This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Randomized clinical trial of skin closure by subcuticular suture or skin stapling after elective colorectal cancer surgery. BJS 2015; 102: 495-500.

Published: 26th February 2015

Authors: S. Kobayashi, M. Ito, S. Yamamoto, Y. Kinugasa, M. Kotake, Y. Saida et al.

Background

The best suture method to prevent incisional surgical‐site infection (SSI) after clean‐contaminated surgery has not been clarified.

Method

Patients undergoing elective colorectal cancer surgery at one of 16 centres were randomized to receive either subcuticular sutures or skin stapling for skin closure. The primary endpoint was the rate of incisional SSI. Secondary endpoints of interest included time required for wound closure, incidence of wound problems, postoperative length of stay, wound aesthetics and patient satisfaction.

Results

A total of 1264 patients were enrolled. The cumulative incidence of incisional SSI by day 30 after surgery was similar after subcuticular sutures and stapled closure (8·7 versus 9·8 per cent respectively; P = 0·576). Comparison of cumulative incidence curves revealed that SSI occurred later in the subcuticular suture group (P = 0·019) (hazard ratio 0·66, 95 per cent c.i. 0·45 to 0·97). Wound problems (P = 0·484), wound aesthetics (P = 0·182) and postoperative duration of hospital stay (P = 0·510) did not differ between the groups; subcuticular sutures took 5 min longer than staples (P < 0·001). Patients in the subcuticular suture group were significantly more satisfied with their wound (52·4 per cent versus 42·7 per cent in the staple group; P = 0·002).

Conclusion

Compared with skin stapling, subcuticular sutures did not reduce the risk of incisional SSI after colorectal surgery. Registration number: UMIN000004001 (http://www.umin.ac.jp/ctr).

Full text

You may also be interested in

Original article

Early MRI predictors of disease‐free survival in locally advanced rectal cancer from the GRECCAR 4 trial. BJS 2019; 106: 1530-1541.

Authors: S. Nougaret, F. Castan, H. Forges, H. A. Vargas, B. Gallix, S. Gourgou et al.

Original article

Secondary technical resectability of colorectal cancer liver metastases after chemotherapy with or without selective internal radiotherapy in the randomized SIRFLOX trial.

Authors: B. Garlipp, P. Gibbs, G. A. Van Hazel, R. Jeyarajah, R. C. G. Martin, C. J. Bruns et al.

Original article

Population‐based study of the impact of small bowel obstruction due to adhesions on short‐ and medium‐term mortality.

Authors: R. Behman, A. B. Nathens, B. Haas, N. Look Hong, P. Pechlivanoglou, P. Karanicolas et al.

Original article

Prospective cohort study of appendicectomy for treatment of therapy‐refractory ulcerative colitis.

Authors: M. E. Stellingwerf, S. Sahami, D. C. Winter, S. T. Martin, G. R. D'Haens, G. Cullen et al.

Original article

Long‐term follow‐up of the AVOD randomized trial of antibiotic avoidance in uncomplicated diverticulitis. BJS 2019; 106: 1542-1548.

Authors: D. Isacson, K. Smedh, M. Nikberg, A. Chabok

Original article

Pushing the boundaries of pelvic exenteration by maintaining survival at the cost of morbidity. BJS 2019; 106: 1393-1403.

Authors: R. L. Venchiarutti, M. J. Solomon, C. E. Koh, J. M. Young, D. Steffens

Systematic review

Meta‐analysis of the role of colonoscopy after an episode of left‐sided acute diverticulitis. BJS 2019; 106: 988-997.

Authors: S. J. Rottier, S. T. Dijk, A. A. W. Geloven, W. H. Schreurs, W. A. Draaisma, W. A. Enst et al.

Randomized clinical trial

Multicentre randomized clinical trial of colonic J pouch or straight stapled colorectal reconstruction after low anterior resection for rectal cancer.

Authors: S. Pucciarelli, P. Del Bianco, U. Pace, F. Bianco, A. Restivo, I. Maretto et al.

Review

Mechanisms of immunogenicity in colorectal cancer. BJS 2019; 106: 1283-1297.

Authors: T. O. Sillo, A. D. Beggs, D. G. Morton, G. Middleton

Systematic review

Meta‐analysis of the effect of extending the interval after long‐course chemoradiotherapy before surgery in locally advanced rectal cancer. BJS 2019; 106: 1298-1310.

Authors: É. J. Ryan, D. P. O'Sullivan, M. E. Kelly, A. Z. Syed, P. C. Neary, P. R. O'Connell et al.

Randomized clinical trial

Randomized clinical trial of accelerated enhanced recovery after minimally invasive colorectal cancer surgery (RecoverMI trial). BJS 2019; 106: 1311-1318.

Authors: B. K. Bednarski, T. P. Nickerson, Y. N. You, C. A. Messick, B. Speer, V. Gottumukkala et al.

Original article

Postoperative complications in relation to overall treatment time in patients with rectal cancer receiving neoadjuvant radiotherapy.

Authors: J. Erlandsson, D. Pettersson, B. Glimelius, T. Holm, A. Martling