Method for suturing skin with a double-row suture

FIELD: medicine, surgery.

SUBSTANCE: one should dissect epidermis up to derma along pre-set lines, perform deepidermization of the stripe of 55 mm width from the side of removed skin section, dissect derma as it is along stripe's edge and then - fatty fiber, apply subcutaneous buried interrupted sutures onto deepidermized stripe of derma by the following technique: perform puncture in into deepidermized skin stripe of one of the edges of skin wound from the side of subcutaneous fiber followed by puncture out at the distance of 1 mm against the edge of dissected epidermis. At another edge of skin wound one should make puncture in with a needle into deepidermized skin stripe at the distance of 1 mm against the edge of dissected epidermis and puncture out from the side of subcutaneous fiber. Then one should apply removable intracutaneous suture. The innovation enables to increase quality of derma healing.

EFFECT: decreased risk for skin deformation.

2 dwg, 1 ex

 

The invention relates to medicine, namely to operative surgery.

Stitching leather includes convergence, comparison and fixation of skin edges of wounds of different types of seams or metal brackets (Operative surgery and topographic anatomy / Ed. Ave. - 2nd ed. - M.: Medicine - 1985. - P.194). In plastic and aesthetic surgery is most commonly used noninvasive nutritionally seam, which allows you to get thin linear scar. However, if the stitching of the skin with some tension, for example by reduction mammaplasty, abdominoplasty, there is a threat of insolvency skin suture after removal intradermal or threads forming a wide linear scar in 3-4 months. In these cases, convergence and comparison of skin wound edges reach the imposition of a number of non-removable hub non-absorbable sutures in the dermis, and the fixation surface deleted continuous intradermal suture.

There is a method of stitching leather double-row suture proposed by the authors as a prototype (Belousov A. Plastic reconstructive and aesthetic surgery. - SPb.: The Hippocrates. - 1998. - S).

Skin impose double seams. Submersible hub seam of nerasseivayushchee material ensures intimate contact of the edges. Pricking atraumatic needle at a distance of 2 cm on the one of the corners of skin wounds produce vcol from subcutaneous tissue and Vicol in the dermis of one of the edges of the skin wound. Then on the other edge of the skin wound to produce vcol needles on the derma and Vicol from subcutaneous tissue. The ends of the ligature tied by immersing the ends of the yarn in the direction of the subcutaneous tissue. Next throughout wounds through 2 cm impose similar seams. Complete the operation by imposing continuous intradermal remove the seam.

Some disadvantages of this method are:

- when applying dip knotted suture may get into the seam heterogeneous tissues (actually the dermis, subcutaneous tissue), which affects their healing,

- due to the scarcity of proper dermis when applying submersible nodal joints possible deformation of the skin in the area of skin removed seam

- submersible nodal joints are located very superficially, therefore, possible dislocation thread on the surface of the skin, which in future will require the removal of the thread and will reduce the mechanical strength of the joint.

The authors suggest the following method stitching leather double-row suture, which can be used for stitching leather with any surgery, when in the course of the operation assumes removal of skin area, and the approximation of the skin edges of the wound occurs with tension.

In the beginning of the operation (figure 1) are sections of the epidermis (1) to the dermis (2) the planned lines (3). By remove skin (4) produce deshaus is iterminal strip width of 5 mm (5), on the edge which cut through the dermis (6) and then the subcutaneous fatty tissue (7).

When the operation completes on the skin impose two joints: hub-submersible and nutritionally continuous deleted. Submersible nodal joints of nerasseivayushchee material placed on epidermization strip itself of the dermis (figure 2). Pricking atraumatic needle (8) at a distance of 2 cm from the corner of cutaneous wounds produce vcol in epidermization strip the skin of one of the edges of the skin wound from subcutaneous tissue (9) and Vical at a distance of 1 mm from the cut edges of the epidermis (10). Then on the other edge of the skin wound to produce vcol needle in epidermization strip of skin at a distance of 1 mm from the cut edges of the epidermis (11) and Vical from subcutaneous tissue (12). The ends of the ligature tied by immersing the ends of the yarn in the direction of the subcutaneous tissue (13). Next throughout wounds through 2 cm impose similar seams. Complete the operation by imposing continuous intradermal remove the seam.

