BACKGROUND: Closure of donor site of the flap has special problems. Reduction of this site will decrease the morbidity of operation. In this study, we present our experience in donor site size reduction.METHODS: Between 2006 and 2008, 15 patients with skin and soft tissue defects underwent operation. In all patients, coverage of defect was performed with various flaps. Substratum horizontal MATTRESS SUTURE was used to reduce donor site dimensions. In all 15 patients, size of the flaps, the defect after the flap elevation and the scar size were measured.RESULTS: The mean size of the flap, the defect after flap elevation, and the scar after 3 months were 43.9 cm2, 69.4 cm2, and 32.2 cm2, respectively. There was 46.5% reduction in the donor site after using this SUTURE.CONCLUSION: The substratum horizontal MATTRESS SUTURE was shown to decrease the donor site dimensions and also its scar size in flap surgery. This SUTURE is highly recommend in order to reduce donor site dimensions.

Introduction & Objective: Acute appendicitis is the most common cause of acute abdomen. Appendectomy is only curative treatment for acute appendicitis. The patients, after appendectomy complain from ugly configuration of SUTURE site, scar problem is stitch abscess and wound infection after appendectomy. This is aesthetically important, because appendicitis is prevalent in the second and third decades of life. This study compared wound closure result by two methods; Subcuticular and MATTRESS SUTURE.Materials & Methods: In this analytic, clinical trial, 207 patients (105 group A and 102 group B) with the initial diagnosis of appendicitis were appendectomised at Shahid Sadooghi, Mortaz and Saidoshohada hospitals, from April 2005 to December 2006. In 4 follow up visit, patients were clinically examed for Maximum of wound scar width, wound infection and stitch abscess to 3 months after appendectomy at the clinics. Collected data were analyzed with ANOVA test using SPSS 11.5 software.Results: The Mean Scar width in Subcuticular group (A) was 0.96 mm and in MATTRESS group (B) was 7 mm. There was significant difference between two groups (P.Value=0.0001). The Abscess in the Subcuticular group was seen in one case (0.8%) and in the MATTRESS group no abscess was seen. There was no significant difference between two groups (P.Value = 0.45). There was no case of wound infection in the two groups. In this study, the age and gender factors were confounding and by using co variance analysis, they were taken care of.Conclusions: Considering the results of this study, the Subcuticular method is a better option in closure of an appendectomy wound.

Background:  Despite the prevalence of palmar injuries and surgeries, no consensus exists regarding the type of wound closure. The present study compares simple SUTUREs and vertical MATTRESSes SUTUREs in carpal tunnel release (CTR), trigger finger release (TFR), and trigger thumb release (TTR). Methods: A total of 89 surgeries were randomized to either simple or vertical MATTRESS SUTUREs. Outcomes including pain, infection, Patient and Observer Scar Assessment Scale (POSAS), satisfaction level, and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) were evaluated on postoperative day 3, week 3, and month 3. Month 3 assessments were mostly performed remotely due to coronavirus disease 2019 (COVID-19). Results: The mean pain was higher in the vertical MATTRESS SUTUREs group compared with simple SUTUREs, though the pain difference was statistically significant only on day 3. No significant mean difference was found between the two groups regarding POSAS items. Some patients underwent bilateral CTR with simple SUTUREs on the one hand and vertical MATTRESSes SUTUREs on the other. The results of their investigation were consistent with the other findings. Conclusion: Vertical MATTRESS SUTURE in palmar surgeries is associated with greater short-term pain. Other variables did not differ between the two groups at different times. Hence, conclusively, regardless of the short-term pain associated with simple SUTURE, both types of SUTUREs can be used in hand surgeries with similar long-term results.

The aim of present investigation was to evaluate the efficacy of the full thickness flap with internal MATTRESS, SUTURE in eliminating deep periodontal pockets in maxillary anterior region, to gain attachment and to preserve the height of the papilla prior to the periodontal surgery. Ten patients suffering from adult periodontitis in maxillary anterior region with minimum of two pockets;≥6mm were Participated in this study. Prior to the above surgery the first chase of therapy was performed the following clinical parameters1- Pocket depth2- Attachment level3- Height of papilla were measured one dayBefore the surgery and three months after the surgery. The total of 34 Pocket ≥ 6 mm was treated and the height of 224 papilla was measured. The mean difference between first two parameters. (Post surgical compare to pre surgical...) were 3.235 and 1.93 mm respectively which the differences were significant. Also the mean difference for the 3rd parameter was 1.305 mm which despite of being significant was acceptable (the differences between 3rd parameters less or closer to zero to be more acceptable. This technique is useful for eliminating pockets in maxillary anterior region.

