Surgical correction of the ruptured testicle should be done by a trans-scrotal approach with evacuation of the hematoma and repair of the injury. Dexon suture material twisted and monofilament manufactured absorbable sutures made out of the homopolymer of glycolic acid. The resulting PGA polymer having Mw from 20 000 to 140 000 is suitable for fiber extrusion and suture manufacturing. Polyglycolic acid (PGA) was the first synthetic absorbable suture introduced in the early 1970s (Frazza and Schmitt, 1971; Schmitt and Polistina, 1967; Katz and Turner, 1970). As originally described, the sling was placed around the urethra and suspended up against the pubic symphysis in a “U” shape (Fig. Frequently, an alcohol like lauryl alcohol is added into the polymerization to control the molecular weight. Return of spermatogenesis after such an injury is unpredictable. In such cases, the sling tension may be increased slightly to maximize the likelihood of having a continent reconstructed sphincter. uses two polyglycolic acid sutures tied together at the tails, run in opposite directions in a running fashion. The absorption time for Polyglycolic Acid (PGA) is 60 to 90 days. These individuals often prefer a Mitrofanoff catheterizable abdominal stoma to urethral catheterization. Table 2.1 summarizes the characteristics of several sutures. The urethral edges are reapproximated with interrupted 2-0 polyglycolic acid sutures. After cross-trigonal ureteral reimplantation, the urethral strip is tubularized in two layers using polyglycolate or monocryl suture (4-0 or 5-0) over an 8- or 10-Fr urethral catheter depending on the size of the patient. The muscles are resutured to their original insertions with 5–0 braided polyglycolic acid sutures (Fig. Bertil E. Damato, ... Wallace S. Foulds, in Retina (Fifth Edition), 2013. When the muscle insertion is located on the scleral flap, the reinsertion of the muscle is safer if a 1 mm stump of tendon is left in situ at the time of the disinsertion. This repair employs a modification of the Leadbetter procedure technique described previously.89 In this modification, a full-thickness transverse incision is made in the anterior urethra and is extended cephalad. It is a synthetic adsorbable suture material. PGA suture retain approximately 75% of PGA initial strength after two weeks. A bladder capacity less than 60 mL under anesthesia or during urodynamic evaluation decreases the success of BNR. Next, the distance around the bladder neck is measured with umbilical tape (see Fig 58-4H). At 2 to 3 weeks postoperatively, urethral catheterization with a coudé catheter is recommended if the patient is to perform urethral CIC (Fig. Experimentation with absorbable polyesters led to the development of poly-l-lactic acid (PLA) and polyglycolic acid (PGA) as resorbable implantable devices. After the closure, dissection around the new bladder neck may be performed if a combined bladder neck wrap or sling will also be created. Postoperatively, urine is drained through a combination of ureteral stents, a suprapubic tube, and a 6-Fr urethral catheter. Penile fracture, although uncommon, demands immediate diagnosis and correction. It also moves fibrotic tissue at the level of the original bladder neck away from the new bladder neck. Urinary drainage is achieved by the use of bilateral ureteral catheters and suprapubic tube drainage. To compensate for any muscle shortening, the distance from the suture knots to the limbus is measured before the muscle tendon is divided and also at the time of reinsertion so that a sling can be used if necessary. It is necessary to place much more tension around the male urethra than the female urethra to achieve continence (see Fig. Occasionally, a portion of the intersymphyseal band must be divided completely for good visualization. 100% pure PGA sutures made by companies other than Covidien have been introduced, such as Medifit® (Japan Medical Supply Co.) Safil and Safil Quick (B. Braun AG, Germany), Bondek (Deknatel, USA), Surucryl (SURU International, India), Surgifit (AILEE, Korea), and Biovek (Dynek, Australia). The urethral edges are reapproximated with interrupted 2-0, Current Therapy of Trauma and Surgical Critical Care, Michael Mitchell MD, Richard Grady MD, in, Ashcraft's Pediatric Surgery (Fifth Edition), the bladder neck is extensively dissected and a vertical cystotomy is made. Ureteral stents are removed at 2 to 3 weeks, and voiding trials are begun in the third week. These tunica injuries should be surgically corrected and involve degloving the penis, controlling the bleeding, and reapproximation of the tunica albuginea with interrupted polyglycolic acid sutures. 3-0 poliglecaprone (Monocryl®, Ethicon, Somerville, NJ) sutures with an RB needle to create a double-armed suture, and perform the anastomosis very similar to Van Velhoven’s technique. This reinforces the neobladder neck, decreases the risk of fistula, and augments the outlet resistance.90 The sutures in the third layer are not cut because they are used in the MMK bladder neck suspension.87. The neourethra is tubularized over an 8-Fr stent using interrupted or running. Rare complications can include wound separation, which can be minimized by avoiding chromic sutures that may resorb prematurely and by closing the incisions in two layers. Michael Mitchell MD, Richard Grady MD, in Ashcraft's Pediatric Surgery (Fifth Edition), 2010. All over the world. a molecule that is not superimposable on its mirror image), it exists in two stereoisomeric forms that give rise to four morphologically different polymers: d-PLA, l-PLA, Dl-PLA and meso-PLA. Coated with a tonsillectomy a return of spermatogenesis after such an injury present... After the operation the world glycolide acids of collagen formation in the healing process conjunctiva is closed with 8–0 polyglactin... 2–4 weeks after implantation suture manufacturing trauma and surgical Critical Care, 2008 this problem, the sling tension increased. 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