The advantages of this method are:

- when applying dip knotted suture stitched homogeneous tissue, which improves their healing,

- there is no shortage of actual dermis when applying submersible nodal joints, which reduces the risk of deformation of the skin in the area of skin removed seam

- ohrozenie anchor sutures are deep enough from the epidermis, therefore, the risk disposition of thread on the surface of the skin and its subsequent removal is reduced.

Clinical example. Patient Century, history No. 168 (surgery Center New clinic"). The operation of the reducing vertical mammaplasty.

Position the patient on his back. In the beginning of the operation prepares the edges of the skin wound to the subsequent imposition of a seam. To do this, when carrying out skin incisions along planned lines cut through the epidermis to the dermis. By remove skin produce epidermization strip width of 5 mm at the edge which cut through the dermis. After the operation completes on the skin impose double seams. Submersible nodal joints of nerasseivayushchee material placed on epidermization strip the actual dermis. Pricking atraumatic needle at a distance of 2 cm from the corner of cutaneous wounds produce vcol in epidermization strip the skin of one of the edges of the skin wound with hand subcutaneous tissue and Vicol at a distance of 1 mm from the cut edges of the epidermis. Then on the other edge of the skin wound to produce vcol needle in epidermization strip of skin at a distance of 1 mm from the cut edges of the epidermis and Vicol from subcutaneous tissue. The ends of the ligature tied by immersing the ends of the yarn in the direction of the subcutaneous tissue. Then throughout the wound 2 cm loser who provide similar seams. Complete the operation by imposing continuous intradermal remove the seam.

By using this method of stitching the skin in specific patient failed to improve the quality of fusion of the layer of the actual dermis, reduce the risk of deformation of the skin in the area intradermal remove the seam and the disposition of the parts of the threads submersible anchor sutures on the skin surface. This has improved weld quality leather, functional and aesthetic characteristics of the postoperative scar.

The method can be used for stitching leather with any surgery, when in the course of the operation assumes removal of skin area, and the approximation of the skin edges of the wound occurs with some tension.

The method of stitching leather double-row suture, including convergence, comparison and fixation of skin wound edges deleted continuous intradermal suture, wherein the overlay node submersible seam along planned lines cut through the epidermis to the dermis, by remove skin produce epidermization strip width of 5 mm at the edge which cut through the dermis and then the subcutaneous fatty tissue, when the operation completes subcutaneous submersible nodal joints impose on epidermization strip the actual dermis, and perform vcol in epidermization strip the skin of one of the edges of the skin wound with the parties subcutaneous tissue and Vicol at a distance of 1 mm from the cut edges of the epidermis, on the other edge of the skin wound to produce vcol needle in epidermization strip of skin at a distance of 1 mm from the cut edges of the epidermis and Vicol from subcutaneous tissue.



 

Same patents:

FIELD: medicine, surgery.

SUBSTANCE: one should apply a single-row uninterrupted suture upon skin and subcutaneous fiber, fix ligature in subcutaneous fiber in one of the wound's corners, apply a subcutaneous-intracutaneous suture up to the wound's opposite corner, form a knot in subcutaneous fiber with the help of terminal ligature of aponeurosis suture. The method enables to prevent purulent complications and provide the development of valuable cicatrix.

EFFECT: higher efficiency of suturing in post-operational wound.

1 dwg, 2 ex

FIELD: medicine; medical engineering.

SUBSTANCE: method involves implanting a ribbon into the body on each side of the urethra between the vaginal wall and abdominal wall. The ribbon is drawn above the pubic bone. The ribbon is introduced on both sides of the urethra to make a loop around the urethra. It is arranged on each side of the urethra between the vaginal wall and abdominal wall and stretched by pulling its ends brought outside of the abdominal wall. The ribbon is introduced pulling it inside through two holes produced in soft tissues with needle-shaped member using tubular envelope prefitted on the needle-shaped member. The tubular envelope is left in the hole when pulling the needle-shaped member from the hole in the direction reversed with respect to PIERCE direction. Ribbon is pulled into the hole in the introduced tubular envelope drawing the corresponding end. Then the tubular envelope is removed from the body in the direction of ribbon end. Surgical instrument has implantable ribbon and rod having handle on the first end with curved needle-shaped member on the second end and through hole on the free end with an ear which sizes are enough for passing from the internal surface of the vagina wall above the posterior back side of the pubic bone to the external surface of the abdominal wall. The instrument additionally has removable tubular envelope which dimensions allow the ribbon under implantation, moving through the hole. The removable tubular envelope is fittable over curved needle-shaped member as far as possible from the rod side to the prominent free end of the curved needle-shaped member projecting from the tubular envelope.

