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Suture-TOOL : A suturing device for swift and standardized abdominal aponeurosis closure

Börner, Gabriel ; Edelhamre, Marcus LU ; Rogmark, Peder LU orcid and Montgomery, Agneta LU (2022) In Surgery in Practice and Science 11.
Abstract

Introduction: Surgeons can reduce incisional hernia formation by adhering to standardized techniques for incisional wound closure. This is often neglected by the time a long operation is to be ended and can lead to the risk of developing an incisional hernia or a wound rupture. To address this issue, a suturing machine (Suture-TOOL) was developed for swift and standardized abdominal closure. The aim was to compare the user safety, speed, and suturing quality between Suture-TOOL and manual Needle-Driver suturing. Method: Fifteen surgeons who were specialists in surgery, urology, and gynaecology as well as surgical trainees were invited. The Suture-TOOL was presented to the surgeons who read the instructions for use before starting the... (More)

Introduction: Surgeons can reduce incisional hernia formation by adhering to standardized techniques for incisional wound closure. This is often neglected by the time a long operation is to be ended and can lead to the risk of developing an incisional hernia or a wound rupture. To address this issue, a suturing machine (Suture-TOOL) was developed for swift and standardized abdominal closure. The aim was to compare the user safety, speed, and suturing quality between Suture-TOOL and manual Needle-Driver suturing. Method: Fifteen surgeons who were specialists in surgery, urology, and gynaecology as well as surgical trainees were invited. The Suture-TOOL was presented to the surgeons who read the instructions for use before starting the test. Each surgeon closed nine 15 cm-long incisions in a human body model; six with Suture-TOOL and three with the Needle-Driver technique. Gloves were examined for puncture damage. Endpoints were suture-length/wound-length (SL/WL)-ratio, closure time, number of stitches, learning curve, and glove puncture rate. A VAS-evaluation concerning different Suture-Tool user impressions was completed. Results: A SL/WL-ratio ≥4 was 98% for Suture-TOOL versus 69% for Needle-Driver (p < 0.001). Suture time was shorter for Suture-TOOL (p < 0.001). Wound stitch count was higher for Needle-Driver (p = 0.013). The median SL/WL-ratio was similar between groups. The learning curve plateaued after three closures using Suture-TOOL. Two glove punctures were detected—all in the Needle-Driver group. Suture-TOOL received high VAS scores for all measured functionalities. Conclusion: Suture-TOOL is a promising device for clinical use. It is safe, easy, and fast resulting in a high-quality suture lines with a short learning curve and a high functionality ranking.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Abdominal wall closure, Mechanical device, Standardization, Suture device, Suture technique, Wound closure technique
in
Surgery in Practice and Science
volume
11
article number
100137
publisher
Elsevier
external identifiers
  • scopus:85164098290
ISSN
2666-2620
DOI
10.1016/j.sipas.2022.100137
language
English
LU publication?
yes
id
89e9c554-5e0a-45a4-9fec-7da31c65aae4
date added to LUP
2023-10-23 13:06:36
date last changed
2023-10-24 11:58:43
@article{89e9c554-5e0a-45a4-9fec-7da31c65aae4,
  abstract     = {{<p>Introduction: Surgeons can reduce incisional hernia formation by adhering to standardized techniques for incisional wound closure. This is often neglected by the time a long operation is to be ended and can lead to the risk of developing an incisional hernia or a wound rupture. To address this issue, a suturing machine (Suture-TOOL) was developed for swift and standardized abdominal closure. The aim was to compare the user safety, speed, and suturing quality between Suture-TOOL and manual Needle-Driver suturing. Method: Fifteen surgeons who were specialists in surgery, urology, and gynaecology as well as surgical trainees were invited. The Suture-TOOL was presented to the surgeons who read the instructions for use before starting the test. Each surgeon closed nine 15 cm-long incisions in a human body model; six with Suture-TOOL and three with the Needle-Driver technique. Gloves were examined for puncture damage. Endpoints were suture-length/wound-length (SL/WL)-ratio, closure time, number of stitches, learning curve, and glove puncture rate. A VAS-evaluation concerning different Suture-Tool user impressions was completed. Results: A SL/WL-ratio ≥4 was 98% for Suture-TOOL versus 69% for Needle-Driver (p &lt; 0.001). Suture time was shorter for Suture-TOOL (p &lt; 0.001). Wound stitch count was higher for Needle-Driver (p = 0.013). The median SL/WL-ratio was similar between groups. The learning curve plateaued after three closures using Suture-TOOL. Two glove punctures were detected—all in the Needle-Driver group. Suture-TOOL received high VAS scores for all measured functionalities. Conclusion: Suture-TOOL is a promising device for clinical use. It is safe, easy, and fast resulting in a high-quality suture lines with a short learning curve and a high functionality ranking.</p>}},
  author       = {{Börner, Gabriel and Edelhamre, Marcus and Rogmark, Peder and Montgomery, Agneta}},
  issn         = {{2666-2620}},
  keywords     = {{Abdominal wall closure; Mechanical device; Standardization; Suture device; Suture technique; Wound closure technique}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Surgery in Practice and Science}},
  title        = {{Suture-TOOL : A suturing device for swift and standardized abdominal aponeurosis closure}},
  url          = {{http://dx.doi.org/10.1016/j.sipas.2022.100137}},
  doi          = {{10.1016/j.sipas.2022.100137}},
  volume       = {{11}},
  year         = {{2022}},
}