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Kiaii, Bob; Johnston, Stephen S.; Jang, Se Ryeong; Elangovanraaj, Nivesh; Tewari, Pranjal; Chen, Brian Po-Han

Clinical and economic outcomes after sternotomy for cardiac surgery with skin closure through 2-octyl cyanoacrylate plus polymer mesh tape versus absorbable sutures plus waterproof wound dressings: a retrospective cohort study

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  • Medientyp: E-Artikel
  • Titel: Clinical and economic outcomes after sternotomy for cardiac surgery with skin closure through 2-octyl cyanoacrylate plus polymer mesh tape versus absorbable sutures plus waterproof wound dressings: a retrospective cohort study
  • Beteiligte: Kiaii, Bob; Johnston, Stephen S.; Jang, Se Ryeong; Elangovanraaj, Nivesh; Tewari, Pranjal; Chen, Brian Po-Han
  • Erschienen: Springer Science and Business Media LLC, 2022
  • Erschienen in: Journal of Cardiothoracic Surgery
  • Sprache: Englisch
  • DOI: 10.1186/s13019-022-01956-x
  • ISSN: 1749-8090
  • Schlagwörter: Cardiology and Cardiovascular Medicine ; General Medicine ; Surgery ; Pulmonary and Respiratory Medicine
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  • Beschreibung: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>To compare clinical and economic outcomes after sternotomy for cardiac surgery with skin closure through 2-octyl cyanoacrylate plus polymer mesh tape (2OPMT) versus conventional absorbable sutures plus waterproof wound dressings (CSWWD).</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Retrospective study using the Premier Healthcare Database. Patients undergoing a cardiac surgery requiring sternotomy with 2OPMT or CSWWD were included. Primary outcome was 60-day cumulative incidence of diagnosis for wound complications (infection, dehiscence). Secondary outcomes were index admission hospital length of stay (LOS), total hospital-borne costs, discharge status, and 60-day cumulative incidences of inpatient readmission and reoperation. After propensity score matching, outcomes were compared between the 2OPMT and CSWWD groups using bivariate multilevel mixed-effects generalized linear models.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Overall, 7,901 2OPMT patients and 10,775 CSWWD patients were eligible for study. After propensity score matching on 68 variables, each group comprised 5,338 patients (total study N = 10,676). The 2OPMT and CSWWD groups did not differ significantly in terms of the 60-day cumulative incidences of wound complication (3.47% vs 3.47%, p = 0.996), inpatient readmission (12.6% vs. 13.6%, p = 0.354), and reoperation (10.3% vs 10.1%, p = 0.808), as well as discharge to home versus non-home setting (77.2% vs. 75.1%), p = 0.254. However, the 2OPMT group had significantly lower LOS (9.2 days vs 10.6 days, p &lt; 0.001) and total hospital-borne costs ($50,174 vs $60,526, p &lt; 0.001).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>This large observational study provides evidence that sternotomy skin closure with 2OPMT is associated with nearly identical 60-day cumulative incidence of wound complication as compared with CSWWD, while exhibiting a significant association with lower LOS and total hospital-borne costs.</jats:p> <jats:p><jats:italic>Trial registration</jats:italic> Not applicable.</jats:p> </jats:sec>
  • Zugangsstatus: Freier Zugang