Background: Forces applied to knots used for interrupted vs. continuous closures are very different. We studied the knot strength and knot security of three knots when simulating a continuous wound closure: the square...Background: Forces applied to knots used for interrupted vs. continuous closures are very different. We studied the knot strength and knot security of three knots when simulating a continuous wound closure: the square, the sliding, and a hybrid constructed using a surgeon’s square knot followed by a sliding knot. Mate-rials and Methods: Knot holding capacity (KHC) of single-strand 1-0 polypropylene was determined by slow distraction on a horizontal testing sled of the strand that would be used to complete a continuous (“running”) closure following placement of an anchoring knot with six throws. Distraction continued until failure of the knot defined as breakage or slippage of the knot. Results: The mean and standard deviation of KHC meas-ured in pounds was determined (n = 30 for each knot): standard square 8.94 +/– 1.04;sliding 10.72 +/– 1.35;and hybrid 10.95 +/– 1.10. For each knot the relative knot security [(KHC of the knot/Tensile strength of untied strand) x 100] was calculated: standard square 69.5%;sliding 83.4%;hybrid 85.2%. Significant dif-ferences (p < 0.0001) in KHC exist between square and sliding knots (favoring sliding knots) and between square and hybrid knots (favoring hybrid knots). Hybrid and sliding knots were not statistically different. Conclusion: Sliding knots and hybrid knots are superior to square knots as anchoring knots for single-strand continuous wound closure.展开更多
目的比较腹腔镜胆总管探查术(laparoscopic common bile duct exploration,LCBDE)中间断缝合(interrupted suture,IS)与连续缝合(continuous suture,CS)治疗胆总管结石的安全性和有效性。方法回顾性分析2018年6月至2023年4月我科行LCBD...目的比较腹腔镜胆总管探查术(laparoscopic common bile duct exploration,LCBDE)中间断缝合(interrupted suture,IS)与连续缝合(continuous suture,CS)治疗胆总管结石的安全性和有效性。方法回顾性分析2018年6月至2023年4月我科行LCBDE治疗的104例胆总管结石患者资料,依据缝合方法分为CS组(n=53)和IS组(n=51)。比较两组患者的手术时间、术中出血量、引流管拔出时间、术后胆漏发生率、下床活动时间、饮食恢复时间、术前术后胆总管直径、住院时间。结果CS组的手术时间、术中出血量、引流管拔出时间、术后胆漏发生率均少于IS组(P<0.05)。两组下床活动时间、饮食恢复时间、住院时间比较,差异均无统计学意义(P>0.05)。两组患者术后胆总管直径均明显大于术前(P<0.05)。结论胆管连续缝合技术缩短了手术时间,减少了术中出血量、术后胆漏发生率以及引流管拔出时间,是治疗胆总管结石的一种安全且有效方法。展开更多
文摘Background: Forces applied to knots used for interrupted vs. continuous closures are very different. We studied the knot strength and knot security of three knots when simulating a continuous wound closure: the square, the sliding, and a hybrid constructed using a surgeon’s square knot followed by a sliding knot. Mate-rials and Methods: Knot holding capacity (KHC) of single-strand 1-0 polypropylene was determined by slow distraction on a horizontal testing sled of the strand that would be used to complete a continuous (“running”) closure following placement of an anchoring knot with six throws. Distraction continued until failure of the knot defined as breakage or slippage of the knot. Results: The mean and standard deviation of KHC meas-ured in pounds was determined (n = 30 for each knot): standard square 8.94 +/– 1.04;sliding 10.72 +/– 1.35;and hybrid 10.95 +/– 1.10. For each knot the relative knot security [(KHC of the knot/Tensile strength of untied strand) x 100] was calculated: standard square 69.5%;sliding 83.4%;hybrid 85.2%. Significant dif-ferences (p < 0.0001) in KHC exist between square and sliding knots (favoring sliding knots) and between square and hybrid knots (favoring hybrid knots). Hybrid and sliding knots were not statistically different. Conclusion: Sliding knots and hybrid knots are superior to square knots as anchoring knots for single-strand continuous wound closure.
文摘目的比较腹腔镜胆总管探查术(laparoscopic common bile duct exploration,LCBDE)中间断缝合(interrupted suture,IS)与连续缝合(continuous suture,CS)治疗胆总管结石的安全性和有效性。方法回顾性分析2018年6月至2023年4月我科行LCBDE治疗的104例胆总管结石患者资料,依据缝合方法分为CS组(n=53)和IS组(n=51)。比较两组患者的手术时间、术中出血量、引流管拔出时间、术后胆漏发生率、下床活动时间、饮食恢复时间、术前术后胆总管直径、住院时间。结果CS组的手术时间、术中出血量、引流管拔出时间、术后胆漏发生率均少于IS组(P<0.05)。两组下床活动时间、饮食恢复时间、住院时间比较,差异均无统计学意义(P>0.05)。两组患者术后胆总管直径均明显大于术前(P<0.05)。结论胆管连续缝合技术缩短了手术时间,减少了术中出血量、术后胆漏发生率以及引流管拔出时间,是治疗胆总管结石的一种安全且有效方法。
