■缝合线和U形钉是全关节置换术中的主要伤口闭合技术。诸如拉链装置和新型皮肤粘合剂的较新技术已经出现,因为它们有可能减少手术时间并可能使并发症最小化。这项研究的目的是将这些较新的技术与传统的缝合线在伤口并发症方面进行比较。关闭时间,和成本。
■对160名患者进行了单中心随机对照试验(52个拉链,55缝合线,53目),在2017年2月至2018年5月期间接受了初次全髋关节或膝关节置换术。患者分为3个闭合组:拉链装置,单丝缝合线加粘合剂,和单丝加上聚酯网与粘合剂。主要终点是闭合时间(浅皮肤层)。其次,我们收集围手术期并发症发生率,包括感染,持续(14天)伤口引流,90天重新接纳,和急诊室就诊率以及比较的材料成本。
■年龄组间的基线特征没有差异,身体质量指数,和美国麻醉医师学会分类。缝合组有缩短闭合时间的趋势。对于我们的次要终点,组间没有显着差异,并发症。
■我们的研究表明,缝合组的闭合时间更短,但提示全关节置换术后的每种闭合方法的并发症发生率相同。闭合时间差异较小,并发症无明显差异,决定使用一种伤口闭合装置或技术而不是另一种伤口闭合装置或技术应该由机构成本和提供者熟悉程度决定.
UNASSIGNED: Sutures and staples are the mainstay wound closure techniques in total joint arthroplasty. Newer techniques such as
zipper devices and novel skin adhesives have emerged because of their potential to decrease operative time and possibly minimize complications. The aim of this
study is to compare these newer techniques against conventional sutures with respect to wound complications, closure time, and costs.
UNASSIGNED: A single-center randomized control
trial was conducted on 160 patients (52
zipper, 55 suture, 53 mesh) who underwent primary total hip or knee arthroplasty between February 2017 and May 2018. Patients were divided into 3 closure groups:
zipper device, monofilament suture plus adhesive, and monofilament plus polyester mesh with adhesive. The primary endpoint was closure time (superficial skin layer). Secondarily we collected perioperative complication rates, including infection, persistent (14-day) wound drainage, 90-day readmission, and emergency room visit rates as well as compared material costs.
UNASSIGNED: There were no differences in baseline characteristics between groups for age, body mass index, and American Society of Anesthesiologists classification. There was a trend toward decreased time to closure for the suture group. There were no significant differences between groups for our secondary endpoint, complications.
UNASSIGNED: Our
study shows that the suture group trended toward shorter closure time but suggests that each of the closure methods after total joint arthroplasty has equivalent complication rates. With small differences in closure time and no significant differences in complications, the decision to use one wound closure device or technique over another should be driven by institutional costs and provider familiarity.