BACKGROUND Skin closure techniques during minimally-invasive gynecologic surgery is largely based on surgeon preference.The optimum technique would theoretically be safe,rapid,inexpensive,and result in good cosmetic a...BACKGROUND Skin closure techniques during minimally-invasive gynecologic surgery is largely based on surgeon preference.The optimum technique would theoretically be safe,rapid,inexpensive,and result in good cosmetic appearance.Cyanoacrylate tissue adhesive(Dermabond)may be a comparable and safe option for port site closure as compared with subcuticular suture.In this randomized clinical trial,we hypothesized that operative time for skin closure would be less than subcuticular suture during robotic urogynecologic procedures.AIM To compare skin closure during robotic urogynecologic surgeries for tissue adhesives and subcuticular suture.METHODS Fifty female subjects>18 years of age undergoing robotic urogynecologic procedures were randomized to have port site closure with either cyanoacrylate tissue adhesive(n=25)or subcuticular suture(n=25).All procedures and postoperative evaluations were performed by the same board certified Female Pelvic Medicine and Reconstructive Surgeon.Incisional closure time was recorded.Each subject was followed for 12-wk postoperatively.Incision cosmesis was evaluated using the Stony Brook Scar Evaluation Scale.RESULTS A total of 47 subjects(cyanoacrylate group,n=23;suture group,n=24)completed the 12-wk postoperative evaluation.Closure time was significantly less(P<0.0005)using cyanoacrylate tissue adhesive(5.4±2.0 min)than subcuticular suture(24.9±5.6 min).Cosmesis scores were significantly higher in the cyanoacrylate tissue adhesive group than subcuticular suture(P=0.025).No differences were found between bleeding,infection,or dehiscence(P=1.00,P=0.609,P=0.234,respectively).No statistical demographical differences existed between the two study arms.CONCLUSION Our study supported our original hypothesis that cyanoacrylate tissue adhesive for port site closure during robotic urogynecolgic procedures uses less time than with subcuticular suture.Our study also supports that tissue adhesive is comparable to cosmetic outcome while not jeopardizing rates of bleeding,infection,or dehiscence.展开更多
Although conventional suturing techniques are commonly used in assisting wound closure,they do pose limited conduciveness and may lead to secondary injury to wound tissues.Inspired by marine organism mussels,we design...Although conventional suturing techniques are commonly used in assisting wound closure,they do pose limited conduciveness and may lead to secondary injury to wound tissues.Inspired by marine organism mussels,we designed and manufactured a bio-inspired hydrogel-based bandage with tough wet tissue adhesion to substitute traditional surgical suture,accelerate wound healing and avoid infection.Poly(γ-glutamic acid)was modified with 3,4-dihydroxyphenylalanine and glycidyl methacylate,then introduced into the acrylic acid-co-acrylamide hydrogel matrix with robust mechanical properties.The hydrogel bandage showed strong chemical linkage adhesion(70±2.1 kPa),which is 2.8 times that of commercial tissue adhesive fibrin glue(25±2.2 kPa).The hydrogel bandage can not only maintain the self-stability,but is also capable of self-tuning adhesive strength in the range of 14-70 kPa to achieve different adhesion effects by tuning constituent ratio.The bandage has desirable compression properties(0.7±0.11 MPa)and tensile elongation(about 25 times),which ensures its resistance to damages,especially in joint spaces.Secondly,the bandage was endowed with antioxidant and endogenous broad-spectrum antibacterial properties with its catechol structure.Results also demonstrated excellent cell compatibility and blood compatibility,certifying its eligible biological safety profile.In a rat full-thickness cutaneous deficiency model,we can clearly observe that the bandage possesses the ability to promote wound healing(only need 6 days).Above all,this research provides a new strategy for the emergency treatment of liver hemostasis and myocardial repair during disaster rescue.展开更多
