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Pannu CD. An in Vitro Evaluation of the 14-Day Microbial Barrier Property of Exofin High Viscosity Topical Skin Adhesive. Surg Infect (Larchmt) 2024; 25:564-573. [PMID: 39049817 DOI: 10.1089/sur.2024.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024] Open
Abstract
Background: Wound closure is a critical aspect of medical care, and the choice of closure methods plays a pivotal role in preventing infections. Traditional sutures and staples can introduce foreign material into the wound, increasing the risk of infection. Adhesives offer a potential alternative by providing a physical barrier against microorganisms. Objective: To assess the microbial barrier properties of Exofin High Viscosity Topical Skin Adhesive (HVTSA), a novel adhesive system, against a range of challenge organisms. Methods: This study, conducted by the independent research organization NAMSA (North American Science Associates, LLC), aimed to evaluate the effectiveness of Exofin HVTSA as a microbial barrier. This study was carried out by an independent research organization NAMSA. Challenge organisms, including Staphylococcus aureus, Staphylococcus epidermidis, methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, Escherichia coli, Candida albicans, and Aspergillus brasiliensis, were used to evaluate the adhesive's effectiveness. Inocula of each organism were placed on cured Exofin HVTSA test articles and observed for 14 days. Positive and negative control plates were included to validate the effectiveness of the challenge organisms and assess the absence of contamination. Results: Exofin HVTSA demonstrated effective microbial barrier properties against all challenge organisms, except Pseudomonas aeruginosa. No growth or color change was observed for Staphylococcus aureus, Staphylococcus epidermidis, MRSA, Escherichia coli, Candida albicans, and Aspergillus brasiliensis over the 14-day observation period. Pseudomonas aeruginosa exhibited no growth, but showed a color change in two out of five replicates on day 14. Conclusion: Exofin HVTSA demonstrated effective microbial barrier properties for 14 days against a range of common wound pathogens, suggesting its potential as a safe and effective alternative to traditional wound closure methods. Further research is warranted to investigate its efficacy in clinical settings.
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Huang J, Chen H, Jia Z, Song X, Wang S, Bai B, Wang J, Zhang J, Zhou G, Lei D. Mechanically skin-like and water-resistant self-healing bioelastomer for high-tension wound healing. Bioact Mater 2024; 39:443-455. [PMID: 38873087 PMCID: PMC11170441 DOI: 10.1016/j.bioactmat.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/09/2024] [Accepted: 04/09/2024] [Indexed: 06/15/2024] Open
Abstract
The biomedical application of self-healing materials in wet or (under)water environments is quite challenging because the insulation and dissociation effects of water molecules significantly reduce the reconstruction of material-interface interactions. Rapid closure with uniform tension of high-tension wounds is often difficult, leading to further deterioration and scarring. Herein, a new type of thermosetting water-resistant self-healing bioelastomer (WRSHE) was designed by synergistically incorporating a stable polyglycerol sebacate (PGS) covalent crosslinking network and triple hybrid dynamic networks consisting of reversible disulfide metathesis (SS), and dimethylglyoxime urethane (Dou) and hydrogen bonds. And a resveratrol-loaded WRSHE (Res@WRSHE) was developed by a swelling, absorption, and crosslinked network locking strategy. WRSHEs exhibited skin-like mechanical properties in terms of nonlinear modulus behavior, biomimetic softness, high stretchability, and good elasticity, and they also achieved ultrafast and highly efficient self-healing in various liquid environments. For wound-healing applications of high-tension full-thickness skin defects, the convenient surface assembly by self-healing of WRSHEs provides uniform contraction stress to facilitate tight closure. Moreover, Res@WRSHEs gradually release resveratrol, which helps inflammatory response reduction, promotes blood vessel regeneration, and accelerates wound repair.
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Affiliation(s)
- Jinyi Huang
- Department of Plastic and Reconstructive Surgery, Department of Cardiology, Shanghai Key Lab of Tissue Engineering, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
- Research Institute of Plastic Surgery, Shandong Second Medical University, Weifang, Shandong, 261053, PR China
| | - Hongying Chen
- Department of Plastic and Reconstructive Surgery, Department of Cardiology, Shanghai Key Lab of Tissue Engineering, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
| | - Zenghui Jia
- Department of Plastic and Reconstructive Surgery, Department of Cardiology, Shanghai Key Lab of Tissue Engineering, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
- Research Institute of Plastic Surgery, Shandong Second Medical University, Weifang, Shandong, 261053, PR China
| | - Xingqi Song
- Department of Plastic and Reconstructive Surgery, Department of Cardiology, Shanghai Key Lab of Tissue Engineering, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
| | - Sinan Wang
- Department of Plastic and Reconstructive Surgery, Department of Cardiology, Shanghai Key Lab of Tissue Engineering, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
| | - Baoshuai Bai
- Department of Plastic and Reconstructive Surgery, Department of Cardiology, Shanghai Key Lab of Tissue Engineering, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
| | - Jian Wang
- Department of Plastic and Reconstructive Surgery, Department of Cardiology, Shanghai Key Lab of Tissue Engineering, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
| | - Junfeng Zhang
- Department of Plastic and Reconstructive Surgery, Department of Cardiology, Shanghai Key Lab of Tissue Engineering, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
| | - Guangdong Zhou
- Department of Plastic and Reconstructive Surgery, Department of Cardiology, Shanghai Key Lab of Tissue Engineering, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
- Research Institute of Plastic Surgery, Shandong Second Medical University, Weifang, Shandong, 261053, PR China
| | - Dong Lei
- Department of Plastic and Reconstructive Surgery, Department of Cardiology, Shanghai Key Lab of Tissue Engineering, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
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Malhotra K, Bondje S, Sklavounos A, Mortada H, Khajuria A. Absorbable versus Nonabsorbable Sutures for Facial Skin Closure: A Systematic Review and Meta-analysis of Clinical and Aesthetic Outcomes. Arch Plast Surg 2024; 51:386-396. [PMID: 39034976 PMCID: PMC11257736 DOI: 10.1055/a-2318-1287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 04/15/2024] [Indexed: 07/23/2024] Open
Abstract
When repairing facial wounds, it is crucial to possess a thorough understanding of suitable suture materials and their evidence base. The absence of high-quality and comprehensive systematic reviews poses challenges in making informed decisions. In this study, we conducted a review of the existing literature and assessed the quality of the current evidence pertaining to the clinical, aesthetic, and patient-reported outcomes associated with absorbable and nonabsorbable sutures for facial skin closure. The study was registered on Prospective Register of Systematic Reviews. We conducted searches on Embase, Ovid, and PubMed/MEDLINE databases. Only randomized controlled trials (RCTs) were eligible for inclusion in this study. Additionally, the risk of bias in the randomized studies was assessed using Cochrane's Risk of Bias Tool. The study included a total of nine RCTs involving 804 participants with facial injuries. Among these injuries, absorbable sutures were utilized in 50.2% (403 injuries), while nonabsorbable sutures were employed in 49.8% (401 injuries). The analysis of cosmesis scales revealed no statistically significant difference between absorbable and nonabsorbable sutures regarding infections ( p = 0.72), visual analog scale ( p = 0.69), wound dehiscence ( p = 0.08), and scarring ( p = 0.46). The quality of the included studies was determined to have a low risk of bias. Absorbable sutures can be considered a suitable alternative to nonabsorbable sutures, as they demonstrate comparable aesthetic and clinical outcomes. Future high-quality studies with a level I evidence design and cost-effectiveness analysis are necessary to enhance clinician-patient shared decision-making and optimize the selection of suture materials. Level of evidence is I, risk/prognostic study.
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Affiliation(s)
- Kashish Malhotra
- Department of Surgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Sophie Bondje
- Department of ENT Surgery & Cancer Services, Torbay Hospital, Torquay, United Kingdom
| | - Alexandros Sklavounos
- Urology Division, Department of Surgery, Addenbrooke's Hospital, University of Cambridge, United Kingdom
| | - Hatan Mortada
- Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
- Department of Plastic Surgery and Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia
| | - Ankur Khajuria
- Department of Surgery & Cancer, Imperial College London, London, United Kingdom
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Seger EW, McClure SP, Neill BC, Jibbe A. Fast absorbing gut sutures in dermatologic surgery: a systematic review and meta-analysis. Arch Dermatol Res 2024; 316:351. [PMID: 38850366 DOI: 10.1007/s00403-024-02973-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/22/2024] [Accepted: 04/26/2024] [Indexed: 06/10/2024]
Abstract
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.
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Affiliation(s)
- Edward W Seger
- Division of Dermatology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA.
| | - Spencer P McClure
- Division of Dermatology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Brett C Neill
- Division of Dermatology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Atieh Jibbe
- Division of Dermatology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
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P A, Kumar K V, Ramachandraiah MK, Shanthappa AH. A Comparative Study of Wound Infections Following Wound Closure Using Staples and Absorbable Sutures Among Obese Patients Undergoing Lumbar Fusion Surgery. Cureus 2024; 16:e63254. [PMID: 39070402 PMCID: PMC11282352 DOI: 10.7759/cureus.63254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2024] [Indexed: 07/30/2024] Open
Abstract
Background Infections of the wounds, organs, or spaces that develop following surgery are known as surgical site infections (SSIs). The incidence of wound infections in obese patients undergoing lumbar spine surgery with the use of absorbable sutures versus staples for skin closure has not been studied previously. Materials and methods We conducted a retrospective observational study in our hospital where cases of lumbar spine surgery meeting the inclusion criteria were chosen retrospectively from March 2021 to March 2023. A total of 40 patients aged >18 years and <75 years who underwent lumbar spine surgery were covered by this investigation. Two cohorts with 20 patients in each were chosen from the population. Group A used a skin stapler to close wounds, whereas group B used absorbable sutures. The number of wound infections was the main result. Using SPSS version 23.0 (IBM SPSS Statistics, Armonk, NY), all data were analyzed after being entered into an Excel sheet (Microsoft Corp., Redmond, WA). Results A total of 40 participants were included in this study, and it revealed that there was no discernible variation in the groups' mean age or gender distribution. There is a significantly higher incidence of SSI in the absorbable suture group (35%) compared to the staple group (15%). The mean duration in days for the development of SSI in the absorbable suture group (9.86±2.12) was early compared to the staple group (12.67±2.08), which was statistically significant (p<0.05). Conclusion Compared to absorbable sutures, the current study showed a decreased incidence of surgical site infection in obese individuals receiving skin staples for wound closure.
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Affiliation(s)
- Akshay P
- Department of Orthopedics, Sri Devaraj Urs Medical College (SDUMC), Kolar, IND
| | - Vinod Kumar K
- Department of Orthopedics and Trauma, Sri Devaraj Urs Medical College (SDUMC), Kolar, IND
| | - Manoj K Ramachandraiah
- Department of Orthopedics, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, IND
| | - Arun H Shanthappa
- Department of Orthopedics, Sri Devaraj Urs Medical College (SDUMC), Kolar, IND
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Anitua E, Pino A, Prado R, Muruzabal F, Alkhraisat MH. Biochemical and biomechanical characterization of an autologous protein-based fibrin sealant for regenerative medicine. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2024; 35:15. [PMID: 38456966 PMCID: PMC10923958 DOI: 10.1007/s10856-024-06780-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 01/10/2024] [Indexed: 03/09/2024]
Abstract
Accidental events or surgical procedures usually lead to tissue injury. Fibrin sealants have proven to optimize the healing process but have some drawbacks due to their allogeneic nature. Autologous fibrin sealants present several advantages. The aim of this study is to evaluate the performance of a new autologous fibrin sealant based on Endoret®PRGF® technology (E-sealant). One of the most widely used commercial fibrin sealants (Tisseel®) was included as comparative Control. E-sealant´s hematological and biological properties were characterized. The coagulation kinetics and the microstructure were compared. Their rheological profile and biomechanical behavior were also recorded. Finally, the swelling/shrinkage capacity and the enzymatic degradation of adhesives were determined. E-sealant presented a moderate platelet concentration and physiological levels of fibrinogen and thrombin. It clotted 30 s after activation. The microstructure of E-sealant showed a homogeneous fibrillar scaffold with numerous and scattered platelet aggregates. In contrast, Control presented absence of blood cells and amorphous protein deposits. Although in different order of magnitude, both adhesives had similar rheological profiles and viscoelasticity. Control showed a higher hardness but both adhesives presented a pseudoplastic hydrogel nature with a shear thinning behavior. Regarding their adhesiveness, E-sealant presented a higher tensile strength before cohesive failure but their elastic stretching capacity and maximum elongation was similar. While E-sealant presented a significant shrinkage process, Control showed a slight swelling over time. In addition, E-sealant presented a high enzymatic resorption rate, while Control showed to withstand the biodegradation process in a significant way. E-sealant presents optimal biochemical and biomechanical properties suitable for its use as a fibrin sealant with regenerative purposes.
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Affiliation(s)
- Eduardo Anitua
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain.
