Carolyn L Kerrigan1, Karen Homa. 1. Lebanon, N.H. From the Section of Plastic Surgery and the Dartmouth-Hitchcock Leadership Preventive Medicine Residency Program, Dartmouth Hitchcock Medical Center.
Abstract
BACKGROUND: Technological innovations are often adopted before scientific comparison to an accepted standard. The authors' study compared suture with a new coaptive film device, 3M Steri-Strip S Surgical Skin Closure, on linear incisions. METHODS:Patients undergoing Wise-pattern breast reduction or abdominal procedures had paired incisions randomly assigned to Steri-Strip S or suture closure. Key outcome measures were closure time, patient comfort, and scar quality at 6 months by patients and surgeons using a new scar evaluation tool, visual assessment of linear scars. Statistical differences between the two closure techniques were assessed by Wilcoxon signed rank test. RESULTS: Of 59 patients, eight were excluded from randomization (a surgeon judged Steri-Strip S to be a nonviable closure technique for mismatched wound edges). Fifty-one patients (breast, n = 24; abdomen, n = 27) were randomized. Operative time with Steri-Strip S for breast was 2.0 minutes (SD = 1.1) versus suture closure at 4.6 minutes (SD = 1.5; p < 0.001). Similarly, Steri-Strip S versus suture for the abdomen was faster (p < 0.001; 4.9 minutes, SD = 2.3 versus 10.1 minutes, SD = 3.4). Comfort scores did not differ between closures [5.8 (SD = 2.7) versus 6.9 (SD = 2.0), respectively, on breast (p = 0.142) and 7.7 (SD = 1.8) versus 7.7 (SD = 2.3) on abdomen (p = 0.903)]. Complication rates did not differ between closure types. Patients' visual assessment of linear scars rating of breasts was 3.8 (SD = 2.9) for Steri-Strip S and better at 2.6 (SD = 2.9) for suture (p = 0.008). One surgeon rated breast Steri-Strip S scars worse than suture scars (4.3 versus 3.7; p = 0.014). For abdominal scars, there was no difference in the patient or surgeon ratings. CONCLUSIONS:Steri-Strip S permits faster wound closure than suture. On the basis of patient reports of comfort and scar quality, surgeons increase efficiency and maintain quality with the use of Steri-Strip S on abdominal wounds but not on breast wounds.
RCT Entities:
BACKGROUND: Technological innovations are often adopted before scientific comparison to an accepted standard. The authors' study compared suture with a new coaptive film device, 3M Steri-Strip S Surgical Skin Closure, on linear incisions. METHODS:Patients undergoing Wise-pattern breast reduction or abdominal procedures had paired incisions randomly assigned to Steri-Strip S or suture closure. Key outcome measures were closure time, patient comfort, and scar quality at 6 months by patients and surgeons using a new scar evaluation tool, visual assessment of linear scars. Statistical differences between the two closure techniques were assessed by Wilcoxon signed rank test. RESULTS: Of 59 patients, eight were excluded from randomization (a surgeon judged Steri-Strip S to be a nonviable closure technique for mismatched wound edges). Fifty-one patients (breast, n = 24; abdomen, n = 27) were randomized. Operative time with Steri-Strip S for breast was 2.0 minutes (SD = 1.1) versus suture closure at 4.6 minutes (SD = 1.5; p < 0.001). Similarly, Steri-Strip S versus suture for the abdomen was faster (p < 0.001; 4.9 minutes, SD = 2.3 versus 10.1 minutes, SD = 3.4). Comfort scores did not differ between closures [5.8 (SD = 2.7) versus 6.9 (SD = 2.0), respectively, on breast (p = 0.142) and 7.7 (SD = 1.8) versus 7.7 (SD = 2.3) on abdomen (p = 0.903)]. Complication rates did not differ between closure types. Patients' visual assessment of linear scars rating of breasts was 3.8 (SD = 2.9) for Steri-Strip S and better at 2.6 (SD = 2.9) for suture (p = 0.008). One surgeon rated breast Steri-Strip S scars worse than suture scars (4.3 versus 3.7; p = 0.014). For abdominal scars, there was no difference in the patient or surgeon ratings. CONCLUSIONS: Steri-Strip S permits faster wound closure than suture. On the basis of patient reports of comfort and scar quality, surgeons increase efficiency and maintain quality with the use of Steri-Strip S on abdominal wounds but not on breast wounds.
Authors: Hyeongtae Kim; Wonhee Kim; Gu Hyun Kang; Yong Soo Jang; Hyun Young Choi; Jae Guk Kim; In Young Kim; Minji Kim Journal: Medicine (Baltimore) Date: 2018-06 Impact factor: 1.889
Authors: Rudradatt C Parmar; Dhruvkumar M Patel; Mukundkumar V Patel; Bhagirath B Solanki; Maitri M Patel; Jayanti K Gurumukhani; Himil J Mahadevia; Rohan A Gajjar; Parth R Patel Journal: J Family Med Prim Care Date: 2019-07