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Using Absorbable Sutures for Traumatic Wound Closure to Avoid Additional Hospital Visits for Suture Removal During the COVID-19 Pandemic: A Randomized Controlled Trial

Introduction The COVID-19 pandemic worldwide forced governments to undertake intervention measures to encourage social distancing. Meanwhile, traumatic skin lacerations require multiple hospital visits for dressing changing and suture removal since they are usually repaired with non-absorbable sutur...

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Autores principales: Alkandari, Ahmed F, Soliman, Diaa M, Madhyastha, Sampath, Alawadhi, Abrar A, Alawadhi, Fatma A, Almotairi, Nawaf M, Alozairi, Ous
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9637447/
https://www.ncbi.nlm.nih.gov/pubmed/36381800
http://dx.doi.org/10.7759/cureus.30012
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author Alkandari, Ahmed F
Soliman, Diaa M
Madhyastha, Sampath
Alawadhi, Abrar A
Alawadhi, Fatma A
Almotairi, Nawaf M
Alozairi, Ous
author_facet Alkandari, Ahmed F
Soliman, Diaa M
Madhyastha, Sampath
Alawadhi, Abrar A
Alawadhi, Fatma A
Almotairi, Nawaf M
Alozairi, Ous
author_sort Alkandari, Ahmed F
collection PubMed
description Introduction The COVID-19 pandemic worldwide forced governments to undertake intervention measures to encourage social distancing. Meanwhile, traumatic skin lacerations require multiple hospital visits for dressing changing and suture removal since they are usually repaired with non-absorbable sutures. These visits can be avoided by using absorbable sutures instead. However, absorbable sutures carry the “potential” risk of wound infection. In the current study, our first objective was to determine the non-inferiority of absorbable sutures regarding infection rate after repairing traumatic wound lacerations in comparison to the conventional non-absorbable ones. Our second objective was to evaluate the superiority of absorbable sutures in regard to postoperative clinic visits for suture removal and wound dressing compared to the non-absorbable ones. Methods A sample of 471 patients with traumatic skin lacerations was analyzed during the COVID-19 pandemic in April 2020. In the control group, wounds were repaired using non-absorbable sutures, while rapid-onset absorbable sutures were used in the treatment group. By conducting a phone/video call follow-up after 21 days, several parameters regarding infection signs and clinic visits were compared between both groups. Results A significant decrease in total trauma patients (45.4%) and those who required suturing (51.2%) was observed in April 2020 compared to the same month of the previous four years (p = 0.001 (2016), p = 0.027 (2017), p = 0.027 (2018), and p = 0.001 (2019)). Regarding wound infection, no statistically significant difference (p = 0.623) was observed between the absorbable (3.2%) and non-absorbable (4.9%) groups. Using absorbable sutures resulted in significantly (p < 0.001) fewer postoperative hospital visits compared to using non-absorbable sutures (mean: one versus three visits). Conclusion Using absorbable sutures to repair traumatic wound lacerations is safe regarding wound healing and infection rates. They also reduce postoperative hospital visits since they are not intended to be removed. Therefore, they should be considered during a pandemic to reduce hospital visits for suture removal, which will subsequently enhance social distancing and relieve hospital load.
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spelling pubmed-96374472022-11-14 Using Absorbable Sutures for Traumatic Wound Closure to Avoid Additional Hospital Visits for Suture Removal During the COVID-19 Pandemic: A Randomized Controlled Trial Alkandari, Ahmed F Soliman, Diaa M Madhyastha, Sampath Alawadhi, Abrar A Alawadhi, Fatma A Almotairi, Nawaf M Alozairi, Ous Cureus Emergency Medicine Introduction The COVID-19 pandemic worldwide forced governments to undertake intervention measures to encourage social distancing. Meanwhile, traumatic skin lacerations require multiple hospital visits for dressing changing and suture removal since they are usually repaired with non-absorbable sutures. These visits can be avoided by using absorbable sutures instead. However, absorbable sutures carry the “potential” risk of wound infection. In the current study, our first objective was to determine the non-inferiority of absorbable sutures regarding infection rate after repairing traumatic wound lacerations in comparison to the conventional non-absorbable ones. Our second objective was to evaluate the superiority of absorbable sutures in regard to postoperative clinic visits for suture removal and wound dressing compared to the non-absorbable ones. Methods A sample of 471 patients with traumatic skin lacerations was analyzed during the COVID-19 pandemic in April 2020. In the control group, wounds were repaired using non-absorbable sutures, while rapid-onset absorbable sutures were used in the treatment group. By conducting a phone/video call follow-up after 21 days, several parameters regarding infection signs and clinic visits were compared between both groups. Results A significant decrease in total trauma patients (45.4%) and those who required suturing (51.2%) was observed in April 2020 compared to the same month of the previous four years (p = 0.001 (2016), p = 0.027 (2017), p = 0.027 (2018), and p = 0.001 (2019)). Regarding wound infection, no statistically significant difference (p = 0.623) was observed between the absorbable (3.2%) and non-absorbable (4.9%) groups. Using absorbable sutures resulted in significantly (p < 0.001) fewer postoperative hospital visits compared to using non-absorbable sutures (mean: one versus three visits). Conclusion Using absorbable sutures to repair traumatic wound lacerations is safe regarding wound healing and infection rates. They also reduce postoperative hospital visits since they are not intended to be removed. Therefore, they should be considered during a pandemic to reduce hospital visits for suture removal, which will subsequently enhance social distancing and relieve hospital load. Cureus 2022-10-06 /pmc/articles/PMC9637447/ /pubmed/36381800 http://dx.doi.org/10.7759/cureus.30012 Text en Copyright © 2022, Alkandari et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Emergency Medicine
Alkandari, Ahmed F
Soliman, Diaa M
Madhyastha, Sampath
Alawadhi, Abrar A
Alawadhi, Fatma A
Almotairi, Nawaf M
Alozairi, Ous
Using Absorbable Sutures for Traumatic Wound Closure to Avoid Additional Hospital Visits for Suture Removal During the COVID-19 Pandemic: A Randomized Controlled Trial
title Using Absorbable Sutures for Traumatic Wound Closure to Avoid Additional Hospital Visits for Suture Removal During the COVID-19 Pandemic: A Randomized Controlled Trial
title_full Using Absorbable Sutures for Traumatic Wound Closure to Avoid Additional Hospital Visits for Suture Removal During the COVID-19 Pandemic: A Randomized Controlled Trial
title_fullStr Using Absorbable Sutures for Traumatic Wound Closure to Avoid Additional Hospital Visits for Suture Removal During the COVID-19 Pandemic: A Randomized Controlled Trial
title_full_unstemmed Using Absorbable Sutures for Traumatic Wound Closure to Avoid Additional Hospital Visits for Suture Removal During the COVID-19 Pandemic: A Randomized Controlled Trial
title_short Using Absorbable Sutures for Traumatic Wound Closure to Avoid Additional Hospital Visits for Suture Removal During the COVID-19 Pandemic: A Randomized Controlled Trial
title_sort using absorbable sutures for traumatic wound closure to avoid additional hospital visits for suture removal during the covid-19 pandemic: a randomized controlled trial
topic Emergency Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9637447/
https://www.ncbi.nlm.nih.gov/pubmed/36381800
http://dx.doi.org/10.7759/cureus.30012
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