Oxygen Penetration Through Full-Thickness Skin by Oxygen-Releasing Sutures for Skin Graft Transplantation

The transplantation of full-thickness skin grafts(FTSGs)is important for reconstructing skin barrier and promoting wound healing.Sufficient oxygen supply is closely related to the success of skin grafting.However,full-thickness oxygen delivery is limited by the poor oxygen permeability of skin.Oxygen-releasing sutures(O_(2)sutures)were developed to facilitate oxygen penetration through full-thickness skin.The O_(2)sutures delivered 100 times more oxygen than topical gaseous oxygen therapy at a 15 mm depth in the skin model.Under extreme hypoxia(<0.5%O_(2),v/v),O_(2)sutures could also promote endothelial cell proliferation.After the transplantation of FTSGs in mice,O_(2)sutures accelerated blood re-perfusion and increased the survival area of the skin graft.It is expected that O_(2)sutures will be adopted in clinical applications to increase the success rate of full-thickness skin transplantation.

Early Triassic Volcanic Rocks in the Western Yarlung Zangbo Suture Zone:Implications for the Opening of the Neo-Tethys Ocean

In this study,zircon U-Pb dating of volcanic rocks from the Zhongba ophiolite of the Yarlung Zangbo Suture Zone(YZSZ)in southern Xizang(Tibet)yielded an age of 247±3 Ma.According to whole rock geochemical and Sr-NdPb isotopic data,the Early Triassic samples could be divided into two groups:Group 1 with P-MORB affinity,showing initial^(87)Sr/^(86)Sr ratios of 0.70253–0.70602,ε_(Nd)(t)values of 4.2–5.3,(^(206)Pb/^(204)Pb)_(t)ratios of 16.353–18.222,(^(207)Pb/^(204)Pb)_(t)ratios of 15.454–15.564,and(^(208)Pb/^(204)Pb)_(t)ratios of 35.665–38.136;Group 2 with OIB affinity,showing initial^(87)Sr/^(86)Sr ratios of 0.70249–0.70513,ε_(Nd)(t)values of 4.4–4.9,(^(206)Pb/^(204)Pb)_(t)ratios of 17.140–18.328,(^(207)Pb/^(204)Pb)_(t)ratios of 15.491–15.575,and(^(208)Pb/^(204)Pb)_(t)ratios of 36.051–38.247.Group 2 rocks formed by partial melting of the mantle source enriched by a former plume,and assimilated continental crustal material during melt ascension.The formation of Group 1 rocks corresponds to the mixing of OIB melts,with the same components as Group 2 and N-MORBs.The Zhongba Early Triassic rocks belong to the continental margin type ophiolite and formed in the continental–oceanic transition zone during the initial opening of the Neo-Tethys in southern Xizang(Tibet).

Double-nylon purse-string suture in closing postoperative wounds following endoscopic resection of large(≥3 cm)gastric submucosal tumors

BACKGROUND Endoscopic full-thickness resection(EFTR)of gastric submucosal tumors(SMTs)is safe and effective;however,postoperative wound management is equally important.Literature on suturing following EFTR for large(≥3 cm)SMTs is scarce and limited.AIM To evaluate the efficacy and clinical value of double-nylon purse-string suture in closing postoperative wounds following EFTR of large(≥3 cm)SMTs.METHODS We retrospectively analyzed the data of 85 patients with gastric SMTs in the fundus of the stomach or in the lesser curvature of the gastric body whose wounds were treated with double-nylon purse-string sutures after successful tumor resection at the Endoscopy Center of Renmin Hospital of Wuhan University.The operative,postoperative,and follow-up conditions of the patients were evaluated.RESULTS All tumors were completely resected using EFTR.36(42.35%)patients had tumors located in the fundus of the stomach,and 49(57.65%)had tumors located in the body of the stomach.All patients underwent suturing with double-nylon sutures after EFTR without laparoscopic assistance or further surgical treatment.Postoperative fever and stomach pain were reported in 13(15.29%)and 14(16.47%)patients,respectively.No serious adverse events occurred during the intraoperative or postoperative periods.A postoperative review of all patients revealed no residual or recurrent lesions.CONCLUSION Double-nylon purse-string sutures can be used to successfully close wounds that cannot be completely closed with a single nylon suture,especially for large(≥3 cm)EFTR wounds in SMTs.

