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The Luojiashan gabbro is a newly discovered mafic pluton emplaced in the Neoproterozoic Yingyangguan Formation in Yingyangguan region of northeastern Guangxi, South China. Comprehensive whole-rock geochemical and zircon geochronological and Hf isotopic analyses are performed on the gabbro and comparisons are made with the coeval mafic-ultramafic sills and dikes located in Longsheng region of northern Guangxi in order to understand the magmatic origin, evolution, and tectonic setting of the Luojiashan gabbro and to address the location of the suture zone of the Southwestern Jiangnan Orogen (SJO). LA-ICP-MS zircon U-Pb ages obtained from the Luojiashan gabbro show that it was emplaced at ∼770 Ma. The gabbro contains abundant inherited zircons aged at 0.9–1.3 Ga, consistent with age spectrum of the Cathaysia Block. Chondrite-normalized REE pattern, primitive mantle-normalized trace element spider diagram, incompatible element ratios of Nb/Ta, Zr/Hf, La/Nb, Ba/Th, Th/La, and Ba/La, and Th/Yb-Ta/Yb discrimination diagram of the gabbro are indicative of OIB-like geochemical characteristics and of derivation from partially melted garnet peridotite of the asthenospheric mantle. Tectonic discrimination based on the trace and rare earth elements also indicate that the Luojiashan gabbro was emplaced in a within-plate extensional rift setting, probably as a result of Rodinia supercontinent dismantling, lithospheric thinning, and underplating and upwelling of the asthenospheric mantle. Based on zircon age, Hf isotopic data and comparison between northern and northeastern Guangxi, it is suggested that the Yingyangguan region was tectonically situated in a different tectonic locale from the Longsheng region of northern Guangxi at about 770 Ma during the post-orogenic mafic-ultramafic magmatic event, with the former within the Cathaysia Block and the latter along the southeast margin of Yangtze Block. The suture between the Yangtze and Cathaysia blocks must be located between Yingyangguan of northeastern Guangxi and Longsheng of northern Guangxi. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the present study was to objectively and subjectively compare the preoperative and postoperative aesthetic and functional outcomes of the correction of crooked noses using a suture technique we call "nasal axis lateralization suture (NALS)". Method: A total of 36 patients who had preoperative and postoperative photographs taken and who completed the Rhinoplasty Outcome Evaluation (ROE) questionnaire were included in the study. Results: Crooked noses were divided into two groups: C-shaped (17 patients) and I-shaped (19 patients). The preoperative and postoperative nasal axis angles were 145.3 ± 11.9 and 178.5 ± 3.3, respectively, in C-shaped nasal deviation. In I-shaped nasal deviation, on the other hand, the preoperative nasal axis angle was 8.8 ± 2.8, while the postoperative nasal axis angle was 1.4 ± 2.4. In terms of the ideal axis percentage before and after surgery, a significant difference was found between the C-shaped and I-shaped nasal deviation patient groups (p < 0.05). While there was a significant improvement in both groups in the evaluation based on the ROE questionnaire, satisfaction was much higher in the C-shaped nasal deviation group. In both groups, the ROE values of functional and aesthetic outcomes were significantly different compared to the preoperative values of both groups (p < 0.005). Conclusion: NALS can be used as an alternative technique to correct both I-shaped and C-shaped nasal axis deviations. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the clinical efficacy of endoscopic debridement combined with compression suture in the treatment of aseptic olecranon bursitis. Methods: A retrospective analysis was conducted on 28 patients, including 25 males and 3 females, who underwent endoscopic debridement combined with compression suture for the treatment of aseptic olecranon bursitis at Huzhou Central Hospital from February 2017 to January 2024. Visual analogue scale (VAS) scores, Mayo elbow function scores, complications, recurrence rates and wound scars were evaluated to assess the treatment efficacy. Results: The average follow-up time was 12 ± 5 months (range: 5–22 months). The VAS score was slightly greater on postoperative day 1 than preoperatively, but this difference was not statistically significant. Compared with the preoperative level, the VAS score was significantly lower at 2 weeks post-surgery, and the patients were generally free of pain. The patients' Mayo elbow function score was significantly improved at 2 weeks after the operation, and their elbow function was generally normal at 1 month after the operation. At the final follow-up, no recurrence or obvious scarring was found in any of the patients, and all of them exhibited normal elbow function without any reported pain. Conclusion: Endoscopic debridement combined with compression suture for the treatment of aseptic olecranon bursitis has several advantages: simple operation, minimal invasiveness, minimal postoperative pain, rapid recovery, a low recurrence rate, and satisfactory overall efficacy. Level of evidence Level IV [ABSTRACT FROM AUTHOR]

Introduction: Fast gut cutaneous sutures have become more prominent due to their low tissue reactivity, rapid absorption, and elimination of suture removal visits. It is not known how fast gut sutures compare to other closure modalities. Methods: A comprehensive literature review was conducted to identify randomized controlled trials comparing fast gut sutures to alternative closure methods during dermatologic surgery. Data collected included patient and physician assessed cosmetic outcome as well as standardized complication rates. Results: Six studies were included in final analysis and reported on 208 patients. Fast gut sutures were associated with lower physician opinions of final scar when compared to polypropylene sutures (SMD 0.438; 95% CI 0.082 to 0.794). No differences existed between physician opinion of fast gut sutures and cyanoacrylate tissue adhesive (SMD − 0.024; 95% CI − 0.605 to 0.556). Complications with fast gut suture placement were rare, and included infection, dehiscence, and hematomas. Fast gut sutures were less likely to experience wound dehiscence than tissue adhesive (p = 0.01). Conclusion: If no contraindications to polypropylene sutures exist, they may provide superior cosmetic outcomes compared to fast gut sutures. Further research is required to better quantify cosmetic outcomes and optimal use of fast gut sutures. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic common bile duct exploration (LCBDE) proves a safe and effective treatment for choledochal stones. After LCBDE, preferred choledochal closure is favored for short- and long-term outcomes compared with t-tube drainage. However, there are no relevant studies on the technique of layered closure of the common bile duct with double-needle bidirectional barbed suture at home and abroad. Materials and Methods: A retrospective study of 37 patients who underwent laparoscopic choledochotomy from January 2021 to October 2023 in our hospital was performed. A continuous layered one-stage suture using two-needle bidirectional barb wire. The primary outcomes were stone clearance, operative time, blood loss, and complications. Secondary outcomes were complications, length of hospitalization, and time to drain removal. Results: During the study period, laparoscopic surgery was successful in all cases, and the initial stones were removed without complications. Conclusion: The treatment of choledocholithiasis with continuous layered one-stage suture with double-needle bidirectional barbed wire after LCBDE is a new convenient and effective treatment in selected patients. [ABSTRACT FROM AUTHOR]

This study investigates the optimization of process parameters for coating silk sutures with Acanthus ilicifolius leaf extract. The increasing awareness of surgical site infections is a critical concern associated with the use of sutures in medical procedure undertaking. Our study aimed to assess the impact of three crucial coating factors, namely extract content, temperature, and duration, on the mechanical and antibacterial characteristics of silk sutures braided together. Through Box–Behnken design, in conjunction with the response surface approach, we conducted a thorough analysis to refine the model. The result showed that extract concentration directly influences both antimicrobial activity and elongation, while temperature and time primarily affect tensile strength and bending stiffness. To achieve the maximum tensile strength, minimum breaking elongation, minimum bending stiffness, and lower friction, all while maintaining the important antimicrobial efficacy of the sutures, this study emphasizes the use of response surface methodology in optimizing coating parameters for A. ilicifolius leaf extract on silk sutures. The response models are developed on the complex relationships between these parameters and the properties of the sutures. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to compare the outcomes of suture-less and multiple suture closure methods on postoperative pain, swelling, and trismus, and associated complications. Materials and methods: This prospective, randomized clinical trial was conducted at the Department of Oral & Maxillofacial Surgery, Goa Dental College & Hospital. Inclusion criteria encompassed subjects aged between 17 and 55 years, classified as American Society of Anaesthesiologists (ASA) I, with asymptomatic impacted third molars falling within the moderately difficult impaction range (Pederson's difficulty index: 5–7). Study excluded individuals classified as ASA II, III, or IV, those with known or suspected allergies to the anaesthetic solution, immunocompromised patients, and individuals taking medications that could affect healing. Pregnant or lactating females and those with a history of bleeding disorders were also excluded. Wound closure methods were compared: Group A underwent primary closure with silk sutures, while Group B had suture-less closure. Subjects were allocated to the specific groups using a simple randomization method. This involved using a lottery-based random sequence to assign each participant to either Group A or Group B. Pain intensity, facial swelling, and trismus were key outcomes. Secondary outcomes included lingual nerve sensation and postoperative complications. Demographics factors, surgical details, radiographic and perioperative data, and physiological parameters were considered. Non-parametric tests and parametric test (repeated measure ANOVA) were employed. Statistical significance was set at P < 0.05. Results: Among 101 participants, both closure techniques exhibited similar outcomes in pain, swelling, and lingual nerve function. However, suture-less closure resulted in significantly less trismus and fewer cases of delayed wound healing. Conclusions: Suture-less method after surgical removal of third molar may reduce trismus compared to multiple sutures. While pain, swelling, and lingual nerve function management were comparable. [ABSTRACT FROM AUTHOR]

