IJCRR - Vol 05 Issue 14, July, 2013
EVALUATION OF PORTAL SITE HEALING WITH CLOSURE AND WITHOUT CLOSURE AFTER ARTHROSCOPIC PROCEDURE- A RANDOMIZED PROSPECTIVE STUDY
Author: Kiran S Patil, Haridas M Somayaji, Santhosh S Nandi, Deepesh Daultani, Mallikarjun Ithli
Objective: To compare the two methods of management of the arthroscopic portal sites. Background: The methods of managing the Arthroscopy Portals are not standardized. The options are to close with the use of Non Absorbable Sutures or leave it open with sterile simple dressing. This study compares the two methods of management. Material and Methods: We present the outcome of 70 knee Arthroscopies carried out over a period of 24 months in Shri. B. M. Patil Medical College, Bijapur which were chosen alternatively into two groups one with simple sutures other with simple dressings. Outcome measures adopted were level of pain, redness, localised swelling, superficial infection, appearance of the wound after healing. Any observations were reported by an independent observer who was blinded with method of management. Results: No patient was lost during follow up. There was significant difference in the two groups with regards to the redness, swelling, severity of the pain and cosmesis.34% patients developed redness in suture group while only 5% patients developed redness in simple dressing group. 28% patients developed mild to moderate swelling in suture group while only 2% patient developed mild swelling in simple dressing group. 5% patients developed minimal superficial infection in suture group while no patients developed such complication in simple dressing group. Regarding the scar appearance 71% were happy in sutured group while 97% were happy in simple dressing group. Fifteen patients in suture group suffered mild to moderate pain while five patients suffered mild pain in simple dressing group. There was no long term complication in any patients. Conclusion: From our findings we suggest that it is preferable to leave arthroscopy portals open with simple dressing.
Keywords: Arthroscopy, portal sites, portal closure.
Kiran S Patil, Haridas M Somayaji, Santhosh S Nandi, Deepesh Daultani, Mallikarjun Ithli. EVALUATION OF PORTAL SITE HEALING WITH CLOSURE AND WITHOUT CLOSURE AFTER ARTHROSCOPIC PROCEDURE- A RANDOMIZED PROSPECTIVE STUDY International Journal of Current Research and Review. Vol 05 Issue 14, July, 36-43
1. Christos K. Yiannakopoulos, MD: Diagnosis and Treatment of Postarthroscopic Synovial Knee Fistulae: J Knee Surg. 2007; 20:34-38. 2. Michael J.strobel .Knee joint –general part. In:manual of arthroscopic surgery.1st edition. ISBN 978-81-8489-082-2.Springer;2009. p57. 3. Robert J Meislin, Jeffrey Halbrecht . Avoiding and managing complications associated with arthroscopic knee surgery.In:Complications in Knee and Shoulder Surgery . ISBN: 978-1-84882-202- 3 .Springer;2009 p171, 4. Warden V, Hurley AC, Volicer L. Development and psychometric evaluation of the pain assessment in advanced dementia (PAINAD) scale.Journal of the American Medical Directors Association 2003;4:9-15. 5. Hussein R, Southgate GW. Management of knee arthroscopy portals. Knee. 2001 Dec;8(4):329-31. 6. Michael J.strobel .Knee joint –general part. In:manual of arthroscopic surgery.1st edition. ISBN 978-81-8489-082-2. Springer;2009. p73. 7. Gristina AG, Price JL, Hobgood CD, Webb LX, Costerton JW. Bacterial colonization of percutaneous sutures. Surgery. 1985 Jul;98(1):12-19.
8. Bhattacharyya M, Bradley H. Intraoperative handling and wound healing of arthroscopic portal wounds: a clinical study comparing nylon suture with wound closure strips. J Perioper Pract. 2008 May;18(5):194-6, 198. 9. Barry B. Phillips . Arthroscopy of the Lower Extremity .In: Canale and Beaty: Campbell's Operative Orthopaedics, 11th ed. ISBN: 978- 0-8089-2361-9 MOSBY ELSEVIER 2008.p2812. 10. Zempsky WT, Zehrer CL, Lyle CT, Hedbloom EC. Economic comparison of methods of wound closure: wound closure strips vs. sutures and wound adhesives. Int Wound J. 2005 Sep;2(3):272-81. 11. Sumathi Muralidhar, Prashant Kumar Singh*, R.K. Jain, Meenakshi Malhotra and Manju Bala Needle stick injuries among health care workers in a tertiary care hospital of India Indian J Med Res 131, March 2010, pp 405- 410.
List of abbreviations
VAS- Visual Analog Score. mm- Millie Metre. p value- Probability value z value- Relative deviate value