orthopedic closure technique

ORTHOPEDIC CLOSURE TECHNIQUE
Wound Preparation
INSORB Technique
Clinical Outcomes
Patient Selection
Use 2 Adson Forceps Technique
Wound Appearance
The INSORB Stapler is contraindicated
for use on tissue which is too thin or too
thick to permit an effective tissue
capture. Assessment of skin thickness
should be made prior to use of the
Stapler with consideration to patient
age, BMI and/or other co-morbidities.
For the initial cases, utilize a 2 person
2 Adson forceps technique. After a
comfort level with the device is
achieved, a 1 person 1 Adson forceps
techique may be used. NOTE: Ensure
Staples are placed at 7 mm intervals.
The INSORB Absorbable Staple is a
subcuticular interrupted skin closure
modality, similar to closing with a
subcuticular interrupted stitch. This
type of closure provides skin eversion
and allows for natural wound drainage,
so the appearance of the wound differs
from a conventional closure with
percutaneous metal skin staples or
subcuticular continous running stitches.
Close in flexion
Joint should be slightly flexed (5-10◦).
Properly Relieve Tension
Relieve tension with deep interrupted
sutures at least 1 cm (KEY) from the
wound edge. This change of technique
is required to allow space to place the
Stapler into the wound and bring the
tissue up around the nose.
2 person 2 Adson
1 person 1 Adson
2 Easy Steps
Grasp 5mm of tissue & Lift. Mate
Stapler with forceps and Fire. To
remove, lift Stapler straight up.
INSORB Knee Closure
Natural Drainage
1 cm
Wound Protection
Surgical Tip – Measure distance from
wound edge with back of an Adson
forceps (≈ 1 cm).
Protect the closure with steri-strips or
equivalent. If a ‘water-tight’ closure is
preferred, skin glue may be used.
Due to the interrupted nature of the
INSORB Skin Closure Modality,
increased wound drainage may be
observed for the first 12 – 18 hours
post-op. Many clinicians believe that
this increased drainage is beneficial
and may result in a decrease in wound
complications. If a ‘water-tight’ closure
is preferred, skin glue may be used.
AV000110rC
ORTHOPEDIC CLOSURES
Total Knee Arthroplasty
INSORB Absorbable
Subcuticular Staples
Percutaneous
Metal Staples
Total Hip Arthroplasty
INSORB Absorbable
Subcuticular Staples
Percutaneous
Metal Staples
At Surgery
At Surgery
At 2 weeks
At 6 weeks
At 2 weeks