Nylon sutures (Dynek, Hendon, South Australia) were used superficially for all defect closures. Where deep dermal absorbable sutures were deemed necessary, Monosyn (B Braun Australia) was used. Melolin (Smith and Nephew Medical, Hull, UK) and Fixomull (BSN Medical Luxembourg) were applied to wounds immediately after surgery. Participants were asked not to use topical creams, ointments or antiseptics on their wounds postoperatively and were given standardised written and verbal instructions on postoperative wound care. Early wound review was encouraged in the event of any participant concern. Sutures were removed 5–7 days postoperatively. Any wound that had not fully healed was redressed until the defect had fully epithelialised.
Monosyn
Manufactured by B. Braun
Sourced in Germany, Australia, United States
Monosyn is a synthetic, absorbable surgical suture material manufactured by B. Braun. It is composed of glycolide and caprolactone polymers.
Automatically generated - may contain errors
11 protocols using monosyn
1
Standardized Wound Closure Protocol
2
Gastrointestinal Anastomosis Techniques and Outcomes
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A population undergoing elective resection in the gastrointestinal tract due to a tumour disease (stomach, small intestine, colon) was recruited.
Patients were treated under routine clinical conditions and the surgical intervention as well as the suture technique used to perform the gastrointestinal anastomosis (GIA) were performed according to the clinic's standard or to the surgeon's preference.
Monofilament, mid-term absorbable suture (Monosyn® manufactured by B. Braun Surgical SA, Rubi, Spain) was applied in all the operations to create the GIA through the following potential suture techniques: single-layer continuous; single-layer interrupted; double-layer continuous inner and interrupted outer; double-layer continuous inner and outer; double-layer interrupted inner and outer. The suture material was applied by senior physicians, consultants and residents who had been trained in, and were familiar with, the use of a monofilament. Monosyn suture 2/0 and 3/0 in combination with a HR needle were used to create the GIA. A perioperative antibiotic prophylaxis was administered to all patients. Subgroup analysis of the anastomosis leakage rate according to the suture technique was performed.
Patients were treated under routine clinical conditions and the surgical intervention as well as the suture technique used to perform the gastrointestinal anastomosis (GIA) were performed according to the clinic's standard or to the surgeon's preference.
Monofilament, mid-term absorbable suture (Monosyn® manufactured by B. Braun Surgical SA, Rubi, Spain) was applied in all the operations to create the GIA through the following potential suture techniques: single-layer continuous; single-layer interrupted; double-layer continuous inner and interrupted outer; double-layer continuous inner and outer; double-layer interrupted inner and outer. The suture material was applied by senior physicians, consultants and residents who had been trained in, and were familiar with, the use of a monofilament. Monosyn suture 2/0 and 3/0 in combination with a HR needle were used to create the GIA. A perioperative antibiotic prophylaxis was administered to all patients. Subgroup analysis of the anastomosis leakage rate according to the suture technique was performed.
3
Cranial Bone Defect Repair Protocol
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The animals were intramuscularly injected and anesthetized with a mixture of ketamine hydrochloride (Ketalar VR, Yuhan Co, Seoul, Korea) and xylazine (Rumpun VR, Bayer Korea Ltd, Seoul, Korea). After that, the surgical sites were shaved and draped with povidone iodine and alcohol followed by local anesthesia with 2% lidocaine. An incision along the sagittal midline from frontal bone to occipital bone was made and full thickness flap elevation was performed. Under the saline irrigation, four circular bi-cortical defects with a diameter of 8 mm were made by using a trephine bur. Then, randomly assigned graft materials were grafted into the defects. The flap was sutured with a biodegradable suture material (Monosyn, B-Braun, Melsungen, Germany) which was removed 10 days later. Five animals were sacrificed at 2 and 8 weeks of post surgery.
4
Surgical Techniques for Wound Approximation
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CSD is aimed at approximation by conservative sharp debridement. Therefore, CSD was proceeded without drawing an excisional line, and debridement was performed only to the extent that the approximation was possible.[5 ,14 ] Meanwhile, TSD is aimed at approximate tissues with minimal injuries by removal beyond the severely macerated, ragged wound edge or partially avulsed segment in the wound edge.[13 ,14 ] After the bleeding was controlled, a skin marker pen (Dual Marking Pen, Ayida, Xiamen, Fujian, China) was used to draw the design according to the aforementioned goal, and wound excision and incision were performed.[13 ,14 ] Various types of LFD were applied in cases of excessive tension or when preserving facial anatomical symmetry or function was required.[13 ,14 ] For all procedures performed in the ED, 6 to 0 Mersilk (Ethicon, Somerville, NJ) was used to close the cutaneous layer, 6 to 0 Monosyn (B. Braun, Rubi, Barcelona, Spain) was used for the subcutaneous layer, and 5 to 0 coated VICRYL (Ethicon, Somerville, New Jersey) was used for closure below the subcutaneous layer.