- BTI-Biotechnology Institute, Vitoria, Spain.
| | - Ander Pino
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
- BTI-Biotechnology Institute, Vitoria, Spain
| | - Roberto Prado
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
- BTI-Biotechnology Institute, Vitoria, Spain
| | - Francisco Muruzabal
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
- BTI-Biotechnology Institute, Vitoria, Spain
| | - Mohammad Hamdan Alkhraisat
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
- BTI-Biotechnology Institute, Vitoria, Spain
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Shrestha O, Basukala S, Karki S, Thapa N, Bhugai N, Bohara S, Joshi N, Paudel S. Comparison between novel zipper device and conventional methods for skin closure: a systematic review and meta-analysis. Ann Med Surg (Lond) 2024; 86:1631-1640. [PMID: 38463064 PMCID: PMC10923315 DOI: 10.1097/ms9.0000000000001769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 01/19/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction The zipper device is a wound closure device that can be directly applied over the intact skin on either side of the wound edges and does not need anchoring into the skin or subcutaneous plane. The noninvasive nature of the zipper device makes it less time-consuming and less painful, but its effectiveness and related complications need to be studied. Methods Prospective registration of the protocol followed in this study was done. Electronic databases were searched for relevant articles, and their screening was completed, followed by data extraction and analysis. The odds ratio, mean difference, or standardised mean difference were used as an effect measure per the nature of the variables. Surgical site infection, wound dehiscence, skin closure time, scar score, and patient satisfaction were compared in this study. Results A total of 10 studies were identified, out of which eight compared zippers with sutures and two compared zippers with stapler devices. Compared to the suture, the zipper device took 4.9 min less to close the incision, and the scar scale outcome reported after one month was inferior, while other results were not significant. Staples showed a lower patient satisfaction level and no difference in complications. Conclusion The zipper device is a less technically demanding and less time-consuming method of skin closure, with no significant difference in the complication rate compared to conventional methods. The zipper device is an effective measure to use in settings with less expertise or at health institutions after assessing the cost at the local level.
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Affiliation(s)
- Oshan Shrestha
- Department of Surgery, Nepalese Army Institute of Health Sciences, Kathmandu
| | - Sunil Basukala
- Department of Surgery, Nepalese Army Institute of Health Sciences, Kathmandu
| | - Sagun Karki
- Department of Surgery, Nepalese Army Institute of Health Sciences, Kathmandu
| | - Niranjan Thapa
- Department of Surgery, Nepalese Army Institute of Health Sciences, Kathmandu
| | - Nabaraj Bhugai
- Department of Surgery, Nepalese Army Institute of Health Sciences, Kathmandu
| | - Sujan Bohara
- Department of Surgery, Nepal Mediciti, Lalitpur, Nepal
| | - Niraj Joshi
- Department of Surgery, Nepalese Army Institute of Health Sciences, Kathmandu
| | - Sushanta Paudel
- Department of Surgery, Nepalese Army Institute of Health Sciences, Kathmandu
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Li G, Huang Y, Song M, Lu M. What are optimum cycles for immediate primary closure of large cutaneous defects? Sci Prog 2024; 107:368504231223037. [PMID: 38439712 PMCID: PMC10916480 DOI: 10.1177/00368504231223037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
BACKGROUND In the reconstruction of large complex cutaneous wounds, a myriad of mechanical devices has been designed to facilitate primary wound closure. However, there is a dearth of studies elucidating how best to achieve optimum use and efficiency of skin stretching (SS) when using the device for immediate primary closure of defects. METHODS Skin defect wounds (7 × 7 cm) were prepared on the back of three Bama miniature pigs. A total of 15 cycles of SS (cycle loading) were subsequently performed on the skin edges of the wound by EASApprox® SS system. Then, the changes in equidistant points were recorded after each cycle. After the SS test, all wounds were sutured under low tension. RESULTS Skin elongation was observed at all equidistant points on the back wounds of three Bama miniature pigs. Up to an additional 1.10 to 3.75 cm of tissue was garnered. The maximum skin elongation was typically achieved within eight cycles of stretching and relaxation. Beyond this range, additional stretching cycles did not result in further skin extension. CONCLUSION There may be a close link between mobilization range and the times of acute cyclic stretching (cycle loading) during the process of primary wound closure. However, larger studies are required to further evaluate the accuracy and effectiveness.
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Affiliation(s)
- Gang Li
- Department of Orthopaedics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
- Department of Orthopaedics, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China
| | - Yajun Huang
- Department of Plastic Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, People's Republic of China
| | - Mingzhi Song
- Department of Orthopaedics, The First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - Ming Lu
- Department of Orthopaedics, Dalian Municipal Central Hospital, Dalian, People's Republic of China
- State Key Laboratory of Structural Analysis, Optimization and CAE Software for Industrial Equipment, Dalian University of Technology, Dalian, People's Republic of China
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Kanamori R, Takae S, Ito K, Mukae A, Shimura M, Suzuki N. Significance and Influence of Suturing for Ovarian Tissue Transplantation. Reprod Sci 2024; 31:162-172. [PMID: 37674005 DOI: 10.1007/s43032-023-01320-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 08/01/2023] [Indexed: 09/08/2023]
Abstract
The purpose of this animal study was to verify the effect of suturing on graft function in ovarian tissue transplantation. Ovaries from 2-week-old rats were transplanted orthotopically into the ovaries of 8-week-old female Wistar rats. The various transplantation methods used were insertion into the ovarian bursa without suturing (group A: control), suturing with a single 6-0 Vicryl stitch (group B: 6-0*1), suturing with a single 10-0 Vicryl stitch (group C: 10-0*1), and suturing with three 10-0 Vicryl stitches (group D: 10-0*3). Two weeks after transplantation, the transplanted ovaries were evaluated histologically and for gene expression. Engraftment rates of the donor ovaries 14 days after transplantation were 62.5%, 100%, 91.7%, and 100% in groups A, B, C, and D, respectively, significantly lower in group A than in the other groups. In terms of gene expression, TNFα levels were significantly higher in group D, and GDF9 and follicle-stimulating hormone receptor (FSHR) levels were significantly lower in group D than in groups A and B. The number of primordial follicles evaluated by HE staining was significantly lower in groups B, C, and D than in group A. Compared to orthotopic transplantation without sutures, direct suturing to the host improved the engraftment rate, although increasing the number of sutures increased inflammatory marker levels and decreased the number of primordial follicles. We believe that it is important to perform ovarian tissue transplantation using optimal suture diameter for good adhesion, but with a minimum number of sutures to preserve ovarian function.
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Affiliation(s)
- Ryo Kanamori
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Seido Takae
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Kaoru Ito
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Azusa Mukae
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Miyuki Shimura
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
| | - Nao Suzuki
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.
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Stratis C, Haider SA, Oleru O, Seyidova N, Sbitany H, Henderson PW. Paper Tape May Improve Scar Aesthetics and Prevent Wound Closure Complications. PLASTIC AND AESTHETIC NURSING 2024; 44:59-69. [PMID: 38166309 PMCID: PMC10964990 DOI: 10.1097/psn.0000000000000537] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
There is uncertainty whether postoperative application of paper tape (PT) improves scar aesthetics and reduces wound closure complications. This study aimed to review and assess the quality of applicable findings from studies investigating PT's efficacy. We queried PubMed and SCOPUS using the search terms "(("paper tape") AND (wound OR closure OR heal* OR complication OR skin OR prevent* OR scar*))." We excluded articles that were duplicates, basic science, or not clinically relevant. We assessed the level of evidence for each article using the American Society of Plastic Surgeons (ASPS) Rating Levels of Evidence and Grading Recommendations for Therapeutic Studies, ranging from I (highest) to V (lowest). Of 186 publications reviewed, we included eight studies in the literature review. Five of these studies reported statistically significant positive outcomes on scar aesthetics and wound closure associated with using PT. Using the ASPS rating system, we found that two studies were Level I, three studies were Level II, two studies were Level IV, and one study was Level V. Notably, heterogeneity in the study designs limited outcome comparison. The data from the studies included in this literature review support using PT to optimize scar and wound management. The lack of higher levels of evidence, however, suggests the need for additional randomized controlled trials to rigorously evaluate patient outcomes when using PT compared with other forms of adhesive dressings.
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Khalid GM, Billa N. Drug-Eluting Sutures by Hot-Melt Extrusion: Current Trends and Future Potentials. MATERIALS (BASEL, SWITZERLAND) 2023; 16:7245. [PMID: 38005174 PMCID: PMC10672932 DOI: 10.3390/ma16227245] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/06/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023]
Abstract
Surgical site infections (SSIs) may result from surgical procedures requiring a secondary administration of drugs at site or systemically in treating the infection. Drug-eluting sutures containing antimicrobial agents symbolise a latent strategy that precludes a secondary drug administration. It also offers the possibility of delivering a myriad of therapeutic agents to a localised wound site to effect analgesia, anti-inflammation, or the deployment of proteins useful for wound healing. Further, the use of biodegradable drug-eluting sutures eliminates the need for implanting foreign material into the wound, which needs to be removed after healing. In this review, we expound on recent trends in the manufacture of drug-eluting sutures with a focus on the hot-melt extrusion (HME) technique. HME provides a solvent-free, continuous one-step manufacturing conduit for drug-eluting sutures, hence, there is no drying step, which can be detrimental to the drug or suture threads and, thus, environmentally friendly. There is the possibility of combining the technology with additive manufacturing platforms to generate personalised drug-loaded implantable devices through prototyping and scalability. The review also highlights key material requirements for fabricating drug-eluting sutures by HME, as well as quality attributes. Finally, a preview of emerging drug-eluting sutures and advocacy for harmonisation of quality assurance by regulatory authorities that permits quality evaluation of novelty sutures is presented.
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Affiliation(s)
- Garba M. Khalid
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK;
- FabRx Ltd., Henwood House, Henwood, Asford TN24 8DH, UK
| | - Nashiru Billa
- Pharmaceutical Sciences Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
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Cui X, Zhang Y, Wang N, Chen Y, Xu J, Hou J. The outcome of sutured wounds compared with tissue adhesive for paediatric wound closure: A meta-analysis. Int Wound J 2023; 20:3298-3306. [PMID: 37221969 PMCID: PMC10502276 DOI: 10.1111/iwj.14210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/25/2023] Open
Abstract
A meta-analysis investigation was executed to measure the outcome of sutured wounds (SWs) compared with tissue adhesive (TA) for paediatric wound closure (PWC). A comprehensive literature inspection till February 2023 was applied and 2018 interrelated investigations were reviewed. The 18 chosen investigations enclosed 1697 children with PWC in the chosen investigations' starting point, 977 of them were utilising SWs, and 906 were utilising TA. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were used to compute the value of the effect of SWs compared with TA for PWC by the dichotomous approaches and a fixed or random model. SWs had significantly higher wound cosmetic (WC) scores (mean deviation [MD], 1.70; 95% CI, 0.57-2.84, P = .003), lower wound dehiscence (WD) (OR 0.60; 95% CI, 0.06-0.43, P < .001), and lower cost (MD, -10.22; 95% CI, -10.94 to -9.50, P < .001) compared with those with TA in PWC. No significant difference was found between children utilising SWs and TA in wound infection (WI) (OR, 0.45; 95% CI, 0.15-1.30, P = .14) with no heterogeneity (I2 = 0%) in PWC. SWs had significantly higher WC scores, lower WD, and lower cost, yet, no significant difference was found in WI compared with those with TA in PWC. However, care must be exercised when dealing with its values because of the low sample size of some of the nominated investigations and the low number of selected investigations for the meta-analysis.
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Affiliation(s)
- Xiaomei Cui
- School of PediatricsHenan University of Traditional Chinese MedicineZhengzhouHenanChina
| | - Yuanbo Zhang
- Department of SurgeryThe Third Affiliated Hospital of Beijing University of Chinese MedicineBeijingChina
| | - Na Wang
- Institutes of Integrative MedicineFudan UniversityShanghaiChina
| | - Yafang Chen
- Department of PediatricsZhumadian Hospital of Traditional Chinese MedicineZhengzhouHenanChina
| | - Jin Xu
- Second School of Clinical MedicineThe Second Affiliated Hospital of Henan University of Chinese MedicineZhengzhouHenanChina
| | - Jianghong Hou
- Second School of Clinical MedicineThe Second Affiliated Hospital of Henan University of Chinese MedicineZhengzhouHenanChina
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Wu M, Zhang P, Li M, Xu R, Zheng X, Cui Q, Cha R, Li B. Bioinspired, Robust, and Absorbable Cellulose Nanofibrils/Chitosan Filament with Remarkable Cytocompatibility and Wound Healing Properties. ACS APPLIED MATERIALS & INTERFACES 2023; 15:43468-43478. [PMID: 37671976 DOI: 10.1021/acsami.3c08525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
Surgical threads are of great importance to prevent wound infection and accelerate tissue healing in surgical treatment. Cellulose nanofibrils (CNF) and chitosan (CS) are attracting increasing attention to be employed as biomedicine materials due to their nontoxicity, cytocompatibility, and biodegradability. However, a robust and absorbable cellulose-based surgical thread has not been explored. Therefore, in this work, a bioinspired CNF/CS composite thread containing 5% cationic polyacrylamide (CPAM) by the mass of CS was prepared, and the obtained CNF/CS-5C thread exhibited excellent mechanical properties and low swelling ratio in water due to the high cross-link degree. Especially, the tensile strength (1877 ± 107 MPa) of this thread was much higher than that of most reported CNF-based threads. Meanwhile, compared with commercial silk and Vicryl surgical threads, the CNF/CS-5C thread exhibited better in vitro cytocompatibility toward endothelial and fibroblast cells and lower inflammatory response in vivo to subcutaneous tissues of rats. In addition, the obtained thread could be regarded as a promising absorbable suture, which exhibited excellent wound healing performances in vivo. Therefore, the prepared absorbable thread will open a new window to prepare novel and advanced cellulose-based threads for medical applications.