Background: Haemostasis during ovarian cystectomy is reported to damage the ovarian reserve, but the comparative impacts of three haemostasis methods (bipolar energy, suture and haemostatic sealant) on ovarian reserve in patients with ovarian cysts are not well known. Methods: The cochrane library, PubMed and Web of Science databases were searched from the date of inception of the database to June 2022 for literature exploring the impact of haemostasis methods during ovarian cystectomy on ovarian reserve. A traditional meta-analysis was performed using Review Manager software. A network meta-analysis (NMA) was performed using Stata and GemTC software. Results: The direct meta-analysis comparison indicated that the mean postoperative reduction of anti-Müllerian hormone (AMH) level was significantly higher in the electrocoagulation (bipolar) group than suture and haemostatic sealant group, both in the overall group and subgroup of women with ovarian endometrioma. In NMA, the reduction of postoperative AMH levels in the electrocoagulation (bipolar) group was higher than the suture group at 6 months with a statistical significance, and at 1, 3 and 12 months without a significant difference. The difference in the postoperative decrease of AMH level did not reach statistical significance between suture and sealant, coagulation and haemostatic sealant. The comprehensive ranking results revealed that suture treatment was, with the highest probability, beneficial to the protection of the ovarian reserve. Conclusions: There was insufficient research to detect the optimal haemostasis method for ovarian reserve preservation in ovarian cystectomy. Nevertheless, haemostasis by electrocoagulation (bipolar) should be avoided when possible, and the suture might be considered as the best choice. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Modern Medicine & Health is the property of Journal of Modern Medicine & Health and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To assess the rate at which sutureless partial nephrectomy (SLPN) transitions to standard partial nephrectomy (SPN), focusing on preoperative factors that might prompt such conversions. Patients and methods: In this retrospective study, we analyzed the efficacy of SLPN performed on adults at our institution from 2016 to 2023. The subjects were patients diagnosed with localized solid renal tumors. The primary technique employed was resection with scissors and argon beam coagulation for hemostasis, with suturing techniques used only when necessary. Predictive factors necessitating conversion to SPN were identified, and the associations among multiple variables were explored using various statistical analysis methods, including logistic regression, to identify key preoperative predictive factors. Results: Our institution performed 353 SLPN, with 21 cases (5.9%) necessitating conversion to SPN. The conversion rates for the Laparoscopic Partial Nephrectomy (LPN) subgroup and the Robotic-assist Partial Nephrectomy (RPN) subgroup were 7.9% (17/215) and 2.9% (4/138), respectively, nearing statistical significance (P =.066). Significant differences were observed between the conversion group and the no conversion group in terms of preoperative estimated Glomerular Filtration Rate (eGFR), age at surgery, tumor size, and exophytic/endophytic characteristics. Multivariate analysis identified age at surgery, preoperative eGFR, radiological tumor size, and tumor exophytic/endophytic nature as significant predictors for conversion to SPN. Conclusion: This investigation highlights the efficacy and feasibility of SLPN while identifying critical factors influencing the necessity for conversion to SPN. The identified predictors, including younger surgical age, superior preoperative eGFR, and specific tumor characteristics, provide valuable insights for refining surgical strategies. [ABSTRACT FROM AUTHOR]

Background: Tension band wire fixation (TBW) is a well-described method for treating displaced olecranon fractures. Further surgery is often needed due to wound breakdown or prominent hardware. An all-suture technique has recently been described as an alternative to TBW but radiographic and clinical outcome are not well established. The aim of this single-center retrospective cohort study was to evaluate outcome after treatment with all-suture technique for simple displaced olecranon fractures. Methods: A retrospective review of olecranon fractures in patients (> 18 years) treated for displaced olecranon fractures with tension band suture fixation (TBSF) between February and August 2019 was performed in our facility. Primary outcome was revision surgery, which was assessed four years after surgery. Clinical and radiographical follow-up was performed at two weeks, six weeks, three months and six months to assess union rate, fracture displacement, range of motion (ROM), Quick-DASH and Oxford Elbow Score. Results: A total of 24 patients were included. Median age was 64 years [IQR:39–73], 9 patients were male and median ASA score was 2 [IQR:1–2]. 15 fractures were Mayo type 2 A and 9 type 2B with minor comminution. At four-year follow-up, three patients had died. None of the remaining 21 patients had undergone revision surgery. At six months, the median Quick-DASH and Oxford Elbow Score were 2.3 [IQR:0-4.5] and 47 [IQR:46–48], respectively. Median elbow extension and flexion deficits were 0° [IQR:0-2.25] and 0° [IQR:0–0], respectively. Radiographic union was achieved in all patients. In two cases radiographic loss of reduction and malunion was observed but both patients were asymptomatic and had no functional deficits. One patient refractured the elbow due to a second trauma and was reoperated. Conclusions: TBSF is a promising technique for Mayo type 2 A and 2B fractures with minor comminution. There were no revision surgeries within the first four years. We found good functional outcomes and a high union rate. [ABSTRACT FROM AUTHOR]

Tension-free hernia repair is the gold standard for groin hernia repair. However, the optimal surgical treatment for incarcerated or strangulated groin hernia in elderly populations is controversial. The aim of this study is to compare the clinical efficacy of mesh repair and suture repair in the treatment of incarcerated or strangulated groin hernia in elderly patients. Patients ≥ 65 years who underwent urgent surgical repair for incarcerated or strangulated groin hernia from January 2012 to June 2022 were included. Patients' demographic data and postoperative outcomes were retrospectively analyzed. Patients with limited life expectancy were screened from the elderly population for subgroup analysis. A total of 103 patients (median age: 84 years old, range 65–96; mean follow-up time: 36.8 ± 24.8 months) were included, involving 42 cases in the suture repair group and 61 cases in the mesh repair group. Suture repair and mesh repair had similar lengths of ICU and hospital stay, and rates of small bowel resection, chronic pain, surgical site infection, and surgical-related death. However, suture repair had a significantly higher recurrence rate than mesh repair (7% vs. 2%, P = 0.04). In our subgroup analysis, for patients with limited life expectancy (41 patients; median age: 88 years old, range: 80–96), suture repair had no statistical difference in postoperative outcomes compared with mesh repair. Mesh repair is suitable for elderly patients with acutely incarcerated or strangulated groin hernias. However, for elderly patients with limited life expectancy, suture repair and mesh repair showed similar clinical outcomes. [ABSTRACT FROM AUTHOR]

N6-methyladenosine (m6A) modification, a eukaryotic messenger RNA modification catalyzed by methyltransferase-like 3 (METTL3), plays a pivotal role in stem cell fate determination. Calvarial bone development and maintenance are orchestrated by the cranial sutures. Cathepsin K (CTSK)–positive calvarial stem cells (CSCs) contribute to mice calvarial ossification. However, the role of m6A modification in regulating Ctsk+ lineage cells during calvarial development remains elusive. Here, we showed that METTL3 was colocalized with cranial nonosteoclastic Ctsk+ lineage cells, which were also associated with GLI1 expression. During neonatal development, depletion of Mettl3 in the Ctsk+ lineage cells delayed suture formation and decreased mineralization. During adulthood maintenance, loss of Mettl3 in the Ctsk+ lineage cells impaired calvarial bone formation, which was featured by the increased bone porosity, enhanced bone marrow cavity, and decreased number of osteocytes with the less-developed cellular outline. The analysis of methylated RNA immunoprecipitation sequencing and RNA sequencing data indicated that loss of METTL3 reduced Hedgehog (Hh) signaling pathway. Restoration of Hh signaling pathway by crossing Sufufl/+ alleles or by local administration of SAG21 partially rescued the abnormity. Our data indicate that METTL3 modulates Ctsk+ lineage cells supporting calvarial bone formation by regulating the Hh signaling pathway, providing new insights for clinical treatment of skull vault osseous diseases. [ABSTRACT FROM AUTHOR]

