ADHESIVE GLUE Vs SUBCUTICULAR SUTURING IN THYROIDECTOMY

2021 ◽  
pp. 16-17
Author(s):  
Anil Kumar K N ◽  
Ashwin Kumar H
Keyword(s):  
Postoperative Pain ◽  
Clinical Outcome ◽  
Wound Closure ◽  
Medical Science ◽  
Wound Dehiscence ◽  
Wound Complications ◽  
P Value ◽  
Skin Closure ◽  
Post Operative Pain ◽  
Needle Prick

BACKGROUND: Suturing has been the commonest method of surgical wound closure that is being practiced because of good results of skin closure. With adhesive glue being an alternative for skin closure which is less time consuming, comfortable, without the risk of needle prick injury and leaves behind a cosmetically acceptable scar. OBJECTIVES: The aim of this study is to compare subcuticular suturing versus adhesive glue for skin closure in thyroidectomy with respect to clinical outcome which included postoperative pain, wound complications, wound dehiscence and cosmesis. MATERIALAND METHODS: This prospective study of 100 cases of skin closure using subcuticular suturing versus adhesive in thyroidectomy was carried out at BGS Global institute of medical science and Hospital, Bangalore with the aim of comparing suturing versus adhesive glue, with respect to clinical outcome which included postoperative pain, wound complications, wound dehiscence and cosmesis. RESULT: 100 patients divided into 2 groups, randomly underwent subcuticular suturing and adhesive glue skin closure. Post- operative pain was less in glue group (p value <0.001) and wound complications were comparable in both groups. CONCLUSION: Octylcyanoacrylate provides an effective and reliable means of skin closure and yields similar cosmetic results as with subcuticular skin sutures. The incidences of wound complications are comparable in both the groups. However the severity of postoperative pain is lesser in the adhesive group.

scholarly journals Which is better for pfannensteil skin incision closure in caesarean section? Interrupted mattress suture or continuous subcuticular suture

2020 ◽  
Vol 9 (9) ◽  
pp. 3711
Author(s):  
Shridevi A S. ◽  
Madhusoodana R. Bhovi ◽  
Prema Prabhudeva ◽  
Renuka . ◽  
Camelia Maitra
Keyword(s):  
Patient Satisfaction ◽  
Caesarean Section ◽  
Caesarean Delivery ◽  
Wound Closure ◽  
Wound Dehiscence ◽  
Skin Wound ◽  
Wound Complications ◽  
Skin Closure ◽  
Pain Level

Background: Caesarean delivery is one of the most commonly performed operations in obstetrics. Postoperative comfort of the woman largely depends on the method of skin closure. Wound complications from caesarean delivery such as dehiscence or infection cause a significant emotional and economic burden in obstetric care. There are many methods and techniques for skin wound closure in caesarean section. Each technique has its own advantages and disadvantages. The aim and objective of this study was to compare the wound outcomes in Pfannensteil incisions closed with mattress sutures using nonabsorbable suture and subcuticular sutures using absorbable sutures in caesarean deliveries.Methods: It is a prospective observational study done on 216 consecutive pregnant women who were admitted to labor room for elective or emergency caesarean section. Patients undergoing caesarean section with Pfannensteil incision between February 2019 to October 2019 were included in this study. Among 216 women, 108 women had mattress sutures and 108 women had subcuticular sutures for skin wound closure. The primary outcome studied was wound complications including erythema, wound dehiscence, burst abdomen, infection and pain which was studied on postoperative day 3-7. The secondary outcome was assessed at 6 weeks follow-up in terms of pain, cosmetic appearance of scar and patient satisfaction about scar.Results: A total of 216 pregnant women undergoing caesarean section were studied who had similar baseline characteristics and risk factors. However, women with previous caesarean section were more in mattress group. The overall incidence of erythema, surgical site infection, wound dehiscence, resuturing and pain was more in mattress group and was statistically significant. During follow-up at 6 weeks, women with subcuticular sutures had cosmetically better scar and more satisfied with their scars than women with mattress sutures but the pain level was same in both groups.Conclusions: Authors conclude that compared to mattress sutures, subcuticular sutures cause significantly fewer wound complications and pain in postoperative period. Also, subcuticular sutures are associated with cosmetically appealing scars and higher patient satisfaction. But there was no difference in pain level at 6 weeks in both methods of skin closure.

scholarly journals Successful surgical closure of infected abdominal wounds following preconditioning with negative pressure wound therapy

