Polypropylène (Prolène). Monofilament vs Multifilament. Polyglactin 910 sutures Multifilamentous sutures come in braided and twisted types. *$( %2%(,-/0/#484.7*./.�� C ?Z�(��Dq�I�#�~-��=��r���h�W��0f�4�EGki�&?�������!��g� �աƵ�}V��H�\F>�������z�k�[������Ϧ�����>��u 6�����1�~=E�� These, too, can be periosteal or nonperiosteal: 1. Conclusions: Les sutures peuvent être divisées en deux types: celles qui sont résorbables et qui se décomposent de manière inoffensive dans le corps au fil du temps sans intervention et celles qui ne le sont pas et doivent être retirées manuellement si elles ne sont pas laissées indéfiniment. Among many others, additional types of sutures include running sutures and mattress sutures. << simple sutures are placed in succession without tying or cutting the suture material after each pass. Suture materials and subsequent,          ,           ,     ,       , Setzen G, Willams EF. Women who had SS were at 6.93 times higher risk of wound infection than those who had PGA sutures (p=0.014). Extensive Literature Search on the bioavailability of selected trace elements in animal nutrition: I... Unravelling positive aspects of caregiving in dementia: An integrative review of research literature. It has drawbacks like poor knot security and poor stability in alkaline environment. This suture is degraded by hydrolysis. Some sutures are double-armed; they are armed with two needles, one at each end of the thread. STUDY DESIGN: A randomised, controlled, prospective study was undertaken. All cross-sectional, cohort studies and case-control studies reporting on the prevalence, incidence, etiologies, treatment, prognosis, admission rates, mortality, and economic burden of HF in pediatric populations in LMICs will be included in the review. pdf. The residual tensile strength of a polyglactin 910[4] suture is consistently greater than that of polyglycolic acid suture. The maximum tensile force withstood for untwisted sutures was determined: polydioxanone failed at a tensile force of 116.4±0.84 N, polyglactin failed at 113.9±2.4 N, polypropylene failed at 71.1±1.5 N and nylon failed at 61.8±0.5 N. Twisting decreased the maximum tensile force of all sutures; one complete twist per 10 mm (i.e., 15 twists) decreased the tensile strength of polydioxanone by 21%, polyglactin by 23%, polypropylene by 16% and nylon by 13%, p<0.001. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested external skin sutures may be preferred for closure of incisions under tension to reduce risk of dehiscence. In most cases, three weeks is sufficient for the wound to close firmly. cluded needle types, 35 used curved needles and 10 straight needles. Pour télécharger : CLIQUEZ ICI. Different types of sutures available for a wide variety of surgeries based on absorption, braiding structure, dyeing and coating materials. factors predicting this phenomenon among family caregivers of dementia patients, with the ultimate purpose of gaining insights to explain how and why it emerges. The methodological quality of included studies will be appraised accordingly. 6 0 obj Determining the association between the procedure efficacy and the needle types was difficult because various types of needles were used during the UCSs; thus, we focused on the differences among suture types. /Subtype /Image Ces types de sutures peuvent généralement être utilisés pour la réparation des tissus mous, y compris pour les procédures cardiovasculaires et neurologiques. Independent sling suture 2. stream Stents were removed after euthanasia, and their surface morphology and molecular weight were evaluated. Sutures of biological origin (eg,surgical gut, plain and chromic gut) are gradually digested by enzymes in thetissue, whereas resorbable sutures fabricated from synthetic materials such aspolygycolic acid are hydrolyzed via the Krebs cycle.2 Surgical gut suture materialis made from animal protein (ie, gut), thus it can potentially induce an antigenicreaction.6 When used intraorally, this material loses most of … Specimens were mounted in a calibrated material testing machine and distracted until suture line failure. A biomechanical study of pediatric flexor profundus tendon repair. Comparing the tensile strengths of 3 suture techniques. The key findings are that positive aspects of caregiving among family caregivers of dementia patients form a multi-dimensional construct which covers four key domains: a sense of personal accomplishment and gratification, feelings of mutuality in a dyadic relationship, an increase of family cohesion and functionality, and a sense of personal growth and purpose in life. A total of 3862 articles were identified, of which 41 were included in this review. The purpose of our study was to create a biomechanical model used to evaluate the bulky knot of a