Skin Closure Technique Matters: Fewer Wound Infections After Kidney Transplant in Patients With Class 2 Obesity Using...

Area of Science:

• Nephrology
• Transplant Surgery
• Infectious Disease

Background:

• Obesity presents significant challenges in kidney transplantation, notably increasing the risk of surgical site infections (SSI).
• Limited data exist on the correlation between wound closure methods and infection rates in this patient population.
• This study aimed to investigate wound complication differences between sutured and stapled closures in obese kidney transplant recipients.

Purpose of the Study:

• To compare the incidence of wound complications between sutured and stapled wound closures in kidney transplant recipients with class 2 obesity (BMI ≥ 35 kg/m²).
• To identify if the method of wound closure impacts the rate of surgical site infections and other wound morbidities.

Main Methods:

• A retrospective cohort analysis of kidney transplant recipients with class 2 obesity (BMI ≥ 35 kg/m²) between 2017 and 2025.
• Comparison of outcomes between patients who underwent sutured closure versus stapled closure.
• Chart review for 7 weeks post-transplant to assess wound complications, including erythema, purulence, and wound separation.

Main Results:

• While wound separation rates were similar (24% vs. 18%), sutured closures showed significantly fewer episodes of erythema (2% vs. 12%) and purulence (0% vs. 7.4%).
• Patients with sutured closures had a statistically lower rate of antibiotic prescription (2% vs. 15%, p=0.023).
• Univariate logistic regression identified sutured closure as the strongest factor associated with a decreased risk of composite infectious complications.

Conclusions:

• The findings suggest that subcuticular sutures, surgical glue, and strategic incision planning may lead to fewer infections compared to stapled closures in obese kidney transplant recipients.
• Further multicenter, prospective trials are warranted to establish an optimal wound closure approach for minimizing infection risk in this vulnerable patient group.