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Horizontal Mattress Suture

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201. 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

202. 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

203. A novel double-row rotator cuff repair exceeds strengths of conventional repairs. Full Text available with Trip Pro

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

204. 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

205. 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

206. Astigmatism after small incision cataract surgery. A prospective, randomized, multicenter comparison of 4- and 6.5-mm incisions. (Abstract)

). Subgroup analysis of the suturing technique for the 6.5-mm incision showed that the technique of wound closure, as well as the wound size, influenced the induced astigmatism. For all four surgeons using three methods of suturing the 6.5-mm wound, however, the variability in the amount of induced cylinder was least with the 4.0-mm wound closed with a horizontal mattress suture. Complications in the two groups were comparable.

1991 Ophthalmology Controlled trial quality: uncertain

207. Bleeding Aortic Cannulation Site: Technique for Repair Full Text available with Trip Pro

Bleeding Aortic Cannulation Site: Technique for Repair A simple technique of controlling a bleeding aortic cannulation site employing autogenous tissue is described in which 3-0 Prolene suture is placed through the lateral pericardial tissue on both sides of the aortotomy closure in a horizontal mattress fashion. This technique is advantageous because of the availability of autogenous tissue, the ease in which the technique can be employed, the better conformance of the tissue to the suture

1986 Texas Heart Institute Journal

208. A modified bronchial anastomosis technique for lung transplantation. (Abstract)

A modified bronchial anastomosis technique for lung transplantation. Low rates of major complications have been reported for the intussuscepting bronchial anastomotic technique but stenosis, malacia, and granulation tissue at the anastomosis may cause clinically important morbidity. We hypothesized that a modification of the telescoping technique that improves bronchial wall apposition might be associated with improved bronchial healing and clinical outcomes.The telescoping horizontal mattress (...) "U-stitch" suture technique was modified to incorporate figure-of-eight sutures placed in the cartilaginous wall between each of three intussuscepting U stitches. Serial videotape records of 152 individual anastomoses (99 modified, 53 telescoped) in 118 consecutive operative survivors were retrospectively reviewed by examiners blinded with respect to technique used. Stenosis, airway instability, mucosa quality, and devascularized luminal tissue were graded at 4 to 14 days (initial), 4 to 12 weeks

2003 Annals of Thoracic Surgery

209. A method of augmenting the cheek area through SMAS, subSMAS, and subcutaneous tissue recruitment during facelift surgery. (Abstract)

horizontal mattress sutures and two interrupted sutures. Upon closure of this defect, SMAS, subSMAS, and subcutaneous tissue overlying the SMAS are recruited into the submalar defect by the simple phenomenon of dog-ear formation. Additionally, there is a component of frank elevation of the tissues inferior to the medial aspect of the fusiform and submalar space.The aforementioned technique has been performed on 123 patients over 7 years and has resulted in consistently good improvement in the submalar (...) implants, or a risky composite technique.An oval is scribed over the depressed submalar areas preoperatively. During facelift surgery, a fusiform area is scribed over the SMAS. This fusiform is scribed so that the medial end is directed at the center of the submalar depression, and the lateral end is toward the posterior earlobe. A defect is created within the lateral aspect of the fusiform, but not the medial portion. The fusiform is subsequently closed with a 2-0 Ethibond suture using three

2003 Dermatologic Surgery

210. Suture repair of pectus excavatum at the time of cardiac surgery on an infant. (Abstract)

Suture repair of pectus excavatum at the time of cardiac surgery on an infant. An 11-month-old girl was diagnosed with pulmonary atresia with intact ventricular septum and symmetrical pectus excavatum that had developed after prior palliative operation. We performed a transannular patch repair and atrial septal defect closure. Simultaneously, to prevent postoperative right ventricular outflow tract compression, the sternum was elevated by two 1-0 braided polyester horizontal mattress sutures

2008 Annals of Thoracic Surgery

211. The effect of suture pattern and tension on cutaneous blood flow as assessed by laser Doppler flowmetry in a pig model. (Abstract)

The effect of suture pattern and tension on cutaneous blood flow as assessed by laser Doppler flowmetry in a pig model. To determine the effects of various suture patterns on cutaneous blood flow (CBF) at the wound edge as increasing tension is applied through the suture.Four different suture patterns commonly used for wound closure (simple, vertical mattress, horizontal mattress, and Allgower-Donati) were placed individually after a full-thickness incision was made in an anesthetized pig (...) ). There were no significant differences between vertical mattress, horizontal mattress, and simple suture patterns.The Allgower-Donati suture pattern had the least effect on CBF with increasing tension in this model. Further study is warranted on the benefits of this suture pattern because it may decrease wound complications in traumatized tissues.

