Articles: sutures.
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Case Reports Comparative Study
Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Staples or sutures for repair of scalp laceration in adults.
A short cut review was carried out to establish whether staples are better than sutures for scalp wound repair in adults. Altogether 42 papers were found using the reported search, of which four presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.
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The most important risk factor for the development of wound dehiscence and incisional hernia is the suture technique that is totally in the hands of the surgeon. A continuous suture line in one layer with a monofilament material should close midline incisions. Self-locking knots should be used for the anchor knots. ⋯ The only way to ascertain a suture length to wound length ratio of at least four is to measure and document the ratio at every laparotomy. An adequate ratio should be achieved by placing many stitches into the aponeurosis. High tension on the suture should be avoided.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of tissue adhesive and suturing in the repair of lacerations in the emergency department.
The objective of this study was to compare the applications of Histoacryl Blue (HAB) and suturing regarding cosmetic outcome, cost and patient and physician satisfaction in the emergency department (ED). A total of 92 consecutive adult patients with lacerations equal to or shorter than 5 cm were enrolled in the study. Patients were randomized to either HAB or suturing. ⋯ Costs of HAB were significantly lower than sutures (p=0.0001). It is concluded that HAB is a cheaper method of laceration repair and results in greater satisfaction of both patients and physicians, while cosmetic outcomes were comparable. These results suggest that HAB is a viable alternative to suturing for selected lacerations in the ED.
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Pediatric emergency care · Jun 2002
Randomized Controlled Trial Comparative Study Clinical TrialCosmetic outcome of scalp wound closure with staples in the pediatric emergency department: a prospective, randomized trial.
The purpose of this study is to compare the cosmetic outcome of scalp wound closure with staples to traditional skin sutures. ⋯ Stapling appears to be a fast and cosmetically acceptable alternative to suturing for simple scalp lacerations.
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Surg Laparosc Endosc Percutan Tech · Jun 2002
Laparoscopic suture closure of perforated duodenal peptic ulcer.
The aim of this study was to assess the outcome of a continuous series of 30 patients with perforated duodenal peptic ulcers treated by a laparoscopic approach. Between January 1996 and December 1998, 30 patients (24 males, 6 females) with a mean age of 69.2 years were operated on with a laparoscopic approach. Laparoscopic treatment included peritoneal lavage, suture of the perforation, and omental patching in 24 cases. ⋯ Mortality and morbidity rates were 6.6% (n = 2) and 16.6% (n = 5). With a median follow-up of 12 months, 96% of the patients were in good condition; one patient had recurrent duodenal ulceration. The results of our study show the feasibility of the laparoscopic approach for perforated peptic ulcer repair, with acceptable mortality and morbidity rates.