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Affiliation(s)
- Meiyan Wu
- CAS Key Laboratory of Biofuels, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao 266101, China
| | - Pai Zhang
- Laboratory of Theoretical and Computational Nanoscience, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing 100190, China
| | - Mei Li
- Center for Mitochondria and Healthy Aging, College of Life Sciences, Yantai University, Yantai 264005, China
| | - Rui Xu
- CAS Key Laboratory of Biofuels, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao 266101, China
| | - Xin Zheng
- Qingdao Hospital of Traditional Chinese Medicine (Municipal Hiser Hospital), Qingdao 266033, China
| | - Qiu Cui
- CAS Key Laboratory of Biofuels, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao 266101, China
- Shandong Energy Institute, Qingdao 266101, China
- Qingdao New Energy Shandong Laboratory, Qingdao 266101, China
| | - Ruitao Cha
- Laboratory of Theoretical and Computational Nanoscience, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing 100190, China
| | - Bin Li
- CAS Key Laboratory of Biofuels, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao 266101, China
- Shandong Energy Institute, Qingdao 266101, China
- Qingdao New Energy Shandong Laboratory, Qingdao 266101, China
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14
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Lisong H, Lianfu W, Jinhong Y, Haibin Z. Clinical effect analysis of using medical glue versus conventional suturing to treat dog bite in children's maxillofacial region after negative pressure sealing drainage: A randomized trial. Medicine (Baltimore) 2023; 102:e34837. [PMID: 37713853 PMCID: PMC10508562 DOI: 10.1097/md.0000000000034837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/28/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND To compare the clinical effectiveness of applying medical glue versus conventional suturing after primary suturing and continuous vacuum sealing drainage (VSD) technology in the treatment of facial wounds caused by dog bites in children's maxillofacial region, with respect to operation time, wound infection rate, treatment effect, and patient satisfaction. METHODS From May 2020 to July 2022, 68 children with a dog bite in the maxillofacial region were randomly divided into medical glue and conventional suturing groups. The patients in both groups were treated with conventional debridement, tetanus and/or rabies immunization, and antibiotic therapy. The medical glue group was treated with VSD after the first-stage of the loose suture of the wound. After 5 days, the suture was removed, and the wound was tightly bonded with medical glue again. The conventional suturing group was treated with VSD after the first-stage of loose suture of the wound. The primary outcomes were the operation time and satisfaction of the 2 groups, and the secondary outcomes was the wound infection rate. RESULTS The operation time of the medical glue group was significantly lower than that of the conventional suturing group. However, there was no significant difference between the 2 groups in the wound infection rate. Still, the patient satisfaction was significantly better in the medical glue group than the conventional suturing group with statistically significant difference (P < .05). CONCLUSION In conclusion, applying medical glue after using negative pressure sealing drainage in treating maxillofacial dog bites can reduce surgeons work intensity, lessen children's pain, and improve the clinical treatment effect.
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Li Y, Meng Q, Chen S, Ling P, Kuss MA, Duan B, Wu S. Advances, challenges, and prospects for surgical suture materials. Acta Biomater 2023; 168:78-112. [PMID: 37516417 DOI: 10.1016/j.actbio.2023.07.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/07/2023] [Accepted: 07/24/2023] [Indexed: 07/31/2023]
Abstract
As one of the long-established and necessary medical devices, surgical sutures play an essentially important role in the closing and healing of damaged tissues and organs postoperatively. The recent advances in multiple disciplines, like materials science, engineering technology, and biomedicine, have facilitated the generation of various innovative surgical sutures with humanization and multi-functionalization. For instance, the application of numerous absorbable materials is assuredly a marvelous progression in terms of surgical sutures. Moreover, some fantastic results from recent laboratory research cannot be ignored either, ranging from the fiber generation to the suture structure, as well as the suture modification, functionalization, and even intellectualization. In this review, the suture materials, including natural or synthetic polymers, absorbable or non-absorbable polymers, and metal materials, were first introduced, and then their advantages and disadvantages were summarized. Then we introduced and discussed various fiber fabrication strategies for the production of surgical sutures. Noticeably, advanced nanofiber generation strategies were highlighted. This review further summarized a wide and diverse variety of suture structures and further discussed their different features. After that, we covered the advanced design and development of surgical sutures with multiple functionalizations, which mainly included surface coating technologies and direct drug-loading technologies. Meanwhile, the review highlighted some smart and intelligent sutures that can monitor the wound status in a real-time manner and provide on-demand therapies accordingly. Furthermore, some representative commercial sutures were also introduced and summarized. At the end of this review, we discussed the challenges and future prospects in the field of surgical sutures in depth. This review aims to provide a meaningful reference and guidance for the future design and fabrication of innovative surgical sutures. STATEMENT OF SIGNIFICANCE: This review article introduces the recent advances of surgical sutures, including material selection, fiber morphology, suture structure and construction, as well as suture modification, functionalization, and even intellectualization. Importantly, some innovative strategies for the construction of multifunctional sutures with predetermined biological properties are highlighted. Moreover, some important commercial suture products are systematically summarized and compared. This review also discusses the challenges and future prospects of advanced sutures in a deep manner. In all, this review is expected to arouse great interest from a broad group of readers in the fields of multifunctional biomaterials and regenerative medicine.
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Affiliation(s)
- Yiran Li
- College of Textiles & Clothing, Qingdao University, Qingdao, 266071, China
| | - Qi Meng
- College of Textiles & Clothing, Qingdao University, Qingdao, 266071, China
| | - Shaojuan Chen
- College of Textiles & Clothing, Qingdao University, Qingdao, 266071, China
| | - Peixue Ling
- Shandong Academy of Pharmaceutical Science, Jinan, 250101, China
| | - Mitchell A Kuss
- Mary & Dick Holland Regenerative Medicine Program and Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Bin Duan
- Mary & Dick Holland Regenerative Medicine Program and Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Shaohua Wu
- College of Textiles & Clothing, Qingdao University, Qingdao, 266071, China; Shandong Academy of Pharmaceutical Science, Jinan, 250101, China.
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Tsai YC, Huang DW, Chou YY, An YC, Cheng YS, Chen PH, Tzeng YS. Comparative Evaluation of Tissue Adhesives and Sutures in the Management of Facial Laceration Wounds in Children. J Pers Med 2023; 13:1350. [PMID: 37763118 PMCID: PMC10532459 DOI: 10.3390/jpm13091350] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND This study evaluated tissue adhesives in comparison to sutures for treating facial lacerations in children. METHODS We retrospectively analyzed data from September 2017 to August 2022 involving pediatric facial lacerations managed with either tissue adhesives or sutures. RESULTS Among 50 children, 20 received tissue adhesives, and 30 received sutures. Both methods showed comparable outcomes in terms of wound complications such as dehiscence (adjusted odds ratio = 1.56, 95% CI = 0.08-31.25) and infection (adjusted odds ratio = 2.17, 95% CI = 0.08-58.80). The cosmetic outcomes, assessed using the Hollander Wound Evaluation Score, were also consistent between groups (adjusted beta = -0.55, 95% CI = -1.15-0.05). Notably, those treated with tissue adhesives reported greater satisfaction (adjusted beta = 1.13, 95% CI = 0.63 -1.63) and experienced significantly less pain (adjusted beta = -3.03, 95% CI = -4.15--1.90). CONCLUSIONS Both techniques displayed similar rates of infection, dehiscence, and cosmetic outcomes. However, tissue adhesives were associated with increased patient comfort, especially in terms of reduced pain and greater satisfaction.
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Affiliation(s)
- Yu-Chi Tsai
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (Y.-C.T.); (D.-W.H.); (Y.-Y.C.)
- Division of Traumatology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Dun-Wei Huang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (Y.-C.T.); (D.-W.H.); (Y.-Y.C.)
| | - Yu-Yu Chou
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (Y.-C.T.); (D.-W.H.); (Y.-Y.C.)
| | - Yu-Chin An
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Yung-Sheng Cheng
- Division of Pediatric Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Po-Huang Chen
- Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Yuan-Sheng Tzeng
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (Y.-C.T.); (D.-W.H.); (Y.-Y.C.)
- Department of Surgery, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung 813204, Taiwan
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Guo X, Patel B, Han L, Van Alstine WG, Noblet JN, Chambers SD, Kassab GS. Novel patch biomaterial treatment for colon diverticulosis in swine model. Front Bioeng Biotechnol 2023; 11:1215362. [PMID: 37588135 PMCID: PMC10425590 DOI: 10.3389/fbioe.2023.1215362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/18/2023] [Indexed: 08/18/2023] Open
Abstract
Current leading managements for diverticular disease cannot prevent the recurrence of diverticulitis, bleeding and/or other complications. There is an immediate need for developing new minimal invasive therapeutic strategies to prevent and treat this disease. Through a biomechanical analysis of porcine colon with diverticular lesions, we proposed a novel adhesive patch concept aiming at mechanical reconstruction of the diseased colon wall. This study aims to evaluate the surgical feasibility (safety and efficacy) of pulmonary visceral pleura (PVP) patch therapy using a pig model of diverticulosis. Six female Yucatan miniature pigs underwent collagenase injection (CI) for the development of diverticular lesions. The lesions in each animal either received patch implantation (treated group, n = 40 for 6 pigs) or left intact (untreated group, n = 44 for 6 pigs). The normal colonic wall in each animal received patch implantation at two spots to serve as control (n = 12 for 6 pigs). After 3 months of observation, the performance and safety of the patch treatment were evaluated through macroscopic and histological examination. We found that 95% of pouch-like herniation of the mucosa was prevented from the colon wall with the treatment. The pouch diameter was significantly reduced in the treated group as compared to the untreated group (p < 0.001). The patch application caused a significant increase in the levels of collagen of the colon tissue as compared to the untreated and control groups (p < 0.001). No difference was found in the lymphocyte and macrophage inflammatory infiltrate between the groups. Our results suggest that patch treatment efficiently inhibits the diverticular pouch deformation and promotes the healing of the colon wall with a normal inflammatory response, which may minimize the risk of diverticulosis reoccurrence and complications over time.
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Affiliation(s)
- Xiaomei Guo
- California Medical Innovations Institute Inc, San Diego, CA, United States
| | - Bhavesh Patel
- California Medical Innovations Institute Inc, San Diego, CA, United States
| | - Ling Han
- California Medical Innovations Institute Inc, San Diego, CA, United States
| | | | | | | | - Ghassan S. Kassab
- California Medical Innovations Institute Inc, San Diego, CA, United States
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18
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Zong Y, Wu K, Fang W, Yu J, Jiang C, Xu G. Modified Intrascleral Fixation for Repositioning the Dislocated Single-Piece, Rigid PMMA Intraocular Lens. Retina 2023; 43:1019-1023. [PMID: 32604344 DOI: 10.1097/iae.0000000000002876] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe a modified intrascleral fixation technique for repositioning single-piece rigid polymethyl methacrylate intraocular lenses (IOLs). METHODS Four patients with dislocated IOLs were enrolled. Surgical modifications included using ≤1-mm scleral incision for haptic externalization, placing the IOL haptic placement in scleral tunnels, and using 8-0 absorbable sutures. Patients were followed up for 6 months with routine ophthalmic examinations, corneal endothelial cell counts, and ultrasound biomicroscopy (UBM). RESULTS The mean follow-up time was 13.5 ± 5.45 months. The IOL was well centered and the spherical refraction improved (+10.25 ± 2.21 vs. -0.81 ± 1.59 D, P < 0.05), whereas the best-corrected visual acuity (pre 20/43 Snellen, 0.42 ± 0.33 logarithm of the minimum angle of resolution equivalent and post 20/36 Snellen, 0.31 ± 0.22 logarithm of the minimum angle of resolution equivalent; P = 0.235), intraocular pressure (pre 13.8 ± 3.21, post 13.55 ± 5.14 mmHg), corneal endothelium density (pre 2,423.8 ± 279.6/mm 2 , post 2,280.25 ± 350.7/mm 2 ), and total astigmatism (pre -1.94 ± 0.43, post -1.69 ± 0.59 D) remained unchanged. The average horizontal and vertical IOL tilt was 0.33 ± 0.22° and 0.81 ± 0.38°, respectively. Intraocular lens decentration was 0.10 ± 0.03 mm horizontally and 0.13 ± 0.06 mm vertically. CONCLUSION The modified intrascleral fixation technique shows encouraging midterm results in patients with dislocated single-piece, rigid polymethyl methacrylate IOLs. Larger samples and longer follow-up are required to confirm the outcomes of this technique.
