Wound Closure Technique, Wound Dehiscence, Surgical
Conditions
Keywords
Surgical wound, Staples, Sutures, Postoperative pain, Wound infection
Brief summary
Surgical wound closure is an essential component of postoperative care that influences wound healing, infection rates, cosmetic appearance, and patient satisfaction. Sutures are conventionally used for skin closure following orthopedic procedures; however, surgical staples have gained popularity because of their rapid application, secure fixation, and potentially superior cosmetic outcomes. Despite their widespread use, there remains limited evidence comparing cosmetic outcomes and patient satisfaction between staple and suture techniques in upper limb surgeries in the local setting. This study aims to compare the cosmetic outcome and patient satisfaction between staples and sutures for wound closure following upper limb surgeries at Dhulikhel Hospital. Secondary objectives include comparing wound infection rates and duration of hospital stay between the two techniques. A prospective comparative study is conducted among adult patients undergoing upper limb surgeries. Patients fulfilling the inclusion and exclusion criteria are recruited consecutively during the study period. Following completion of surgery, wound closure is performed either with interrupted sutures or surgical staples according to the operative plan. Wounds are to be evaluated on postoperative day 2, day 7, and day 14, with further follow-up at 30 days and 6 weeks. Cosmetic outcome and patient satisfaction are assessed using a 5-point Visual Analogue Scale (VAS). Pain assessment, wound complications including infection, and duration of hospital stay are also documented and compared between the two groups. The findings of this study can help identify the optimal skin closure method for upper limb surgeries and contribute to improved postoperative outcomes and patient satisfaction. HYPOTHESES OF THE STUDY Null hypothesis (Ho): there is no difference in cosmetic outcome and patient satisfaction between sutures and staple technique for wound closure following upper limb surgeries. Alternative hypothesis (H1): there is difference in cosmetic outcome and patient satisfaction between sutures and staple technique for wound closure following upper limb surgeries Hence, Ho : (Cosmetic and Patient satisfaction score) in Suture group = Cosmetic and Patient satisfaction score) in Staples group H1 : (Cosmetic and Patient satisfaction score) in Suture group ≠ (Cosmetic and Patient satisfaction score) in Staples group
Interventions
PROCEDUREStaples
Following completion of the upper limb surgical procedure, skin closure is performed using sterile surgical skin staples under aseptic precautions.
PROCEDURESutures
Following completion of the upper limb surgical procedure, skin closure is performed using interrupted non-absorbable skin sutures under aseptic precautions. Skin closure is mattress as it allows for inversion or eversion of the repaired tissue, greater repair strength, and provides a greater area of soft tissue apposition to bone.
Sponsors
Kathmandu University School of Medical Sciences
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patient (\> 18 years and above) * Any wound more than two centimeters in length * All closed fracture of upper limb requiring open reduction and internal fixations * All implant removal and benign tumor excision of upper limb
Exclusion criteria
* Open upper limb fracture * Known metal allergy(nickel, titanium) * Active infection * Malignant tumor excision * Tendon repair * Closed Reduction Percutaneous Pinning
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cosmetic Outcome Assessed by 5-Point Visual Analogue Scale (VAS) | 1 year | Cosmetic outcome following wound closure with staples or sutures will be assessed at 30 days and 6 weeks using a 5-point Visual Analogue Scale (VAS). The scale ranges from 1 to 5, where 1 indicates excellent cosmetic appearance and 5 indicates very poor cosmetic appearance. Lower scores indicate better cosmetic outcome. |
| Patient Satisfaction Assessed by 5-Point Satisfaction Scale | 1 year | Patient satisfaction regarding wound closure will be assessed at 30 days and 6 weeks using a 5-point satisfaction scale. The scale ranges from 1 to 5, where 1 indicates extremely satisfied and 5 indicates extremely dissatisfied. Lower scores indicate greater patient satisfaction. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Pain Assessed by 5-Point Pain Scale | 1 year | Postoperative pain at the wound site will be assessed during follow-up visits using a 5-point pain scale ranging from 1 to 5, where 1 indicates no pain and 5 indicates very severe pain. Lower scores indicate less postoperative pain. |
| Surgical Site Infection | 1 year | Surgical site infection will be assessed clinically during postoperative follow-up visits on day 2, day 7, day 14, and day 30. Infection will be reported as presence or absence of clinical signs including redness, swelling, discharge, or wound tenderness. |
| Length of Hospital Stay | 1 year | Length of hospital stay will be measured in days from the date of surgery until discharge from hospital. Shorter hospital stay indicates improved postoperative recovery. |
Countries
Nepal
Outcome results
None listed