2021 ◽  
Author(s):  
Johanna C. Wagner ◽  
Anja Wetz ◽  
Armin Wiegering ◽  
Johan F. Lock ◽  
Stefan Löb ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Wound Closure ◽  
Negative Pressure Wound Therapy ◽  
Wound Complications ◽  
Skin Closure ◽  
Wound Treatment ◽  
Open Wound ◽  
Wound Therapy ◽  
Significant Difference ◽  
Open Wound Treatment

Abstract Purpose Traditionally, previous wound infection was considered a contraindication to secondary skin closure; however, several case reports describe successful secondary wound closure of wounds “preconditioned” with negative pressure wound therapy (NPWT). Although this has been increasingly applied in daily practice, a systematic analysis of its feasibility has not been published thus far. The aim of this study was to evaluate secondary skin closure in previously infected abdominal wounds following treatment with NPWT. Methods Single-center retrospective analysis of patients with infected abdominal wounds treated with NPWT followed by either secondary skin closure referenced to a group receiving open wound therapy. Endpoints were wound closure rate, wound complications (such as recurrent infection or hernia), and perioperative data (such as duration of NPWT or hospitalization parameters). Results One hundred ninety-eight patients during 2013–2016 received a secondary skin closure after NPWT and were analyzed and referenced to 67 patients in the same period with open wound treatment after NPWT. No significant difference in BMI, chronic immunosuppressive medication, or tobacco use was found between both groups. The mean duration of hospital stay was 30 days with a comparable duration in both patient groups (29 versus 33 days, p = 0.35). Interestingly, only 7.7% of patients after secondary skin closure developed recurrent surgical site infection and in over 80% of patients were discharged with closed wounds requiring only minimal outpatient wound care. Conclusion Surgical skin closure following NPWT of infected abdominal wounds is a good and safe alternative to open wound treatment. It prevents lengthy outpatient wound therapy and is expected to result in a higher quality of life for patients and reduce health care costs.

Postoperative Pain Relief: The Comparison of Bupivacaine before Incision and Near Closure of Wound

2021 ◽  
Vol 15 (10) ◽  
pp. 2622-2624
Author(s):  
Haq dad Durrani ◽  
Rafia Kousar ◽  
Ejaz Iqbal ◽  
Muhammad Abdul Aziz ◽  
Syed Aushtar Abbas Naqvi ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Subcutaneous Tissue ◽  
Difficult Problem ◽  
P Value ◽  
Trial Methodology ◽  
Analgesic Requirement ◽  
Rescue Analgesia ◽  
Post Operative Pain ◽  
Significant Difference

Background: Pain is the most common and most difficult problem faced by patients after operation. Due to inadequate management 30-70% patients suffer from post-operative pain. Acute pain resulting in chronic pain reduces quality of life and creates economic burden. Aim: To compare post-operative pain relief between infiltration of 0.25% bupivacaine into skin and subcutaneous tissue in the line of incision before incision and along edges of wound near completion of procedure. Study design: Randomized control trial Methodology: Sixty four patients were randomly divided into two groups i.e. (0.25% Bupivacaine 6 to 30ml) at the site of incision into skin and subcutaneous tissue Preincision (Group P) and (0.25% Bupivacaine 6 to 30ml) along the edges of wound at near closure of procedure (Group C). Intensity of pain was assessed on visual analogue scale in the recovery room, 3, 6 and 24 hours postoperatively.The time of first dose of rescue analgesia within 24 hours was also noted in both groups. Results: There was no statistically significant difference between two groups regarding age (p-value = 0.324), gender i.e. males (p=0.545) females (p=0.763) and duration of operation (P=Value=0.208). The mean time of rescue analgesia in Group P and Group C in minutes was 318.12±149.47 and 374.84±125.67 respectively (p value =1.5) reflecting no statistically significant difference. Conclusion: Postoperative analgesia and analgesic requirement do not differ significantly whether bupivacaine is infiltrated before incision or just before closure of wound. Keywords: Postoperative pain, bupivacaine, rescue analgesia, Preincision

scholarly journals Evaluation of postoperative pain in closure versus non-closure of parietal peritoneum at caesarean section

2017 ◽  
Vol 6 (5) ◽  
pp. 1969
Author(s):  
Avantika Sharma ◽  
Nupur Hooja ◽  
Apoorv Shastri ◽  
Brijesh Dadhich ◽  
Richa Manish
Keyword(s):  
Postoperative Pain ◽  
Tertiary Care ◽  
Postoperative Outcome ◽  
Parietal Peritoneum ◽  
P Value ◽  
Care Hospital ◽  
Post Operative Pain ◽  
Background Pain ◽  
One Year ◽  
Closure Group

