The comparison of staples and prolene suture for wound closure in total knee arthroplasty patients: a retrospective cohort study

Yıl 2022, Cilt: 13 Sayı: 4, 490 - 494, 30.12.2022

Zekeriya Ersin Çelen

https://doi.org/10.18663/tjcl.1135701

Öz

Aim: The wound closure method applied after total knee replacement, plays a critical role in the success of the surgery. Various skin closure methods have been described in the literature in order to reduce infection rates, shorten the surgical time, and increase patient satisfaction. However, there is no standardized guideline on which type of suture should be used. The aim of this study was to compare the efficiency and safety of staples with prolene sutures in wound closure after total knee arthroplasty.
Materials and Methods: Eighty-five patients that underwent total knee arthroplasty between January 2021 and October 2021 were retrospectively assessed. Patients were divided into two groups according to the wound closure method. The two groups were compared in terms of wound complication rate, operative time, postoperative hospitalization duration, and Likert scale level of patient satisfaction.
Results: The majority (87.1%) of the patients were women . The mean age of the patients was 64.6±7.2 (range, 45-79). The prolene suture group had no wound complications while the staples group had five (11.9%) (p<0.05). These complications consisted of three superficial infections, one deep infection, and one wound dehiscence. The mean operation time was 102.6±10.7 minutes in the staples group and 106.2±10.7 minutes in the prolene suture group (p=0.097). There was no significant difference in terms of Likert scores between the staples group and the prolene group (4.0±1.4 vs 4.4±0.9, respectively; p=0.248). Postoperative hospitalization durations were similar between the groups (p=0.296).
Conclusion: The prolene suture provided lower wound complication rates compared to staples. There was no significant difference between the two groups in terms of surgical time, postoperative hospitalization, and patient satisfaction. Randomized prospective studies with larger patient series are needed to fully clarify this issue.

Anahtar Kelimeler

Total Knee Replacement, Arthroplasty, Surgical Staples, Prolene, Suture, Surgical Wound Infection

Total diz artroplastisi sonrası yara kapamada stapler ile prolen sütürün karşılaştırılması: Retrospektif kohort çalışması

Öz

Amaç: Total diz artroplastisi sonrasında uygulanan yara kapama metodu, ameliyat başarısında kritik rol oynamaktadır. Literatürde enfeksiyon oranlarının azaltılması, cerrahi sürenin kısaltılması ve hasta memnuniyetinin yükseltilmesi amacıyla çeşitli cilt kapama yöntemleri tanımlanmıştır.Bununla birlikte, hangi tip sütür kullanılması gerektiğine dair standart bir kılavuz bulunmamaktadır. Bu çalışmanın amacı, total diz artroplastisi sonrası yara kapamada cerrahi stapler ile prolen sütürlerin etkinlik ve güvenlik açısından karşılaştırılmasıdır.
Gereç ve Yöntemler: Ocak 2021 ile Ekim 2021 arasında total diz artroplastisi uygulanan 85 hasta retrospektif olarak değerlendirildi. Hastalar yara kapama yöntemine göre iki gruba ayrıldı. İki grup yara komplikasyon oranları, ameliyat süreleri, ameliyat sonrası yatış süreleri ve Likert hasta memnuniyet ölçekleri açısından karşılaştırıldı.
Bulgular: Hastaların çoğunluğu (%87,1) kadındı. Hastaların yaş ortalaması 64,6±7,2 (45-79 arası) idi. Prolen grubunda hiç yara komplikasyonu görülmezken, stapler grubunda 5 (11,9%) hastada görüldü (p<0,05). Bu komplikasyonların üçü yüzeyel enfeksiyon, biri derin enfeksiyon ve biri yarada ayrılmaydı. Ortalama ameliyat süresi stapler grubunda 102,6±10,7 dakika, prolen grubunda 106,2±10,7 dakikaydı (p=0,097). Stapler grubu ile prolen grubu arasında Likert hasta memnuniyet ölçekleri açısından anlamlı farklılık yoktu (sırasıyla 4,0±1,4 ve 4,4±0,9; p=0,248). Ameliyat sonrası yatış süreleri gruplar arasında benzerdi (p=0,296)
Sonuç: Prolen sütür, stapler kullanımına kıyasla daha düşük yara komplikasyon oranları sağladı. Cerrahi süre, postoperatif hospitalizasyon ve hasta memnuniyeti açısından iki grup arasında anlamlı fark saptanmadı. Bu konunun tam olarak açıklığa kavuşabilmesi için daha geniş hasta serili randomize prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Total Diz Replasmanı, Artroplasti, Cerrahi Stapler, Prolen, Sütür, Cerrahi Yara Enfeksiyonu

Kaynakça

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