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Archive August 2020 XXI, No. 8

Winning Wound-Closure Solutions

Innovative devices save time, minimize scarring and satisfy patients.

Jared Bilski


INDELIBLE MARK Patients care a great deal about scarring and appreciate any steps taken to improve post-op cosmesis.

Most surgeons seal up incisions with sutures or staples out of repetition and routine. Cosmesis is an afterthought as their focus begins to shift to the next case. But should it be? "The scar is often the only thing patients remember about their surgeries," says Jeffrey S. Freed, MD, MPH, FACS, a clinical professor in the department of surgery at the Icahn School of Medicine at Mount Sinai in New York City. "I tell all my third-year medical students the same thing — don't overlook the scar."

The next time a surgeon tells you there's no reason to stop using tried-and-true wound closure methods, let them know new alternatives provide plenty of benefits, including sending their patients home with a constant visual reminder of the cutting-edge care they received.

1. Cost savings

Many of the wound closure products on the market are non-invasive devices such as adhesives and adhesive and tension-distributing combos or more-involved external tissue expanders. If you're like most surgical facility leaders, you want to know if adding one of these new products will save your facility money. They can — as long as you properly assess the true cost of wound closure. Factor into your decision-making the time savings that can neutralize the difference in upfront costs between most wound closure options and traditional sutures or staples. Mere minutes can determine whether a procedure is profitable for your facility.

"You can save around three or four minutes in closure time alone at the end of a case," says Sherwin S.W. Ho, MD, a professor of orthopaedic surgery and rehabilitation medicine and the director of the sports medicine fellowship program at University of Chicago (Ill.) Medicine. "That time really does add up."

When it comes to evaluating emerging wound-care devices, weigh your options the same way you would with new drugs — by analyzing randomized, controllable studies on the efficacy of the product as well as whether it's able to save your facility money. Dr. Freed points out the healthcare industry spends hundreds of millions of dollars on wound care each year, and there's a lot of incentive for companies to create the ideal product. That means you should keep a close eye on what's in the pipeline and identify products that show promise.

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