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Les premières étapes du développement du front aboutissent à la formation des centres d'ossification frontaux et à leur croissance centrifuge. La croissance suturaire prend ensuite le relai, avec une importance cruciale des interactions fonctionnelles, représentées surtout par le cerveau en croissance, via des processus de mécanosensation et de mécanotransduction. Dans cet article, nous passons en revue ces différentes étapes et tentons d'en dégager la pertinence clinique pour la compréhension des malformations craniofaciales. Craniofacial development involves processes leading to the positioning and early growth of the frontal ossification centers. Growth then occurs, mostly secondary to the activity of the sutures, with major interactions with the functional environment, mostly consisting in the growing brain, based on mechanosensation and mechanotransduction mechanisms. Here, we review these processes and assess their relevance in the understanding of craniofacial malformations. [ABSTRACT FROM AUTHOR]

The Middle Allochthon of the Galicia-Trás-os-Montes Zone (GTMZ) in NW Iberia is an assemblage of oceanic units representing the Variscan suture of one or more peri-Gondwanan oceans. This contribution brings new geochronological and geochemical data from the Middle Allochthon of the Morais Complex, in northern Portugal. There, the oceanic ensemble consists of a stack of five tectonic units which from bottom to top are the Junqueira, Pombais and Izeda oceanic supracrustals and the Remondes and Morais-Talhinhas ophiolitic units. The Junqueira and Pombais units consist of greenschists and metapelites. No age data are available for these two units, but a correlation is established with a Cambro-Ordovician unit in the Órdenes Complex of Galicia (NW Spain) dated at 500 Ma. The Izeda Unit consists of fine-grained, low-grade amphibolites transitional to epidote-amphibolites and greenschists, for which an age of 484 ± 3 Ma has been obtained for a metabasic tuff. In the ophiolitic ensemble, the Remondes and Morais-Talhinhas units consist of fine-grained amphibolites associated with deformed metagabbros, mafic cumulates and serpentinized ultramafics. In this study, two plagiogranite samples from the Remondes Unit yielded a complex spread of age data with Silurian ages representing the dominant population. This suggests that the newly defined Remondes Unit is younger than the Izeda Unit but older than the previously published age for these rocks, which are considered part of the overlying Morais-Talhinhas Unit, dated as Devonian (406–395 Ma) in a previous study. The geochemistry of the basic rocks in the five units is that of NMORB with a subduction-derived component that varies from weak to null. The ages, together with new and previously published whole rock geochemical data obtained from basic igneous samples, are interpreted to date and reflect the formation of igneous protoliths in oceanic ridge settings associated with the Mid-Variscan Ocean, a part of the Rheic oceanic realm that registered magmatic activity between the late Cambrian and the Lower Devonian. [ABSTRACT FROM AUTHOR]

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]

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]

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]

Facial lacerations are commonly encountered in emergency departments and require effective management to optimise aesthetic outcomes. Non-resorbable sutures are traditionally favoured for their tensile strength and minimal inflammatory response, despite the inconvenience of the required follow up for removal. This single-centre, single-blinded randomised controlled trial aimed to compare the clinical efficacy and cost-effectiveness of resorbable (Vicryl Rapide) versus non-resorbable (Ethilon) sutures for the closure of facial lacerations in adults. Between November 2021 and February 2023, 200 adult patients presenting with facial lacerations were randomly allocated to either resorbable or non-resorbable sutures. Outcomes assessed included aesthetic results via the Visual Analogue Scale (VAS) and Hamilton Scar Scale, patient-reported satisfaction using the Patient Scar Assessment Questionnaire (PSAQ), complication rates, and cost analysis. No significant differences were found in mean VAS scores between the two groups in both modified intention-to-treat and per-protocol analyses. The majority of patients reported high satisfaction levels. Early complication rates were significantly higher in the non-resorbable group at the one-week follow up, with no long-term differences noted. Preliminary cost analysis indicated a more than five-fold cost saving with resorbable sutures. Resorbable sutures provide a viable and cost-effective alternative to non-resorbable sutures for adult facial lacerations, with comparable aesthetic outcomes and patient satisfaction. Their use could reduce healthcare burdens by eliminating the need for follow-up suture removal, supporting broader adoption in clinical practice. [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]

