Suture

We carried out a blinded prospective randomised controlled trial comparing 2-octylcyanoacrylate (OCA), subcuticular suture (monocryl) and skin staples for skin closure following total hip and total knee arthroplasty. We included 102 hip replacements and 85 of the knee.OCA was associated with less wound discharge in the first 24 hours for both the hip and the knee. However, with total knee replacement there was a trend for a more prolonged wound discharge with OCA. With total hip replacement there was no significant difference between the groups for either early or late complications. Closure of the wound with skin staples was significantly faster than with OCA or suture. There was no significant difference in the length of stay in hospital, Hollander wound evaluation score (cosmesis) or patient satisfaction between the groups at six weeks for either hips or knees. We consider that skin staples are the skin closure of choice for both hip and knee replacements.

A Sm-Nd model age traverse across the Kola Peninsula has been undertaken to gain insight into the major episodes of crustal growth and to test the possible presence of early Archaean "Saamian" crust in the region. Granitoid gneisses and subordinate metasediments have been sampled from the main Archaean geological units, i.e. from northeast to southwest: the Murmansk domain (model ages of 2.68-2.96 Ga); Central Kola domain including samples from the Superdeep Borehole (2.74-2.92 Ga); Belomorian domain, including the eastern part of the Tersk area (2.70-2.93 Ga). The narrow range of depleted mantle model ages from 2.68 to 2.96 Ga for Archaean granitoid orthogneisses, close to the oldest crystallization ages from the region, indicate a major episode of late Archaean crustal growth and reveal no indication of ancient "Saamian" material in keeping with other geochronological evidence. Similar results (2.86 to 2.93 Ga) for Archaean metasediments support this conclusion. Proterozoic model ages for supracrustals from the western part of the Tersk area (2.16 to 2.23 Ga) indicate that the crust in this area is much younger than previously recognized. Initial eNd values for late Archaean samples with reasonable age constraints fall within a range of + 2.3 to -2.5. Two well-dated samples from the Belomorian domain have the highest initial ~d values [~d(2.81 Ga) = + 2.0 and eNd (2.78 Ga ) = + 2.3 ] and suggest that a depleted mantle source was present in the Kola region in late Archaean times. Dated samples from the Central Kola domain have lower initial ~d (between --2.5 and + 1.2) suggesting a possible regional difference in mantle character. In contrast to the depleted signature of the Archaean orthogneisses between 2.7 Ga and ~ 2.8 Ga, previous studies of earliest Paiaeoproterozoic rift-related mafic intrusives in the Kola and Karelia regions report negative end values at 2.4-2.5 Ga. Possibly these data reflect a change to more enriched-mantle values. * Corresponding author. Fax + 353 ( 1 ) 2837733. 0301-9268/95/$09.50 © 1995 Elsevier Science B.V. All fights reserved SSDI0301-9268 ( 94 ) 00045 -S M.

Background With the introduction of a self-expanding, memory-containing, circular hernia patch, surgeons have been enthusiastic about its use to repair ventral hernias smaller than 3 cm in diameter. The aim of this study was to evaluate the efficiency, reliability, and safety of the device laparoscopically with respect to adequate deployment of the patch. Methods During 1 year all patients with small ventral hernias were treated with this memory-containing patch and were inspected by laparoscopy. Just prior to insertion of the patch, remaining adhesions on top of the peritoneum were analyzed, as was the interference of the umbilical ligament. The final position of the patch was monitored, identifying the cupping phenomenon, exposure of the polypropylene to the viscera, and the amount of tension on the straps. All patients were followed for 2 years and postoperative complications and recurrence rate were monitored. Results Twenty-eight patients were operated on for repair of a small ventral hernia with laparoscopic control. Adhesions, not digitally palpable, that interfered with adequate patch deployment were observed in more than 80% of the cases. After a median follow-up of 25 months a 14.8% recurrence rate was observed. Conclusions The patch, consisting of both polypropylene and ePTFE, leads to unacceptable morbidity and a high rate of recurrences. By laparoscopic evaluation, these recurrences are probably based on a combination of material characteristics and unavoidable technical errors.

This course aims to introduce you to film theory through a variety of foundational texts, important essays, and screenings of both familiar contemporary works and works of historical and theoretical significance. The material presented in the course aims to foster a dynamic and inquisitive environment where you can engage with cinema as a popular medium that is problematized by its medium specificity, ideological impact, and struggle for artistic and philosophical authenticity.

