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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Polyglycolic acid sutures (Dexon) were compared to chromic catgut sutures in episiotomy repair. When polyglycolic acid sutures were used, the degree of postpartum perineal pain was approximately half as great, and the incidence of dehiscence of episiotomy was 3--5 times greater in the chromic catgut group. The cosmetic results 3 months postpartum were clearly better by using Dexon sutures, especially when the perineal skin was closed by a continuous intracutaneous suture.
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PMID:[A comparison between chromic catgut and polyglycolic acid sutures in episiotomy repair (author's transl)]. 34 30

The need for nasal packing in septal surgery is not proven though its use is widespread. Post-operative complications, while uncommon, are frequently pack related. Consenting adults were prospectively randomized to one of the following: Vaseline gauze nasal packing or 30 Dexon mucosal suture. All patients were operated on by one surgeon who was made aware of the randomization decision only when the corrective surgery was complete. Details of post-operative morbidity were collected and pain scored subjectively by a visual analogue scale the morning after surgery. The first 50 available pain scales illustrated a difference between the groups (P less than 0.05), means 4 and 3 in the pack and suture group respectively. There was no demonstrable difference in post-operative haemorrhage, adhesions, nasal crusting or mucosal atrophy. The need for nasal packing is not supported.
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PMID:An evaluation of post-operative packing in nasal septal surgery. 178 16

A trial of injection of the vas deferent duct with ethacridine lactate (Rivanol) 1% as a perioperative procedure during vasectomy, to ensure immediate sterility was conducted on 66 Danish men between January 1983 through January 1984. 14 patients were excluded for personal or technical reasons or did not comply with follow up, leaving 52 study subjects. Vasectomy was performed under local anesthesia by resecting 0.5-1.0 cm of the vas. The central vas was flushed with 2.0 ml Rivanol 1% 4 times at 2 min intervals before ligation and embedding in membranes with Dexon 3.0. Patients were instructed in vital staining with eosin as follows: collect semen, 30 minutes later draw up in a capillary tube, apply 1 drop on a slide layered with dried eosin, mix 1 minute, cover with a clean slide, draw the cover slide off longitudinally, and air dry. All subjects had infertile (red stained) sperm or azoospermia at 10 days. Azoospermia occurred in 51 men (86.7%) within 3 months. 2 patients developed sperm granuloma, one with infection that required re-operation because of recanalization. 80% complained of pain which was associated with the wound in 73%, but 33% noted pain in the lower abdomen, often described as an oppressive feeling, probably due to Rivanol, usually disappearing within 10 days. there were no pregnancies. This were no pregnancies. This method greatly simplified post-vasectomy follow up.
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PMID:Vasectomy with rivanol injection and fertility control by vital staining with eosin. 244 62

A systematic review of the 14 relevant controlled trials was conducted because there is no agreement about the choice of material and technique for repair of perineal trauma sustained during childbirth. Derivatives of polyglycolic acid (marketed as Dexon and Vicryl) appear to be the absorbable material of choice for both deep and skin closure. Compared with catgut their use is associated with about a 40% reduction in short-term pain and need for analgesia. The main drawback is that some material often needs removal during the puerperium. Glycerol-impregnated catgut is ruled out because of its link with long-term dyspareunia. Compared with the non-absorbable materials (silk and nylon) polyglycolic acid skin sutures were associated with less short-term perineal pain, and had no clear disadvantages. Continuous, subcuticular stitching appears preferable to interrupted, transcutaneous suturing, particularly in terms of perineal pain in the early puerperium.
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PMID:The choice of suture materials and techniques for repair of perineal trauma: an overview of the evidence from controlled trials. 255 6

A rare case of Richter's hernia after laparoscopy, the 2nd such hernia reported among a total of 4 cases of small bowel hernia, is presented. This patient was a 32-year old woman who had Hulka clip sterilization without any difficulties, using a 10 mm trocar and a Wolff laparoscope, with 3 liter carbon dioxide for induction of pneumoperitoneum. Her symptoms were only severe pain and vomiting starting on the 5th postoperative day, and a hematoma-like swelling. Since her pain was so intense, the area was explored under general anesthesia the same day. A plum-sized, strangulated loop of the jejunum was apparent, with serous fluid but no blood, incarcerated between the skin and the abdominal muscles. A small serosal laceration in the bowel was corrected with 2 interrupted Dexon sutures. Symptoms of hernia have occurred 3-15 days after laparoscopy in previously reported cases. It is fortunate that this patient was not treated as though she had a hematoma, since serious perforation of the bowel and peritonitis would have resulted. It is important to insure that all gas has flowed out of the abdomen before removing the laparoscope or the trocar sheath, and advisable to shake the abdomen wall carefully while removing the instruments, to prevent this complication.
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PMID:Incarcerated Richter's hernia after laparoscopy: a case report. 296 30

Three methods of episiotomy repair were randomly assigned after 900 consecutive deliveries. The three procedures were: (1) continuous No. 00-plain catgut in the vagina; No. 00-plain catgut interrupted stitches in the perineal muscles and fascia, and No. 00-nylon interrupted stitches in the skin. (2) The same technique as in (1), but with No. 0-polyglycolic acid (Dexon) in all layers. (3) The suture material as in (2), but used with a subcuticular technique. The women treated with method 3 reported statistically significant less pain and disabilities in the early puerperium. Three months after delivery 262 women (33%) still had perineal complaints which could be directly related to the episiotomy in 25% (8% of total number). The group treated with method 3 had the best long-term results and we conclude that the subcuticular technique using polyglycolic acid should be the method of choice.
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PMID:Episiotomy repair--immediate and long-term sequelae. A prospective randomized study of three different methods of repair. 301 Oct 61

