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.

Simple tape-stripping method for highly reliable and quantitative analysis of skin microbiome.

The composition of human skin microbiome profoundly impacts host skin health and disease. However, the relationship between skin homeostasis or the development of skin diseases and daily changes in skin microbial composition is poorly understood. Longitudinal samplings at more frequent intervals would address this issue, while conventional sampling methods have technical difficulties, leading to limitations in sampling opportunities. Here, we developed a simple and stable tape-stripping method regardless of the operator's skill. Our method enables skin microbial sampling within 30 seconds and taking multiple skin microbial samples from the same body site. The amount of microbial DNA among multiple sampling sites could be measured within 13.5%. The sequencing results of multiple sampling showed high consistency, Pearson's correlation coefficient between multiple samples of 0.98. Furthermore, these results were comparable to those collected by the conventional swabbing method. These results demonstrate that our tape-stripping method enables simple microbiome collection and highly reliable quantitative skin microbiome analysis. These features of our method would lead to a further understanding of skin disease development or diagnosis of skin conditions in clinical research by increasing the opportunities for microbial sampling.

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.

The Use of Knotless Suture Tape Construct vs Screw Fixation for Lisfranc Injuries: A Cadaveric Biomechanical Study.

BACKGROUND: Lisfranc injuries are often treated with open reduction and internal fixation using rigid fixation techniques. The use of flexible fixation to stabilize the Lisfranc joint is a newer technique. The purpose of this cadaveric study is to compare the amount of diastasis at the Lisfranc interval under diminished physiologic loads when treated with a knotless suture tape construct and a solid screw. METHODS: Ten cadavers (20 feet) had native motion at the intact Lisfranc interval assessed at multiple increasing loads (69, 138, and 207 N). The Lisfranc ligamentous complex was then disrupted, and testing repeated to evaluate the amount of diastasis. Randomization was performed to determine the type of fixation for each cadaver: solid screw or knotless suture tape construct. Once fixation was completed, specimens were cyclically loaded for 10 000 cycles at loads, and diastasis was quantified after each load cycle to compare the interventions. Diastasis was measured using motion tracking cameras and retroreflective marker sets. A non-inferiority statistical analysis was performed. RESULTS: Diastasis mean values were confirmed to be >2 mm for all load bearing conditions in the injury model. Posttreatment, diastasis was significantly reduced when compared to the sectioned conditions (P < .01) for both treatment options. Non-inferiority analyses showed that the knotless suture tape construct did not perform inferior to screw fixation for diastasis at the Lisfranc interval at any of the compared load states. CONCLUSION: Under the loads tested, there is no significant difference in diastasis at the Lisfranc interval when treating ligamentous Lisfranc injuries with a knotless suture tape construct or solid screws. Both reduced diastasis from the injured state and were not different from the intact state. CLINICAL RELEVANCE: In this cadaveric model with ligamentous Lisfranc injury, diastasis of a knotless suture tape construct is compared to solid screw fixation as tested.

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.

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.

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.

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.

A new surgical tape with a mesh designed to prevent skin tears and reduce pain during tape removal.

We devised a surgical tape that prevents skin tears while maintaining adhesive strength. Under the assumption that microscopic damage to the skin is reflected in pain felt on the skin, we statistically analyzed skin pain when the tape was peeled off to show the skin protection effect of the mesh on the new tape. This tape has a three-layer structure consisting of a tape substrate, adhesive, and mesh. When the tape is applied to the skin, a mesh is located between the adhesive and the skin. The adhesive contacts the skin through the mesh holes and fixes the substrate to the skin; it does not come into contact with the skin at the mesh body; therefore, the adhesive-skin contact area is reduced. In this experiment, we used surgical tape with and without mesh. At 8 hours after the application of each tape to the forearm of five adult males, it was removed. All tapes were peeled off while maintaining an angle of approximately 120° between the skin and tape substrate. For the tape with mesh, the tape substrate was peeled off in two ways: peeling off the substrate together with the mesh and peeling off the substrate, leaving the mesh on the skin. A perception and pain quantification analyzer (Pain Vision™) was used to quantify pain. The data were compared and examined statistically (Friedman's test and Wilcoxon's coded rank test). The least pain was experienced while peeling off the tape substrate, leaving the mesh on the skin. There was a significant difference in pain levels among the three tape removal methods. There was also a significant difference between the two peeling methods in the experimental group. The skin protection effect of the mesh reduced pain when the surgical tape was removed.