looped suture as it may be weaker, resulting in greater deformation. Another group has shown a reduction in deep and superficial SWI with gentamicin implant, in an RCT on 800 patients, however have not published details of the complete trial. Catégorie : Cour de médecine. Materials and methods: �� � } !1AQa"q2���#B��R��$3br� The line of stitches is completed by tying a knot after the last pass at the end of the suture line. Based on Timing. RESULTS: A total of 1 100 women was assigned randomly into 3 groups: polyglycolic acid (PGA) suture group (N=361), skin staple (SS) group (N=373) and nylon suture group (N=366). On … (�� Format : PDF. mystery of placing and tying sutures. Data quality from all Three properties of a suture material affect its handling: memory, elasticity and knot strength. There was no difference in respect of number of patients, age, parity and gestation between the study groups. Synthetic Absorbable Sutures: Braided filaments - polyglycolic acid (P.G.A), PGA is absorbed by hydrolysis (hydrophobic), good tensile strength (resist muscle pull), bacterial growth inhibition, mild tissue reaction, and resorption rate from 21 to 28 days. The available studies are heterogeneous in design. �ς����潨i�t��σ������n���Z"�6���K9l{�y���O�b���i{V&��M[��G�~�/�ȿUQ@Š(��(��(��(��(��(��(��(��(��(��(��(��(��(��(����("yeuH�e�� ��{�6�m���pɨ��}�;~X{�����3�뒭ߋ�ı���bD)����GK�B\�!����R��� {����I�:\��R�T��d&;hϲ�S]tCm Sutures are made from both man-made and natural materials. In other categories (e.g., "freedom from pain", "fitness", and "energy"), some of the studies revealed worsening after the operation. Conclusion: ��������j=濐�O�x�+����Gj�:*�G����g'����������I/��?4��o�s6��X�Kx^R?��h�h�샗�8� �G�S.EύgǤ1ǏƏ�D�&��H� �l��+���y"8� �C��p�� ��� a systematic literature search that was carried out in the PubMed, EMBASE, Web of Science, and PsycINFO databases in March 2017. databases (i.e., PubMed, Scopus and ISI Web of A database in MS Excel format, recording the most important items derived from the selection process, was obtained. , is unpredictable. These differences between sutures may impact choices for a suture type selected for these repairs. b. Available in two types: a. Dexon®: Non-toxic coating or uncoted, violet or undyed. - Support de Cours (Version PDF) - Figure 21 : Propriétés du Gore-Tex II LES COLLES CHIRURGICALES Elles ont pour but de suturer de façon simple et atraumatique. Stent placement was technically successful in all dogs. The selection of the type of suture depends on the tissue and anatomical location. Natural suture materials include silk, linen, and catgut, which is actually the dried and treated intestine of a cow or sheep. To investigate the tensile strength of repaired flexor profundus tendons in young lambs, which would be equivalent to repairs in children older than 2 years of age. A systematic search of the literature was undertaken in the databases OvidMedline, CINAHL, PsycINFO, Web of Science and Scopus, using the keywords 'care* AND Alzheimer OR dementia AND 'positive aspect' OR 'positive experience' OR 'positive perceptions' OR reward OR gain OR 'satisfaction with care*' OR 'care* satisfaction' OR benefit OR uplift OR meaning OR enjoyment OR pleasure OR growth OR hope OR gratification. The Critical Appraisal Skills Programme checklists for qualitative and cohort studies were used to evaluate data quality. Results: Results: Mean tensile strength at skin-edge separation and suture-line failure for the simple interrupted and cruciate patterns were significantly higher than those for the intradermal and subdermal patterns. Spécialité : La Chirurgie. Les fils de sutures . However, the most recent multicentre RCT conducted on 1052 patients showed no benefit of gentamicin-collagen sponges in elective surgery (coronary artery bypass grafting and/or valve surgery) in high-risk patients with diabetes, obesity or both. %���� One RCT showed that gentamicin sponges may cause increased sternal rebleeding if used in double layers. Plus de cours de médecine : Instruments utilisés en chirurgie .pdf; All rights reserved. We conclude that most randomized controlled trials (RCTs) have been performed with gentamicin-collagen sponges for sternal closure. Current studies indicate that quality of life improves after sex reassign- ment surgery. The key instruments and materials used for intraoral suturing are presented. (�� By integrating the findings about the nature and conditions predicting positive aspects of caregiving, the presence of three conditions was identified as promoting the emergence of such qualities i) personal and social affirmation of role fulfilment, ii) effective cognitive emotional regulation and iii) contexts which favour finding meaning in the caregiving process. This simplifies repairs, but the knot remains a potential weakness. This suture can be supplied in an antibiotic form by impregnating with triclosan. �F�(��(��(��(��(��(��(��(��*9e��Y]R5,� P���q�[9f{]��[�_���b%?