Outpatient Surgery Magazine

F irst, a disclaimer on emerging alterna- tive wound-closure devices: There is nothing superior to the traditional suture in terms of approximating wound edges. On this, plastic surgeon Richard Vagley, MD, FACS, of Spectrum Aesthetics in Coral Gables, Fla., is adamant. Still, Dr. Vagley is bullish on the latest wound closure technologies, 6 of which we profile in this article, that can come pretty close to the precision of a traditional suture in a fraction of the time. And he isn't the only one. Asit K. Shah, MD, PhD, an orthopedic surgeon with Englewood (N.J.) Hospital, is also encouraged by recent advances. "Wound closure has never really been improved upon," says Dr. Shah, "and the bulk of major surger- ies have simply been closed by staples." But there are plenty of compelling reasons to rethink this status-quo approach to wound closure. • Patient satisfaction. Dr. Shah recently sur- veyed his patients on wound closure, and what he found was eye-opening. "There's a real fear among patients about having these staples removed," says Dr. Shah. "With a knee revision, we're talking about 30, 40 or 50 staples we need to remove." In addition to reducing the need for inconvenient follow-up staple-removal appointments, the use of non- or less-invasive adhesive wound closure alter- natives can also help with what's often referred to as the patient's "halo effect" or overall impression of your facility. "If a patient sees the surgeon is on the cutting A U G U S T 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 4 9 ZipLine Medical Zip Surgical Skin Closure ziplinemedical.com 408-412-7228 FYI: It's not a staple, a suture or a glue, so what exactly is the Zip Surgical Skin Closure? It's a wound closure device that combines the noninvasive ben- efits of glue — via an advanced hydrocolloid skin adhesive — with the strength of traditional sutures or staples via force-distribution technology and micro-adjustable zip straps that look like tiny plas- tic screws and can be twisted to approximate the incision or wound, and readjusted as needed. The surgeon places the Zip on one end of the incision and pulls down toward the other end as he presses the ladder-like straps over the incision. He then trims off excess material, and tightens the incision to the ideal place- ment and approximation. It's the only device in the wound closure space that allows for the exposure of the wound, says the company. Plus, for knee pro- cedures, the Zip extends with the incision during flexion, which provides the compres- sion needed to maintain wound integrity during a patient's rehab or normal daily movement, says the company. Jared Bilski | Senior Associate Editor What's New in Alternative Wound Closure Will these devices supplant traditional sutures and staples? • CLOSING TIME New wound-closure products let busy physicians forgo the time- consuming process of staple and suture removal. Pamela Bevelhymer, RN, BSN, CNOR

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