Intermittent sliding-lock-knot suture for limbal conjunctival autograft fixation in pterygium surgery:a technique note

AIM:To report a technique used with intermittent slidinglock-knot(ISLK)fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent(RI)fixation.METHODS:Consecutive patients with primary pterygium who had undergone pterygium excision combined with limbal conjunctival autograft transplantation between March 2021 and March 2022 at our institute were retrospectively analyzed.Primary outcome measures were mean duration of surgery and suture removal,degree of conjunctival hyperemia on postoperative day 1,pain score at suture removal,postoperative symptoms at 6mo,including conjunctival hyperemia,foreign body sensation,and graft stability.RESULTS:Ninety-eight patients underwent monocular surgery and were divided into ISLK(51 eyes)and RI(47 eyes)groups according to the type of conjunctiva autograft fixation method planned.There was no significant difference in mean duration of surgery between the two groups(18.59±2.39min vs 18.15±2.20min,P=0.417);however,compared to the RI group,shorter suture removal times were observed in the ISLK group[0.58min(0.42-0.87)vs 3.00min(2.21-4.15),P<0.001].The degree of conjunctival hyperemia on postoperative day 1 was milder in the ISLK group(P<0.001).Pain scores at suture removal were lower in the ISLK group than in RI group[1(0-3)vs 2(1-4),P<0.001].Postoperative symptoms at 6mo were comparable between the groups(P=0.487),with no recurrence.CONCLUSION:ISLK is an innovative method for limbal conjunctival autograft fixation after pterygium excision.Compared to RI fixation,ISLK facilitates suture removal and reduces discomfort,with comparable surgery duration and less conjunctival hyperemia.

Outcomes of a non-randomised audit of single pigtail suture stents in urolithiasis management of Asian patients in Singapore

Objective:Double-J(DJ)ureteric stents are commonly placed perioperatively for semirigid or flexible ureteroscopic renal surgery.It is believed that lesser stent material within the bladder mitigates stent-related symptoms.This study aimed to evaluate the J-Fil ureteral stent,a single pigtail suture stent compared with conventional DJ stent in relation to stent symptoms in an Asian population undergoing ureterorenal intervention.Methods:Based on internal audit committee recommendation approval,the records of 50 patients retrieved,available data of 41 patients who were prospectively enrolled into two groups(Group 1[J-Fil stent group],n=21 and Group 2[DJ stent group],n=20)between August 2020 to January 2021,were analysed.Parameters compared were nature of procedure,stone location and size,ease of deployment or removal,and complications.A modified universal stent symptom questionnaire was used to assess morbidity of stent symptoms within 48 h of insertion and at removal.Results:Both groups had similar median age,distribution in male to female ratio,and stone size.The overall median universal stent symptom questionnaire score at insertion was similar for bladder pain,flank or loin pain,and quality of life between Group 1 and 2;however,at removal Group 1 fared significantly better than Group 2,especially for flank or loin pain and pain at voiding.Both groups had similar ease in insertion with no hospital readmissions.Conclusion:Our audit favoured the single pigtail suture stent in Asian ureters in mitigating stent-related issues.It showed a good safety profile with easy deployment and removal.It promises a new standard in stenting.