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Affiliation(s)
- Yuan Zong
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China ; and
- Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, People's Republic of China
| | - Kaicheng Wu
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China ; and
- Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, People's Republic of China
| | - Wangyi Fang
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China ; and
- Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, People's Republic of China
| | - Jian Yu
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China ; and
- Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, People's Republic of China
| | - Chunhui Jiang
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China ; and
- Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, People's Republic of China
| | - Gezhi Xu
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Fudan University, Shanghai, People's Republic of China ; and
- Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, People's Republic of China
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Zamora-Mendoza L, Guamba E, Miño K, Romero MP, Levoyer A, Alvarez-Barreto JF, Machado A, Alexis F. Antimicrobial Properties of Plant Fibers. Molecules 2022; 27:7999. [PMID: 36432099 PMCID: PMC9699224 DOI: 10.3390/molecules27227999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/09/2022] [Accepted: 11/12/2022] [Indexed: 11/19/2022] Open
Abstract
Healthcare-associated infections (HAI), or nosocomial infections, are a global health and economic problem in developed and developing countries, particularly for immunocompromised patients in their intensive care units (ICUs) and surgical site hospital areas. Recurrent pathogens in HAIs prevail over antibiotic-resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa. For this reason, natural antibacterial mechanisms are a viable alternative for HAI treatment. Natural fibers can inhibit bacterial growth, which can be considered a great advantage in these applications. Moreover, these fibers have been reported to be biocompatible and biodegradable, essential features for biomedical materials to avoid complications due to infections and significant immune responses. Consequently, tissue engineering, medical textiles, orthopedics, and dental implants, as well as cosmetics, are fields currently expanding the use of plant fibers. In this review, we will discuss the source of natural fibers with antimicrobial properties, antimicrobial mechanisms, and their biomedical applications.
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Affiliation(s)
- Lizbeth Zamora-Mendoza
- School of Biological Sciences & Engineering, Yachay Tech University, Urcuquí 100119, Ecuador
| | - Esteban Guamba
- School of Biological Sciences & Engineering, Yachay Tech University, Urcuquí 100119, Ecuador
| | - Karla Miño
- School of Biological Sciences & Engineering, Yachay Tech University, Urcuquí 100119, Ecuador
| | - Maria Paula Romero
- School of Biological Sciences & Engineering, Yachay Tech University, Urcuquí 100119, Ecuador
| | - Anghy Levoyer
- Colegio de Ciencias e Ingenierías, Universidad San Francisco de Quito (USFQ), Departamento de Ingeniería Química, Quito 170901, Ecuador
| | - José F. Alvarez-Barreto
- Colegio de Ciencias e Ingenierías, Universidad San Francisco de Quito (USFQ), Departamento de Ingeniería Química, Quito 170901, Ecuador
| | - António Machado
- Colegio de Ciencias Biológicas y Ambientales COCIBA, Instituto de Microbiología, Universidad San Francisco de Quito (USFQ), Laboratorio de Bacteriología, Quito 170901, Ecuador
| | - Frank Alexis
- Colegio de Ciencias e Ingenierías, Universidad San Francisco de Quito (USFQ), Departamento de Ingeniería Química, Quito 170901, Ecuador
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20
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Jamshaid H, Mishra R, Hussain U, Rajput AW, Tichy M, Muller M. Natural Fiber Based Antibacterial, Wound Healing Surgical Sutures by the Application of Herbal Antimicrobial Compounds. JOURNAL OF NATURAL FIBERS 2022; 19:9531-9546. [DOI: 10.1080/15440478.2021.1988798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Affiliation(s)
- Hafsa Jamshaid
- Faculty of Textile Engineering, National Textile University, Faisalabad, Pakistan
| | - Rajesh Mishra
- Faculty of Engineering, Czech University of Life Sciences, Prague, Czech Republic
| | - Uzair Hussain
- Faculty of Textile Engineering, National Textile University, Faisalabad, Pakistan
| | - Abdul Waqar Rajput
- Department of Textile Engineering, Bzu College of Textile Engineering, Multan, Pakistan
| | - Martin Tichy
- Faculty of Engineering, Czech University of Life Sciences, Prague, Czech Republic
| | - Miroslav Muller
- Faculty of Engineering, Czech University of Life Sciences, Prague, Czech Republic
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21
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Tandon S, Ensor ND, Pacilli M, Laird AJ, Bortagaray JI, Stunden RJ, Nataraja RM. Tissue adhesive, adhesive tape, and sutures for skin closure of paediatric surgical wounds: prospective randomized clinical trial. Br J Surg 2022; 109:1087-1095. [PMID: 35913888 PMCID: PMC10364679 DOI: 10.1093/bjs/znac254] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/05/2022] [Accepted: 07/05/2022] [Indexed: 08/02/2023]
Abstract
BACKGROUND Tissue adhesive, adhesive tape, and sutures are used to close surgical incisions. However, it is unclear which produces the best results in children, and whether combination wound closure is better than sutures alone. METHODS In this parallel randomised controlled trial (ANZCTR: ACTRN12617000158369), children (aged 18 years or less) undergoing elective general surgical or urological procedures were randomized to skin closure with sutures alone, sutures and adhesive tape, or sutures and tissue adhesive. Participants were assessed 2 weeks, 6 weeks, and more than 6 months after operation. Outcomes included wound cosmesis (clinician- and parent-rated) assessed using four validated scales, parental satisfaction, and wound complication rates. RESULTS 295 patients (333 wounds) were recruited and 277 patients (314 wounds) were included in the analysis. Tissue adhesive wounds had poorer cosmesis at 6 weeks: median 10-point VAS score 7.7 with sutures alone, 7.5 with adhesive tape, and 7.0 with tissue adhesive (P = 0.014). Respective median scores on a 100-point VAS were 80.0, 77.2, and 73.8 (P = 0.010). This difference was not sustained at over 6 months. There was no difference in parent-rated wound cosmesis at 6 weeks (P = 0.690) and more than 6 months (P = 0.167): median score 9.0 with sutures alone, 10.0 with adhesive tape, and 10.0 with tissue adhesive at both stages. Parental satisfaction was similar at all points, with a median score of 5 (very satisfied) for all groups. There was one instance of wound dehiscence in the tissue adhesive group and no wound infections. CONCLUSION Short-term wound cosmesis was poorer with tissue adhesive although it is unclear whether this difference is sustained in the long-term. There were no differences between techniques for the study outcomes. REGISTRATION NUMBER ACTRN12617000158369 (ANZCTR) (https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372177&isReview=true).
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Affiliation(s)
- Sarthak Tandon
- Department of Paediatric Surgery, Urology and Surgical Simulation, Monash Children’s Hospital, Melbourne, Victoria, Australia
| | - Nicholas D Ensor
- Department of Paediatric Surgery, Urology and Surgical Simulation, Monash Children’s Hospital, Melbourne, Victoria, Australia
| | - Maurizio Pacilli
- Department of Paediatric Surgery, Urology and Surgical Simulation, Monash Children’s Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Department of Surgery, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Ashleigh J Laird
- Department of Paediatric Surgery, Urology and Surgical Simulation, Monash Children’s Hospital, Melbourne, Victoria, Australia
| | - Juan I Bortagaray
- Department of Paediatric Surgery, Urology and Surgical Simulation, Monash Children’s Hospital, Melbourne, Victoria, Australia
| | - Robert J Stunden
- Department of Paediatric Surgery, Urology and Surgical Simulation, Monash Children’s Hospital, Melbourne, Victoria, Australia
| | - Ramesh M Nataraja
- Correspondence to: Ramesh M. Nataraja, Monash Children’s Hospital and Monash University, Department of Paediatric Surgery, 246 Clayton Road, Clayton, Melbourne, Victoria, Australia, 3168 (e-mail: )
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Eichinger JK, Oldenburg KS, Lin J, Wilkie E, Mock L, Tavana ML, Friedman RJ. Comparing Dermabond PRINEO versus Dermabond or staples for wound closure: a randomized control trial following total shoulder arthroplasty. J Shoulder Elbow Surg 2022; 31:2066-2075. [PMID: 35568261 DOI: 10.1016/j.jse.2022.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 04/12/2022] [Accepted: 04/18/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND The method of surgical incision closure after total shoulder arthroplasty is an important factor to consider, as it affects operating room time, procedure cost, cosmetic outcomes, and patient satisfaction. The optimal method of wound management is unknown, but should be cost-effective, reproducible, and provide a reliable clinical result. This study aimed to compare the following wound closure methods after total shoulder arthroplasty: staples, Dermabond, and Dermabond PRINEO. We hypothesized that wound closure time for Dermabond PRINEO would be faster than Dermabond and comparable to that of staples, and Dermabond PRINEO would be more cost-effective than Dermabond and staples, and provide equal or superior closure outcomes to Dermabond and staples. METHODS A randomized, prospective clinical trial comparing wound closure time and cost for 2 surgeons' traditional technique with that of Dermabond PRINEO was conducted. This study included at least 18 subjects in each group. Surgeon 1's patients were randomized to traditional Dermabond or Dermabond PRINEO, whereas surgeon 2's patients were randomized to staples or Dermabond PRINEO. Cosmetic outcomes and satisfaction scores were collected at 6 weeks and 3 months, postoperatively. Incisions were photographed, at both the 6-week and 3-month visits, and subsequently evaluated by a plastic surgeon blinded to the treatment method. RESULTS The wound closure time for surgeon 1 was significantly faster for Dermabond PRINEO vs. Dermabond, and surgeon 2 closed significantly faster with staples vs. Dermabond PRINEO. The mean cost of closure was significantly less with Dermabond PRINEO compared with Dermabond, whereas the mean cost of staples was significantly less than Dermabond PRINEO. For both surgeons 1 and 2, there were no significant differences in patient satisfaction at 6 weeks or 3 months. In addition, the wound closure methods did not produce differing cosmetic outcomes. CONCLUSIONS Although significant, the closing time for each method did not differ by a clinically relevant amount. Staples were the most cost-effective closing method, followed by Dermabond PRINEO. As neither method was superior over the other in terms of patient satisfaction, adverse events, and cosmetic outcomes, cost-effectiveness may be the greatest differentiator between the 3 methods.
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Affiliation(s)
- Josef K Eichinger
- Department of Orthopaedics, Medical University of South Carolina, Charleston, SC, USA.
| | - Kirsi S Oldenburg
- Department of Orthopaedics, Medical University of South Carolina, Charleston, SC, USA
| | - Jackie Lin
- Department of Orthopaedics, Medical University of South Carolina, Charleston, SC, USA
| | - Erin Wilkie
- Department of Orthopaedics, Medical University of South Carolina, Charleston, SC, USA
| | - Lisa Mock
- Department of Orthopaedics, Medical University of South Carolina, Charleston, SC, USA
| | - M Lance Tavana
- Department of Plastic and Reconstructive Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Richard J Friedman
- Department of Orthopaedics, Medical University of South Carolina, Charleston, SC, USA
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23
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Lacquaniti A, Salvi F, Russo A, Marcheselli A, De Rosa R, Caroselli C. Adhesive strips for wound closure of cardiovascular implantable electronic devices. J Cardiovasc Med (Hagerstown) 2022; 23:626-628. [PMID: 35904998 DOI: 10.2459/jcm.0000000000001320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | - Fabio Salvi
- Geriatrics, Geriatric Emergency Unit and Aging Research Centre - INRCA-IRCCS, Ancona, Italy
| | - Antonella Russo
- Emergency Department, Parodi Delfino Hospital, Colleferro (Rome)
| | | | | | - Costantino Caroselli
- Geriatrics, Geriatric Emergency Unit and Aging Research Centre - INRCA-IRCCS, Ancona, Italy
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24
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A single-blind randomised controlled trial comparing clinical equivalence of Trulon® and Ethilon® polyamide sutures for the skin closure following laparotomy incisions. INTERNATIONAL JOURNAL OF SURGERY OPEN 2022. [DOI: 10.1016/j.ijso.2022.100534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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25
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Deo JK, Rehan HS, Mehra P. Materiovigilance of unidirectional barbed and poliglecaprone 25 nonbarbed sutures used for intraoral incision closure: An open-label prospective study. Indian J Pharmacol 2022; 54:345-348. [PMID: 36537403 PMCID: PMC9846911 DOI: 10.4103/ijp.ijp_795_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 10/05/2022] [Accepted: 11/09/2022] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION The adverse events of sutures used for the closure of surgical incisions influence clinical outcomes. Literature on the safety profile of the application of unidirectional barbed sutures in oral and maxillofacial surgery is scarce. Hence, focused materiovigilance was done to monitor and compare the adverse events of unidirectional barbed and poliglecaprone 25 nonbarbed sutures for intraoral incision closure. METHODS In a prospective randomized comparative study, 64 patients requiring intraoral incision closure were randomized to receive either unidirectional barbed or poliglecaprone 25 nonbarbed sutures. Postoperatively, patients were monitored for any adverse events for 15 days. Causality association of adverse events with sutures was done using the European Commission directives on safety reporting of medical devices. RESULTS Adverse events observed with unidirectional barbed suture were suture extrusion (n = 7; 21.875%) and suture discomfort (n = 3; 9.375%). While subjects who received poliglecaprone 25 suture experienced suture discomfort (n = 6; 18.75%) and knot unraveling (n = 2; 6.25%). The number of adverse events in both groups was statistically comparable (P = 0.78). Causality assessment of adverse events was probable for suture extrusion and discomfort with nonbarbed and barbed sutures, while it was possible for knot unraveling for nonbarbed sutures. CONCLUSION Both types of study sutures were associated with minor severity adverse events when used for the closure of intraoral surgical incisions. Suture extrusion had a probable causal association with barbed suture. Knot unraveling was possibly associated with the nonbarbed suture. Both types of suture materials were equally safe in oral and maxillofacial intraoral surgical incision closure.
