Mohammed Hamouda, Umu-Hawa Rogers, Alik Farber, Vincent L Rowe, Michael S Conte, Mahmoud B Malas
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引用次数: 0
Abstract
Objective: Wound complications are one of the major sources of morbidity after open vascular procedures, especially lower extremity bypass (LEB). The preferred skin closure method is based on surgeon preference. Because no data clearly demonstrates the superiority of one method over the other, we aimed to compare outcomes of staples vs sutures for skin closure after LEB.
Methods: The Vascular Quality Initiative database was queried for patients who underwent LEB from August 2014 to March 2024. Patients were stratified according to skin closure method: staples vs sutures (which included either absorbable subcuticular or nonabsorbable interrupted sutures). The primary outcome was surgical site infection (SSI). Secondary outcomes were return to operating room (RTOR), prolonged length of stay >7 days (PLOS), and 30-day mortality. After adjusting to baseline and clinically relevant variables, multivariate logistic regression modeling analyzed primary and secondary outcomes.
Results: A total of 18,268 LEB procedures were included (staples, n = 5676; 31.07%); sutures (n = 12,592; 68.93%). Compared with suture closure, staples utilization was associated with 57% higher odds of SSI (196 [3.46%] vs 259 [2.06%]; odds ratio [OR], 1.57; 95% confidence interval [CI], 1.21-2.04; P = .001) and 30% higher odds of RTOR (860 [15.17%] vs 1449 [11.53%]; OR, 1.30; 95% CI, 1.12-1.50; P = .001) and PLOS (1630 [28.72%] vs 2835 [22.51%]; OR, 1.30; 95% CI, 1.16-1.45; P < .001). However, there was no significant difference in 30-day mortality among both closure methods (P > .05).
Conclusions: In this large multi-institutional study, our analysis demonstrates increased risk of SSI, RTOR, and PLOS after wound closure with staples compared with sutures in patients who underwent LEB. Although staple closure might be easier and more time efficient, meticulous wound closure with sutures should be the preferred closure method for LEB.
期刊介绍：
Journal of Vascular Surgery ® aims to be the premier international journal of medical, endovascular and surgical care of vascular diseases. It is dedicated to the science and art of vascular surgery and aims to improve the management of patients with vascular diseases by publishing relevant papers that report important medical advances, test new hypotheses, and address current controversies. To acheive this goal, the Journal will publish original clinical and laboratory studies, and reports and papers that comment on the social, economic, ethical, legal, and political factors, which relate to these aims. As the official publication of The Society for Vascular Surgery, the Journal will publish, after peer review, selected papers presented at the annual meeting of this organization and affiliated vascular societies, as well as original articles from members and non-members.
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