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Kaur Randhawa R, Dubey T, Pansuriya I, Mishra T, Tanwar M, Kumar A, Singh R. Assessment of the Mechanical Properties of Different Suture Materials for Oral Surgery: An In Vitro Tensile Strength Study. Cureus 2024; 16:e65952. [PMID: 39221394 PMCID: PMC11365713 DOI: 10.7759/cureus.65952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 07/29/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Sutures are essential components of wound closure in oral surgery, and the mechanical properties of suture materials play a crucial role in determining surgical outcomes. Understanding the tensile strengths of various suture materials is vital for selecting the most appropriate material for specific clinical applications. OBJECTIVE This study aimed to assess the tensile strength of suture materials commonly used in oral surgery through an in vitro tensile strength study. METHODS A total of 192 samples of six commonly used suture materials (polyglycolic acid (PGA), polyglactin 910 (PGLA), polylactic acid (PLA), polydioxanone (PDO), silk, and nylon) were subjected to tensile strength testing using a universal testing machine. Descriptive statistics were used to summarize the tensile strength of each suture material. A comparative analysis was conducted using appropriate statistical tests to identify any significant differences in the tensile strength among the different materials. RESULTS Significant variability in tensile strength was observed among the suture materials in newtons (N). PGLA exhibited the highest mean tensile strength (38.7 N), followed closely by PDO (37.1 N), whereas silk displayed the lowest tensile strength (32.8 N). Comparative analysis revealed significant differences in the tensile strength among the materials (p < 0.001). CONCLUSION This study provides valuable insights into the mechanical properties of the suture materials commonly used in oral surgery. These findings underscore the importance of considering tensile strength when selecting suture materials for specific clinical scenarios, thereby optimizing wound closure techniques and improving patient outcomes.
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Affiliation(s)
- Rajbir Kaur Randhawa
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Jamnagar, IND
| | - Tushar Dubey
- Department of Oral and Maxillofacial Surgery, ITS Dental College and Research Centre, Ghaziabad, IND
| | - Ishita Pansuriya
- Department of Oral and Maxillofacial Surgery, ITS Dental College and Research Centre, Ghaziabad, IND
| | - Tanisha Mishra
- Department of Dentistry, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, IND
| | - Monika Tanwar
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Shree Guru Gobind Singh Tricentenary (SGT) University, Gurugram, IND
| | - Ankit Kumar
- Department of Oral and Maxillofacial Surgery, Kothiwal Dental College and Research Centre, Moradabad, IND
| | - Ramanpal Singh
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Chhattisgarh, IND
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Maheshwari M, Khan IA. Advances and Techniques in Subcuticular Suturing for Abdominal Wall Closure: A Comprehensive Review. Cureus 2024; 16:e65069. [PMID: 39171061 PMCID: PMC11336517 DOI: 10.7759/cureus.65069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Accepted: 07/21/2024] [Indexed: 08/23/2024] Open
Abstract
Subcuticular suturing has emerged as a prominent technique for abdominal wall closure, offering notable benefits in cosmetic outcomes, infection reduction, and patient satisfaction. This comprehensive review delves into the evolution and current state of subcuticular suturing, examining its principles, techniques, and advancements. Traditional methods like continuous and interrupted suturing are compared with modern innovations like barbed sutures and knotless techniques. Clinical outcomes, including healing efficacy, complication rates, and cost-effectiveness, are analyzed to highlight the technique's advantages. The review also explores specific applications in various surgical specialities, presenting case studies and clinical trials to substantiate its effectiveness. Despite certain challenges and limitations, the future of subcuticular suturing appears promising with ongoing research and technological advancements. This review aims to thoroughly understand subcuticular suturing, emphasizing its significance in improving surgical outcomes and patient care in abdominal wall closure.