The degree of cutaneous sensory deficit in the leg was assessed after removal of the long saphenous vein in 50 consecutive patients undergoing coronary artery bypass vein grafts randomly assigned subcutaneous sutures or a single layer of sutures. Removal of the vein and repair of the leg incision were done by the same team of surgeons. In group 1 (25 patients) the leg incision was repaired with "00" Dexon subcutaneous and "00" prolene subcuticular sutures while in group 2 (25 patients) closure was effected by a single layer of interrupted "00" nylon sutures. All had crepe pressure bandage from the base of the toes to the groin for the first 24 hours followed by TED stockings for six to eight weeks. Sutures were removed on the eighth postoperative day. Cutaneous sensation in the leg and ankle was assessed 48 hours, seven days, and six to eight weeks after surgery, and a final comparison of the cosmetic effects and sensory perception after one year or more was made in 37 patients. There were no major differences between the groups at 48 hours in sensory abnormalities (anaesthesia, hyperaesthesia, and pain) but sensory recovery was significantly better in group 2 at the second and third assessments. There was some reduction in sensory abnormalities at the final review in group 1. No appreciable difference was noted in the quality of the scar between the two groups. We conclude that cutaneous sensation is better preserved by repairing the leg incision in a single layer. Subcutaneous sutures may produce neuropraxia of the long saphenous nerve by direct pressure as healing progresses.
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PMID:Postoperative neuralgia in the leg after saphenous vein coronary artery bypass graft: a prospective study. 328 8

Disruption of the ureter is very rarely caused by a blunt trauma, only 12 cases having been reported in Japan. A 20-year-old male suffered from a blunt abdominal trauma in a traffic accident. Although his urinalysis showed no abnormalities, a dull pain in the left flank region persisted for over a week after the injury. Under the suspicion of renal or ureteral injury, an excretory urogram (DIP) was conducted. The form of renal pelvis and calyces was almost normal on both sides, while extravasation of contrast medium was recognized around the lower pole of the left kidney. The retrograde pyelogram of the left side revealed that catheterization was possible up to 30 cm from the ureteral orifice, but the injected medium leaked into the retroperitoneal space making it impossible to visualize the left renal pelvis and calyces. An operation was performed under the diagnosis of left ureteral injury on the 19th day after trauma. The left ureter was completely disrupted 2 cm distally from the ureteropelvic junction. An end to end anastomosis of the ureter was done with 6-0 Dexon sutures. The DIP taken on the 25th day after the operation showed slight dilatation of the left pelvis and calyces. However, the renogram conducted 6 months after the operation demonstrated a normal pattern on both sides.
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PMID:[A case of ureteral disruption caused by a traffic accident]. 389 74

The study purpose was to assess the value of laparoscopy in a small community hospital (Northeastern Ohio General Hospital) with 1 operator utilizing the procedure and to examine its complications, failures, and problems. 518 laparoscopies were performed over the August 1972 to November 1975 period. 93% of the procedures (484 patients) were for interval sterilization. 4% (18 patients) were for diagnostic purposes, and 3% (16 patients) were for infertility. The surgical technique utilized throughout most of the study was a single puncture method using the Jacobs-Palmer operating laparoscope. Study results are derived from analysis of 3 different factors. The 1st part of the study was carried out to collect the data on the population in general, and this was acquired from a review of the hospital charts. The 2nd segment was the 3 week and 6 week office follow-up reviews of the patients and their problems. The 3rd part was the longterm follow-up in which patients returned for routine gynecologic care. There were 5 failures of the procedure in this study, or 10/1000. There have been no cases of delayed postoperative bleeding. All bleeding that was identified was seen at the time of the surgery and managed at that point. There were no deaths in this series. The following side effects were found in longterm follow-up. This consisted of 376 patients. 3% (15 patients) had delayed menses after the surgery, which appeared to be associated with longterm use of oral contraceptives, 6% (30 patients) had amenorrhea for more than 75 days postoperatively. 22 patients (5.5%) had hypomenorrhea within the 1st 2 years postoperatively. 5% (25 patients) had a discharge from catgut suture while less than 1% had an umbilical difficulty or discharge from the Dexon suture. 18 patients (3.6%) of the population had postoperative dysuria within the 1st month. Delayed pain, dysmenorrhea, or dysparenuia within the 1st 2 years was detected in 2.5% (12) of the total population but could not be totally explained on a physiologic or anatomic basis. 7 patients (1.2%) had sexual anhedonia. There were 3 hysterectomies carried out subsequent to laparoscopic sterilization. The report of the Complications Committee of the American Association of Gynecologic Laparoscopists is reviewed. In this series the major difficulties or complications encountered in laparoscopy have not been observed. This is due in part to the training of the individual operator but also to a team effort at this hospital.
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PMID:Laparoscopy: a retrospective study with two or more years follow-up of patients in a small community hospital. 621 Jun 47

Polyglycolic acid (PGA) sutures and traditional catgut were compared in 190 patients undergoing episiotomy. Each group was also randomly allocated to a double blind comparison of therapy with oral proteolytic enzymes (Chymoral) and placebo. The combination of Chymoral and polyglycolic acid sutures was shown to reduce the level of pain, assessed subjectively, and there was a significant reduction in analgesic requirements in the Chymoral/PGA group.
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PMID:Polyglycolic acid and catgut sutures, with and without oral proteolytic enzymes, in the healing of episiotomies. 630 40


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