staples or a sub q running stitch?

[heathermed]

Hello Everyone

Just wanted to get a quick idea and thinking of trying some different things.

For those that implant SCS and intrathecal pumps, do you guys prefer to close skin with staples or a sub cutaneous running stitch with monocryl?

Wanted to see if one is preferred over the other

thank you

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[lobelsteve]

0 vicrl deep
2-0 superficial
Dermabond on skin
Telfaderm over that

 

[deleted472101]

2-0 viycryl pop offs intermittent for deep
3-0 moncryl running superficial
Dermabond superficial
4x4
Tegaderm

 

[NOSfan]

Sutures......You guys are so ancient Egypt.........Welcome to the 21st century:

http://www.surgizip.com/ProductVideoManual.html

Video here: http://www.surgizip.com/ProductVideoManual.html

 

[Extralong]

Kind of off topic. Do you guys place an On-Q pump for 5 days when doing perms or pumps?

 

[lobelsteve]

Kind of off topic. Do you guys place an On-Q pump for 5 days when doing perms or pumps?

No way. It's sore for 2-3 days max.

 

[Extralong]

So no ON-Q at all?

 

[EtherBunny]

So no ON-Q at all?

back incision: 3-0 vicryl sutures interrupted, running 4-0 monocryl suture for the skin, longitudinal steri-strips, Telfa, tegaderm

IPG or reservoir pockets: a few 2-0 vicryl sutures to reduce tension on the wound then 3-0 vicryl sutures and running 4-0 monocryl, longitudinal steri-strips, Telfa, tegaderm

Incisions heal beautifully.

No On q pumps for perms. I often inject exparel mixed with bupivacaine at each incision to help with postop analgesia though.

 

[Yo GabbaPentin]

I use a pen. And I write "refer to dr. Surgeon." Implants not worth the time or headaches for me.

 

[Extralong]

No way. It's sore for 2-3 days max.

Maybe consider leaving it in for less days?

back incision: 3-0 vicryl sutures interrupted, running 4-0 monocryl suture for the skin, longitudinal steri-strips, Telfa, tegaderm

IPG or reservoir pockets: a few 2-0 vicryl sutures to reduce tension on the wound then 3-0 vicryl sutures and running 4-0 monocryl, longitudinal steri-strips, Telfa, tegaderm

Incisions heal beautifully.

No On q pumps for perms. I often inject exparel mixed with bupivacaine at each incision to help with postop analgesia though.

I guess my thinking would be less chance of infection and longer postop analgesia?

Thanks all for the feedback.

 

[Ducttape]

i am reconsidering having surgeons do them all, with Nevro... if i did, would do some with surgeon and first, to reacquaint myself...

 

[Extralong]

Sutures......You guys are so ancient Egypt.........Welcome to the 21st century:

Video here: http://www.surgizip.com/ProductVideoManual.html

You seriously using that???

 

[nvrsumr]

Deep 2-0 vicryl, staples, steri- strips dermabond. Take out after 5-7 days and more steri-strips. Cosmesis is good. Faster. Last I looked(admittedly awhile back) less infection risk.

 

[NJPAIN]

Deep 2-0 vicryl, staples, steri- strips dermabond. Take out after 5-7 days and more steri-strips. Cosmesis is good. Faster. Last I looked(admittedly awhile back) less infection risk.

Staples, steris AND dermabond? Am I reading correctly?

 

[nvrsumr]

Staples, steris AND dermabond? Am I reading correctly?

Staples with dermabond. Steris between staples take out staples early .. More steris

 

[NJPAIN]

So you are using dermabond over staples just to make watertight? Curious the order you are putting these various things on.


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[nvrsumr]

yes. but I space my staples out a bit with the steris in-between. Had a plastics friend suggest above.

 

[NJPAIN]

yes. but I space my staples out a bit with the steris in-between. Had a plastics friend suggest above.

Interesting. Especially if you don't do a lot of implants and suturing slows the process down. You don't find that everything is glued together with dermabond making staple removal tough? Do you let them shower immediately post-op?

 

[nvrsumr]

That was me. Infection risk directly related to length of surgery. Anything quicker was my motto. I have stopped doing implants so my technique isn't worth much.