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Affiliation(s)
- Maulik Maheshwari
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Imran Ali Khan
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Padinhare Madathil J, Kumar RP, Haridas TV, Job J, Chandran P, Siby J. A Prospective Study of Sutured Versus Non-sutured Subcutaneous Fat Tissue in Laparotomy Wound Closure. Cureus 2024; 16:e62034. [PMID: 38989352 PMCID: PMC11234059 DOI: 10.7759/cureus.62034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2024] [Indexed: 07/12/2024] Open
Abstract
Background This study was conducted to determine the wound-related complications, such as wound dehiscence, delayed post-operative stay, and reinterventions in both groups, and compare the incidence of surgical site infection in elective laparotomy wounds in two groups - those with closing subcutaneous fat tissue and those without. Methods At the Government Medical College, Thrissur, 248 patients undergoing elective abdominal surgeries during the period from August 2019 to August 2020 participated in this one-year prospective cross-sectional study. The institutional ethics committee approved the study, and participants provided written informed consent. Patients were randomly assigned to the subcutaneous closure group (S) and the non-closure group (N). Post-operative events were then systematically documented. Results The group with no subcutaneous suture (N) had a considerably greater percentage of patients with seromas (12 patients, 9%), hematomas (13 patients, 10.5%), superficial surgical site infection and total wound dehiscence as compared to the subcutaneous tissue closure group (S). Groups N and S displayed comparable numbers of suture sinus developments and partial wound dehiscence. Group N and Group S had similar hospital stays, according to the overall length of stay displayed. Conclusion Subcutaneous suturing during elective laparotomy wound closure significantly reduced superficial surgical site infection, hematoma, seroma, and total wound dehiscence; in the remaining categories, subcutaneous and non-subcutaneous sutures did not differ significantly. It also did not help to reduce hospital stays.
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Affiliation(s)
| | - Revathy P Kumar
- Plastic Surgery, Government Medical College, Kozhikode, Kozhikode, IND
| | - T V Haridas
- General Surgery, Government Medical College, Thrissur, Thrissur, IND
| | - Jim Job
- Upper Gastrointestinal and Bariatric Surgery, Princess Royal University Hospital, London, GBR
| | | | - Jayas Siby
- General Surgery, Whipps Cross University Hospital, London, GBR
- General Surgery, Royal Sussex County Hospital, Brighton, GBR
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Sharma C, Sharma S, Soni A. Subcuticular skin closure at cesarean delivery with poliglecaprone-25 vs polyglactin-910: a randomized controlled trial. Am J Obstet Gynecol MFM 2024; 6:101256. [PMID: 38109995 DOI: 10.1016/j.ajogmf.2023.101256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/13/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Cesarean delivery is a commonly performed surgical procedure worldwide. There is limited good-quality evidence regarding subcuticular skin closure with absorbable sutures in transverse incisions after cesarean delivery. OBJECTIVE This study aimed to compare poliglecaprone-25 (3-0) and polyglactin-910 (4-0) sutures for subcuticular skin closure in Pfannenstiel incisions among women undergoing cesarean delivery. STUDY DESIGN In this double-blind, single-center, randomized controlled trial among women undergoing cesarean delivery (elective and emergency), 200 women were randomized (Group 1-subcuticular skin closure with poliglecaprone-25 [3-0] vs Group 2-subcuticular skin closure with polyglactin-910 [4-0]). All women received similar preoperative and postoperative care. A sample size of 200 women was selected with the aim of reducing the composite wound complication rate from 15.8% to 3.6% with a power of 0.80 and a 2-tailed α of 0.05. Thus, 90 women were required in each group, but 100 were selected to account for attrition. RESULTS Composite wound complications (including surgical site infection, hematoma, seroma, need for resuturing or readmission for wound complications) were similar in the 2 groups (Group 1 vs 2: 16 vs 10; P=.293; relative risk, 1.28; 95% confidence interval, 0.91-1.79). Surgical site infection (8 vs 7; P=1.000; relative risk, 1.08; 95% confidence interval, 0.64-1.83), hematoma (1 vs 2; P=.561; relative risk, 0.66; 95% confidence interval, 0.13-3.31), seroma (8 vs 2; P=.052; relative risk, 1.65; 95% confidence interval, 1.17-2.33), need for resuturing (4 vs 3; P=.700; relative risk, 1.15; 95% confidence interval, 0.60-2.22), and need for readmission (4 vs 4; P=1.000) were similar in the 2 groups. Pain score on the visual analog scale at 3 days (3.2±1.0 vs 3.6±1.2) and 6 weeks after operation (1.6±0.8 vs 1.7±0.9;) was significantly lower in Group 1 (P=.023 and P=.033, respectively). There was no difference between observer and patient scar assessment scores measured at 6 weeks after operation (P=.069 and P=.431, respectively). CONCLUSION Poliglecaprone-25 (3-0) and polyglactin-910 (4-0) subcuticular sutures were comparable regarding composite wound complications (surgical site infection, hematoma, seroma, wound separation or re-suturing, need for readmission) and cosmetic appearance (patient scar assessment score & observer scar assessment score) related to skin closure among women undergoing cesarean delivery through a Pfannenstiel incision in nonobese women (average body mass index, 25).