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Affiliation(s)
- Jaspreet Kaur Deo
- Department of Dental and Oral Surgery, Lady Hardinge Medical College, New Delhi, India
| | | | - Pravesh Mehra
- Department of Dental and Oral Surgery, Lady Hardinge Medical College, New Delhi, India
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26
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Liu DX, Lam DV, Gao Y, LeBlanc RC, Usab AA, Fielding ES, Brunkalla CL, Yang K, Shoffstall AJ. Characterization of a Temporary Peripheral Nerve Stimulation Electrode Utilizing a Bioabsorbable Suture Substrate. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:5094-5098. [PMID: 36086486 PMCID: PMC10369404 DOI: 10.1109/embc48229.2022.9871604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Electrical stimulation after peripheral nerve injury (PNI) has the potential to promote more rapid and complete recovery of damaged fiber tracts. While permanently implanted devices are commonly used to treat chronic or persistent conditions, they are not ideal solutions for transient medical therapies due to high costs, increased risk of surgical injury, irritation, infection, and persistent inflammation at the site of the implant. Furthermore, removal of temporary leads placed on or around peripheral nerves may have unacceptable risk for nerve injury, which is counterproductive in developing therapies for PNI treatment. Transient devices which provide effective clinical stimulation while being capable of harmless bioabsorption may overcome key challenges in these areas. However, current bioabsorbable devices are limited in their robustness and require complex fabrication strategies and novel materials which may complicate their clinical translation pathway. In this study, we present a simple bioabsorbable / biodegradable electrode fabricated by modifying standard absorbable sutures, and we present data characterizing our prototype's stability in vitro and in vivo.
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27
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Maltseva ES, Nikolaeva VO, Savin AM, Dobryakov MY, Koshel EI, Krivoshapkin PV, Krivoshapkina EF. Fluorescent Hybrid Material Based on Natural Spider Silk and Carbon Dots for Bioapplication. ACS Biomater Sci Eng 2022; 8:3310-3319. [PMID: 35763797 DOI: 10.1021/acsbiomaterials.2c00322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Since the outcome of an operation largely depends on the quality of wound healing, it is one of the most challenging stages in surgery. Today, wound closure is mostly undertaken by means of a surgical suture. Good surgical sutures are biocompatible and biodegradable and possess excellent mechanical properties. Preferably, these sutures demonstrate optical activity for bacteria detection as there is a risk of surgical site infections. In this study, a solution, which fulfills all the requirements for manufacturing a multifunctional hybrid material, is proposed. In this work, a method for the in situ modification of spider silk with fluorescent carbon dots has been developed. The basic concept is the use of silk fibers as both the main framework for tissue regeneration and a carbon source during carbon dot synthesis. The resulting hybrid material exhibits strong photoluminescence in the red region of the spectrum (590 nm) when irradiated with blue light (480 nm). The proposed approach potentially allows for simultaneous wound closure and pathogen detection.
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Affiliation(s)
- Elizaveta S Maltseva
- Institute of Solution Chemistry of Advanced Materials and Technologies, ITMO University, Lomonosova Street 9, Saint Petersburg 191002, Russia
| | - Valeria O Nikolaeva
- Institute of Solution Chemistry of Advanced Materials and Technologies, ITMO University, Lomonosova Street 9, Saint Petersburg 191002, Russia
| | - Artemii M Savin
- Institute of Solution Chemistry of Advanced Materials and Technologies, ITMO University, Lomonosova Street 9, Saint Petersburg 191002, Russia
| | - Mikhail Y Dobryakov
- Institute of Solution Chemistry of Advanced Materials and Technologies, ITMO University, Lomonosova Street 9, Saint Petersburg 191002, Russia
| | - Elena I Koshel
- Institute of Solution Chemistry of Advanced Materials and Technologies, ITMO University, Lomonosova Street 9, Saint Petersburg 191002, Russia
| | - Pavel V Krivoshapkin
- Institute of Solution Chemistry of Advanced Materials and Technologies, ITMO University, Lomonosova Street 9, Saint Petersburg 191002, Russia
| | - Elena F Krivoshapkina
- Institute of Solution Chemistry of Advanced Materials and Technologies, ITMO University, Lomonosova Street 9, Saint Petersburg 191002, Russia
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28
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Contact Dermatitis in the Surgical Patient: A Focus on Wound Closure Materials. Dermatitis 2022; 34:191-200. [PMID: 35481860 DOI: 10.1097/der.0000000000000860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Irritant and allergic contact dermatitis from wound closure materials can occur in patients after surgical procedures. The resulting inflammation from contact dermatitis can compromise wound healing, mimic surgical site infections, and result in wound dehiscence. Components of wound closure material, such as antibiotic coatings, dyes, sterilizing compounds, or the material itself, have been implicated as contact allergens. This article provides the latest overview of the components of 3 major forms of wound closure materials-sutures, staples, and tissue adhesives-associated with contact dermatitis, discusses their cross-reactivity, and provides diagnostic and treatment guidelines.
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29
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Dukaew N, Sakuludomkan W, Na Takuathung M, Pruksakorn D, Punyodom W, Koonrungsesomboon N. Analysis of Study Designs and Primary Outcome Measures in Clinical Trials of Investigational Suture Materials. Expert Rev Med Devices 2022; 19:247-258. [PMID: 35289244 DOI: 10.1080/17434440.2022.2054333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Clinical trials are a prerequisite for any investigational suture materials before a market approval application. The appropriate study designs and primary outcome measures are key to the validity and reliability of clinical trial results. This study aimed to characterize the study designs and primary outcome measures being applied in clinical trials of investigational suture materials. METHODS The systematic searches on PubMed, EMBASE, Web of Sciences, Scopus, and Cochrane databases were conducted to gather relevant studies published between January-2019 and May-2021. Data on general characteristics, suture intervention, study design, and primary outcome measures were extracted and analyzed. RESULTS Of 46 included studies, the majority of them were conducted with a randomized-controlled (93.5%), single-blind (50.0%), two-arm (84.8%), and parallel (76.1%) design with a 1:1 allocation ratio (95.7%). Through correlation network and heatmap analysis, the moderate-to-very strong correlations between some types of investigational suture materials and primary outcome measures were found including barbed vs non-barbed suture and suturing time, antibacterial-coated vs non-coated suture and wound infection, mono- vs multi-filament suture and wound healing index/markers, and different sizes of suture materials and scar assessment. CONCLUSIONS Our analysis provides guidance, with several key considerations, for designing a clinical trial evaluating investigational suture materials.
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Affiliation(s)
- Nahathai Dukaew
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wannachai Sakuludomkan
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Mingkwan Na Takuathung
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Dumnoensun Pruksakorn
- Musculoskeletal Science and Translational Research Center (MSTR), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Center of Multidisciplinary Technology for Advanced Medicine (CMUTEAM), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Biomedical Engineering Institute, Chiang Mai University, Chiang Mai, Thailand
| | - Winita Punyodom
- Polymer Research Laboratory, Department of Chemistry, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand.,Center of Excellence in Materials Science and Technology, Chiang Mai University, Chiang Mai, Thailand
| | - Nut Koonrungsesomboon
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Musculoskeletal Science and Translational Research Center (MSTR), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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30
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Klein CE, Engiles JB, Roessner HA, Hopster K, Hurcombe SD. Comparison of the zip skin closure system with conventional suture for skin closure of ventral midline incisions in horses. Am J Vet Res 2022; 83:455-464. [PMID: 35113797 DOI: 10.2460/ajvr.21.08.0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare the application and healing of the zip skin closure system (ZSCS) with sutured closure by use of a split-scar model of ventral midline incisions in horses in a prospective, randomized experimental study. ANIMALS 8 adult horses. PROCEDURES All horses underwent an exploratory ventral midline celiotomy with a standardized 30-cm skin incision. Each horse was randomized to have either the cranial 15 cm closed with suture and caudal 15 cm with the ZSCS or vice versa (split-scar model). Skin closure time was recorded and compared. Photography and skin biopsies were taken preoperatively and 14 days postoperatively. Cosmetic appearance was assessed by use of a proposed equine celiotomy incision score. Healing at 14 days was assessed by histopathology. RESULTS Skin closure times were faster with the ZSCS compared to sutured incisions. At 14 days postoperatively, the cosmetic appearance (equine celiotomy incision scores) for ZSCS incisions were better than sutured closure and histologic healing scores were not different between methods of closure. Subcuticular sutures were associated with deep dermal inflammation and necrosis independent of epidermal closure methods. CLINICAL RELEVANCE While limitations to the utility of the ZSCS are recognized, the potential benefits of expedient closure, good cosmetic outcome, and satisfactory healing make this method viable for closure of linear wounds or incisions in horses.
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Affiliation(s)
- Chelsea E Klein
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA
| | - Julie B Engiles
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA.,Department of Pathobiology, New Bolton Center, University of Pennsylvania, Kennett Square, PA
| | - Holly A Roessner
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA
| | - Klaus Hopster
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA
| | - Samuel D Hurcombe
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA
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31
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Raja BS, Choudhury AK, Paul S, Gowda AKS, Kalia RB. No Additional Benefits of Tissue Adhesives for Skin Closure in Total Joint Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Arthroplasty 2022; 37:186-202. [PMID: 34419313 DOI: 10.1016/j.arth.2021.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/07/2021] [Accepted: 07/24/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND This systematic review is aimed to compare the performance of tissue adhesives (TA) as an adjunct or closure method with traditional wound closure methods for cutaneous closure in arthroplasty and evaluate whether they have any added benefits in terms of decreasing wound complications and increasing postoperative patient satisfaction. METHODS Cochrane Library, PubMed, and EMBASE were searched until February 2021. Randomized controlled trials (RCTs) comparing outcomes of TA with emphasis on skin closure time, in-hospital stay, complication rates, cosmetic scoring systems, and patient satisfaction scores (PSS) compared to subcuticular sutures (SCS) and skin staples (ST) in arthroplasty. The quality of RCTs was assessed using the National Institutes of Health quality assessment tool. RESULTS Ten RCTs were included. The pooled and the subgroup analysis revealed no significant difference in the wound infection rates, discharge rates, dehiscence rates, and PSS between TA (as an adjunct or closure method) and SCS or ST. TA (as an adjunct or closure method) was significantly (P < .00001) associated with a longer time to closure compared to ST and a shorter time compared to SCS as a closure method. Length of stay was comparable in all groups. CONCLUSION Using TA in combination with subcuticular sutures or ST or as a cutaneous method of closure does not provide additional benefits in terms of decreased hospital stay, decreased infection rates, or wound discharge rates. The PSS and pain scores of the scars also appear to be comparable to standard wound closure methods. No clear conclusion could be drawn regarding cosmetic scoring systems, because of the paucity of data. LEVEL OF EVIDENCE Level I (Meta-analysis of RCTs).
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Affiliation(s)
- Balgovind S Raja
- Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India
| | | | - Souvik Paul
- Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India
| | - Aditya K S Gowda
- Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India
| | - Roop Bhushan Kalia
- Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India
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32
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Zinc-nutrient element based alloys for absorbable wound closure devices fabrication: Current status, challenges, and future prospects. Biomaterials 2021; 280:121301. [PMID: 34922270 DOI: 10.1016/j.biomaterials.2021.121301] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 11/25/2021] [Accepted: 11/29/2021] [Indexed: 01/22/2023]
Abstract
The need for the development of load-bearing, absorbable wound closure devices is driving the research for novel materials that possess both good biodegradability and superior mechanical characteristics. Biodegradable metals (BMs), namely: magnesium (Mg), zinc (Zn) and iron (Fe), which are currently being investigated for absorbable vascular stent and orthopaedic implant applications, are slowly gaining research interest for the fabrication of wound closure devices. The current review presents an overview of the traditional and novel BM-based intracutaneous and transcutaneous wound closure devices, and identifies Zn as a promising substitute for the traditional materials used in the fabrication of absorbable load-bearing sutures, internal staples, and subcuticular staples. In order to further strengthen Zn to be used in highly stressed situations, nutrient elements (NEs), including calcium (Ca), Mg, Fe, and copper (Cu), are identified as promising alloying elements for the strengthening of Zn-based wound closure device material that simultaneously provide potential therapeutic benefit to the wound healing process during implant biodegradation process. The influence of NEs on the fundamental characteristics of biodegradable Zn are reviewed and critically assessed with regard to the mechanical properties and biodegradability requirements of different wound closure devices. The opportunities and challenges in the development of Zn-based wound closure device materials are presented to inspire future research on this rapidly growing field.