The present invention provides a suture biomaterial for clinical application comprising of fine fibre derived from B.nivea (Ramie) fiber, which is extracted from suitably degummed B.nivea (Ramie) fiber, said suture biomaterial having smooth, uniform, plain texture and other traits as described herein for being suitable to be applied clinically. The present invention also provides a method for preparing such suture biomaterial

This paper sheds new light on Peter Greenaway's early films made in the 1970s as a remarkable seedbed of his later features. Reframing his experimental position accompanies two correlated registers that can be reexamined together: the then other avant-garde tendencies and the larger cultural context of poststructuralist and postmodern imagination. To link the former to the latter, the paper examines how the notion of ‘suture’ particularly worked in the Screen-theory-based experimental filmmaking and how Greenaway inspires us to expand and redefine it especially in ways of embodying Deleuzian ideas on any-space-whatever, automata, the virtual matrix of actual images, the plane of immanence of beings, etc. Analyzing seven films in two groups, this theoretical approach ultimately emphasizes what underlies Greenaway's apparently systematic cosmos: the system's becoming its own virtual chaos of non-system, which unfolds a creative disorder of post-apocalyptic, posthumous and post-human heterotopias.

Protection of right pneumonectomy bronchial sutures with a pedicled thymus flap http://ats.ctsnetjournals.org/cgi/content/full/77/1/351 located on the World Wide Web at: The online version of this article, along with updated information and services, is Print ISSN: 0003-4975; eISSN: 1552-6259. Southern Thoracic Surgical Association.

In orthopaedic surgery the reattachment of tendon to bone requires suture materials that have stable and durable properties to allow healing at the tendon-bone interface. Failure rates of this type of surgery can be as high as 25%. While the tissue suture interface is a weak link, proportions of these failures are caused by in-vivo abrasion of the suture with bone and suture anchor materials. Abrasion of the suture material results from the movement of the suture through the eyelet by the surgeon during surgery, or with limb movement after surgery as the suture is not rigidly restrained within the eyelet. During movement the suture is subjected to bending and frictional forces that can lead to fatigue induced failure. This paper investigates the mechanism of bending abrasion fatigue induced failure of number two grade braided sheath only and braided sheath/multifilament core sutures. Sutures were oscillated over a stainless steel wire at low frequency under load in a dry state to simulate the bending and frictional forces between suture and eyelet. Failure mechanism was determined by video microscopy of the suture during abrasion combined with optical microscopy analysis of partially and fully abraded sutures. Braided only structures had high friction loading on the small number of fibres at the abrasion interface. This caused rapid single fibre breakages that accumulate to cause suture failure. The addition of ultra-high molecular weight polyethylene core fibres to a braided suture distributed the applied load across multiple fibres at the abrasion interface. This improved abrasion resistance by 15-20 times that of braided sheath alone.

In this book, Seung-hoon Jeong introduces the cinematic interface as a contact surface that mediates between image and subject, proposing that this mediation be understood not simply as transparent and efficient but rather as asymmetrical, ambivalent, immanent, and multidirectional. Jeong enlists the new media term "interface" to bring to film theory a synthetic notion of interfaciality as underlying the multifaceted nature of both the image and subjectivity. Drawing on a range of films, Jeong examines cinematic interfaces seen on screen and the spectator’s experience of them, including: the direct appearance of a camera/filmstrip/screen, the character’s bodily contact with such a medium-interface, the object’s surface and the subject’s face as "quasi-interface," and the image itself. Each of these case studies serves as a platform for remapping and revamping major concepts in film studies such as suture, embodiment, illusion, signification, and indexicality. Looking to such theories as the ontology of the image and the phenomenology of the body, this original theorization of the cinematic interface not only offers a conceptual framework for rethinking and re-linking film and media studies, but also suggests a general theory of the interface.