2008 Journal of Orthopaedic Trauma

212. Arthroscopic rotator cuff repair using a triple-loaded suture anchor and a modified Mason-Allen technique (Alex stitch). (Abstract)

of a combination of a horizontal mattress and 2 vertical simple sutures that are positioned medial to the mattress suture. The suture anchor used is the 5-mm self-tapping ThRevo (Linvatec). This anchor is loaded with 3 sutures: 2 No. 2 nonabsorbable braided polyester sutures of different colors and a central high-strength No. 2 polyethylene suture. The shape of the anchor eyelet permits all 3 sutures to glide freely. A modified Mason-Allen technique (Alex stitch) that combines a horizontal side-to-side suture (...) the center of the anchor; 1 is placed anterior and the other posterior. The sutures are tied through the lateral portal. The mattress horizontal central stitch is always tied first, followed by the 2 vertical sutures. The horizontal mattress suture serves as a "rip stop stitch" and theoretically reduces the possibility of cutting out of the simple sutures.

2007 Arthroscopy

213. Triple-loaded single-anchor stitch configurations: an analysis of cyclically loaded suture-tendon interface security. (Abstract)

central horizontal mattress suture passed deeper into the tendon, creating a larger footprint (bigfoot-print anchor); 2 peripheral simple stitches with 1 central horizontal mattress stitch passed through the same holes as the simple sutures (stitch-of-Burns); and 2 simple stitches (TwoVo anchor; Linvatec). The constructs were cyclically loaded between 10 N and 180 N for 3,500 cycles and then destructively tested. The number of cycles required to create a 5-mm gap and a 10-mm gap and the ultimate load (...) provide superior suture-tendon security than combinations of one mattress and two simple stitches subjected to cyclic loading. A central mattress stitch placed more medially than two peripheral simple stitches (bigfoot-print anchor) configured to enlarge the tendon-suture footprint was not as resistant to cyclic loading or destructive testing as three simple stitches (ThreeVo anchor).Placing a central mattress stitch more medially than 2 peripheral simple stitches to enlarge the tendon-suture

2006 Arthroscopy

214. Avoiding Early Revision Rhytidectomy: A Biomechanical Comparison of Tissue Plication Suture Techniques. (Abstract)

during rhytidectomy: a double-layered running locking (DRL) stitch and multiple horizontal mattress stitches.Fourteen horizontal mattress plications, in rows of six sutures, and comparable lengths of 16 DRL stitch plications of pig skin samples, were stressed using a tensometer with grip displacement increasing at a constant rate of 0.5 cm/Min. The required force to cause plication failure was recorded for each sample at three suture break points.There was no significant difference between the two (...) groups in the force required to cause the initial suture failure. Unlike the horizontal mattress plication, an initial break seemed to cause minimal to no distortion of the DRL tissue plication. When results were normalized by the initial break forces to account for small variations in tissue properties, the force ratio required to cause a second suture break was significantly larger in the DRL group than in the horizontal mattress technique. This is evidenced by the average second to first break

2008 Laryngoscope

215. Laparoscopic Repair of Diaphragmatic Defect By Total Intracorporeal Suturing: Clinical and Technical Considerations Full Text available with Trip Pro

guidance. The tube was kept clamped until the end of the procedure. Decreasing intraabdominal pneumoperitoneum pressure made suturing easier with less tension on the edges of the diaphragmatic incision. Nonabsorbable interrupted horizontal mattress sutures were placed to close the diaphragmatic defect.The repair was uneventful; no intraoperative complications occurred. Extubation was done at the end of the procedure in the operating room. The chest tube was removed on postoperative day 2 (...) Laparoscopic Repair of Diaphragmatic Defect By Total Intracorporeal Suturing: Clinical and Technical Considerations The use of laparoscopy in urology is increasing. Tumor of the kidney or adrenal gland and, in some cases, metastatic disease can involve the diaphragm. We describe the application of laparoscopic suturing techniques in the case of diaphragmatic involvement with a renal tumor.After resection of the tumor and a small area of the diaphragm, a chest tube was placed under laparoscopic

2001 JSLS : Journal of the Society of Laparoendoscopic Surgeons

216. Elongation and structural properties of meniscal repair using suture techniques in distraction and shear force scenarios: biomechanical evaluation using a cyclic loading protocol. (Abstract)

was found (P > .05).The results of the present study do not support the authors' hypothesis. In the shear force test, horizontal sutures were superior to vertical suture techniques.Meniscal repair with horizontal suture techniques can withstand elongation due to shear forces more effectively than can vertical mattress sutures. (...) will result in significantly less elongation when subjected to a cyclic loading protocol than that resulting from a horizontal suture technique.Controlled laboratory study.In fresh-frozen porcine menisci (n = 10 in each group), horizontal and vertical 2.0 Ethibond suturing techniques were tested in distraction and shear force scenarios. Elongation after 1000 cycles between 5 and 20 N and the structural properties such as stiffness, yield load, maximum load to failure, and failure mode were evaluated using

