Knee Replacement Surgery
Sutures Versus Staples in Total Knee Replacement Infection Rates
Maryville University
Author’s Note
In my experience as a nurse in both home health and rehab settings total knee replacement surgery is very common. During the post-op period of this surgery complication prevention is the number one nursing care goal for these patients. Complications of this surgery are usually related to infection and blood clots. Blood clots can be prevented with careful medication administration and other precautions, but infection can occur even when precautions are taken. Sutures and staples seem to be the most common wound closures for this surgery, “The most commonly used methods for skin closure after orthopedic surgery are metal …show more content…
A retrospective chart review study of primary joint reconstruction was done by Ronak, Patel, Cayo, Patel, Albarillo and Puri. This study examined hospital charts from 278 consecutive cases performed by a single surgeon. Clinic follow up notes were used as well. Postoperative complications were described as persistent drainage, antibiotic usage, revision surgery and clinic procedures. Comorbidities were accounted for each patient and not patients were excluded based on age or comorbidities. The study found that 7 complications occurred in 181 cases of staple wound closure (3.9%). The study found that 4 complications occurred in 51 cases with suture wound closure (7.8%). This study is very limited in that it is retrospective and charting may not be complete or completely representative of what happened with each case. This study’s groups are also very small. This study found that staples have a lower associated rate of infection but the reliability of these findings is not strong. This study also pointed out that staple wound closure offers the advantage of faster wound closure during surgery. This is beneficial due to the shorter amount of time the inside of the body is exposed to possible …show more content…
Surgeons are forced to choose a type of wound closure based on personal experience and judgment. As a result nurses are also forced to use personal experience and judgment about wound care and what precautions to take with each type of wound closure. My initial impression that everything in the healthcare world is based on research and constant reassessment was incorrect in this particular area. Further research in this area would be invaluable to patients and healthcare clinicians due to the high risk associated with infection for these patients. This knowledge also makes me curious about what other areas of healthcare are not based on evidence or research as well and what that indicates for my own practice as a nurse. As a final thought, should protocols be set in place in situations where research is not available? This might ensure continuity of care and some form of organization in situations where there is a lack in scientific
Maryville University
Author’s Note
In my experience as a nurse in both home health and rehab settings total knee replacement surgery is very common. During the post-op period of this surgery complication prevention is the number one nursing care goal for these patients. Complications of this surgery are usually related to infection and blood clots. Blood clots can be prevented with careful medication administration and other precautions, but infection can occur even when precautions are taken. Sutures and staples seem to be the most common wound closures for this surgery, “The most commonly used methods for skin closure after orthopedic surgery are metal …show more content…
A retrospective chart review study of primary joint reconstruction was done by Ronak, Patel, Cayo, Patel, Albarillo and Puri. This study examined hospital charts from 278 consecutive cases performed by a single surgeon. Clinic follow up notes were used as well. Postoperative complications were described as persistent drainage, antibiotic usage, revision surgery and clinic procedures. Comorbidities were accounted for each patient and not patients were excluded based on age or comorbidities. The study found that 7 complications occurred in 181 cases of staple wound closure (3.9%). The study found that 4 complications occurred in 51 cases with suture wound closure (7.8%). This study is very limited in that it is retrospective and charting may not be complete or completely representative of what happened with each case. This study’s groups are also very small. This study found that staples have a lower associated rate of infection but the reliability of these findings is not strong. This study also pointed out that staple wound closure offers the advantage of faster wound closure during surgery. This is beneficial due to the shorter amount of time the inside of the body is exposed to possible …show more content…
Surgeons are forced to choose a type of wound closure based on personal experience and judgment. As a result nurses are also forced to use personal experience and judgment about wound care and what precautions to take with each type of wound closure. My initial impression that everything in the healthcare world is based on research and constant reassessment was incorrect in this particular area. Further research in this area would be invaluable to patients and healthcare clinicians due to the high risk associated with infection for these patients. This knowledge also makes me curious about what other areas of healthcare are not based on evidence or research as well and what that indicates for my own practice as a nurse. As a final thought, should protocols be set in place in situations where research is not available? This might ensure continuity of care and some form of organization in situations where there is a lack in scientific