Suture-Tool: A Mechanical Needle Driver for Standardized Wound Closure

Research output: Contribution to journalArticle

Abstract

Introduction: A laparotomy is commonly required to gain abdominal access. A safe standardized access and closure technique is warranted to minimize abdominal wall complications like wound infections, burst abdomen and incisional hernias. Stitches are recommended to be small and placed tightly, obtaining a suture length-to-incision length (SL/WL) ratio of ≥ 4:1. This can be time-consuming and difficult to achieve especially following long trying surgical procedures. The aim was to develop and evaluate a new mechanical suture device for standardized wound closure. Methods: A mechanical suture device (Suture-tool) was developed in collaboration between a medical technology engineer team with the aim to achieve a standardized suture line of high quality that could be performed speedy and safe. Ten surgeons closed an incision in an animal tissue model after a standardized introduction of the instrument comparing the device to conventional needle driver suturing (NDS) using the 4:1 technique. Outcome measures were SL/WL ratio, number of stitches and suture time. Results: In total, 80 suture lines were evaluated. SL/WL ratio of ≥ 4 was achieved in 95% using the Suture-tool and 30% using NDS (p < 0,001). Number of stitches was similar. Suture time was 30% shorter using the Suture-tool compared to NDS (2 min 54 s vs. 4 min 5 s; p < 0.001). Conclusions: The mechanical needle driver seems to be a promising device to perform a speedy standardized high-quality suture line for fascial closure.

Details

Authors
Organisations
External organisations
  • Helsingborg Hospital
  • Skåne University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Surgery
Original languageEnglish
Pages (from-to)95-99
Number of pages5
JournalWorld Journal of Surgery
Volume44
Issue number1
Early online date2019 Sep 23
Publication statusPublished - 2020 Jan
Publication categoryResearch
Peer-reviewedYes