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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
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.

Kaynakça

  • 1. Bade MJ, Stevens-Lapsley JE. Early high-intensity rehabilitation following total knee arthroplasty improves outcomes. J Orthop Sports Phys Ther 2011;41:932-941.
  • 2. Shetty AA, Kumar VS, Morgan-Hough C, et al. Comparing wound complication rates following closure of hip wounds with metallic skin staples or subcuticular vicryl suture: a prospective randomised trial. J Orthop Surg (Hong Kong) 2004;12:191-193.
  • 3. Patel RM, Cayo M, Patel A, Albarillo M, Puri L. Wound complications in joint arthroplasty: comparing traditional and modern methods of skin closure. Orthopedics 2012;35:e641-e646.
  • 4. Wolford HM, Hatfield KM, Paul P, Yi SH, Slayton RB. The projected burden of complex surgical site infections following hip and knee arthroplasties in adults in the United States, 2020 through 2030. Infect Control Hosp Epidemiol. 2018;39(10):1189-1195.
  • 5. Hardt S, Schulz MRG, Pfitzner T, et al. Improved early outcome after TKA through an app-based active muscle training programme-a randomized-controlled trial. Knee Surg Sports Traumatol Arthrosc. 2018;26(11):3429-3437.
  • 6. Vieira RB, Waldolato G, Fernandes JS, et al. Evaluation of three methods of suture for skin closure in total knee arthroplasty: a randomized trial. BMC Musculoskelet Disord. 2021;22(1):747.
  • 7. Yuenyongviwat V, Iamthanaporn K, Hongnaparak T, Tangtrakulwanich B. A randomised controlled trial comparing skin closure in total knee arthroplasty in the same knee: nylon sutures versus skin staples. Bone Joint Res. 2016;5(5):185-190.
  • 8. Chen L, Yang J, Xie J, Hu Y, Zeng M. Clinical outcome of different skin closure in total-knee arthroplasty: running subcuticular closure vs intermittent closure: A retrospective study. Medicine (Baltimore). 2020;99(34):e21947.
  • 9. Newman JT, Morgan SJ, Resende GV, Williams AE, Hammerberg EM, Dayton MR. Modality of wound closure after total knee replacement: are staples as safe as sutures? A retrospective study of 181 patients. Patient Saf Surg. 2011;5(1):26.
  • 10. Zhang Z, Zhou YG, Lin F, et al. Case control study on the biodegradable barbed sutures in total knee arthroplasty. Zhongguo Gu Shang. 2016;29(9):809-813.
  • 11. Liu S, Wang Y, Kotian RN, et al. Comparison of Nonabsorbable and Absorbable Suture in Total Knee Arthroplasty. Med Sci Monit. 2018;24:7563-7569.
  • 12. Krebs VE, Elmallah RK, Khlopas A, Chughtai M, Bonutti PM, Roche M, Mont MA. Wound Closure Techniques for Total Knee Arthroplasty: An Evidence-Based Review of the Literature. J Arthroplasty. 2018;33(2):633-638.
  • 13. Barrow J, Divecha H, Board T. Skin closure in arthroplasty surgery: Current practice. Int Wound J. 2018;15(6):966-970.
  • 14. Krishnan RJ, Crawford EJ, Syed I, Kim P, Rampersaud YR, Martin J. Is the Risk of Infection Lower with Sutures than with Staples for Skin Closure After Orthopaedic Surgery? A Meta-analysis of Randomized Trials. Clin Orthop Relat Res. 2019;477(5):922-937.
  • 15. Hlubek R, Walder P, Káňa J, Salounová D. Použití kovových klipů při sutuře kůže u totální endoprotézy kolene [Metal staples versus conventional suture for wound closure in total knee arthroplasty]. Acta Chir Orthop Traumatol Cech. 2014;81(3):233-7.
  • 16. Nepal S, Ruangsomboon P, Udomkiat P, Unnanuntana A. Cosmetic outcomes and patient satisfaction compared between staples and subcuticular suture technique for wound closure after primary total knee arthroplasty: a randomized controlled trial. Arch Orthop Trauma Surg. 2020;140(9):1255-1263.
  • 17. Krishnan R, MacNeil SD, Malvankar-Mehta MS. Comparing sutures versus staples for skin closure after orthopaedic surgery: systematic review and meta-analysis. BMJ Open. 2016;6(1):e009257.
  • 18. Eggers MD, Fang L, Lionberger DR. A comparison of wound closure techniques for total knee arthroplasty. J Arthroplasty. 2011;26(8):1251-8.e1-4.
  • 19. Kim KY, Anoushiravani AA, Long WJ, Vigdorchik JM, Fernandez-Madrid I, Schwarzkopf R. A Meta-Analysis and Systematic Review Evaluating Skin Closure After Total Knee Arthroplasty-What Is the Best Method? J Arthroplasty. 2017;32(9):2920-2927.
  • 20. Smith TO, Sexton D, Mann C, Donell S. Sutures versus staples for skin closure in orthopaedic surgery: meta-analysis. BMJ. 2010;340:c1199.
  • 21. Hasan O, Jiwani A, Mazhar L, Begum D, Lakdawala R, Noordin S. Comparison of Surgical Site Infection After Skin Closure by Prolene or Staples in Bilateral Simultaneous Knee Arthroplasty Patients: A Parallel Design Randomized Controlled Trial Protocol. Int J Surg Protoc. 2021;25(1):154-159.
  • 22. Khan RJ, Fick D, Yao F, et al. A comparison of three methods of wound closure following arthroplasty: a prospective, randomised, controlled trial. J Bone Joint Surg Br. 2006;88(2):238-242.
  • 23. Tajirian AL, Goldberg DJ. A review of sutures and other skin closure materials. J Cosmet Laser Ther. 2010;12(6):296-302.
  • 24. Moy RL, Lee A, Zalka A. Commonly used suturing techniques in skin surgery. Am Fam Physician. 1991;44(5):1625-34.
  • 25. Campbell AL, Patrick DA Jr, Liabaud B, Geller JA. Superficial wound closure complications with barbed sutures following knee arthroplasty. J Arthroplasty. 2014;29(5):966-969.
  • 26. Chawla H, van der List JP, Fein NB, Henry MW, Pearle AD. Barbed Suture Is Associated With Increased Risk of Wound Infection After Unicompartmental Knee Arthroplasty. J Arthroplasty. 2016;31(7):1561-1567.
  • 27. Sah AP. Is there an advantage to knotless barbed suture in TKA wound closure? a randomized trial in simultaneous bilateral TKAs. Clin Orthop Relat Res. 2015;473:2019–27.
  • 28. Chan VWK, Chan P-K, Chiu K-Y, Yan C-H, Ng F-Y. Does barbed suture lower cost and improve outcome in total knee arthroplasty? A randomized controlled trial. J Arthroplasty. 2017;32:1474–7.
  • 29. Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M, et al. The global burden of hip and knee osteoarthritis: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73:1323-30.

