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Multifaceted spiral suture: A hemostatic technique in managing placenta praevia or accrete: A retrospective study.

ABSTRACT: Patients with total placenta previa and past history of cesarean delivery often experience overwhelming hemorrhage during childbirth. In order to control intraoperative and postoperative bleeding, we propose a novel multifaceted spiral suture of the lower uterine segment which directly sutures the bleeding site.To evaluate the efficacy and safety of multifaceted spiral suture, a retrospective study was conducted using data from 33 patients with total placenta praevia and caesarean history.All participants underwent multifaceted spiral suture and no patient experienced uncontrollable bleeding or underwent hysterectomy.The average blood loss of all patients involved was 1327.3 ± 1244.1 mL. Five patients reported blood loss exceeding 3000 mL (15.15%), and the highest reached to 4000 mL. No complications such as fever, pyometra, synechiae, or uterine necrosis were observed. Three cases (3/33, 9.09%) reported hematuria in the first 3 days following surgery and spontaneous resolution were observed within 3 to 7 days following insertion of indwelling catheters. No complaints were received during 6-month follow-up visits.These findings suggest that multifaceted spiral suture is a practical, feasible, and promising technique in potentially minimizing postpartum bleeding and avoiding hysterectomy for patients with placenta praevia or accrete.

SUBMITTER: Meng Y

PROVIDER: S-EPMC5728953 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Multifaceted spiral suture: A hemostatic technique in managing placenta praevia or accrete: A retrospective study.

Meng Yifan Y Wu Peng P Deng Dongrui D Wu Jianli J Lin Xingguang X Beejadhursing Rajluxmee R Zha Ying Y Qiao Fuyuan F Feng Ling L Liu Haiyi H Zeng Wanjiang W

Medicine 20171201 49

Patients with total placenta previa and past history of cesarean delivery often experience overwhelming hemorrhage during childbirth. In order to control intraoperative and postoperative bleeding, we propose a novel multifaceted spiral suture of the lower uterine segment which directly sutures the bleeding site.To evaluate the efficacy and safety of multifaceted spiral suture, a retrospective study was conducted using data from 33 patients with total placenta praevia and caesarean history.All pa ...[more]

PMID: 29245338

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Project description:BackgroundThe management of anterior colliculus fractures in combination with deltoid ligament injuries is a topic of debate, and there is a need to improve surgical outcomes. The purpose of the present study was to describe the application of a modified double-row suture bridge technique and evaluate its early clinical outcomes in the management of anterior colliculus fracture combined with deltoid ligament injury.MethodsFrom 2020 to 2022, 12 patients with anterior colliculus fracture combined with deltoid ligament injury were treated using a modified double-row suture bridge technique. For clinical outcome evaluation, objective data are presented through clinical examination findings; radiographic assessments, including X-rays and computed tomography (CT); and follow-up analysis utilizing American Orthopaedic Foot & Ankle Society ankle‒hindfoot (AOFAS) scores, Olerud Molander Ankle Scores (OMAS), and visual analogue scale (VAS) scores. Preoperative and follow-up scores were compared with Student's t test. (p < .05).ResultsThe mean age of the patients was 52.67 ± 9.42 years (range: 39-74). The mean duration of follow-up was 14.42 ± 1.51 months (range: 12-17). At the final follow-up, the mean AOFAS score (P < 0.001) improved to 91.50 ± 2.65 points (range: 87-96), the mean OMAS (P < 0.001) improved to 77.08 ± 3.97 points (range: 70-85), and the mean VAS score (P < 0.001) improved to 0.25 ± 0.45 points (range: 0-1). Nine patients achieved excellent outcomes, and three achieved good outcomes according to the AOFAS score. Follow-up imaging evaluation indicated satisfactory alignment of the fracture and complete healing. Clinical examination suggested good mobility of the ankle. At the last follow-up, ankle dorsiflexion mobility was 14-18 degrees, plantar flexion mobility was 42-45 degrees, inversion mobility was 27-32 degrees, and eversion mobility was 22-25 degrees.ConclusionsThe modified double-row suture bridge technique is effective for achieving anatomic reduction of anterior colliculus fractures, and the technique also provides substantial benefit to the injured deltoid ligament. With this technique, the clinical outcomes can be significant and encouraging, indicating a new stage in its application and development.

Dataset Information

Multifaceted spiral suture: A hemostatic technique in managing placenta praevia or accrete: A retrospective study.

Publications

Multifaceted spiral suture: A hemostatic technique in managing placenta praevia or accrete: A retrospective study.

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