Fibrin glue vs. sutures for conjunctival autograft in pterygium.

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Journal name: World Journal of Pharmaceutical Research
Original article title: Retrospective study of fibrin glue versus sutures for conjunctival autograft in pterygium surgery
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Original source:

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Author:

Dr. Ameetkumar Shamsunder Agrawal, Dr. Suvarna P. Golecha and Dr. Neelam Gidwani


World Journal of Pharmaceutical Research:

(An ISO 9001:2015 Certified International Journal)

Full text available for: Retrospective study of fibrin glue versus sutures for conjunctival autograft in pterygium surgery

Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research

Doi: 10.20959/wjpr202214-25986

Copyright (license): WJPR: All rights reserved


Download the PDF file of the original publication


Summary of article contents:

Introduction

Pterygium is a degenerative condition characterized by the growth of subconjunctival tissue as vascularized granulation that invades the cornea, leading to potential vision impairment when it covers the pupillary axis. While surgery is the definitive treatment for pterygium, it can be complex and often involves the risk of recurrence. This retrospective study aimed to compare the effectiveness of fibrin glue versus sutures in securing conjunctival autografts during pterygium surgery, focusing on graft stability, recurrence rates, and patient comfort.

Graft Stabilization Techniques

The study consisted of 54 patients undergoing pterygium surgery, divided into two groups based on the technique used for securing the graft: Group A received a 10-0 VICRYL suture fixation, while Group B used fibrin glue. Both groups showed stability in graft presence during the initial follow-up periods of one day, 15 days, and one month post-surgery. The findings implied that both techniques could ensure solid graft attachment, with no significant differences noted in immediate graft stability, as all grafts remained adhered at these time points.

Patient Comfort and Post-Surgical Symptoms

A significant aspect of the study was the evaluation of patient comfort and the presence of postoperative symptoms such as foreign body sensation, watering, and lid edema. Results indicated that Group B, utilizing fibrin glue, reported significantly higher comfort levels than Group A, associated with the irritation caused by sutures. The detailed observations demonstrated that patients in Group A experienced more pronounced symptoms, notably in the first month following surgery, while symptoms progressively eased in the fibrin glue group.

Recurrence Rates and Complications

With respect to recurrence rates, the study recorded a total of 5.55% overall. In Group A, two cases experienced recurrence (6.06%), while Group B had one case (4.76%). Despite a slightly higher recurrence in the sutured group, the rates from both groups were deemed low. Moreover, the frequency of major complications was negligible—no instances of graft dehiscence or serious suture-related infections were reported, indicating that both techniques maintained a high level of safety for patients.

Conclusion

In conclusion, the findings suggest that fibrin glue is as effective as traditional suturing for securing conjunctival autografts in pterygium surgery, while offering the additional benefits of higher patient comfort and reduced procedural time. Despite a marginal difference in recurrence rates, both methods demonstrated comparable efficacy, making fibrin glue a favorable alternative due to its ease of use and enhanced patient experience. This study underscores the continued need for refining surgical techniques to improve outcomes in pterygium management.

FAQ section (important questions/answers):

What is the purpose of the study on pterygium surgery?

The study aimed to compare the graft stability, recurrence rate, and surgical outcomes of using fibrin glue versus sutures in conjunctival autografts for pterygium surgery.

What were the characteristics of the patients included in the study?

The study included 54 patients aged 20-50 years with primary nasal pterygium, excluding those with other ocular pathologies or systemic drugs that could affect outcomes.

What surgical techniques were used in the study groups?

Group A used the 10-0 VICRYL suture technique, while Group B utilized fibrin glue to fix the conjunctival autograft during pterygium surgery.

What were the main findings regarding graft recurrence rates?

Recurrence rates were 6.06% for sutured grafts in Group A and 4.76% for fibrin glue in Group B, with an overall recurrence rate of 5.55% in the study.

How did patient comfort compare between the two methods?

Patients in the fibrin glue group reported significantly higher comfort levels than those in the sutured group, likely due to less irritation from sutures.

How does the time required for each technique compare?

The fibrin glue technique is quicker, taking about 5 minutes, compared to 15-20 minutes for the suturing method, making it advantageous in surgical settings.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Fibrin glue vs. sutures for conjunctival autograft in pterygium.”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
A table is a structured representation of data that organizes information for easier understanding and analysis. In the study, tables are used to present the distribution of patients, age groups, gender, graft stability, patient comfort, watering, and recurrence rates for clearer visual comparison and comprehension of the study results.

2) Study (Studying):
Studying involves dedicated learning and analysis concerning a particular subject. In this research, studying indicates the methodical approach taken to analyze the results and implications of using fibrin glue versus sutures in pterygium surgery, ultimately contributing to improved surgical practices and patient care.

3) Observation:
Observation involves the careful examination of a subject or phenomenon. In this research, observations were made regarding patient comfort, graft stability, and signs of complications post-surgery. This method provided crucial insights into the effectiveness of the surgical techniques used, which can guide future practices in ophthalmic surgery.

4) Edema (Oedema):
Edema signifies swelling caused by fluid accumulation in tissues. In the study, lid edema was monitored to assess postoperative complications related to the surgical procedure. Understanding the incidence and severity of edema can help evaluate the recovery process and guide clinicians in managing patient discomfort.