关节镜辅助下Suture-button弹性固定治疗高位踝关节扭伤

背景:高位踝关节扭伤容易漏诊导致踝关节功能障碍,关节镜检查可发现隐匿性高位踝关节扭伤,采用Suture-button弹性固定能恢复远端胫腓联合的生物力学稳定性。目的:探讨踝关节镜辅助下采用Suture-button弹性固定治疗高位踝关节扭伤的临床疗效。方法:回顾性分析2019年8月至2021年8月武汉市第四医院足踝外科在踝关节镜辅助下进行Suture-button弹性固定治疗的40例高位踝关节扭伤患者的病历资料。所有患者均采用Suture-button弹性固定,记录患者术前及术后末次随访美国矫形外科足踝协会踝-后足功能评分、目测类比疼痛评分、踝关节活动度,将患者术前影像学数据与术中关节镜下分离程度进行相关性分析,按照Meislin标准进行疗效评估并记录术后并发症发生情况。结果与结论:①40例患者术后获16-48个月随访;②术后末次随访美国矫形外科足踝协会踝-后足功能评分为(88.95±6.64)分,目测类比评分为(1.78±1.23)分,踝背伸活动度为(33.50±5.79)°,踝跖屈活动度为(34.50±5.97)°,与术前相比差异均有显著性意义(P<0.05);③影像学分离指标与关节镜下分离程度存在低度正相关(r=0.612,P<0.01);④采用Meislin标准对疗效进行评估,优良率为95%(38/40);术后踝关节疼痛减轻,踝关节自主活动明显改善;⑤随访期间所有患者均未出现神经损伤及切口感染情况;1例患者因术后存在皮肤刺激、下蹲卡顿感取出内固定;⑥提示采取关节镜辅助Suture-button弹性固定治疗高位踝关节扭伤的临床疗效确切,能够更有效地恢复患肢足踝功能,恢复并维持关节稳定性且无需二次取出,值得临床应用。

V-Locsutures与普通可吸收线在后腹腔镜肾部分切除术中应用比较

目的:比较V-Loc sutures与普通可吸收线在后腹腔镜肾癌部分切除术中的应用价值。方法:2012年5月-2013年6月,本手术组共收治了25例确诊的病理分期为T1N0M0的肾癌患者,其中12例术中肾脏创面缝合均采用V-Loc sutures,其中男9例,女3例,年龄28-68岁,平均48.2岁;肿瘤大小为0.9-4.7cm,平均2.8cm;另13例术中采用普通可吸收线缝合创面,其中男8例,女5例,年龄34-74岁,平均45.5岁;肿瘤大小为1.2-4.5cm,平均2.6cm;比较两组患者手术中的手术时间、术中出血量、肾动脉阻断时间、创面缝合时间、各组手术前后测血肌酐、胱抑素C变化,术后并发症。结果:25例手术均在后腹腔镜下顺利完成。V-Loc sutures组和普通可吸收线组手术时间、术中出血、肾动脉阻断时间、肾创面缝合时间均有差异(P<0.05);V-Loc sutures组手术前后血肌酐、胱抑素C无明显差异(P>0.05),普通可吸收线组手术前后血肌酐、胱抑素C有差异(P<0.05);V-Loc sutures组出现1例血尿,普通可吸收线组出现1例漏尿。结论:V-Loc sutures较普通可吸收线可缩短手术时间及肾创面缝合时间,减少术中出血,更好的保护小肾癌患者的肾功能。

How many sutures in the southern Central Asian Orogenic Belt:Insights from East Xinjiang-West Gansu(NW China)?