'This original, brilliant, and graceful book uses the concept of the "interface" both theoretically and philosophically to develop an extremely useful framework through which to coherently explore and compare our experience not only of cinema but also of other moving image platforms. Also providing an analytic history of contemporary film theory, it will be an exciting addition to the graduate classroom.'-- Vivian Sobchack, UCLA School of Theater, Film & Television

'Operating in the gap between phenomenological and apparatus theory, Jeong brings Deleuze's and Levinas' understandings of the face together with the cultural theory of interface to make a powerful new way to consider the cinema in a period of rapid and radical change.'—Sean Cubitt, Goldsmiths, University of London

'Cinematic Interfaces combines speculative theoretical inquiry with rigorous analysis of films. It presents a radical rethinking of both film and film theory in the age of new media. Of particular significance is its reassessment of the cinematic apparatus – especially of image and subjectivity – as a series of interfaces.'--Warren Buckland, Oxford Brookes University

Introduction
1. The Medium-Interface
2. The Body-Interface
3. The Surface of the Object
4. The Face of the Subject
5. Image and Subjectivity

Urban living constantly attempts to 'suture' the city, finding ways to stitch gains and losses, or pasts and futures together in the moment of the 'urban now'. De Boeck's reflection on the complexities of the postcolonial urban world in the Central African locale is shaped around the visual archive that he built up over the past years with photographer Sammy Baloji. This article addresses the possibilities of such a combination of ethnography and photography to de-centre and reframe urban theory and build an alternative urban archive to explore in novel ways what this 'suturing', this living and living together, might mean in Central Africa's urban worlds today.

The Neoproterozic Allaqi-Heiani suture in southeastern Egypt is the western extension of the Allaqi-Heiani-Onib-Sol Hamed-Yanbu suture that represents one of arc-arc sutures in the Arabian-Nubian Shield. It extends for more than 250 km from the N-trending Hamisana Shear Zone in the east to Lake Nasser in the west. It separates the 750-Ma-old Southeastern Desert terrane in the north from the 830-720-Ma-old Gabgaba terrane in the south. Structural studies supported by remote sensing investigations including Landsat Thematic Mapper (TM) images show that the western part of Allaqi-Heiani suture zone constitutes three S-to SW-verging nappes in the north overriding an autochthonous block to the southwest. SW-verging, low-angle thrust sheets and folds, forming a 10-km wide imbrication fan, dominate the northern upper nappe (northern allochthon). These folds and thrusts deform shelf metasedimentary rocks including psammitic metasediments, marble and subordinate conglomerate. Volcanic rocks including rhyolites and felsic tuffs dominate the upper part of the northern allochthon. The contacts between the metasedimentary rocks on the one hand and the rhyolites and felsic tuffs on the other hand are extrusive. This allochthon overrides an internally deformed nappe (central allochthon) dominated by arc and ophiolitic assemblages now preserved as felsic and mafic schist, talc schist, serpentinites, and metagabbros. This allochthon is characterized by NW-trending, upright folds, which deform the earlier sub-horizontal structures. The structurally lower nappe (southern allochthon) is dominated by NNE-trending folds which deform amphibolite facies schistose metavolcanic and metavolcanoclastic rocks. The NNE-trending folds deform earlier NW-trending folds to produce crescentic dome interference pattern with well-developed NE-trending axial planar cleavage, consistent with ESE-WNW bulk shortening. The southernmost structural unit is an autochthonous block dominated by arc-related volcanic and volcanoclastic rocks. This block has suffered only minor deformation compared to the nappes to its north. The consistent SW-vergence of the structures indicates tectonic transport from northeast to southwest, followed by ESE-WNW shortening similar to that found in the Hamisana Shear Zone, further east. Collision between the Gabgaba-Gebeit terrane and the Southeastern Desert terrane along the Allaqi-Heiani suture, after the consumption of a marginal basin probably over an N-dipping subduction zone, led to the formation of EW-to NW-trending folds and thrusts. This was followed by ESE-WNW tectonic shortening to form NNE-trending folds, which are found to be overprinting the earlier structures. This latest might be due to collision between the Arabian-Nubian Shield and the Saharan Metacraton along an N-trending arc-continent suture represented farther south by the Keraf suture.