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Affiliation(s)
- Chanderdeep Sharma
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, Bilaspur, India (Dr C Sharma); Department of Obstetrics & Gynaecology, Dr. Rajendra Prasad Government Medical College, Tanda, Kangra, India (Drs C Sharma, S Sharma, and Soni).
| | - Shikha Sharma
- Department of Obstetrics & Gynaecology, Dr. Rajendra Prasad Government Medical College, Tanda, Kangra, India (Drs C Sharma, S Sharma, and Soni)
| | - Anjali Soni
- Department of Obstetrics & Gynaecology, Dr. Rajendra Prasad Government Medical College, Tanda, Kangra, India (Drs C Sharma, S Sharma, and Soni)
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DCunha P, Silpa KP, Gadwalker SM, Moharana AK, Ts D. Clinical Equivalence of Trusynth® and Vicryl® Polyglactin 910 Sutures for Subcutaneous Tissue Closure During Cesarean Delivery: A Single-Blind Randomized Controlled Trial. Cureus 2023; 15:e39982. [PMID: 37416026 PMCID: PMC10321360 DOI: 10.7759/cureus.39982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 07/08/2023] Open
Abstract
Background Post-cesarean complications such as surgical site infection (SSI), bleeding, and dehiscence may occur after cesarean delivery. Subcutaneous tissue closure will reduce these complications. With this background, this study assessed the clinical equivalence of Trusynth® and Vicryl® polyglactin 910 sutures for subcutaneous tissue closure. Methods In this randomized, single-blind study (from January 5, 2021 to December 24, 2021), a total of 113 women with a singleton pregnancy scheduled for cesarean section were included in the study and randomized to Trusynth® (n=57) and Vicryl® (n=56) group. The primary endpoint was the incidence of subcutaneous abdominal wound disruption within six weeks of cesarean delivery. The secondary endpoints included postoperative complications (SSI, hematoma, seroma, and skin disruptions), operative time, intraoperative handling characteristics, postoperative pain, hospital stay, time taken to return to normal activities, suture removal, microbial deposits on sutures, and adverse events. Results No incidence of subcutaneous abdominal wound disruption was recorded. Non-significant differences in intraoperative handling parameters (except memory, p=0.007), postoperative pain, skin disruption, SSI, hematoma, seroma, hospital stay, and time to return to normal activities were observed between Trusynth® and Vicryl® groups. Conclusion Both Trusynth® and Vicryl® polyglactin 910 sutures can be regarded as clinically equivalent. These are safe and effective for subcutaneous tissue closure during cesarean section with minimal risk of subcutaneous abdominal wound disruptions.