How ophiolitic mèlanges can be defined as sutures is controversial with regard to accretionary orogenesis and continental growth.The Chinese Altay,East junggar,Tianshan,and Beishan belts of the southern Central Asian Orogenic Belt（CAOB） in Northwest China,offer a special natural laboratory to resolve this puzzle.In the Chinese Altay,the Erqis unit consists of ophiolitic melanges and coherent assemblages,forming a Paleozoic accretionary complex.At least two ophiolitic melanges（Armantai,and Kelameili） in East Junggar,characterized by imbricated ophiolitic melanges,Nb-enriched basalts,adakitic rocks and volcanic rocks,belong to a Devonian-Carboniferous intra-oceanic island arc with some Paleozoic ophiolites,superimposed by Permian arc volcanism.In the Tianshan,ophiolitic melanges like Kanggurtag,North Tianshan,and South Tianshan occur as part of some Paleozoic accretionary complexes related to amalgamation of arc terranes.In the Beishan there are also several ophiolitic melanges,including the Hongshishan,Xingxingxia-Shibangjing,Hongliuhe-Xichangjing,and Liuyuan ophiolitic units.Most ophiolitic melanges in the study area are characterized by ultramafic,mafic and other components,which are juxtaposed,or even emplaced as lenses and knockers in a matrix of some coherent units.The tectonic settings of various components are different,and some adjacent units in the same melange show contrasting different tectonic settings.The formation ages of these various components are in a wide spectrum,varying from Neoproterozoic to Permian.Therefore we cannot assume that these ophiolitic melanges always form in linear sutures as a result of the closure of specific oceans.Often the ophiolitic components formed either as the substrate of intra-oceanic arcs,or were accreted as lenses or knockers in subduction-accretion complexes.Using published age and paleogeographic constraints,we propose the presence of （1） a major early Paleozoic tectonic boundary that separates the Chinese Altay-East Junggar multiple subduction systems of the southern Siberian active margin from those of the northern Tarim;and （2） a major Permian suture zone that separates the Tianshan-Beishan from the northern active margin of the Tarim Craton.These new observations and interpretations have broad implications for the architecture and crustal growth of central Asia and other ancient orogens as well.

Can trans-anal reinforcing sutures after double stapling in lower anterior resection reduce the need for a temporary diverting ostomy?

AIM:To evaluate trans-anal reinforcing sutures in low anterior resection using the double-stapled anastomosis technique for primary rectal cancers performed at a single institution.METHODS:The data of patients who received transanal reinforcing sutures were compared with those of patients who did not receive them after low anterior resection.Patients who underwent laparoscopic low anterior resection and the double-stapled anastomosis technique for primary rectal cancer between January2008 and December 2011 were included in this study.Patients with no anastomosis,a hand-sewn anastomosis,high anterior resection,or preoperative chemoradiation were excluded.The primary outcomes measured were the incidence of postoperative anastomotic complications and placement of a diverting ileostomy.RESULTS:Among 110 patients,the rate of placement of a diverting ileostomy was significantly lower in the suture group(SG)compared with the non-suture control group(CG)[SG,n=6(12.8%);CG,n=19(30.2%),P=0.031].No significant difference was observed in the rate of anastomotic leakage[SG,n=3(6.4%);CG,n=5(7.9%)].CONCLUSION:Trans-anal reinforcing sutures may reduce the need for diverting ileostomy.A randomized prospective study with a larger population should be performed in the future to demonstrate the efficacy of trans-anal reinforcing sutures.

Matched-pair analysis of postoperative morbidity and mortality for pancreaticogastrostomy and pancreaticojejunostomy using mattress sutures in soft pancreatic tissue remnants

BACKGROUND:After pancreaticoduodenectomy,the incidence of postoperative pancreatic fistula remains high,especially in patients with 'soft' pancreatic tissue remnants.No 'gold standard' surgical technique for pancreaticoenteric anastomosis has been established.This study aimed to compare the postoperative morbidity and mortality of pancreaticogastrostomy and pancreaticojejunostomy for 'soft' pancreatic tissue remnants using modified mattress sutures.METHODS:Seventy-five patients who had undergone pancreaticogastrostomy and 75 who had undergone pancreaticojejunostomy after pancreaticoduodenectomy between 2002 and 2008 were retrospectively compared using matched-pair analysis.A modified mattress suture technique was used for the pancreaticoenteric anastomosis.Patients with an underlying 'hard' pancreatic tissue remnant,as in chronic pancreatitis,were excluded.Both groups were homogeneous for age,gender,and underlying disease.Postoperative morbidity,mortality,and preoperative and operative data were analyzed.RESULTS:There were no significant differences between the groups for the incidence of postoperative pancreatic fistula (10.7% in both).Postoperative morbidity and mortality,median operation time,median length of hospital stay,intraoperative blood loss,and the amount of intraoperatively transfused erythrocyte concentrates also did not significantly differ between the groups.Patient age >65 years (P=0.017),operation time >350minutes (P=0.001),and intraoperative transfusion of erythrocyte concentrates (P=0.038) were identified as risk factors for postoperative morbidity.CONCLUSIONS:Our results showed no significant differences between the groups in the pancreaticogastrostomy and pancreaticojejunostomy anastomosis techniques using mattress sutures for 'soft' pancreatic tissue remnants.In our experience,the mattress sutures are safe and simple to use,and pancreaticogastrostomy in particular is feasible and easy to learn,with good endoscopic accessibility to the anastomosis region.However,the location of the anastomosis and the surgical technique need to be individually evaluated to further reduce the incidence of postoperative pancreatic fistula.

