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Wound Closure Technique Affects Postoperative Infection Rate

Percutaneous suturing results in fewer superficial wound infections than does intracutaneous suturing after open-heart surgery, according to results of a randomized study comparing the two techniques.

“Intracutaneous suture technique has been our standard method for closing sternal wounds in cardiac surgery, mainly for cosmetic reasons,” Dr. Ivar Risnes and fellow cardiac surgeons from Rikshospitalet in Oslo note in the November issue of the Annals of Thoracic Surgery.

“However, an increased rate of postoperative infections has been reported in cosmetic surgery with this method compared with the percutaneous or transcutaneous closure technique.”

When Dr. Risnes and colleagues randomized 150 cardiac surgery patients to intracutaneous suturing and 150 to percutaneous suturing, they found that the total infection rate was lower in percutaneous group compared with the intracutaneous group, 3% versus 8% (p = 0.007), respectively. The rate of superficial infections was also significantly lower in the percutaneous group than in the intracutaneous group, at 2.3% versus 6.7%. There were no between-group differences in the rate of deep infections.

There were also no between-group differences in the cosmetic result, leading Dr. Risnes’ group to recommend the percutaneous suture technique over the intracutaneous approach for wound closure after cardiac surgery.

Ann Thorac Surg 2001;72:1587-1591.

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