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Horizontal Mattress Suture

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181. Technique for aortic valve annuloplasty using an intra-annular "hemispherical" frame. (Full text)

from a water reservoir at a constant pressure of 100 mm Hg, and valve leak was measured by timed collection in a beaker. Baseline leak was negligible, and the 2 commissures adjacent to the right coronary leaflet were incised vertically to create severe valve insufficiency. Through a transverse aortotomy, a "hemispherical" annuloplasty frame was sutured to the aortic valve annulus with horizontal mattress sutures. The 3 posts of the frame were sutured first to the 3 subcommissural regions to align (...) the device horizontally and vertically. The 3 frame curvatures then were sutured into the leaflet annuli using horizontal mattress "looping" sutures, supported with supra-annular pledgets. Post-repair valve leak was measured, and significance of the change was assessed with a 2-tailed paired t test. One survival implant was evaluated in an intact calf.Subcommissural incision disrupted annular geometry and created a valve leak of 1400 ± 847 mL/min (mean ± standard deviation). Suturing the 3-dimensional

2011 Journal of Thoracic and Cardiovascular Surgery PubMed abstract

182. A Biomechanical Analysis of Point of Failure During Lateral-Row Tensioning in Transosseous-Equivalent Rotator Cuff Repair. (Abstract)

A Biomechanical Analysis of Point of Failure During Lateral-Row Tensioning in Transosseous-Equivalent Rotator Cuff Repair. The purpose of this study was to determine the maximum load and point of failure of the construct during tensioning of the lateral row of a transosseous-equivalent (TOE) rotator cuff repair.In 6 fresh-frozen human shoulders, a TOE rotator cuff repair was performed, with 1 suture from each medial anchor passed through the tendon and tied in a horizontal mattress pattern. One (...) of 2 limbs from each of 2 medial anchors was pulled laterally over the tendon. After preparation of the lateral bone for anchor placement, the 2 limbs were passed through the polyether ether ketone (PEEK) eyelet of a knotless anchor and tied to a tensiometer. The lateral anchor was placed into the prepared bone tunnel but not fully seated. Tensioning of the lateral-row repair was simulated by pulling the tensiometer to tighten the suture limbs as they passed through the eyelet of the knotless

2011 Arthroscopy

183. Automated remote transapical wound closure system study. (Abstract)

tested for remote automated placement of 2 pledgeted horizontal mattress sutures delivered concentrically around a transmural apical guidewire, which provided a tract to enable therapeutic intervention. Mechanical pledgeted knots secured these sutures after cannula removal.Automated transapical closures were created in 47 ex vivo porcine hearts and in 10 human cadavers, 8 through a thoracotomy and 2 thoracoscopically. Automated apical closures achieved hemostasis in an acute beating heart thoracotomy (...) model in 3 anesthetized pigs. An ex vivo porcine heart pressurized infusate model demonstrated the intraventricular pressure tolerated by automated closures (mean, 327 mm Hg) compared with hand-sutured closures (mean, 303 mm Hg).All automated apical closures were effective. Early results encourage further evaluation.Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

2011 Annals of Thoracic Surgery

184. Modified Edge-to-Edge Technique for Correction of Congenital Mitral Regurgitation in Infants and Children. (Abstract)

Modified Edge-to-Edge Technique for Correction of Congenital Mitral Regurgitation in Infants and Children. Since 2008, 28 patients with congenital mitral regurgitation have undergone mitral valve repair with a modified edge-to-edge technique at our institution. The regurgitant mitral leaflet was sutured with a pledget-reinforced, horizontal mattress suture with No. 4-0 polypropylene on the ventricle side and a pledget-reinforced mattress suture with Gore-Tex sutures (W.L. Gore & Associates (...) , Flagstaff, AZ) and Dacron pledgets (Chest, Shanghai) placed on the anterior and posterior annulus corresponding to the edge-to-edge suturing site. Early results are encouraging, but a longer follow-up is needed.Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

2011 Annals of Thoracic Surgery

185. Dynamic contact mechanics of the medial meniscus as a function of radial tear, repair, and partial meniscectomy. (Full text)

) an inside-out repair with horizontal mattress sutures, and (6) a partial meniscectomy. The effects of these different types of meniscal manipulation on the magnitude and location of the peak contact pressure were assessed at 14% and 45% of the gait cycle.The peak tibial contact pressure in the intact knees was 6 +/- 0.5 MPa and 7.4 +/- 0.6 MPa at 14% and 45% of the gait cycle, respectively. The magnitude and location of the peak contact pressure were not affected by radial tears involving up to 60 (...) % of the meniscal rim width. Radial tears involving 90% resulted in a posterocentral shift in peak-pressure location manifested by an increase in pressure in that quadrant of 1.3 +/- 0.5 MPa at 14% of the gait cycle relative to the intact condition. Inside-out mattress suture repair of a 90% tear did not restore the location of the pressure peak to that of the intact knee. Partial meniscectomy led to a further increase in contact pressure in the posterocentral quadrant of 1.4 +/- 0.7 MPa at 14% of the gait