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Affiliation(s)
- Prema DCunha
- Obstetrics and Gynecology, Father Muller Medical College, Mangaluru, IND
| | - Kranti P Silpa
- Obstetrics and Gynecology, CARE Hospitals, Telangana, IND
| | | | | | - Deepak Ts
- Clinical Affairs, Healthium Medtech, Bengaluru, IND
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Anushya P, Ganesh SB, Jayalakshmi S. Evaluation of tensile strength of surgical absorbable and nonabsorbable suture materials after immersion in different fruit juices: An in vitro study. J Adv Pharm Technol Res 2022; 13:S108-S111. [PMID: 36643124 PMCID: PMC9836114 DOI: 10.4103/japtr.japtr_267_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/05/2022] [Indexed: 01/17/2023] Open
Abstract
Surgical sutures are the most well-known surgical biomaterial device for ligating blood vessels. The primary goal of wound closure is to align wound margins to provide a closed and stable environment. Sutures with lesser tensile strength are susceptible to break throughout the healing process due to edema. To evaluate the tensile strength of absorbable and nonabsorbable suture materials after immersion in fruit juices. In this in vitro study, eight samples of commercially available sutures such as black silk and vicryl were divided into two groups: sample -1 were immersed in grape juice and sample -2 were immersed in lemon juice for 1 week. Universal testing machine INSTRON E300 UTM was used to test the tensile strength of various suture materials. The data are statistically analyzed using an independent t-test. The P < 0.05 was considered to be statistically significant. The mean of vicryl suture after immersion in grape and lemon juice was found to be 34.445 and 43.39; the mean value of black silk after immersion in grape and lemon juice was found to be 36.95 and 33.1. The tensile strength of black silk was slightly lower than the vicryl. Independent sample t-test showed that P = 0.561 (>0.05) which is statistically insignificant. Vicryl suture tested to have the highest tensile strength along with excellent knot holding capacity than black silk suture after immersion in fruit juices.
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Affiliation(s)
- P. Anushya
- Undergraduate Student, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - S. Balaji Ganesh
- White Lab - Material Research Centre, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - S. Jayalakshmi
- White Lab - Material Research Centre, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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7
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Aldhabaan S, Hudise JY, ALqarny M, Alarfaj A. Catgut Versus Polypropylene Sutures for Transcolumellar Incision Closure in Open Rhinoplasty: A Retrospective Cohort Study. Cureus 2020; 12:e9769. [PMID: 32944480 PMCID: PMC7489783 DOI: 10.7759/cureus.9769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background Open rhinoplasty, including the transcolumellar approach, is commonly performed as it has fewer side effects and provides superior anatomical control to the surgeons compared to closed rhinoplasty. However, the postoperative scar outcomes, such as scar appearance, vary depending on the type of suture used in wound closure, and the optimal suture type is not firmly established. Objective To compare the impact of catgut versus polypropylene sutures on the postoperative transcolumellar scar outcomes and patient satisfaction following open rhinoplasty. Methods This retrospective cohort study, including 100 patients who underwent transcolumellar open rhinoplasty, was conducted at otolaryngology department of King Abdulaziz University Hospital, Riyadh, KSA. The patients were divided into two groups: the propylene suture group (group 1), which included 15 males and 35 females with a mean age of 31.5 years and underwent surgery using propylene sutures, and the catgut suture group (group 2), which included 10 males and 40 females with a mean age of 30.5 years and underwent surgery using catgut sutures. The postoperative transcolumellar scar outcomes, as determined by visual analogue scale (VAS) and Stony Brook Scar Evaluation Scale (SBSES) scores, and patient satisfaction, as assessed using a self-assessment scale, were compared between groups. Results The scars were unnoticeable in the majority of both groups: 88% in group 1 and 86% in group 2. The VAS and SBSES scores did not significantly differ between groups. Patients' satisfaction rates were also comparable and did not significantly differ between groups (p = 0.341). Conclusion Both catgut and polypropylene sutures lead to similar outcomes and patient satisfaction rates in terms of postoperative rhinoplasty transcolumellar scars. Thus, catgut may be the optimal suture for closing transcolumellar incisions following open rhinoplasty.