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33
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Hodge JG, Pistorio AL, Neal CA, Dai H, Nelson-Brantley JG, Steed ME, Korentager RA, Zamierowski DS, Mellott AJ. Novel insights into negative pressure wound healing from an in situ porcine perspective. Wound Repair Regen 2021; 30:64-81. [PMID: 34618990 PMCID: PMC8724420 DOI: 10.1111/wrr.12971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 08/13/2021] [Accepted: 09/10/2021] [Indexed: 12/27/2022]
Abstract
Negative pressure wound therapy (NPWT) is used clinically to promote tissue formation and wound closure. In this study, a porcine wound model was used to further investigate the mechanisms as to how NPWT modulates wound healing via utilization of a form of NPWT called the vacuum-assisted closure. To observe the effect of NPWT more accurately, non-NPWT control wounds containing GranuFoam™ dressings, without vacuum exposure, were utilized. In situ histological analysis revealed that NPWT enhanced plasma protein adsorption throughout the GranuFoam™, resulting in increased cellular colonization and tissue ingrowth. Gram staining revealed that NPWT decreased bacterial dissemination to adjacent tissue with greater bacterial localization within the GranuFoam™. Genomic analysis demonstrated the significant changes in gene expression across a number of genes between wounds treated with non-NPWT and NPWT when compared against baseline tissue. However, minimal differences were noted between non-NPWT and NPWT wounds, including no significant differences in expression of collagen, angiogenic, or key inflammatory genes. Similarly, significant increases in immune cell populations were observed from day 0 to day 9 for both non-NPWT and NPWT wounds, though no differences were noted between non-NPWT and NPWT wounds. Furthermore, histological analysis demonstrated the presence of a foreign body response (FBR), with giant cell formation and encapsulation of GranuFoam™ particles. The unique in situ histological evaluation and genomic comparison of non-NPWT and NPWT wounds in this pilot study provided a never-before-shown perspective, offering novel insights into the physiological processes of NPWT and the potential role of a FBR in NPWT clinical outcomes.
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Affiliation(s)
- Jacob G Hodge
- Bioengineering Graduate Program, University of Kansas, Lawrence, Kansas, USA
| | - Ashley L Pistorio
- Department of Plastic Surgery, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Christopher A Neal
- KIDDRC Imaging Core Facility, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Hongyan Dai
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | | | - Molly E Steed
- Department of Pharmacy Practice, University of Kansas, Lawrence, Kansas, USA
| | - Richard A Korentager
- Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - David S Zamierowski
- Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Adam J Mellott
- Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
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34
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Wanasingha N, Dutta NK, Choudhury NR. Emerging bioadhesives: from traditional bioactive and bioinert to a new biomimetic protein-based approach. Adv Colloid Interface Sci 2021; 296:102521. [PMID: 34534751 DOI: 10.1016/j.cis.2021.102521] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/04/2021] [Accepted: 09/04/2021] [Indexed: 12/29/2022]
Abstract
Bioadhesives have reached significant milestones over the past two decades. Research has shown not only to produce adhesives capable of adhering to dry tissue but recently wet tissue as well. However, most bioadhesives developed have exhibited high adhesion strength yet lack other properties required for versatility in application, such as elasticity, biocompatibility and biodegradability. Adapting from limitations met from early bioadhesives and meeting the current demand allows novel bioadhesives to reach new milestones for the future. In this review, we overview the progression and variations of bioadhesives, current trends, characterisation techniques and conclude with future perspectives for bioadhesives for tissue engineering applications.
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Affiliation(s)
- Nisal Wanasingha
- School of Engineering, RMIT University, Melbourne, VIC 3000, Australia
| | - Naba K Dutta
- School of Engineering, RMIT University, Melbourne, VIC 3000, Australia
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35
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Lindsey M, Vishal S, Gardner JM, Shalin SC. Characterization of Morphologic and Cytochemical Staining Properties of Exogenous Materials Mimicking Fungal Organisms Encountered in Skin Biopsies. Am J Dermatopathol 2021; 43:679-687. [PMID: 34546986 DOI: 10.1097/dad.0000000000001854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Exogenous materials may be encountered in skin biopsies as contamination. Contamination may occur during the biopsy procedure in the clinic or during tissue processing in the laboratory. Although the experienced pathologist may often instinctively ignore clear examples of contamination, such tissue may be a source of confusion for young pathologists and those in training. Foreign materials can typically be recognized as exogenous by morphology, polarizability, and the presence or absence of a tissue reaction, but we have rarely encountered situations in which exogenous materials could be misinterpreted as organisms, either by their morphologic appearance or staining properties. METHODS Exogenous materials used during skin biopsy and grossing were embedded in a nonhuman tissue scaffold and prepared into histologic slides. Hematoxylin and eosin (H&E), periodic acid-Schiff with diastase, and Grocott methenamine silver stains were performed, and each material was evaluated under polarized microscopy. RESULTS Exogenous materials were divided into the following 3 categories with shared morphologic appearances and staining properties: suture materials, plant-based materials, and synthetic materials. CONCLUSION We present a comprehensive characterization of the morphologic and cytochemical staining properties of multiple exogenous materials that may contaminate a skin biopsy. This characterization will aid the pathologist by providing a mechanism to identify potential contaminants in skin biopsies.
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Affiliation(s)
- Miki Lindsey
- Resident Physician, Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Sagar Vishal
- Cytopathology Fellow, Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA. Dr. Vishal is now with the Pathologist, Private Practice ThedaCare Medical Center, Appleton, WI
| | - Jerad M Gardner
- Associate Professor of Pathology and Dermatology, Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR. Gardner is now with the Faculty Dermatopathologist, Geisinger Medical Center, Danville, PA; and
| | - Sara C Shalin
- Associate Professor of Pathology and Dermatology, Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR
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36
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Richard AS, Verma RS. Bioactive nano yarns as surgical sutures for wound healing. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 128:112334. [PMID: 34474885 DOI: 10.1016/j.msec.2021.112334] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/08/2021] [Accepted: 07/23/2021] [Indexed: 11/19/2022]
Abstract
Surgical sutures are the most widely used medical device in any surgical procedure worldwide. In this study, modified electrospinning technique has been used as manufacturing technique to produce nanofiber bundles twisted simultaneously to obtain nanofiber yarns. Taking the advantage of nanofiber yarns in terms of biomimetic structure, mechanical strength and handling properties, the material is chosen. Curcumin, a natural compound is incorporated to the nanofiber yarns by blend electrospinning technique for its anti-inflammatory, antibiotic and wound healing properties. The synthesized nanofiber yarns were characterized by various characterization techniques such as XRD, FTIR, SEM, Tensile testing, stem cell interaction, hemocompatibility, bacterial response, drug release profiling and in vivo studies. Curcumin loaded nanofiber yarns demonstrated sustained release with improved antibacterial, antiplatelet, cell migration and stem cell interaction in vitro. The results from skin inflammation animal model revealed that curcumin laden nanofiber yarn suture manifested reduced inflammation and cellularity. The three dimensional structure, adequate mechanical strength and biological properties of the nanofiber yarn provide naive environment for wound healing with the balanced degradation of suture material in rat model.
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Affiliation(s)
- Arthi Sunil Richard
- Bhupat and Jyoti Mehta School of Biosciences, Department of Biotechnology, Indian Institute of Technology Madras, Chennai 600036, India.
| | - Rama Shankar Verma
- Bhupat and Jyoti Mehta School of Biosciences, Department of Biotechnology, Indian Institute of Technology Madras, Chennai 600036, India.
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Lenschow C, Rinschen S, Lindner K, Colombo-Benkmann M. Current practice of thyroid surgery in Germany: a nationwide survey. Minerva Surg 2021; 77:205-213. [PMID: 34338458 DOI: 10.23736/s2724-5691.21.08898-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Due to the lack of perioperative standards in thyroid surgery, this study aimed to evaluate the perioperative management and wound closure techniques used in a nationwide survey. MATERIAL AND METHODS A questionnaire evaluating preferred technique in thyroid resection, postoperative management, and the occurrence of complications was sent to all hospitals in Germany performing more than 50 thyroid operations p.a. (n=362, response rate 78% (n=283)). Subsequently, hospitals were subdivided into university and maximum care hospitals (Category A, n=54) and tertiary hospitals and basic care hospitals (Category B, n=229). RESULTS 10.6% of the hospitals were certified as a center for thyroid surgery, with a significantly higher percentage in Category A (20.4% vs. 8.3%; p<0.01). Concerning the surgical techniques, Kocher´s incision was the favored cervical approach in 96% of the hospitals. A minimally invasive approach was performed in 30.1%, with a significantly more common description in category A. 97.8% of all clinics stated that they perform a platysma muscle suture, primarily as a single stitch interrupted. Skin closure was predominantly performed via intracutaneous suture in 84.5% using absorbable suture material in 63.1%. There was no difference in the technology used in terms of hospital size. The mean in-hospital stay was significantly shorter in Category A hospitals (p=0.035). CONCLUSIONS The suture technique used in thyroid surgery in Germany is a simple interrupted suture technique for platysma and a continuous suture with absorbable skin closure material. Maximum care hospitals are characterized by shorter in-hospital stays and improved quality assurance.
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Affiliation(s)
- Christina Lenschow
- Department of General, Visceral, Transplantation, Vascular and Pediatric Surgery, University Hospital Wuerzburg, Wuerzburg, Germany -
| | - Stephan Rinschen
- Department of Internal Medicine, Evangelisches Krankenhaus Münster, Münster, Germany
| | - Kirsten Lindner
- LAKUMED, Department of Endocrine Surgery, Vilsbiburg, Germany
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Butt E, Ashraf I, Veitch D, Wernham A. Dermatological surgery: an update on suture materials and techniques. Part 2. Clin Exp Dermatol 2021; 46:1411-1419. [PMID: 34155674 DOI: 10.1111/ced.14812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2021] [Indexed: 11/28/2022]
Abstract
This is the second part of a two-part series summarizing the latest evidence related to suture materials and wound closure techniques in dermatological surgery. We critically appraised evidence focusing on the following consequences of suture choice: scar/cosmesis, pain, patient satisfaction, cost, infection and wound complications. We searched the databases MEDLINE, PubMed and Embase using the keywords 'skin surgery', 'dermatological surgery', 'sutures', 'braided sutures', 'monofilament sutures' and 'antibacterial sutures' to identify relevant English-language articles. This part of the review assesses the evidence for different types of buried sutures, including braided vs. monofilament sutures, longer-absorbing sutures and antibacterial sutures. The majority of trials were noted to be of poor quality, single-centre (thus lacking external validity) and underpowered, which presents challenges in comparing suture techniques in skin surgery. Future large-scale, multicentre, randomized trials are needed, with both surgeon and patient-assessed validated outcomes.
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Affiliation(s)
- E Butt
- Department of Dermatology, Birmingham City Hospital, Birmingham, UK
| | - I Ashraf
- Department of Dermatology, Solihull Hospital, Solihull, UK
| | - D Veitch
- Department of Dermatology, Leicester Royal Infirmary, Leicester, UK
| | - A Wernham
- Department of Dermatology, Leicester Royal Infirmary, Leicester, UK.,Department of Dermatology, Walsall Healthcare NHS Trust, Walsall, UK
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de la Harpe KM, Kondiah PPD, Marimuthu T, Choonara YE. Advances in carbohydrate-based polymers for the design of suture materials: A review. Carbohydr Polym 2021; 261:117860. [PMID: 33766349 DOI: 10.1016/j.carbpol.2021.117860] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/12/2021] [Accepted: 02/22/2021] [Indexed: 12/25/2022]
Abstract
Suture materials constitute one of the largest biomedical material groups with a huge global market of $ 1.3 billion annually and employment in over 12 million procedures per year. Suture materials have radically evolved over the years, from basic strips of linen to more advanced synthetic polymer sutures. Yet, the journey to the ideal suture material is far from over and we now stand on the brink of a new era of improved suture materials with greater safety and efficacy. This next step in the evolutionary timeline of suture materials, involves the use of natural, carbohydrate polymers that have, until recent years, never before been considered for suture material applications. This review exposes the latest and most important advancements in suture material development while digging deep into how natural, carbohydrate polymers can serve to advance this field.
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Affiliation(s)
- Kara M de la Harpe
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Science, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown, 2193, South Africa
| | - Pierre P D Kondiah
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Science, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown, 2193, South Africa
| | - Thashree Marimuthu
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Science, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown, 2193, South Africa
| | - Yahya E Choonara
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Science, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown, 2193, South Africa.
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Greenbaum S, Zak S, Tesoriero PJ, Rudy H, Vigdorchik J, Long WJ, Schwarzkopf R. A Single-Center Randomized Prospective Study Investigating the Efficacy of Various Wound Closure Devices in Reducing Postoperative Wound Complications. Arthroplast Today 2021; 9:83-88. [PMID: 34136609 PMCID: PMC8180960 DOI: 10.1016/j.artd.2021.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/10/2021] [Accepted: 04/26/2021] [Indexed: 01/03/2023] Open
Abstract
Background Sutures and staples are the mainstay wound closure techniques in total joint arthroplasty. Newer techniques such as zipper devices and novel skin adhesives have emerged because of their potential to decrease operative time and possibly minimize complications. The aim of this study is to compare these newer techniques against conventional sutures with respect to wound complications, closure time, and costs. Methods A single-center randomized control trial was conducted on 160 patients (52 zipper, 55 suture, 53 mesh) who underwent primary total hip or knee arthroplasty between February 2017 and May 2018. Patients were divided into 3 closure groups: zipper device, monofilament suture plus adhesive, and monofilament plus polyester mesh with adhesive. The primary endpoint was closure time (superficial skin layer). Secondarily we collected perioperative complication rates, including infection, persistent (14-day) wound drainage, 90-day readmission, and emergency room visit rates as well as compared material costs. Results There were no differences in baseline characteristics between groups for age, body mass index, and American Society of Anesthesiologists classification. There was a trend toward decreased time to closure for the suture group. There were no significant differences between groups for our secondary endpoint, complications. Conclusions Our study shows that the suture group trended toward shorter closure time but suggests that each of the closure methods after total joint arthroplasty has equivalent complication rates. With small differences in closure time and no significant differences in complications, the decision to use one wound closure device or technique over another should be driven by institutional costs and provider familiarity.