Continuous removal of single cell layers by tape stripping the stratum corneum - a histological study.

Studies on the penetration of toxicologically or pharmaceutically relevant substances through the skin and, more specifically, through the stratum corneum (s.c.) often rely on the well-established method of tape stripping. Tape stripping involves the removal of skin layers by means of adhesive tape, which is usually followed by quantification of dermally applied substances in these layers. However, the amount of s.c. removed by each individual tape strip is still a matter of scientific debate. While some studies imply that the amount of s.c. adhering to each tape strip decreases with increasing depth into the s.c., others observed a constant removal rate. All these studies rely on the quantification of the amount of s.c. captured on individual or pooled tape strips. Here, we present an approach whereby we measured the amount of s.c. remaining on excised porcine skin in the process of tape stripping. Staining and bloating of the s.c. allowed to measure its thickness and to count individual s.c. layers, respectively. Histologically, we show that the s.c. remaining on the skin decreased linearly as a function of strips taken. We found that each tape strip removes about 0.4 µm of s.c., which corresponds to approximately one cellular layer. With a high coefficient of determination (r2 > 0.95), we were able to linearly correlate the thickness of the remaining s.c., the number of remaining cell layers and the number of tape strips applied. Furthermore, we elaborate on possible reasons for the discrepancies reported in the scientific literature regarding the amount of s.c. removed by each tape strip.

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.

Improving the incubation results by sealing the eggshell of cracked hatching eggs with surgical tape.

In broiler breeder production, up to 2% of hatching eggs are rejected because of cracked or broken shells. Eggs with cracks give a reduced hatchability and a lower chick quality and cause economic loss. The main goal of this study was to determine the effect of sealing eggshell cracks with surgical tape on hatching parameters. A total of 3,000 eggs from a 34 weeks old Cobb 500 broiler breeder flock was used in the experiment. Six hundred intact eggs represented a positive control. Other eggs were artificially cracked by the operator either on the first day of storage (1,200 eggs) or on the fourth day of storage (1,200 eggs). In both groups, cracks on 600 eggs were sealed by the adhesive surgical tape while the other 600 eggs remained untreated and were used as a negative control. Within each experimental group, eggs were assigned randomly to 4 setter trays representing 4 replicates of 150 eggs. The egg weight loss during incubation was the highest (P < 0.01) in groups of nonsealed cracked eggs. The egg weight loss in sealed groups was higher compared to the control group (P < 0.01). Percentage of egg contamination was not different between groups. Embryonic mortality was higher in non-sealed groups in all stages of embryonic development (P < 0.01) compared to groups of sealed cracked eggs and the control group. Hatching percentage was significantly lower in non-sealed groups (P < 0.01) compared to sealed groups and positive control. No significant difference in hatching parameters was observed between sealed groups and positive control, indicating that surgical tape can be used for sealing cracks on the eggshell to support embryonic survival.

3M microfoam™ surgical tape prevents nasal pressure injury associated with nasotracheal intubation: A randomized double-blind trial.