Abstract 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

Background: Torsion of the right middle lobe following right upper lobectomy is a rare but potentially fatal complication. To prevent this, fixation of the right middle lobe has been suggested. This study was performed to examine the impact of right middle lobe fixation on postoperative outcomes and bronchial changes. Methods: We enrolled patients who underwent curative-intent video-assisted thoracic surgery (VATS) right upper lobectomy for lung cancer from 2019 to 2022. Participants were grouped based on whether they did or did not receive right middle lobe fixation. Bronchial angles were measured using preoperative and postoperative chest computed tomography images, and postoperative outcomes and bronchial changes were compared between the 2 groups. Results: The study included a total of 50 patients, with 17 (34%) undergoing right middle lobe fixation. All procedures were performed using VATS. No significant differences between groups were observed in preoperative characteristics or postoperative outcomes. After surgery, both groups exhibited a significant increase in the right bronchus intermedius angle and a significant decrease in the branch angle. The postoperative right bronchus intermedius angle was significantly larger in the group without right middle lobe fixation compared to the group with fixation (47.38°±10.98° vs. 39.41°±9.21°, p=0.014). Three cases of atelectasis occurred in the group that did not undergo fixation while no cases were observed in the fixation group; however, this difference was not statistically significant. Conclusion: Fixation of the right middle lobe reduced postoperative angulation of the right bronchus intermedius, which may help prevent postoperative atelectasis.

Controversy remains regarding the optimal technique and suture type for wound closure after carpal tunnel surgery. Adult patients undergoing open carpal tunnel release were prospectively randomized to receive either interrupted, buried Monocryl sutures or traditional nylon horizontal mattress sutures for their wound closures. At the 2-week and 6-week postoperative visits, Patient and Observer Scar Assessment Scale questionnaires were completed. At 2 weeks, patients and observers had a significantly better opinion of incisions closed with Monocryl. By 6 weeks, neither patients nor observers found a difference between suture types in any category. Scars of wounds closed with Monocryl did not change appreciably in appearance between 2 and 6 weeks. However, patients and observers noted significant improvement in scar appearance in the nylon group over time. Monocryl suture represents an effective method for carpal tunnel closure that leads to improved patient- and observer-reported outcome scores in the early postoperative period compared with nylon.Level of evidence: II.

Introduction: Polypropylene material is commonly used for posterior wall reconstruction in hernia repair, in contrast with the classically described stainless-steel wire used at Shouldice Hospital. This study was conducted to evaluate possible differences in Shouldice Repair outcomes using polypropylene or stainless-steel wire sutures. Methods: A prospective follow-up of consecutive patients who underwent elective unilateral Shouldice primary inguinal hernia repair at Shouldice Hospital between December 6, 2021, and September 1, 2022, was conducted. Data was collected from follow-up telephone calls as well as manually reviewing patient's charts. The primary objective was to determine whether the use of polypropylene was non-inferior to the use of stainless-steel wire, regarding the recurrence rate reported by the patients with a minimum follow-up of 1 year after Shouldice primary inguinal hernia repair. Results: A total of 1120 patients were contacted by telephone (polypropylene: 560; stainless-steel wire: 560). The median follow-up period was 16 months (interquartile range: 15–18). In 22 (1.96%) cases a surgical site infection was diagnosed. There was a total of 18 recurrences reported by the patients (1.6%). There was no statistical difference between the groups (polypropylene: 7 (1.25%) vs. stainless steel wire: 11 (1.96%), p > 0.05) for the recurrence rate. Conclusion: The use of polypropylene is non-inferior to the use of stainless-steel wire regarding recurrence rate at a median follow-up period of 16 months after elective unilateral Shouldice primary inguinal hernia repair. This finding may encourage other centers where stainless-steel wire is not easily available to perform the Shouldice Repair. [ABSTRACT FROM AUTHOR]