Stress and strain analysis on the anastomosis site sutured with either epineurial or perineurial sutures after simulation of sciatic nerve injury

The magnitude of tensile stress and tensile strain at an anastomosis site under physiological stress is an important factor for the success of anastomosis following suturing in peripheral nerve injury treatment. Sciatic nerves from fresh adult cadavers were used to create models of sciatic nerve injury. The denervated specimens underwent epineurial and perineurial suturing. The elastic modulus （40.96 ＋ 2.59 MPa） and Poisson ratio （0.37 ＋ 0.02） of the normal sciatic nerve were measured by strain electrical measurement. A resistance strain gauge was pasted on the front, back left, and right of the edge of the anastomosis site after suturing. Strain electrical measurement results showed that the stress and strain values of the sciatic nerve following perineurial suturing were lower than those following epineurial suturing. Scanning electron microscopy revealed that the sciatic nerve fibers were disordered following epineurial compared with perineurial suturing. These results indicate that the effect of perineurial suturing in sciatic nerve injury repair is better than that of epineurial suturing.

Rejuvenation of Fossil Sutures and Related Mesozoic Intracontinental Orogenies in South China

The Huanan (South China) subcontinent was created by amalgamation of the Yangtze, Xianggan, Cathaysia and Zhemin microcontinents by the Guangxi orogeny in the Early Palaeozoic. The closure of the Tethyan Ocean and subsequent collision event outside the amalgamated continent reactivated fossil sutures and resulted in intracontinental (ensialic) orogenies in the Mesozoic. Based on evidence from deformation, molasse and granitoids, the Sichuan-Guizhou-Hunan—southern Hubei and Hunan-Jiangxi-Fujian Yanshanian fold-thrust systems and the Lower Yangtze-northwestern Fujian Indosinian fold-thrust system are thought to be intracontinental orogens. Their main features are as follows: intracontinental orogenies occurred areally, thrusting propagated towards the interior of the continental, they extend parallelly to the strikes of the fossil sutures, and the details of the temporal-spatial evolution of the orogens depend on subduction-collision events.

Timing of formation of the Western Jinshajiang and Ganze–Litang sutures:evidence from the Duocai Granite in the Zhiduo region,West China

The timing of the closure of the Paleo-Tethys Ocean in West China remains debated.To investigate this problem,we examined the geochemical characteristics,zircon U-Pb chronology,and Hf isotopes of monzogranites and quartz diorites from the Duocai granite in the Zhiduo region,at the intersection of the Jinshajiang and GanzeLitangsutures.The monzogranites have the chemical characteristics of calc-alkalineⅠ-type granites and yield a weighted mean zircon U-Pb age of 234.6±0.9 Ma[mean square weighted deviation(MSWD)=0.36].InitialεHf(-t)values are high and positive,ranging from+7.9 to+13.6 with a mean of+10.7,corresponding to two-stage Hf isotope model ages(TDM2)of 762-395 Ma.Geochemical and isotopic data indicate that the source magma of the monzogranites formed from mantle-derived magmas mixed with the overlying crustal materials.The quartz diorites,which also have compositional characteristics of calcalkaline I-type granites,yield a weighted mean zircon UPb age of 209.1±0.7 Ma(MSWD=0.29).InitialεHf(-t)values range from-2.5 to+0.6 with a mean of-1.5,with the corresponding TDM2 of 1402-1210 Ma.Geochemical and isotopic data indicate that the primary magma of the quartz diorites was derived mainly from partial melting of the mafic lower crust and small amount mantle-derived magma involved.Combining these results with regional data,the studied granites are inferred to have formed as a result of continuous subduction of plates underlying the Western Jinshajiang Ocean-Ganze-Litang Ocean from 234 to 209 Ma,and were unrelated to subduction of the South Jinshajiang oceanic plate.We suggest that the Western Jinshajiang Ocean-Ganze-Litang Ocean closed by the end of Late Triassic.

