Objective: Evaluate secondary closure of superficial wound dehiscence with suture versus tape.
Methods: Postoperative obstetrics and gynecologic patients with superficial wound dehiscence were eligible. Wounds were opened for their entire length, debrided, and irrigated. They were packed with moistened gauze until the granulation tissue covered the wound. Randomization occurred when the patient selected a sealed envelope containing a closure technique. Demographic data and wound characteristics were recorded. Pain was determined by using a 100-mm visual analogue scale, which the patient marked immediately after the procedure. Wound closure was measured in minutes. Healing time was measured in days from wound closure to complete wound epithelialization and no need for further wound care. Reopening a closed wound defined treatment failure. Time for complete healing was the primary outcome.
Results: Fifteen patients were randomized to each arm over a 20-month period. Demographics and wound characteristics were similar between groups. Pain scores were significantly less in the tape group (21.4 ± 17.0 vs 60.7 ± 23.0 mm, P < 0.001) as was time for closure (12.3 ± 3.6 vs 31.0 ± 6.8 minutes, P < 0.001). Time for complete healing was significantly less in the suture group (23.0 ± 7.9 vs 16.1 ± 3.36 days, P < 0.001). One wound (7%) in each group was reopened.
Conclusions: Suture closure seems to be the superior technique for secondary closure of wound dehiscence based on the primary outcome of time to complete healing for this study. Therefore, suture closure seems to be the best option for secondary closure of superficial wound dehiscence.
However, both suture and surgical tape are effective treatments when historically compared with second intention.
From the Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS.
Reprints: G. Rodney Meeks, MD, Department of Obstetrics and Gynecology, University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216-4500. E-mail: firstname.lastname@example.org.
This article has been presented orally at the Society of Gynecologic Surgeons 35th scientific meeting, New Orleans, Louisiana, March 30, 2009.