Evaluation of three methods of suture for skin closure in total knee arthroplasty: a randomized trial.

BACKGROUND: There are several studies comparing techniques and different materials, yet the results are not unanimous. We compared three methods of skin closure in total knee arthroplasty (TKA), including suture with single stitches and unabsorbable MonoNylon®, as well as continuous subcuticular suture with Monocryl® or barbed Stratafix® absorbable suture. METHODS: A prospective, randomized study was conducted with 63 patients undergoing TKA between March 2016 and December 2016. Patients were divided into three groups: traditional suture MonoNylon® (n 22), subcuticular continuous suture with Monocryl® (n 20), and another barbed with Stratafix® (n 21). The closure time, length of wire used, pain intensity, possible complications, and cosmeses were evaluated. RESULTS: Subcuticular continuous suture using Monocryl® was superior to traditional suture using MonoNylon® as less thread was used (p 0.01) and a better cosmetic effect was achieved (p < 0.01), which was equal to Stratafix® aspects analyzed (p > 0.05). Complications were observed mostly in patients who used Stratafix®. CONCLUSIONS: This study concluded that the subcuticular suture with absorbable monofilament Monocryl® proved to be advantageous compared to the others because it presented results equal to the barbed Stratafix®, however with fewer complications. Furthermore, Monocryl® was shown to be equal or superior to traditional MonoNylon® suture regarding in relation pain intensity, aesthetic result, and effective cost. TRIAL REGISTRATION: WHO ICTRP identifier RBR78dh5d. Retrospectively registered: 07/29/2020.

Terapia a laser de baixa potência e sua eficácia na cicatrização de incisões cirúrgicas na pele de ratos / Effects of low laser power laser therapy in wound healing in rats

A terapia com laser de baixa potencia se tornou algo de inúmeras pesquisas,devido a melhora do processo cicatricial.Um estudo experimental foi realizado para avaliar se há benefícios dessa terapia na cicatrização de feridas na pele de ratos com análises não pareadas e pareadas. Foram utilizados 20 ratos Wistar dividos em 4 grupos, submetidos a 4 incisões lineares na pele do dorso.No Grupo 1, usamos uma dose de laser no pós-operatório; no Grupo 2, duas doses, uma no pós-operatório e após 24 horas; no Grupo 3, três doses, no pós-operatório , 24 e 48 horas.O grupo controle foi submetido às incisões da pele.Foram testadas a força de ruptura e analisados os achados histopatológicos das incisões.Em análise não pareada, o grupo 1 apresenta o maior valor, tendo diferença (p = 0,040). A força de ruptura dos quatro grupos de ratos para as feridas não tratadas, não ocorreu. Na análise pareada as feridas tratadas com laser nos grupos 1, 2 e 3 e grupo controle, não houve diferença. Em análise não pareada, segundo a epitelização e a granulação, o grupo 3 apresentou maior freqüência para epitelização (p=0,002) e granulação (p=0,012).Nas feridas não tratadas nos quatro grupos não houve diferença entre elas em relação à epitelização e à granulação. Na análise pareada, não ocorreram diferenças dessas para os ferimentos produzidos nos grupos.É improvável existir relação entre a terapia a laser e a cicatrização, sendo a associação na análise não pareada apenas aparente, justificada pelo método de avaliação .(AU)

Low power laser therapy is recently in focus due to its properties in angiogenesis, fibroblast and colagenase activity. Based on these facts, the benefits of low laser power therapy in wound healing have been considered. In order to evaluate the benefits of low power therapy in wound healing, twenty Wistar rats were divided into four groups (n=5) which received four linear incisions in the back and then the following treatments, 1: a post-incision laser dose 2: one post-incision and 24 hours later dose 3: one post-incision, 24 and 48 hours later laser doses. 4: control group, with the four skin incisions and no laser therapy. Rupture force and histopathological analyses were performed. Unpaired analyses showed that epithelialization (p= 0.002) and granulation (p=0.012) were more frequent. But there were no differences between groups, using paired analyses. Thus, it is not likely that there is a correlation between low power laser treatment and wound healing. Our findings using unpaired analyses can be justified by the findings using unpaired analyses can be justified by the method of analyses.(AU)