Treatment of glenohumeral instability and capsulolabral pathology continues to evolve as arthroscopic techniques improve. A growing body of biomechanical and clinical research provides an enhanced perspective on results obtained with both arthroscopic and open treatment of these conditions. Labral repair and capsulolabral reconstruction can effectively be treated with suture anchors by both arthroscopic and open methods. Suture anchors are low-profile fixation devices that can minimize articular surface compromise and afford an anatomic reconstruction of the labrum and glenohumeral ligament complex. Although the use of suture anchors has become increasingly common to obtain stable fixation and healing at the bone-tendon interface in rotator cuff repair, critical distinctions exist between this function and their implementation in labral repair and capsulolabral reconstruction. This article examines the technical aspects of labral repair and capsulolabral reconstruction with metallic and bioabsorbable suture anchors. The emphasis is on implant options, technical advantages, potential limitations, and relevant biomechanical considerations to better achieve an optimal outcome. Oper Tech Sports Med 12:225-231

The tentorium, the anterior sulci of the head capsule (epistomal, subgenal, subantennal, circumantennal, and circumocular sulci), and the extension of the anterior tentorial pit were studied in 26 species of Blattaria (representing most principal lineages), 4 species of Mantodea (including the basal Mantoida schraderi), and 1 species each of Isoptera (the basal Mastotermes darwiniensis) and Mantophasmatodea (Austrophasma caledonense). The morphology of these head structures is compared with literature data on other insect orders, mainly Phasmatodea, Orthoptera, Dermaptera, Embioptera, and Plecoptera, and partly Odonata and Zygentoma. Characters are defined, presented in a matrix, and evaluated with regard to phylogenetic implications and homoplastic evolution. The structural relationships of the subantennal sulcus to the subgenal, circumocular, and circumantennal sulci, which are highly variable and strongly homoplastic (depending much on the size of the compound eyes) are a focal issue; several types of subantennal sulci are defined. The presence of an anterior transverse bridge in the tentorium (''perforated tentorium'') of all Dictyoptera here studied confirms the monophyly of this group. Mantophasmatodea lacks this element.

Magnetotelluric data were obtained along a 450 km, almost west-east profile at approximately 31.5°S, which extends from La Rioja to Santa Fé provinces in central Argentina. The profile crosses two main crustal domains that were juxtaposed during the Early-Middle Cambrian Pampean Orogeny: the Pampean terrane to the west and the Río de la Plata craton to the east. The electrical resistivity structure of the crustal domains together with their boundary is presented. Through dimensionality analysis of the data, it was demonstrated that regional-scale electrical structures are mainly two-dimensional with a strike direction oriented parallel to the surface geological strike. The resistivity model shows a subvertical limit approximately along the eastern border of the Sierra Chica de Córdoba. To the east, the shallower structure is the Chaco-Paranense basin extending to a depth of 6 km with resistivities between 1 and 30 Ohm-m, whereas below the basin the ca 2.1-2.3 Ga Río de la Plata craton shows resistivities in a range of 300-10,000 Ohm-m. The Pampean terrane presents a 6 km layer with a resistivity higher than 10,000 Ohm-m whereas below this layer the resistivity values range from 50 to 200 Ohm-m. Based on both the geological information and the magnetotelluric results, the sharp lateral discontinuity observed in the resistivity model to the east of the Sierras de Córdoba is conjectured to represent the boundary between the Río de la Plata craton and the Pampean terrane which may correspond to the Early Cambrian suture.

1. Volten der Mediatisierung – 'Cinema Returns'
2. Das symptomatische Lachen des Guy Fawkes: 'flashover'
3. 'Post-Cinema' und neue Imaginationsprojekte: Kino als Mobilisierung gesellschaftlicher Erfahrungs-Register
4. Spektralität: Visionen in Streuung, schimmernde Netze und wilde Aneignung
5. 'Neue Visionen': Post-Cinema und Sonderwege der Mediatisierung
6. Neue Radien der Medien-Soziologie: Soziale Semiotik, hybride Imagination und post-cinematische Sinnprojektionen
7. Horizont (und zentraler 'Einsatz'): Mediensoziologie als 'spektrale' und 'projektive' Hetero-Soziologie
8. Ausblick: Anlage, Struktur und Methodologie der Arbeit
9. Zur möglichen Anlagerung experimenteller/mediografischer Formate

Motif-Boards :
I. 'V for Vendetta' + ‚Guy Fawkes Maske‘ – post-anonyme Aufstände der Zeichen
II. 'Mockingjay-Revolutions‘ – Große Gesten: Thailand + Ferguson 2013
III. Motif-Board III : ‚Tahrir Cinema‘ – Spuren eines minoritären Post-Cinema
IV. Motif-Board IV : ‚The Interview‘ + the ‚Sony-Hack‘ – A more complex case of spectral post-cinematics