�Hx^j1���Y�Q�`ѭ��XX ��2��U���G2���_�XE��^Am��p���n_h&C�o5I��Y��4�� A comprehensive search of articles published between January 01, 2000, and December 31, 2017, will be performed in PubMed/MEDLINE, EMBASE, Global Index Medicus, and Web of Science. RESULTS Mean suture placement time for the cruciate pattern was significantly less than that for other patterns. Elective Surgery; The name “elective” might imply that this type of surgery is optional, but that’s not always the case. Non-Absorbable sutures include :- Polypropylene sutures, Nylon (poylamide), Polyester, PVDF, silk and stainless steel sutures. Download full-text PDF. However, these were robustly refuted by the authors. In general terms, the ELS protocol allowed retrieving a high number of manuscripts from the most commonly used databases, performing an accurate selection of articles, and therefore accomplishing with the aims of the study. The 13 articles (11 quantitative and 2 mixed quantitative/qualitative studies) that were found to be suitable for inclusion in this review contained information on 1101 study participants. Concerns were raised that gentamicin sponges dipped in saline 1-2 s prior to application may have lost the gentamicin into the saline, thereby reducing their efficacy and that some surgeons may have been unfamiliar with wound closure with sponges. Classification of Sutures Absorbable al tic Silk Natural tic Nylon Propylene Polyester SS Titanium al tic Plain Gut Chromic Gut Vicryl PDS Non-Absorbable (�� This systematic review and meta-analysis will be reported following the PRISMA guidelines. There were no significant differences between group B and group C. The average inflammatory cell infiltration did not differ significantly in the three groups. �� � w !1AQaq"2�B���� #3R�br� Two out of four RCTs showed a significant benefit of the implant in a reduction in superficial and deep SWIs in routine and emergency cardiac surgery. We additionally meet the expense of variant types and also type of the books to browse. All tendons were repaired with a 4-strand repair technique using 4/0 polypropylene core sutures. The use of locking sutures increases the tensile strength to values that may allow protective mobilization in children. Surgery can be classified based on the urgency and need to perform the surgery. In group C, PDO stents were completely decomposed. The effect of excessive twisting on the mechanical properties of sutures is a previously unrecognised phenomenon. /Length 25027 A polyamide looped suture doubles the number of core strands for every needle path. SAMPLE 60 skin specimens from the pelvic limbs of 30 purpose-bred Beagles. Surgical Mesh Dolphin Mesh is the brand name of surgical mesh manufactured by Futura Surgicare. sutures and it has good suture handling characteristics. A detailed description and heavily illustrated guide to suturing follows. Sutures, or stitches, are a way to close an open wound to speed healing and usually to ensure the least possible amount of scarring. /ColorSpace /DeviceRGB ��b�* Altogether, more than 484 papers were found using the reported search; of these, 7 represented the best evidence to answer the clinical question. The symmetry of funnel plot and Egger's test will be used to identify publication bias. The luminal diameter of the stent-implanted urethra was assessed by follow-up retrograde urethrography, and histologic findings were obtained after the dogs were killed. Methods: This paper provides a description of a model to evaluate various suture materials and knot strengths in isolation of the tendon itself. Sutures of biological origin like plain and chromic catgut are gradually digested by enzymes in the tissue, whereas absorbable sutures fabricated from synthetic materials like polyglycolic acid are hydrolyzed via the kreb’s cycle. Is contraindicated in bleeding duodenal, ,      ,           , MacLean AB, MacLean SB. Gentamicin resistance among common pathogens causing SWIs can vary from 15 to 80%. ���� Adobe d �� C CoG*"��*cO�����Akmoi���/ݎ4 Coagulase-negative staphylococci were predominantly isolated from infected wounds in all the trials except the one from USA, where infections were polymicrobial. Absorbable sutures include :- Polyglycolic Acid sutures, Polyglactin 910 , Catgut, Poliglecaprone 25 and Polydioxanone sutures. Les fils de sutures .pdf Par - Santé Zone on - octobre 13, 2018. There are various types of surgery and they can be classified based on different parameters. frequency of AVN after more than 5 years of follow-up in children that underwent closed reduction at younger than 2-years of age for DDH. DESIGN Randomized trial. Terminology — A number of terms are used to describe the properties of various types of sutures. Read PDF Guide To Sutures Guide To Sutures Right here, we have countless ebook guide to sutures and collections to check out. The effect of axial twisting on polydioxanone (PDS*II), polyglactin (Vicryl), polypropylene (Prolene) and nylon (Ethilon) sutures was investigated using a uniaxial testing device. Repair techniques have been developed to strengthen and optimize the number of core strands crossing a repair. A continuous running suture is the preferential method for abdominal closure. At each tissue bite, the needle is rotated through the tissue; in doing so, the suture can twist around the knot which acts as an anchor. The drop-out rates, insofar as they were given, ranged from 12% to 77% (median: 56%). Excessive twisting caused a nonlinear decrease in suture strength, with one twist per 75 mm (i.e., 20 twists) of polydioxanone decreasing strength by 39%, P<0.001. Narrative data synthesis was undertaken using the five-stage Whittermore and Knafl method. Elles favorisent l’hémostase locale, renforcent les sutures et assurent l’adhésion tissulaire. This study will report and summarize epidemiology data, as well as the economic burden of HF in neonates, infants, children, and adolescents of LMICs. An overall summary estimate of prevalence/incidence of pediatric HF across studies will be obtained from study-specific estimates pooled through a random-effect model. Flexor tendon repair in zone II remains a vexing problem. Seven different questionnaires were used to assess postoperative quality of life. Sutures should be evenly spaced, and tension should be evenly distributed along the suture line. produz força de 1.500g, aproximadamente 15N. Types of Sutures Sutures are classified based on their structure, what they are made up of, and whether or not they are absorbable. Recently, there is a growth in the development of classes of suture materials based on their properties and capabilities to improve tissue approximation and wound closure. Dolphin Surgical Meshes are also known as polypropylene mesh or hernia mesh. Most papers answered data quality questions well, with the exception of the justification of the sample size, which was only correctly addressed in a reduced number of articles (<10%). $4�%�&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyz�������������������������������������������������������������������������� ? Knowledge), and the resulting references were managed by using the open-source reference tool DistillerSR© systematic review software. Given the importance of surgery within the specialty of Obstetrics and Gynecology it is crucial to understand the process of wound healing and the suture available to surgical repair. Disadvantages The main disadvantage of continuous sutures is that if the suture breaks, the flap may become loose or the suture may come untied from multiple teeth. /BitsPerComponent 8 An 8-cm incision was made in each specimen and sutured with 1 of 4 randomly assigned suture patterns (simple interrupted, cruciate, intradermal, or subdermal). Types de sutures non résorbables. These sutures are braided, multifilament, coated, absorbable synthetic sutures. In group III (n=10 tendons), the locked cruciate repair was used. It is absorbed by hydrolysis over a The question addressed was: Are antibiotic implants like gentamicin-collagen implants useful in preventing sternal wound infections (SWIs)? In order to avoid the loss of key papers, each selection was performed by duplicate. This article is protected by copyright. This review outlines and discusses the current and emerging trends in suture technology including knotless barbed sutures, antimicrobial sutures, bio-active sutures such as drug-eluting and stem cells seeded sutures, and smart sutures including elastic and electronic sutures. Nylon. Types The choice of continuous suture depends on the operator’s preference. In group I (n=10 tendons), 2 separate figure-of-eight sutures were applied. The constructs were tested under increased cyclic loading recording both forces applied and suture construct lengthening ("clinical gapping") and ultimate breaking strength. Methods: >> The effective tensile strength of such sutures remains high over time. In the future, prospective studies with standardized methods of assessing quality of life and with longer follow-up times would be desirable. Tensile strength at skin-edge separation and suture-line failure and mode of failure were compared among the 4 patterns. Sutures size 1 and curved needles were used most often. They are used therefore in many of the internal tissues of the body. There are two types of sutures, absorbable and non absorbable sutures. Monofilament, Multifilament Sutures and Barb Sutures ... and biological characteristics of absorbable sutures, wires, monofilaments and multifilamentary. Methods: %PDF-1.5 Conclusion: Searches were undertaken using Pubmed, Scopus and Web of Science up to and including May, 2016 to identify potential studies. The physical configuration of a suture describes whether it is monofilamentous (Prolene or Ethilon) or multifilamentous (silk). In this technique the suture is secured with an initial knot and successive tissue bites are taken. An experimental study in a canine urethral model has demonstrated acceptable inflammatory reaction with gradually increasing granulation tissue but no luminal obstruction within 12 weeks. This allowed us to evaluate mechanical differences between looped and non-looped sutures for polyamide, which are commonly used in flexor tendon repair. Their protein composition can elicit the most During continuous periods of cyclic loading, we measured permanent deformation and ultimate breaking strength. There are many different types of sutures, just like there are many different kinds of procedures and injuries. Within the constraints of this model, a looped suture fared worse than a non-looped suture especially when comparing 4-0 and 3-0 sutures. The number of trans women in each study ranged from 3 to 247. It is the copolymer of glycolic acid and lactic acid and it is coated with calcium stearate. The customary book, fiction, history, novel, scientific research, as well as various new sorts of books are readily clear here. PDO biodegradable stents were placed in the proximal and distal urethra of nine male mongrel dogs. When used to close skin, non-absorbable sutures are usually removed in 10-14 days, but this may vary by location and situation. SMI: Surgical sutures of the highest quality SMI AG was established in 1987 - the first Belgian company manufacturing surgical sutures - since then it has grown continuously. Mean tensile strength at skin-edge separation and suture-line failure did not differ significantly between the intradermal and subdermal patterns or the simple interrupted and cruciate patterns. A total of seven papers met the a priori inclusion and exclusion criteria of this review. In group II (n=10 tendons), simple locking sutures were added to the corners of 2 separate figure-of-eight sutures. There are many different types of sutures, with the most commonly used one called the interrupted suture. ! (�� However, two-knot 3-0 looped suture constructs did resist the force generally accepted as occurring with early non-resistive tendon motion protocols, while two-knot 4-0 looped suture constructs did not. Polyglactin 910: It is available in braided form. Results: Hematologic examination was performed to evaluate inflammatory reaction. Their mean age was 39.9 years (range: 18-76). Tensile strength, tissue reaction and capability to be absorbed are other important characteristics of the suture material. Percentage of skin apposition did not differ among the 4 patterns. These studies were conducted with surgical sutures of various types, including absorbable, non-absorbable, monofilament and braided materials [19,20], such as Vircyl, silk, and catgut, providing evidence of the antibacterial and anti-inflammatory potential O�E����z����#I? Molecular weight losses were 54% in group A and 84% in group B. Those who had nylon sutures as opposed to PGA sutures were 9.5 times more likely to experience wound infection (p=0.055). Section III addresses the topic of diagnostic pathology, providing a well-reasoned … It was concluded that 4 mm-wide pediatric flexor tendons allow a 4-strand repair and the use of 4/0 sutures. Four-strand 3-0 and 4-0 looped sutures failed at 39.9 and 27.1 N faring worse than a four-strand non-looped suture which reached a rod separation of 2 mm at 60.7 and 41.3 N. The ultimate breaking strength demonstrated absolute failure (construct rupture) with the 3-0 looped suture breaking at the knot at 50.3 N and the non-looped suture at 61.5 N. For the 4-0 suture, these values were 32.4 and 41.76 N. Gentamicin-collagen is unlikely to reduce SWIs in high-risk patients and polymicrobial infections. Synthetic sutures are made from a variety of textiles such as nylon or polyester, formulated specifically for surgical use. Il permet de mieux rapprocher les chairs, ce qui favorise la cicatrisa/on et diminue le risque de These newer strategies expand the versatility of sutures from being used as just a physical entity approximating opposing tissues to a more biologically active component enabling delivery of drugs and cells to the desired site with immense application potential in both therapeutics and diagnostics. Read full-text. The primary mode of failure for the simple interrupted pattern was suture breakage, whereas that for the cruciate, intradermal, and subdermal patterns was tissue failure. Using machined steel rods to hold our suture constructs, we compared four different knot configurations using looped and non-looped sutures in 3-0 and 4-0 varieties using a four-core strand technique. Identification and removal of duplicates were executed in 2 steps: one based on the title and abstract, and the following one according to the full text. ...................................................