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Dr. Kolb,

I have a question for you. I have a horrible allergy to prolene and vicryl

sutures and as such, my docs have had to use alternatives when I've had

surgery. My neurosurgeon, as I've stated before, sutures like he's a

plastic surgeon. With both surgeries, he's used a monofilament nylon suture

which is subcuticular. He leaves the ends out at the end of each incision,

and I guess in the middle, loops it for easy removal.

Each time, my incisions have been unbelievably tiny, and as with all scars,

have faded incredibly over time, to the point that about 3 months or less

after my first cervical spinal surgery, you couldn't even tell I had a scar

on my anterior neck.

My question is this: is this particular suturing technique something that

is used commonly? Or is it really just the skill of the surgeon doing the

suturing? Do you ever use this method? Dr. Huang used the same method for

my explantation and my scars are barely visible. I'm impressed with this

technique, even though it does mean having to come back to the doc to have

your sutures removed. But I'm really just curious if more docs use it or

they just lack in their suturing technique.

Thanks,

e

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I have used this technique but prefer buried Maxon or PDS with just a few

nylon as sometimes the nylon can break off if subcuticular. These buried

sutures take 5 months to dissolve and the scars are very narrow. .

----- Original Message -----

From: e Rene <e_Rene@...>

< >

Sent: Saturday, March 09, 2002 6:18 PM

Subject: Suturing technique

>

>

> Dr. Kolb,

>

> I have a question for you. I have a horrible allergy to prolene and

vicryl

> sutures and as such, my docs have had to use alternatives when I've had

> surgery. My neurosurgeon, as I've stated before, sutures like he's a

> plastic surgeon. With both surgeries, he's used a monofilament nylon

suture

> which is subcuticular. He leaves the ends out at the end of each

incision,

> and I guess in the middle, loops it for easy removal.

>

> Each time, my incisions have been unbelievably tiny, and as with all

scars,

> have faded incredibly over time, to the point that about 3 months or less

> after my first cervical spinal surgery, you couldn't even tell I had a

scar

> on my anterior neck.

>

> My question is this: is this particular suturing technique something that

> is used commonly? Or is it really just the skill of the surgeon doing the

> suturing? Do you ever use this method? Dr. Huang used the same method

for

> my explantation and my scars are barely visible. I'm impressed with this

> technique, even though it does mean having to come back to the doc to have

> your sutures removed. But I'm really just curious if more docs use it or

> they just lack in their suturing technique.

>

> Thanks,

>

> e

>

> _________________________________________________________________

> Chat with friends online, try MSN Messenger: http://messenger.msn.com

>

>

>

>

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Dr. Kolb, I know my neurosurgeon used interrupted 2-0 PDS sutures in the platysma, and inverted interrupted 2-0 PDS in the subcutaneous tissues in my neck. For my hip, he closed the fascia with interrupted 0 Panacryl sutures, and then used the inverted interrupted 2-0 PDS for the SQ tissues. The skin incisions, (both anterior neck and hip) were closed with running subcuticular 4-0 monofilament nylon sutures. Another question--I've never heard of Panacryl sutures before. What type of suture is this? And how long does it take for that to dissolve? And another question--he had no problem pulling the sutures out of my neck; however, when he went to pull the sutures out of my hip, the first set (the most lateral) came out pretty easy, but the more medial ones were very difficult to get out. He had to do quite a bit of pulling to get them out. Would it be possible that some nylon broke off and has lodged in the SQ tissue? My hip is still pretty sore, and while I know that taking autologous bone can be very painful, I have to wonder if perhaps some nylon broke off and is causing the tenderness. And will the sutures he used in the deep tissue dissolve in about 5 months, or will it take longer since it involves bone? Do you see many allergic rxns to the above sutures? Thanks again, e ----- Original Message ----- From: Dr. Kolb Sent: Saturday, March 09, 2002 4:37 PM Subject: Re: Suturing technique I have used this technique but prefer buried Maxon or PDS with just a fewnylon as sometimes the nylon can break off if subcuticular. These buriedsutures take 5 months to dissolve and the scars are very narrow. .----- Original Message -----From: e Rene <e_Rene@...>< >Sent: Saturday, March 09, 2002 6:18 PMSubject: Suturing technique>>> Dr. Kolb,>> I have a question for you. I have a horrible allergy to prolene andvicryl> sutures and as such, my docs have had to use alternatives when I've had> surgery. My neurosurgeon, as I've stated before, sutures like he's a> plastic surgeon. With both surgeries, he's used a monofilament nylonsuture> which is subcuticular. He leaves the ends out at the end of eachincision,> and I guess in the middle, loops it for easy removal.>> Each time, my incisions have been unbelievably tiny, and as with allscars,> have faded incredibly over time, to the point that about 3 months or less> after my first cervical spinal surgery, you couldn't even tell I had ascar> on my anterior neck.>> My question is this: is this particular suturing technique something that> is used commonly? Or is it really just the skill of the surgeon doing the> suturing? Do you ever use this method? Dr. Huang used the same methodfor> my explantation and my scars are barely visible. I'm impressed with this> technique, even though it does mean having to come back to the doc to have> your sutures removed. But I'm really just curious if more docs use it or> they just lack in their suturing technique.>> Thanks,>> e>> _________________________________________________________________> Chat with friends online, try MSN Messenger: http://messenger.msn.com>>>>