Purpose: This study was designed to comprehensively compare the mechanical properties of 4 types of braided polyblend sutures with widely used braided polyester and monofilament polydioxanone sutures. Methods: Polyblend polyethylene sutures (FiberWire [Arthrex, Naples, FL], Herculine [Linvatec, Largo, FL], Orthocord [DePuy Mitek, Raynham, MA], and Ultrabraid [Smith & Nephew Endoscopy, Andover, MA]), a braided polyester suture (Ethibond; Ethicon, Somerville, NJ), and an absorbable monofilament polydioxanone suture (PDS II; Ethicon), all USP No. 2, were mechanically

Purpose: The reliability of poly-p-dioxanone (PDS) suture for sternal closure was tested on 264 consecutive sternotomies in the authors' department from April 1987 to May 1998. Methods: The reason for sternotomy was tetralogy of Fallot in 65 cases (24.6%), ventricular septal defect (VSD) in 38 cases (14.4%), atrial septal defect (ASD) in 77 cases (29.2%), ASD + VSD in 23 (8.7%), mitral valve replacement in 22 cases (8.3%), aortic valve replacement in 10 cases (3.8%), and other cardiac disorders in 29 cases (11.0%). Results: Sternal wound infection, sternal dehiscence, and mediastinitis occurred in 1.5% of patients (4 of 264). The overall hospital mortality rate related to the mediastinitis was 1.1% (3 of 264) in the early postoperative period. Conclusion: This absorbable suture and our different technique are a safe alternative to standard sternotomy closure after pediatric open cardiac surgery. J Pediatr Surg 35:1309-1311.

A clinical and radiographic review was undertaken in 27 patients (30 feet) who underwent a chevron osteotomy stabilized with a double loop of polydioxanone suture. The mean patient age at the time of surgery was 40 years (range, 16 to 66 years). At 6 weeks postoperatively, all patients showed clinical and radiographic union at the osteotomy site. In 1 foot, the initial correction was lost with radiographic evidence of an angulated distal fragment with no medial translation. There were no cases of wound infection, sinus formation, or avascular necrosis of the metatarsal head. No patients required further surgery. This method of stabilizing a chevron osteotomy is technically straight forward, with a predictable outcome, and provides a valid low cost alternative to screw, bioabsorbable implant, or Kirschner wire.

We present the clinical findings and treatment of haemangiomas and arteriovenous malformations only, although many other vascular lesions affect the lip. We used simple clinical findings for our diagnosis and treated our patients by applying the Tabaksbeutelnaht (tobacco-pouch suture) technique to encircle the tumour and strangle it. Subsequently 10% saline (2-3 ml), which acted as a sclerosant, was injected into the tumour. Despite the absence of advanced imaging techniques and limited options for treatment, we achieved total success and good cosmetic results in 13 patients. This may be an effective therapeutic alternative to expensive methods used in developed countries and may be emulated by maxillofacial surgeons in poorer countries.

The purpose of this study was to compare suture anchor and EndoButton repair of distal biceps injuries in a human bone-tendon model. Right and left arm repairs were alternately performed with either the En-doButton or 2 single-loaded 5-mm suture anchors. Each construct was cyclically loaded by use of a servohydraulic materials testing machine. Initial and final displacements were recorded. All repairs were then loaded to ultimate failure. Ten millimeters of displacement was designated the clinical failure point. The En-doButton group had more stiffness than the suture anchor group during initial cyclic loading (P ϭ .01). There were no differences in final displacement measured after cyclic loading (2.06 mm for suture anchors and 2.58 mm for EndoButton). The EndoButton group had a 16% greater ultimate tensile load than the suture anchor group (274.77 N vs 230.06 N). The En-doButton group also had a 16% higher load to clinical failure (249.95 N vs 209.56 N). These differences were not statistically significant. The EndoButton and suture anchors provide comparable fixation strength for the repair and rehabilitation of distal biceps tendon ruptures. (J Shoulder Elbow Surg 2006;15:509-514.)

Cervical cerclage has been used in the management of cervical insufficiency for several decades, yet the indications are uncertain and benefits marginal. It remains a controversial intervention. The diagnosis of cervical insufficiency is traditionally based on a history of recurrent second trimester miscarriages, or very preterm delivery whereby the cervix is unable to retain the pregnancy until term.

