The Experts below are selected from a list of 1869 Experts worldwide ranked by ideXlab platform
Jack L Kelly - One of the best experts on this subject based on the ideXlab platform.
-
use of a Barbed Suture tie over technique for skin graft dressings a case series
Archives of Plastic Surgery, 2015Co-Authors: Kenneth M Joyce, Cormac W Joyce, Jack L Kelly, Nicola A MahonAbstract:Background A tie-over dressing is the accepted method to secure skin grafts in order to prevent haematoma or seroma formation. We describe the novel application of a Barbed Suture tie-over for skin graft dressing. The barbs act as anchors in the skin so constant tensioning of the Suture is not required.
-
a Barbed Suture repair for flexor tendons a novel technique with no exposed barbs
Plastic and reconstructive surgery. Global open, 2014Co-Authors: Cormac W Joyce, Conor M Sugrue, Jeffrey C Y Chan, L Delgado, Dimitrios I Zeugolis, Seam M Carroll, Jack L KellyAbstract:Flexor tendon repair methods have evolved over the years, and multistrand core Suture techniques have become the gold standard repair technique. However, there is no widespread agreement over the ideal number of strands or Suture material used.1,2 Four-strand cruciate repair methods have grown in popularity and provide a compromise between complexity and strength.3 Despite refinements in repair methods and reduced rates of rupture, there are several drawbacks to traditional repair methods. The presence of a knot has been shown to be a weak point in the repair,4–7 and it also increases the cross-sectional area (CSA) at repair site, thereby adversely affecting gliding through the intricate pulley system.5,8 There is a theoretical disadvantage if locking configurations are used for repair, as they can act in a constricting manner that may have a negative impact on the vascularity and healing capabilities of the tendon.3,9,10 The advent of Barbed Suture technology could conceivably avoid some of the limitations of traditional repair methods. The potential advantage to Barbed Sutures for tendon repairs is that the load is distributed evenly throughout the intratendinous Suture length rather than creating stress points at the locking zones. Furthermore, this even distribution of load would reduce the constricting action of the Suture on the tendon.3 The use of a Barbed device for tendon repair was first described by McKenzie11 in 1967, but there has been little reported on their use until quite recently. There are now several commercially available Barbed Suture devices on the market, but they are not licensed for tendon repairs as of yet. Their main use has been in wound closure12,13 and abdominal14 and gynecological procedures.15 Barbed Suture devices have been described before for flexor tendon repairs,3,6,11,16–20 and the results have been promising. A major advantage in using Barbed Sutures is that there is no requirement for a knot. This creates a reduced CSA at the repair site and also permits a quicker repair.17 A major concern with most Barbed repair techniques described to date has been the presence of barbs on the outer surface of the tendon. These have the potential ability to cause attritional damage to the pulley system in vivo, which increases gliding resistance and promotes adhesion formation.3 We have compared a simple and quick Barbed Suture repair without any exposed barbs on the tendon surface to a traditional 4-stranded Adelaide repair using a monofilament Suture.21
-
a novel Barbed Suture tie over dressing for skin grafts a comparison with traditional techniques
Journal of Plastic Reconstructive and Aesthetic Surgery, 2014Co-Authors: Cormac W Joyce, Conor M Sugrue, Jeffrey C Y Chan, Kenneth M Joyce, Sean M Carroll, N Mahon, Peter Dockery, Jack L KellyAbstract:Summary Introduction Barbed Suture devices have a widespread application in plastic surgery. The unidirectional nature of the barbs facilitates a strong grip on tissues and reduces the need to constantly tension the Suture manually. We hypothesized that a Barbed Suture tie-over Suture to secure skin grafts would be quicker to perform than traditional tie-overs and would also exert a greater downward pressure on the skin graft. Methods Thirty uniform areas of skin were excised from a cadaver. A pressure transducer was placed on the wound bed and covered with the excised skin along with a mineral oil-soaked wool dressing to act as a bolster. Three different Sutures were used to secure the graft in place and the pressure was recorded. The tie-over techniques used were the classic silk tie-over, a running Vicryl Rapide™ tie-over and a running Barbed tie-over. Results The Barbed tie-over exerted the most downward pressure (82.8 ± 7.3 mmHg) compared to the silk (46 ± 4.85 mmHg) and the Vicryl Rapide™ (18.6 ± 2.4 mmHg). Furthermore, the Barbed tie-over was the quickest to perform (1:45 ± 22 s) when compared to the Vicryl Rapide™ (02:57 ± 27 s) and the silk tie-overs (04:26 ± 39 s). Conclusion Barbed Sutures are a viable option for securing skin grafts. They are quick to perform and provide significantly improved downward pressure on the skin graft. We feel that this technique would be especially suited to the sole operator as it can be carried out without the need of an assistant.
