Modality of wound closure after total knee replacement: are staples as safe as sutures? A retrospective study of 181 patients

Patient Safety in Surgery

Michael R Dayton¹  E Mark Hammerberg³  Allison E Williams²  Gustavo V Resende³  Steven J Morgan⁴  Justin T Newman¹ 

[1] The Department of Orthopaedic Surgery, University of Colorado School of Medicine, Denver, Colorado USA;Bay Pines VA Health Care System, Bay Pines, Florida, USA;The Department of Orthopaedic Surgery, Denver Health Medical Center, University of Colorado School of Medicine, Denver, Colorado, USA;Swedish Medical Center, Englewood, Colorado, USA

关键词: complications;    total knee arthroplasty;    staples;    sutures;    wound closure;   

Others  :  790379
DOI  :  10.1186/1754-9493-5-26

 received in 2011-05-17, accepted in 2011-10-19,  发布年份 2011

【 摘 要 】

Background

Surgical site wound closure plays a vital role in post-operative success. This effect is magnified in regard to commonly performed elective procedures such as total knee arthroplasty. The use of either sutures or staples for skin re-approximation remains a contested subject, which may have a significant impact on both patient safety and surgical outcome. The literature remains divided on this topic.

Methods

Two cohorts of patients at a level one trauma and regional referral center were reviewed. Cohorts consisted of consecutive total knee arthroplasties performed by two surgeons who achieved surgical wound re-approximation by either staples or absorbable subcuticular sutures. Outcome variables included time of surgery, wound dehiscence, surgical site infection per Center for Disease Control criteria and repeat procedures for debridement and re-closure.

Results

181 patients qualified for study inclusion. Staples were employed in 82 cases (45.3% of total) and sutures in 99 cases (54.7%). The staples group had no complications while the sutures group had 9 (9.1%). These consisted of: 4 infections (2 superficial, one deep, one organ/space); three patients required re-suturing for dehiscence; one allergic type reaction to suture material; and one gout flare resulting in dehiscence. The mean surgical time with sutures was 122.3 minutes (sd = 33.4) and with staples was 114 minutes (sd = 24.4).

Conclusion

This study demonstrated significantly fewer complications with staple use than with suture use. While all complications found in this study cannot be directly attributed to skin re-approximation method, the need for further prospective, randomized trials is established.

【 授权许可】

   
2011 Newman et al; licensee BioMed Central Ltd.

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