Observational Study
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World J Gastroenterol. Nov 14, 2014; 20(42): 15815-15819
Published online Nov 14, 2014. doi: 10.3748/wjg.v20.i42.15815
Healing time of incision infection after hepatobiliary surgery treated by needle-free incision suture closure
Wen-Jie Ma, Yong Zhou, Hui Mao, Rui-Hua Xu, Anuj Shrestha, Fu-Yu Li, Alex Lorance, Qin Yang, Yong-Qiong Zhang, Ting Jiang, Huan Feng, Wei Zhang, Nan-Sheng Cheng
Wen-Jie Ma, Yong Zhou, Rui-Hua Xu, Anuj Shrestha, Fu-Yu Li, Alex Lorance, Qin Yang, Yong-Qiong Zhang, Ting Jiang, Huan Feng, Nan-Sheng Cheng, Department of Hepatobiliary Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Hui Mao, Department of Medicine, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Wei Zhang, Department of Medicine, the George Washington University, Washington, District of Columbia, Washington, DC 20052, United States
Author contributions: Ma WJ and Zhou Y contributed equally to this work; Ma WJ and Zhou Y performed the majority of experiments; Xu RH, Shrestha A, Lorance A, Yang Q, Zhang YQ, Jiang T, and Feng H collected all the human material and were also involved in editing the manuscript; Mao H, Li FY, Zhang W and Cheng NS revised the manuscript critically and gave the final approval of the version to be published.
Supported by National Nature Science Foundation of China, No. 30801111 and No. 30972923; Science and Technology Support Project of Sichuan Province No. 14ZC1337, No. 14ZC1335 and No. 2014SZ0002-10
Correspondence to: Hui Mao, MD, PhD, Department of Medicine, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, China. lanfengziye@qq.com
Telephone: +86-28-85422465 Fax: +86-28-85422468.
Received: December 28, 2013
Revised: May 19, 2014
Accepted: June 20, 2014
Published online: November 14, 2014
Processing time: 323 Days and 16.9 Hours
Abstract

AIM: To compare the effectiveness of needle-free incision suture closure with butterfly tape and traditional secondary suturing techniques in treating incision infection.

METHODS: Two hundred and twenty-three patients with incision infection following hepatobiliary surgery at a tertiary hospital were randomly divided into three groups: 90 patients were closed by needle-free incision suture closure, which gradually closed the incision wound when drainage from incision infection was visibly decreased and healthy granulation tissues had grown; 79 patients were closed by butterfly bandage; another 54 patients were closed by traditional secondary suturing technique. Healing time of incision infection was calculated from the beginning of dressing change to the healing of the incision.

RESULTS: Healing time in the needle-free incision suture closure group (24.2 ± 7.2 d) was significantly shorter than that in the butterfly bandage group (33.3 ± 11.2 d) and the traditional secondary suturing group (36.2 ± 15.3 d) (P < 0.05). Healing time in the butterfly bandage group appeared to be slightly shorter than that in the secondary suture group, but the difference was not statistically significant (P > 0.05).

CONCLUSION: Needle-free incision suture closure could gradually close the infection wound at the same time of drainage and dressing change, thereby shortening the healing time.

Keywords: Incision infection; Needle-free incision suture closure; Secondary suture; Drainage; Wound healing; Hepatobiliary surgery

Core tip: Both the secondary suturing closure and butterfly bandage methods have been widely used in clinical practice to treat incision infections for many years but have many drawbacks. In comparison to traditional methods the needle-free method of incision infection closure had following advantages: significant decrease in wound closure time; ability to adjust the suture tension at different times and gradually close the wound, thus allowing drainage and dressing at the same time; elimination of complicated and painful secondary suture; elimination of risk of secondary infection; and extreme ease of use.