5
Surgical Procedure for Maxillary Sinus Elevation
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The overall surgical procedure used in this study followed that used by Choi et al. [23 (link)]. A mixture of ketamine hydrochloride (Ketalar, Yuhan, Seoul, Republic of Korea) and xylazine (Rompun, Bayer Korea, Seoul, Republic of Korea) was injected intramuscularly for general anesthesia. After shaving the nasal bone area and preparing the skin surface with povidone iodine, 2% lidocaine (Lidocaine HCl, Huons, Seoul, Republic of Korea) was injected for local anesthesia. A linear incision was made along the sagittal midline on the nasal bone, and then a full-thickness flap was elevated bilaterally. On the lining bony plate over the maxillary sinus area at a position decided in the previous study [23 (link)], a circular bony window with a diameter of 6 mm was made using a trephine bur (3i Implant Innovation, Palm Beach Gardens, FL, USA) under saline irrigation while taking great care not to perforate the Schneiderian membrane. The excised bony disc was removed, and then the Schneiderian membrane was elevated carefully and 0.15 g of deproteinized bovine bone mineral was grafted. The flap was replaced and sutured layer by layer with 4-0 absorbable glyconate monofilament (Monosyn, B-Braun, Aesculap, Center Valley, PA, USA). The stitches were removed 7 days postoperatively.
6
Postoperative Wound Care Protocol
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If the wound required deep dermal absorbable sutures, Monosyn (B. Braun, Sydney, Australia) was used. All defects were closed superficially with nylon sutures (Dynek Pty Ltd., Hendon, South Australia). Following wound closure, Melolin (Smith and Nephew Medical Ltd, Hull, UK) and Fixomull (BSN Medical, Luxenburg) was applied.
Standardized verbal and written postoperative wound care instructions were given to all participants, stressing the importance of applying no topical creams, ointments, or antiseptics to the wound for the month after surgery. All participants were reviewed 7 days postoperatively for wound inspection and redressing. Information related to the use of postoperative oral analgesia (strongest analgesic used) was also recorded at this time. Early review at the study practice was encouraged in the event of discomfort, erythema, swelling, or discharge associated with the wound. Sutures were removed 14 days after surgery. If at the time of suture removal the wound had not fully healed, it was dressed again and regularly reviewed until it had completely epithelialized.
Standardized verbal and written postoperative wound care instructions were given to all participants, stressing the importance of applying no topical creams, ointments, or antiseptics to the wound for the month after surgery. All participants were reviewed 7 days postoperatively for wound inspection and redressing. Information related to the use of postoperative oral analgesia (strongest analgesic used) was also recorded at this time. Early review at the study practice was encouraged in the event of discomfort, erythema, swelling, or discharge associated with the wound. Sutures were removed 14 days after surgery. If at the time of suture removal the wound had not fully healed, it was dressed again and regularly reviewed until it had completely epithelialized.
7
Laparoscopic Ovariectomy in Dogs
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All dogs underwent a midline– three– port LapOV. Pneumoperitoneum was created using a Veress technique, and abdominal pressure was maintained at 8−10 mmHg. Two 5– mm portals were placed on the midline, in the middle and cranial position, and a 5– or 3– mm trocar was inserted in the caudal position depending on the dog’s size. The animal was positioned with lateral tilt, and the ovary was suspended with laparoscopic Allis grasping forceps (Clickline®, Karl Storz Endoscopy, Tuttlingen, Germany). The LigaSure™ (Medtronic, Minneapolis, MN, USA) vessel– sealing device was used to coagulate and cut the suspensory ligament, ovarian pedicle, and fallopian tube. The procedure was repeated at the contralateral side, and both ovaries were removed through the middle or caudal cannula or the abdominal incision. Finally, the pneumoperitoneum was released, and the portals were closed with 2/0 polyglyconate sutures (Monosyn®, B Braun, Tuttlingen, Germany) for inner layers and 3/0 for intradermal sutures.
