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Optimal closure method of five-millimeter trocar sites
Kristi L Harold1, Sharon L Goldstein, Cynthia D Nelms
1Department of General Surgery, Carolinas Medical Center, Carolinas Laparoscopic and Advanced Surgery Program, 1000 Blythe Blvd., MEB 601, Charlotte, NC 28203, USA.
American Journal of Surgery
|January 7, 2004
Summary
Vicryl suture (VS) offers superior wound healing and patient comfort for 5-mm trocar site closure compared to cyanoacrylate tissue adhesive (CTA) and skin tape (ST). Despite longer closure times, VS minimizes scarring and adverse outcomes.
Area of Science:
- Laparoscopic surgery
- Surgical wound closure techniques
- Minimally invasive procedures
Background:
- 5-mm trocar site closure is commonly performed using absorbable sutures.
- Alternative closure materials like cyanoacrylate tissue adhesive (CTA) and skin tape (ST) exist.
- Comparison of vicryl suture (VS), CTA, and ST for 5-mm trocar site closure is warranted.
Purpose of the Study:
- To compare the efficacy and patient outcomes of vicryl suture (VS), cyanoacrylate tissue adhesive (CTA), and skin tape (ST) for 5-mm trocar site closure.
- To evaluate wound pain, appearance, and scarring at 1 and 6 weeks post-surgery.
Main Methods:
- Randomized trial involving 48 patients and 137 laparoscopic procedure wounds.
- Closure methods included vicryl suture (VS), cyanoacrylate tissue adhesive (CTA), and skin tape (ST).
- Patient-reported outcomes (pain, appearance) and surgeon-assessed wound healing using the Hollander wound evaluation scale were recorded.
Main Results:
- Vicryl suture (VS) closure times were longer than CTA and ST.
- Patients preferred VS for pain and appearance at 1 week (P=0.04, P=0.02).
- CTA showed higher rates of pain, poor appearance, scarring, step-off, contour irregularities, separation, distortion, and edge inversion at 6 weeks (P<0.05).
Conclusions:
- Vicryl suture (VS) provides superior scar formation and patient comfort for 5-mm trocar site closure compared to CTA and ST.
- Cyanoacrylate tissue adhesive (CTA) is associated with poor wound healing and increased pain.
- VS is a favorable option for 5-mm trocar site closure despite longer closure times.