�� !�" �� Surgeons should be aware that this can result in a decrease in suture strength and reduce the elasticity of the material, and therefore need to adapt their practice to reduce the torsional force placed on sutures. Results: Sutures are used to close wounds … A p value less than 0.05 will be considered significant for factors that predict mortality. (��9�s�.��[�@�+�\BvJ����k����� �C����二{�����M����0t/�:�4V�2]����t����V�k���3�k{d��Ἇ�U�d��fֱF���Y�x�S҇R�����j��~��T�]��ꊭcykkݕ�s� ���5f����( ��( ��( ��( ��( ��( ��( ��( ��( ��( ��( ��()M��j�:=��ڄ� ��'�愮��;x�Y�X�A�fl =I�*][U�T�g�{=-[lګ//�"����MԼc2^��e�)���4��/� �OmQ[Đ��*���^��dk/C3@�4�ݢ����s,��J}Y���j)jmݔ�[Q@Š(��(��(��(��(��(��(��(��(��� ��ڝE qW���.��� �k�����+Oþ%��KI"{-N��s�"{�Q�] `��Ö���6��� ���$�� Q�W̥���ֱ7�+���Ewk~���m��C�o����� �ƦQ�妘�QE!�Q@Q@Q@Q@Q@Q@Q@Q@Q@%��k6z�׷�ǝ�ă/+�����&ݐ��k�Ն�bo/�8'lq'/+vU�`��%����hǜ����R�y�_�'�-��. The approximation of wound edges can be made with natural or synthetic suture, mono or multifilament. Results: They can be further sub-classified into synthetic or natural sutures, and monofilament or multifilament sutures. Quelques exemples de sutures non résorbables peuvent être trouvés ci-dessous. Broadly, sutures can be classified into absorbable or non-absorbable materials. Discussion: Today SMI is recognised as a world-wide supplier of quality surgical sutures and medical devices. There is a wide range of suture materials for medical purpose and the main types include absorbable and non-absorbable. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Comparison of tensile strength among simple interrupted, cruciate, intradermal, and subdermal suture patterns for incision closure in ex vivo canine skin specimens, Polydioxanone Biodegradable Stent Placement in a Canine Urethral Model: Analysis of Inflammatory Reaction and Biodegradation, Use of gentamicin-collagen sponges in closure of sternal wounds in cardiothoracic surgery to reduce wound infections, Suture materials - Current and emerging trends, Nonanastomotic Rupture of a Woven Polyester Graft Caused by a Tacking Stitch After Aortic Arch Replacement, Biomechanical Evaluation of Double-Strand (Looped) and Single-Strand Polyamide Multifilament Suture: Influence of Knot and Suture Size, Torsion of monofilament and polyfilament sutures under tension decreases suture strength and increases risk of suture fracture, Quality of Life Following Male-To-Female Sex Reassignment Surgery. A comparative in-vitro experimental study conducted at King Saud University, Riyadh, Kingdom of Saudi Arabia from October 2014 to December 2015. La stérilisation est faite soit par irradiation, thermiquement ou chimiquement. Suture placement time and percentage of skin apposition were evaluated. Types of sutures A. Absorbable Sutures Are made of materials which are broken down in tissue after a given period of time, which depending on the material can be from ten days to eight weeks. There was no significant difference between groups II and III with regards to gap and breaking forces; and all forces of these 2 groups were significantly higher than the forces in group I. Actuellement, la plupart des sutures sont faites avec du fil synthétique depuis l'interdiction du catgut à la fin du XXe siècle à la suite de la crise de la vache folle. To determine the effect of axial torsional forces on sutures used in abdominal closure. Permanent deformation results when there is no recoverable change after force removal defined as a permanent rod separation (or gapping) of 2 mm. Limitations will mainly arise from the heterogeneity in the diagnostic of HF. Types of Surgery. /Width 420 /Height 545 All of the studies were judged to be at moderate to high risk of bias. (�� Une suture monofilament naturelle. We utilized 30 flexor profundus tendons of young lambs with a width of 4 mm. The average number of epithelial layers (2.93 vs 4.42; P < .001), the average thickness of papillary projection (0.80 mm vs 1.28 mm; P < .001), and the average thickness of submucosal fibrosis (0.34 mm vs 0.49 mm ; P < .001) were significantly increased in group B versus group A. There was no difference in respect of number of core strands crossing a repair different of. Tendon repairs were tested to single-cycle tensile failure two needles, one at each end of the were! 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