Background: The cosmetic result of the surgical scar has long been considered by surgeons as an important factor for patient satisfaction. On the other hand, there has been an old teaching that perfect closure of contaminated wounds increases the rate of infection. We decided to look into this matter and see if this is a fact or a myth.Methods: In this prospective randomized study conducted on 200 patients with suppurative or gangrenous appendicitis, we closed the wounds with a cosmetic subcuticular SUTURE of 4/0 nylon in 100 patients and in the other 100 patients the wound was approximated loosely with a few stitches of 3/0 nylon in vertical MATTRESS fashion during a 14-month period.Results: There was no significant difference in the rate of wound infection between these two groups.Conclusions: This study shows that perfect closure of the wound with subcuticular closure, which gives a very good cosmetic result in comparison with traditional loose closure, does not increase the rate of wound infection.

Background: Adjustable SUTUREs increase the success rate of strabismus surgery. However, the optimal timing of postoperative SUTURE adjustment remains controversial. This trial was aimed at comparing the surgical outcomes and pain scores of early or 2 –,4 h and delayed or 24 h postoperative SUTURE adjustment in adult patients undergoing strabismus surgery. Methods: An open-label, prospective, randomized, comparative interventional study was performed in consecutive adult patients scheduled for eye muscle surgery. Patients were randomized into two groups: the early group, with SUTURE adjustment 2 –,4 h postoperatively, and the delayed group, with SUTURE adjustment 24 h postoperatively. Subjective pain scores during the adjustment were also analyzed. The angles of misalignment at 1 and 3 months and the success rate at 3 months postoperatively were compared. Results: Forty-five (90%) patients completed the follow-up, including 23 (92%) in the early adjustment group and 22 (88%) in the delayed adjustment group, with a mean (standard deviation) age of 25. 6 (9. 5) years and a male-to-female ratio of 46. 7: 53. 3. Thirty patients (66. 7%) had exotropia, and 15 (33. 3%) patients had esotropia. Both groups had comparable baseline characteristics (all P > 0. 05). The mean pain scores during adjustment did not differ significantly between groups (P > 0. 05). The postoperative angles of alignment were comparable between the groups before SUTURE adjustment and at the 1-and 3-month follow-ups (all P > 0. 05). The success rate in the early adjustment group was slightly higher (87. 0% versus 63. 6%), but the difference was not statistically significant (P > 0. 05). The success rate was comparable between the groups in patients with esotropia or exotropia (both P > 0. 05). Conclusions: Although the early adjustment group had a slightly higher success rate, the difference was not significant. Both groups had comparable subjective pain scores during adjustment, final motor alignment, or success rate. Future clinical trials should be performed different time intervals for postoperative SUTURE adjustment, and subjective and objective outcomes, such as diplopia and stereopsis, should be compared between patients with a first strabismus surgery and those who underwent reoperation. This could better resolve the persistent controversy related to the optimal time for SUTURE adjustment.

The individual penetration of aggregates is an important problem in the construction of breakwater on soft seabed. Any overall resisting mechanism of the foundation could not be formed when aggregates are individually penetrating seabed. In this situation a large volume of breakwater material penetrates into bed. In design, "aggregate local penetration" control should be considered in addition to usual controls such as bearing capacity and settlement. In this paper, with the use of proposed laboratory method, penetration of aggregate into soft soil is investigated. In addition to laboratory studies, some breakwaters that constructed on soft seabed in the south coasts of Iran were studied. Finally, it has been concluded that fine MATTRESS decreases penetration of aggregates. A relationship is proposed for determining MATTRESS thickness.

Introduction & Objective: It is often advised to have repair of subcutaneous soft tissue using absorbable SUTURE at the end of surgery before skin closure. We decided to compare the complication of subcutaneous suturing with those without subcutaneous suturing in the clean orthopedic wounds.Materials & Methods: We conducted a single blind randomized clinical trial on all admitted orthopedic patients who were candidate for primary wound clousure, during 1382-88 in Sina hospital. After categorizing patients based on upper/lower limb and fascia repair, the patients were divided into two groups with or without subcutaneous repair, by using computerized random numbers chart. The patients were assessed for probable complications (wound dehiscence, infection, fluid collection, inflammation, and skin necrosis) for 3 months postoperatively. Exclusion criteria were; the patients who need any kind of skin or muscle flaps, those who needed subcutaneous drainage, those who need secondary repair and those with loss to follow up.Results: After applying exclusion criteria, 14953 patients (1662 female, 13291 male, mean age 40.6±4.9 years) were enrolled into our study. Of these, 4153 were allocated to upper limb and the others to lower limb group. These groups were further divided based on fascia and subcutaneous repair. Totally, 6120 (41% of patients) had subcutaneous repair. The observed complications were more in patients without subcutaneous SUTURE in comparison to those having with subcutaneous SUTURE. Other parameters (upper or lower extremity and fascia repair) were not statistically significant regarding wound inflammation, infection, fluid collection, necrosis and dehiscence.Conclusions: It seems that omitting subcutaneous soft tissue repair will not lead to major complications in several cases of orthopedic surgery. It shortens the time of surgery and it may also reduce the costs, because of avoiding the use of SUTURE materials.