Staple vs. subcuticular vicryl skin closure in knee replacement surgery: a spectrophotographic assessment of wound characteristics

Graham, Dionne A.; Jeffery, J.A; Bain, Duncan; Davies, P. R. F.; Bentley, G.

doi:10.1016/s0968-0160(00)00055-7

Cited by 30 publications

(45 citation statements)

References 10 publications

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“…Many studies have previously compared wound closure techniques in TKA [2,3,6,[15][16][17][18]. Results have been highly variable and currently there is no consensus on a superior closure method.…”

Section: Discussionmentioning

confidence: 99%

“…Third, this study involves the first-time use of a technology, namely the quantitative function of an LA-ICGA device in orthopaedic surgery. Previous attempts at this type of investigation have been limited by feasibility, cost, poor quality of data, or static nature of perfusion assessment [3,22]. The LA-ICGA used in this study overcame all of these challenges with a quantitative software interface that has been validated by the design engineers [12].…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have compared different closure techniques in TKA [2,3,6,[15][16][17][18]. From the perspective of wound complications, one recent meta-analysis by Smith et al showed that staple closure resulted in increased rates of infection after both hip and knee arthroplasty in comparison to running subcuticular [17].…”

Section: Discussionmentioning

confidence: 99%

“…Multiple studies have compared different closure techniques in TKA [2,3,6,[15][16][17][18]. The majority of these studies have involved running subcuticular closure versus staple closure and focused on factors such as cost, performance time, patient satisfaction, and wound complications.…”

Section: Introductionmentioning

confidence: 99%

“…To date, no study has adequately determined which closure technique enables the most robust perfusion in TKA. One investigation attempted to describe differences in blood content and wound oxygenation between staple and running subcuticular closure in TKA with the use of tissue spectrophotography [3]. This technology has limitations because it only obtains a static view of blood in soft tissue and is influenced more by blood pooling than perfusion status.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The Chitranjan Ranawat Award: Running Subcuticular Closure Enables the Most Robust Perfusion After TKA: A Randomized Clinical Trial

Wyles

Jacobson

Houdek

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Maintaining robust perfusion is an important physiologic parameter in wound healing. The effect of different closure techniques on wound perfusion after total knee arthroplasty (TKA) has not been established previously and may have implications for wound healing. Questions/purposes We asked whether a running subcuticular, vertical mattress, or skin staple closure technique enables the most robust wound perfusion after TKA as measured by laser-assisted indocyanine green angiography (LA-ICGA) in patients without specific risk factors for wound healing complications. Methods Forty-five patients undergoing primary TKA without comorbidities known to impact wound healing and perfusion were prospectively randomized to receive superficial skin closure with one of the following techniques: (1) running subcuticular (3-0 monofilament); (2) vertical mattress (2-0 nylon); or (3) skin staples. Twenty procedures were performed by RTT, 15 by RJS, and 10 by FHS. All surgeons used an anterior skin incision over the medial third of the patella in combination with a median parapatellar arthrotomy. Perfusion was assessed with a LA-ICGA device and software system immediately after closure to quantify fluorescence. Twenty-seven points were assessed immediately after closure in the operating room in each patient (nine along the incision and nine pairs medial and lateral to the incision). Mean incision perfusion was determined from the nine points along the incision with One of the authors (RJS) lists the following relevant financial activities outside of this work and/or any other relationships or activities that readers could perceive to have influenced, or that give the appearance of potentially influencing, this manuscript: Lifecell Corporation (Branchburg, NJ, USA) in an amount of less than USD 10,000 and Biomet Inc (Warsaw, IN, USA) in an amount of USD 10,000 to USD 100,000. One of the authors (MJT) lists the following relevant financial activities outside of this work and/or any other relationships or activities that readers could perceive to have influenced, or that give the appearance of potentially influencing, this manuscript: DJO Global (Vista, CA, USA) in an amount of less than USD 10,000. One of the authors (RTT) lists the following relevant financial activities outside of this work and/or any other relationships or activities that readers could perceive to have influenced, or that give the appearance of potentially influencing, this manuscript: DePuy Orthopaedics, Inc (Warsaw, IN, USA) in an amount of USD 10,000 to USD 100,000. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. higher values indicating greater blood flow. Mean perfusion impairment was determined by calculating the difference between the nine pairs of surrounding skin and the nine points along the incision with smaller values ind...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The Chitranjan Ranawat Award: Running Subcuticular Closure Enables the Most Robust Perfusion After TKA: A Randomized Clinical Trial

Wyles

Jacobson

Houdek

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

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Selection of Suture Materials, Suture Patterns, and Drains for Wound Closure

Céleste¹

2016

Equine Wound Management

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A Cadaveric Study of Cutaneous Vascular Anatomy about the Elbow Using Computed Tomography Angiography

et al. 2019

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The posterior approach is a commonly employed exposure of the elbow that provides excellent visualization and efficacy for various orthopedic procedures, including total elbow arthroplasty (TEA) and fracture care. The posterior approach to the elbow has been associated with an increased rate of wound complications, including infection, skin necrosis, and wound dehiscence. Despite an association between these complications and decreased elbow perfusion, data regarding the intrinsic anatomic etiology for preferential complications in this area has been scarcely reported in the literature. This study characterizes the subdermal and cutaneous vascular perfusion about the elbow by describing the predominant direction of circulation, subdermal anastomoses, and volume of perfusion through cadaveric modeling using computed tomography angiography (CTA). Fifteen upper extremity cadaver specimens were prepared with injection of radiographic contrast directly into the axillary artery immediately preceding CTA imaging of each specimen. Sectra IDS7 software for Windows was used for analysis of all images to produce superimposed axial and 3-D reconstructions of each CTA series. From these images it was discerned that the predominant direction of flow in the posterior elbow integument is anterior medial to posterior lateral. Both the posterior medial and posterior lateral subdermal vascular networks emanate from proximally derived medial arterial sources with few anastomoses and minimal collateral perfusion from the anterolateral location. Consequently, it is important to preserve medial subdermal vascular structures to prevent ischemic wound complications. This is especially true in previously incised elbow integuments. Clin. Anat. 32:509-514, 2019.

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Staple vs. subcuticular vicryl skin closure in knee replacement surgery: a spectrophotographic assessment of wound characteristics

Cited by 30 publications

References 10 publications

The Chitranjan Ranawat Award: Running Subcuticular Closure Enables the Most Robust Perfusion After TKA: A Randomized Clinical Trial

The Chitranjan Ranawat Award: Running Subcuticular Closure Enables the Most Robust Perfusion After TKA: A Randomized Clinical Trial

Selection of Suture Materials, Suture Patterns, and Drains for Wound Closure

A Cadaveric Study of Cutaneous Vascular Anatomy about the Elbow Using Computed Tomography Angiography

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