{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T08:11:52Z","timestamp":1782979912566,"version":"3.54.5"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Deep dermal suturing is critical for scar quality outcomes. The authors evaluated a new, fast medical device for dermal suturing, with the hypothesis of noninferiority with regard to clinical scar and cost-effectiveness.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>A prospective, patient-blind, randomized, multicenter noninferiority study in 26 French hospitals was conducted. Patients were randomized 1:1 to suturing with conventional thread or a semiautomatic stapler. The Patient Scar Assessment Scale was rated at 3 months for primary endpoint effectiveness. Secondary endpoints were cost-effectiveness of the two suturing methods, prevalence of complications, suturing\/operating time, Observer Scar Assessment Scale and Patient Scar Assessment Scale score, scar aesthetic quality 18 months after surgery, and occupational exposure to blood during surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Six hundred sixty-four patients were enrolled, 660 were randomized, and 649 constituted the full analysis (stapler arm, <jats:italic toggle=\"yes\">n<\/jats:italic> = 324; needle arm, <jats:italic toggle=\"yes\">n<\/jats:italic> = 325). Primary endpoint Patient Scar Assessment Scale score in the stapler arm was not inferior to that in the needle arm at 3 months or after 18 months. The mean operating time was 180 minutes in the stapler arm and 179 minutes in the needle arm (<jats:italic toggle=\"yes\">p<\/jats:italic> = not significant). The mean suturing time was significantly lower in the stapler arm (<jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001). There were seven occupational exposures to blood in the needle arm and one in the stapler arm. The two arms did not differ significantly in terms of complications (<jats:italic toggle=\"yes\">p<\/jats:italic> = 0.41). The additional cost of using the device was \u20ac51.57 for the complete-case population.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>Wound healing outcome was no worse than with conventional suturing using a semiautomatic stapler and associated with less occupational exposure to blood.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CLINICAL QUESTION\/LEVEL OF EVIDENCE:<\/jats:title>\n            <jats:p>Therapeutic, I.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/prs.0000000000007356","type":"journal-article","created":{"date-parts":[[2020,9,13]],"date-time":"2020-09-13T10:04:03Z","timestamp":1599991443000},"page":"777e-789e","source":"Crossref","is-referenced-by-count":4,"title":["A Novel Absorbable Stapler Provides Patient-Reported Outcomes and Cost-Effectiveness Noninferior to Subcuticular Skin Closure: A Prospective, Single-Blind, Randomized Clinical Trial"],"prefix":"10.1097","volume":"146","author":[{"given":"Olivier","family":"Malard","sequence":"first","affiliation":[{"name":"From the Departments of Ear, Nose, and Throat Surgery, Burn Plastic Surgery, Gynaecology and Obstetrics, Plastic Surgery, and Research and Innovation and the Methodology and Biostatistics Unit, Nantes University Hospital; the Clinical Research Department, District Hospital Center; EA 4275 Biostatistics, Pharmacoepidemiology and Human Sciences Research Unit, and SPHERE, UMR INSERM U1246, Faculty of Medicine, University of Nantes; and the French School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franck","family":"Duteille","sequence":"additional","affiliation":[{"name":"From the Departments of Ear, Nose, and Throat Surgery, Burn Plastic Surgery, Gynaecology and Obstetrics, Plastic Surgery, and Research and Innovation and the Methodology and Biostatistics Unit, Nantes University Hospital; the Clinical Research Department, District Hospital Center; EA 4275 Biostatistics, Pharmacoepidemiology and Human Sciences Research Unit, and SPHERE, UMR INSERM U1246, Faculty of Medicine, University of Nantes; and the French School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Darnis","sequence":"additional","affiliation":[{"name":"From the Departments of Ear, Nose, and Throat Surgery, Burn Plastic Surgery, Gynaecology and Obstetrics, Plastic Surgery, and Research and Innovation and the Methodology and Biostatistics Unit, Nantes University Hospital; the Clinical Research Department, District Hospital Center; EA 4275 Biostatistics, Pharmacoepidemiology and Human Sciences Research Unit, and SPHERE, UMR INSERM U1246, Faculty of Medicine, University of Nantes; and the French School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florent","family":"Espitalier","sequence":"additional","affiliation":[{"name":"From