A prospective randomized comparison of two skin closure techniques in acetabular fracture surgery
| Autor: | Berton R. Moed, Christopher D. Mudd, John A. Boudreau |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty 2-Octyl cyanoacrylate Polyesters Operative Time law.invention Dioxanes Fractures Bone chemistry.chemical_compound Suture (anatomy) Randomized controlled trial Skin closure law medicine Humans Surgical Wound Infection Orthopedics and Sports Medicine Cyanoacrylates Prospective Studies Prospective cohort study Acetabular fracture Sutures Wound Closure Techniques business.industry Acetabulum medicine.disease Hospital Charges eye diseases Surgery chemistry Cyanoacrylate Orthopedic surgery Drainage Original Article Female Tissue Adhesives business |
| Zdroj: | Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology |
| ISSN: | 1590-9999 1590-9921 |
| Popis: | Background Recent publications have shown an infection rate of 5–7 % for acetabular fractures treated with the Kocher-Langenbeck (K-L) approach. Using metallic staples to close hip skin incisions has been considered the gold standard. The purpose of this study was to answer the following: (1) will closure of a K-L incision after acetabular fracture surgery with a running subcuticular monocryl suture, then sealing the wound with 2-octyl cyanoacrylate (OCA), result in a lower infection rate compared to metallic staple closure? (2) Do incisions closed with subcuticular monocryl and OCA exhibit decreased drainage? (3) Is there a cost difference between these two methods? Materials and methods In a prospective clinical study, 103 patients with acetabular fractures treated using the K-L approach were randomized into two groups: skin closure with metallic staples (n = 52) versus subcuticular running monocryl suture sealed with OCA (n = 51). Results Two postoperative deep infections (4 %) in the staples group required multiple debridements; no infections developed in the OCA group. However, there was no statistical difference between the groups, (p = 0.495). There was a statistically significant difference (p = 0.032) comparing days from surgery to a dry incision favoring OCA (4.2 versus 5.85 days). The patient charge was approximately $900 greater on average in the OCA group due to the increased time in the operating room required for the subcuticular closure. Conclusions Closure with OCA and subcuticular monocryl showed no clinical disadvantages and appears to have a clinical advantage when compared to standard metallic staple skin closure in acetabular fracture surgery. However, additional patient costs may be incurred. Level of evidence II. |
| Databáze: | OpenAIRE |
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