Comparison of the wound healing and complications of zipper type closure adhesive tape and stapler for surgical wound suture: A randomized control, single-centre, open-label trial.

Xkin closure is a newly developed medical suture device for lacerations and surgical wounds that can reduce scarring, pain and the risk of infection compared with conventional sutures or staplers. A randomized controlled study was performed to compare the wound healing effects and complications of Xkin closure with stapler closure. Fifty patients who underwent robot-assisted radical prostatectomy for prostate cancer were randomly assigned. Only the wound above the navel, which was extended to take out the prostate was targeted. The wound was examined at 2, 6 and 12 weeks after surgery, and the modified Vancouver Scar Scale (mVSS), scar height and side effects were assessed with a 3D skin analyser. Forty-six patients (23 Xkin, 23 Stapler) were analysed. The mVSS scores, vascularity and pliability were significantly lower in the Xkin group compared with the stapler group at the 12-week follow-up. No significant differences in the maximum peak and depth of the scars were detected between the two groups using 3D photographs at 12 weeks. Xkin is an effective wound closure method for improving scar outcomes. This method is expected to be widely used for surgical wounds and lacerations caused by trauma in daily life.

Effects of neuromuscular taping form I on wound temperature and erythema in diabetic foot ulcer: a preliminary study.

OBJECTIVE: This study aimed to measure the effectiveness of neuromuscular taping (NMT) form I (a polyacrylate tape 0.6cm wide and 30cm long) on wound temperature and erythema in diabetic foot ulcers (DFUs) as an initial study in NMT intervention trials. METHOD: The study employed a quasi-experimental pretest and post-test design with a seven-day observation. The research sample was 38 patients with DFU grades 2 and 3. The sample was divided into two groups: the control group (n=19) and the intervention group (n=19). In wound care, the modern dressing was applied to both groups while NMT was applied to the intervention group in form I with 30cm long and 6mm wide strips, and on the proximal, distal and lateral sides. The wound bed temperature was measured with a non-contact infrared thermometer, and erythema was measured with Corel Photo-Paint X5 software (Corel Corp, Canada). Statistical analysis between the two groups was carried out using the Mann-Whitney test, independent t-test and Chi-squared test with p< 0.05 representing statistical significance. RESULTS: The preliminary results revealed that no statistically significant differences (p>0.05) were noted between the groups in sociodemographic or clinical characteristics, including age, body mass index, blood sugar, duration of diabetes, sex, smoking history, wound temperature and degree of erythema. Finally, it was also observed that, after seven days of application, NMT form I increased wound bed temperature, and reduced the level of erythema (p<0.05). CONCLUSION: In this study, NMT form I has been shown to increase the wound bed temperature and reduce the degree of erythema in DFUs.

Multiligament Knee Reconstruction With Suture Tape Augmentation: Patient-Reported Outcomes at Minimum 2-Year Follow-up.

BACKGROUND: Multiligament knee injury (MLKI) is a severe subclass of orthopedic injury and can result in significant functional impairment. Novel MLKI graft constructs such as suture augmentation aim to enhance graft strength and optimize knee stability. The purpose of this study was to present patient-reported outcome measurements of a cohort at a minimum follow-up of 2 years after multiligament knee reconstruction (MLKR) with suture augmentation. MATERIALS AND METHODS: A retrospective chart review was performed to identify patients who underwent MLKR with suture augmentation. Demographic and injury-specific variables were gathered preoperatively and postoperatively. Patients were contacted at a minimum of 2 years postoperatively to collect Patient-Reported Outcomes Measurement Information System, Multiligament Quality of Life, and Lysholm knee scores. RESULTS: Twenty-seven patients underwent MLKR with suture augmentation, with 15 being female (55.6%) and 12 being male (44.4%). The mean pain score was 49.93±9.96, the mean physical function score was 49.56±10.94, and the mean mobility score was 47.56±8.58. The mean physical impairment score was 33.96±23.69, the mean emotional impairment score was 36.55±26.60, the mean activity limitation score was 28.00±25.61, and the mean societal involvement score was 30.09±27.45. The mean Lysholm knee score for the cohort was 67.93±22.36. CONCLUSION: Patients who underwent MLKR with suture augmentation had satisfactory scores across all patient-reported outcome measurements. On the basis of these criteria, the average patient achieved an acceptable clinical outcome, demonstrating that MLKR with suture augmentation is a safe and efficacious surgical technique for the treatment of MLKI. [Orthopedics. 2024;47(4):238-243.].