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Affiliation(s)
- Simon Greenbaum
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY
| | - Stephen Zak
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY
| | - Paul J. Tesoriero
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY
| | - Hayeem Rudy
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY
| | - Jonathan Vigdorchik
- Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, New York, NY
| | - William J. Long
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY
| | - Ran Schwarzkopf
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY
- Corresponding author. 301 E 17th St, New York, NY 10003, USA. Tel.: 1 646 501 7070.
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Ashraf I, Butt E, Veitch D, Wernham A. Dermatological surgery: an update on suture materials and techniques. Part 1. Clin Exp Dermatol 2021; 46:1400-1410. [PMID: 34056751 DOI: 10.1111/ced.14770] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 05/27/2021] [Indexed: 11/28/2022]
Abstract
Significant variation exists in the surgical suture materials and techniques used for dermatological surgery. Many wound-closure techniques are now practised, including use of sutures, staples and topical adhesives. The focus of our review article is to summarize the latest evidence relating to suture materials and wound-closure techniques, considering the following areas: scar/cosmesis, pain, patient satisfaction, cost, infection and wound complications. We searched the databases Medline, PubMed and Embase using the keywords 'skin surgery', 'dermatologic surgery', 'sutures', 'suture techniques', 'suturing techniques' and 'surgical techniques' to identify relevant English-language articles. Absorbable superficial sutures may be a preferred alternative to nonabsorbable sutures by both patients and surgeons. Subcuticular sutures may be preferable to simple interrupted sutures for superficial wound closure, and there may also be a role for skin staples in dermatological surgery, particularly on the scalp. However, there remains limited evidence specific to dermatological surgery supporting the use of particular suture materials and suturing techniques. Further high-quality research is required, including multicentre randomized trials with larger cohorts.
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Affiliation(s)
- I Ashraf
- Department of Dermatology, Solihull Hospital, Solihull, UK
| | - E Butt
- Department of Dermatology, Birmingham City Hospital, Birmingham, UK
| | - D Veitch
- Department of Dermatology, Leicester Royal Infirmary, Leicester, UK
| | - A Wernham
- Department of Dermatology, Leicester Royal Infirmary, Leicester, UK.,Department of Dermatology, Walsall Healthcare NHS Trust, Walsall, UK
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Yang N, Balasubramani N, Venezuela J, Almathami S, Wen C, Dargusch M. The influence of Ca and Cu additions on the microstructure, mechanical and degradation properties of Zn-Ca-Cu alloys for absorbable wound closure device applications. Bioact Mater 2021; 6:1436-1451. [PMID: 33210035 PMCID: PMC7658446 DOI: 10.1016/j.bioactmat.2020.10.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/21/2020] [Accepted: 10/21/2020] [Indexed: 12/14/2022] Open
Abstract
Novel ternary Zn-Ca-Cu alloys were studied for the development of absorbable wound closure device material due to Ca and Cu's therapeutic values to wound healing. The influence of Ca and Cu on the microstructure, mechanical and degradation properties of Zn were investigated in the as-cast state to establish the fundamental understanding on the Zn-Ca-Cu alloy system. The microstructure of Zn-0.5Ca-0.5Cu, Zn-1.0Ca-0.5Cu, and Zn0.5Ca-1.0Cu is composed of intermetallic phase CaZn13 distributed within the Zn-Cu solid solution. The presence of CaZn13 phase and Cu as solute within the Zn matrix, on the one hand, exhibited a synergistic effect on the grain refinement of Zn, reducing the grain size of pure Zn by 96%; on the other hand, improved the mechanical properties of the ternary alloys through solid solution strengthening, second phase strengthening, and grain refinement. The degradation properties of Zn-Ca-Cu alloys are primarily influenced by the micro-galvanic corrosion between Zn-Cu matrix and CaZn13 phase, where the 0.5% and 1.0% Ca addition increased the corrosion rate of Zn from 11.5 μm/y to 19.8 μm/y and 29.6 μm/y during 4 weeks immersion test.
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Affiliation(s)
- Nan Yang
- Queensland Centre for Advanced Materials Processing and Manufacturing (AMPAM), School of Mechanical and Mining Engineering, Advanced Engineering Building, Bld 49, The University of Queensland, Staff House Rd, St Lucia, QLD, 4072, Australia
| | - Nagasivamuni Balasubramani
- Queensland Centre for Advanced Materials Processing and Manufacturing (AMPAM), School of Mechanical and Mining Engineering, Advanced Engineering Building, Bld 49, The University of Queensland, Staff House Rd, St Lucia, QLD, 4072, Australia
| | - Jeffrey Venezuela
- Queensland Centre for Advanced Materials Processing and Manufacturing (AMPAM), School of Mechanical and Mining Engineering, Advanced Engineering Building, Bld 49, The University of Queensland, Staff House Rd, St Lucia, QLD, 4072, Australia
| | - Sharifah Almathami
- Queensland Centre for Advanced Materials Processing and Manufacturing (AMPAM), School of Mechanical and Mining Engineering, Advanced Engineering Building, Bld 49, The University of Queensland, Staff House Rd, St Lucia, QLD, 4072, Australia
| | - Cuie Wen
- School of Engineering, RMIT University, Melbourne, Victoria, 3001, Australia
| | - Matthew Dargusch
- Queensland Centre for Advanced Materials Processing and Manufacturing (AMPAM), School of Mechanical and Mining Engineering, Advanced Engineering Building, Bld 49, The University of Queensland, Staff House Rd, St Lucia, QLD, 4072, Australia
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Tandon S, Smale M, Pacilli M, Nataraja RM. Tissue adhesive and adhesive tape for pediatric wound closure: A systematic review and meta-analysis. J Pediatr Surg 2021; 56:1020-1029. [PMID: 32888718 DOI: 10.1016/j.jpedsurg.2020.07.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/15/2020] [Accepted: 07/28/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Tissue adhesive (TiA), adhesive tape (AdT), and sutures can be used to close surgical wounds and lacerations in children. However, it is unclear which technique produces the best results. METHODS In this prospectively registered study, the PubMed, Ovid MEDLINE, Cochrane Library, Centre for Reviews and Dissemination Database, and ScienceDirect databases were searched. English language studies published between January 1980 and August 2017 evaluating TiA and/or AdT for primary skin closure of surgical wounds or lacerations in patients aged ≤18 years were included. Study endpoints included clinician-rated wound cosmesis and incidence of wound complications. RESULTS Thirty-one studies were included in the systematic review and 16 studies in the meta-analysis. Amongst heterogeneous studies, AdT yielded marginally better cosmetic outcomes than TiA (p = 0.04). There was no difference in cosmesis between sutured wounds and those closed with TiA (p = 0.2). No difference in overall risk of wound infection or dehiscence was identified when comparing TiA with AdT (p = 0.3), and TiA with sutures (p = 0.9 and 0.3 respectively). CONCLUSIONS TiA, AdT, and sutures can all be used for wound closure with equivalent risk of wound infection and dehiscence. AdT appears to convey better cosmesis. Further adequately powered studies directly comparing techniques are required. LEVELS OF EVIDENCE Level IV.
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Affiliation(s)
- Sarthak Tandon
- Department of Paediatric Surgery, Monash Children's Hospital, 246 Clayton Road, Clayton, VIC 3168, Australia
| | - Matthew Smale
- Department of Paediatric Surgery, Monash Children's Hospital, 246 Clayton Road, Clayton, VIC 3168, Australia
| | - Maurizio Pacilli
- Department of Paediatric Surgery, Monash Children's Hospital, 246 Clayton Road, Clayton, VIC 3168, Australia; Department of Paediatrics & Surgery, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia
| | - Ramesh M Nataraja
- Department of Paediatric Surgery, Monash Children's Hospital, 246 Clayton Road, Clayton, VIC 3168, Australia; Department of Paediatrics & Surgery, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3168, Australia.
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Gonzalez-Navarro AR, Quiroga-Garza A, Acosta-Luna AS, Salinas-Alvarez Y, Martinez-Garza JH, de la Garza-Castro O, Gutierrez-de la O J, de la Fuente-Villarreal D, Elizondo-Omaña RE, Guzman-Lopez S. Comparison of suturing models: the effect on perception of basic surgical skills. BMC MEDICAL EDUCATION 2021; 21:250. [PMID: 33933058 PMCID: PMC8088011 DOI: 10.1186/s12909-021-02692-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/23/2021] [Indexed: 05/25/2023]
Abstract
BACKGROUND Acquisition of Basic Surgical Skills (BSS) are essential for medical students. The objective was to determine it's fidelity impact. METHODS Using four suturing models (SM) (pigskin, sponge, commercial pad, and orange), SM-quality and student-SM interaction were evaluated. After a 1-h class, participants were divided into groups and randomly assigned exercises in SM in 15-min intervals. The experiment included completing three individual simple stitches and a 3-stitch continuous suture in each SM. RESULTS Eighty-two medical students participated. Suturing quality was better in pigskin and sponge, which were also the preferred models (p < 0.001). Significant differences in quality between the insertion and exit point, and firmness of knots (p < 0.05) in both simple and continuous sutures, as well as between length and distance in continuous ones (p < 0.001) were identified. CONCLUSIONS Acquisition and quality of BSS are influenced by the intrinsic characteristics of SM. An adequate degree of resistance, consistency, and elasticity are necessary.
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Affiliation(s)
- Alejandro Rafael Gonzalez-Navarro
- Departamento de Anatomia Humana. Francisco I. Madero and Jose E. Gonzalez sin número, Colonia Mitras Centro Monterrey, Universidad Autónoma de Nuevo León, Facultad de Medicina, 64460, Monterrey, Nuevo León, Mexico
| | - Alejandro Quiroga-Garza
- Departamento de Anatomia Humana. Francisco I. Madero and Jose E. Gonzalez sin número, Colonia Mitras Centro Monterrey, Universidad Autónoma de Nuevo León, Facultad de Medicina, 64460, Monterrey, Nuevo León, Mexico
- Instituto Mexicano del Seguro Social, Delegación de Nuevo Leon, General Surgery, Monterrey, Nuevo Leon, Mexico
| | - Adriana Sharai Acosta-Luna
- Departamento de Anatomia Humana. Francisco I. Madero and Jose E. Gonzalez sin número, Colonia Mitras Centro Monterrey, Universidad Autónoma de Nuevo León, Facultad de Medicina, 64460, Monterrey, Nuevo León, Mexico
| | - Yolanda Salinas-Alvarez
- Departamento de Anatomia Humana. Francisco I. Madero and Jose E. Gonzalez sin número, Colonia Mitras Centro Monterrey, Universidad Autónoma de Nuevo León, Facultad de Medicina, 64460, Monterrey, Nuevo León, Mexico
| | - Javier Humberto Martinez-Garza
- Departamento de Anatomia Humana. Francisco I. Madero and Jose E. Gonzalez sin número, Colonia Mitras Centro Monterrey, Universidad Autónoma de Nuevo León, Facultad de Medicina, 64460, Monterrey, Nuevo León, Mexico
| | - Oscar de la Garza-Castro
- Departamento de Anatomia Humana. Francisco I. Madero and Jose E. Gonzalez sin número, Colonia Mitras Centro Monterrey, Universidad Autónoma de Nuevo León, Facultad de Medicina, 64460, Monterrey, Nuevo León, Mexico
| | - Jorge Gutierrez-de la O
- Departamento de Anatomia Humana. Francisco I. Madero and Jose E. Gonzalez sin número, Colonia Mitras Centro Monterrey, Universidad Autónoma de Nuevo León, Facultad de Medicina, 64460, Monterrey, Nuevo León, Mexico
| | - David de la Fuente-Villarreal
- Departamento de Anatomia Humana. Francisco I. Madero and Jose E. Gonzalez sin número, Colonia Mitras Centro Monterrey, Universidad Autónoma de Nuevo León, Facultad de Medicina, 64460, Monterrey, Nuevo León, Mexico
| | - Rodrigo Enrique Elizondo-Omaña
- Departamento de Anatomia Humana. Francisco I. Madero and Jose E. Gonzalez sin número, Colonia Mitras Centro Monterrey, Universidad Autónoma de Nuevo León, Facultad de Medicina, 64460, Monterrey, Nuevo León, Mexico.
| | - Santos Guzman-Lopez
- Departamento de Anatomia Humana. Francisco I. Madero and Jose E. Gonzalez sin número, Colonia Mitras Centro Monterrey, Universidad Autónoma de Nuevo León, Facultad de Medicina, 64460, Monterrey, Nuevo León, Mexico.