the Departments of Ear, Nose, and Throat Surgery, Burn Plastic Surgery, Gynaecology and Obstetrics, Plastic Surgery, and Research and Innovation and the Methodology and Biostatistics Unit, Nantes University Hospital; the Clinical Research Department, District Hospital Center; EA 4275 Biostatistics, Pharmacoepidemiology and Human Sciences Research Unit, and SPHERE, UMR INSERM U1246, Faculty of Medicine, University of Nantes; and the French School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Perrot","sequence":"additional","affiliation":[{"name":"From the Departments of Ear, Nose, and Throat Surgery, Burn Plastic Surgery, Gynaecology and Obstetrics, Plastic Surgery, and Research and Innovation and the Methodology and Biostatistics Unit, Nantes University Hospital; the Clinical Research Department, District Hospital Center; EA 4275 Biostatistics, Pharmacoepidemiology and Human Sciences Research Unit, and SPHERE, UMR INSERM U1246, Faculty of Medicine, University of Nantes; and the French School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Ferron","sequence":"additional","affiliation":[{"name":"From the Departments of Ear, Nose, and Throat Surgery, Burn Plastic Surgery, Gynaecology and Obstetrics, Plastic Surgery, and Research and Innovation and the Methodology and Biostatistics Unit, Nantes University Hospital; the Clinical Research Department, District Hospital Center; EA 4275 Biostatistics, Pharmacoepidemiology and Human Sciences Research Unit, and SPHERE, UMR INSERM U1246, Faculty of Medicine, University of Nantes; and the French School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie","family":"Planche","sequence":"additional","affiliation":[{"name":"From the Departments of Ear, Nose, and Throat Surgery, Burn Plastic Surgery, Gynaecology and Obstetrics, Plastic Surgery, and Research and Innovation and the Methodology and Biostatistics Unit, Nantes University Hospital; the Clinical Research Department, District Hospital Center; EA 4275 Biostatistics, Pharmacoepidemiology and Human Sciences Research Unit, and SPHERE, UMR INSERM U1246, Faculty of Medicine, University of Nantes; and the French School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Benoit","family":"Hardouin","sequence":"additional","affiliation":[{"name":"From the Departments of Ear, Nose, and Throat Surgery, Burn Plastic Surgery, Gynaecology and Obstetrics, Plastic Surgery, and Research and Innovation and the Methodology and Biostatistics Unit, Nantes University Hospital; the Clinical Research Department, District Hospital Center; EA 4275 Biostatistics, Pharmacoepidemiology and Human Sciences Research Unit, and SPHERE, UMR INSERM U1246, Faculty of Medicine, University of Nantes; and the French School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Tessier","sequence":"additional","affiliation":[{"name":"From the Departments of Ear, Nose, and Throat Surgery, Burn Plastic Surgery, Gynaecology and Obstetrics, Plastic Surgery, and Research and Innovation and the Methodology and Biostatistics Unit, Nantes University Hospital; the Clinical Research Department, District Hospital Center; EA 4275 Biostatistics, Pharmacoepidemiology and Human Sciences Research Unit, and SPHERE, UMR INSERM U1246, Faculty of Medicine, University of Nantes; and the French School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine","family":"Bellanger","sequence":"additional","affiliation":[{"name":"From the Departments of Ear, Nose, and Throat Surgery, Burn Plastic Surgery, Gynaecology and Obstetrics, Plastic Surgery, and Research and Innovation and the Methodology and Biostatistics Unit, Nantes University Hospital; the Clinical Research Department, District Hospital Center; EA 4275 Biostatistics, Pharmacoepidemiology and Human Sciences Research Unit, and SPHERE, UMR INSERM U1246, Faculty of Medicine, University of Nantes; and the French School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Dert","sequence":"additional","affiliation":[{"name":"From the Departments of Ear, Nose, and Throat Surgery, Burn Plastic Surgery, Gynaecology and Obstetrics, Plastic Surgery, and Research and Innovation and the Methodology and Biostatistics Unit, Nantes University Hospital; the Clinical Research Department, District Hospital Center; EA 4275 Biostatistics, Pharmacoepidemiology and Human Sciences Research Unit, and SPHERE, UMR INSERM U1246, Faculty of Medicine, University of Nantes; and the French School of Public Health."