8
Single-port Laparoscopic Adnexal Surgery
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All surgeries were performed by a single surgeon (SH Shim). After general anesthesia, the patient was placed in the dorsal lithotomy position. A Cohen cannula was used for uterine manipulation and was handled by the second assistant. An approximately 2 cm intraumbilical skin incision was made, and a single port device (Glove port; Nelis, Bucheon, Korea) was installed transumbilically. Rounded distention of the abdomen after initial pneumoperitoneum was made adequately. The adnexal surgeries were performed with the monopolar or bipolar forceps, atraumatic forceps, scissors, toothed grasper, and a suction-irrigator. The tissue was placed in a 10 mm endobag and removed from the pelvic cavity via the 20 mm incision site. The inserted single port device was removed from the abdominal wall. Group 1 did not receive local injection and group 2 received 10 mL of 0.25% bupivacaine (100 mg) into the 20 mm trocar incision site at the end of LESS. Injecting the local anesthetic through all preperitoneal layers provided a full-thickness local injection. Bupivacaine (0.25%) was injected with a 22G needle. The fascia of the 20 mm puncture site was closed layer by layer with a 2-0 polyglactin suture (Vicryl, Ethicon Inc., Somerville, NJ, USA). The skin was closed by interrupted sutures with 3-0 resorbable monofilament suture (Monosyn, B. Braun, Melsungen, Germany).
9
Dental Implant Surgery with GBR
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Implant surgery with GBR was conducted by 3 board-certified periodontists (JHL, DWL, and JHY) at the 3 participating dental hospitals. After mucoperiosteal flaps were fully elevated under local anesthesia (2% lidocaine HCl with 1:100,000 epinephrine), dental implants (Anyone®, MegaGen Implant Co., Ltd., Daegu, Korea; Astra OsseoSpeed Tx®, Dentsply Sirona Implants, Mannheim, Germany; Superline®, Dentium, Seoul, Korea; Roxolid®, Straumann, Basel, Switzerland; or TS III®, Osstem, Seoul, Korea) were placed in the correct prosthetic position according to the manufacturer’s instructions.
Primary wound closure of the flap was achieved using interrupted and horizontal mattress suture techniques with or without vertical releasing incisions with non-absorbable (4–0 Biotex®, Purgo, Seongnam, Korea; 4–0 Dafilon®, Braun Surgical, Tuttlingen, Germany) and absorbable (5–0 and 6–0 Vicryl®, Johnson & Johnson, New Brunswick, NJ, USA; 5–0 Monosyn®, B. Braun, Melsungen, Germany) sutures. All enrolled patients were instructed on proper oral hygiene and were provided with analgesics (amoxicillin [500 mg], 3 times daily) and antibiotics (ibuprofen [200 mg], 3 times daily) for 5 days, as well as mouthwash containing 0.12% chlorhexidine gluconate. The sutures were removed 2 weeks after implant placement (Figure 1 ).
Primary wound closure of the flap was achieved using interrupted and horizontal mattress suture techniques with or without vertical releasing incisions with non-absorbable (4–0 Biotex®, Purgo, Seongnam, Korea; 4–0 Dafilon®, Braun Surgical, Tuttlingen, Germany) and absorbable (5–0 and 6–0 Vicryl®, Johnson & Johnson, New Brunswick, NJ, USA; 5–0 Monosyn®, B. Braun, Melsungen, Germany) sutures. All enrolled patients were instructed on proper oral hygiene and were provided with analgesics (amoxicillin [500 mg], 3 times daily) and antibiotics (ibuprofen [200 mg], 3 times daily) for 5 days, as well as mouthwash containing 0.12% chlorhexidine gluconate. The sutures were removed 2 weeks after implant placement (
10
Suture Technique for Mucoperiosteal Flap Closure
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Primary closure of the crestal mucoperiosteal flaps was achieved using vertical mattress sutures: 6/0 nylon (Monosyn, B. Braun, Hessen, Germany) and/or 5/0 PTFE (Biotex, Purgo Biologics). To ensure intimate flap adaptation, the near and far points of needle insertion for the vertical mattress suture were within 1 mm of the wound margin and 5 mm from the near point, respectively. Minimally advanced mucoperiosteal flaps were passively closed but supported the biomaterial grafted space without aid of fixation devices. Interrupted sutures repositioned the vertical aspects of the flap.
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