The Experts below are selected from a list of 60 Experts worldwide ranked by ideXlab platform
Divya Selvaraju - One of the best experts on this subject based on the ideXlab platform.
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comparative study of episiotomy repair Absorbable Synthetic versus chromic catgut Suture material
International journal of reproduction contraception obstetrics and gynecology, 2017Co-Authors: Devika Perumal, Divya SelvarajuAbstract:Background: The choice of Suture material for repair of episiotomy or perineal laceration is largely of one’s personal preference. Chromic catgut was widely used in most institutions. It now appears that chromic catgut is associated with more postpartum discomfort and hence chromic catgut has been largely replaced by Synthetic Absorbable materials like polyglactin and polyglycolic acid. Methods: The study was conducted in Institute of Social Obstetrics and Government Kasturba Gandhi Hospital, Chennai. This is a prospective, comparative study involving two groups. The use of a rapidly absorbing form of Synthetic Absorbable Suture material, in the repair of episiotomy or perineal laceration in 100 patients during the study period February 2012 to July 2012, were simultaneously compared with the traditional natural Absorbable Suture material. Results: With the use of rapidly absorbing polyglactin 910, there was a significant reduction (p=0.000) in the short-term pain, 19 compared to 80 in the control group. With regard to wound dehiscence and the need for resuturing, there was statistically significant difference in the control group (15%) compared to the study group (0%). There was no statistical significance between the two groups in terms of dyspareunia (12.4% vs 10.7%). Conclusions: Fast-absorbing form of Polyglactin seems to be effective in reducing some of the morbidity associated with perineal repair following childbirth. There was significant reduction in the short-term pain and the need for analgesia. The incidence of wound dehiscence was markedly reduced.
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Comparative study of Episiotomy Repair: Absorbable Synthetic Versus Chromic Catgut Suture material
2013Co-Authors: Divya SelvarajuAbstract:INTRODUCTION : Perineal trauma is the most commonly encountered surgery in the day-today practice of an obstetrician. It can be either a spontaneous tear or a surgical (episiotomy) enlargement of the pelvic soft tissue outlet during the last phase of second stage of labor or delivery. The first surgical opening of the perineum in order to prevent severe perineal tear was suggested by Ould, in 1741. However, the first publication in a medical journal about episiotomy was only in 1810. Prevalence of the episiotomy varies around the world depending on whether it is used as a routine or a restricted procedure. Rates vary from 8% in the Netherlands, 13% in England to 25% in USA. The rates are still higher in developing countries, like ours, since the use of restricted episiotomy is not being practiced widely in primigravidas. Although the Cochrane Database Review has now recommended the practice of restrictive episiotomy, routine use of it still continues in most of our maternity units. Prevalence rate of 54.9% and 99% have been reported in West African countries and East European countries respectively. Perineal trauma affects the physical, mental and social well-being of the mother in her peurperium. A large proportion of women suffer short term perineal pain and up to 20% have long term problems like dyspareunia. Other complications involve removal of retained Suture material, wound dehiscence and re-suturing. AIM OF THIS STUDY: To compare Absorbable Synthetic Sutures with chromic catgut Sutures for episiotomy repair with respect to pain, analgesic requirement, wound dehiscense, removal of residual Suture material, long term pain & superficial dyspareunia. PRIMARY OBJECTIVE: Whether the Synthetic Absorbable Suture material is better than the natural Absorbable Suture material in relieving the postpartum morbidity associated with episiotomy or perineal laceration repair. PRIMARY OUTCOME : Early short term pain ( up to 48 hrs) • Late short term pain ( up to 7 days) • Use of Analgesia. SECONDARY OUTCOME: • Long term pain • Nature of wound healing • Need for re-suturing • Removal of unabsorbed Suture material INCLUSION CRITERIA: • All patients with an elective episiotomy • Second degree perineal laceration EXCLUSION CRITERIA : Episiotomy incisions extended by instrumental deliveries • Severe anemia • Diabetes mellitus • On drugs like steroids & immunosuppressant • Epidural labor analgesia • Women whose membranes had ruptured for >24hrs • Patients with foul smelling vaginal discharge. MATERIALS AND METHODS: The study was conducted in Institute of Social Obstetrics and Govt. Kasturba Gandhi Hospital, Triplicane, Chennai-5. This is a prospective, comparative study involving two groups of patients selected randomly as per the inclusion criteria. Each group will have 100 women. A) Polyglactin 910 (Fast-absorbing) – group I, B) Chromic catgut – group II. All women in the reproductive age group, attending the Government Kasturba Gandhi Hospital, who had a normal vaginal delivery, requiring an episiotomy or had a second degree perineal tear, were eligible to enter the trail. Enrolment took place immediately after delivery, after taking their consent. All episiotomies were repaired using the same technique: single continuous sub-cuticular perineal Sutures, by the post-graduates. Mothers were interviewed at 48hrs, 7days, 15days, 6 and 12 wks regarding perineal pain perception, analgesic requirement and dysparuenia. Local examination was done for nature of healing. RESULTS AND ANALYSIS: This study commenced with 100 women in each group who underwent episiotomy or perineal laceration repair. None of the patients in our study had epidural analgesia for pain relief in labor. In our study, all the perineal repairs were performed under local anesthesia by the post graduates in the labor ward. Descriptive statistics were utilized and all results are presented in terms of percentages. Categorical data were compared using Chi Square Test or Fischer’s Exact Test if appropriate. Statistical significance was p
Devika Perumal - One of the best experts on this subject based on the ideXlab platform.