Background: Pain is one of the major discomfort which drives post caesarean mothers to seek help. Thus, it is important to know if any change in surgical technique could have effect on the post-operative pain which affects all the woman’s activities. Hence, the study was undertaken to study the effect of closure and non-closure of parietal peritoneum on postoperative pain.Methods: It was a hospital based interventional study done in a tertiary care hospital over one year. Detailed history, investigations, operative details, postoperative outcome in terms of pain were recorded and analysed.Results: Women in the closure group had more postoperative pain. P value was highly significant at 8h (P=0.0001), 16h (P=0.0001), 24h (P=0.00001) and 32h (P=0.000001), 40 hour (P=0.00001) and 48h (P=0.0001).Conclusions: Peritoneal should not be closed routinely in caesarean sections as it is shown to cause less postoperative pain.

scholarly journals A Comparative Study between Staplers and Suture (Silk 2-0) for Skin Closure in Cesarean Sections at Gandaki Medical College Teaching Hospital

2018 ◽  
Vol 10 (2) ◽  
pp. 1-5
Author(s):  
K Jahan ◽  
R Shrestha ◽  
P Adhikari ◽  
M Tripathi ◽  
C P Neupane ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Comparative Study ◽  
Hospital Stay ◽  
Teaching Hospital ◽  
College Teaching ◽  
Wound Dehiscence ◽  
Wound Complications ◽  
Skin Closure ◽  
Medical College ◽  
Suture Group

Background: Skin closure in the abdominal surgeries is an important factor that affects the prognosis of wound in terms of hospital stay as well as overall outcome of the surgery.Objectives: Cesarean section being the commonly performed operation, choice of suture material has the unexceptional role on it. This study has been performed with an objective to look for the merits and demerits of the skin closure by suture (Silk 2-0) and stapler.Methods: Prospective comparative study conducted among the patients admitted in a Maternity Ward of Gandaki Medical College Teaching Hospital for elective and emergency cesarean section. The comparison has been made in terms of time taken during the skin closure, presence or absence of soakage and wound dehiscence, day of suture removal and pain during the suture removal.Results: The average time taken for skin closure for suture group was found to be 5.46 min (±0.97) and the same for stapler group was found to be 1.22 min (±0.15) respectively. Similarly, the mean day of stitch removal in suture and staples were found to be 6.94 (±1.75) and 7.95 (±1.89) respectively. Surgical site infection (SSI) i.e. soakage was present in eight percent of those in suture group and 20% in stapler group. Wound dehiscence was present in two percent among the suture group and five percent among the stapler group. The severity of pain is more in stapler group than that of suture group during its removal.Conclusions: Our study concluded suture being superior to staplers for skin closure during cesarean section. Though time taken for the closure is less in the stapler group, other factors like wound complications, duration of hospital stay, pain during its removal favored for the suture to be used.J-GMC-N | Volume 11 | Issue 01 | January-June 2018, Page: 1-4

scholarly journals Comparison of 2-octyl cyanoacrylate skin adhesive and interrupted polypropylene sutures for wound closure in total ankle arthroplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Gun-Woo Lee ◽  
Woo Kyoung Kwak ◽  
Keun-Bae Lee
Keyword(s):  
Patient Satisfaction ◽  
Surgical Site Infection ◽  
Wound Closure ◽  
Wound Dehiscence ◽  
Wound Complications ◽  
Site Infection ◽  
Ankle Arthroplasty ◽  
Suture Group ◽  
Allergic Contact ◽  
Polypropylene Sutures

Abstract Background Adhesive skin materials have increasingly been used in orthopedic surgery. We aimed to compare the efficacy and safety of skin adhesive (2-octyl cyanoacrylate and polymer mesh, Dermabond Prineo) and interrupted polypropylene sutures for wound closure in patients undergoing total ankle arthroplasty (TAA). Methods We prospectively enrolled 107 consecutive patients (108 ankles) undergoing TAA and divided them into two groups: skin adhesive group (36 ankles) and suture group (72 ankles). The primary outcome assessment included wound complications and patient satisfaction for wound cosmesis. The secondary outcome assessment included duration of surgery, length of hospital stay, and the Ankle Osteoarthritis Scale (AOS) pain and disability score. Results There was one case of allergic contact dermatitis, three cases of wound dehiscence, and one case of superficial surgical site infection in the skin adhesive group. Among them, one case each with allergic contact dermatitis and wound dehiscence finally progressed to deep surgical site infection. Three cases of wound dehiscence were also reported in the suture group; however, there was no case of surgical site infection. Patient satisfaction for wound cosmesis was significantly higher in the skin adhesive group than in the suture group (p = 0.001). There was no statistically significant difference between the groups in terms of secondary outcomes (p > 0.05). Conclusions Although the use of Dermabond Prineo showed better patient satisfaction for wound cosmesis, it showed significantly high wound complication rates and no other clinical benefits compared to interrupted polypropylene suture in TAA. Our results suggest that awareness of the possibility of wound complications is necessary when Dermabond Prineo is used in TAA.