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.. I have never heard of the other suture you mentioned. PDS takes about 5 months to dissolve. Your surgeon would know if any nylon was left in the subcut tissue. It usually works its way out. .

----- Original Message -----

From: e Rene

Sent: Saturday, March 09, 2002 7:41 PM

Subject: Re: Suturing technique

Dr. Kolb,

I know my neurosurgeon used interrupted 2-0 PDS sutures in the platysma, and inverted interrupted 2-0 PDS in the subcutaneous tissues in my neck. For my hip, he closed the fascia with interrupted 0 Panacryl sutures, and then used the inverted interrupted 2-0 PDS for the SQ tissues. The skin incisions, (both anterior neck and hip) were closed with running subcuticular 4-0 monofilament nylon sutures.

Another question--I've never heard of Panacryl sutures before. What type of suture is this? And how long does it take for that to dissolve? And another question--he had no problem pulling the sutures out of my neck; however, when he went to pull the sutures out of my hip, the first set (the most lateral) came out pretty easy, but the more medial ones were very difficult to get out. He had to do quite a bit of pulling to get them out. Would it be possible that some nylon broke off and has lodged in the SQ tissue? My hip is still pretty sore, and while I know that taking autologous bone can be very painful, I have to wonder if perhaps some nylon broke off and is causing the tenderness.

And will the sutures he used in the deep tissue dissolve in about 5 months, or will it take longer since it involves bone? Do you see many allergic rxns to the above sutures?

Thanks again,

e

----- Original Message -----

From: Dr. Kolb

Sent: Saturday, March 09, 2002 4:37 PM

Subject: Re: Suturing technique

I have used this technique but prefer buried Maxon or PDS with just a fewnylon as sometimes the nylon can break off if subcuticular. These buriedsutures take 5 months to dissolve and the scars are very narrow. .----- Original Message -----From: e Rene <e_Rene@...>< >Sent: Saturday, March 09, 2002 6:18 PMSubject: Suturing technique>>> Dr. Kolb,>> I have a question for you. I have a horrible allergy to prolene andvicryl> sutures and as such, my docs have had to use alternatives when I've had> surgery. My neurosurgeon, as I've stated before, sutures like he's a> plastic surgeon. With both surgeries, he's used a monofilament nylonsuture> which is subcuticular. He leaves the ends out at the end of eachincision,> and I guess in the middle, loops it for easy removal.>> Each time, my incisions have been unbelievably tiny, and as with allscars,> have faded incredibly over time, to the point that about 3 months or less> after my first cervical spinal surgery, you couldn't even tell I had ascar> on my anterior neck.>> My question is this: is this particular suturing technique something that> is used commonly? Or is it really just the skill of the surgeon doing the> suturing? Do you ever use this method? Dr. Huang used the same methodfor> my explantation and my scars are barely visible. I'm impressed with this> technique, even though it does mean having to come back to the doc to have> your sutures removed. But I'm really just curious if more docs use it or> they just lack in their suturing technique.>> Thanks,>> e>> _________________________________________________________________> Chat with friends online, try MSN Messenger: http://messenger.msn.com>>>>

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