Obana Ayato, Minagawa Takuya, Shimada Ayako, Mukohyama Junko, Hirano Yuki, Hoshimoto Sojun, Oyama Takashi, Masashi Tsuruta, Ishida Takashi, Tamura Takuya, Matsuzaki Kyoichi, Takaku Mitsuru, Ohara Hirotoshi, Koyama Motoi, Shinoda Masahiro, Suwa Tatsushi, Itano Osamu
Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, School of Medicine, International University of Health and Welfare, Hatakeda 852, Narita, Chiba, 286-0124, Japan.
Department of Surgery, Kashiwa Kousei General Hospital, Kashiwa, Japan.
Surg Today. 2025 May 8. doi: 10.1007/s00595-025-03043-9.
Subcuticular sutures, which are effective and cosmetically advantageous in gastroenterological surgery, are time-consuming and heavily dependent on the surgeon's technical expertise. This study aims to evaluate whether Zipline skin closure could be an alternative to subcuticular sutures in gastroenterological surgery. A multicenter randomized controlled trial (UMIN000048169) was conducted on 76 patients who underwent elective gastroenterological surgery. The patients were randomized to either the Zipline group (N = 35) or the subcuticular suture group (N = 41). Primary outcomes included skin closure time and secondary outcomes included postoperative wound complications and cosmetic results, assessed 6 months post-surgery, using the Stony Book Scar Evaluation Scale (SBSES). The Zipline group demonstrated significantly shorter closure times than the suture group (median: 438 s [406-526] vs. 575 s [537-638]; p = 0.003). This difference was more pronounced for incisions > 55 mm (median:399 s [307-533] vs. 605 s [493-736]; p = 0.001). No significant differences were observed in wound infection rates (5.7% vs. 2.4%; p = 0.46) or SBSES scores (median: 4.0 [4.0-5.0] vs. 4.0 [3.0-5.0; p = 0.82) between the two groups. The Zipline device reduced the skin closure time in gastroenterological surgery significantly, particularly for large incisions, without compromising wound healing or cosmetic outcomes. These findings suggest that the Zipline system may be a viable alternative to traditional subcuticular sutures in gastroenterological procedures, potentially promoting operating room efficiency without compromising surgical quality or patient outcomes.
皮下缝合在胃肠外科手术中效果良好且具有美容优势，但耗时较长且严重依赖外科医生的技术专长。本研究旨在评估Zipline皮肤闭合器在胃肠外科手术中是否可替代皮下缝合。对76例行择期胃肠外科手术的患者进行了一项多中心随机对照试验（UMIN000048169）。患者被随机分为Zipline组（N = 35）或皮下缝合组（N = 41）。主要结局包括皮肤闭合时间，次要结局包括术后伤口并发症和美容效果，术后6个月使用石溪瘢痕评估量表（SBSES）进行评估。Zipline组的闭合时间明显短于缝合组（中位数：438秒[406 - 526] vs. 575秒[537 - 638]；p = 0.003）。对于长度> 55毫米的切口，这种差异更为明显（中位数：399秒[307 - 533] vs. 605秒[493 - 736]；p = 0.001）。两组之间在伤口感染率（5.7% vs. 2.4%；p = 0.46）或SBSES评分（中位数：4.0 [4.0 - 5.0] vs. 4.0 [3.0 - 5.0；p = 0.82]）方面未观察到显著差异。Zipline装置显著缩短了胃肠外科手术中的皮肤闭合时间，特别是对于大切口，且不影响伤口愈合或美容效果。这些发现表明，在胃肠手术中，Zipline系统可能是传统皮下缝合的可行替代方案，有可能提高手术室效率，而不影响手术质量或患者预后。