2010 The Journal of Bone and Joint Surgery. American Volume PubMed abstract

186. Comparative evaluation of the tendon-bone interface contact pressure in different single- versus double-row suture anchor repair techniques (Full text)

Comparative evaluation of the tendon-bone interface contact pressure in different single- versus double-row suture anchor repair techniques The aim of the study was to evaluate the time zero contact pressure over a defined rotator cuff footprint using different repair and stitch techniques in an established sheep model. Forty fresh-frozen sheep shoulders were randomly assigned to five repair groups: single-row repair using simple stitches (SRA-s), single-row repair using horizontal mattress (...) stitches (SRA-m), and single-row repair using arthroscopic Mason-Allen stitches (SRA-ama). Double-row repair was either performed with a combination of simple and horizontal mattress stitches (DRA-sm) or with arthroscopic Mason-Allen/horizontal mattress stitches (DRA-amam). Investigations were performed using a pressure-sensitive film system. The average contact pressure and pressure pattern were measured for each group. Contact pressure was lowest in SRA-m followed by SRA-s. SRA-ama showed highest

2009 Knee Surgery, Sports Traumatology, Arthroscopy PubMed abstract

187. Horizontal mattress technique for superior oblique suture spacer. (Abstract)

Horizontal mattress technique for superior oblique suture spacer. Superior oblique tendon overaction and Brown syndrome have been managed surgically by means of tenotomy/tenectomy, use of a silicon expander, and elongation with autologous fascia lata. These solutions are problematic with respect to corrective precision, injury and complications, or surgical difficulty. We present a simple "mattress" suture spacer technique that allows a precise and secure intraoperative adjustment.

2009 JAAPOS - Journal of the American Association for Pediatric Ophthalmology and Strabismus

188. Biomechanical testing of a shape memory alloy suture in a meniscal suture model. (Abstract)

Biomechanical testing of a shape memory alloy suture in a meniscal suture model. The purpose of this study was to evaluate the biomechanical results of meniscal repair in vitro by a nitinol suture and compare them with Ethibond (Ethicon, Somerville, NJ) and nylon.The 6 testing groups consisted of nitinol, Ethibond, and nylon sutures (No. 2-0 and No. 3-0). Sixty bovine menisci with a vertical longitudinal tear were repaired with 1 horizontal mattress suture and were fully immersed into a water (...) bath, adjusted to a tensile testing machine. All specimens were subjected to tensile testing, and force/displacement curves were obtained. Load to 5-mm gap, load to failure, tensile strength, stiffness, and mode of failure for each suture group were recorded. Statistical analysis included analysis of variance with Bonferroni correction for the post hoc multiple comparisons.Nylon sutures achieved the lowest scores in all measurements. Nitinol achieved better scores, but not significantly better

2009 Arthroscopy

189. Use of nasal packs and intranasal septal splints following septoplasty. (Abstract)

meshes at the end of the operation) and non-packing (using four separate trans-septum through and through horizontal mattress sutures without any mesh or intranasal splint insertion). Randomization was performed using the four block randomization system. Patients who failed the regular follow-up were excluded, and the two groups were compared for postoperative bleeding, hematoma, perforation and synechiae. Patients were asked to record pain levels using a visual analogue scale. The authors found (...) Use of nasal packs and intranasal septal splints following septoplasty. The aim of this study was to compare the efficacy of a trans-septum suturing technique with conventional nasal packing and intranasal splints in the classic septoplasty operation. The study is a prospective, randomized clinical trial. 114 patients underwent septoplasty for septal deviation and ensuing nasal obstruction. These patients were divided into two groups: packing (using intranasal septal splints and antibiotic

2009 International Journal of Oral and Maxillofacial Surgery Controlled trial quality: uncertain

190. Optimizing biomechanical performance of the 4-strand cruciate flexor tendon repair. (Abstract)

groups were repaired using the cruciate core technique without a peripheral suture. The locking loops were set using 10%, 25%, 33%, or 50% of the tendon width and loaded to failure using a distraction rate of 20 mm/min. The 3 groups of tendons then were repaired by using the established optimal locking loop size. These 3 groups were combined with a simple running, cross-stitch, or the interlocking horizontal mattress (IHM) peripheral suture. Repairs were tested to failure and the load at a 2-mm gap (...) Optimizing biomechanical performance of the 4-strand cruciate flexor tendon repair. The purpose of this study was to determine whether increasing the size of the locking loop increased the repair strength of the cruciate 4-strand suture technique and to quantify the biomechanical properties that various peripheral suture techniques provide in the cruciate 4-strand suture technique.Fifty-six deep flexor tendons harvested from adult sheep hind limbs were divided randomly into 7 groups of 8. Four