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Affiliation(s)
| | - Jibril Y Hudise
- Otolaryngology, King Abdulaziz University Hospital, Riyadh, SAU
| | | | - Ahmed Alarfaj
- Otolaryngology, King Abdulaziz University Hospital, Riyadh, SAU
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Koroglu N, Temel Yuksel I, Aslan Cetin B, Aytufan Z, Deniz N, Akca A, Yetkin Yildirim G, Yuksel A. Skin closure at cesarean section, polypropylene versus polyglactin 910: a randomized controlled study. J Matern Fetal Neonatal Med 2020; 35:1088-1092. [PMID: 32228099 DOI: 10.1080/14767058.2020.1743654] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aim: To compare the rates of surgical wound infection in women who have undergone cesarean delivery with subcuticular skin closure with polyglactin 910 or polypropylene.Methods: Between April 2018 and October 2018, patients who had undergone a cesarean delivery for any reason were randomized with polyglactin 910 or polypropylene for subcuticular skin closure. Participants were evaluated for wound complications on day 7 and 30 postoperatively. The primary outcome was surgical site infection within the first 30 days following delivery. In addition, factors affecting surgical site infections were analyzed by binary regression.Results: A total of 220 women who had undergone cesarean delivery were randomized and 213 were included in the final analysis. The groups were similar in terms of demographic characteristics and perioperative features. No statistically significant difference was observed between the groups in terms of wound complications or superficial site infections (8.3% in the polypropylene group versus 10.6% in the polyglactin 910 group, p = .642). Similarly, no difference was observed between the groups in terms of other wound complications. A binary logistic regression analysis indicated that superficial wound site infection was not affected by gravidity, BMI, duration of operation, repeated or unplanned cesarean delivery.Conclusion: It was observed that surgical site infections and other wound complications in skin closures with polyglactin 910 were similar to those with polypropylene.
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Affiliation(s)
- Nadiye Koroglu
- Istanbul Kanuni Sultan Suleyman Research and Teaching Hospital, Istanbul, Turkey
| | - Ilkbal Temel Yuksel
- Istanbul Kanuni Sultan Suleyman Research and Teaching Hospital, Istanbul, Turkey
| | - Berna Aslan Cetin
- Istanbul Kanuni Sultan Suleyman Research and Teaching Hospital, Istanbul, Turkey
| | - Zubeyde Aytufan
- Istanbul Kanuni Sultan Suleyman Research and Teaching Hospital, Istanbul, Turkey
| | - Necip Deniz
- Istanbul Kanuni Sultan Suleyman Research and Teaching Hospital, Istanbul, Turkey
| | - Aysu Akca
- Istanbul Kanuni Sultan Suleyman Research and Teaching Hospital, Istanbul, Turkey
| | - Gonca Yetkin Yildirim
- Department of Obstetrics and Gynecology, Istanbul Medipol University Faculty of Medicine, Fatih, Turkey
| | - Aytac Yuksel
- Department of Obstetrics and Gynecology, Beykent University, Istanbul, Turkey.,Maternal-Fetal Medicine Unit, Acıbadem University Atakent Hospital, Istanbul, Turkey
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9
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Nayak G B, Saha PK, Bagga R, Joshi B, Rohilla M, Gainder S, Sikka P. Wound complication among different skin closure techniques in the emergency cesarean section: a randomized control trial. Obstet Gynecol Sci 2020; 63:27-34. [PMID: 31970125 PMCID: PMC6962586 DOI: 10.5468/ogs.2020.63.1.27] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 07/02/2019] [Accepted: 07/15/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Cesarean section is the most commonly performed obstetrical surgical procedure; however, there are no standard guidelines on appropriate skin closure techniques and materials. Only few comparative studies have been conducted on different skin closure techniques, and they have shown conflicting results. Therefore, we compared different skin closure techniques during emergency cesarean section to identify the best technique with minimal wound complication rates. METHODS Patients were randomized into 3 groups (group A, n=100; group B, n=102; and group C, n=98). In group A, the skin was closed using staples; in group B, via the subcuticular technique using monocryl 3-0; and in group C, using mattress suture nylon (2-0). The primary outcome was a composite of wound complications, including infection, seroma, gaping, and need for resuturing and antibiotic administration. The secondary outcome included closure time, pain perception, patient satisfaction, and cost. Analyses were performed in accordance with the intention-to-treat principle. RESULTS The composite wound complication rate in the entire cohort was 16.6% (n=50); the complication rate was significantly higher in group A than in the other groups. Infection was the most common wound complication observed in the entire study group (86%) and was significantly higher in group A than in groups B and C (P≤0.001). CONCLUSION The use of staples for cesarean section skin closure is associated with an increased risk of wound complications and prolonged hospital stay postoperative visits.
