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Your search keyword '"Mellia, Joseph A."' showing total 173 results
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173 results on '"Mellia, Joseph A."'

1. End-Stage Hernia Disease

Author

Mellia, Joseph A., Mauch, Jaclyn T., Fischer, John P., Docimo Jr., Salvatore, editor, Blatnik, Jeffrey A., editor, and Pauli, Eric M., editor

Published
2023
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10. Sticking to What Matters: A Matched Comparative Study of Fibrin Glue and Mechanical Fixation for Split-Thickness Skin Grafts in the Lower Extremity.

Author

Othman, Sammy, Messa IV, Charles A., Elfanagely, Omar, Bormann, Bradford, Mellia, Joseph A., Broach, Robyn B., Kovach, Stephen J., and Fischer, John P.

Abstract

Background: Split-thickness skin grafts (STSGs) remain a valuable tool in the reconstructive surgeons' armamentarium. Staple or suture mechanical fixation (MF) serves as the gold standard of care, though fibrin glue (FG) has gained popularity as a fixation modality. We compare STSG outcomes following application of FG versus MF through a study of lower extremity wounds. Methods: A retrospective review (2016-2019) of patients who underwent a STSG was performed. Two cohorts consisting of patients undergoing a STSG with FG or MF (suture or staple) were matched according to wound size, wound location, and body mass index. Results: A total of 67 patients with 79 wounds were included (FG: n = 30, wounds = 39; MF: n = 37; wounds = 40). There was no significant difference between groups regarding time to 100% graft take (FG: 39 days, MF: 35.1 days; P <.384) or 180-day graft complications (FG: 10.3%, MF: 15%; P <.737). Adjusted operative time for FG (51.8 min) was lower than for MF cases (67.5 min) at a level that approached significance (P <.094). FG patients were significantly less likely to require a postoperative wound vacuum-assisted closure (VAC) (FG: 16.7%; MF: 76.7%; P <.001) and required a significantly lower number of 30-day postoperative visits (FG: 1.5 ±.78 visits; MF: 2.5 ±.03 visits; P <.001). The MF group had higher mean aggregate charges ($211,090) compared with the FG group (mean: $149,907), although these were not statistically significant (P >.05). Conclusion: The use of FG for STSG shows comparable clinical outcomes to MF, with a significantly decreased need for postoperative wound VAC, the number of 30-day postoperative visits, and a lower wound-adjusted operative time. [ABSTRACT FROM AUTHOR]

Published
2024
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