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Related Experiment Videos

Clips versus suture technique: is there a difference?

T Chughtai1, L Q Chen, G Salasidis

  • 1Department of Cardiothoracic Surgery, Montreal General Hospital, McGillUniversity Health Centre, Montreal, Quebec, Canada.

The Canadian Journal of Cardiology
|December 8, 2000
PubMed
Summary
This summary is machine-generated.

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Subcuticular suture closure for coronary artery bypass grafting (CABG) incisions resulted in fewer infections and lower costs compared to skin clips. This technique offers better wound outcomes for CABG patients.

Area of Science:

  • Cardiovascular Surgery
  • Wound Healing
  • Surgical Techniques

Background:

  • Coronary artery bypass grafting (CABG) is a common procedure with significant wound complication rates.
  • Wound complications increase patient morbidity and healthcare costs.

Purpose of the Study:

  • To compare wound outcomes and costs of subcuticular suture versus skin stapling for sternal and leg incisions in CABG patients.
  • To evaluate the economic impact in a Canadian healthcare setting.

Main Methods:

  • Prospective randomized trial of 162 CABG patients.
  • Incisions closed with either subcuticular sutures or skin clips.
  • Wound assessments included leakage, inflammation, infection, necrosis, swelling, dehiscence, and cosmesis (graded 1-4).
  • Cost analysis in Canadian dollars.

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Main Results:

  • Trends toward increased inflammation with skin clips for sternal (P=0.09) and leg (P=0.17) incisions.
  • Significantly higher sternal wound infection rate with skin clips (P=0.05).
  • Tendency for increased mediastinitis with clips (P=0.15).
  • Similar cosmetic outcomes for both techniques.
  • Significantly greater cost with skin clips, exceeding $10,000 annually.

Conclusions:

  • Subcuticular suture closure demonstrates superior wound outcomes compared to skin clips in CABG patients.
  • Subcuticular closure is more cost-effective, considering direct costs and intangible factors.
  • Subcuticular suture technique is a favorable method for CABG wound closure.