Background: Forces applied to knots used for interrupted vs. continuous closures are very different. We studied the knot strength and knot security of three knots when simulating a continuous wound closure: the square...Background: Forces applied to knots used for interrupted vs. continuous closures are very different. We studied the knot strength and knot security of three knots when simulating a continuous wound closure: the square, the sliding, and a hybrid constructed using a surgeon’s square knot followed by a sliding knot. Mate-rials and Methods: Knot holding capacity (KHC) of single-strand 1-0 polypropylene was determined by slow distraction on a horizontal testing sled of the strand that would be used to complete a continuous (“running”) closure following placement of an anchoring knot with six throws. Distraction continued until failure of the knot defined as breakage or slippage of the knot. Results: The mean and standard deviation of KHC meas-ured in pounds was determined (n = 30 for each knot): standard square 8.94 +/– 1.04;sliding 10.72 +/– 1.35;and hybrid 10.95 +/– 1.10. For each knot the relative knot security [(KHC of the knot/Tensile strength of untied strand) x 100] was calculated: standard square 69.5%;sliding 83.4%;hybrid 85.2%. Significant dif-ferences (p < 0.0001) in KHC exist between square and sliding knots (favoring sliding knots) and between square and hybrid knots (favoring hybrid knots). Hybrid and sliding knots were not statistically different. Conclusion: Sliding knots and hybrid knots are superior to square knots as anchoring knots for single-strand continuous wound closure.展开更多
为探讨单向倒刺线连续缝合与可吸收线连续锁边缝合在全膝关节置换术加速康复中的临床应用效果,回顾性分析2020年3月—2022年6月邯郸市中心医院行初次全膝关节置换手术的106例患者,分为对照组(52例)和观察组(54例)。对照组采用可吸收线...为探讨单向倒刺线连续缝合与可吸收线连续锁边缝合在全膝关节置换术加速康复中的临床应用效果,回顾性分析2020年3月—2022年6月邯郸市中心医院行初次全膝关节置换手术的106例患者,分为对照组(52例)和观察组(54例)。对照组采用可吸收线连续锁边缝合切口,观察组采用单向倒刺线连续缝合切口。比较两组缝合时间、手术时间、失血量和术后住院时间、膝关节活动度(range of motion,ROM)、膝关节功能以及并发症差异。结果表明:观察组缝合时间短于对照组(P<0.05),皮下瘀斑、针刺伤发生率低于对照组(P<0.05)。观察组手术时间、平均失血量和平均住院时间、术后7 d美国纽约特种外科医院评分(hospital for special surgery knee score,HSS)、Rasmussen评分、膝关节ROM、切口红肿、切口感染、切口延迟愈合发生率与对照组比较差异无统计学意义(P>0.05)。可见单向倒刺线连续缝合可缩短缝合时间,降低术后皮下瘀斑和针刺伤发生率,有利于患者术后功能的恢复,缩短住院时间,在全膝关节置换术加速康复中具有一定优势。展开更多
文摘Background: Forces applied to knots used for interrupted vs. continuous closures are very different. We studied the knot strength and knot security of three knots when simulating a continuous wound closure: the square, the sliding, and a hybrid constructed using a surgeon’s square knot followed by a sliding knot. Mate-rials and Methods: Knot holding capacity (KHC) of single-strand 1-0 polypropylene was determined by slow distraction on a horizontal testing sled of the strand that would be used to complete a continuous (“running”) closure following placement of an anchoring knot with six throws. Distraction continued until failure of the knot defined as breakage or slippage of the knot. Results: The mean and standard deviation of KHC meas-ured in pounds was determined (n = 30 for each knot): standard square 8.94 +/– 1.04;sliding 10.72 +/– 1.35;and hybrid 10.95 +/– 1.10. For each knot the relative knot security [(KHC of the knot/Tensile strength of untied strand) x 100] was calculated: standard square 69.5%;sliding 83.4%;hybrid 85.2%. Significant dif-ferences (p < 0.0001) in KHC exist between square and sliding knots (favoring sliding knots) and between square and hybrid knots (favoring hybrid knots). Hybrid and sliding knots were not statistically different. Conclusion: Sliding knots and hybrid knots are superior to square knots as anchoring knots for single-strand continuous wound closure.
文摘为探讨单向倒刺线连续缝合与可吸收线连续锁边缝合在全膝关节置换术加速康复中的临床应用效果,回顾性分析2020年3月—2022年6月邯郸市中心医院行初次全膝关节置换手术的106例患者,分为对照组(52例)和观察组(54例)。对照组采用可吸收线连续锁边缝合切口,观察组采用单向倒刺线连续缝合切口。比较两组缝合时间、手术时间、失血量和术后住院时间、膝关节活动度(range of motion,ROM)、膝关节功能以及并发症差异。结果表明:观察组缝合时间短于对照组(P<0.05),皮下瘀斑、针刺伤发生率低于对照组(P<0.05)。观察组手术时间、平均失血量和平均住院时间、术后7 d美国纽约特种外科医院评分(hospital for special surgery knee score,HSS)、Rasmussen评分、膝关节ROM、切口红肿、切口感染、切口延迟愈合发生率与对照组比较差异无统计学意义(P>0.05)。可见单向倒刺线连续缝合可缩短缝合时间,降低术后皮下瘀斑和针刺伤发生率,有利于患者术后功能的恢复,缩短住院时间,在全膝关节置换术加速康复中具有一定优势。