Purpose: Recent guidelines indicate the use of mesh in UHR for defects > 1 cm, as it reduces recurrence, with 10% recurrence rate compared to up to 54.5% with primary closure. However, Nguyen et al. shows that primary closure is still widely performed in UHR, especially for small defects (1–2 cm), for which there is no published data to determine the optimal approach. In addition, previous meta-analysis by Madsen et al. comparing mesh repair with primary closure in UHR didn't exclude emergency conditions and recurrent hernias; also, didn't report subgroup analysis on hernia defect size. Thus, we aimed to perform a systematic review and meta-analysis comparing the mesh repairs vs. primary closure of the defect in an open elective primary UHR. Methods: We searched for studies comparing mesh with suture in open UHR in PubMed, Scopus, Cochrane, Scielo, and Lilacs from inception until October 2023. Studies with patients ≤ 18 years old, with recurrent or emergency conditions were excluded. Outcomes were recurrence, seroma, hematoma, wound infection, and hospital length of stay. Subgroup analysis was performed for: (1) RCTs only, and (2) hernia defects smaller than 2 cm. We used RevMan 5.4. for statistical analysis. Heterogeneity was assessed with I² statistics, and random effect was used if I² > 25%. Results: 2895 studies were screened and 56 were reviewed. 12 studies, including 4 RCTs, 1 prospective cohort, and 7 retrospective cohorts were included, comprising 2926 patients in total (47.6% in mesh group and 52.4% in the suture group). Mesh repair showed lower rates of recurrence in the overall analysis (RR 0.50; 95% CI 0.31 to 0.79; P = 0.003; I2 = 24%) and for hernia defects smaller than 2 cm (RR 0.56; 95% CI 0.34 to 0.93; P = 0.03; I2 = 0%). Suture repair showed lower rates of seroma (RR 1.88; 95% CI 1.07 to 3.32; P = 0.03; I2 = 0%) and wound infection (RR 1.65; 95%CI 1.12 to 2.43; P = 0.01; I2 = 15%) in the overall analysis, with no differences after performing subgroup analysis of RCTs. No differences were seen regarding hematoma and hospital length of stay. Conclusion: The use of mesh during UHR is associated with significantly lower incidence of recurrence in a long-term follow-up compared to the suture repair, reinforcing the previous indications of the guidelines. Additionally, despite the overall analysis showing higher risk of seroma and wound infection for the mesh repair, no differences were seen after subgroup analysis of RCTs. Study registration: A review protocol for this systematic review and meta-analysis was registered at PROSPERO (CRD42024476854). [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]

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: Polypropylene is a commonly used suturing material for intraocular lens (IOL) scleral fixation, but a high breakage rate after several years of follow-up is reported. Meanwhile, Gore-Tex has been a popular artificial material in ophthalmic surgery. Aim: This pilot study investigated the safety and efficacy of a modified surgical technique for scleral fixation of a four-point, close-loop haptic IOL using Gore-Tex as the suture material for aphakic patients without adequate capsular support. Methods: A modified IOL scleral fixation technique was developed using a four-point, close-loop haptic IOL and Gore-Tex as the suture material. Patients undergoing the operation between March 2018 and May 2019 at one center were included in the study. The preoperative uncorrected distance visual acuity (UDVA) with spectacles and postoperative UDVA with an IOL were compared as the main outcome. Follow-up time was 17–43 months. Results: A total of 10 eyes of 10 patients were enrolled, including 3 with iatrogenic IOL dislocation, 3 with iatrogenic lens drop, 2 with traumatic lens dislocation, and 2 with late in-the-bag IOL dislocation. The mean age was 70.8 ± 12.11 years. The mean UDVA, evaluated by the logarithm of the minimum angle of resolution, was decreased from preoperative 1.89 ± 0.28 to postoperative 0.58 ± 0.70 (P < 0.001). No complications were reported except in one case with a postoperative corneal ulcer which healed after antibiotic treatment. Conclusion: The favorable outcome suggests Gore-Tex sutures as a safe and stable material for IOL scleral fixation. Prospective studies with a larger sample size would be necessary for more details on the safety and efficacy of the Gore-Tex suture in IOL scleral fixation.

Abstract 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 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.

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.