scholarly journals Use of Pregabalin as a Pre-Medication for Post-Operative pain in patients undergoing Laparoscopic Cholecystectomy

2019 ◽  
Vol 8 (1) ◽  
pp. 29-33
Author(s):  
Tabish Hussain ◽  
Asifa Anwar Mir ◽  
Jawad Zahir ◽  
Pervaiz Minhas
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
P Value ◽  
Chi Square ◽  
Vas Score ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Operative Evaluation ◽  
Group A ◽  
Group B

Background: Postoperative pain creates complications by increasing circulating level of catecholamines and systemic vascular resistance, thus putting the patients on increased risks of having stroke and myocardial infarction. In addition, it increases hospital stay, causing burden over economic as well as healthcare infrastructure. The aim of this study was to determine the frequency of pain in the postoperative period while using Pregabalin as pre-medication among patients undergoing laparoscopic cholecystectomy.Material and Methods: The randomized control trail was conducted at Department of Anesthesiology, Holy Family hospital, Rawalpindi from 1st Sept 2015 to 28th Feb 2016 over a period of 6 months. A total of 200 patients undergoing laparoscopic cholecystectomy were randomly divided in group A and B by consecutive non-probability lottery method. Group A received 100 mg oral Pregabalin 1 hour before surgery and Group B were not given Pregabalin and were taken as controls. Post-operative pain was measured by visual analog scale (VAS) in terms of pain scores at 4 hours postoperatively after the arrival of patient in the post-anesthesia care unit (PACU). SPSS version 17.0 was used to analyze the data.Results: A total of 200 patients were included in the study. There were 100 patients in each group. Based on the visual analog pain scores, 9 patients were pain free in group A compared with none in group B. Similarly, there were 55 patients in group A, who reported a pain score of 1 whereas no patient in group B had a VAS score of 1. There were 29 patients in group A and only 3 patients in group B with VAS score of 2 (90.6% vs. 9.4%). For VAS score of 3, there were 6 patients in group A and 34 patients from group B (15% vs. 85%). For a VAS score of 4, there were 1 patient in group A and 61 patients in group B (1.6% vs. 98.4%). Two patients in group B experienced a VAS score of 5. All this data was significant with chi square p value of 0.0001.Conclusion: Oral Pregabalin administered prior to laparoscopic cholecystectomy was effective in reducing postoperative pain in the patients. Further studies are needed for post-operative evaluation of side effects, different dosing schedules at different time intervals for both rest and dynamic pain.

scholarly journals Effect of pre-incisional infiltration of 0.5% ropivacaine versus placebo in post-operative pain relief among patients undergoing tonsillectomy under general anaesthesia: a comparative study

2020 ◽  
Vol 6 (9) ◽  
pp. 1638
Author(s):  
Sushil Namdeorao Meshram ◽  
Ankesha Ghanshyam Walthare ◽  
Jayant Krishna Sonone ◽  
Alok Kumar
Keyword(s):  
Postoperative Pain ◽  
Rating Scale ◽  
Data Entry ◽  
Oral Intake ◽  
Pain Scale ◽  
Bivariate Analysis ◽  
P Value ◽  
Chi Square ◽  
Postoperative Haemorrhage ◽  
Post Operative Pain

