Randomized Controlled Trial of Topical Skin Adhesive vs Nylon Sutures for Incision Closure in Forefoot Surgery.
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OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2021;9(20):7 Foot Ankle Int. 2021 Sep;42(9): 1106-1114.What this means for my practice?
The results of this study demonstrated that the use of topical skin adhesive for incision closure was significantly more likely to result in wound edge separation and inflammation compared to nylon sutures. However, topical skin adhesive resulted in significantly less pain and quicker dressing change time, but longer time for incision closure. This study was limited by the short follow up of 6 weeks, and inapplicability to trauma settings where the presence of swelling and soft tissue damage could compromise wound healing. Future research on long term complications are required.
Study Summary
Seventy patients (84 feet) scheduled for forefoot surgery were randomized to receive wound closure via a topical skin adhesive (n=42 feet) or nylon suturing (n=42 feet). The primary outcome of interest was a wound evaluation on the Hollander Wound Evaluation Scale (HWES). Secondary outcomes of interest included pain, time to final layer closure, dressing change time, and patient satisfaction. Pain and wound evaluation were assessed at 2 weeks post-operation, and complications and satisfaction were assessed at 6 weeks post-operation. As per HWES scores, wound edge separation and inflammation were significantly more likely in the topical skin adhesive group. Also, the time to final layer closure was significantly longer in the topical skin adhesive group compared to the suture. However, significantly lower pain and shorter dressing change time were observed in the topical skin adhesive group.
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