Sutures versus Sterile Strips for Closure of Ankle Arthroscopy Portals: Prospective Crossover Trial

Abstract

Background: Either a nylon single suture or adhesive tape in the form of Steri strip are commonly used for the closure of portals in ankle arthroscopy. The purpose of this study was to compare the two methods with regards to their safety, complications and cosmetic result. Methods: This was a prospective cross over study of 100 patients who underwent ankle arthroscopy. Materials used for wound closure were either a 3–0 nylon suture or a single Steri strip. Portals were reviewed according to a validated wound scoring system. Parameters such as the age and gender of the patients, the duration of tourniquet use and the use of an intraarticular corticosteroid injection at wound closure were also studied. Results: Ninety-five patients were included in the statistical analysis. No technique was found to be superior in terms of the wound description (p = 0.164), infection grade (p = 0.232), infection treatment (p = 0.557) and the cosmetic appearance (p = 0.371). Seventy-two percent of patients had a good to excellent cosmetic result. There were two cases of infection requiring administration of antibiotics, one from each method of closure. Of the independent parameters, the use of cortisone was related to a lower infection treatment score (p = 0.013). Patients with signs of infection had a shorter total tourniquet time compared to the patients with no infection (p = 0.002). Conclusion: The use of either a single suture or Steri strip in the closure of ankle arthoscopy portals has equivalent results. Both methods were safe with equivalent cosmesis and low infection rates.

Level of Evidence: II; Prospective Comparative Study

Keywords

Arthroscopy Suture Closure Wound Portal Infection

Get full access to this article

View all access options for this article.

References

1. Abdel-Salam

Eyres

: Effects of tourniquet during total knee arthroplasty. A prospective randomised study. J Bone Joint Surg Br. 77:250, 1995.

2. Bellamy

Campbell

Robinson

: Intraarticular corticosteroid for treatment of osteoarthritis of the knee. Cochrane Database Syst Rev. 19:CD005328, 2006.

3. Bunker

: Problems with the use of Op-Site sutureless skin closures in orthopaedic procedures. Ann R Coll Surg Engl 65:260, 1983.

4. Conolly

Hunt

Zederfeldt

: Clinical comparison of surgical wounds closed by suture and adhesive tapes. Am J Surg 117:318, 1969. https://dx-doi-org.web.bisu.edu.cn/10.1016/0002-9610(69)90364-X.

5. Fairclough

Moran

: The use of sterile adhesive tape in the closure of arthroscopic puncture wounds: a comparison with a single layer nylon closure. Ann R Coll Surg Engl 69:140, 1987.

6. Ferkel

Small

Gittins

: Complications in foot and ankle arthroscopy. Clin Orthop Relat Res 391:89, 2001. https://dx-doi-org.web.bisu.edu.cn/10.1097/00003086-200110000-00010.

7. Gillman

Penn

Bronks

: Influence of cortisone on connective tissue; epithelial relations in wound healing, hair regeneration and the pathogenesis of experimental skin cancers. Nature 176:932, 1955. https://dx-doi-org.web.bisu.edu.cn/10.1038/176932a0.

8. Hollander

Singer

Valentine

: Wound registry: development and validation. Ann Emerg Med 25:675, 1995. https://dx-doi-org.web.bisu.edu.cn/10.1016/S0196-0644(95)70183-4.

9. Hussein

Southgate

: Management of knee arthroscopy portals. Knee 8:329, 2001. https://dx-doi-org.web.bisu.edu.cn/10.1016/S0968-0160(01)00096-5.

10.

10. Katz

Desciak

Maloney

: The optimal application of surgical adhesive tape strips. Dermatol Surg 25:686, 1999. https://dx-doi-org.web.bisu.edu.cn/10.1046/j.1524-4725.1999.99084.x.

11.

11. Kolt

: Use of adhesive surgical tape with the absorbable continuous subcuticular suture. ANZ J Surg 73:626, 2003. https://dx-doi-org.web.bisu.edu.cn/10.1046/j.1445-2197.2003.02696.x.

12.

12. Maffulli

Pintore

Petricciuolo

: Arthroscopy wounds: to suture or not to suture. Acta Orthop Belg 57:154, 1991.

13.

13. Ordman

Gillman

: Studies in the healing of cutaneous wounds. 3. A critical comparison in the pig of the healing of surgical incisions closed with sutures or adhesive tape based on tensile strength and clinical and histological criteria. Arch Surg 93:911, 1966. https://dx-doi-org.web.bisu.edu.cn/10.1001/archsurg.1966.01330060055003.

14.

14. Papavasiliou

Isaac

Marimuthu

: Infection in knee replacements after previous injection of intra-articular steroid. J Bone Joint Surg Br 88:321, 2006. https://dx-doi-org.web.bisu.edu.cn/10.1302/0301-620X.88B3.17136.

15.

15. Sherman

Fox

Snyder

: Arthroscopy–no-problem surgery. An analysis of complications in two thousand six hundred and forty cases. J Bone Joint Surg Am 68:256, 1986.

16.

16. Sikand

Murtaza

Desai

: Healing of arthroscopic portals: a randomised trial comparing three methods of portal closure. Acta Orthop Belg 72:583, 2006.

17.

17. Tritle

Haller

Gray

: Aesthetic comparison of wound closure techniques in a porcine model. Laryngoscope 111:1949, 2001. https://dx-doi-org.web.bisu.edu.cn/10.1097/00005537-200111000-00014.

18.

18. Williamson

Copeland

: Suturing arthroscopy wounds: brief report. J Bone Joint Surg Br 70:146, 1988.

19.

19. Zempsky

Zehrer

Lyle

: Economic comparison of methods of wound closure: wound closure strips vs. sutures and wound adhesives. Int Wound J 2:272, 2005. https://dx-doi-org.web.bisu.edu.cn/10.1111/j.1742-4801.2005.00130.x.