EFFECT: enhanced effectiveness of treatment; reduced instrument production costs; simplified design.

23 cl, 8 dwg

FIELD: medicine; traumatic surgery; orthopedics; neuron-surgery.

SUBSTANCE: device can also be used in rehabilitation surgery for curing nerve pipes. Extension has drive mechanism and traction unit, both disposed inside cylindrical case onto vertical axis. Case and cap have cylindrical shape. Drive mechanism is made in form of spring-loaded unit which has crown-shaped ring with beveled teeth and double-teeth pusher with single-sided beveled teeth connected by compression-torsion spring. Drive mechanism is installed of form of horizontal protrusions inside guides onto internal surface of case to provide movement of rest pins along circle onto horizontal arms of which pins it is placed. Under pressure applied to cap of case, reciprocal motion of cap transforms to interrupted rotational motion of coil in cheek of which coil the rest pins are fixed. Coil has flexible link fastened onto hub. Free end of flexible link is drawn outside through the hole in wall of case. Coil and hub compose traction unit being rigidly connected with axis of the extension. Lugs provided with holes are made in bottom of case.

EFFECT: reduced traumatism of surgical operation; better results of cure.

4 dwg

FIELD: medicine, surgery.

SUBSTANCE: one should apply a P-shaped suture, then it is necessary to form a V-shaped suture: one of the free ends of a ligature should be applied under the one that forms the top of letter P, then this ligature should be tightened and thrown over the wound as a Latin letter V. Then free ends of ligature should be tightened into the knot. The method enables to improve hemostasis and increase reliability of sutures.

EFFECT: higher efficiency.

3 dwg, 1 ex

FIELD: general surgery methods and facilities.

SUBSTANCE: material for various genesis, localization, and configuration defect grafting is made from thin (up to 100 mcm in diameter) titanium nickelid wire weaved into porous-permeable structure according to knitted-fabric and textile technology or by felting. Thanks to plasticity of titanium nickelid and quasiplasticity of woven structure, effective plasticity of material is many times superior to that in nonwoven porous sheet materials and meets requirements of congruent disposition of materials in organs and tissues to be operated.

EFFECT: increased plasticity of grafting material.

7 dwg

FIELD: medicine, abdominal surgery.

SUBSTANCE: one should perform marginal serous-muscular-submucous suturing for every wall of intestinal wound in oblique direction against cross-sectional intestinal axis being parallel to lateral branches of intraparietal intestinal vessels at an angle being opened towards mesenteric edge. Puncturing in and puncturing out of stitches at the serous membrane of every further suture should be performed being on the same line with puncturing in and puncturing out of stitches at the border of submucous and mucous layers of previous suture. Sutures should be tightened at forming the knots at serous membrane. The innovation suggested enables to decrease the frequency in developing failed sutures.

EFFECT: higher efficiency.

1 dwg

FIELD: medical engineering.

SUBSTANCE: device has handle having reel inside and casing having end for capturing needle. The handle has transverse reels and is connected to the hollow casing. Longitudinal bed bearing manipulation plate having lock and manipulation hook. The manipulation plate becomes a rod in its frontal part. Adaptation spring and eccentric pressed cone are put-on over the rod. The cone serves for fixing needle and reaches casing rest member. The rod comes in into opening of the rest member being convex ahead of it. Transverse concave groove is available near the rest member base for receiving curved surgical needle. The eccentric pressed cone base and the adaptation spring are covered with stabilizing buckle. Holes for passing thread ends are available above the buckle. Members for fixing ends of threads, coming from the reels placed in the handles, are arranged near the holes.

EFFECT: accelerated suturing process; retained suture material sterility; reduced thread consumption.

4 cl, 4 dwg

FIELD: medical engineering.

SUBSTANCE: method involves mounting implant on supporting platform. The platform is turned and moved about and along its longitudinal axis to enable one to arrange needle in any given position on implant surface. The needle is controllable in a way that the first thread is brought through the implant wall from the first side of the wall. The first loop is formed from the first loop on the second implant wall. The thread is brought through the loop. The loop is tightened to produce a stitch. The stage the thread is passed through the loop is carried out by means of device movable back and forth along longitudinal implant axis. The device additionally has at least one driving mechanism for turning and moving transplant platform about and along its longitudinal axis to enable one to arrange needle in any given position on implant surface and additional driving mechanism for passing thread through the loop back and forth along longitudinal implant axis. Main device head piece is movable into any required position as a result of implant-carrying cylinder rotation or axial displacement on implant surface.

