Randomized clinical trial comparing skin closure with tissue adhesives vs subcuticular suture after robotic urogynecologic procedures
| Autor: | Sunetris Fluellen, Kyle Mackey, Muhammad Faisal Aslam, Karen H. Hagglund |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Closure (topology) Clinical Trials Study Skin closure in robotic surgery 02 engineering and technology Urogynecology 01 natural sciences law.invention Randomized controlled trial law 0103 physical sciences Medicine Dermabond 010303 astronomy & astrophysics Closure time integumentary system business.industry Tissue adhesives technology industry and agriculture Cosmesis 021001 nanoscience & nanotechnology Surgery body regions Subcuticular suture 0210 nano-technology business human activities |
| Zdroj: | World Journal of Methodology |
| ISSN: | 2222-0682 |
| Popis: | BACKGROUND Skin closure techniques during minimally-invasive gynecologic surgery is largely based on surgeon preference. The optimum technique would theoretically be safe, rapid, inexpensive, and result in good cosmetic appearance. Cyanoacrylate tissue adhesive (Dermabond) may be a comparable and safe option for port site closure as compared with subcuticular suture. In this randomized clinical trial, we hypothesized that operative time for skin closure would be less than subcuticular suture during robotic urogynecologic procedures. AIM To compare skin closure during robotic urogynecologic surgeries for tissue adhesives and subcuticular suture. METHODS Fifty female subjects > 18 years of age undergoing robotic urogynecologic procedures were randomized to have port site closure with either cyanoacrylate tissue adhesive (n = 25) or subcuticular suture (n = 25). All procedures and postoperative evaluations were performed by the same board certified Female Pelvic Medicine and Reconstructive Surgeon. Incisional closure time was recorded. Each subject was followed for 12-wk postoperatively. Incision cosmesis was evaluated using the Stony Brook Scar Evaluation Scale. RESULTS A total of 47 subjects (cyanoacrylate group, n = 23; suture group, n = 24) completed the 12-wk postoperative evaluation. Closure time was significantly less (P < 0.0005) using cyanoacrylate tissue adhesive (5.4 ± 2.0 min) than subcuticular suture (24.9 ± 5.6 min). Cosmesis scores were significantly higher in the cyanoacrylate tissue adhesive group than subcuticular suture (P = 0.025). No differences were found between bleeding, infection, or dehiscence (P = 1.00, P = 0.609, P = 0.234, respectively). No statistical demographical differences existed between the two study arms. CONCLUSION Our study supported our original hypothesis that cyanoacrylate tissue adhesive for port site closure during robotic urogynecolgic procedures uses less time than with subcuticular suture. Our study also supports that tissue adhesive is comparable to cosmetic outcome while not jeopardizing rates of bleeding, infection, or dehiscence. |
| Databáze: | OpenAIRE |
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