Introduction: Pain management after hysterectomy is a critical concern, and limited studies have investigated the effect of LigaSure on postoperative pain. This study aimed to compare pain levels after Total Abdominal Hysterectomy (TAH) using traditional methods versus the LigaSure device. Methods: This registered clinical trial included 29 patients undergoing TAH at an institutional tertiary hospital in Tehran, Iran, from 2021 to 2023. 16 patients underwent TAH with traditional methods, and 13 with LigaSure. Data on pain intensity (6 hours and 24 hours post-surgery), analgesic consumption, intraoperative blood loss, hospitalization length, hemoglobin drop, and cancer surgery duration were collected through patient interviews and medical records. SPSS 26 and the Mann-Whitney U test were used for analysis (Registry ID: IRCT20221109056457N1). Results: Pain intensity at 6 hours and 24 hours post-surgery was significantly lower in the LigaSure group compared to the traditional method group (p<0.05). Surgery duration was also significantly shorter with LigaSure (p<0.05). No significant differences were found between the two groups in terms of analgesic consumption, intraoperative blood loss, hospitalization length, or hemoglobin drop (p>0.05). Conclusion: TAH with LigaSure significantly reduces postoperative pain and cancer surgery duration compared to traditional methods. This method is recommended for women undergoing hysterectomy. However, cancer multicenter clinical trials with larger sample sizes are needed to further evaluate its benefits and potential complications. [ABSTRACT FROM AUTHOR]

The development of novel robotic devices specifically designed for open microsurgery leads to increasing applications in reconstructive procedures. While initial studies revealed improved precision and surgical ergonomics upon robotic assistance, surgical time was consistently observed to be increased. This study compares two robotic suturing techniques using the Symani Surgical System and RoboticScope in a preclinical setting, to further leverage the benefits of novel robotic devices in microsurgery. Six experienced microsurgeons performed three microvascular anastomoses with a "steady-thread" suturing technique and a "switch-thread" technique on 1.0-mm-diameter artificial silicone vessels. Time for anastomosis and participant's satisfaction with the techniques and robotic setup were recorded. Anastomosis quality and microsurgical skills were assessed using the Anastomosis Lapse Index and Structured Assessment of Microsurgery Skills. Lastly, technical error messages and thread ruptures were quantified. Knot tying was significantly faster and evaluated significantly better by participants using the steady-thread technique (4.11 ± 0.85 vs. 6.40 ± 1.83 min per anastomosis). Moreover, microsurgical skills were rated significantly better using this technique, while both techniques consistently led to high levels of anastomosis quality (2.61 ± 1.21 vs. 3.0 ± 1.29 errors per anastomosis). In contrast, the switch-thread technique was associated with more technical error messages in total (14 vs. 12) and twice as many unintended thread ruptures per anastomosis (1.0 ± 0.88 vs. 0.5 ± 0.69). This study provides evidence for the enhanced performance of a steady-thread suturing technique, which is suggested to be applied upon robot-assisted microsurgical procedures for optimized efficiency. [ABSTRACT FROM AUTHOR]

Background: Free gingival graft is commonly used to augment the keratinized mucosa and vestibular depth around dental implants. The proper suturing technique is fundamental to achieve a successful result following free gingival graft. However, there are limited studies that focus on the details of the suturing methods to optimize graft adaptation. The purpose of this technical note is to describe a new suturing technique for optimal approximation and stabilization of free gingival graft around dental implants. Case presentation: Here, we present a 53-year-old Persian female with peri-implantitis and lack of keratinized mucosa around mandibular implants who was a candidate for free gingival graft. A new suturing technique, double vertical interrupted suture, was conducted in the interimplant areas. In addition, the suspensory cross-mattress sutures were added to ensure the adaptation of the graft over the implants. The proposed suturing technique is useful for soft tissue augmentation around multiple implants with concave or uneven recipient bed. Conclusion: The present article describes a novel suturing technique for good adaptation and fixation of free gingival graft around dental implants. [ABSTRACT FROM AUTHOR]

Background: The management of the surgical wound of partially impacted mandibular third molar surgery has a great impact on recovery as well as on food impact retention. The present study used clinical parameters and health-related quality of life (HRQL) to compare outcomes of cyanoacrylate application versus traditional suture of third molar impaction surgery. Methods: This was a retrospective observational study of subjects scheduled for outpatient third molar surgery. Each participant signed an informed consent agreement. Inclusion criteria were as follows: presence of at least one partially impacted mandibular third molar, confirmed with a preoperative panoramic radiograph. Exclusion criteria were the following: smoking, diagnosed diabetes mellitus. Between June 2020 and September 2023, a total of 78 patients of mean age 31.14 years old (range 21–40 years, standard deviation 9.14), were included in this study—38 patients were male, 40 patients were female. A group of patients received traditional silk suture (G1 = 41 patients), while the second group (G2 = 37 patients) received hemostasis performed with fibrin sponge and, after complete soaking of the sponge, the application of cyanoacrylate gel on the blood clot and suture with one 2/0 stitch in order for recovery for secondary closure. The following parameters were measured: HRQL, average pain (AP), maximum pain (MP), complication score (CS), facial swelling (FS), and erythema. Results: For HRQL parameters, oral disability was found to be significantly higher in G1 while AP was significantly higher in G2 (p < 0.05). AP was higher in G2 (p = 0.0098), as well as MP (p = 0.001). No differences were found with regards to CS (p = 0.0759). FS and erythema were higher in G1 (p < 0.0001 for facial swelling, and p = 0.0001 for erythema). Conclusions: on the basis of this study, the use of cyanoacrylate after mandibular third molar surgery appears to be useful in order to reduce postoperative oral disability, facial swelling, and erythema after tooth extraction, with increased average and medium pain: clinicians may consider its use in selected cases. [ABSTRACT FROM AUTHOR]

Patellar fractures represent approximately 1% of all fractures and the pattern is influenced by the quality of the bone and the energy of the trauma. Transverse fractures are associated with extensor mechanism failure and interruption of joint congruence. Patellar fractures are generally fixed using tension band principles, through K-wires and metal cerclage. The tension band was conceived to transform the considerable tensile force applied to the patella into a compressive one to obtain a stable fixation. The use of metal implants might be associated with a significant discomfort, mostly related to the irritating action of K-wires and cerclage on the surrounding soft tissues, often leading to the need for implant removal. Therefore, we introduced an original technique for fix patellar fractures by using only a non-adsorbable braided polyblend suture. Postoperative care included progressive range of motion recovery using an articulated knee brace and a specific protocol. The suture-only tension band technique seems to be a useful technique in terms of complications and reoperation rate while allowing secure and early mobilization. [ABSTRACT FROM AUTHOR]

Aim: The purpose of the study was to compare the ovarian reserve after cystectomy of ovarian endometrioma by bipolar coagulation, suture method, or hemostatic sealants (HSs). Methods: We performed a meta‐analysis of studies in which post‐cystectomy serum anti‐Müllerian hormone (AMH) values were compared between bipolar coagulation and suture method or between bipolar coagulation and HSs. Through a literature search, we retrieved 14 articles which met inclusion criteria and were eligible for final analysis. The articles included 10 randomized trials, 3 prospective studies, and 1 retrospective study (n = 1435). The primary outcome was post‐cystectomy serum AMH values. Results: Both bipolar coagulation and suture methods showed significantly lower post‐cystectomy AMH values at 3, 6, and 12 months. However, post‐cystectomy serum AMH values at 12 months were significantly higher in the suture method group compared to the bipolar coagulation (weighted mean difference [WMD]: −1.10, 95% confidence interval [CI]: −1.83, −0.38, p = 0.003, I2 = 89, n = 3). The suture method also showed a lower decline rate at 3 months post‐cystectomy compared to the bipolar coagulation group (WMD: −25.13%, 95% CI: −49.56 to −0.70, p = 0.04, I2 = 95%, n = 2). Overall, pregnancy rates were similar between the two groups. Between the bipolar coagulation and HSs group, serum AMH values at 3 months post‐cystectomy were similar (WMD: −0.46, 95% CI: −1.04 to 0.13, p = 0.13, I2 = 0%, n = 3). However, the HSs group showed a less decline rate at 3 months post‐cystectomy compared to the bipolar coagulation group (WMD: −17.02%, 95% CI: −22.81, −11.23, p < 0.00001, I2 = 0%, n = 3). Conclusions: Both the suture method and HSs may have potential benefits in the preservation of ovarian reserve over the bipolar coagulation method when cystectomy for ovarian endometrioma is performed. [ABSTRACT FROM AUTHOR]