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

Yıl 2022, Cilt: 13 Sayı: 4, 490 - 494, 30.12.2022
https://doi.org/10.18663/tjcl.1135701

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.

Kaynakça

  • 1. Bade MJ, Stevens-Lapsley JE. Early high-intensity rehabilitation following total knee arthroplasty improves outcomes. J Orthop Sports Phys Ther 2011;41:932-941.
  • 2. Shetty AA, Kumar VS, Morgan-Hough C, et al. Comparing wound complication rates following closure of hip wounds with metallic skin staples or subcuticular vicryl suture: a prospective randomised trial. J Orthop Surg (Hong Kong) 2004;12:191-193.
  • 3. Patel RM, Cayo M, Patel A, Albarillo M, Puri L. Wound complications in joint arthroplasty: comparing traditional and modern methods of skin closure. Orthopedics 2012;35:e641-e646.
  • 4. Wolford HM, Hatfield KM, Paul P, Yi SH, Slayton RB. The projected burden of complex surgical site infections following hip and knee arthroplasties in adults in the United States, 2020 through 2030. Infect Control Hosp Epidemiol. 2018;39(10):1189-1195.
  • 5. Hardt S, Schulz MRG, Pfitzner T, et al. Improved early outcome after TKA through an app-based active muscle training programme-a randomized-controlled trial. Knee Surg Sports Traumatol Arthrosc. 2018;26(11):3429-3437.
  • 6. Vieira RB, Waldolato G, Fernandes JS, et al. Evaluation of three methods of suture for skin closure in total knee arthroplasty: a randomized trial. BMC Musculoskelet Disord. 2021;22(1):747.
  • 7. Yuenyongviwat V, Iamthanaporn K, Hongnaparak T, Tangtrakulwanich B. A randomised controlled trial comparing skin closure in total knee arthroplasty in the same knee: nylon sutures versus skin staples. Bone Joint Res. 2016;5(5):185-190.
  • 8. Chen L, Yang J, Xie J, Hu Y, Zeng M. Clinical outcome of different skin closure in total-knee arthroplasty: running subcuticular closure vs intermittent closure: A retrospective study. Medicine (Baltimore). 2020;99(34):e21947.
  • 9. Newman JT, Morgan SJ, Resende GV, Williams AE, Hammerberg EM, Dayton MR. Modality of wound closure after total knee replacement: are staples as safe as sutures? A retrospective study of 181 patients. Patient Saf Surg. 2011;5(1):26.
  • 10. Zhang Z, Zhou YG, Lin F, et al. Case control study on the biodegradable barbed sutures in total knee arthroplasty. Zhongguo Gu Shang. 2016;29(9):809-813.
  • 11. Liu S, Wang Y, Kotian RN, et al. Comparison of Nonabsorbable and Absorbable Suture in Total Knee Arthroplasty. Med Sci Monit. 2018;24:7563-7569.
  • 12. Krebs VE, Elmallah RK, Khlopas A, Chughtai M, Bonutti PM, Roche M, Mont MA. Wound Closure Techniques for Total Knee Arthroplasty: An Evidence-Based Review of the Literature. J Arthroplasty. 2018;33(2):633-638.
  • 13. Barrow J, Divecha H, Board T. Skin closure in arthroplasty surgery: Current practice. Int Wound J. 2018;15(6):966-970.
  • 14. Krishnan RJ, Crawford EJ, Syed I, Kim P, Rampersaud YR, Martin J. Is the Risk of Infection Lower with Sutures than with Staples for Skin Closure After Orthopaedic Surgery? A Meta-analysis of Randomized Trials. Clin Orthop Relat Res. 2019;477(5):922-937.
