Abstract：
BACKGROUND: The method of surgical incision closure after total shoulder arthroplasty is an important factor to consider, as it affects operating room time, procedure cost, cosmetic outcomes, and patient satisfaction. The optimal method of wound management is unknown, but should be cost-effective, reproducible, and provide a reliable clinical result. This study aimed to compare the following wound closure methods after total shoulder arthroplasty: staples, Dermabond, and Dermabond PRINEO. We hypothesized that wound closure time for Dermabond PRINEO would be faster than Dermabond and comparable to that of staples, and Dermabond PRINEO would be more cost-effective than Dermabond and staples, and provide equal or superior closure outcomes to Dermabond and staples.
METHODS: A randomized, prospective clinical trial comparing wound closure time and cost for 2 surgeons\' traditional technique with that of Dermabond PRINEO was conducted. This study included at least 18 subjects in each group. Surgeon 1\'s patients were randomized to traditional Dermabond or Dermabond PRINEO, whereas surgeon 2\'s patients were randomized to staples or Dermabond PRINEO. Cosmetic outcomes and satisfaction scores were collected at 6 weeks and 3 months, postoperatively. Incisions were photographed, at both the 6-week and 3-month visits, and subsequently evaluated by a plastic surgeon blinded to the treatment method.
RESULTS: The wound closure time for surgeon 1 was significantly faster for Dermabond PRINEO vs. Dermabond, and surgeon 2 closed significantly faster with staples vs. Dermabond PRINEO. The mean cost of closure was significantly less with Dermabond PRINEO compared with Dermabond, whereas the mean cost of staples was significantly less than Dermabond PRINEO. For both surgeons 1 and 2, there were no significant differences in patient satisfaction at 6 weeks or 3 months. In addition, the wound closure methods did not produce differing cosmetic outcomes.
CONCLUSIONS: Although significant, the closing time for each method did not differ by a clinically relevant amount. Staples were the most cost-effective closing method, followed by Dermabond PRINEO. As neither method was superior over the other in terms of patient satisfaction, adverse events, and cosmetic outcomes, cost-effectiveness may be the greatest differentiator between the 3 methods.
METHODS: A randomized, prospective clinical trial comparing wound closure time and cost for 2 surgeons\' traditional technique with that of Dermabond PRINEO was conducted. This study included at least 18 subjects in each group. Surgeon 1\'s patients were randomized to traditional Dermabond or Dermabond PRINEO, whereas surgeon 2\'s patients were randomized to staples or Dermabond PRINEO. Cosmetic outcomes and satisfaction scores were collected at 6 weeks and 3 months, postoperatively. Incisions were photographed, at both the 6-week and 3-month visits, and subsequently evaluated by a plastic surgeon blinded to the treatment method.
RESULTS: The wound closure time for surgeon 1 was significantly faster for Dermabond PRINEO vs. Dermabond, and surgeon 2 closed significantly faster with staples vs. Dermabond PRINEO. The mean cost of closure was significantly less with Dermabond PRINEO compared with Dermabond, whereas the mean cost of staples was significantly less than Dermabond PRINEO. For both surgeons 1 and 2, there were no significant differences in patient satisfaction at 6 weeks or 3 months. In addition, the wound closure methods did not produce differing cosmetic outcomes.
CONCLUSIONS: Although significant, the closing time for each method did not differ by a clinically relevant amount. Staples were the most cost-effective closing method, followed by Dermabond PRINEO. As neither method was superior over the other in terms of patient satisfaction, adverse events, and cosmetic outcomes, cost-effectiveness may be the greatest differentiator between the 3 methods.
摘要：
背景：全肩关节置换术后手术切口闭合的方法是需要考虑的重要因素，因为它会影响手术室时间，程序成本，美容结果，患者满意度。伤口管理的最佳方法是未知的，但应该具有成本效益，可重复,并提供了可靠的临床结果。本研究旨在比较全肩关节置换术后的以下伤口闭合方法：Dermabond,还有DermabondPRINEO.我们假设DermabondPRINEO的伤口闭合时间将比Dermabond快，并且与钉书钉的伤口闭合时间相当，DermabondPRINEO比Dermabond和主食更具成本效益，并为Dermabond和staples提供相等或优越的闭合结果。
方法：随机，进行前瞻性临床试验,比较2名外科医生传统技术与DermabondPRINEO的伤口闭合时间和成本。该研究包括每组至少18名受试者。外科医生1的患者被随机分配到传统的Dermabond或DermabondPRINEO，而外科医生2的患者被随机分配到钉钉或DermabondPRINEO。在6周和3个月时收集化妆品结果和满意度评分，术后。拍摄了切口，在为期6周和3个月的访问中，随后由对治疗方法视而不见的整形外科医生进行评估。
结果：对于DermabondPRINEO，外科医生1的伤口闭合时间明显更快。Dermabond,和外科医生2关闭显著更快的钉与DermabondPRINEO.与Dermabond相比，DermabondPRINEO的平均关闭成本明显较低，而主食的平均成本显著低于DermabondPRINEO。对于外科医生1和2，在6周或3个月时，患者满意度没有显着差异。此外,伤口闭合方法没有产生不同的美容效果.
结论：尽管意义重大，每种方法的关闭时间在临床相关量上没有差异.主食是最具成本效益的关闭方法，其次是DermabondPRINEO。由于两种方法在患者满意度方面都优于另一种方法，不良事件,和美容结果，成本效益可能是这三种方法之间最大的区别。
方法：随机，进行前瞻性临床试验,比较2名外科医生传统技术与DermabondPRINEO的伤口闭合时间和成本。该研究包括每组至少18名受试者。外科医生1的患者被随机分配到传统的Dermabond或DermabondPRINEO，而外科医生2的患者被随机分配到钉钉或DermabondPRINEO。在6周和3个月时收集化妆品结果和满意度评分，术后。拍摄了切口，在为期6周和3个月的访问中，随后由对治疗方法视而不见的整形外科医生进行评估。
结果：对于DermabondPRINEO，外科医生1的伤口闭合时间明显更快。Dermabond,和外科医生2关闭显著更快的钉与DermabondPRINEO.与Dermabond相比，DermabondPRINEO的平均关闭成本明显较低，而主食的平均成本显著低于DermabondPRINEO。对于外科医生1和2，在6周或3个月时，患者满意度没有显着差异。此外,伤口闭合方法没有产生不同的美容效果.
结论：尽管意义重大，每种方法的关闭时间在临床相关量上没有差异.主食是最具成本效益的关闭方法，其次是DermabondPRINEO。由于两种方法在患者满意度方面都优于另一种方法，不良事件,和美容结果，成本效益可能是这三种方法之间最大的区别。
