Spring 2013
Volume 1/Number 1
An Incisive Surgical Publication
Dear Clinician,
Welcome to the inaugural issue of CLOSING
COMMENTS, a periodic clinical newsletter from
Incisive Surgical, the developer of the revolutionary
INSORB® Absorbable Skin Stapler. The goal of the
newsletter is to present valuable information to
leading edge clinicians regarding the latest findings
involving skin closure modalities.
We encourage you to review the content of CLOSING
COMMENTS, and forward any comments or insights
you would like to share. Good health to all!
Incisive Surgical
We are extremely pleased to announce the sale
of our one millionth INSORB® Absorbable
Skin Stapler – approaching 30,000,000 INSORB
Staples – on February 19, 2013. This is a
significant milestone for our company and a
testament to the profound benefits of our
revolutionary surgical modality for patients,
clinicians and providers.
New Peer Review Study
The Influence of Absorbable Subcuticular Staples, Continuous Subcuticular Absorbable Suture, and
Percutaneous Metal Skin Staples on Infection in Contaminated Wounds
A Pineros-Fernandez, LS Salopek, PR Rodeheaver, GT Rodeheaver,
Journal of the Long-Term Effects of Medical Implants, University of Virginia Health Systems, December 2012
Methods:
Full-thickness skin wounds on the abdomen of six pigs were contaminated with S. aureus and closed with one of four
devices: INSORB Absorbable Staples, percutaneous metal staples, VICRYLTM Suture and MONOCRYLTM Suture.
Wound infection was assessed 7 days after closure by clinical signs and quantitative bacterial swabs.
Conclusion:
“Following closure with subcuticular staples, the wounds demonstrated less infection, less inflammation, and
acceptable cosmesis compared to subcuticular suture closure. …percutaneous staples cause peri-wound injury and
inflammation, can be uncomfortable, and require removal that can be painful. These results suggest that
subcuticular absorbable staples may be a superior alternative for the closure of skin incisions.”
At analysis on Day 7, wounds closed with
INSORB Staples demonstrated continued edge
eversion, minimal inflammation, and uniform
incision line healing.
At analysis on Day 7, all wounds closed
with VICRYL (V) or MONOCRYL (M)
sutures contained purulent exudate.
At analysis on Day 7, wounds closed with metal
staples exhibited classic railroad tracks before
and after staple removal, from the compression
and inflammation at the points of skin puncture.
If you want the most recent issue of CLOSING COMMENTS delivered straight to your inbox, view previous issues,
or make a comment, please go to www.insorb.com/closing_comments
Peer Review Study Finds Decreased Pain Results
in Lower Costs & ‘Happier’ Patients
Skin Closure With Subcuticular Absorbable Staples After Cesarean Section Is Associated With
Decreased Analgesic Use
J Nitsche, T Howell, Archives of Gynecology & Obstetrics, The MAYO Clinic and District One Hospital, October 2011
Methods:
Retrospective cohort study of 95 cesarean patients closed with metal skin staples and 89 patients closed with
INSORB absorbable staples. Patients in the cohort groups were all treated by the same physician in the same setting
and analgesic use conformed to the institution’s post operative analgesic protocol, according to which patients
received intravenous ketorolac, oral ibuprofen, and oral hydrocodone/acetaminophen. Demographic data and inhospital post-operative analgesic use were compared between the groups.
Key Findings:
“Our results suggest that the use of subcuticular absorbable staples for skin closure at the time of cesarean section
may lead to less in-hospital analgesic use, and positively impact a patient’s post-operative course.…the decreased
use of [average of 83 mg less IV administered Toradol] associated with absorbable staples would result in a cost
savings of approximately $200 per patient even after considering the higher cost of the absorbable stapler.”
INSORB Absorbable
Subcuticular Staples
Percutaneous Metal
Skin Staples
At Surgery
(midline incision)
INSORB Absorbable
Subcuticular Staples
Percutaneous Metal
Skin Staples
At 1 Week
(midline incision)
A study recently published in the Journal of the American
College of Obstetricians & Gynecologists cites significantly
greater wound complications with percutaneous metal skin
staples compared to subcuticular suturing. The article titled,
“Surgical [Percutaneous Metal] Staples Compared With
Subcuticular Suture for Skin Closure After Cesarean Delivery:
A Randomized Controlled Trial”, reviews the findings of a
prospective randomized 398 patient study at the University of
Alabama at Birmingham (Fiquera, et al., January 2103).
KEY FINDING: Although subcuticular suture closures
increased operative/anesthesia times by 10 minutes,
percutaneous metal skin staples present a 14X greater risk of
wound morbidity at discharge compared to suture closure.
REMINDER: The proprietary INSORB Skin
Closure Technology utilizes 2 surgically-sharp
needles to capture a precise bilateral ‘bite’ of
dermis and to deliver the INSORB Absorbable
Staple into the tissue. ANY contact with a
forceps, previously placed staple or other
object WILL cause damage to the needles. If
ANY damage is suspected, or if the device is
not operating smoothly, discard and replace
the device.
For additional clinical information, please
contact your Incisive Surgical Sales
Representative, or Incisive Surgical at 1-8662INSORB. Or, visit the insorb.com website.
Closing Comments is an Incisive Surgical Newsletter © 2013 Incisive Surgical, Inc.