AIM: To report a systematic review of published randomized controlled trials(RCTs) investigating the role of absorbable suture(AS) against non-AS(NAS) used for the closure of surgical incisions.METHODS: RCTs investiga...AIM: To report a systematic review of published randomized controlled trials(RCTs) investigating the role of absorbable suture(AS) against non-AS(NAS) used for the closure of surgical incisions.METHODS: RCTs investigating the use of AS vs NAS for the closure of surgical incisions were statistically analysed based upon the principles of meta-analysis and the summated outcomes were represented as OR.RESULTS: The systematic search of medical literature yielded 10 RCTs on 1354 patients. Prevalence of wound infection(OR = 0.97; 95%CI: 0.56, 1.69; Z = 0.11; P = 0.92) and operative morbidity(P = 0.45) was comparable in both groups. Nonetheless, the use of AS lead to lower risk of wound break-down(OR = 0.12; 95%CI: 0.04, 0.39; Z = 3.52; P 【 0.0004).CONCLUSION: This meta-analysis of 10 RCTs demonstrates that the use of AS is similar to NAS for skin closure for surgical site infection and other operative morbidities. AS do not increase the risk of skin wound dehiscence,rather lead to a reduced risk of wound dehiscence compared to NAS.展开更多
Objective To analyze the effects of different surgical procedures on the healing and cosmetic effects of skin lesions.Methods 102 patients with skin defects after skin tumor resection in our hospital from January 2018...Objective To analyze the effects of different surgical procedures on the healing and cosmetic effects of skin lesions.Methods 102 patients with skin defects after skin tumor resection in our hospital from January 2018 to December 2019 were selected and randomly divided into observation group and control group.The control group was treated with a traditional skin flap transplantation,while the observation group was treated with a skin stretch closure device.The effective rate,bleeding volume,wound healing time,total scar length,short-term and long-term complications and patient satisfaction were compared between the two groups.Results The effective rates of the observation group and the control group were 90.2%and88.24%,there was no significant difference in the treatment efficiency between the two groups(P>0.05),but there were significant differences in the amount of bleeding,the time of wound healing and the total length of postoperative scars between the two groups(all P<0.05);the short-term complication rates of the observation group and the control group were 5.88%and 19.61%,and long-term complications rate was 1.96%and 13.73%.The difference in the incidence of short-term and long-term complications between the two groups was statistically significant(all P<0.05);the satisfaction rate of patients in the observation group and the control group was 90.2%and 72.55%,the difference was statistically significant(P<0.05).Conclusion The former can effectively shorten wound healing time and scar length,reduce the incidence of short-term and long-term complications,and improve patients’satisfaction with the treatment,which is worthy of promotion.展开更多
基金This study was reviewed and approved by Ascension St John Hospital Institutional Review Board,reference number 1165375.
文摘BACKGROUND Skin closure techniques during minimally-invasive gynecologic surgery is largely based on surgeon preference.The optimum technique would theoretically be safe,rapid,inexpensive,and result in good cosmetic appearance.Cyanoacrylate tissue adhesive(Dermabond)may be a comparable and safe option for port site closure as compared with subcuticular suture.In this randomized clinical trial,we hypothesized that operative time for skin closure would be less than subcuticular suture during robotic urogynecologic procedures.AIM To compare skin closure during robotic urogynecologic surgeries for tissue adhesives and subcuticular suture.METHODS Fifty female subjects>18 years of age undergoing robotic urogynecologic procedures were randomized to have port site closure with either cyanoacrylate tissue adhesive(n=25)or subcuticular suture(n=25).All procedures and postoperative evaluations were performed by the same board certified Female Pelvic Medicine and Reconstructive Surgeon.Incisional closure time was recorded.Each subject was followed for 12-wk postoperatively.Incision cosmesis was evaluated using the Stony Brook Scar Evaluation Scale.RESULTS A total of 47 subjects(cyanoacrylate group,n=23;suture group,n=24)completed the 12-wk postoperative evaluation.Closure time was significantly less(P<0.0005)using cyanoacrylate tissue adhesive(5.4±2.0 min)than subcuticular suture(24.9±5.6 min).Cosmesis scores were significantly higher in the cyanoacrylate tissue adhesive group than subcuticular suture(P=0.025).No differences were found between bleeding,infection,or dehiscence(P=1.00,P=0.609,P=0.234,respectively).No statistical demographical differences existed between the two study arms.CONCLUSION Our study supported our original hypothesis that cyanoacrylate tissue adhesive for port site closure during robotic urogynecolgic procedures uses less time than with subcuticular suture.Our study also supports that tissue adhesive is comparable to cosmetic outcome while not jeopardizing rates of bleeding,infection,or dehiscence.