Taping alone for persistent ventral curvature after urethral plate transection in hypospadias.

INTRODUCTION: Ventral penile curvature is a key factor in determining the surgical approach to proximal hypospadias repair. However, there is limited evidence regarding the efficacy and long-term effects of the procedures used to address curvature. This study aimed to evaluate the effects of urethral plate transection alone with tissue traction therapy on penile curvature in two-stage repair of proximal hypospadias. MATERIAL AND METHODS: This was a prospective study of primary hypospadias patients who underwent a two-stage repair with urethral plate transection as the sole straightening procedure. After stage 1, taping was applied as tissue traction therapy and continued until stage 2. Penile curvature was measured using a goniometer under artificial erection before and immediately after urethral plate transection and during the second stage of repair. The primary focus of this investigation is the angle of curvature after 6-month taping. RESULTS: The study included 46 patients with a median age of 13 months at the start of treatment. The median angle of penile ventral curvature was 70° after degloving, 60° after urethral plate transection, and 0° during the second stage of repair. Full correction of ventral curvature was achieved in 42 patients (91 %). DISCUSSION: This publication is the first of its kind to propose taping as a method for penile traction therapy in hypospadias. The study reveals that penile ventral lengthening can be achieved through tissue traction therapy following UP transection alone. These findings challenge the current consensus that complete straightening of the penis in the first stage is necessary to prevent recurrent curvature and that ventral lengthening is required to correct corporal disproportion. However, further validation and long-term data are needed to definitively confirm the effectiveness of tissue traction therapy after urethral plate transection. CONCLUSIONS: This study demonstrated significant resolution rate of penile ventral curvature in proximal hypospadias following urethral plate transection alone with taping. Long-term follow-up studies are needed to confirm the sustainability of the results through puberty.

RNA-sequencing of paired tape-strips and skin biopsies in atopic dermatitis reveals key differences.

BACKGROUND: Skin tape-strips and biopsies are widely used methods for investigating the skin in atopic dermatitis (AD). Biopsies are more commonly used but can cause scarring and pain, whereas tape-strips are noninvasive but sample less tissue. The study evaluated the performance of skin tape-strips and biopsies for studying AD. METHODS: Whole-transcriptome RNA-sequencing was performed on paired tape-strips and biopsies collected from lesional and non-lesional skin from AD patients (n = 7) and non-AD controls (n = 5). RNA yield, mapping efficiency, and differentially expressed genes (DEGs) for the two methods (tape-strip/biopsy) and presence of AD (AD/non-AD) were compared. RESULTS: Tape-strips demonstrated a lower RNA yield (22 vs. 4596 ng) and mapping efficiency to known genes (28% vs. 93%) than biopsies. Gene-expression profiles of paired tape-strips and biopsies demonstrated a medium correlation (R2 = 0.431). Tape-strips and biopsies demonstrated systematic differences in measured expression levels of 6483 genes across both AD and non-AD samples. Tape-strips preferentially detected many itch (CCL3/CCL4/OSM) and immune-response (CXCL8/IL4/IL5/IL22) genes as well as markers of epidermal dendritic cells (CD1a/CD207), while certain cytokines (IL18/IL37), skin-barrier genes (KRT2/FLG2), and dermal fibroblasts markers (COL1A/COL3A) were preferentially detected by biopsies. Tape-strips identified more DEGs between AD and non-AD (3157 DEGs) then biopsies (44 DEGs). Tape-strips also detected higher levels of bacterial mRNA than biopsies. CONCLUSIONS: This study concludes that tape-strips and biopsies each demonstrate respective advantages for measuring gene-expression changes in AD. Thus, the specific skin layers and genes of interest should be considered before selecting either method.

Editorial Commentary: Clinical and Basic Science Evidence Supports the Use of Suture Tape Augmentation of Posterior Cruciate Ligament Reconstruction.

