The Routine Use of Running Subcuticular Closures in Orthopaedic Trauma Patients Does Not Increase Wound Complications

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OBJECTIVE: To investigate whether the routine use of running subcuticular closures (RSC) in orthopaedic trauma patients increases the rate of wound complications and reoperations.

DESIGN: Retrospective comparative study.

SETTING: Urban Level 1 trauma center.

PATIENTS/PARTICIPANTS: Two hundred sixty-six patients undergoing orthopaedic trauma procedures between June 2020 and March 2022.

INTERVENTION: Adoption of an RSC protocol where any incision/wound that could be approximated with interrupted subcuticular 2-0 monofilament sutures was closed with a running subcuticular 3-0 monofilament suture.

MAIN OUTCOME MEASUREMENTS: Wound complications and subsequent reoperations.

RESULTS: With adoption of the RSC protocol, 91.0% of all orthopaedic trauma procedures were closed with RSC compared with 7.5% of the historical control group. There were no observed differences in the rate of wound complications (proportional difference (PD) 6.0%, confidence interval (CI) -2.3% to 14.1%; P = 0.15) or reoperations (PD 5.2%, CI -1.9% to 12.2%; P = 0.14) between the RSC and the control group. Wound complications were not associated with RSC on univariate analysis (PD 7.2%, CI -10.0% to 24.0%; P = 0.41). On multivariate analysis, an ASA>2 (odds ratio (OR) 2.4, CI 1.0 to 5.7; P = 0.03), lower extremity injuries (OR 4.9, CI 1.3 to 17.8; P = 0.01), and open reduction internal fixation procedures (OR 2.8, CI 1.1 to 7.2; P = 0.02) were found to be independently associated with wound complications.

CONCLUSION: RSC for orthopaedic trauma procedures was not associated with increased wound complications when compared a historical cohort.

LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:37

Enthalten in:

Journal of orthopaedic trauma - 37(2023), 4 vom: 01. Apr., Seite e153-e158

Sprache:

Englisch

Beteiligte Personen:

Aravindan, Shreyaas [VerfasserIn]
Kim, Ye Joon [VerfasserIn]
Tucker, Nicholas J [VerfasserIn]
Heare, Austin [VerfasserIn]
Parry, Joshua A [VerfasserIn]

Links:

Volltext

Themen:

Journal Article

Anmerkungen:

Date Completed 20.03.2023

Date Revised 28.08.2023

published: Print

Citation Status MEDLINE

doi:

10.1097/BOT.0000000000002534

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM352401532