Assessing Alternative Approaches for Wound Closure in a National Pediatric Learning Health System

Lindsay A. Gil, Lindsey Asti, Leah Nishimura, Ashley R. Banks, Jennifer Woodard, Saleem Islam, Christopher B. Forrest, Shannon N. Acker, Loren Berman, Myron Allukian, Beth Rymeski, Sarah Greenberg, Kelly Kelleher, Peter C. Minneci

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Our objective was to perform a feasibility study using real-world data from a learning health system (LHS) to describe current practice patterns of wound closure and explore differences in outcomes associated with the use of tissue adhesives and other methods of wound closure in the pediatric surgical population to inform a potentially large study. Methods: A multi-institutional cross-sectional study was performed of a random sample of patients <18 y-old who underwent laparoscopic appendectomy, open or laparoscopic inguinal hernia repair, umbilical hernia repair, or repair of traumatic laceration from January 1, 2019, to December 31, 2019. Sociodemographic and operative characteristics were obtained from 6 PEDSnet (a national pediatric LHS) children's hospitals and OneFlorida Clinical Research Consortium (a PCORnet collaboration across 14 academic health systems). Additional clinical data elements were collected via chart review. Results: Of the 692 patients included, 182 (26.3%) had appendectomies, 155 (22.4%) inguinal hernia repairs, 163 (23.6%) umbilical hernia repairs, and 192 (27.8%) traumatic lacerations. Of the 500 surgical incisions, sutures with tissue adhesives were the most frequently used (n = 211, 42.2%), followed by sutures with adhesive strips (n = 176, 35.2%), and sutures only (n = 72, 14.4%). Most traumatic lacerations were repaired with sutures only (n = 127, 64.5%). The overall wound-related complication rate was 3.0% and resumption of normal activities was recommended at a median of 14 d (interquartile ranges 14-14). Conclusions: The LHS represents an efficient tool to identify cohorts of pediatric surgical patients to perform comparative effectiveness research using real-world data to support medical and surgical products/devices in children.

Original languageEnglish
Pages (from-to)783-790
Number of pages8
JournalJournal of Surgical Research
Volume295
DOIs
Publication statusPublished - Mar 2024
Externally publishedYes

Keywords

  • Learning health systems
  • Real word data
  • Real world evidence
  • Wound closure

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