  • 15. Hlubek R, Walder P, Káňa J, Salounová D. Použití kovových klipů při sutuře kůže u totální endoprotézy kolene [Metal staples versus conventional suture for wound closure in total knee arthroplasty]. Acta Chir Orthop Traumatol Cech. 2014;81(3):233-7.
  • 16. Nepal S, Ruangsomboon P, Udomkiat P, Unnanuntana A. Cosmetic outcomes and patient satisfaction compared between staples and subcuticular suture technique for wound closure after primary total knee arthroplasty: a randomized controlled trial. Arch Orthop Trauma Surg. 2020;140(9):1255-1263.
  • 17. Krishnan R, MacNeil SD, Malvankar-Mehta MS. Comparing sutures versus staples for skin closure after orthopaedic surgery: systematic review and meta-analysis. BMJ Open. 2016;6(1):e009257.
  • 18. Eggers MD, Fang L, Lionberger DR. A comparison of wound closure techniques for total knee arthroplasty. J Arthroplasty. 2011;26(8):1251-8.e1-4.
  • 19. Kim KY, Anoushiravani AA, Long WJ, Vigdorchik JM, Fernandez-Madrid I, Schwarzkopf R. A Meta-Analysis and Systematic Review Evaluating Skin Closure After Total Knee Arthroplasty-What Is the Best Method? J Arthroplasty. 2017;32(9):2920-2927.
  • 20. Smith TO, Sexton D, Mann C, Donell S. Sutures versus staples for skin closure in orthopaedic surgery: meta-analysis. BMJ. 2010;340:c1199.
  • 21. Hasan O, Jiwani A, Mazhar L, Begum D, Lakdawala R, Noordin S. Comparison of Surgical Site Infection After Skin Closure by Prolene or Staples in Bilateral Simultaneous Knee Arthroplasty Patients: A Parallel Design Randomized Controlled Trial Protocol. Int J Surg Protoc. 2021;25(1):154-159.
  • 22. Khan RJ, Fick D, Yao F, et al. A comparison of three methods of wound closure following arthroplasty: a prospective, randomised, controlled trial. J Bone Joint Surg Br. 2006;88(2):238-242.
  • 23. Tajirian AL, Goldberg DJ. A review of sutures and other skin closure materials. J Cosmet Laser Ther. 2010;12(6):296-302.
  • 24. Moy RL, Lee A, Zalka A. Commonly used suturing techniques in skin surgery. Am Fam Physician. 1991;44(5):1625-34.
  • 25. Campbell AL, Patrick DA Jr, Liabaud B, Geller JA. Superficial wound closure complications with barbed sutures following knee arthroplasty. J Arthroplasty. 2014;29(5):966-969.
  • 26. Chawla H, van der List JP, Fein NB, Henry MW, Pearle AD. Barbed Suture Is Associated With Increased Risk of Wound Infection After Unicompartmental Knee Arthroplasty. J Arthroplasty. 2016;31(7):1561-1567.
  • 27. Sah AP. Is there an advantage to knotless barbed suture in TKA wound closure? a randomized trial in simultaneous bilateral TKAs. Clin Orthop Relat Res. 2015;473:2019–27.
  • 28. Chan VWK, Chan P-K, Chiu K-Y, Yan C-H, Ng F-Y. Does barbed suture lower cost and improve outcome in total knee arthroplasty? A randomized controlled trial. J Arthroplasty. 2017;32:1474–7.
  • 29. Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M, et al. The global burden of hip and knee osteoarthritis: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73:1323-30.
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Özgün Makale
Yazarlar

