Outcomes of layered closure and adjunctive adhesive retention suture device use following ankle fracture open reduction and internal fixation: a single center, retrospective cohort study.

INTRODUCTION: Wound edge necrosis, dehiscence, infection, and need for reoperation can occur following ankle fracture ORIF. An assistive retention suture device has been developed to serve as an adjunct to skin closure to help mitigate the potential for wound dehiscence and subsequent complications. OBJECTIVE: This single-center retrospective review compared early postoperative healing and functional outcomes following ankle fracture ORIF in 39 patients in which layered closure alone (n = 20) and layered closure with use of a DAC (n = 19) was performed. RESULTS: Adjunctive assistive retention suture device use with layered closure following ankle fracture ORIF resulted in a 60% decrease in the time to healing, an 80% reduction in postoperative dehiscence, a 90% reduction in the need for reoperation, and a 53% reduction in the time in which use of an ambulatory assistive device, brace, or orthoses was required compared to layered closure alone. CONCLUSIONS: The results of this study suggest that use of this assistive retention suture device minimizes potential postoperative healing complications, decreases need for revisional surgery, and reduces time until return to activity.

Use of a Novel Adhesive Suture Retention Device in Non-traumatic Diabetic Lower Extremity Amputations: A Multicenter Case Review.

Background: Amputations in the diabetic foot are commonly associated with complications, including delayed wound healing, surgical site dehiscence, and the need for additional amputations. Use of a novel adhesive suture retention device (ASRD) has been previously shown to support improved linear closure outcomes. The purpose of this retrospective case review was to determine if the adoption of the ASRD in 5 podiatric surgical practices would reduce postoperative complications in patients with diabetes undergoing foot amputations including surgical site dehiscence and the need for additional amputation. Methods: A 5-center retrospective chart review was performed to assess the difference in postoperative surgical site dehiscence and reamputation rates for patients with diabetes undergoing minor and major lower extremity amputations before and after adopting the use of the ARSD. Results: Adoption of the adhesive retention suture device was associated with an overall decrease in wound dehiscence of 81% (P < .01). Additionally, there was an 89% reduction in progression to higher level amputation in the ARSD cohort (P = .015). Conclusions: Utilization of the ARSD decreased the incidence of postoperative wound dehiscence and reamputation in this patient cohort, thus lessening patient morbidity and decreasing the overall cost of care.