Cormac W Joyce - One of the best experts on this subject based on the ideXlab platform.
-
use of a Barbed Suture tie over technique for skin graft dressings a case series
Archives of Plastic Surgery, 2015Co-Authors: Kenneth M Joyce, Cormac W Joyce, Jack L Kelly, Nicola A MahonAbstract:Background A tie-over dressing is the accepted method to secure skin grafts in order to prevent haematoma or seroma formation. We describe the novel application of a Barbed Suture tie-over for skin graft dressing. The barbs act as anchors in the skin so constant tensioning of the Suture is not required.
-
a Barbed Suture repair for flexor tendons a novel technique with no exposed barbs
Plastic and reconstructive surgery. Global open, 2014Co-Authors: Cormac W Joyce, Conor M Sugrue, Jeffrey C Y Chan, L Delgado, Dimitrios I Zeugolis, Seam M Carroll, Jack L KellyAbstract:Flexor tendon repair methods have evolved over the years, and multistrand core Suture techniques have become the gold standard repair technique. However, there is no widespread agreement over the ideal number of strands or Suture material used.1,2 Four-strand cruciate repair methods have grown in popularity and provide a compromise between complexity and strength.3 Despite refinements in repair methods and reduced rates of rupture, there are several drawbacks to traditional repair methods. The presence of a knot has been shown to be a weak point in the repair,4–7 and it also increases the cross-sectional area (CSA) at repair site, thereby adversely affecting gliding through the intricate pulley system.5,8 There is a theoretical disadvantage if locking configurations are used for repair, as they can act in a constricting manner that may have a negative impact on the vascularity and healing capabilities of the tendon.3,9,10 The advent of Barbed Suture technology could conceivably avoid some of the limitations of traditional repair methods. The potential advantage to Barbed Sutures for tendon repairs is that the load is distributed evenly throughout the intratendinous Suture length rather than creating stress points at the locking zones. Furthermore, this even distribution of load would reduce the constricting action of the Suture on the tendon.3 The use of a Barbed device for tendon repair was first described by McKenzie11 in 1967, but there has been little reported on their use until quite recently. There are now several commercially available Barbed Suture devices on the market, but they are not licensed for tendon repairs as of yet. Their main use has been in wound closure12,13 and abdominal14 and gynecological procedures.15 Barbed Suture devices have been described before for flexor tendon repairs,3,6,11,16–20 and the results have been promising. A major advantage in using Barbed Sutures is that there is no requirement for a knot. This creates a reduced CSA at the repair site and also permits a quicker repair.17 A major concern with most Barbed repair techniques described to date has been the presence of barbs on the outer surface of the tendon. These have the potential ability to cause attritional damage to the pulley system in vivo, which increases gliding resistance and promotes adhesion formation.3 We have compared a simple and quick Barbed Suture repair without any exposed barbs on the tendon surface to a traditional 4-stranded Adelaide repair using a monofilament Suture.21
-
a novel Barbed Suture tie over dressing for skin grafts a comparison with traditional techniques
Journal of Plastic Reconstructive and Aesthetic Surgery, 2014Co-Authors: Cormac W Joyce, Conor M Sugrue, Jeffrey C Y Chan, Kenneth M Joyce, Sean M Carroll, N Mahon, Peter Dockery, Jack L KellyAbstract:Summary Introduction Barbed Suture devices have a widespread application in plastic surgery. The unidirectional nature of the barbs facilitates a strong grip on tissues and reduces the need to constantly tension the Suture manually. We hypothesized that a Barbed Suture tie-over Suture to secure skin grafts would be quicker to perform than traditional tie-overs and would also exert a greater downward pressure on the skin graft. Methods Thirty uniform areas of skin were excised from a cadaver. A pressure transducer was placed on the wound bed and covered with the excised skin along with a mineral oil-soaked wool dressing to act as a bolster. Three different Sutures were used to secure the graft in place and the pressure was recorded. The tie-over techniques used were the classic silk tie-over, a running Vicryl Rapide™ tie-over and a running Barbed tie-over. Results The Barbed tie-over exerted the most downward pressure (82.8 ± 7.3 mmHg) compared to the silk (46 ± 4.85 mmHg) and the Vicryl Rapide™ (18.6 ± 2.4 mmHg). Furthermore, the Barbed tie-over was the quickest to perform (1:45 ± 22 s) when compared to the Vicryl Rapide™ (02:57 ± 27 s) and the silk tie-overs (04:26 ± 39 s). Conclusion Barbed Sutures are a viable option for securing skin grafts. They are quick to perform and provide significantly improved downward pressure on the skin graft. We feel that this technique would be especially suited to the sole operator as it can be carried out without the need of an assistant.