2004 Journal of Hand Surgery - American

191. Biomechanical study of cross-locked cruciate versus Strickland flexor tendon repair. (Abstract)

Biomechanical study of cross-locked cruciate versus Strickland flexor tendon repair. Zone II flexor tendon repairs may create a bulging effect with resistance to tendon gliding. A biomechanical study was performed comparing the 4-strand cross-locked cruciate (CLC) to a 4-strand Strickland repair, both with and without an interlocking horizontal mattress (IHM) suture, in terms of strength characteristics and work of flexion.Sixteen fresh-frozen human fingers were placed in a custom jig. Flexor (...) digitorum profundus tendons were sectioned at the A3 pulley level. Fingers were separated into 2 repair groups: 4-strand CLC and 4-strand Strickland core suture. Work of flexion was determined for each group, with and without an IHM circumferential suture. Final repair including IHM was tested for 2-mm gap failure and ultimate load to failure.The CLC-IHM had a significantly smaller increase in work of flexion than the Strickland-IHM. For both suture types, the circumferential suture resulted

2008 Journal of Hand Surgery - American

192. Comparison of long-term papilla healing following sulcular full thickness flap and papilla base flap in endodontic surgery. (Abstract)

apical periodontitis and included in the study. The flap design consisted of two releasing incisions connected by a horizontal incision. The marginal incision involved the complete mobilization of the entire papilla in one interproximal space but in the other interproximal space the PBI was performed. Further apically a full thickness flap was raised. Following flap retraction, standard apical root-end resection and root-end filling was performed. Flap closure was achieved with microsurgical sutures (...) . The PBI was sutured with two to three interrupted sutures (size 7/0), the elevated papilla was reapproximated with vertical mattress sutures (size 7/0), which were removed 3-5 days after the surgery. The height of the interdental papilla was evaluated preoperatively and postoperatively after 1-, 3- and 12-month recall using plaster replicas. The loss of papilla height was measured using a laser scanner. Papilla paired sites were evaluated and statistically analysed.Most papilla recession took place

2004 International endodontic journal Controlled trial quality: uncertain

193. Technique for insertion of the inflow cannula of the INCOR left ventricular assist device. (Abstract)

Technique for insertion of the inflow cannula of the INCOR left ventricular assist device. Our insertion technique for the inflow cannula of the INCOR left ventricular assist device (Berlin Heart AG, Berlin, Germany) is as follows. The apex ring is secured to the left ventricular apex using eight horizontal mattress sutures with full-thickness bites of myocardium. Another eight horizontal mattress sutures are then placed first through the Dacron felt pledgets (DuPont, Wilmington, DE (...) ) of the previously placed mattress sutures and then through the myocardium, the apex ring, and the suture collar of the inflow cannula. A double purse-string 3-0 polypropylene suture is placed on the Dacron pledgets around the apical hole and tightly tied.

2008 Annals of Thoracic Surgery

194. Gelatin matrix treatment of complex renal injuries in a porcine model. (Abstract)

with conventional horizontal mattress sutured gelatin sponge bolsters over the capsular injury. Operative blood loss, time to hemostasis and volume of gelatin matrix required for hemostasis were compared among the groups. Abdominal computerized tomography with intravenous contrast medium was performed in each animal 7 days postoperatively.Gelatin matrix use resulted in significantly less mean blood loss (80.7 and 99.0 ml in groups 1 and 2, respectively) vs conventional suture treatment (191.8 ml in group 3, p

2005 Journal of Urology

195. Load to failure testing of new meniscal repair devices. (Abstract)

-Fix (Smith & Nephew Endoscopy, Andover, MA) device. Group 2 had a horizontally oriented mattress suture using the FasT-Fix device. Group 3 had a repair using 2 Arthrex (Naples, FL) meniscal darts. The Group 4 repair used a RapidLoc (Mitek Surgical Products, Westwood, MA) device. The Group 5 repair used the Arthrotek meniscal screw (Biomet, Warsaw, IN). Group 6 had a single vertical suture, and group 7 a single horizontal suture, both of 2-0 Mersilene (Ethicon, Somerville, NJ). Load to failure (...) testing was performed.The vertical FasT-Fix suture had a mean load to failure of 70.9 N (1 SD +/- 33). The horizontal FasT-Fix suture had a mean load to failure of 72.1 N (+/- 23.5). The double Dart repair had a mean load to failure of 61.7 N (+/- 19). The RapidLoc repair had a mean load to failure of 43.28 N (+/- 3.98). The Arthrotek meniscal screw repair had a mean load to failure of 28.09 N (+/- 7.93). Failure occurred with device pullout of the inner rim (9 of 10) for the Darts, device pullout