The role of calvarial sutures in transmitting biomechanical forces within the head is unclear. Methods: To examine the biomechanical characteristics of sutures, the authors measured bite force changes in rats and tested for alterations in strain across intrafrontal and sagittal sutures and within parietal bone with age. To understand the effects of suture fusion on strain distribution in the head, the authors measured percentage fusion of the intrafrontal sutures with age (n ϭ 6 per age group). The masticatory muscles in anesthetized 9-, 24-, and 70-day-old rats (n ϭ 15 per group) were bilaterally stimulated. Stacked delta rosette gauges were fixed across the intrafrontal sutures and sagittal suture, or on the parietal bone. Strain and bite force were measured with a bite force transducer positioned at the incisors. Results: Bite force increased significantly (p Ͻ 0.05) with age (9-day-old rats, 72.6 Ϯ 20 gf; 24-day-old rats, 707.3 Ϯ 150 gf; 70-day-old rats, 2425.6 Ϯ 255 gf). Some significant differences were found between the volume and direction of strain among sites and age groups. Compressive strains of 230 on average were found across the intrafrontal sutures at all ages. In contrast, tensile strains less than 180 on average were found across the sagittal sutures of 9-and 24-day-old rats, increasing to 940 on average at day 70. Tensile strains in parietal bone tended to be less than 150 . Conclusions: The timing of sutural closure and patterns of transsutural strain do not suggest that strain patterns contribute to initial fusion in the intrafrontal sutures. Differences in strain are likely related to changes in rat skull kinetics with growth, perhaps resulting from fusion of the intrafrontal sutures. (Plast. Reconstr. Surg. 119:

Purpose: This study evaluates the abrasion properties of different suture materials through the rotator cuff tendon and proximal humerus tuberosity bone. Methods: Three types of sutures were compared: monofilament polypropylene, braided polyester, and braided polyblend polyester with a polyethylene core. For soft-tissue testing, the suture was passed through the infraspinatus tendons of 11 cadaveric shoulders. The suture was cycled with a fixed load, and the migration of the suture as it cut through the tissue was measured at intervals of 5 cycles, for a total of 50 cycles. For tuberosity testing, the sutures were passed through a transosseous tunnel created in the lesser tuberosity, and the suture was cycled with a fixed load until suture failure occurred. Results: On soft-tissue testing, the monofilament suture showed the least amount of abrasion, followed by the braided polyblend and then the braided polyester suture (cutting rate of 0.06 Ϯ 0.11 mm/cycle, 0.99 Ϯ 0.44 mm/cycle, and 1.75 Ϯ 0.91 mm/cycle, respectively; P Ͻ .0001). On tuberosity testing, suture breakage for the braided polyblend suture occurred at 501.3 Ϯ 220.4 cycles. The braided polyester and monofilament sutures broke after 256.6 Ϯ 120.9 and 193.5 Ϯ 144.8 cycles, respectively. The difference between cycles to failure of the polyblend and latter 2 sutures was statistically significant (P Ͻ .0001). Conclusions: This study shows increased abrasion properties for braided sutures compared with monofilament sutures, as well as different abrasion properties among different types of braided sutures. Furthermore, the braided polyblend suture showed significantly increased cycles before suture failure through a transosseous tunnel. Clinical Relevance: Although development of new suture materials has increased their failure strength, further advancements in suture material design should focus on decreasing soft-tissue abrasion properties and increasing strength to suture failure when cycled through bone.