2006 American Journal of Sports Medicine

217. Biomechanical comparison of traditional and locked suture configurations for arthroscopic repairs of the rotator cuff. (Abstract)

Biomechanical comparison of traditional and locked suture configurations for arthroscopic repairs of the rotator cuff. The optimal suture configuration for arthroscopic rotator cuff repairs is controversial. "Locked" suture configurations, which use a combination of simple and transverse suture loops, have demonstrated better fixation strength than have traditional simple and horizontal mattress techniques.To compare traditional arthroscopic suture configurations to locked arthroscopic (...) configurations in ability to resist gap formation under cyclic loading.Controlled laboratory study.Crescent-shaped defects were created at the infraspinatus tendon insertion in 32 bovine shoulders. Four arthroscopic suture configurations were tested (8 specimens in each group): simple (group 1), horizontal mattress (group 2), locked mattress (group 3), and locked inverted mattress (group 4). A metal corkscrew suture anchor doubly loaded with No. 2 Fiberwire suture was used for the repairs. A cyclic loading

2006 American Journal of Sports Medicine

218. Biomechanical comparison of a single-row versus double-row suture anchor technique for rotator cuff repair. (Abstract)

, the supraspinatus tendon from 1 shoulder was repaired with a double-row suture anchor technique: 2 medial anchors with horizontal mattress sutures and 2 lateral anchors with simple sutures. The tendon from the contralateral shoulder was repaired using a single lateral row of 2 anchors with simple sutures. Each specimen underwent cyclic loading from 10 to 180 N for 200 cycles, followed by tensile testing to failure. Gap formation and strain over the footprint area were measured using a video digitizing system (...) Biomechanical comparison of a single-row versus double-row suture anchor technique for rotator cuff repair. Reestablishment of the native footprint during rotator cuff repair has been suggested as an important criterion for optimizing healing potential and fixation strength.A double-row rotator cuff footprint repair will demonstrate superior biomechanical properties compared with a single-row repair.Controlled laboratory study.In 9 matched pairs of fresh-frozen cadaveric shoulders

2006 American Journal of Sports Medicine

219. Biomechanical characteristics of single-row repair in comparison to double-row repair with consideration of the suture configuration and suture material Full Text available with Trip Pro

coupled with (1) braided, nonabsorbable polyester suture sized USP No. 2 (SRAE) or (2) braided polyblend polyethylene suture sized No. 2 (SRAH). The double-row repair was coupled with (3) USP No. 2 (DRAE) or (4) braided polyblend polyethylene suture No. 2 (DRAH). Arthroscopic Mason-Allen stitches were used (single-row) and combined with medial horizontal mattress stitches (double-row). Shoulders were cyclically loaded from 10 to 180 N. Displacement to gap formation of 5- and 10-mm at the repair site (...) different suture material (P > 0.05). Double-row suture anchor repair with arthroscopic Mason-Allen/medial mattress stitches provides initial strength superior to single-row repair with arthroscopic Mason-Allen stitches under isometric cyclic loading as well as under ultimate loading conditions. Our results support the concept of double-row fixation with arthroscopic Mason-Allen/medial mattress stitches in rotator cuff tears with improvement of initial fixation strength and ultimate tensile load. Use

2008 Knee Surgery, Sports Traumatology, Arthroscopy

220. Horizontal mattress with a knotless anchor to better recreate the normal superior labrum anatomy. (Abstract)

Horizontal mattress with a knotless anchor to better recreate the normal superior labrum anatomy. Arthroscopic repair of type II superior labral tears using suture anchors has resulted in a good to excellent outcome in most cases. In throwing athletes, however, the results have not been as consistent. Although it has not been reported in the literature, it is also possible that, in a very small number of throwers, the limited space in the glenohumeral joint combined with the bulky knots used (...) to secure the labrum to the anchor may be a cause of discomfort. In addition, the superior labrum is meniscoid in appearance, which traditional SLAP repair techniques do not recreate. We describe here a novel technique using a knotless anchor to repair the superior labrum, thereby eliminating the potential for knot-related complications. More importantly, this horizontal mattress-knotless anchor technique better recreates the normal meniscoid appearance of the superior labrum.

2008 Arthroscopy

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