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Closing Time: One Last Call for Patient Preference

BACKGROUND: Wound closure method in total hip and knee arthroplasty is a controversial topic with no differences in clinical outcomes between surgical staples (SS) and subcutaneous sutures with Dermabond (SCD). When clinically appropriate, providers should focus more on what the patient may prefer....

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Autores principales: Parikh, Nihir, Langfitt, Maxwell K., Shilt, John, Bullock, Garrett S., Shields, John S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943337/
https://www.ncbi.nlm.nih.gov/pubmed/35342782
http://dx.doi.org/10.1016/j.artd.2022.02.022
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author Parikh, Nihir
Langfitt, Maxwell K.
Shilt, John
Bullock, Garrett S.
Shields, John S.
author_facet Parikh, Nihir
Langfitt, Maxwell K.
Shilt, John
Bullock, Garrett S.
Shields, John S.
author_sort Parikh, Nihir
collection PubMed
description BACKGROUND: Wound closure method in total hip and knee arthroplasty is a controversial topic with no differences in clinical outcomes between surgical staples (SS) and subcutaneous sutures with Dermabond (SCD). When clinically appropriate, providers should focus more on what the patient may prefer. This study aimed to collect data on patient preference between SS and SCD and analyze differences in preference based on gender and previous surgical histories. METHODS: Patients were surveyed on their wound closure preferences prior to surgery. The handout given collected preference and patient demographics. Risk ratios and risk difference with 95% confidence intervals (95% CI) were calculated along with Firth-corrected logistic regressions. RESULTS: A total of 163 participants were analyzed (53% female) (average age = 63.8 years), in which 12 participants selected SS as their preferred method. Males demonstrated no difference in relative risk (risk ratio: 2.3 [95% CI: 0.7, 7.3], P = .150) or absolute risk (risk difference: 5.9 [−2.2, 14.1], P = .156) in choosing SS over SCD. Patients that previously sustained SS for other surgeries demonstrated no difference in adjusted odds (adjusted: 0.9 [95% CI: 0.2, 3.2], P = .839) in choosing SS over SCD. CONCLUSION: More patients favored SCD over SS. There was no difference in preferences based on gender or previous surgical history. Current literature shows that successful wound closure is achieved with minimized risks for infection and other complications using both methods. Providers should adopt a patient-centric approach and perform the closure method that most patients prefer when medically warranted.
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spelling pubmed-89433372022-03-25 Closing Time: One Last Call for Patient Preference Parikh, Nihir Langfitt, Maxwell K. Shilt, John Bullock, Garrett S. Shields, John S. Arthroplast Today Original Research BACKGROUND: Wound closure method in total hip and knee arthroplasty is a controversial topic with no differences in clinical outcomes between surgical staples (SS) and subcutaneous sutures with Dermabond (SCD). When clinically appropriate, providers should focus more on what the patient may prefer. This study aimed to collect data on patient preference between SS and SCD and analyze differences in preference based on gender and previous surgical histories. METHODS: Patients were surveyed on their wound closure preferences prior to surgery. The handout given collected preference and patient demographics. Risk ratios and risk difference with 95% confidence intervals (95% CI) were calculated along with Firth-corrected logistic regressions. RESULTS: A total of 163 participants were analyzed (53% female) (average age = 63.8 years), in which 12 participants selected SS as their preferred method. Males demonstrated no difference in relative risk (risk ratio: 2.3 [95% CI: 0.7, 7.3], P = .150) or absolute risk (risk difference: 5.9 [−2.2, 14.1], P = .156) in choosing SS over SCD. Patients that previously sustained SS for other surgeries demonstrated no difference in adjusted odds (adjusted: 0.9 [95% CI: 0.2, 3.2], P = .839) in choosing SS over SCD. CONCLUSION: More patients favored SCD over SS. There was no difference in preferences based on gender or previous surgical history. Current literature shows that successful wound closure is achieved with minimized risks for infection and other complications using both methods. Providers should adopt a patient-centric approach and perform the closure method that most patients prefer when medically warranted. Elsevier 2022-03-21 /pmc/articles/PMC8943337/ /pubmed/35342782 http://dx.doi.org/10.1016/j.artd.2022.02.022 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Parikh, Nihir
Langfitt, Maxwell K.
Shilt, John
Bullock, Garrett S.
Shields, John S.
Closing Time: One Last Call for Patient Preference
title Closing Time: One Last Call for Patient Preference
title_full Closing Time: One Last Call for Patient Preference
title_fullStr Closing Time: One Last Call for Patient Preference
title_full_unstemmed Closing Time: One Last Call for Patient Preference
title_short Closing Time: One Last Call for Patient Preference
title_sort closing time: one last call for patient preference
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943337/
https://www.ncbi.nlm.nih.gov/pubmed/35342782
http://dx.doi.org/10.1016/j.artd.2022.02.022
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