Although isolated posterior cruciate ligament (PCL) injuries often can be treated successfully without surgical intervention, in the setting of persistent instability or multiligamentous knee injury, PCL reconstruction is indicated. PCL reconstructions often have resulted in persistent postoperative laxity. Recent research suggests there may be a role for suture tape-augmented grafts, which have demonstrated decreased clinical and radiographic laxity as well as improved rates of return to previous level of activity, as compared with PCL reconstruction alone. Several biomechanical studies also have supported the use of suture tape augmentation in PCL reconstruction, and the use of suture tape augmentation or internal bracing and ligament surgery is gaining widespread popularity. These ultrahigh molecular weight polyethylene/polyester suture tapes have been shown to be safe and effective. We may be at the point at which the evidence supports the use of suture tape augmentation of PCL reconstruction.

Suture Tape Augmentation Improves Posterior Stability After Isolated Posterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft With Single-Bundle Transtibial Technique.

PURPOSE: To assess whether posterior cruciate ligament reconstruction (PCLR) with suture tape augmentation can yield more stability after isolated PCLR. METHODS: A prospective database was retrospectively reviewed to identify patients who underwent primary isolated PCLR (control group) or isolated PCLR with suture tape augmentation (study group) from January 2016 to September 2020. We analyzed subjective International Knee Documentation Committee (IKDC), Lysholm, and Tegner knee scores; posterior drawer test findings; posterior stress radiographs; and return-to-sports activity rates. The minimal clinically important difference (MCID) was used to evaluate clinical relevance (subjective IKDC, Lysholm, and Tegner scores). RESULTS: A total of 59 patients were included in this analysis (28 in control group and 31 in study group). The average length of follow-up was similar between the study and control groups (48.6 months vs 47.9 months, P = .800). Knee function was significantly improved in the study group in terms of subjective IKDC scores (85.1 ± 6.4 in study group vs 79.8 ± 6.4 in control group, P = .002), Lysholm scores (86.3 ± 7.4 vs 80.8 ± 7.4, P = .005), and Tegner scores (7.0 ± 1.4 vs 5.6 ± 1.7, P = .006). However, the differences between the control and study groups were less than the MCID for the subjective IKDC score and Lysholm score. In the control and study groups, 21.4% of patients (6 of 28) and 48.4% of patients (15 of 31), respectively, returned to their preinjury sports activity levels (P = .031). At last follow-up, the mean side-to-side difference in posterior laxity was significantly improved in the study group compared with the control group (1.52 ± 0.70 mm in study group vs 3.17 ± 2.01 mm in control group, P < .01). CONCLUSIONS: Primary isolated PCLR with suture tape augmentation provides better posterior stability than PCLR without suture tape augmentation at a minimum of 2 years' follow-up. No differences between the groups were observed in the percentage of patients who met or exceeded the MCID for the subjective IKDC and Lysholm scores. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

Detection of cutaneous malignant melanoma by tape stripping of pigmented skin lesions - A systematic review.

BACKGROUND: Cutaneous malignant melanoma (MM) is potentially aggressive, and numerous clinically suspicious pigmented skin lesions are excised, causing unnecessary mutilation for patients at high healthcare costs, but without histopathological evidence of MM. The high number of excisions may be lowered by using more accurate diagnostics. Tape stripping (TS) of clinically suspicious lesions is a non-invasive diagnostic test of MM that can potentially lower the number needed to biopsy/excise. MATERIALS AND METHODS: The aim is to determine the diagnostic accuracy of TS in detecting MM in clinically suspicious pigmented skin lesions. This systematic review following PRISMA guidelines searched PubMed, Web of Science, and Embase (September 2022) using melanoma combined with tape stripping, adhesive patch(es), pigmented lesion assay, or epidermal genetic information retrieval. RESULTS: Ten studies were included. Sensitivity ranged from 68.8% (95% confidence interval [CI] 51.5, 82.1) to 100% (95% CI 91.0, 100). Specificity ranged from 69.1% (95% CI 63.8, 74.0) to 100% (95% CI 78.5, 100). A pooled analysis of five studies testing the RNA markers LINC00518 and PRAME found a sensitivity of 86.9% (95% CI 81.7, 90.8) and a specificity of 82.4% (95% CI 80.8, 83.9). CONCLUSION: Overall quality of studies was low, and the reliability of sensitivity and specificity is questionable. However, TS may supplement well-established diagnostic methods as pooled analysis of five studies indicates a moderate sensitivity. Future studies are needed to obtain more reliable data as independent studies with no conflict of interest.