EFFECT: wide range of functional applications; enabled fitting of anatomical tubes of different diameters in several points arranged on an axis.

11 cl, 7 dwg

FIELD: medical engineering.

SUBSTANCE: device has elongated body having operation end engageable with ligature loop, lateral slit for ligature to exit and movable rod, mounted in the device body, having operation end for holding the ligature. The elongated body has special purpose design to match endosurgical port or trocar lumen. The rod is spring-loaded and has nonworking end projecting from the device body as handle. The rod operation end is hook arranged in front of the lateral slit for ligature to exit and making displacement at a distance minimum equal to distance from operation body end to end face of slit for ligature to exit, oriented towards the handle.

EFFECT: improved tissue and organ engagement conditions; simplified maintenance procedure; accelerated operation process.

3 cl, 2 dwg

FIELD: medicine, surgery.

SUBSTANCE: the present innovation deals with treating patients with chronic ulcerous duodenal disease. One should cross main stems of anterior main gastric nerve and posterior main gastric nerve to skeletize then lesser curvature up to gastro-intestinal passage, cross gastro-diaphragmatic ligament, mobilize gastric bottom up to the first short vessels, open anterior esophageal semi-circumference by crossing esophago-diaphragmatic ligament; on removing patient's stomach against minor omentum one should treat posterior wall of cardial gastric part and abdominal esophageal department, cross gastro-pancreatic ligament, cross collaterals between anterior and posterior stems of vagus nerve at the level of abdominal esophageal section and form esophagofundoplicational cuff. The innovation enables to decrease the number of relapses of ulcerous disease due to decreasing acidity of gastric juice.

EFFECT: higher efficiency.

2 dwg, 1 ex

FIELD: medicine.

SUBSTANCE: method involves applying hydroxyapatite collagen material plate so that plate size is selected to be by 5-8 mm greater than trepanation opening.

EFFECT: enhanced effectiveness in making plastic repair of maxillary sinus; excluded allergic responses.

FIELD: medicine, cosmetology.

SUBSTANCE: one should carry out therapy including 3 stages, moreover, at the first 1-2-mo-long stage one should interrupt acute acne process and treatment of urogenital infection due to applying sanitation and antibacterial skin protection, at the second 3-5-mo-long stage it is necessary to conduct hygienic care for patient's skin by applying methods of ultrasound and chemical peeling to remove neoplasms caused by human papilloma virus, remove nevuses in operational area, perform treatment of keloid cicatrices to remove vaginal dysbiosis and urogenital diseases, at the third stage one should fulfill mechanic dermabrasion followed by post-operational 1-2-mo-long care, moreover, as antibacterial preparations during sanitation one should apply butol, after sanitation - butol and baneocin, and after epithelization of acne foci and vaginal epithelium - butol and butolol applied in pre-menstrual period not combining the use of the preparations mentioned with treating surface with alcohol- and metal-containing solutions. The present innovation provides decreased number of relapses due to interrupting inflammatory processes and normalizing diybiosis.

EFFECT: higher efficiency of therapy.

1 ex, 1 tbl

FIELD: medical equipment; surgical tools.

SUBSTANCE: device can be used for weight-reducing treatment. Device for miniaturizing stomach has retaining envelope inside which the working container made of elastic material is disposed. Working container has aid for endoscopic extraction, check valve and connecting member for plug-type connection with pipeline. Pipeline is connected with excess pressure source. Aid for endoscopic extraction is made in form of rib which has thickness being equal or bigger than 2/3 thickness of wall of working container and it is disposed inside recess. Any wall of recess equals at least to thickness of wall of working container. The aid can be also made in form flexible loop fastened to rib. Rib has thickness being equal or bigger than 2/3 thickness of wall of working container and it is disposed in recess. Each wall of the recess equals at least to thickness of wall of working container.

EFFECT: improved reliability of operation; simplified design; optimal way of interaction of walls of working container with adjacent tissues.

5 cl, 6 dwg

FIELD: medicine.