Herein, a method was proposed for testing the dynamic tensile properties of a sports medicine suture and investigating the fatigue properties and elongation of the suture after a fatigue test. A test device was designed to test the dynamic tensile properties of sutures. The endurance limit of Nos. 1 and 4 sutures, which were used for laboratory comparisons, was 2 3. 7 ± 1. 4 N and 6 8. 5 ± 2. 3 N and the elongation rate was 3. 3 % ± 0. 6 % , 4. 0 % ± 0. 3 % , respectively. Furthermore, the Z-score, which is the offset divided by the standard deviation, was < 2. The proposed test method is accurate and the repeatability is satisfied, making it suitable for determining the dynamic tensile properties of sutures. It is used as an industry standard to provide technical support for supervising sports medicine sutures. [ABSTRACT FROM AUTHOR]

Background Duramesh (Mesh Suture Inc. Chicago, IL) is a new suturing concept, combining the principles of mesh with the precision, flexibility, and versatility of a suture, suitable also for abdominal rectus diastasis (ARD) correction. Objectives This prospective research aimed to compare mesh with the standard polypropylene suture plication for rectus diastasis repair with regard to safety (infection, seroma, hematoma, surgical wound dehiscence, and fistula rates and hospital stay); effectiveness (ARD recurrence by ultrasound sonography, palpability of the muscular suture, surgical time, and postoperative pain evaluation); and satisfaction of the patients based on the BODY-Q, a patient-reported outcome measure. Methods Sixty-five of the initial 70 patients who underwent rectus diastasis repair with a 6-month follow-up were randomly divided into 2 groups, comprising 33 patients treated with Duramesh and 32 patients treated with standard 0 polypropylene suture plication. Data regarding infection, seroma, hematoma, surgical wound dehiscence, and fistula rates; hospital stay; ARD recurrence; palpability of the muscular suture; surgical time; postoperative pain evaluation (measured by visual analog scale, or VAS); and the BODY-Q were analyzed by Prism 9 (GraphPad Software Inc. San Diego, CA). Results No significant differences were reported between the 2 groups with regard to infection, seroma, hematoma, surgical wound dehiscence, and fistula rates and hospital stay. The mesh decreased the time required to perform plication compared with standard polypropylene detached sutures. No statistically significant differences were found with respect to the VAS and BODY-Q data. Conclusions Duramesh 0 application for rectus diastasis repair is safe and effective without compromising aesthetic improvement when compared with standard 0 polypropylene plication. Level of Evidence: 2 [ABSTRACT FROM AUTHOR]

Background: Recently, all-suture, all-inside meniscal repair devices—including devices containing flat sutures or tapes—have been introduced. Similar to those in suture anchors, these modifications may have different performance characteristics than conventional sutures and polyether ether ketone (PEEK)-anchored devices. Purpose: To compare the biomechanical characteristics of all-suture meniscal repair devices with those of a conventional PEEK-anchored device and an inside-out meniscal suture construct. Study Design: Controlled laboratory study. Methods: A total of 48 adult porcine menisci with simulated bucket-handle tears were included. Single-device repairs were performed with the SuperBall Meniscal Repair System, FiberStitch, and FAST-FIX 360 with 2 PEEK anchors, and a vertical mattress inside-out suture repair was performed using a Ti-Cron No. 2-0 braided polyethylene terephthalate suture. All specimens were preloaded (10 N) and cycled 200 times (between 10 and 50 N). Specimens surviving cyclic loading were then destructively tested. Endpoints included maximum failure load, stiffness, cyclic displacement, and failure mode. The goal was 12 successful tests in each group. Metrics between groups were compared using analysis of variance with post hoc tests to control for multiple comparisons. Results: The SuperBall (108.9 N) was significantly stronger than the FAST-FIX 360 (67.3 N) and Ti-Cron (75.2 N), and the FiberStitch (102.8 N) was significantly stronger than the FAST-FIX 360 (P ≤.01 for all). Cyclic stiffness increased during cyclic loading for all constructs (P <.001). The Ti-Cron was significantly stiffer than the SuperBall during 5 to 200 cycles (P <.001). Cyclic displacement significantly increased in all constructs during cycling (P <.001) but did not differ between devices. Failure mode varied by device: the Ti-Cron repairs failed because of suture breakage, the SuperBall and FAST-FIX 360 failed at the anchor, and the FiberStitch showed both failure modes. Conclusion: The all-suture, all-inside meniscal repair devices demonstrated superior strength to the PEEK-anchored device and the classic inside-out suture meniscal repair but no statistically significant difference in cyclic displacement. [ABSTRACT FROM AUTHOR]

Soft tissue injuries are frequently repaired using various suture material. The ideal suture should have the biomechanical properties of low displacement, high maximum load to failure, and high stiffness to avoid deformation. Since tendon healing occurs over a period of months, it is important for the surgeon to select the proper suture with certain biomechanical properties. Therefore, the purpose of this study is to qualitative summarize the published literature on biomechanical properties of different suture materials used in orthopaedic procedures. Following PRISMA guidelines, PubMed and Cochrane databases were queried for original articles containing "biomechanic(s)" and "suture" keywords. Following screening for inclusion and exclusion, final articles were reviewed for relevant data and collected for qualitative analysis. Data collected from each study included the tissue type repaired, suture material, and biomechanical properties, such as elongation, maximum load to failure, stiffness, and method of failure. 17 articles met final inclusion criteria. Two studies found No.2 Fiberwire™ to have the lowest elongation and 4 studies found No. 2 Ultrabraid™ to have the greatest. 12 studies reported Maximum load to failure was highest in No. 2 Fiberwire™, No. 2 Ultrabraid™, and FiberTape™ while No. 2 Ethibond ™ had the lowest in 5 studies. 3 of the 5 studies that evaluated No. 2 Fiberwire™ found it to have the highest stiffness. No. 2 Ethibond™, No. 2 Orthocord™, and No. 2 PDS™ were reported as the least stiff sutures in 2 studies each. Fiberwire™, FiberTape™, and Ultrabraid™ demonstrated the highest load to failure while Ethibond™ consistently was the weakest. Fiberwire™ was found to have the lowest elongation while Ultrabraid™ had the highest. Fiberwire™ was also noted to be the stiffest while PDS, Ethibond™, and Orthocord™ were found to be the least stiff. Final treatment decisions on which suture to utilize to optimize repair integrity and healing are complex, and rarely solely dependent upon the biomechanical properties of the materials used. Systematic Review, Level IV. [ABSTRACT FROM AUTHOR]

