A randomized, controlled study comparing two standardized closure methods of laparoscopic port sites

Kai Chen, Allan S. Klapper, Hayley Voige, Giuseppe del Priore

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objectives: To compare octyl-cyanoacrylate tissue adhesive (OCT) with the standard suture technique for the closure of laparoscopic port sites. Methods: This was a randomized clinical trial of 40 patients. All participants had 2 lower abdominal ports, with one port closed using OCT while the opposite port was closed with 4-0 monocryl suture. An evaluation of the wound was performed 2 weeks to 4 weeks after surgery. The Hollander Wound Evaluation Scale (HWES, including stepoff of borders, contour irregularities, margin separation, edge inversion, excessive distortion, and overall appearance) was used for cosmetic evaluation. Complications, such as erythema, warmth, tenderness, drainage, and wound infection, were evaluated. Analysis of complications was performed using the chi-square test, and cosmetic evaluation including individual components of the HWES was compared with the t test, P<0.05 considered significant. Results: Eighty wounds were evaluated in 40 patients. The number of patients with complications including erythema (1/40 vs. 16/40), tenderness (1/40 vs. 19/40), and drainage (1/40 vs. 9/40) was lower with OCT than with sutures, respectively (all P<0.001). The ports closed with OCT had higher overall HWES, ie, better cosmetic score (5.92±0.05 vs 5.50±0.13) and lower margin separation (1/40 vs. 10/40) but had higher contour irregularity (6/40 vs. 1/40) (all P<0.05). However, skin contour irregularity was significantly better when OCT was applied using fine tissue forceps (P=0.002). Conclusion: Laparoscopic ports closed with OCT had fewer early complications, such as wound erythema, tenderness, and drainage. Ports closed with OCT had a better cosmetic appearance.

Original languageEnglish (US)
Pages (from-to)391-394
Number of pages4
JournalJournal of the Society of Laparoendoscopic Surgeons
Volume14
Issue number3
DOIs
StatePublished - Jul 1 2010

Fingerprint

Tissue Adhesives
Cyanoacrylates
Cosmetics
Suture Techniques
Wounds and Injuries
Wound Infection
Chi-Square Distribution
Erythema
Sutures
Drainage
Randomized Controlled Trials
glycolide E-caprolactone copolymer

Keywords

  • Closure methods
  • Laparoscopic port
  • Octylcyanoacrylate tissue adhesive
  • Suture

ASJC Scopus subject areas

  • Surgery

Cite this

A randomized, controlled study comparing two standardized closure methods of laparoscopic port sites. / Chen, Kai; Klapper, Allan S.; Voige, Hayley; del Priore, Giuseppe.

In: Journal of the Society of Laparoendoscopic Surgeons, Vol. 14, No. 3, 01.07.2010, p. 391-394.

Research output: Contribution to journalArticle

Chen, Kai ; Klapper, Allan S. ; Voige, Hayley ; del Priore, Giuseppe. / A randomized, controlled study comparing two standardized closure methods of laparoscopic port sites. In: Journal of the Society of Laparoendoscopic Surgeons. 2010 ; Vol. 14, No. 3. pp. 391-394.
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abstract = "Objectives: To compare octyl-cyanoacrylate tissue adhesive (OCT) with the standard suture technique for the closure of laparoscopic port sites. Methods: This was a randomized clinical trial of 40 patients. All participants had 2 lower abdominal ports, with one port closed using OCT while the opposite port was closed with 4-0 monocryl suture. An evaluation of the wound was performed 2 weeks to 4 weeks after surgery. The Hollander Wound Evaluation Scale (HWES, including stepoff of borders, contour irregularities, margin separation, edge inversion, excessive distortion, and overall appearance) was used for cosmetic evaluation. Complications, such as erythema, warmth, tenderness, drainage, and wound infection, were evaluated. Analysis of complications was performed using the chi-square test, and cosmetic evaluation including individual components of the HWES was compared with the t test, P<0.05 considered significant. Results: Eighty wounds were evaluated in 40 patients. The number of patients with complications including erythema (1/40 vs. 16/40), tenderness (1/40 vs. 19/40), and drainage (1/40 vs. 9/40) was lower with OCT than with sutures, respectively (all P<0.001). The ports closed with OCT had higher overall HWES, ie, better cosmetic score (5.92±0.05 vs 5.50±0.13) and lower margin separation (1/40 vs. 10/40) but had higher contour irregularity (6/40 vs. 1/40) (all P<0.05). However, skin contour irregularity was significantly better when OCT was applied using fine tissue forceps (P=0.002). Conclusion: Laparoscopic ports closed with OCT had fewer early complications, such as wound erythema, tenderness, and drainage. Ports closed with OCT had a better cosmetic appearance.",
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