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Sutures of the Skull

Sutures of the Skull

The human skull is composed of several bones that come together to protect the brain and support the structures of the face. The junctions where these bones meet are called sutures.
Sutures are immobile joints between adjacent bones of the skull. The narrow gap between the bones is filled with dense, fibrous connective tissue that unites the bones. The long sutures located between the skull bones are not straight but instead follow irregular, tightly twisting paths. These twisting lines tightly...

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Knotless Independent Double-Row Repair and Biceps Augmentation for Anterosuperior Rotator Cuff Tears

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The double loop mattress suture.

John Biddlestone¹, Madan Samuel, Terry Creagh

¹CRUK Clinical Research Fellow, Centre for Gene Regulation and Expression, College of Life Sciences, University of Dundee, Dundee, United Kingdom; Honorary Speciality Registrar, Department for Plastic and Reconstructive Surgery, Ninewells Hospital, Dundee, United Kingdom.

Wound Repair and Regeneration : Official Publication of the Wound Healing Society [And] the European Tissue Repair Society

|April 5, 2014

Summary

This summary is machine-generated.

A new double loop mattress stitch offers a high-strength, low-tension wound repair. This innovative technique significantly reduces tissue tension and improves wound healing, minimizing complications in surgical closures.

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Area of Science:

Surgical Innovation
Wound Healing Research
Biomedical Engineering

Background:

Local wound complications are often linked to interrupted stitch types.
Developing sutures with favorable tissue characteristics is crucial for reducing these complications.
Existing interrupted closure methods may not offer optimal strength and tension balance.

Purpose of the Study:

To introduce and evaluate a novel high-strength, low-tension interrupted suture: the double loop mattress stitch.
To compare the performance of the double loop mattress stitch against other interrupted closure methods.
To assess the efficacy of the double loop mattress stitch in various tissue types and in vivo settings.

Main Methods:

Experimental comparison of the double loop mattress stitch with simple, mattress, and loop mattress sutures in porcine cartilage and skeletal muscle.
Utilized a novel porcine loading chamber and mechanical model for in vitro testing.
Assessed wound apposition via electron microscopy and in vivo performance in 805 pediatric laparotomies/laparoscopies.
Evaluated wound eversion, dehiscence, and stitch extrusion.

Main Results:

The double loop mattress suture demonstrated 3.5 times greater strength in muscle and 1.6 times in cartilage compared to the loop mattress (p≤0.001).
It reduced tissue tension by 66%, significantly more than the loop mattress's 53% (p≤0.001).
In vivo, it performed comparably to the loop mattress and superiorly to the mattress stitch regarding wound eversion and dehiscence, with no stitch extrusion episodes.

Conclusions:

The double loop mattress stitch offers superior strength and reduced tissue tension due to its intrinsic pulley arrangement.
This novel stitch type enhances wound repair by minimizing complications like dehiscence.
The double loop mattress stitch is recommended for all surgical disciplines requiring high-strength, low-tension wound closure.