Subcuticular sutures versus staples for skin closure after open gastrointestinal surgery: a phase 3, multicentre, open-label, randomised controlled trial

Tsujinaka, Toshimasa; Yamamoto, Keiji; Fujita, Junya; Endo, Shunji; Kawada, Junji; Nakahira, Shin; Shimokawa, Toshio; Kobayashi, Shogo; Yamasaki, Makoto; Akamaru, Yusuke; Miyamoto, Atsushi; Mizushima, Tsunekazu; Shimizu, Junzo; Umeshita, Koji; Ito, Toshinori; Doki, Yuichiro; Mori, Masaki

doi:10.1016/s0140-6736(13)61780-8

Cited by 67 publications

(49 citation statements)

References 38 publications

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“…c N1 means perigastric lymph-node metastasis. [35]. In our meta-analysis, the incidence of intra-abdominal abscess did not differ significantly between LDG and ODG, supporting the outcomes of other meta-analyses.…”

Section: D2supporting

confidence: 87%

Laparoscopic distal gastrectomy reduced surgical site infection as compared with open distal gastrectomy for gastric cancer in a meta-analysis of both randomized controlled and case-controlled studies

Inokuchi¹,

Sugita²,

Otsuki³

et al. 2015

International Journal of Surgery

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Section: D2supporting

confidence: 87%

Laparoscopic distal gastrectomy reduced surgical site infection as compared with open distal gastrectomy for gastric cancer in a meta-analysis of both randomized controlled and case-controlled studies

Inokuchi¹,

Sugita²,

Otsuki³

et al. 2015

International Journal of Surgery

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“…Recently, we performed a multicenter open-label phase III RCT to compare subcuticular sutures with staples for skin closure after open gastrointestinal surgery: our results concerning wound complications have been reported (UMIN00002480) [6]. Because only patients who underwent elective open surgery were included, patients with high risk of SSI were excluded, and fascia and skin closure methods were controlled, the patients enrolled in this trial seemed ideal candidates for evaluating risk factors for superficial incisional SSI and for comparing surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for superficial incisional surgical site infection after gastrectomy: analysis of patients enrolled in a prospective randomized trial comparing skin closure methods

et al. 2015

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Background Surgical site infection is one of the commonest complications of gastrointestinal surgery. The nature of surgical procedures and wound closure methods may influence the incidence of superficial incisional surgical site infection. Patients enrolled in a prospective randomized controlled trial comparing skin closure methods are the best subjects for analyzing surgical site infection risk.Method From a cohort of 1080 patients who had been enrolled in our previous randomized controlled trial, data for 685 patients who had undergone elective open total gastrectomy or distal gastrectomy for gastric cancer were extracted. The incidences of superficial incisional surgical site infection after total gastrectomy and distal gastrectomy were compared and risk factors for superficial incisional surgical site infection were investigated by univariate analyses using logistic regression models. Results In all, 42 patients (6.1 %) developed superficial incisional surgical site infections after gastrectomy; 15 of 288 patients (5.2 %) developed these infections after total gastrectomy, and 27 of 397 patients (6.8 %) developed these infections after distal gastrectomy-these differences are not significant. According to univariate analysis, age (75 years or older or younger than 75 years) was the only risk factor for superficial incisional surgical site infections (P = 0.049). There was a tendency for the incidence of superficial incisional surgical site infection to increase in parallel with age. Conclusion The incidence of superficial incisional surgical site infection did not differ between total gastrectomy and distal gastrectomy. Advanced age was the only identified risk factor for superficial incisional surgical site infections after gastrectomy.

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“…5 A RCT gave its view as the use of conventional methods of suturing was not validated to reduce the incidence of wound complications after open gastrointestinal surgery. 23 In caesarean surgery, two studies were of the opinion that staples are preferred by women after caesarean delivery. 24,25 The other review article contradicted them by associating the staple use with high risk of wound complication in obstetric surgeries.…”

Section: Discussionmentioning

confidence: 99%

Abdominal skin incision closure with non-absorbable sutures versus staples- a comparative study

Muthukumar¹,

Venugopal²,

Subramaniam³

2017

Int Surg J

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Background: Bacterial smartness and innovations have clearly outsmarted and drained the antibiotic discovery pipelines of pharmaceutical brains throughout the globe. Postoperative infection is a major cause of antibiotic use. The aim of the study was to compare the effects of using non-absorbable suture materials and staples for abdominal skin incision closure in terms of the occurrence rate of surgical site infections, the level of comfort experienced by patient and the cosmetic acceptability of scar by the patient.Methods: A randomized control study conducted at the general surgical department of a tertiary hospital in Southern India. The final scores of the study in the categories of surgical site infection, pain and cosmesis were analyzed using Students t-test or Anova test.Results: The use of staples to close skin incision in laparotomy cases reduces surgical site infection, improves the perception of cosmetic appearance of scar to the patient and adds to the comfort of patient by reducing the pain experienced by the patient. The subgroup of population who may comprehensively benefit are patients below 40 years, middle and high socio economic status population, clean and clean contaminated surgeries where incision length is more than 5cm.Conclusions: The results of this study illustrated the fact that the use of staples in closure of skin incision in laparotomy case especially in selected subgroup of population significantly reduces the surgical site infection, hence slashing the use of antibiotics and in turn has the potential to reduce the incidence of antibiotic resistance.

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Subcuticular sutures versus staples for skin closure after open gastrointestinal surgery: a phase 3, multicentre, open-label, randomised controlled trial

Cited by 67 publications

References 38 publications

Laparoscopic distal gastrectomy reduced surgical site infection as compared with open distal gastrectomy for gastric cancer in a meta-analysis of both randomized controlled and case-controlled studies

Laparoscopic distal gastrectomy reduced surgical site infection as compared with open distal gastrectomy for gastric cancer in a meta-analysis of both randomized controlled and case-controlled studies

Risk factors for superficial incisional surgical site infection after gastrectomy: analysis of patients enrolled in a prospective randomized trial comparing skin closure methods

Abdominal skin incision closure with non-absorbable sutures versus staples- a comparative study

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