-
flexor tendon repair a comparative study between a knotless Barbed Suture repair and a traditional four strand monofilament Suture repair
Journal of Hand Surgery (European Volume), 2014Co-Authors: Cormac W Joyce, K E Whately, J C Chan, M Murphy, Fergal J Obrien, Sean M CarrollAbstract:We compared the tensile strength of a novel knotless Barbed Suture method with a traditional four-strand Adelaide technique for flexor tendon repairs. Forty fresh porcine flexor tendons were transe...
Richard D Goldner - One of the best experts on this subject based on the ideXlab platform.
-
a knotless flexor tendon repair technique using a bidirectional Barbed Suture an ex vivo comparison of three methods
Plastic and Reconstructive Surgery, 2011Co-Authors: W Mcclellan, Matthew J Schessler, David S Ruch, L S Levin, Richard D GoldnerAbstract:Background: Flexor tendon repairs using conventional Suture require knots that enlarge the cross-sectional area at the repair site. This enlargement increases the force of finger flexion and jeopardizes the integrity of a nascent tendon repair during rehabilitation. The authors hypothesized that a knotless flexor tendon repair using bidirectional Barbed Suture has similar strength and with reduced cross-sectional area compared with traditional techniques. Methods: Sixty-six fresh porcine flexor digitorum profundus tendons were divided randomly into three groups. Tendons were transected and repaired with one of the following techniques: two-strand Kessler technique, four-strand Savage technique, or four-strand knotless technique. The cross-sectional area of each tendon was calculated at the repair site before and after repair. All tendons underwent mechanical testing to assess the 2-mm-gap formation force and ultimate strength. Results: The 2-mm-gap formation force and ultimate strength of the Savage and knotless technique groups were not significantly different; however, both were significantly greater than those of the Kessler repair group (p Conclusions: The authors demonstrate that knotless flexor tendon repair with Barbed Suture has equivalent strength and reduced repair-site cross-sectional area compared with traditional techniques. The smaller tendon profile may decrease gliding resistance, thus reducing the risk for postsurgical tendon rupture during rehabilitation.
Sean M Carroll - One of the best experts on this subject based on the ideXlab platform.