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Effective and Stable Zeolite Imidazole Framework-Supported Copper Nanoparticles (Cu/ZIF-8) for Glycerol to Lactic Acid. Catal Letters 2021. [DOI: 10.1007/s10562-021-03610-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Jummaat F, Yahya EB, Khalil H.P.S. A, Adnan AS, Alqadhi AM, Abdullah CK, A.K. AS, Olaiya NG, Abdat M. The Role of Biopolymer-Based Materials in Obstetrics and Gynecology Applications: A Review. Polymers (Basel) 2021; 13:633. [PMID: 33672526 PMCID: PMC7923797 DOI: 10.3390/polym13040633] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/11/2021] [Accepted: 02/17/2021] [Indexed: 12/17/2022] Open
Abstract
Biopolymers have gained tremendous attention in many daily life applications, including medical applications, in the past few years. Obstetrics and gynecology are two fields dealing with sensitive parts of the woman's body and her newborn baby, which are normally associated with many issues such as toxicity, infections, and even gene alterations. Medical professions that use screening, examination, pre, and post-operation materials should benefit from a better understanding of each type of material's characteristics, health, and even environmental effects. The underlying principles of biopolymer-based materials for different obstetric and gynecologic applications may discover various advantages and benefits of using such materials. This review presents the health impact of conventional polymer-based materials on pregnant women's health and highlights the potential use of biopolymers as a safer option. The recent works on utilizing different biopolymer-based materials in obstetric and gynecologic are presented in this review, which includes suture materials in obstetric and gynecologic surgeries, cosmetic and personal care products, vaginal health, and drug delivery; as well as a wound dressing and healing materials. This review highlights the main issues and challenges of biopolymers in obstetric and gynecologic applications.
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Affiliation(s)
- Fauziah Jummaat
- Management & Science University Medical Centre, University Drive, Off Persiaran Olahraga, Section 13, Shah Alam 40100, Malaysia
| | - Esam Bashir Yahya
- School of Industrial Technology, Universiti Sains Malaysia, Penang 11800, Malaysia; (E.B.Y.); (C.K.A.); (N.G.O.)
| | - Abdul Khalil H.P.S.
- School of Industrial Technology, Universiti Sains Malaysia, Penang 11800, Malaysia; (E.B.Y.); (C.K.A.); (N.G.O.)
| | - A. S. Adnan
- Management & Science University Medical Centre, University Drive, Off Persiaran Olahraga, Section 13, Shah Alam 40100, Malaysia
| | | | - C. K. Abdullah
- School of Industrial Technology, Universiti Sains Malaysia, Penang 11800, Malaysia; (E.B.Y.); (C.K.A.); (N.G.O.)
| | - Atty Sofea A.K.
- Hospital Seberang Jaya, Jalan Tun Hussein Onn, Seberang Jaya, Permatang Pauh 13700, Malaysia;
| | - N. G. Olaiya
- School of Industrial Technology, Universiti Sains Malaysia, Penang 11800, Malaysia; (E.B.Y.); (C.K.A.); (N.G.O.)
| | - Munifah Abdat
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia;
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Chung JH, Kim HK, Lee YH, Lee HC, You HJ, Kim DW. Aesthetic Comparison of Abdominal Donor Site Scar Between Absorbable Dermal Staple and Subcutaneous Suture after Autologous Breast Reconstruction: A Prospective Randomized Controlled, Double-Blinded Study. Aesthetic Plast Surg 2021; 45:143-150. [PMID: 33057829 DOI: 10.1007/s00266-020-01969-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/07/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Abdominal tissue transfer has become the most commonly used tool for breast reconstruction. However, a secondary operator is often responsible for donor closure, which leaves dissatisfaction to patients due to inconsistent donor scars. Now, an absorbable dermal stapler is popularized worldwide and currently used for wound closure in many surgical fields. In this study, we aim to evaluate the abdominal donor site scar in using an absorbable dermal staple compared to a conventional suture. METHODS This is a prospective, randomized controlled and double-blinded study. Between January 2018 and April 2019, a total of 30 patients who underwent breast reconstruction using abdominal flap were included. Donor sites were divided into equal halves, and the each dermal layer was sutured with either dermal staples or traditional suturing, respectively. At 1, 3 and 6 months after operation, the scar was evaluated by two blinded plastic surgeons by using the modified Manchester scar scale (MSS). RESULTS An averaged sum of modified MSS was lower for the side sutured with a dermal stapler at the first month (11.76 ± 2.12 vs. 12.28 ± 2.03, p = 0.097), third month (12.17 ± 1.86 vs. 12.62 ± 2.31, p = 0.301) and sixth month (11.28 ± 2.63 vs. 12.14 ± 2.76, p = 0.051). Also, the dermal stapler side scored significantly higher for patient satisfaction than did the suture side (4.03 ± 0.98 vs 3.66 ± 0.97, p < 0.05). CONCLUSION The objective outcome of the scar closed by an absorbable dermal stapler was not statistically superior to conventional suturing. (p > 0.05) In the subjective outcome, however, it showed a significantly higher patients' satisfaction (p < 0.05). LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Jae-Ho Chung
- Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Hyung-Kyu Kim
- Department of Plastic and Reconstructive Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea
| | - Yun-Hwan Lee
- Department of Plastic and Reconstructive Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea
| | - Hyung-Chul Lee
- Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Hi-Jin You
- Department of Plastic and Reconstructive Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea
| | - Deok-Woo Kim
- Department of Plastic and Reconstructive Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea.
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Bal-Ozturk A, Cecen B, Avci-Adali M, Topkaya SN, Alarcin E, Yasayan G, Ethan YC, Bulkurcuoglu B, Akpek A, Avci H, Shi K, Shin SR, Hassan S. Tissue Adhesives: From Research to Clinical Translation. NANO TODAY 2021; 36:101049. [PMID: 33425002 PMCID: PMC7793024 DOI: 10.1016/j.nantod.2020.101049] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Sutures, staples, clips and skin closure strips are used as the gold standard to close wounds after an injury. In spite of being the present standard of care, the utilization of these conventional methods is precarious amid complicated and sensitive surgeries such as vascular anastomosis, ocular surgeries, nerve repair, or due to the high-risk components included. Tissue adhesives function as an interface to connect the surfaces of wound edges and prevent them from separation. They are fluid or semi-fluid mixtures that can be easily used to seal any wound of any morphology - uniform or irregular. As such, they provide alternatives to new and novel platforms for wound closure methods. In this review, we offer a background on the improvement of distinctive tissue adhesives focusing on the chemistry of some of these products that have been a commercial success from the clinical application perspective. This review is aimed to provide a guide toward innovation of tissue bioadhesive materials and their associated biomedical applications.
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Affiliation(s)
- Ayça Bal-Ozturk
- Department of Analytical Chemistry, Faculty of Pharmacy, Istinye University, 34010, Zeytinburnu, Istanbul, Turkey
- Department of Stem Cell and Tissue Engineering, Institute of Health Sciences, Istinye University, 34010 Istanbul, Turkey
| | - Berivan Cecen
- Division of Engineering in Medicine, Department of Medicine, Harvard Medical School, Brigham and Women’s Hospital, Cambridge, MA 02139, USA
| | - Meltem Avci-Adali
- Department of Thoracic and Cardiovascular Surgery, University Hospital Tuebingen, Calwerstraße 7/1, 72076 Tuebingen, Germany
| | - Seda Nur Topkaya
- Department of Analytical Chemistry, Faculty of Pharmacy, Izmir Katip Celebi University, Izmir, Turkey
| | - Emine Alarcin
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Marmara University, 34668, Haydarpasa, Istanbul, Turkey
| | - Gokcen Yasayan
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Marmara University, 34668, Haydarpasa, Istanbul, Turkey
| | - Yi-Chen Ethan
- Department of Chemical Engineering, Feng Chia University, Taichung, Taiwan
| | | | - Ali Akpek
- Institute of Biotechnology, Gebze Technical University, 41400, Gebze Kocaeli-Turkey
- Department of Bioengineering, Gebze Technical University, 41400, Gebze Kocaeli-Turkey
- Sabanci University Nanotechnology Research & Application Center, 34956, Tuzla Istanbul-Turkey
| | - Huseyin Avci
- Department of Metallurgical and Materials Engineering, Faculty of Engineering and Architecture Eskisehir Osmangazi University Eskisehir Turkey
| | - Kun Shi
- Division of Engineering in Medicine, Department of Medicine, Harvard Medical School, Brigham and Women’s Hospital, Cambridge, MA 02139, USA
| | - Su Ryon Shin
- Division of Engineering in Medicine, Department of Medicine, Harvard Medical School, Brigham and Women’s Hospital, Cambridge, MA 02139, USA
| | - Shabir Hassan
- Division of Engineering in Medicine, Department of Medicine, Harvard Medical School, Brigham and Women’s Hospital, Cambridge, MA 02139, USA
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James O, Adekunle AA, Adeyemo WL. How Does Octyl-2-Cyanoacrylate Tissue Adhesive Compare With Prolene Sutures in Cleft Lip Repair? J Oral Maxillofac Surg 2021; 79:1540-1548. [PMID: 33621479 DOI: 10.1016/j.joms.2021.01.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/21/2021] [Accepted: 01/21/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Comparative evidence of the usefulness of octyl-2-cyanoacrylate tissue adhesive in cleft lip epidermal skin closure especially in Africans is still lacking. This study aimed to compare the outcome of wound healing after the use of Dermabond tissue adhesive and 5/0 Prolene sutures in cleft lip repair. METHODS This was a prospective randomized controlled clinical study. The sampled population was patients undergoing cleft lip repair at a tertiary health facility in Lagos, Nigeria. Study patients were randomly allocated to either group A (Dermabond) or group B (suture). The predictor variable was the type of material used in skin closure; the primary outcome variable was the esthetics of the resulting scar, and secondary outcome variables were wound healing complications. Assessment of the 3-month postoperative wound scar was performed using the cosmetic visual analog scale (CVAS) and the Hollander Wound Evaluation scale (HWES). Calculated sample size was 14 participants per group. Descriptive and comparative statistics were computed, and the P value was set at <0.05. RESULTS Analysis of result included 38 participants. Median age was 4 months and 52.6% were women. Two cases (5.3%) of wound healing complications were recorded (1 in each group). Blinded evaluation of the 3-month postoperative photographs yielded a mean CVAS score of 86.0 (±11.2) and HWES score of 5.0 (±0.9) for group A and a mean CVAS score of 76.5 (±14.5) and HWES score of 4.5 (±1.1) for group B. There was no statistically significant difference between these 2 groups based on the CVAS (P = .052) and HWES (P = .152). CONCLUSIONS The results of this study suggest Dermabond offers a comparable cosmetic outcome as 5/0 Prolene suture in epidermal closure of cleft lip. There was no statistically significant difference in wound complications and wound cosmetic scores between the 2 groups.
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Affiliation(s)
- Olutayo James
- Senior Lecturer, Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Idi - Araba, Lagos, Nigeria
| | - Adegbayi Adeola Adekunle
- Senior Resident, Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi - Araba, Lagos, Nigeria.
| | - Wasiu Lanre Adeyemo
- Professor, Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Idi - Araba, Lagos, Nigeria
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50
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Pérez-Delgado S, Mozos E, Guerra R, Lucena R, Molina V, Ginel PJ. Tissue tolerance to cyanoacrylate adhesives for closure of surgical wounds in Trachemys scripta skin. Vet Rec 2021; 188:e59. [PMID: 33666962 DOI: 10.1002/vetr.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 11/10/2020] [Accepted: 12/15/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the histological tolerance of medical cyanoacrylate adhesives (CAs), butyl-CA and octyl-CA, applied by two different methods in surgical skin incisions of T. scripta. METHODS A two-trial controlled blind study each one including 12 female adult T. scripta turtles. Two 1-cm long full-thickness surgical skin incisions were made on the dorsal aspect of each hind limb. In trial 1 CAs were applied superficially over the apposed wound edges; each animal's four wounds were closed using butyl-CA, octyl-CA and ethyl-CA or absorbable suture as controls. In trial 2 adhesives were applied holding wound edges everted, and octyl-CA was replaced by a non-sutured control wound. At each time point (2, 7, 14 and 21 days) all wounds from three randomly chosen animals were biopsied. RESULTS Medical grade CAs did not induce any sign of tissue damage and/or inflammatory reaction attributable to histotoxicity independently of the method of application. Wound dehiscence rate was higher when CAs were applied superficially over the apposed wound edges. CONCLUSIONS Octyl and butyl-CA are well tolerated by turtles' soft skin but because of their high rate of dehiscence they are not recommended in high tension wounds; use in low tension wounds needs further investigation.
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Affiliation(s)
- Sayda Pérez-Delgado
- Department of Animal Medicine and Surgery, Facultad de Medicina Veterinaria, Universidad de Córdoba, Córdoba, Spain.,Department of Veterinary Medicine and Zootechnics, Escuela de Ciencias Agrarias y Veterinarias, Universidad Nacional Autónoma de Nicaragua, León, Nicaragua
| | - Elena Mozos
- Department of Anatomy and Comparative Pathology, Facultad de Medicina Veterinaria, Universidad de Córdoba, Córdoba, Spain
| | - Rafael Guerra
- Veterinary Service Department, Zoological Garden of Córdoba, Córdoba, Spain
| | - Rosario Lucena
- Department of Animal Medicine and Surgery, Facultad de Medicina Veterinaria, Universidad de Córdoba, Córdoba, Spain
| | - Verónica Molina
- Department of Anatomy and Comparative Pathology, Facultad de Medicina Veterinaria, Universidad de Córdoba, Córdoba, Spain
| | - Pedro J Ginel
- Department of Animal Medicine and Surgery, Facultad de Medicina Veterinaria, Universidad de Córdoba, Córdoba, Spain
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