Double Eyelid Tape as a Treatment Option for Severe Ptosis in Patients With Myotonic Dystrophy Type 1.

ABSTRACT: Myotonic dystrophy is a systemic disorder associated with progressive muscle weakness of the limbs and multiorgan dysfunction. This condition commonly affects the levator palpebrae superioris muscle, which leads to ptosis and eventually affects patients' activities of daily living. The effects of ptosis on activities of daily living are usually overlooked; therefore, the importance of treatment is underestimated, and surgical procedures are considered infeasible in patients with preexistent levator palpebrae superioris muscle weakness. This case report describes the case of a middle-aged man with myotonic dystrophy type 1, who presented with ptosis, which significantly restricted his participation in rehabilitation and activities of daily living secondary to a limited visual field. He was evaluated by an ophthalmologist; however, surgery was contraindicated in view of the high risk of complications, such as exposure keratitis and corneal ulcer. Double eyelid tapes were used as a nonsurgical intervention, which significantly increased the palpebral fissure height and improved the visual field, with a higher modified functional index score. Double eyelid tapes may serve as an effective, safe, and reliable therapeutic option for severe ptosis in patients with myotonic dystrophy.

Deterioro de la piel asociado con aseguramiento del dispositivo de acceso intravascular / Skin breakdown associated with securing of the intravascular access device / Ruptura da pele associada à fixação do dispositivo de acesso intravascular

El deterioro de la piel asociado con adhesivos de uso médico en dispositivos de acceso intra-vascular es un evento adverso que puede contribuir a la interrupción de la terapia de infusión intravascular. La Sociedad de enfermeras de infusión recomienda usar tecnologías de protec-ción como apósito estéril para aseguramiento del catéter y cinta quirúrgica para aseguramien-to complementario. Objetivo: Analizar las causas y prevalencia del deterioro de la piel aso-ciado con aseguramiento del dispositivo de acceso intravascular. Métodos: Estudio analítico, de corte transversal. Para recolectar datos se empleó un formato digital y observación directa a pacientes hospitalizados (n=813) con algún dispositivo de aseguramiento en acceso intra-vascular central o periférico, y aseguramiento complementario con cinta quirúrgica, dando seguimiento durante 7 días en febrero 2020. Resultados: El deterioro de la piel incluyó de-sprendimiento de epidermis, maceración, dermatitis irritativa por contacto y alérgica, con prevalencia de 2.2%. Se atribuyeron a catéter venoso central (f=8), catéter venoso periférico (f=7) y cinta quirúrgica para aseguramiento complementario del apósito transparente (f=3). Discusión: Las causas de deterioro de la piel se debieron al tipo de dispositivo y material implementado para aseguramiento; en la mayoría de casos las lesiones se encontraron en accesos venosos periféricos, seguida de accesos venosos centrales, siendo el aseguramiento complementario la menor causa de deterioro de la piel. Conclusiones: La técnica correcta de aplicación y retiro de insumos adhesivos de estabilización y aseguramiento del catéter intravascular evitará el desprendimiento de los mismos, lesiones de piel e interrupción de la terapia de infusión intravascular

Deterioration of the skin associated with medical adhesives in intravascular access devices is an adverse event that can contribute to the discontinuation of intravascular infusion ther-apy. The Society of Infusion Nurses recommends the use of protective technologies such as sterile dressing for catheter securing and surgical tape for supplemental securing. Objective: To analyze the causes and prevalence of skin deterioration associated with securing the intravascular access device. Methods: Analytical, cross-sectional study. To collect data, a digital format and direct observation of hospitalized patients (n = 813) were used with some device for securing in central or peripheral intravascular access, and complementary securing with surgical tape, with follow-up for 7 days in February 2020. Results: The Skin deterioration included epidermal detachment, maceration, irritant contact and allergic dermatitis, with a prevalence of 2.2%. They were attributed to central venous catheter (f = 8), peripheral venous catheter (f = 7) and surgical tape for complementary securing of the transparent dressing (f = 3). Discussion: The causes of skin deterioration were due to the type of device and mate-rial implemented for belaying; In the majority of cases, the lesions were found in peripheral venous accesses, followed by central venous accesses, with supplementary insurance being the least cause of skin deterioration. Conclusions: The correct technique for applying and removing adhesive supplies for stabilization and securing of the intravascular catheter will avoid their detachment, skin lesions and interruption of intravascular infusion therapy