-
a novel Barbed Suture tie over dressing for skin grafts a comparison with traditional techniques
Journal of Plastic Reconstructive and Aesthetic Surgery, 2014Co-Authors: Cormac W Joyce, Conor M Sugrue, Jeffrey C Y Chan, Kenneth M Joyce, Sean M Carroll, N Mahon, Peter Dockery, Jack L KellyAbstract:Summary Introduction Barbed Suture devices have a widespread application in plastic surgery. The unidirectional nature of the barbs facilitates a strong grip on tissues and reduces the need to constantly tension the Suture manually. We hypothesized that a Barbed Suture tie-over Suture to secure skin grafts would be quicker to perform than traditional tie-overs and would also exert a greater downward pressure on the skin graft. Methods Thirty uniform areas of skin were excised from a cadaver. A pressure transducer was placed on the wound bed and covered with the excised skin along with a mineral oil-soaked wool dressing to act as a bolster. Three different Sutures were used to secure the graft in place and the pressure was recorded. The tie-over techniques used were the classic silk tie-over, a running Vicryl Rapide™ tie-over and a running Barbed tie-over. Results The Barbed tie-over exerted the most downward pressure (82.8 ± 7.3 mmHg) compared to the silk (46 ± 4.85 mmHg) and the Vicryl Rapide™ (18.6 ± 2.4 mmHg). Furthermore, the Barbed tie-over was the quickest to perform (1:45 ± 22 s) when compared to the Vicryl Rapide™ (02:57 ± 27 s) and the silk tie-overs (04:26 ± 39 s). Conclusion Barbed Sutures are a viable option for securing skin grafts. They are quick to perform and provide significantly improved downward pressure on the skin graft. We feel that this technique would be especially suited to the sole operator as it can be carried out without the need of an assistant.
-
flexor tendon repair a comparative study between a knotless Barbed Suture repair and a traditional four strand monofilament Suture repair
Journal of Hand Surgery (European Volume), 2014Co-Authors: Cormac W Joyce, K E Whately, J C Chan, M Murphy, Fergal J Obrien, Sean M CarrollAbstract:We compared the tensile strength of a novel knotless Barbed Suture method with a traditional four-strand Adelaide technique for flexor tendon repairs. Forty fresh porcine flexor tendons were transe...
Alan Tyroch - One of the best experts on this subject based on the ideXlab platform.
-
Small bowel obstructions following the use of Barbed Suture: a review of the literature and analysis of the MAUDE database
Surgical Endoscopy, 2020Co-Authors: Benjamin Clapp, William Klingsporn, Carlos Lodeiro, Ellen Wicker, Loyd Christensen, Robert Jones, Alan TyrochAbstract:Background Barbed Suture has been adopted across all surgical specialties. One of the infrequent complications seen with the use of Barbed Suture is small bowel obstructions (SBOs). In this study, we perform a review of the literature and the Manufacturer and User Facility Device Experience Database (MAUDE) to characterize SBOs after the use of Barbed Sutures in a variety of operative procedures. Methods A review of the literature was performed by searching PubMed and Ovid. We used the search terms: “Barbed,” “Suture,” “bowel,” and “obstructions.” For each case report, we examined the initial surgical procedure, type of Barbed Suture used, the type of complication, the time to complication, the presentation, and the type of operative interventions required. We did the same with the MAUDE database. Results Our review of the literature revealed 18 different cases of SBO secondary to the use of Barbed Suture. The four most common procedures, with a total of four cases each, were inguinal hernia procedures, myomectomy, hysterectomy, and pelvic floor reconstructive procedures. The average time of presentation to SBO was found to be 26.3 days post-op (1–196 days). A total of 16 patients (88.9%) presented with abdominal pain. Other common complaints included vomiting (33.3%), abdominal distension (27.8%), oral intolerance (22.2%), and constipation (16.7%). A total of 5 cases were also found to have a possible volvulus on computed tomography (CT), and 2 cases were reported to have strangulation. The MAUDE database had 14 cases reporting on obstruction. Conclusions Surgeons should have a high index of suspicion for SBO if a patient presents with obstructive symptoms after a surgery that used Barbed Suture. This will often present as a mesenteric volvulus on CT. These particular SBOs require operative exploration, with laparoscopy being successful in the majority of cases.
-
small bowel obstructions following the use of Barbed Suture a review of the literature and analysis of the maude database
Surgical Endoscopy and Other Interventional Techniques, 2020Co-Authors: Benjamin Clapp, William Klingsporn, Carlos Lodeiro, Ellen Wicker, Loyd Christensen, Robert Paul Jones, Alan TyrochAbstract:Background Barbed Suture has been adopted across all surgical specialties. One of the infrequent complications seen with the use of Barbed Suture is small bowel obstructions (SBOs). In this study, we perform a review of the literature and the Manufacturer and User Facility Device Experience Database (MAUDE) to characterize SBOs after the use of Barbed Sutures in a variety of operative procedures.