<p><strong>Background:</strong>  Pain is the most common complaint in the immediate post-tonsillectomy period. Inadequate post-tonsillectomy pain management has many drawbacks. Ropivacaine is a new long acting local anaesthetic, structurally closely related to bupivacaine.</p><p><strong>Methods: </strong>It was a prospective double blinded randomized control trial on a total of 50 patients who were posted for tonsillectomy. Randomization of each patient was done into two groups one of which had received 4 ml of 0.5% ropivacaine hydrochloride solution and other 4 ml normal saline. Data entry and analysis was done with (SPSS IBM) version 21.0. Both univariate and bivariate analysis done. Proportions were calculated for qualitative variables and mean with standard deviation was done for quantitative variables. Required tests of significance such as Chi square test and independent test were applied. Significance of p value is taken as p&lt;0.05. Postoperative pain, first post op oral intake, duration of post-operative hospital stay, and postoperative haemorrhage was assessed. The intensity of postoperative pain was assessed on behavioural observational pain Scale and Wong baker faces pain rating scale.</p><p><strong>Results:</strong> Pre-incisional infiltration of 0.5% Ropivacaine was an effective method to reduce post-operative pain in patients undergoing tonsillectomy under GA. Effect of  Ropivacaine was statistically significant (p&lt;0.05).</p><p><strong>Conclusions:</strong> We recommend the use of 0.5% ropivacaine pre-incisional infiltration in patients undergoing tonsillectomy.</p>

scholarly journals Comparative study of steristrips and subcuticular suture for wound closure after thyroid surgery

2017 ◽  
Vol 4 (10) ◽  
pp. 3392 ◽  
Author(s):  
Vinay G. ◽  
Balasubrahmanya K. S.
Keyword(s):  
Comparative Study ◽  
Thyroid Surgery ◽  
Wound Closure ◽  
Thyroid Neoplasms ◽  
Skin Closure ◽  
Chi Square ◽  
Post Operative Pain ◽  
Acceptable Method ◽  
Chi Square Test ◽  
Neck Mobility

Background: Any skin closure technique aims at opposing the skin edges precisely without tension for sufficient time to allow healing to take place. The ease and speed with which the skin closure is completed, the level of patient discomfort, the complication rate, and the final cosmetic result are the factors which has to be considered in making a comparison of different types of wound closure. This study aims at comparing steristrips and subcuticular sutures for wound closure after thyroid surgery based on assessment of post-operative pain, neck mobility and cosmetic appearance.Methods: A comparative study was carried out among 90 subjects attending Department of Surgery, K. R. Hospital, Mysuru over a period of 10 months. Subjects of either sex undergoing thyroidectomy will be randomized to had their wounds closed by steristrips or subcuticular sutures using a simple randomization table. Patients who underwent previous neck irradiations, secondary neck surgeries, and patients with poor compliance were excluded from the study. Descriptive statistics, unpaired t-test and chi-square test were used to analyse the results.Results: The mean age group of the study subjects was 48.6 (range 24-76) years. The gender distribution showed a higher number of females (82) as compared to males (8). 70 patients were diagnosed with multinodular goitre, 16 patients were of thyroid neoplasms and 4 were of inflammatory thyroid conditions. 12 patients underwent subtotal thyroidectomy and 78 patients underwent total thyroidectomy. Wound closure by steristrips had less post-operative pain, acceptable neck mobility and excellent scar appearance as compared to subcuticular sutures.Conclusions: The choice of materials for wound closure will depend on the surgeon's preference. However, this study does show that steristrips sutures can be removed more quickly and is more acceptable method of wound closure as compared to subcuticular sutures after thyroid surgery.

scholarly journals Outcome of skin incision by cautery versus steel scalpel in hernia surgery: a prospective cohort study at a tertiary medical college hospital in South India

2017 ◽  
Vol 4 (5) ◽  
pp. 1521 ◽  
Author(s):  
Ragesh K. V. ◽  
Mahendran S. ◽  
Siddarth Mathad
Keyword(s):  
Postoperative Pain ◽  
Wound Infection ◽  
Infection Rate ◽  
Skin Incision ◽  
Wound Infection Rate ◽  
P Value ◽  
Hernia Surgery ◽  
College Hospital ◽  
Post Operative Pain ◽  
Group B

Background: Since a long time, skin incisions have routinely been made with scalpels. Now a days there is a shift in trend from this method to electrosurgical skin incisions. However, fear of bad scars and improper wound healing has prevented its wide spread use. The aim of the study was to compare the Diathermy versus Scalpel skin incision in elective hernia surgeries with regards to post-operative pain, post-operative wound infection rate and wound healing.Methods: A total of 200 patients were taken for this study. 100 patients underwent diathermy incision (group A) who were compared with 100 scalpel incision patients (group B). Variables used in this study were postoperative pain, wound infection and scar.Results: Patients with diathermy skin incision were having less post-operative pain which was assessed by visual analogue scale when compared with scalpel incision since the p value was 0.01 which is significant (<0.05). The postoperative infection rate and scar were comparable in both the groups since the p-value is >0.05 in each which is insignificant.Conclusions: Diathermy incisions are therefore less harmful to the skin. It has got more advantages than scalpel incisions like less postoperative pain.

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