A deterioração da pele associada a adesivos médicos em dispositivos de acesso intravascular é um evento adverso que pode contribuir para a descontinuação da terapia de infusão intra-vascular. A Society of Infusion Nurses recomenda o uso de tecnologias de proteção, como curativo estéril para fixação do cateter e esparadrapo para fixação suplementar. Objetivo: Analisar as causas e a prevalência da deterioração da pele associada à fixação do dispositivo de acesso intravascular. Métodos: Estudo analítico, transversal. Para a coleta de dados, uti-lizou-se o formato digital e observação direta dos pacientes internados (n = 813) com algum dispositivo de fixação em acesso intravascular central ou periférico e a fixação complementar com esparadrapo, com seguimento de 7 dias em fevereiro de 2020. Resultados: A deterio-ração da pele incluiu descolamento epidérmico, maceração, contato com irritante e dermatite alérgica, com prevalência de 2,2%. Foram atribuídos a cateter venoso central (f = 8), cateter venoso periférico (f = 7) e esparadrapo para fixação complementar do curativo transparente (f = 3). Discussão: As causas da deterioração da pele foram devido ao tipo de dispositivo e material implementado para amarração; Na maioria dos casos, as lesões foram encontradas em acessos venosos periféricos, seguidos de acessos venosos centrais, sendo a amarração suplementar a menor causa de deterioração da pele. Conclusões: A técnica correta de apli-cação e retirada de suprimentos adesivos para estabilização e fixação do cateter intravascular evitará seu descolamento, lesões cutâneas e interrupção da terapia de infusão intravascular

Hydrogel tapes for fault-tolerant strong wet adhesion.

Fast and strong bio-adhesives are in high demand for many biomedical applications, including closing wounds in surgeries, fixing implantable devices, and haemostasis. However, most strong bio-adhesives rely on the instant formation of irreversible covalent crosslinks to provide strong surface binding. Repositioning misplaced adhesives during surgical operations may cause severe secondary damage to tissues. Here, we report hydrogel tapes that can form strong physical interactions with tissues in seconds and gradually form covalent bonds in hours. This timescale-dependent adhesion mechanism allows instant and robust wet adhesion to be combined with fault-tolerant convenient surgical operations. Specifically, inspired by the catechol chemistry discovered in mussel foot proteins, we develop an electrical oxidation approach to controllably oxidize catechol to catecholquinone, which reacts slowly with amino groups on the tissue surface. We demonstrate that the tapes show fast and reversible adhesion at the initial stage and ultrastrong adhesion after the formation of covalent linkages over hours for various tissues and electronic devices. Given that the hydrogel tapes are biocompatible, easy to use, and robust for bio-adhesion, we anticipate that they may find broad biomedical and clinical applications.

Capitonnage method selection in pulmonary hydatidosis with purse-string or interrupted suture.

BACKGROUND: Disfigurements in the lung parenchyma due to capitonnage methods may lead to long-term atelectasis. The aim of the present study was to examine whether there are any complication differences between the capitonnage applied via interrupted suture or purse-string suture. METHOD: Of the total of 120 cases that underwent hydatid cyst surgery during 2007 and 2020, those that were subject to capitonnage were included in the study. The preoperative and postoperative findings were analyzed for 76 cases subject to purse-string capitonnage (Group I) and 24 interrupted capitonnage (Group II). RESULTS: While the number of cases with complication in Group I was 16 (21.1%), there were only 2 (8.3%) complications in Group II; however, the difference was not statistically significant (P = 0.23). Bronchopleural fistula (n = 1) and prolonged air leak (n = 2) were observed in Group I, there was no bronchopleural fistula or prolonged air leak in Group II. Atelectasis was the most frequently observed complication observed in 12 (15.8%) cases in Group I and 2 (8.3%) cases in Group II (P = 0.53). The duration of hospitalization was lower for the patients in Group II. The number of days was 7.3 ± 2.7 for Group I and 5.3 ± 2.1 for Group II (P < 0.01). CONCLUSION: This study is the first to compare whether there are any complication differences between the capitonnage methods via interrupted suture or purse-string suture. The results of the study put forth that the duration of hospitalization is lower in the interrupted capitonnage group. Parenchymal anatomy may be preserved better in interrupted capitonnage method.