Background: The purpose of this study was to compare the tensile strengths of commonly used sutures over a 2-week period under simulated oral conditions. Methods: Three suture materials (chromic gut [CG], polyglactin [PG], and polyglactin-fast absorbing [PG-FA]) were used in 4-0 and 5-0 gauges. After pretensioning, 252 suture samples (42 of each material and gauge) were used. A biologic simulation was created in vitro by mixing 9 ml sterile human saliva and human serum in a 1:1 ratio in a petri dish maintained at a pH of 7.4 to 8.1 at 37°C. All samples were tested preimmersion and 1 hour and 1, 3, 7, 10, and 14 days postimmersion. The tensile strength was assessed using a microtensile tester, and the maximum load required to cause suture breakage was determined. The point of breakage in the samples and the samples themselves were also assessed. Results: During the first 24 hours of immersion, all 4-0 and 5-0 samples of CG and PG maintained their initial level of tensile strength; PG-FA 5-0 decreased in strength, which was statistically significant (P = 0.001). Between days 1 and 3, the tensile strength of PG and PG-FA decreased significantly, with PG-FA 5-0 showing a greater and more precipitous decrease than PG-FA 4-0; the tensile strength of CG changed little during this time. After 7 days of immersion, PG 4-0 had significantly greater tensile strength than CG, and both were significantly greater than that of PG-FA. By day 10, CG and PG had statistically greater strength (P = 0.01) than PG-FA, and values were similar for the 4-0 and 5-0 gauge materials. All samples of PG-FA 5-0 and most samples of the PG-FA 4-0 exhibited 0.00 N strength (i.e., they had disintegrated) at the 10-and 14-day periods of evaluation. Conclusions: 4-0 sutures are stronger and have greater tensile strength than 5-0 sutures. CG seems to sustain its strength better than PG and PG-FA after 2 weeks. PG-FA may not be a desirable suture if tensile strength is required after 10 days. Appropriately designed clinical studies are necessary to confirm this finding in an in vivo environment.

Lisfranc fracture dislocations are complex and difficult to treat. Making the correct diagnosis and achieving an anatomical reduction are important factors in regard to achieving a favorable outcome with this injury. We describe a new technique that we have found to be useful for stabilizing Lisfranc fracture dislocations. This method is relatively fast, minimally invasive, and effective, and it eliminates the need for implant removal. To date, we have achieved predictable results for stabilizing and treating these difficult injuries with the use of a suture endobutton, instead of traditional interfragmental screw fixation. In this report, we describe 3 cases in which this method was used with satisfactory short-term results.

Dismembered late Mesozoic ophiolites occur in two parallel belts along the eastern margin of the Indian Plate. The Eastern Belt, closely following the magmatic arc of the Central Burma Basin, coincides with a zone of high gravity. It is considered to mark a zone of steeply dipping mafic-ultramafic rocks and continental metamorphic rocks, which are the locus of two closely juxtaposed sutures. In contrast, the Western Belt, which follows the eastern margin of the Indo-Burma Range and the Andaman outer-island-arc, broadly follows a zone of negative gravity anomalies. Here the ophiolites occur mainly as rootless subhorizontal bodies overlying Eocene-Oligocene flyschoid sediments. Two sets of ophiolites that were accreted during the Early Cretaceous and mid-Eocene are juxtaposed in this belt. These are inferred to be westward propagated nappes from the Eastern Belt, emplaced during the late Oligocene collision between the Burmese and Indo-Burma-Andaman microcontinents.

Although the argon laser is used successfully to weld a number of different tissues, the underlying chemical and cellular mechanisms for this process are not precisely defined. Consequently, a biochemical model has been developed in vitro using the welldefined extracellular matrix from the murine Engelbreth-Holm-Swarm (EHS) sarcoma. Control and experimental samples of EHS basement membranes were irradiated with a Trimedyne argon laser at 5003,000 Joules/cm2 at 0°C. The samples were diluted into cold phosphate-buffered saline and allowed to gel at 35°C. The time course of the gelation reaction was followed in a spectrophotometer at 360 nm. Irradiation reduced the absorbance 7.5-15% compared to controls and was independent of the dilution over a 10-fold range. Gelation was also measured by determining the amount of protein by the Bradford assay that could be collected by centrifugation at 10, OOOg for 10 minutes. Argonirradiated samples had 3040% less protein in the precipitate than the controls. The addition of 5 mM beta-mercaptoethanol to the EHS extract blocked the effect of the laser on the gelation reaction. In addition, when gelation was carried out in the absence of calcium and magnesium, there were no differences between laser-treated samples and controls. The basement membrane proteins were separated by electrophoresis through polyacrylamide gels under denaturing plus reducing or denaturing and non-reducing conditions. No differences in the polypeptide composition were noted between irradiated and control samples using either Coomassie-or silver-staining techniques. The irradiated and control samples were also analyzed on 1.5% agarose gels in 10 mm Tris-HC1, pH 8 containing 0.1% SDS. Both samples produced a single Coomassie-positive band, but the control migrated at 0.5 and the irradiated sample at 0.6. In sum, the conformation of extracellular matrix proteins can be altered by the argon laser at welding energies at low temperatures, even though no new covalent interactions were observed.

