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Patients may complain of bleeding, prolapse, personal discomfort and minor anal leakage. Where traditional non-surgical measures such as rest, suppositories and dietary advice fail to improve the condition, there is then a choice of further treatments. Opinion on the best management for patients varies considerably.
This is different from a traditional hemorrhoidectomy, which focused on excising the hemorrhoidal bundle. In this procedure, there is no tissue excision. Because the suture line is above the pectinate line, post-operative pain is minimized for patients. THD can be performed with conscious sedation, local [5] or general anesthesia.
Catgut Chrome (B Braun) suture is a variant treated with chromic acid salts. This treatment produces roughly twice the stitch-holding time of plain catgut, but greater tissue inflammation occurs. Full tensile strength is extended to 18–21 days. It is brown rather than straw-colored, and has improved smoothness due to the dry presentation of ...
Surgical staples are specialized staples used in surgery in place of sutures to close skin wounds or to resect and/or connect parts of an organ (e.g. bowels, stomach or lungs). The use of staples over sutures reduces the local inflammatory response, width of the wound, and time it takes to close a defect. [1]
A surgical suture, also known as a stitch or stitches, is a medical device used to hold body tissues together and approximate wound edges after an injury or surgery. Application generally involves using a needle with an attached length of thread. There are numerous types of suture which differ by needle shape and size as well as thread material ...
After the patient is anesthetized, an incision is made posterior to (behind) the anus and a space between the EAS and IAS is opened up. This plane is followed, freeing the rectum from its attachment to the pelvic floor. Puborectalis and pubococcygeus are folded and held with stitches. These folds will lengthen the anal canal.
With a blood vessel the surgeon will clamp the vessel perpendicular to the axis of the artery or vein with a hemostat, then secure it by ligating it; i.e. using a piece of suture around it before dividing the structure and releasing the hemostat.
They tend to absorb this suture at a higher rate. Special precautions should be taken in elderly patients and patients with history of anemia and malnutrition conditions. As with any suture material, adequate knot security requires the accepted surgical technique of flat and square ties. The PDS suture knots must be properly placed to be secure.