Investigation of the best suture pattern to close a stuffed Christmas turkey
ABSTRACT Instructions on how to debone and stuff a turkey are available, but what is the best way to close it up? A randomised trial involving 15 turkeys was performed in order to evaluate skin disruption scores and cosmetic outcomes following the use of different suture patterns. Turkeys were deboned, stuffed and cooked according to guidelines of the US Department of Agriculture Food Safety and Inspection Services. After stuffing, they were randomly assigned to one of five closure groups: simple continuous Lembert; simple continuous Cushing; simple continuous Utrecht; simple continuous; or staples. Turkeys were cooked at 180 °C for two hours ensuring core temperature reached 75 °C. Suture line integrity was evaluated after removal of the sutures and the cosmetic aspect was graded. Before cooking, the Utrecht pattern and skin staples offered the best cosmetic result. After removal of the sutures, the skin remained intact only in the stapled group. All other suture patterns disrupted the skin after removal of the sutures, rendering the turkey less cosmetically appealing for serving. Closure of a stuffed turkey was best performed using skin staples to achieve the best cosmetic results. Using this technique you will be able to impress family and friends at a Christmas dinner, and finally show them your surgical skills.
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ABSTRACT: To compare functional indices of end-to-end (EEA) jejunojejunal anastomosis using skin staples in horses with a 2-layer inverting hand-sewn technique. Experimental study. Jejunal segments from 8 fresh equine cadavers. For each bowel segment, 2 EEA anastomoses were created: one 2-layer hand-sewn and one 1-layer using skin staples. Time for anastomosis creation was recorded and compared. Lumen diameter of each anastomosis was measured on digital radiographs after intraluminal instillation of contrast medium and inflation of the jejunal segments to 14 mm Hg. Anastomotic indices (a compensated measure of stoma diameter) and bursting pressure were determined. EEA jejunal anastomosis using skin staples was significantly faster than use of a 2-layer hand-sewn technique. Anastomotic index, a measure of lumen size, was significantly larger with the skin-staple technique; however, the bursting pressure of stapled anastomoses was significantly less than for the hand-sewn technique, but the values were well above those reported for other anastomotic techniques. An anastomotic technique using skin staples was easy to learn and perform, effective and faster, and mechanically comparable with a hand-sewn 2-layer technique. The staple technique could be beneficial in equine gastrointestinal surgery by reducing anastomosis time, although further in vivo studies are needed to establish clinical safety.Veterinary Surgery 11/2006; 35(7):678-82. DOI:10.1111/j.1532-950X.2006.00208.x · 0.99 Impact Factor
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ABSTRACT: To evaluate single and double layer end-to-end anastomosis in equine jejunum. Experimental in vitro study. Mid-jejunal sections from 12 adult horses without gastrointestinal disease. Jejunal end-to-end anastomoses were performed by a continuous Lembert pattern or a simple continuous pattern oversewn with a Cushing pattern. Jejunal segments were distended with fluid at 1 L/min, and intraluminal pressure at failure, and mode of failure were recorded. Bursting pressure and bursting wall tension were calculated. Anastomosis construction time and degree of luminal reduction were recorded. Results- Single layer anastomoses were constructed in less time than 2-layer anastomoses. Both anastomotic techniques resulted in luminal reduction compared with control tissue; however, the reduction was smaller with a 1-layer continuous Lembert anastomosis. No differences were noted in bursting pressure or bursting wall tension between groups. Anastomosis using a 1-layer continuous Lembert pattern resulted in a larger stoma, was faster to perform, and as strong as a 2-layer anastomosis. Use of a 1-layer continuous Lembert pattern for jejunojejunosotomy may be beneficial by decreasing anastomosis time and produce a larger stoma than a 2-layer anastomosis.Veterinary Surgery 11/2006; 35(7):669-73. DOI:10.1111/j.1532-950X.2006.00206.x · 0.99 Impact Factor