Copyright of Revue d'Orthopédie Dento-Faciale is the property of Parresia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Mongol‐Okhotsk suture and the Adaatsag ophiolite belt are associated with the closure of the Mongol‐Okhotsk paleo‐ocean and are located within the Central Asian Orogenic Belt (CAOB) and Mongolia. The suture zone is flanked by volcanic‐plutonic belts that host significant metallogenic zones, containing deposits of copper and gold. The tectonic evolution of this region is not fully understood and the lithospheric structure has been poorly studied. We analyze magnetotelluric data and generate a model of the electrical resistivity distribution across this region. Whereas the northern segment has a sharp transition from a high‐resistivity upper crust to a low‐resistivity lower crust, as observed beneath the Hangai Dome, the southern segment does not show this transition. A wide, low‐resistivity zone (1–100 Ωm) imaged in the crust and lithospheric mantle is coincident with the Mongol‐Okhotsk suture and ophiolite, revealing a clear and significant lithospheric‐scale feature. Across the profile, numerous narrow, vertically oriented, low‐resistivity features (1–100 Ωm) are spatially associated remarkably well with the proposed boundaries of tectonic domains. These results confirm ideas about the development of the CAOB. Some of these low‐resistivity features are beneath the surface locations of large mineral zones, and likely represent fossil fluid pathways. We show congruent seismic velocity models for comparison and the results show a large‐scale low‐velocity anomaly (decrease of 2%–3%) that correlates with the location of the low‐resistivity anomaly below the Mongol‐Okhotsk suture. The geophysical results, combined with geological and geochemical data, provide insights into the structure of this region and help shed light on unanswered questions. Plain Language Summary: When the ancient Mongol‐Okhotsk ocean closed, due to subduction from tectonic re‐arrangement, it left the Mongol‐Okhotsk suture zone and the Adaatsag ophiolite as a trace of its location. Similarly, other tectonic boundaries are hypothesized to exist from terrane accretion across the Central Asian Orogenic Belt (CAOB) and Central and Southern Mongolia, which is located between the Siberian and North China cratons. This region is also rich in economically significant copper and gold deposits. The tectonic evolution of this region and especially the lithospheric structure is not fully understood and has been poorly studied. We analyze magnetotelluric data and generate a model of the electrical resistivity distribution. Additionally, we show models of the seismic velocity for comparison. Examining multiple complementary geophysical models helps to reduce interpretation uncertainty. Anomalies are observed in both models (e.g., low resistivity and low velocity). The suture zone is proven to be a strong lithospheric‐scale boundary. The proposed boundaries of tectonic domains are also imaged, confirming ideas about the development of the CAOB, and solving some controversies. Key Points: Lithospheric‐scale, wide, low‐resistivity zone revealed below the ophiolite belt associated with the closure of the Mongol‐Okhotsk oceanVertical, narrow low‐resistivity features aligned with proposed tectonic boundaries and locations of large mineral zones (copper and gold)The northern part of central Mongolia has a sharp mid‐crustal transition from high to low resistivity, whereas the southern part does not [ABSTRACT FROM AUTHOR]

Premature fusion of craniofacial joints, i.e. sutures, is a major clinical condition. This condition affects children and often requires numerous invasive surgeries to correct. Minimally invasive external loading of the skull has shown some success in achieving therapeutic effects in a mouse model of this condition, promising a new non-invasive treatment approach. However, our fundamental understanding of the level of deformation that such loading has induced across the sutures, leading to the effects observed is severely limited, yet crucial for its scalability. We carried out a series of multiscale characterisations of the loading effects on normal and craniosynostotic mice, in a series of in vivo and ex vivo studies. This involved developing a custom loading setup as well as software for its control and a novel in situ CT strain estimation approach following the principles of digital volume correlation. Our findings highlight that this treatment may disrupt bone formation across the sutures through plastic deformation of the treated suture. The level of permanent deformations observed across the coronal suture after loading corresponded well with the apparent strain that was estimated. This work provides invaluable insight into the level of mechanical forces that may prevent early fusion of cranial joints during the minimally invasive treatment cycle and will help the clinical translation of the treatment approach to humans. [ABSTRACT FROM AUTHOR]

The most challenging and time-consuming step in the free gingival graft (FGG) for keratinized mucosa augmentation is the compression suture anchoring the FGG to the periosteum. This article proposed a novel "microscrew with tie-down sutures" technique to anchor the FGG to the recipient site without the traditional trans-periosteum suture. This patient's keratinized mucosa width (KMW) around the healing abutments of teeth #29 and #30 was less than 1 mm. After an apically positioned flap (AFP) was prepared, 2 microscrews were placed at the buccal plate of the alveolar ridge bone, which is the coronal margin of the AFP. Then, the sutures winded between the microscrews and the healing abutments to anchor the FGG. In conclusion, the "microscrew with tie-down sutures" technique offers a feasible and straightforward alternative for the trans-periosteum compression suture, mainly when the periosteum is fragile, thin, or injured. [ABSTRACT FROM AUTHOR]

Background: Suture and screw fixations are widely used to treat tibial eminence fractures (TEFs). Although a few biomechanical and clinical studies have compared suture fixation (SF) and screw fixation in the treatment of TEFs in children, no comparative clinical studies are available regarding headless screw fixation (HSF). Purpose: To evaluate the clinical and functional outcomes of children with TEF who underwent SF and HSF. Study Design: Cohort study; Level of evidence, 3. Methods: The study included 24 patients treated with either SF (11 patients) or HSF (13 patients) within 1 month of TEF (type 2 or 3) without associated ligamentous and bone injury between 2015 and 2020. All patients were evaluated at a minimum 2-year follow-up in terms of Lysholm score, Tegner activity level, International Knee Documentation Committee subjective score, and isometric strength test. Knee stability was compared based on the Lachman test, pivot-shift test, and KT-1000 arthrometer side-to-side difference. Results: No significant differences were found between the 2 groups in terms of Lysholm score, Tegner activity level, and International Knee Documentation Committee subjective score at follow-up. All patients were able to resume their daily activities within 6 months after the injury. However, flexion deficits (6°-10°) were found in 2 patients in the SF group and 1 patient in the HSF group, and extension deficits (3°-5°) were found in 3 patients in the SF group and 1 patient in the HSF group, without significant intergroup difference. Stability based on the Lachman test, pivot-shift test, and KT-1000 arthrometer side-to-side difference was also similar between the 2 groups at follow-up. No statistically significant difference was found between the 2 groups in isometric tests performed. Conclusion: The present study is the first to compare the clinical and functional results of SF and HSF techniques. The HSF technique demonstrated comparable clinical and functional outcomes, suggesting its potential as an alternative to the SF technique. [ABSTRACT FROM AUTHOR]

Background: Within the realm of surgical decision-making, wound closure material is frequently overlooked. Recent findings from a meta-analysis indicate a heightened risk of surgical site infections (SSIs) associated with the use of staples for wound closure. However, the impact of closure material on non-infectious wound complications remains less defined. In this study, we aim to compare sutures and staples with regard to the clinical outcome of wound closure using the Hollander wound evaluation score (HWES) and Visual analogue patient satisfaction scale (VAS). Materials & Methods: In this randomized prospective study, 60 patients with closed fractures were divided randomly into two groups with 30 patients in each - Group A: Suture, Group B: Staple and evaluated for their wound closure outcome at the 4th and 12th week using HWES and VAS. Result: Group B had a shorter mean closure time (6.8 minutes) compared to Group A (11.3 minutes), but the time to heal was slightly longer in Group B (12 days) than in Group A (11 days). While the cost of materials was higher in Group B than Group A, there were more cases of infection (5 cases) and wound dehiscence (6 cases) in Group B compared to Group A (3 cases each). Additionally, the pain experienced during removal, as per VAS, was higher in Group B (3.1) than in Group A (1.9). However, the assessment of overall cosmesis at 4 and 12 weeks favored Group B (2.1) over Group A (3.2). Conclusion: Sutures vs. Staples in orthopedic surgery in our study show similar healing times, but staples show higher infection risk and cost but overall better cosmesis; sutures have less pain during removal. Further research is needed for conclusive guidance. [ABSTRACT FROM AUTHOR]

Complications that can occur in the postoperative period of impacted lower third molar extraction are factors that have an impact on the daily routine of patients. This study aimed to evaluate the efficacy of polybutester and polypropylene sutures on postoperative complications after impacted lower third molar surgery. Two different suture materials were used in the 35 patients with bilateral impacted lower third molars included in the study: polybutester sutures in group 1 and polypropylene sutures in group 2. Measurements were taken to evaluate swelling and trismus before surgery and on the 2nd and 7th days after surgery, and pain was evaluated using a visual analogue scale (VAS), which patients were asked to complete after surgery. Wound healing, suture-related injury and suture-related discomfort in patients were also evaluated. The pain and suture-related discomfort felt on the side where the polybutester suture was used was less on the second postoperative day than on the side where the polypropylene suture was used. These results support the use of polybutester sutures in impacted third molar surgery. [ABSTRACT FROM AUTHOR]

