A COMPARATIVE STUDY OF GUT SUTURE ,HUMAN AMNION COLLAGEN,BOVINE SKIN COLLAGEN AND VICRYL SUTURE IMPLANTS IN RATS

This study compares the persistence and histological characteristics of gut suture with those of human amnion collagen ,bovine collagen ,and Vicryl suture implants in rats. Gut suture and human amnion collagen more resembled living tissue than did bovine collagen and were characterized by their cellularity and the presence of numerous capillaries. The Vicryl suture implants were quickly absorbed. Picrcalrius polarization revealed the synthesis of host collagen by rat fibroblasts which immigrated into the gut suture and human amnion collagen implants. The authors suggest the potential of gut suture as a soft tissue substitute to improve linear skin contour deficits.     

巩膜瓣可调整缝线小梁切除术的临床观察

目的 探讨巩膜瓣可调整缝线小梁切除术的临床效果。方法 对31例（40眼）青光眼患者施行巩膜瓣可调整缝线小梁切除术。术后在裂隙灯显微镜下观察前房深度，并用非接触眼压计测量眼内压。结果 术后4眼发生浅前房（10%），经调整缝线后浅前房持续时间小于24小时，其余36眼前房深度正常。随诊6-12月，1例2眼需再次手术，余38眼眼压均在7-15mmHg。所有患者视力均无下降。其中8眼视力有不同程度的提高。结论 巩膜瓣可调整缝线小梁切除术是目前较为理想的预防小梁切除术后浅前房的好方法。     

Nerve grafts in nerve roots

Summary The positive results of microsurgical technique in suturing and grafting of peripheral nerves have encouraged us to consider grafting of nerve roots. Experimental replantation of anterior nerve root fragments on dogs and rats were performed. Microsurgery was used in all operations. By bioelectrical stimulation, as well as histologically, it is shown that functional regeneration in these animals occurs after grafting of motor nerve roots. The consequences of these experiments in human surgery are discussed.Presented in parts at the annual meeting of the Swiss Society for Plastic and Reconstructive Surgery, Sion, Switzerland, September 1973     

Flexor tendon repair in the hand in the prevention of suture “rake-out”

It is important to understand the mechanical properties of tendons and sutures as well as the modes of failure in flexor tendon repair. We have described a failure mode in which the suture pulls through the tendon and have coined this “rake-out.” Our laboratory results suggest that it is necessary for the core suture to grasp each end of the tendon at a distance of at least 1 cm from the transected end to minimize failure of the repair by suture “rake-out.” We also further describe our approach to flexor tendon repair.     

纵切横缝术与改良纵切横缝术治疗慢性肛裂的临床对比研究

目的：寻求慢性肛裂的最佳手术方法。方法：将80例慢性肛裂病人随机分成2组，对照组（40例）采用常规纵切横缝术；治疗组（40例）采用改良纵切横缝术。对2组患者的术后疗效、愈合时间、术后并发症等进行观察分析。结果：对照组与治疗组在愈合时间，术后并发症方面有显著差异。结论：改良术式操作简便，疗效确切，便于临床推广使用。     

Changes in the biomechanical properties of the rat interparietal suture incident to continuous tensile force application

This study was designed to investigate the relation between the biomechanical behaviour of rat interparietal sutures and expansion forces placed on them. Thirty-five 4-week-old rats were divided into four groups, a control group and three experimental groups subjected to mechanical expansion of the interparietal sutures with a tensile force for 15, 30 and 50 h. After expansion, the parietal bones, including the interparietal suture, were dissected as specimens for tensile tests. Under tension, the relaxed stress–strain plots in the control group could be better fitted by a power of 2.00, and the relaxed moduli were 0.64 and 4.51 MPa at the lower and the higher applied strains, respectively. An initial fall in the relaxed moduli at 15 h of expansion was followed by an increase over time. It is therefore suggested that the biomechanical behaviour of the interparietal sutures is influenced by the duration of an external force.     

An easier method for performing a pancreaticojejunostomy for the soft pancreas using a fast-absorbable suture

AIM： To clarify the usefulness of a new method for performing a pancreaticojejunostomy by using a fast-absorbable suture material irradiated polyglactin 910, and a temporary stent tube for a narrow pancreatic duct with a soft pancreatic texture.METHODS： Among 63 consecutive patients with soft pancreas undergoing a pancreaticoduodenectomy from 2003 to 2006, 35 patients were treated with a new reconstructive method. Briefly, after the pancreatic transaction, a stent tube was inserted into the lumen of the pancreatic duct and ligated with it by a fast-absorbable suture. Another tip of the stent tube was introduced into the intestinal lumen at the jejunal limb, where a purse-string suture was made by another fast-absorbable suture to roughly fix the tube. The pancreaticojejunostomy was completed by ligating two fast-absorbable sutures to approximate the ductal end and the jejunal mucosa, and by adding a rough anastomosis between the pancreatic parenchyma and the seromuscular layer of the jejunum. The initial surgical results with this method were retrospectively compared with those of the 28 patients treated with conventional duct-to-mucosa anastomosis.RESULTS： The incidences of postoperative morbidity including pancreatic fistula were comparable between the two groups （new; 3%-17% vs conventional; 7%-14% according to the definitions）. There was no mortality and re-admission. Late complications were also rarely seen.CONCLUSION： A pancreaticojejunostomy using an irradiated polyglactin 910 suture material and a temporary stent is easy to perform and is feasible even in cases with a narrow pancreatic duct and a normal soft pancreas.