Subcuticular Sutures Versus Staples for Wound Closure in Open Liver Resection: A Randomised Clinical Trial
- PDF / 530,218 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 48 Downloads / 225 Views
ORIGINAL SCIENTIFIC REPORT
Subcuticular Sutures Versus Staples for Wound Closure in Open Liver Resection: A Randomised Clinical Trial Yoritaka Matsuno1 • Shintaro Yamazaki1 • Yusuke Mitsuka1 • Hayato Abe1 • Masamichi Moriguchi1 • Tokio Higaki1 • Tadatoshi Takayama1
Accepted: 11 October 2020 Ó Socie´te´ Internationale de Chirurgie 2020
Abstract Background Subcuticular sutures reduce wound complication rates only in clean surgeries. Repeat resection is frequently required in liver surgery, due to the high recurrence rate (30–50%) of liver cancers. The aim of this study is to assess that subcuticular sutures is superior to staples in liver surgery. Methods This single-centre, single-blinded, randomised controlled trial was conducted at a university hospital between January 2015 and October 2018. Patients were randomly assigned (1:1) to receive either subcuticular sutures or staples for skin closure. Three risk factors (repeat resection, diabetes mellitus and liver function) were matched preoperatively for equal allocation. The primary endpoint was the wound complication rate, while secondary endpoints were surgical site infection (SSI), duration of postoperative hospitalisation and total medical cost. Subset analyses were performed only for the 3 factors allocated as secondary endpoints. Results Of the 581 enrolled patients, 281 patients with subcuticular sutures and 283 patients with staples were analysed. As the primary outcome, the wound complication rate with subcuticular sutures (12.5%) did not differ from that with staples [15.9%; odds ratio (OR), 1.33; 95% confidence interval (CI), 0.83–2.15; p = 0.241]. As secondary outcomes, no significant differences were identified between the two procedures in the overall cohort while overall wound complications [7 patients (8.5%) vs. 17 patients (20.0%); OR, 2.68; 95% CI, 1.08–7.29; p = 0.035] with repeat incision were significantly less frequent with subcuticular sutures. Conclusion Subcuticular sutures were not shown to reduce wound complications compared to staples in open liver resection, but appear beneficial for repeat incisions.
Introduction Abdominal skin closure is frequently achieved using either subcuticular sutures or approximation by metallic staples. Subcuticular sutures for skin closure are known to offer effective approximation for skin closure in most types of surgery, whereas approximation by metallic staples & Shintaro Yamazaki [email protected] 1
Department of Digestive Surgery, Nihon University School of Medicine, 30-1 Ohyaguchikami-machi, Itabashi-ku, Tokyo 173-8610, Japan
contributes to faster wound closure and easier handling. Several clinical trials of clean surgery have demonstrated that subcuticular sutures are associated with a significantly lower incidence of wound complications. [1–3] However, regarding clean-contaminated surgeries such as digestive tract surgery, subcuticular sutures have shown superiority only in sub-group analyses. [4, 5] The incidence of wound complications is higher in hepatobiliary surgery than in other fie
Data Loading...
