Staple Versus Suture Closure for Foot and Ankle Surgery
Incision, Foot Ankle Injuries
About this trial
This is an interventional other trial for Incision
Eligibility Criteria
Inclusion Criteria:
- Over 18 years of age
- Scheduled to undergo any elective foot or ankle procedures with one of our included surgeons investigators during the approved protocol period.
- Patients with comorbidities such as rheumatoid arthritis, diabetes, and other systemic diseases will still be included so long as they are not considered uncontrolled or immunocompromised.
- In patients with rheumatoid arthritis, the usual protocol for discontinuing disease-modifying antirheumatic drugs (DMARDs) prior to surgery will be continued as done per each surgeon's protocol.
- Patients undergoing urgent surgery (e.g. within a few days of the inciting event, such as a traumatic fracture) will be considered for the study.
Exclusion Criteria:
- Patients under 18 years old
- Patients who are not competent to give consent for themselves, or to read and answer questions about their scar formation (proxies will not be allowed);
- Any surgery that requires a non-linear surgical incision;
- Previous surgery(ies) on the same area;
- Known history of keloid/abnormal scar formation;
- Patients with uncontrolled diabetes (as documented by ICD-9 codes 250.x2 or 250.x3);
- Patients who are immunocompromised (i.e. HIV/AIDS+ patients, patients who have had a previous organ transplantation, patients who have been diagnosed with an immunodeficiency syndrome- congenital or acquired, as a result of immunomodulatory medication secondary to autoimmune disease, or undergoing current chemotherapy for cancer).
- Patients undergoing emergent surgery will not be considered for the study.
- Patients who have had a previous allergic or adverse reaction to any of the suture/staple materials we plan to use will not be included.
- If the closure requires multiple layers of sutures (i.e. subcutaneous layers, deep dermal layers) in addition to the usual closing staples/sutures which are through the skin, the patient will be excluded from the study
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Active Comparator
Other
Staples
Suture
Half Staple Half Suture
For short single incisions, these patients will receive superficial closure using only metal skin staples. Closure will be performed by resident or fellow involved in the case.
For short single incisions, these patients will receive superficial closure using only nylon sutures. No metal skin staples will be used. Closure will be performed by resident or fellow involved in the case.
Some patients will receive both nylon sutures and metal skin staples for superficial closure. If multiple incisions are involved, each incision will count as 1 in the alternation method (i.e. toe 1 will be all sutures, then toe 2 will be all staples). For long incisions, closure will alternate between nylon sutures and metal skin staples on the part of the incision which is closer (more proximal) or farther away (more distal) from the rest of the body.