Wound Healing on the Dorsal Hands: An Intrapatient Comparison of Primary Closure, Purse-String Closure, and Secondary Intention.

Nonmelanoma skin cancers are common on the dorsal hands where reserve tissue is limited. We highlight the case of an elderly man who had 3 nonmelanoma skin cancers on the left hand that were treated on the same day and left similar wounds. The wounds were repaired by primary closure, secondary intention, and purse-string circumferential closure. All wounds healed with excellent and essentially equivalent cosmetic results. For small shallow wounds on the dorsal hands, dermatologic surgeons should have confidence that secondary intention healing likely will lead to acceptable cosmetic and functional results.

Heel Complications.

Postoperative complications can be burdensome on both the patient and the surgeon. Attention in literature is often directed toward different forms of treatment and successful outcomes in surgery. The incentive of this article is to bring insight toward postoperative complications in rearfoot surgery, more specifically, the repair of the Achilles tendon with suture tape and suture anchors. This article directs attention to the recent reports on hypersensitivity reactions seen with the use of suture tape and nonabsorbable suture anchors and may encourage physicians to make patients aware of this potential complication when using these materials.

Tissue adhesive and adhesive tape for pediatric wound closure: A systematic review and meta-analysis.

BACKGROUND: Tissue adhesive (TiA), adhesive tape (AdT), and sutures can be used to close surgical wounds and lacerations in children. However, it is unclear which technique produces the best results. METHODS: In this prospectively registered study, the PubMed, Ovid MEDLINE, Cochrane Library, Centre for Reviews and Dissemination Database, and ScienceDirect databases were searched. English language studies published between January 1980 and August 2017 evaluating TiA and/or AdT for primary skin closure of surgical wounds or lacerations in patients aged ≤18 years were included. Study endpoints included clinician-rated wound cosmesis and incidence of wound complications. RESULTS: Thirty-one studies were included in the systematic review and 16 studies in the meta-analysis. Amongst heterogeneous studies, AdT yielded marginally better cosmetic outcomes than TiA (p = 0.04). There was no difference in cosmesis between sutured wounds and those closed with TiA (p = 0.2). No difference in overall risk of wound infection or dehiscence was identified when comparing TiA with AdT (p = 0.3), and TiA with sutures (p = 0.9 and 0.3 respectively). CONCLUSIONS: TiA, AdT, and sutures can all be used for wound closure with equivalent risk of wound infection and dehiscence. AdT appears to convey better cosmesis. Further adequately powered studies directly comparing techniques are required. LEVELS OF EVIDENCE: Level IV.

Intercostal chest drain fixation strength: comparison of techniques and sutures.

OBJECTIVE: The accidental removal of an intercostal chest drain (ICD) is common and may result in serious complications. A number of fixation techniques and suture material are in use, and the selection is often based on personal preferences and equipment availability. This study is designed to determine which of the common techniques provides the strongest ICD fixation. METHODS: This study compared the mechanical strength of eight different ICD fixation techniques (purse string, 'Roman sandal', 'Jo'burg' (JO) technique, a suture through the tube, one and two passes through a locking plastic tie, tape fixation and a commercial disposable drainage tube holder) and two silk suture sizes using porcine cadavers and a digital push-pull dynamometer to simulate accidental removal of an ICD. A total of 14 different experimental set-ups produced 280 measurements. RESULTS: Significant differences in ICD fixation strength were observed. A modified JO technique using a size 1 silk suture was nearly three times stronger than a purse-string fixation using a size 0 silk and 10 times stronger from a commercial, adhesive-based device (180, 70 and 22, respectively). CONCLUSION: In situations where the mechanical strength of ICD fixation is important, using a size 1 silk and a modified JO technique may provide the strongest fixation.