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,9,9]]},"reference":[{"key":"R1-20231017","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1016\/0142-9612(96)81421-9","article-title":"In vitro biocompatibility of bioresorbable polymers: Poly(L, DL-lactide) and poly(L-lactide-co-glycolide).","volume":"17","author":"Ignatius","year":"1996","journal-title":"Biomaterials"},{"key":"R2-20231017","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.2460\/ajvr.2005.66.1975","article-title":"Comparison of gross and histologic tissue responses of skin incisions closed by use of absorbable subcuticular staples, cutaneous metal staples, and polyglactin 910 suture in pigs.","volume":"66","author":"Fick","year":"2005","journal-title":"Am J Vet Res"},{"key":"R3-20231017","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1615\/JLongTermEffMedImplants.v16.i1.30","article-title":"A revolutionary advance in skin closure compared to current methods.","volume":"16","author":"Pi\u00f1eros-Fernandez","year":"2006","journal-title":"J Long Term Eff Med Implants"},{"key":"R4-20231017","doi-asserted-by":"crossref","first-page":"665","DOI":"10.3928\/01477447-20100722-12","article-title":"A randomized, prospective study of total hip wound closure with resorbable subcuticular staples.","volume":"33","author":"Fisher","year":"2010","journal-title":"Orthopedics"},{"key":"R5-20231017","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1111\/j.1399-0012.2007.00661.x","article-title":"Renal transplant incision closure using new absorbable subcuticular staple device.","volume":"21","author":"Tellis","year":"2007","journal-title":"Clin Transplant"},{"key":"R6-20231017","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1097\/PRS.0b013e3181a805c5","article-title":"The absorbable dermal staple device: A faster, more cost-effective method for incisional closure.","volume":"124","author":"Cross","year":"2009","journal-title":"Plast Reconstr Surg"},{"key":"R7-20231017","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1001\/archfaci.8.1.47","article-title":"Duration of anesthesia as an indicator of morbidity and mortality in office-based facial plastic surgery: A review of 1200 consecutive cases.","volume":"8","author":"Gordon","year":"2006","journal-title":"Arch Facial Plast Surg"},{"key":"R8-20231017","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1097\/01.prs.0000181520.87883.94","article-title":"Standardized assessment of breast cancer surgical scars integrating the Vancouver Scar Scale, Short-Form McGill Pain Questionnaire, and patients\u2019 perspectives.","volume":"116","author":"Truong","year":"2005","journal-title":"Plast Reconstr Surg"},{"key":"R9-20231017","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1097\/BCR.0b013E318053D3BB","article-title":"Determination of inter-rater reliability in pediatric burn scar assessment using a modified version of the Vancouver Scar Scale.","volume":"28","author":"Forbes-Duchart","year":"2007","journal-title":"J Burn Care Res"},{"key":"R10-20231017","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1177\/1553350612442796","article-title":"Reduction of skin closure time without loss of healing quality: A multicenter prospective study in 100 patients comparing the use of Insorb absorbable staples with absorbable thread for dermal suture.","volume":"20","author":"Duteille","year":"2013","journal-title":"Surg Innov"},{"key":"R11-20231017","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.jval.2015.02.001","article-title":"Cost-effectiveness analysis alongside clinical trials II: An ISPOR Good Research Practices Task Force report.","volume":"18","author":"Ramsey","year":"2015","journal-title":"Value Health"},{"key":"R13-20231017","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.medmal.2003.06.001","article-title":"Assessing the cost of occupational exposures to blood, in a French university hospital (in French).","volume":"34","author":"Nidegger","year":"2004","journal-title":"Med Mal Infect"},{"key":"R14-20231017","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.accpm.2014.11.002","article-title":"Example of cost calculations for an operating room and a post-anaesthesia care unit.","volume":"34","author":"Raft","year":"2015","journal-title":"Anaesth Crit Care Pain Med"}],"container-title":["Plastic &amp; Reconstructive Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PRS.0000000000007356","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T11:42:53Z","timestamp":1697542973000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PRS.0000000000007356"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,9]]},"references-count":13,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1097\/prs.0000000000007356","relation":{},"ISSN":["0032-1052"],"issn-type":[{"value":"0032-1052","type":"print"}],"subject":[],"published":{"date-parts":[[2020,9,9]]}}}