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comparative study of episiotomy repair Absorbable Synthetic versus chromic catgut Suture material
International journal of reproduction contraception obstetrics and gynecology, 2017Co-Authors: Devika Perumal, Divya SelvarajuAbstract:Background: The choice of Suture material for repair of episiotomy or perineal laceration is largely of one’s personal preference. Chromic catgut was widely used in most institutions. It now appears that chromic catgut is associated with more postpartum discomfort and hence chromic catgut has been largely replaced by Synthetic Absorbable materials like polyglactin and polyglycolic acid. Methods: The study was conducted in Institute of Social Obstetrics and Government Kasturba Gandhi Hospital, Chennai. This is a prospective, comparative study involving two groups. The use of a rapidly absorbing form of Synthetic Absorbable Suture material, in the repair of episiotomy or perineal laceration in 100 patients during the study period February 2012 to July 2012, were simultaneously compared with the traditional natural Absorbable Suture material. Results: With the use of rapidly absorbing polyglactin 910, there was a significant reduction (p=0.000) in the short-term pain, 19 compared to 80 in the control group. With regard to wound dehiscence and the need for resuturing, there was statistically significant difference in the control group (15%) compared to the study group (0%). There was no statistical significance between the two groups in terms of dyspareunia (12.4% vs 10.7%). Conclusions: Fast-absorbing form of Polyglactin seems to be effective in reducing some of the morbidity associated with perineal repair following childbirth. There was significant reduction in the short-term pain and the need for analgesia. The incidence of wound dehiscence was markedly reduced.
Forestieri P - One of the best experts on this subject based on the ideXlab platform.
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Comparison of five Synthetic Absorbable Suture materials in intestinal anastomosis: experimental study in rats
Chirurgia italiana, 2003Co-Authors: De Werra C, Rendano F, D'armiento F, Somma P, Forestieri PAbstract:The purpose of this experimental study was to evaluate the efficacy of five Synthetic Absorbable Suture materials in intestinal anastomoses in rats together with their interference with the normal physiopathological cicatrization process. The materials analysed were polyglycolic acid (Dexon), polygluconate (Maxon), polydioxanone (PDS), polygalactic acid (Vycril) and Glycomer 631 (Byosin). An anatomopathological study, performed in three groups of rats undergoing postmortem examinations after 6, 20 and 90 days showed that the least interference was caused by Glycomer 631, while polyglycolic acid and polygluconate yielded very good results though giving rise to a greater fibrous component. Polydioxanone and polygalactic acid yielded less satisfactory results. In addition, immunohistochemical techniques were applied to Glycomer 631. The evaluation of the surgical characteristics enabled us to divide the materials studied into two different groups, one in which characteristics such as smoothness and elasticity (Glycomer 631, polygluconate and polydioxanone) prevailed, and the second in which ease of knotting, stitch resistance, memory and lower cost (polyglycolic acid, polygalactic acid and Glycomer 63) prevailed. A general assessment showed better results for polyglycolic acid and Glycomer 631, while the other three materials presented slightly inferior performance, particularly polygalactic acid (inferior stitch resistance).
Ashish Sham Nichani - One of the best experts on this subject based on the ideXlab platform.
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evaluation of tensile strength of surgical Synthetic Absorbable Suture materials an in vitro study
Journal of Periodontal & Implant Science, 2013Co-Authors: Sujeet V Khiste, V Ranganath, Ashish Sham NichaniAbstract:Purpose: The purpose of this study was to evaluate the tensile strength of surgical Synthetic Absorbable Sutures over a period of 14 days under simulated oral conditions. Methods: Three Suture materials (polyglycolic acid [PGA], polyglactin [PG] 910, and poly (glycolide-co-є-caprolactone) [PGC]) were used in 4-0 and 5-0 gauges. 210 Suture samples (35 of each material and gauge) were used. All of the samples were tested preimmersion and 1 hour and 1, 3, 7, 10, and 14 days postimmersion. The tensile strength of each Suture material and gauge was assessed. The point of breakage and the resorption pattern of the Sutures were also assessed. Results: During the first 24 hours of immersion, all 4-0 and 5-0 samples of PGA, PG 910, and PGC maintained their initial tensile strength. At baseline (preimmersion), there was a statistically significant (P < 0.001) difference in the tensile strengths between the 4-0 and 5-0 gauge of PGA, PG 910, and PGC. PGA 4-0 showed the highest tensile strength until day 10. At 7 days, all the 4-0 Sutures of the three materials had maintained their tensile strength with PGA 4-0 having significantly greater (P = 0.003) tensile strength compared to PG. Conclusions: 4-0 Sutures are stronger and have greater tensile strength than 5-0 Sutures. The PGA 4-0 Suture showed the highest tensile strength at the end of day 10.
S T Irwi - One of the best experts on this subject based on the ideXlab platform.
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irradiated polyglactin 910 a new Synthetic Absorbable Suture
Journal of The Royal College of Surgeons of Edinburgh, 1995Co-Authors: S C Tando, J Kelly, M Turtle, S T IrwiAbstract:Two hundred and thirty-six patients had a variety of skin and mucosal wounds Sutured with a new rapidly absorbed Suture material (irradiated polyglactin 910). No wound complications could be attributed to the material. These included 62 patients with scalp wounds, taking part in a comparative trial with traditional interrupted, monofilament, non-Absorbable suturing. No difference in the cosmetic result could be detected three months later. The irradiated polyglactin disappeared from the wound surface spontaneously and Suture removal was not normally required. Irradiated polyglactin 910 is suitable for closure of wounds where rapid Suture absorption is desirable, particularly for wounds in the scalp, scrotum, and perineum and is an ideal material for mucocutaneous anastomosis at stoma surgery. Loss of Suture strength is so rapid that Suture removal is unnecessary, eliminating the need for further medical or paramedical care. As absorption is by hydrolysis rather than enzymatic digestion, stitch abscesses are not seen.
