Trans-septal quilting suture versus intranasal silicone splint for preventing complications post endoscopic septoplasty

<p class="abstract"><strong>Background:</strong> Septoplasty is a common procedure in the field of otolaryngology for treatment of septal deviations. Intranasal splints and trans-septal quilting suture are commonly utilized to prevent post-operative complications. The silicone splint is a quick and simple technique to aid in cartilage support; however, it can cause discomfort. Trans-septal quilting suture is more available, well-tolerated and can help in mucosal tear closure, though is time-consuming. This study aimed to compare the efficacy of intranasal silicone splints versus quilting suture in the prevention of post endoscopic septoplasty complications.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective COHORT study comprised of patients who underwent endoscopic septoplasty between January 2017 and December 2019 at Qatif central hospital. The patients were assigned into two groups: group S, who received intranasal splints and group Q, who received trans-septal quilting suturing. Patients’ medical records were reviewed for evaluation of post-operative visits and post-operative nasal endoscopic video recordings from the image archive software were evaluated to document complications. Statistical analysis was conducted using SPSS 23.0 software.</p><p class="abstract"><strong>Results:</strong> The study included 65 patients, of whom 41 were in group S and 24 were in group Q. None of the patients had major bleeding, local infection or mucosal synechia. There was a higher complication rate in terms of mucosal crustation, septal hematoma and perforation among group S; however, the difference was not statistically significant.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that trans-septal quilting suture and intranasal silicone splints are both equally effective in preventing complications following septoplasty.</p>

Our Experience of Tie Over bolster and Quilting Sutures Versus Stapler fixation for Split thickness skin graft in post burn neck contracture – A Comparative study

Background: Traditional method to fix Split thickness skin graft in post burn neck contracture is Tie over Bolster dressing and Quilting sutures. We used staplers to fix split thickness skin graft. Materials & methods: A comparative study conducted in 30 patients with post burn neck contracture at Dr. Vasantrao Pawar Medical College, Nashik, during January 2015 to December 2020. Time required for fixation of split thickness skin graft, outcome in terms of graft uptake and patients comfort level while removing sutures and stapler recorded. Results: Total 30 Patients were included in our study. Mean time required for Tie over and quilting suture was 10.53 ± 0.88 min, significantly higher than the mean time in stapler fixation 4.87 ± 0.81 min. (p<0.001). Graft take was 95% in stapler and 93% in Tie over and quilting suture. Conclusion: Fixation of Split thickness skin graft with stapler is more rapid, less time consuming also results in decreased surgical and anaesthesia time. More patient friendly while removing staplers with comparable skin graft uptake.

Conventional suture with prolonged timing of drainage is as good as quilting suture in preventing seroma formation at pectoral area after mastectomy

Background The aim of this study was to compare conventional suture with prolonged timing of drainage with quilting suture on the formation of seroma at pectoral area after mastectomy (ME) with sentinel lymph node biopsy (SLN) or axillary lymph node dissection (ALND) for breast cancer. Methods Three hundred and eighty-eight consecutive breast cancer patients were retrospectively analyzed and categorized into three groups. Patients in group 1 were with quilting suture, group 2 with conventional suture and 13–15 days drainage in situ, and group 3 with conventional suture and 20–22 days drainage. The primary outcome was the incidence of grades 2 and 3 seroma at anterior pectoral area within 1 month postoperatively. Cox regression was used for analysis. Results The incidence of grades 2 and 3 seroma was comparable among groups (9.5% vs. 7.9% vs. 5.3%, p = 0.437), as well as late grades 2 and 3 seroma among groups (4.3% vs. 2.9% vs. 1.5%, p = 0.412). Old age, high body mass index, and hypertension were independent risk factors for grades 2 and 3 seroma. Conclusions Prolonged timing of drainage to 13–15 days in conventional suture was long enough to decrease the incidence of grades 2 and 3 seroma as lower as that in quilting suture group at pectoral area within 1 month after mastectomy.

Conventional Suture with Prolonged Timing of Drainage Is As Good As Quilting Suture In Preventing Seroma Formation at Pectoral Area After Mastectomy

BackgroundThe aim of this study was to compare conventional suture with prolonged timing of drainage with quilting suture on the formation of seroma at pectoral area after mastectomy (ME) with sentinel lymph nodes biopsy (SLN) or axillary lymph nodes dissection (ALND) for breast cancer.Methods388 consecutive breast cancer patients were retrospectively analyzed and categorized into three group. Patients in group 1 were with quilting suture, group 2 with conventional suture and 13-15 days drainage in situ, and group 3 with conventional suture and 20-22 days drainage. The primary outcome was the incidence of Grade 2 and 3 seroma at anterior pectoral area within one month postoperatively. Cox regression was used for analysis.ResultsThe incidence of Grade 2 and 3 seroma was comparable among groups (9.5% vs. 7.9% vs. 5.3%, p = 0.437), as well as late Grade 2 and 3 seroma among groups (4.3% vs. 2.9% vs. 1.5%, p = 0.412). Old age, high body mass index and hypertension were independently risk factors for Grade 2 and 3 seroma.ConclusionsProlonged timing of drainage to 13-15 days in conventional suture was long enough to decrease the incidence of Grade 2 and 3 seroma as lower as that in quilting suture group at pectoral area within one month after mastectomy.

Conventional Suture With Prolonged Timing of Drainage is as Good as Quilting Suture in Preventing Seroma Formation at Pectoral Area After Mastectomy

BackgroundThe aim of this study was to compare conventional suture with prolonged timing of drainage with quilting suture on the formation of seroma at pectoral area after mastectomy (ME) with sentinel lymph nodes biopsy (SLN) or axillary lymph nodes dissection (ALND) for breast cancer.Methods388 consecutive breast cancer patients were retrospectively analyzed and categorized into three group. Patients in group 1 were with quilting suture, group 2 with conventional suture and 13-15 days drainage in situ, and group 3 with conventional suture and 20-22 days drainage. The primary outcome was the incidence of Grade 2 and 3 seroma at anterior pectoral area within one month postoperatively. Cox regression was used for analysis.ResultsThe incidence of Grade 2 and 3 seroma was comparable among groups (9.5% vs. 7.9% vs. 5.3%, p = 0.437), as well as late Grade 2 and 3 seroma among groups (4.3% vs. 2.9% vs. 1.5%, p = 0.412). Old age, high body mass index and hypertension were independently risk factors for Grade 2 and 3 seroma.ConclusionsProlonged timing of drainage to 13-15 days in conventional suture was long enough to decrease the incidence of Grade 2 and 3 seroma as lower as that in quilting suture group at pectoral area within one month after mastectomy.