Prospective randomized controlled trial investigating the type of sutures used during hepatectomy

AIM: To determine whether absorbable sutures or non-absorbable sutures are better in preventing surgical site infection (SSI), in this paper we discuss the results of a randomized clinical trial which examined the type of sutures used during hepatectomy. METHODS: All hepatic resections performed from January 2007 to November 2008 at the Department of Surgery at Iizuka Hospital in Japan were included in this study. There were 125 patients randomly assigned to an absorbable sutures (Vicryl) group or non-absorbable sutures (Silk) group. RESULTS: SSI was observed in 13.6% (17/125) patients participating in this study, 11.3% in the Vicryl group and 15.8% in the Silk group. Incisional SSI including superficial and deep SSI, was observed in 8% of the Vicryl group and 9.5% of the Silk group. Organ/ space SSI was observed in 3.2% of the Vicryl group and 6.0% of the Silk group. There were no significant differences, but among the patients with SSI, the period for recovery was significantly shorter for the Vicryl group compared to the Silk group.CONCLUSION: The incidence of SSI in patients receiving absorbable sutures and silk sutures is not significantly different in this randomized controlled study; however, the period for recovery in patients with SSI was significantly shorter for absorbable sutures.

Systematic review of absorbable vs non-absorbable sutures used for the closure of surgical incisions

AIM: To report a systematic review of published randomized controlled trials(RCTs) investigating the role of absorbable suture(AS) against non-AS(NAS) used for the closure of surgical incisions.METHODS: RCTs investigating the use of AS vs NAS for the closure of surgical incisions were statistically analysed based upon the principles of meta-analysis and the summated outcomes were represented as OR.RESULTS: The systematic search of medical literature yielded 10 RCTs on 1354 patients. Prevalence of wound infection(OR = 0.97; 95%CI: 0.56, 1.69; Z = 0.11; P = 0.92) and operative morbidity(P = 0.45) was comparable in both groups. Nonetheless, the use of AS lead to lower risk of wound break-down(OR = 0.12; 95%CI: 0.04, 0.39; Z = 3.52; P < 0.0004).CONCLUSION: This meta-analysis of 10 RCTs demonstrates that the use of AS is similar to NAS for skin closure for surgical site infection and other operative morbidities. AS do not increase the risk of skin wound dehiscence,rather lead to a reduced risk of wound dehiscence compared to NAS.

Facial Asymmetry Correction in Facial Palsy Patients with Silhouette Sutures

Introduction: over the last few decades several techniques static and dynamics, have been performed to improve facial asymmetry and functionality alter suffering facial paralysis. Methods: we present a pilot study to show and evaluate the benefits of a new form of facial suspension, with Silhouette sutures. We performed two patients with total and complete facial palsy due to otical tuberculosis in one case and to parotid carcinoma in the other. Results: one year after surgery, both patients have improved facial asymmetry, mastication and speech production which have lead to a higher self-esteem and major social interaction. Conclusions: static facial suspension with Silhouette sutures is a non invasive alternative to dynamic techniques in patients who don’t want or can’t undergo more complex surgeries.

Fabrication and Tissue Anchoring Performance of Nylon and Polypropylene Barbed Surgical Sutures

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.

