Shunsuke Hotokezaka

Effect of circumferential sutures on tensile and gap strength of repaired canine flexor tendons

Sixty-four dog cadaver flexor digitorum profundus tendons in zone 2 were lacerated and repaired with a simple or a cross-stitch peripheral circumferential suture in combination with two-, four-, or six-strand core sutures. The tensile and gap strengths were compared. The range of tensile strengths with the cross-stitch circumferential suture in combination with various core suture techniques (4.28–9.37 kgf) was significantly higher than the range of values for the simple circumferential suture and similar core suture techniques (1.70–4.98kgf). The tensile strength with two-strand core suture plus the cross-stitch circumferential suture (5.29kgf) was as great as that of the six-strand core suture plus the simple circumferential suture (4.98kgf). Increased gap strength values were also observed with the cross-stitch (1.11–3.19 kgf) compared to the simple (0.84 to 1.76 kgf) circumferential sutures. The cross-stitch circumferential suture had a mechanical advantage in flexor tendon repair compared to the simple circumferential suture.

Usefulness of Electric Clinical Pathway for Prevention of Thrombosis Events in Hip Fracture by Standardization of Treatment

【目的】当院では，2009年3月より大腿骨近位部骨折に対して電子パスを用い，治療方針の標準化・医療の質の向上を図っている．その具体例として今回，DVT/PE予防にどのように関わっているかを検討した．【対象と方法】電子パス運用開始後の大腿骨近位部骨折手術例53例と運用開始前53例を対象とした．これら2群の抗血栓薬の使用状況，術後7日目のD-dimer測定状況を比較した．また，抗血栓薬使用のあり群となし群で分けて術後7日目のD-dimer値，術後DVT/PEの発症数を比較した．【結果】血栓予防薬の使用状況は電子パス運用前26.4％，電子パス運用例81.1％であった．術後7日目のD-dimer値は電子パス運用前では88.7％，電子パス運用例では96.2％で測定されていた．血栓予防薬使用群のD-dimer値は8.10でDVT/PEは認めなかった．一方，血栓予防薬非使用群のD-dimer値は10.75でDVT/PEを5例認めた．【結論】電子パスを運用することで薬剤使用の標準化が図られ，DVT/PE発生の予防に効果があった．