AIM: To observe the clinical effect of invisible anchor hook intraocular lens(IOL)fixation surgery.METHODS: Prospective and uncontrolled case study. A total of 19 patients(19 eyes)with aphakia, IOL dislocation, or lens dislocation from January 2019 to December 2020 were selected for this study, all of whom underwent anchor hook IOL scleral fixation implantation surgery. The main postoperative observation indicators are best corrected visual acuity(BCVA), uncorrected visual acuity(UCVA), corneal endothelial cell density, tilt of IOL position, and complications.RESULTS: The UCVA(LogMAR)before and at 1 mo after surgery was 1.06±0.63 and 0.40±0.26, respectively(P

Objective To explore the effect of multi-dimensional reduction in the treatment of keloid in high-tension areas, using layered fishbone-type reduction suture, combined with superficial X-ray radiotherapy as postoperative treatment. Methods From July 2020 to January 2023, a total of 110 cases (162 lesions) were selected from the outpatient department and inpatient department of Dermatology of Sichuan People's Hospital, who were treated with fishbone layered tensioning suture, combined with superficial X-ray radiotherapy after surgery and were able to follow up. According to the location, number and tension of keloids, the scar tissue was removed by single or partial resection. In the operation, the improved multi-layer reduction suture was used to form the fishbone type, and the skin was tension-free and mildly eversion, superficial X-ray radiotherapy was started 24-72 hours after operation, four times, the total dose was 20 Gy; the skin tension was reduced by 3-6 months using a needle-free suture device, and the silicone preparation was externally applied for three months. Follow-up observations were 8-24 months. Patients with postoperative recurrence were treated with dye laser and (or) intra-cicatricial drug injection according to the situation, and shallow X-ray radiotherapy was added twice if necessary. Results In 110 cases (162 lesions), keloid was clinically cured in 103 cases (151 lesions), no obvious signs of recurrence were found, and the average scar stretching was less than 5 mm. Signs of recurrence occurred in seven cases (11 lesions), which were improved after superficial X-ray therapy, dye laser therapy, and local injection of fluorouracil and glucocorticoid. Conclusion Keloid in the high tension area is still difficult in treatment. The method of layered fishbone suture combined with multi-dimensional tension reduction in the surgical treatment can reduce the postoperative incision tension in the high tension area, which is worthy of popularization and application in clinic. [ABSTRACT FROM AUTHOR]

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]

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]

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]

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]

Introduction: Tendon injures rank as the second most common hand injuries, and unsatisfactory repair can significantly impact a patient's everyday life. Over the years, various suture techniques have been studied in the pursuit of finding the optimal repair method. The ideal tendon repair should achieve maximum strength, while being easy to perform and minimizing tissue trauma. This study aims to compare the mechanical properties of the cross-locked U-Tang 4-strand suture to its unmodified version, the U-Tang 4-strand suture, to assess which technique offers greater repair strength. Methods: Sixteen Achilles tendons from New Zealand White rabbits were randomly assigned to one of two suture technique groups; an original U-Tang 4-strand suture or a cross-locked U-Tang 4-strand suture, both performed using a 4-0 Supramid thread. The specimens were tested in uniaxial tension after a preconditioning phase. Cross-sectional area, load until failure, gap formation, stiffness, elastic modulus, and failure stress were determined. Results: The standard U-Tang 4-strand suture withstood a maximum force of 25.48 ± 6.06 N, while the cross-locked version endured 33.90 ± 6.09 N. This indicates that the modified version demonstrated significantly greater strength (p = 0.021). The elastic modulus of the cross-locked U-Tang 4-strand suture (0.02 ± 0.003 MPa) was significantly higher than that of the original version (0.01 ± 0.006 MPa) (p = 0.028). No significant differences were observed regarding the cross-sectional area, load at 2 mm gap formation, stiffness and failure stress. Conclusion: Employing the cross-locked U-Tang 4-strand suture results in a significantly greater maximum force and elastic modulus compared to the original U-Tang 4-strand suture, utilizing the same thread and number of strands and knots. Therefore, the cross-locking version provides an alternative for achieving more stable initial repair strength.

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]

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]

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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]