Background: Low anterior resection in patients with rectal cancer may require a defunctioning loop ileostomy formation that requires closure after a period of time. There are three common techniques for ileostomy closure: anterior repair (AR or fold-over closure), resection and hand-sewn anastomosis (RHA), and resection and stapled anastomosis (RSA). We aimed to compare them on the basis of operative and postoperative features. Methods: Patients with rectal cancer who underwent low anterior resection without complications were included in this study and randomly assigned to three parallel groups to undergo loop ileostomy closure via either AR, RHA, or RSA. Early and late outcomes were gathered from all included patients. Results: Among 93 patients with a mean age of 56.21 ± 11.78 years, consisting of 58 (62.4%) men, 31 patients underwent AR, 30 patients RHA, and 32 patients RSA. There was no significant difference among the groups regarding the frequency and location of intraoperative injuries (P = 0.157). The AR groups demonstrated significantly less consumption of gauzes following intraoperative bleeding compared to the two others groups. The results showed that the duration of surgery in the RSA was significantly shorter than in the AR or RHA group (both P < 0.001). Regarding postoperative course, only one case of hematoma and two cases of surgical wound infection occurred in the RHA group. Anastomotic leakage and complete or partial obstruction did not occur in any group of patients. Latent postoperative complications did not occur in any group of patients. The median time between surgery and discharge as well as the interval until first gas passage, first defecation, oral tolerated liquid diet, as well as oral tolerated soft and regular diet in the AR group were significantly lower than in the two other groups (both P < 0.001). However, there was no statistical difference in these intervals between the RHA and RSA groups. Conclusions: Resection and stapled anastomosis had the shortest duration among the three techniques; however, anterior repair had faster recovery, including earlier tolerated oral diet, gas passing and defecation, and discharge, in comparison with the other techniques. Trial registration: Trial registration number IRCT20120129008861N5. [ABSTRACT FROM AUTHOR]

Background: This study assessed the diagnostic yield of high-throughput sequencing methods in a cohort of craniosynostosis (CS) patients not presenting causal variants identified through previous targeted analysis. Methods: Whole-genome or whole-exome sequencing (WGS/WES) was performed in a cohort of 59 patients (from 57 families) assessed by retrospective phenotyping as having syndromic or nonsyndromic CS. Results: A syndromic form was identified in 51% of the unrelated cases. A genetic cause was identified in 38% of syndromic cases, with novel variants detected in FGFR2 (a rare Alu insertion), TWIST1, TCF12, KIAA0586, HDAC9, FOXP1, and NSD2. Additionally, we report two patients with rare recurrent variants in KAT6A and YY1 as well as two patients with structural genomic aberrations: one with a 22q13 duplication and one with a complex rearrangement involving chromosome 2 (2p25 duplication including SOX11 and deletion of 2q22). Moreover, we identified potentially relevant variants in 87% of the remaining families with no previously detected causal variants, including novel variants in ADAMTSL4, ASH1L, ATRX, C2CD3, CHD5, ERF, H4C5, IFT122, IFT140, KDM6B, KMT2D, LTBP1, MAP3K7, NOTCH2, NSD1, SOS1, SPRY1, POLR2A, PRRX1, RECQL4, TAB2, TAOK1, TET3, TGFBR1, TCF20, and ZBTB20. Conclusion: These results confirm WGS/WES as a powerful diagnostic tool capable of either targeted in silico or broad genomic analysis depending on phenotypic presentation (e.g., classical or unusual forms of syndromic CS). [ABSTRACT FROM AUTHOR]

Purpose: The coracoclavicular (CC) loop stabilization technique is proposed for unstable distal clavicular fractures. This study aims to compare single and double CC loop stabilizations and evaluate differences in functional and radiographic outcomes between them. Methods: We conducted a prospective randomized controlled trial involving 46 patients who sustained unstable distal clavicular fractures between April 2017 and 2019. The participants were randomly assigned to one of two groups: the single CC loop stabilization group (n = 23) or the double CC loop stabilization group (n = 23). We assessed their Constant score, American Shoulder and Elbow Surgeons score (ASES), and pain level. Additionally, we recorded data on time to union, CC distance, and any complications. Results: The single CC loop group demonstrated a shorter operative time and significantly higher Constant score than the double CC loop group at 1 month (77.32 ± 5.65 vs. 71.91 ± 8.33; p = 0.016) and 3 months (86.17 ± 4.05 vs. 81.13 ± 6.34; p = 0.009) postoperatively. However, there was no differences in the ASES score, time to union or CC distance restoration between two groups. Implant irritation was observed in the double CC loop group (26.1%), but there were no cases requiring revision surgery. Conclusions: Both single and double CC loop stabilization demonstrated favorable outcomes, including a high union rate and minimal complications. Single CC loop stabilization showed slightly better early functional outcomes, reduced implant-related irritation, and shorter operative times. [ABSTRACT FROM AUTHOR]

Introduction: Sutures or tacks are commonly used to secure a mesh in intraperitoneal onlay mesh (IPOM) hernia repair, but such penetrating fixations can cause local damage, that can be associated with pain. The use of an adhesive could be an alternative to reduce complications. However, a risk associated with this approach has been identified, particularly when the defect cannot be closed. A mesh glued to the peritoneum only might not provide as much mechanical reinforcement to the abdominal wall (AW) as a mesh anchored to the myofascial structure with penetrating fixations, which could lead to an increased recurrence rate. Additionally, the high elasticity of the peritoneum may increase mesh bulging. Leveraging an ex vivo approach, the objective of this study was to investigate the impact of mesh fixation using glue versus barbed sutures, on its biomechanical response for IPOM surgery. Methods: An experimental method was developed using ex vivo porcine abdominal wall samples (n = 12). A 4-cm centered circular defect was created by dissecting the skin and the subcutaneous tissue and removing muscle and extraperitoneal fat, while keeping the peritoneum intact. A 14-cm diameter mesh was secured (Dermabond™ cyanoacrylate adhesive or V-Loc™ barbed sutures) to the AW. The mesh was placed on the peritoneum to remain consistent with the IPOM placement. The sample was then subjected to some inflation tests to simulate increased levels of intra-abdominal pressure (IAP) representing daily activities. For each test, mesh bulging into the defect was assessed as a function of the pressure using Digital Image Correlation (DIC) analysis. Results: Mesh bulging was studied for 2 configurations: suture fixation and glue. Glued meshes exhibited significantly higher bulging values than when sutured with a significant difference (p = 0.013) observed at 252 mmHg and a certain trend for statistical difference (p < 0.1) for stair climbing or coughing activities. Additionally, the stiffness of the repair was also significantly higher when the mesh was sutured compared to when it was glued to the peritoneum (p < 0.05). Conclusion: This study demonstrated that a mesh glued to the peritoneum exhibited higher bulging and a behavior of the repair less stiff compared to when it was sutured to the myofascial structure of the AW, particularly for high intra-abdominal pressures. However, the impact of these differences remains to be evaluated over time. Further preclinical investigations are needed to quantify their impact post-operatively. [ABSTRACT FROM AUTHOR]

A surgical suture is a vital medical device to uphold wounded tissue during surgery. However, the application to improve tissue healing must still be developed. This study offered to solve this problem by incorporating tannic acid (TA) into polydioxanone (PDS) sutures. The PDS suture was immersed in TA complexing with iron (III) solutions in pH 8.0 solution. The engineered suture was successful, as revealed by the OH peak of TA in FTIR spectra. Furthermore, it was confirmed by TA particle appearance under Scanning Electron Microscopy. Contact angle measurement showed better wettability in biological mimicking solutions, such as water, serum, and saline solution. Thereby, it improved in vitro wound healing activity. Moreover, our bioinformatics data showed that TA enhanced the wound healing process by addressing multiple targets in the early phase of inflammation. For instance, it induced platelets to reduce bleeding at the early wound healing stage, activated T cells at the inflammation stage, accelerated epidermis cell proliferation, and activated fibroblast as a key player in wound healing. Due to multiple wound healing targets, our suture system was expected to be emphasized in clinical applications. [ABSTRACT FROM AUTHOR]