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Affiliation(s)
- Bhimeswar Nayak G
- Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pradip Kumar Saha
- Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rashmi Bagga
- Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Bharti Joshi
- Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Minakshi Rohilla
- Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shalini Gainder
- Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pooja Sikka
- Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Alalfy M, Elgazzar A, Fares T, Nagy O, Ellithy A, Lasheen Y, Kamel A, Soliman M, Hassan A, Samy A, Taher AM, Ogila AI, Saad H, Salah H, Ramadan M, Nabil M, Hatem DL, Fikry M. Effect of subcutaneous tissue closure technique in cesarean section on postoperative wound complications in obese Egyptian women. J Matern Fetal Neonatal Med 2018; 32:2452-2459. [DOI: 10.1080/14767058.2018.1438399] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Mahmoud Alalfy
- Department of Reproductive Health and Family Planning, National Research Centre, Aljazeerah Hospital, CAIFM, Geza, Egypt
| | - Ahmed Elgazzar
- Department of Obstetrics and Gynecology, Kasralainy, Cairo University, Cairo, Egypt
| | - Tamer Fares
- Department of Obstetrics and Gynecology, AlAzhar University, Cairo, Egypt
| | - Omar Nagy
- Department of Reproductive Health and Family Planning, National Research Centre, Cairo, Egypt
| | - Ahmed Ellithy
- Department of Obstetrics and Gynecology, Kasralainy, Cairo University, Cairo, Egypt
| | - Yossra Lasheen
- Department of Obstetrics and Gynecology, Kasralainy, Cairo University, Cairo, Egypt
| | - Ahmed Kamel
- Department of Obstetrics and Gynecology, Kasralainy, Cairo University, Cairo, Egypt
| | - Mahmoud Soliman
- Department of Obstetrics and Gynecology, Kasralainy, Cairo University, Cairo, Egypt
| | - Ahmed Hassan
- Department of Obstetrics and Gynecology, Suez Canal University, Ismaelia, Egypt
| | - Ahmed Samy
- Department of Obstetrics and Gynecology, Kasralainy, Cairo University, Cairo, Egypt
| | - Ayman M. Taher
- Department of Obstetrics and Gynecology, Kasralainy, Cairo University, Cairo, Egypt
| | - Asmaa I. Ogila
- Department of Obstetrics and Gynecology, Kasralainy, Cairo University, Cairo, Egypt
| | - Hany Saad
- Department of Obstetrics and Gynecology, Kasralainy, Cairo University, Cairo, Egypt
| | - Hend Salah
- Department of Obstetrics and Gynecology, AlAzhar University, Cairo, Egypt
| | - Mohamed Ramadan
- Department of Obstetrics and Gynecology, Kasralainy, Cairo University, Cairo, Egypt
| | - Mohamed Nabil
- Department of Obstetrics and Gynecology, Kasralainy, Cairo University, Cairo, Egypt
| | - Dina L. Hatem
- Department of Obstetrics and Gynecology, Kasralainy, Cairo University, Cairo, Egypt
| | - Mohamed Fikry
- Department of Obstetrics and Gynecology, Kasralainy, Cairo University, Cairo, Egypt
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11
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12
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Abstract
Tissue adhesives have been introduced as a promising alternative for the traditional wound closure method of suturing.
