditions were applied on each barb and tested in ANSYS Workbench using a finite element analysis technique. Results: Studies showed that a barbed suture with 0.18-mm depth, 150° cut angle and ρ = 3 produced the lowest stresses within the barb itself, while a barbed suture with 0.18-mm depth, 160° cut angle and ρ = 4 demonstrated lowest stress within the entire suture. Conclusion: The stress values in these two configurations are observed to be very close and both can fit a single barbed suture for tendon insertion and repair.
文摘Aim: Use of barbed sutures for fiexor tendon repair is a promising technique. These sutures lie within the substance of the tendon, avoiding the need of external knots and so improving tendon gliding. The load is dispersed equally along the length of the barbed suture, decreasing the possibility of rupture. The purpose of this article is to propose enhanced suture geometry by comparing different cross-sectional configurations, barb cut angles and cut depths using the finite element method. Methods: lnspired by the geometry of fiexor tendons, an elliptical cross-sectional wire was investigated. Mechanical behavior of five different aspect ratios (ρ = 1/3, 1/2, 1, 2, 3), three different cut angles (150°, 154°, 160°) and three cut depths (0.07-mm, 0.12-mm, 0.18-mm) were studied via extended finite element analysis using ABAQUS, for two different loading conditions: one to assess the strength of the suture and the second to evaluate the strength of a single barb. An extended finite element method has been implemented on ABAQUS to predict crack growth in viscoelastic material. Results: Based on these results, an elliptical suture having an aspect ratio of 1/2, 160° of cut angle, and 0.12-mm of cut depth is recommended. Conclusion: Barbed sutures are a good option for tendon repair. Our experiments assessed the mechanical performance of barbed sutures and suggested an optimized suture geometry for a single-stranded repair technique.
文摘Aim:The primary author previously described his technique for periareolar closure in mastopexy using a pinwheel interlocking purse string with absorbable barbed suture and now reports the results of a retrospective photometric analysis comparing this technique with the same closure using Gortex®suture.This study is designed to compare the degree of areolar widening and safety profile of using absorbable barbed sutures for periareolar closure versus permanent smooth suture.Methods:A retrospective chart review was conducted of all patients whose periareolar closures were performed using an interlocking purse-string technique over a 10-year period.Only patients undergoing circumvertical mastopexy were included.All had photometric evaluation and follow-up performed within 6-24 months.Results:In total,20 patients(40 areolas),which were closed with absorbable barbed suture,were analyzed photometrically.In this suture group,areola size increased a mean of 4.9%from baseline,and no complications(0%)were observed.This compared favorably with previously reported complication rates using permanent sutures and with a series of cases presented herein in which permanent smooth suture was used for purse string closure.The degree to which absorbable barbed suture controls areolar spread was shown to be significantly better than those where permanent smooth purse string techniques were employed.Conclusion:Circumvertical mastopexy closures using absorbable barbed suture was shown to be safe and effective and compared favorably to older techniques using permanent smooth suture for similar closures.This paper lends support to the safety of using absorbable barbed suture in circumareolar closures to limit areolar spread.
文摘A new glacial history paradigm that describes huge and prolonged southwest-oriented meltwater floods flowing along the rising rim of a deep “hole” (which a large continental icesheet created and occupied) is used to explain previously unexplained or poorly explained central Pennsylvania Bald Eagle through valley region topographic map evidence. Pennsylvania’s Bald Eagle through valley as defined here extends in a northeast direction from near Altoona to near Williamsport along the Allegheny Front escarpment base and forms the boundary between the Appalachian Plateau to the northwest and the Ridge and Valley Province to the southeast. The Lycoming and Towanda Creek valleys follow a probable northeastern Bald Eagle through valley extension and a probable southern extension continues southward along the Allegheny Front base by crossing Juniata River tributary drainage basins to reach the Potomac River drainage basin. Landform features identified on topographic maps, which include through valleys (valleys crossing drainage divides), barbed tributaries, drainage route orientations, drainage route direction changes, water gaps, and gaps located along the Allegheny Front crest, are used to reconstruct how the Pennsylvania Susquehanna and Juniata River drainage systems developed. The resulting geomorphic history describes how massive southwest-oriented floods moving across what was probably a low relief and rising surface (now preserved if preserved at all by the region’s highest elevations) flowed to an actively eroding Potomac River drainage system before being captured and sometimes reversed first by Juniata River valley headward erosion, second by West Branch Susquehanna River valley headward erosion (to create northeast-oriented Bald Eagle Creek and the northeast-oriented West Branch Susquehanna River segment) and third by North Branch Susquehanna River valley headward erosion. This interpretation explains most if not all of the previously poorly explained and unexplained topographic map evidence.