基金supported by the National Natural Science Foundation of China(31771049)the Foundation of Key R&D Project of Jiangsu Province(BE2018731)+3 种基金the Research Foundation of State Key Laboratory of Materials-Oriented Chemical Engineering(ZK201806,KL18-06 and ZK201606)the Six Talent Peaks Project of Jiangsu Province(SWYY-046)the Natural Science Foundation of Jiangsu Province(BK20200682)the Postgraduate Research&Practice Innovation Program of Jiangsu Province(SJCX20_0408).
文摘Although conventional suturing techniques are commonly used in assisting wound closure,they do pose limited conduciveness and may lead to secondary injury to wound tissues.Inspired by marine organism mussels,we designed and manufactured a bio-inspired hydrogel-based bandage with tough wet tissue adhesion to substitute traditional surgical suture,accelerate wound healing and avoid infection.Poly(γ-glutamic acid)was modified with 3,4-dihydroxyphenylalanine and glycidyl methacylate,then introduced into the acrylic acid-co-acrylamide hydrogel matrix with robust mechanical properties.The hydrogel bandage showed strong chemical linkage adhesion(70±2.1 kPa),which is 2.8 times that of commercial tissue adhesive fibrin glue(25±2.2 kPa).The hydrogel bandage can not only maintain the self-stability,but is also capable of self-tuning adhesive strength in the range of 14-70 kPa to achieve different adhesion effects by tuning constituent ratio.The bandage has desirable compression properties(0.7±0.11 MPa)and tensile elongation(about 25 times),which ensures its resistance to damages,especially in joint spaces.Secondly,the bandage was endowed with antioxidant and endogenous broad-spectrum antibacterial properties with its catechol structure.Results also demonstrated excellent cell compatibility and blood compatibility,certifying its eligible biological safety profile.In a rat full-thickness cutaneous deficiency model,we can clearly observe that the bandage possesses the ability to promote wound healing(only need 6 days).Above all,this research provides a new strategy for the emergency treatment of liver hemostasis and myocardial repair during disaster rescue.
文摘AIM: To report a systematic review of published randomized controlled trials(RCTs) investigating the role of absorbable suture(AS) against non-AS(NAS) used for the closure of surgical incisions.METHODS: RCTs investigating the use of AS vs NAS for the closure of surgical incisions were statistically analysed based upon the principles of meta-analysis and the summated outcomes were represented as OR.RESULTS: The systematic search of medical literature yielded 10 RCTs on 1354 patients. Prevalence of wound infection(OR = 0.97; 95%CI: 0.56, 1.69; Z = 0.11; P = 0.92) and operative morbidity(P = 0.45) was comparable in both groups. Nonetheless, the use of AS lead to lower risk of wound break-down(OR = 0.12; 95%CI: 0.04, 0.39; Z = 3.52; P 【 0.0004).CONCLUSION: This meta-analysis of 10 RCTs demonstrates that the use of AS is similar to NAS for skin closure for surgical site infection and other operative morbidities. AS do not increase the risk of skin wound dehiscence,rather lead to a reduced risk of wound dehiscence compared to NAS.
文摘Objective To analyze the effects of different surgical procedures on the healing and cosmetic effects of skin lesions.Methods 102 patients with skin defects after skin tumor resection in our hospital from January 2018 to December 2019 were selected and randomly divided into observation group and control group.The control group was treated with a traditional skin flap transplantation,while the observation group was treated with a skin stretch closure device.The effective rate,bleeding volume,wound healing time,total scar length,short-term and long-term complications and patient satisfaction were compared between the two groups.Results The effective rates of the observation group and the control group were 90.2%and88.24%,there was no significant difference in the treatment efficiency between the two groups(P>0.05),but there were significant differences in the amount of bleeding,the time of wound healing and the total length of postoperative scars between the two groups(all P<0.05);the short-term complication rates of the observation group and the control group were 5.88%and 19.61%,and long-term complications rate was 1.96%and 13.73%.The difference in the incidence of short-term and long-term complications between the two groups was statistically significant(all P<0.05);the satisfaction rate of patients in the observation group and the control group was 90.2%and 72.55%,the difference was statistically significant(P<0.05).Conclusion The former can effectively shorten wound healing time and scar length,reduce the incidence of short-term and long-term complications,and improve patients’satisfaction with the treatment,which is worthy of promotion.