BACKGROUND: 3M microfoam™ surgical tape (3ST: 3M Japan Limited) is used for pressure wound control of medical equipment. It is cushioned and can be fitted to any body part. Here we investigated whether 3ST prevents nasal pressure injury associated with nasotracheal intubation (NTI). METHODS: We conducted a prospective, randomized double-blind study, enrolling 63 patients aged 20 to 70 years, who underwent general anesthesia with NTI. They were divided into 2 groups; those treated with 3ST (group S; n = 31) and control (group C; n = 31). After NTI and before securing the nasotracheal tube, a 35 × 25 mm 3ST was used to protect the nasal wing in group S, and the nasotracheal tube was fixed in place after NTI without protection in group C. The primary outcome was the presence or absence of nasal pressure injury after extubation. The Chi-Square test was used to assess the association between the 2 categorical variables. RESULTS: Nasal pressure injury was observed in 7 and 19 patients from groups S and C, respectively, representing a significant difference between the 2 groups (24.1% vs 67.8%, P = .001). Remarkably, none of the patients developed ulcers. CONCLUSION: 3ST prevents nasal pressure injury associated with NTI.

Durapore vs. Hy-Tape for securing endotracheal tubes during general anaesthesia: a prospective randomised controlled non-inferiority trial.

INTRODUCTION: Adhesive tape is commonly used to secure endotracheal tubes (ETT) during general anaesthesia. Although a variety of adhesives are used in practice, few studies have investigated the likelihood of different adhesives in producing facial skin injury. Given that differences in cost exist between adhesives that are often used interchangeably, it would be prudent to use the most economical option. MATERIAL AND METHODS: A single-centre, prospective, randomised controlled non-inferiority trial of patients undergoing general anaesthesia with an ETT was conducted. Patients were randomised in a blinded fashion to use Durapore (DP) on either the right or left side of the face to secure the ETT, with Hy-Tape (HT) on the contralateral side. Skin photographs were taken prior to tape application and following tape removal. These were evaluated by three dermatologists to determine presence or absence of facial skin erythema, scaling, oedema, and tearing. Differences were compared using McNemar's test. For outcomes analysis, a non-inferiority margin of 20% difference was used with respect to the 95% CI. RESULTS: Among 112 patients, 33.0% were male, with a mean (SD) age of 55.6 (15.9) years. Comparing DP vs. HT, noninferiority was demonstrated in the patients with skin erythema (1.8% difference, 95% CI: -5.6 to 9.2, P = 0.79), oedema (3.6% difference, 95% CI: -2.8 to 10.0%, P = 0.34), scaling (5.4% difference, 95% CI: -4.1 to 14.8, P = 0.31), and tearing (0.9% difference, 95% CI: -5.2 to 7.3, P > 0.99). CONCLUSIONS: There is a non-inferior difference in the proportion of patients with facial skin erythema after use of DP vs. HT to secure the ETT.

Allergic contact dermatitis from ("hypoallergenic") adhesives containing D-limonene.

BACKGROUND: Besides being a potential component of (some species of) colophonium, D-limonene is also used as a tackifier in the production of adhesives. Hydroperoxides of limonene are well-known skin sensitizers. OBJECTIVES: To show that D-limonene may be present in colophonium-containing but also colophonium-free ("hypoallergenic") adhesives, and that patients suffering from allergic contact dermatitis (ACD) from both types of adhesives might display positive patch test reactions to limonene hydroperoxides in this regard. METHODS: Five patients with suspected ACD from adhesives were patch tested to the baseline series (containing limonene hydroperoxides 0.3 and 0.2% pet.), additional series and, if available, to the culprit adhesives. The adhesives labelled as containing colophonium (n = 3) or free from it (n = 2) were analysed with gas chromatography - mass spectrometry (GC-MS) for the presence of D-limonene. RESULTS: All five patients sensitised to adhesives had (strong) positive patch test reactions to limonene hydroperoxides. The presence of D-limonene, and/or related components, could be demonstrated in all three colophonium-containing and, surprisingly, also in two colophonium-free ("hypoallergenic") tapes. CONCLUSIONS: D-limonene may be present in both regular and "hypoallergenic" adhesives, with limonene hydroperoxides potentially contributing to ACD from such medical devices. The use of fragrance chemicals in adhesives deserves further research.