Zekeriya Ersin Çelen

Yayımlanma Tarihi 30 Aralık 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 13 Sayı: 4

Kaynak Göster

APA Çelen, Z. E. (2022). The comparison of staples and prolene suture for wound closure in total knee arthroplasty patients: a retrospective cohort study. Turkish Journal of Clinics and Laboratory, 13(4), 490-494. https://doi.org/10.18663/tjcl.1135701
AMA Çelen ZE. The comparison of staples and prolene suture for wound closure in total knee arthroplasty patients: a retrospective cohort study. TJCL. Aralık 2022;13(4):490-494. doi:10.18663/tjcl.1135701
Chicago Çelen, Zekeriya Ersin. “The Comparison of Staples and Prolene Suture for Wound Closure in Total Knee Arthroplasty Patients: A Retrospective Cohort Study”. Turkish Journal of Clinics and Laboratory 13, sy. 4 (Aralık 2022): 490-94. https://doi.org/10.18663/tjcl.1135701.
EndNote Çelen ZE (01 Aralık 2022) The comparison of staples and prolene suture for wound closure in total knee arthroplasty patients: a retrospective cohort study. Turkish Journal of Clinics and Laboratory 13 4 490–494.
IEEE Z. E. Çelen, “The comparison of staples and prolene suture for wound closure in total knee arthroplasty patients: a retrospective cohort study”, TJCL, c. 13, sy. 4, ss. 490–494, 2022, doi: 10.18663/tjcl.1135701.
ISNAD Çelen, Zekeriya Ersin. “The Comparison of Staples and Prolene Suture for Wound Closure in Total Knee Arthroplasty Patients: A Retrospective Cohort Study”. Turkish Journal of Clinics and Laboratory 13/4 (Aralık 2022), 490-494. https://doi.org/10.18663/tjcl.1135701.
JAMA Çelen ZE. The comparison of staples and prolene suture for wound closure in total knee arthroplasty patients: a retrospective cohort study. TJCL. 2022;13:490–494.
MLA Çelen, Zekeriya Ersin. “The Comparison of Staples and Prolene Suture for Wound Closure in Total Knee Arthroplasty Patients: A Retrospective Cohort Study”. Turkish Journal of Clinics and Laboratory, c. 13, sy. 4, 2022, ss. 490-4, doi:10.18663/tjcl.1135701.
Vancouver Çelen ZE. The comparison of staples and prolene suture for wound closure in total knee arthroplasty patients: a retrospective cohort study. TJCL. 2022;13(4):490-4.


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