2004 Arthroscopy

196. A novel double-row rotator cuff repair exceeds strengths of conventional repairs. (Full text)

and single-knot fixation; (2) anchor-only with horizontal mattress stitch and single-knot fixation; and (3) TOAK. The mean ultimate failure load was 238 N for the transosseous suture-only group and 215 N for the anchor-only group. Although the bones had lower density, TOAK specimens failed at 55% to 67% higher loads (mean, 404 N) than the other groups. These data support further evaluation of the TOAK technique for full-thickness supraspinatus tears in middle-aged to elderly patients. (...) A novel double-row rotator cuff repair exceeds strengths of conventional repairs. Double-row rotator cuff repairs are becoming popular because of their ability to improve initial ultimate failure load for full-thickness rotator cuff tears, especially in middle-aged to elderly patients. We hypothesized a quasi-double-row repair using a combination of transosseous sutures, anchors, and double knots (TOAK technique) would exceed the clinically relevant 250-N load threshold and the initial mean

2007 Clinical Orthopaedics and Related Research PubMed abstract

197. Arthroscopic patellar "bankart" repair after acute dislocation. (Abstract)

Arthroscopic patellar "bankart" repair after acute dislocation. We present a case of acute patellar dislocation in a skeletally immature patient treated with arthroscopic medial patellofemoral ligamentous complex repair using suture anchors with a horizontal mattress suture technique. Patellar dislocation is a common problem in the skeletally immature. Treatment is controversial for first-time dislocators because of the high rate of recurrent instability and functional disability

2005 Arthroscopy

198. Meniscal repair using the FasT-Fix all-inside meniscal repair device. (Abstract)

for failure of engagement of the T-Fix bar. An additional FasT-Fix device was then inserted without difficulty in each case. No case of postoperative extra-articular or intra-articular complications was encountered.The FasT-Fix suture device affords an all-inside method of meniscal repair using a strong vertical or horizontal mattress suture configuration and appears to be a safe and effective technique for meniscal repair for tears with at least a 2-mm peripheral rim. It has a high success rate and low (...) Meniscal repair using the FasT-Fix all-inside meniscal repair device. We performed a prospective study of meniscal repair using a new all-inside suture meniscal repair device to evaluate its clinical efficacy.Prospective case series.The results of 42 meniscal tears in 37 patients who underwent meniscal repair using the FasT-Fix device (Smith & Nephew, Andover, MA) were prospectively evaluated. All cases were performed by 1 surgeon (A.A.S.). Preoperative and follow-up evaluation was performed

2005 Arthroscopy

199. Arthroscopic placement of a modified Mason-Allen stitch. (Abstract)

suture anchor (Arthrex). The Scorpion suture passer places a stitch from inferior to superior through the torn rotator cuff. The suture is grabbed and reloaded into the Scorpion device. The device is then turned upside down, and a horizontal stitch is placed from superior to inferior. The stitch is retrieved again and reloaded a third time. The last pass is placed so that the final stitch passes anterior to the inferior suture but beyond the previously placed horizontal mattress stitch (...) Arthroscopic placement of a modified Mason-Allen stitch. Recent studies have shown all-arthroscopic rotator cuff repairs to have comparable clinical results to mini-open or open repairs. Previous drawbacks to arthroscopic repair have included not being able to place a modified Mason-Allen stitch with a suture anchor technique. We present a technique using the Arthrex Scorpion device (Arthrex, Naples, FL) to place a modified Mason-Allen stitch arthroscopically via a double-loaded FiberWire metal

2006 Arthroscopy

200. Tendon augmentation grafts: biomechanical failure loads and failure patterns. (Abstract)

, IN), and TissueMend (TEI Biosciences, Boston, MA; licensed to Stryker Howmedica Osteonics, Kalamazoo, MI) measuring 2 x 5 cm were hydrated according to manufacturers guidelines, a horizontal mattress stitch 5-mm wide was placed 5 mm from the narrow edge of the graft. Tensile loads to failure were applied on the suture while an Instron machine held the graft material and mean loads to failure of the suture graft construct were obtained and modes of graft failure noted.The mean loads to failure were obtained (...) : GraftJacket thin (157 N), GraftJacket MaxForce (182 N), GraftJacket Extreme (229 N), CuffPatch (32 N), Restore (38 N), Permacol (128 N), and TissueMend (70 to 76 N). Failure occurred principally by suture pull-through in all specimens and patterns tended to vary by implant type. CuffPatch and TissueMend tended to fail by isthmus pullout, whereas Restore and Graft jacket failed by end pullout. The tissues were statistically stratified into four groups depending on the material. Human skin (GraftJacket

2006 Arthroscopy

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