Purpose: Sutures used in oral surgery should avoid or limit bacterial adhesion and proliferation to those parts exposed to oral fluids. Hence, microbial colonization on various intraoral suture materials from patients undergoing dental surgery was compared. Patients and Methods: During dentoalveolar surgery, various suture materials were used in 60 patients, who were randomly divided into 5 groups of 12. In each group, silk was placed intraorally in association with a different type of suture (ie, Supramid, Synthofil, Ethibond Excel, Ti-cron, Monocryl) at the same site to compare microbial colonization intraindividually. Eight days postoperatively, the sutures were removed, and adhered micro-organisms were isolated, counted, and identified through enzymatic activities and fermentation of sugars. Results: In all 60 patients, silk sutures exhibited the smallest affinity toward the adhesion of bacteria compared with considerable proliferation with nonresorbable multifilament sutures (Supramid, Synthofil, Ethibond Excel, Ti-cron). On the contrary, the microbial load was significantly lower when absorbable monofilament Monocryl was used. A greater quantity of bacteria was found on nonresorbable sutures than on absorbable ones, and nearly 2 times more facultative anaerobic bacteria were isolated in total. Conclusions: Our results show that bacteria adhere with different affinity to various types of suture materials. Absorbable silk and Monocryl exhibited the smallest number of adherent bacteria. Colonization by pathogens on sutures leads to the recommendation that sutures should be removed as early as possible after surgery is performed, to eliminate or to limit the reservoir for oral pathogens. This recommendation is dependent on whether the suture is absorbable.

BACKGROUND. Vertical mattress sutures are used in skin surgery to produce eversion of the wound edges, which produces a better, cosmetically acceptable scar. The disadvantages of this closure include the risk of wound hypereversion if tied too tightly, longer time to perform the stitch, and difficulties with grasping the externalized loops during suture removal. OBJECTIVE. To examine and discuss the new modification of running vertical mattress sutures, which can overcome the disadvantages. METHODS. Running combined simple and vertical mattress suture techniques are presented in a series of schematic diagrams that follow. RESULTS. The running combined simple and vertical mattress is easier and quicker to close the wound than the classic interrupted or running vertical mattress suture. Whereas the mattress suture everts the wound edges, the simple suture coapts the sides, preventing undue inversion or hypereversion of the wound. Suture removal is less uncomfortable for the patient and is performed faster by the medical staff owing to a reduction in the number of externalized loops by half compared with the classic vertical mattress stitch. CONCLUSION. Alternation of the vertical mattress and simple running suture saves the surgeon's time without lessening the advantages of good wound eversion and hence the formation of a less apparent, cosmetically more appealing scar after wound contraction.

Flexor digitorum profundus (FDP) tendon avulsions, although uncommon, are not infrequent injuries. A widely accepted method of treating Type 1 FDP avulsions is a pullout suture tied over a button on the nail plate. The external dorsal button is often a source of inconvenience for the patient. Potential risks associated with button use include nail plate deformities, nail fold necrosis and infections tracking along the sutures. The use of small suture anchors provides a satisfactory alternative, because buried fixation avoids these potential complications. This in vitro, biomechanical study examined the influence of the anchor orientation on the properties of the repaired FDP tendon using human cadavers.

A novel silver-doped bioactive glass powder (AgBG) was used to coat resorbable Vicryl s (polyglactin 910) and non-resorbable Mersilk s surgical sutures, thereby imparting bioactive, antimicrobial and bactericidal properties to the sutures. Stable and homogeneous coatings on the surface of the sutures were achieved using an optimised aqueous slurry-dipping technique. Dynamic mechanical analysis (DMA) was used to investigate the viscoelastic parameters of storage modulus and tan d and thermal transitions of the as-received and composite (coated) sutures. The results generally showed that the bioactive glass coating did not affect the dynamic mechanical and thermal properties of the sutures. The in vitro bioactivity of the sutures was tested by immersion in simulated body fluid (SBF). After only 3 days of immersion in SBF, bonelike hydroxyapatite formed on the coated suture surfaces, indicating their enhanced bioactive behaviour. Resorbable sutures with bioactive coatings as fabricated here, in conjunction with 3-D textile technology, may provide attractive materials for producing 3-D scaffolds with controlled porosities for tissue engineering applications. The bactericidal properties imparted by the Ag-containing glass coating open also new opportunities for use of the composite sutures in wound healing and body wall repair. r