Al-Ajlouni Jihad M, Alisi Mohammed S, Hammad Yazan S, Alsousi Ahmed A, Karameh Haya O, Kawasmi Sanad H, Aladwan Rwand H, Awawdeh Reem A, Almazaraa Yahya A, Hassan Freih O Abu
Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman, Jordan.
Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine.
J Wound Care. 2023 Feb 2;32(2):98-103. doi: 10.12968/jowc.2023.32.2.98.
This study aimed to compare two methods of wound skin closure-staples versus vertical mattress nylon sutures-in patients undergoing primary total hip (THR) and total knee replacements (TKR). The comparison was for wound complications as a primary outcome, and satisfaction of patient and nurse as secondary outcomes.
A prospective cohort study was conducted at an academic teaching hospital. All the patients who were admitted for either primary THR or TKR from September 2018 to September 2019 were included. Revision surgeries, patients >85 years of age, and those who were on steroid therapy were excluded. Patients were divided into two groups (staples and sutures) to compare the two methods of wound closure. Patients in each group were assessed for characteristics such as age, sex, weight, height, comorbidities, smoking status, postoperative wound complications, reoperation and patient/nurse satisfaction.
A total of 100 patients met the inclusion criteria. In the staples group (n=50), 26 patients underwent THR while 24 patients underwent TKR. In the sutures group (n=50), 23 patients underwent THR and 27 patients underwent TKR. Overall, there was no significant difference between the two groups (staples versus sutures) in terms of wound complications (p=0.401), patient satisfaction (p=0.357) and nurse satisfaction (p=0.513). Further analysis compared THR and TKR subgroups (THR staples versus THR sutures and TKR staples versus TKR sutures). The results showed no significant difference between the staples and sutures subgroups of THR and TKR in terms of wound complications, patient satisfaction and nurse satisfaction.
In THR and TKR, there was no significant difference between either vertical mattress nylon sutures or staples primary skin closure in terms of wound complications and patient satisfaction in this study. The decision on wound closure method should be based on the availability of resources in the institution/country.
本研究旨在比较初次全髋关节置换术（THR）和全膝关节置换术（TKR）患者伤口皮肤闭合的两种方法——吻合钉与垂直褥式尼龙缝线。比较以伤口并发症作为主要结局，患者和护士的满意度作为次要结局。
在一家学术教学医院进行了一项前瞻性队列研究。纳入2018年9月至2019年9月因初次THR或TKR入院的所有患者。排除翻修手术患者、85岁以上患者以及接受类固醇治疗的患者。将患者分为两组（吻合钉组和缝线组）以比较两种伤口闭合方法。对每组患者进行年龄、性别、体重、身高、合并症、吸烟状况、术后伤口并发症、再次手术以及患者/护士满意度等特征评估。
共有100例患者符合纳入标准。吻合钉组（n = 50）中，26例患者接受THR，24例患者接受TKR。缝线组（n = 50）中，23例患者接受THR，27例患者接受TKR。总体而言，两组（吻合钉组与缝线组）在伤口并发症（p = 0.401）、患者满意度（p = 0.357）和护士满意度（p = 0.513）方面无显著差异。进一步分析比较了THR和TKR亚组（THR吻合钉组与THR缝线组以及TKR吻合钉组与TKR缝线组）。结果显示，THR和TKR的吻合钉组与缝线组在伤口并发症、患者满意度和护士满意度方面无显著差异。
在本研究中，对于THR和TKR，垂直褥式尼龙缝线或吻合钉进行初次皮肤闭合在伤口并发症和患者满意度方面无显著差异。伤口闭合方法的选择应基于机构/国家的资源可用性。