SUBSTANCE: method involves mobilizing the duodenum after having stated tumor resectability. Retrocaval, laterocaval, precaval, interaortic, preaortic lymphatic viae are dissected. The removable region and intramesenteric lymph collector are immobilized with additional iliocolic and middle colic artery ligation and skeletonization of a. mesemterica superior and right ureter. Retroperitoneal cellular tissue is withdrawn within the limits of right lumbar muscle. The preparation is excised in doing right-side hemicolonectomy.

EFFECT: enhanced effectiveness of treatment; radically removed tumor dissemination collectors.

FIELD: medicine, surgery.

SUBSTANCE: before operation one should detect the type of patient's constitution. Patient should be put onto his/her left side, in case of dolichomorphous type of constitution at the angle of 70°. In case of mesomorphous type - at the angle of 60°. And at brachymorphous type - at the angle of 50° against horizontal plane of operation table, moreover, the angle is open to anterior surface of patient's body. Then one should introduce trocars for desired manipulations, perform videothoracoscopic esophageal extirpation or resection. The innovation suggested enables to improve objective criteria for accessibility of the organ under removal.

EFFECT: higher efficiency of therapy.

3 dwg, 3 ex

FIELD: medicine.

SUBSTANCE: method involves setting two thoracoports into pleural cavity after determining fistula position using bronchoscope. Conducting thread is introduced through fibrobronchoscope canal. Draining tube is introduced through manipulation thoracoport and connected to suction unit. Fistula canal is catheterized along the conducting thread to a depth of 1.0 cm and glue suspension is supplied through it.

EFFECT: enhanced effectiveness of treatment; longer extent of fistula glue treatment.

5 dwg

FIELD: medicine, thoracic surgery, phthisiology, pulmonology.

SUBSTANCE: the present innovation deals with carrying out urgent and planned curative aid. For this purpose, one should pre-conduct puncturing of anterior tracheal wall along its median line being caudally against thyroid isthmus; then one should introduce a catheter with, at least, one lateral foramen at its working end into tracheal lumen to apply it into the main bronchus of affected lung to be installed so that its working end to be at the level of the upper-lobar bronchus mouth and its lateral foramen facing towards its side. Then comes the occlusion of the main bronchus of affected lung due to applying an obturator into corresponding bronchus followed by sanitation of tracheobronchial tree through the catheter - evacuation, washing and introduction of medicinal preparations. The innovation enables to decrease traumatism, provide reliable protection of healthy department of tracheobronchial tree.

EFFECT: higher efficiency of sanitation in case of different pulmonary diseases.

1 ex

FIELD: medical equipment.

SUBSTANCE: apparatus intends for surgical cure of children with inborn or acquired defects of pollex. Distraction apparatus has oval ring with holes, needles and profiled bracket with two lobes, provided with holes for needles. Bracket is fastened to distraction bar by nuts. Distraction bar passes through support plank, which is made to have working surface's slope of 25°. Plank is fixed in holes of oval ring by means of two bars and nuts to provide movement along those bars. Needles are fixed in holes of oval ring and lobes by means of screws. Distraction bar has flat side surface to match the hole in support plank for preventing rotation.

EFFECT: elongation of III middle metacarpal bone and proximal phalanx of pollex; adjustment of speed of distraction; reduced weight and size of construction.

1 dwg

FIELD: medicine, orthopedics, traumatology.

SUBSTANCE: one should perform correcting osteotomy of the middle third of radius at simultaneously cutting a periosteal fragment that continue the tendon of round pronator in distal direction to separate it against cortical part of radius not dissecting it against the site of fixation to replace it through developed defect in radius from volar side onto its rear side by simultaneously lengthening the muscle's power action lever due to osteotomic level that decreases traumatism of operation, prevents possibility for damaging inter-osseous membrane, excludes the necessity in destructing the integrity of round pronator and dissecting it against the tendon and improves its subsequent function as a supinator due to increased power action lever.

EFFECT: higher efficiency of therapy.

3 dwg, 1 ex

FIELD: medicine.

SUBSTANCE: method involves applying one or two parallel through draining tubes having lateral perforations. Flow lavage of the retroperitoneal space with antiseptic solutions is carried out via the perforations at room temperature and cooled solutions are administered concurrently with vacuum suction. Omental bursa is concurrently drained using the two parallel through draining tubes. Flow lavage of the omental bursa is carried out using these tubes.

EFFECT: enhanced effectiveness of treatment in healing pyo-inflammation foci.

5 cl, 1 dwg

Up!