The objective of this study is to compare the clinical effectiveness of visualization of percutaneous endoscopic lumbar discectomy (VPELD) combined with annulus fibrosus suture technique and simple percutaneous endoscopic lumbar discectomy (PELD) technique in the treatment of lumbar disc herniation. A retrospective analysis was conducted on 106 cases of lumbar disc herniation treated with foraminoscopic technique at our hospital from January 2020 to February 2022. Among them, 33 cases were treated with VPELD combined with annulus fibrosus suture in group A, and 73 cases were treated with PELD in group B. The preoperative and postoperative visual analogue scale (VAS), functional index (Oswestry Disability Index, ODI), healing of the annulus fibrosus, intervertebral space height, and postoperative recurrence were recorded and compared between the two groups. All patients underwent preoperative and postoperative MRI examinations, and the average follow-up period was 12 ± 2 months. Both groups showed significant improvements in postoperative VAS and ODI scores compared to the preoperative scores (P < 0.05), with no statistically significant difference between the groups during the same period (P > 0.05). There was no significant decrease in intervertebral space between the two groups after surgery (P > 0.05). Group A showed significantly lower postoperative recurrence rate and better annulus fibrosus healing compared to group B (P < 0.05). The VPELD combined with annulus fibrosus suture technique is a safe, feasible, and effective procedure for the treatment of lumbar disc herniation. When the indications are strictly adhered to, this technique can effectively reduce the postoperative recurrence rate and reoperation rate. It offers satisfactory clinical efficacy and can be considered as an alternative treatment option for eligible patients. [ABSTRACT FROM AUTHOR]

Featured Application: This study provides data and rationales to aid researchers in the selection of surrogate models for in vitro assessments of surgically repaired meniscal roots. The results are potentially applicable in experimental in vitro investigations aimed at evaluating the performance of surgical repair both in existing approaches and emerging techniques. It could also be of interest for studies seeking to adjust material models of the meniscal tissue around the suture area for incorporation into computational models. Meniscal root repair is not routinely recommended for patients over 75 years old, yet surrogate age-unrestricted human or porcine models are used for its evaluation. This study assesses the suitability of older human or porcine meniscus models for in vitro testing of the sutured meniscal horn. Three groups of menisci underwent a load-to-failure test with continuous monitoring of the traction force and deformation around the suture: human < 75 years, human ≥ 75 years, and porcine. Both surrogate models were compared to the younger group. The porcine group exhibited a 172.1%-higher traction force before tearing (p < 0.001) and a 174.1%-higher ultimate force (p < 0.001), without there being differences between the human groups. At tissue level, the older group had a 28.7%-lower cut-out stress (p = 0.012) and the porcine group had a 57.2%-higher stress (p < 0.001). Regarding elasticity at the sutured area, a 48.1%-greater deformation rate was observed in the older group (p < 0.001), without difference for the porcine group. In conclusion, neither the porcine nor the older human model demonstrated a clear advantage as a surrogate model for young human sutured meniscal horns. The older human meniscus is preferable for resistance at the specimen level, while the porcine model better represents deformation in the sutured zone. [ABSTRACT FROM AUTHOR]

Background: Uncontrolled ulcer bleeding of duodenal ulcer (DU) after endoscopic therapy often needs surgery. At present, cutting the bottom of the ulcer with ligation and performing its excision-lesion are the common ways to achieve immediate efficacy in stopping bleeding. For the problem of its great trauma, we seek an easy and useful technical method to reach the same therapeutic effect to stop acute bleeding. Methods: We determined the distribution of the lesion and its innervated blood vessels under the guidance of the endoscopy and then performed suture and hemostasis on the external surface of the stomach and duodenum. Results: An immediate efficacy in stopping bleeding was shown and the hemoglobin (Hb) level returned to normal after operation with no recurrence of bleeding. Conclusion: We created a successful and novel strategy for laparotomy-endoscopic assisted suture for DU emergency hemostasis without duodenectomy. [ABSTRACT FROM AUTHOR]

Copyright of Current Neurology / Aktualno?ci Neurologiczne is the property of Medical Communications Sp. z o.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Africaine de Chirurgie et Spécialités is the property of Faculty of Medicine & Biomedical Sciences, University of Yaounde I, Cameroon and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: General Surgery course is a mandatory in medical schools and continuing surgery training is important even to experienced surgeons which they need to maintain and/or improve their surgical skills. Additionally, the models used for that practice are human cadavers, anesthetized porcine, or simulators and are not accessible for medicine schools or physicians in many countries. Therefore, we present a new technical procedure for preparation of frozen experimental animal's cadavers for medical surgical training. Materials and Methods: To perform the study, one porcine slaughtered and frozen at −20°C was used. The porcine cadaver was thawed at room temperature (25°C) and then the pneumoperitoneum test was performed and viscera inspection carried out. Results: The porcine cadaver took 20 hours to completely thaw. The pneumoperitoneum was successfully performed with total distention of the abdominal cavity. All viscera were well preserved maintaining important in vivo characteristics for consistency. Conclusion: The use of thawed porcine cadaver as a model to train many surgical procedures including videolaparoscopy is feasible. The tissues were well preserved by this method and was financially accessible and could be used for different techniques, equipment, and material tests. [ABSTRACT FROM AUTHOR]

The development and evaluation of synthesis materials are crucial to reducing the morbidity and magnitude of post‐enterorrhaphy surgical complications. Despite the possibility of production, chitosan thread has not yet been used in enterorrhaphy, and its effects on intestinal healing have not been evaluated. Therefore, this study aimed to evaluate the effects of chitosan thread on the intestinal wall repair of rabbits submitted to cecorrhaphy. For this, 42 rabbits were allocated into two groups with 21 animals. One group was submitted to cecorrhaphy with chitosan suture thread (CG) and the other with poliglecaprone suture thread (PG). The occurrence of postoperative complications, the intensity of edema, cellular response, formation of granulation tissue, as well as the deposition and maturation of collagen fibers, and the intensity of vascular endothelial growth factor (VEGF‐α) expression, were evaluated during the intestinal wall repair process. The evaluations occurred on the 5th, 15th, and 25th postoperative (PO) days. The animals did not develop peritonitis, but adherence was observed in six animals from CG and seven from PG, with no difference between groups. The polymorphonuclear infiltrate showed higher intensity and higher amount of type III collagen fibers in CG on the 15th PO day. In contrast, a lower amount of type I collagen fibers was observed in CG samples on the 25th PO day. Therefore, the chitosan thread used for cecorrhaphy in rabbits results in minimal postoperative complications, presents biocompatibility, and bioactively assists the tissue repair process of the cecal wall, inducing minimal tissue reaction, stimulating the deposition of type III collagen fibers in the proliferative phase, with sustained VEGF‐α expression, but with reduced deposition of type I fibers, indicating a delay in collagen maturation. [ABSTRACT FROM AUTHOR]

Background: Low anterior resection in patients with rectal cancer may require a defunctioning loop ileostomy formation that requires closure after a period of time. There are three common techniques for ileostomy closure: anterior repair (AR or fold-over closure), resection and hand-sewn anastomosis (RHA), and resection and stapled anastomosis (RSA). We aimed to compare them on the basis of operative and postoperative features. Methods: Patients with rectal cancer who underwent low anterior resection without complications were included in this study and randomly assigned to three parallel groups to undergo loop ileostomy closure via either AR, RHA, or RSA. Early and late outcomes were gathered from all included patients. Results: Among 93 patients with a mean age of 56.21 ± 11.78 years, consisting of 58 (62.4%) men, 31 patients underwent AR, 30 patients RHA, and 32 patients RSA. There was no significant difference among the groups regarding the frequency and location of intraoperative injuries (P = 0.157). The AR groups demonstrated significantly less consumption of gauzes following intraoperative bleeding compared to the two others groups. The results showed that the duration of surgery in the RSA was significantly shorter than in the AR or RHA group (both P < 0.001). Regarding postoperative course, only one case of hematoma and two cases of surgical wound infection occurred in the RHA group. Anastomotic leakage and complete or partial obstruction did not occur in any group of patients. Latent postoperative complications did not occur in any group of patients. The median time between surgery and discharge as well as the interval until first gas passage, first defecation, oral tolerated liquid diet, as well as oral tolerated soft and regular diet in the AR group were significantly lower than in the two other groups (both P < 0.001). However, there was no statistical difference in these intervals between the RHA and RSA groups. Conclusions: Resection and stapled anastomosis had the shortest duration among the three techniques; however, anterior repair had faster recovery, including earlier tolerated oral diet, gas passing and defecation, and discharge, in comparison with the other techniques. Trial registration: Trial registration number IRCT20120129008861N5. [ABSTRACT FROM AUTHOR]