5) Shalakyatantra (Salakyatantra, Shalakya-tantra, Shalakyatamtra):
Shalakya-tantra is a branch of Ayurveda that deals with diseases of the head and neck, including ophthalmic conditions. It plays a vital role in the study as the surgical techniques applied to treat pterygium align with Ayurvedic principles, promoting a holistic approach to patient management in ophthalmology.

6) Ayurveda (Ayus-veda):
Ayurveda is an ancient Indian system of medicine centered on balancing the mind, body, and spirit. The research incorporates Ayurvedic practices through the perspective of Shalakya-tantra, reflecting a traditional approach to treating eye diseases. This integration emphasizes the importance of holistic healing in modern surgical techniques.

7) Surface:
Surface refers to the outermost layer of an anatomical structure. In the context of this study, it is predominantly used concerning the ocular surface, as the surgical procedures aim to restore the integrity of the cornea’s surface following pterygium removal, enhancing visual function and patient comfort.

8) Tantra (Tantrism, Tamtra):
Tantra refers to a framework of techniques and practices within various spiritual or medical traditions. In Ayurveda, tantra encompasses methods of treatment for specific conditions. The study links to Shalakya-tantra, implying a cultural and medicinal context within which the surgical techniques are applied and studied.

9) India:
India is the country where the study was conducted, and its rich historical context in traditional medicine, particularly Ayurveda, heavily influences the surgical methods employed. The demographic and cultural background of the patient population is imperative in understanding the results and outcomes of the study.

10) Inflammation:
Inflammation is a biological response to harmful stimuli, often causing redness, swelling, and pain. In this surgical context, inflammation can arise postoperatively, and assessing its levels can provide insights into the body's healing response and the effectiveness of the surgical technique applied to the pterygium.

11) Irritation:
Irritation refers to an uncomfortable or painful sensation often resulting from inflammation or mechanical factors. The sensation of irritation was noted as a significant factor in the study, affecting patient comfort and recovery. Understanding this aspect can help improve surgical techniques and patient management postoperatively.

12) Antibiotic (Antibacterial):
Antibiotics are medications used to prevent or treat infections by killing or inhibiting the growth of bacteria. In this study, antibiotics were used in the postoperative care of patients to avert infection risks, indicating the importance of prophylactic measures in ensuring successful surgical outcomes.

13) Relative:
The term relative is used to indicate the comparative or proportionate relationship of one factor to another. In the study, it is employed in assessing the size of the conjunctival autograft relative to the bare sclera, stressing the importance of appropriate graft sizing for optimal surgical outcomes.

14) Suvarna:
Suvarna refers to one of the authors, Dr. Suvarna P. Golecha, whose expertise contributes to the research findings. Recognizing the roles of key individuals in the study facilitates understanding of the collaborative effort and diverse expertise that underpin the research outcomes presented in the publication.

15) Cotton:
Cotton is a natural fiber commonly used for various medical applications, including surgical procedures and wound care. In the study, cotton was mentioned in relation to the technique used to dry the graft and the receptor zone, emphasizing the importance of maintaining a clear surgical field for better adhesion.

16) Nilam:
Neelam refers to another contributing author, Dr. Neelam Gidwani, who adds value to the study through her expertise. Identifying the authors establishes accountability and recognizes the collaborative nature of medical research, which is essential for ensuring quality findings and credible results in the publication.

17) Water:
Water in this research context is associated with the finding of watering as a postoperative symptom. This symptom is crucial for evaluating patient comfort and graft stability post-surgery, as excessive tearing could indicate complications or discomfort that need to be addressed for optimal recovery.

18) Sign:
Sign refers to any indication or evidence of a condition observed during the study. Doctor's evaluations often look for visible signs postoperatively, such as graft adherence or inflammation levels. Identifying these signs is essential for assessing surgical outcomes and patient recovery during follow-up visits.

19) Pain:
Pain is an integral part of the postoperative experience for patients following surgery. Understanding and monitoring pain levels in this study were critical for assessing patient comfort and satisfaction with the surgical techniques used, thus informing improvements in practice and overall patient care in ophthalmology.

20) Drug:
A drug can refer to any substance used for medical purposes, including pain relief or infection prevention. In the context of this study, it relates to medications used during or after surgery, highlighting the importance of pharmacological assistance in promoting healing and ensuring positive surgical outcomes.

21) Male:
Male refers to one of the gender demographics analyzed in the study. Understanding the distribution of male and female patients allows for insights into gender-related trends in pterygium cases, which may impact treatment approaches and possibly the efficacy of surgical techniques for different populations.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Fibrin glue vs. sutures for conjunctival autograft in pterygium.’. Further sources in the context of Science might help you critically compare this page with similair documents:

Study design, Recurrence Rate, Fibrin glue, Ocular pathology, Surgical outcome, Intraoperative complications, Patient demographic, Patient comfort, Conjunctival autograft, Pterygium surgery, Suture technique, Graft stability, Topical mitomycin C, Amniotic membrane, Surgical records, Limbal conjunctival autograft, Biological adhesive kit, Vical suture, Scleral necrosis, Mechanical injuries.

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