Journal Title: پائیز 89
Article title: Is Subcutaneous Suture Really Necessary?

Article PDF File:
Page From: 58 To: 64      
Article abstract:
Introduction & Objective: It is often advised to have repair of subcutaneous soft tissue using absorbable suture at the end of surgery before skin closure. We decided to compare the complication of subcutaneous suturing with those without subcutaneous suturing in the clean orthopedic wounds. Materials & Methods: We conducted a single blind randomized clinical trial on all admitted orthopedic patients who were candidate for primary wound clousure, during 1382-88 in Sina hospital. After categorizing patients based on upper/lower limb and fascia repair, the patients were divided into two groups with or without subcutaneous repair, by using computerized random numbers chart. The patients were assessed for probable complications (wound dehiscence, infection, fluid collection, inflammation and skin necrosis) for 3 months postoperatively. Exclusion criteria were; the patients who need any kind of skin or muscle flaps, those who needed subcutaneous drainage, those who need secondary repair and those with loss to follow up. Results: After applying exclusion criteria, 14953 patients (1662 female, 13291 male, mean age 40.6±4.9 years) were enrolled into our study. Of these, 4153 were allocated to upper limb and the others to lower limb group. These groups were further divided based on fascia and subcutaneous repair. Totally, 6120(41% of patients) had subcutaneous repair. The observed complications were more in patients without subcutaneous suture in comparison to those having with subcutaneous suture. Other parameters (upper or lower extremity and fascia repair) were not statistically significant regarding wound inflammation, infection, fluid collection, necrosis and dehiscence. Conclusions: It seems that omitting subcutaneous soft tissue repair will not lead to major complications in several cases of orthopedic surgery. It shortens the time of surgery and it may also reduce the costs, because of avoiding the use of suture materials.
Article KeyWords:
Suture, Subcutaneous, Complications
Article Authors:

	دکتر بابک سیاوشی	First Author	Siavashi@Tums.ac.ir
	دکتر احسان پندار	Other Author
	دکتر محمد رضا گلبخش	Other Author
	دکتر میر مصطفی سادات	Other Author
	دکتر محمد جواد زهتاب	Other Author
	دکتر داریوش گوران سوادکوهی	Other Author