Use of Absorbable Dermal Staples During Bilateral Breast Reduction Surgery: Effects on Operative Times, Surgical Outcomes, and Procedure Costs
Dylan K. Kim*1, Matthew A. Wright2, Jeffrey A. Ascherman2
1Columbia University Vagelos College of Physicians and Surgeons, New York, NY; 2Plastic and Reconstructive Surgery, Columbia University Irving Medical Center, New York, NY
Use of the absorbable dermal stapler in wound closure has become more common in plastic surgery due to its reduction in operative times and subsequent decrease in operative room costs. In this study, we examine the effects of the absorbable stapler on operative times and postoperative complications in bilateral reduction mammoplasties.
A retrospective, observational cohort study was conducted via electronic chart review on patients who underwent bilateral reduction mammoplasties by the senior author from January 2014 to December 2022 using either inferior or superior wedge pedicles. Patients were stratified by wound closure method. Incidences of patient co-morbidities and postoperative complications, such as bleeding, infection, and wound dehiscence, were collected. Relationships between collected variables were analyzed via student's t-tests, multivariate linear regression, and logistic regression.
The records of 66 consecutive women who underwent bilateral reduction surgery were included for final analysis. Deep dermal closure of the inframammary fold (IMF) incision in 30 patients involved use of absorbable dermal staples, whereas deep dermal IMF closure in the other 36 patients was done solely with absorbable sutures. There were no statistically significant differences between the two groups in average BMI (p = 0.34) and average weight of breast tissue removed (p = 0.91). Operative time was reduced by an average of 19.3 minutes when using the absorbable staples compared to when closing solely with sutures (p = 0.034). When controlling for mass of breast tissue removed and type of pedicle, absorbable staple closure still predicted a reduction of 23.4 minutes in operative time (p = 0.031). Postoperative complications were not affected by wound closure method (p = 0.58) or pedicle type (p = 0.81).
The use of absorbable dermal staples in wound closure during reduction mammoplasty surgery produced a significant decrease in operative time, with no increase in postoperative complication rates. These benefits were present in both types of pedicles used during the study.
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