Modified Removable Sutures in Trabeculectomy

Objective To develop a simple removable suture that not only Prevents complications of over filtration but provides sufficient outflow of aqueous after trabeculectomy. Methods 80 eyes of 70 patients with Primary angle closure glaucoma were randomly and equally divided into 2 groups: each eye of the experimental group received 4 permanent and 2 removable scleral flap sutures and each of the control group received 4 permanent scleral flap sutures. Results After a mean follow up of 27 3 months(24 36 months),the incidences of shallow anterior chamber and lens opacity in the experimental group were 10 0% and 5 0% respectively, while the incidences of shallow anterior chamber and lens opacity in the control group were 32 5% and 25 0% respectively (P<0 05). The control rates of intraocular pressure(IOP) in the experimental group and in the control group were 92 5% and 85 0% respectively (P>0 05). Conclusion This showed that removable sutures could reduce effectively the incidence of complications and at the same time maintain high control rate of intraocular pressure after trabeculectomy.

New-Fangled Slowly-Absorbable versus Non-Absorbable Sutures for Abdominal Fascial Closure. Have the Goals towards an Advantageous Suture Been Met?

Background-Aim: The technique of abdominal closure along with the material to be used is constantly evolving. The aim of the present study is to evaluate differences in midline laparotomy closure with a standard closure technique and new-fangled slow-absorbable versus non-absorbable sutures. Material and Methods: A prospective, comparative study of patients undergoing laparotomy closure with either STARDIOX (Polydioxanone) or STARLENE (Polypropylene) sutures during a 9 month period was performed. Patients were evaluated and compared in terms of surgical site infection, incisional hernia, burst abdomen, and suture sinus formation. Results: A total of 284 patients were included [141 in the STARDIOX (Polydioxanone) group and 143 in the STARLENE (Polypropylene) group]. Sinus formation was not noticed and no palpable knots were reported in both groups. Moreover burst abdomen was never encountered. Incisional hernia rates were similar for both suture materials: n = 6 (4.3%) for the STARDIOX (Polydioxanone) group and n = 5 (3.5%) for the STARLENE (Polypropylene) group. There was not statistically significant relationship between the type of suture that was used and wound infection: n = 5 (3.5%) in the STARDIOX (Polydioxanone) group and n = 6 (4.2%) in the STARLENE (Polypropylene) group. Complications did not occur in 96.1% of all patients. Conclusions: Our study suggests that there are no significant differences between these two new-fangled sutures. It seems that progress of suture materials has led to a step towards the goals of a beneficial suture and from then on complications of surgical wound closure should be merely a matter of operative technique.

Different compression sutures combined with intracameral air injection for acute corneal hydrops

·AIM:To evaluate the efficacy and safety of full-thickness sutures combined with intracameral air injection(FTS-AI)versus pre-Descemet’s membrane sutures combined with intracameral air injection(PDS-AI)in the management of acute corneal hydrops in keratoconus.·METHODS:The research included 8 patients(8 eyes)suffering from acute corneal hydrops caused by keratoconus.Four patients were randomly assigned to FTS-AI.And the other four were randomly assigned to PDS-AI.Corneal oedema,visual acuity,corneal thickness were assessed during follow-up.·RESULTS:The demographics,preoperative duration of symptoms and severity of corneal hydrops between the two groups were not significantly different.The mean corneal oedema resolution time after FTS-AI and PDSAI were 11±1.15 and 15±1.41 d,respectively(P=0.005).The maximum corneal thickness of the scarred region decreased in both groups at one week postoperatively(P<0.05).No obvious difference was found in the mean maximal corneal thickness between the two groups postoperatively.The BCVA improved significantly after FTS-AI and PDS-AI at three months postoperatively.No obvious difference was found in the BCVA after FTS-AI and PDS-AI at three months postoperatively.·CONCLUSION:FTS-AI and PDS-AI are safe and effective therapies to accelerate the resolution of corneal oedema in acute corneal hydrops secondary to keratoconus.Despite faster resolution of corneal oedema in the FTS-AI group,we recommend PDS-AI to avoid potential endothelium cell damage.