Objective: To compare, among patients undergoing third molar surgeries, whether the use or omission of sutures improves postoperative clinical parameters. Method: A systematic literature review was conducted to identify randomized clinical trials in humans. The steps of this review were conducted following the PRISMA protocol. The risk of bias assessment was performed using the revised Cochrane tool (RoB 2). The RevMan software was employed for meta-analyses, and the quality of evidence was evaluated using GRADE. Result: A total of seven articles were included in the systematic review; however, only one article quantitatively measured bleeding, rendering meta-analysis for this outcome unfeasible. The group of patients in whom sutures were not used presented lower pain and edema on the first day (respectively: MD − 1.08; 95% CI − 1.35 to − 0.81; MD − 1.23; 95% CI − 2.34 to − 0.11) and second day (respectively: MD − 0.50; 95% CI − 0.83 to − 0.17; MD − 10.66; 95% CI − 1.16 to − 0.16) postoperatively, compared to the group where sutures were employed. The group of patients who received sutures exhibited increased trismus on the first day postoperatively (MD 1.04; 95% CI 0.67 to 1.41). Conclusion: The omission of postoperative sutures in third molar surgeries appears to favor pain and edema outcomes within the first 24 h after the procedure, as well as trismus within the same timeframe. Clinical relevance. Despite the suture being the standard conduct in tooth extractions. The omission of sutures in third molar extractions may favor inflammatory outcomes of pain, edema, and trismus in the immediate postoperative period. [ABSTRACT FROM AUTHOR]

The Malaguide Complex occupies the highest position in a thick-skinned Alpine thrust stack. It includes polydeformed, sedimentary and low-grade metamorphic rocks of Palaeozoic basements and their Meso-Cenozoic covers. NE of Granada the complex results severely sheared and stretched along the Betic suture zone in the metamorphic hinterland (orogenic backstop). The suture developed after the Burdigalian, due to oblique collision of the Alboran Domain (including the Malaguide Complex) with the South-Eastern Iberian Paleomargin. The orogenic evolution in the backstop region started with late Palaeogene to Early Miocene N-directed pre-collisional shortening and early thrust stacking, associated with low-grade metamorphism in the lowest Malaguide units increasing downwards into the underlying Alpujarride Complex. An accretionary prism developed at the expense of deep-marine (Flysch) sediments and the sedimentary covers of the Iberian and Alboran conjugate margins (External Zones and Frontal units, respectively). Later orogenic stages were characterized by SSE-directed back-folding and -thrusting in the Middle Miocene affecting both sides of the Betic suture related to dextral wrenching causing plurikilometric displacements. In this way, the suture evolved towards a several kilometres wide megashear zone (Cogollos-Diezma Corridor), prior to a final phase of SW-directed post-orogenic extension in the Late Miocene. Despite this protracted Alpine evolution, the Malaguide basements also preserve a record of orogenic activity during Late Carboniferous stages of the Variscan Orogeny in the form of a set of NE-SW trending folds with SE vergence and associated slaty cleavage, which are not found in the post-Carboniferous cover. The temperature conditions of this event (>300°C) in the less metamorphic Malaguide units are determined by colour alteration index (CAI) data from conodonts that have also allowed biostratigraphic dating of the Devonian-Carboniferous successions. [ABSTRACT FROM AUTHOR]

To provide a historic snapshot as regards the evolution of headache treatment throughout the human history, i.e. starting from trepanation to perisutural botulinum toxin (BoNT) injections. Ancient surgeons had aimed to reach the cranium with trepanation (a surgical operation) for headache. As BoNT inhibits the release of nociceptive and pro-inflammatory neuropeptides, it has been recently suggested as an effective alternative in the prophylactic treatment of chronic migraine headache. Chronic migraine is a complex neurological disorder for which the underlying pathophysiology is yet not totally explained. According to the generally accepted hypotheses, peripheral neurogenic activation and central trigeminal sensitization are the two main mechanisms through which its pain develops. Since the headache most commonly occurs around the perisutural areas, and as the primary pathogenesis stem from the meningeal nerve fibers; collateral sensorial branches of the meningeal nerves can be optimal paths to transport BoNT inside the cranium. Concerning the therapeutic efficacy, we anticipate that perisutural injections would be technically challenging with blind techniques and actually possible only if performed under an imaging guidance, e.g. very conveniently with high frequency ultrasound. [ABSTRACT FROM AUTHOR]

Background: Mesh repair in incarcerated or strangulated groin hernia is controversial, especially when bowel resection is required. We aimed to perform a meta-analysis comparing mesh and non-mesh repair in patients undergoing emergency groin hernia repair. Methods: We performed a literature search of databases to identify studies comparing mesh and primary suture repair of patients with incarcerated or strangulated inguinal or femoral hernias who underwent emergency surgery. Postoperative outcomes were assessed by pooled analysis and meta-analysis. Statistical analysis was performed using RevMan 5.4. Heterogeneity was assessed with I2 statistics. Results: 1095 studies were screened and 101 were thoroughly reviewed. Twenty observational studies and four randomized controlled trials comprising 12,402 patients were included. We found that mesh-based repair had reduced recurrence (OR 0.36; 95% CI 0.19, 0.67; P = 0.001; I2 = 35%), length of hospital stay (OR − 1.02; 95% CI − 1.87, − 0.17; P = 0.02; I2 = 94%) and operative time (OR − 9.21; 95% CI − 16.82, − 1.61; P = 0.02; I2 = 95%) without increasing surgical site infection, mortality or postoperative complications such as seroma, chronic, ileus or urinary retention. In the subgroup analysis of patients that underwent bowel resection, we found that mesh repair was associated with an increased risk of surgical site infection (OR 1.74; 95% CI 1.04, 2.91; P = 0.04; I2 = 9%). Conclusions: Mesh repair for incarcerated and strangulated groin hernias reduces recurrence without an increase in postoperative complications and should be considered in clean cases. However, in the setting of bowel resection, mesh repair might increase the incidence of surgical site infection. [ABSTRACT FROM AUTHOR]

To reduce the risk of surgical site infections, and then make silk sutures have antibacterial properties, the natural antibacterial agent curcumin (Cur) was encapsulated into zeolitic imidazolate framework-8 (ZIF-8) by solvent synthesis method to prepare drug-loaded nanoparticles ZIF-8@Cur. A series of antibacterial silk sutures were prepared by adjusting the mass concentration of ZIF-8@Cur by loading ZIF-8@Cur onto the silk sutures with dip coating method. The influence law of ZIF-8@Cur mass concentration on the chemical structure, surface morphology, mechanical properties and drug loading of silk sutures was investigated by systematic physical and chemical characterization, and the optimal ZIF-8@Cur coating mass concentration was selected. The antibacterial properties and cytocompatibility of silk sutures were analyzed by antibacterial and cell experiments. The research indicates that ZIF-8@Cur is successfully synthesized and loaded onto the sutures surface. When the mass concentration of ZIF-8@Cur is 15 mg/mL, the nanoparticle coating on the surface of S/ZC15 is uniform and smooth, and the drug loading of S/ZC15 is 15.45 μg. The sutures still maintain excellent mechanical properties after coating, which meet the strength requirements of medical sutures. In addition, S/ZC15 has good antibacterial properties and cytocompatibility, which is expected to inhibit the occurrence of surgical site infections [ABSTRACT FROM AUTHOR]

Objective: Endoscopic cauterization is an effective method for treating pyriform sinus fistula (PSF). However, these approaches sometimes result in a higher failure rate. We present an effective technique utilizing suture combined with chemocauterization as first‐line treatment in patients with PSF and evaluate the safety and efficacy of its use in 126 patients. Study Design: Retrospective study. Setting: Tertiary referral center. Methods: Retrospective case review of patients treated between March 2012 and June 2021 at our institution with descriptive statistical analysis. Results: A total of 126 patients with PSF were included in this study with a mean age of 14.7 years. There was no sex predilection. The majority of patients presented with a left‐sided neck lesion (89.7%). Ten patients presented following prior attempts at the surgery of the PSF at another institution; 8 via open surgery and 2 following endoscopic CO2 laser cauterization; other patients only had a history of repeat incision and drainage or antibiotic treatment. The success rate of obliteration of the internal opening was 96.83% after a single treatment without complications. Following reoperation, a successful outcome was achieved in the remaining 4 patients. Length of stay ranged from 10 to 14 days. No recurrences occurred within 12 to 120 months followed‐up. Conclusion: Endoscopic suture combined with chemocauterization is a safe and effective treatment of PSF. Surgery can be performed during the acute cervical inflammatory period without increased risk of complication or recurrence, however, patients found to have acute changes affecting the pyriform sinus should be treated with a staged surgery strategy. [ABSTRACT FROM AUTHOR]