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Affiliation(s)
| | - Wen Zhong
- Department of Biosystem Engineering
- University of Manitoba
- Canada
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13
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Sajid MS, McFall MR, Whitehouse PA, Sains PS. Systematic review of absorbable vs non-absorbable sutures used for the closure of surgical incisions. World J Gastrointest Surg 2014; 6:241-7. [PMID: 25548609 PMCID: PMC4278146 DOI: 10.4240/wjgs.v6.i12.241] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 10/22/2014] [Accepted: 10/31/2014] [Indexed: 02/06/2023] Open
Abstract
AIM To report a systematic review of published randomized controlled trials (RCTs) investigating the role of absorbable suture (AS) against non-AS (NAS) used for the closure of surgical incisions. METHODS RCTs investigating the use of AS vs NAS for the closure of surgical incisions were statistically analysed based upon the principles of meta-analysis and the summated outcomes were represented as OR. RESULTS The systematic search of medical literature yielded 10 RCTs on 1354 patients. Prevalence of wound infection (OR = 0.97; 95%CI: 0.56, 1.69; Z = 0.11; P = 0.92) and operative morbidity (P = 0.45) was comparable in both groups. Nonetheless, the use of AS lead to lower risk of wound break-down (OR = 0.12; 95%CI: 0.04, 0.39; Z = 3.52; P < 0.0004). CONCLUSION This meta-analysis of 10 RCTs demonstrates that the use of AS is similar to NAS for skin closure for surgical site infection and other operative morbidities. AS do not increase the risk of skin wound dehiscence, rather lead to a reduced risk of wound dehiscence compared to NAS.
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14
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Husslein H, Gutschi M, Leipold H, Herbst C, Franz M, Worda C. Suture Closure versus Non-Closure of Subcutaneous Fat and Cosmetic Outcome after Cesarean Section: A Randomized Controlled Trial. PLoS One 2014; 9:e114730. [PMID: 25494177 PMCID: PMC4262443 DOI: 10.1371/journal.pone.0114730] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Accepted: 11/05/2014] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION To investigate the effect of subcutaneous fat suture closure versus non-closure at cesarean section (CS) on long-term cosmetic outcome. MATERIAL AND METHODS Women undergoing planned or unplanned CS were randomized to either subcutaneous fat suture closure or non-closure using a 1∶1 allocation algorithm. Participants and outcome assessors were blinded to group allocation. Scar evaluation was performed after two and six months. Primary outcome measures were Patient and Observer Scar Assessment Scale (POSAS) summary scores six months after surgery. Secondary outcome measures were Vancouver Scar Scale (VSS) summary scores, retraction of the scar below the level of the surrounding skin, duration of surgery, and development of hematoma, seroma, surgical site infection (SSI) or wound disruption. Data were analyzed according to the intention to treat principle. RESULTS A total of 116 women were randomized and 91 participants, 47 in the closure and 44 in the non-closure group, completed the trial and were analyzed. There were no differences in patient morphometrics or surgery indications between groups. At two and six months no significant differences were found with respect to POSAS or VSS scores between groups. After two months significantly more women in the non-closure group described their scar as being retracted below the level of the skin (36% vs. 15%, p = 0.02) whereas no difference was observed at six months. There were significantly more hematomas in the non-closure (25%) compared to the closure group (4%) (p = 0.005). There was no difference in duration of surgery, SSI, seroma formation or wound disruption between groups. CONCLUSIONS Suture closure of the subcutaneous fat at CS does not affect long-term cosmetic outcome. (Level I evidence). TRIAL REGISTRATION ClinicalTrials.gov NCT01542346.
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Affiliation(s)
- Heinrich Husslein
- Department of Obstetrics and Gynecology, Klinikum Klagenfurt am Woerthersee, Feschnigstrasse 11, 9020 Klagenfurt, Austria
- Department of Obstetrics and Gynecology, Medical University Vienna, Waehringer Guertel 18–20, 1090 Wien, Austria
| | - Martina Gutschi
- Department of Obstetrics and Gynecology, Klinikum Klagenfurt am Woerthersee, Feschnigstrasse 11, 9020 Klagenfurt, Austria
| | - Heinz Leipold
- Department of Obstetrics and Gynecology, Klinikum Klagenfurt am Woerthersee, Feschnigstrasse 11, 9020 Klagenfurt, Austria
| | - Christoph Herbst
- Department of Obstetrics and Gynecology, Klinikum Klagenfurt am Woerthersee, Feschnigstrasse 11, 9020 Klagenfurt, Austria
| | - Maximilian Franz
- Department of Obstetrics and Gynecology, Medical University Vienna, Waehringer Guertel 18–20, 1090 Wien, Austria
| | - Christof Worda
- Department of Obstetrics and Gynecology, Klinikum Klagenfurt am Woerthersee, Feschnigstrasse 11, 9020 Klagenfurt, Austria
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