Journal of Long-Term Effects of Medical Implants

ISSN for PRINT: 1050-6934

For Online Access

Best Paper Award Selection - Editorial Board Site

2006, Volume16

Issue 1

120 pages

Issue price - $189.00

Angela Pineros-Fernandez, MD
Research Assistant in Plastic Surgery, University of Virginia Health System, Charlottesville, Virginia, USA

Lisa S. Salopek, LVT, RLAT
Registered Laboratory Animal Technician, University of Virginia Health System, Charlottesville, Virginia, USA

Pamela F. Rodeheaver, BA
Research Assistant in Plastic Surgery, University of Virginia Health System, Charlottesville, Virginia, USA

David B. Drake, MD
Associate Professor of Plastic Surgery & Orthopedic Surgery. University of Virginia Health System PO Box 800376 Charlottesville VA 22908-0376, USA

Richard F. Edlich
Distinguished Professor of Plastic Surgery, Director of Trauma Prevention, Education, and Research, Trauma Specialists, LLP, Legacy Emanuel Hospital; 22500 NE 128th Circle, Brush Prairie WA 98606, USA; Phone: 360-944-7641, Fax: 360-944-7612

George T. Rodeheaver, PhD
Distinguished Research Professor of Plastic Surgery. Plastic Surgery Research Program, University of Virginia Health System, P.O. Box 801351 Charlottesville, VA 22908-1351, USA

Six pigs were used to evaluate the influence of three separate modalities on contaminated wounds. Full-thickness skin wounds on the abdomen were contaminated with 10⁴ or 10⁵ Staphylococcus aureus and then closed with one of three methods. The three closure modalities included (1) a new absorbable staple (Insorb™) placed in the subcuticular tissue, (2) a braided Vicryl™ suture, and (3) percutaneous metal staples. Any foreign body material implanted in tissue increases the risk of infection at that site. Wound closure always involves the use of a foreign body. Historically, sutures have been the primary material used to close tissue. The newer synthetic sutures are significangly more biodegradable and cause less infection than sutures composed of protein, such as silk and catgut. Metal staples are also associated with a low risk of infection. Recently, Incisive Surgical, Inc. (Plymouth, Minnesota) has developed an absorbable polymer staple specifically for subcuticular skin closure. The purpose of this study was to compare the new Insorb™ staple to both an absorbable polymer suture and a metal staple. Wound infection was assessed 7 days after closure by clinical signs and quantitative bacterial swabs. The results demonstrated that wounds closed with Insorb™ staples had the lowest incidence (33%) of infection, followed by percutaneous metal staples (44%). All wounds (100%) closed with Vicryl™ suture became infected. The incidence of wound infection directly correlated with the level of quantitative bacterial count at analysis. The Insorb™ staple was associated with significantly reduced closure time, less inflammation and infection, and better aesthetic result compared to Vicryl™. Compared to metal staples, the Insorb™ subcuticular staplers demonstrated comparable closure time without the need for later staple removal. In conclusion, the closure of contaminated wounds with the Insorb™ staples is a superior choice to Vicryl™ suture because they have a significantly (p = 0.009) lower incidence of infection. The Insorb™ staple is a revolutionary advance in subcuticular skin stapling.

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