Xkin Suture Device Acts as Effective Wound Closure Method, Improves Scar Outcomes

Xkin (Surginus Co., Ltd), a new zipper-type closure and medical suture device, outperformed staple closure in a comparison of laceration and surgical wound closure, according to a study published in the International Wound Journal.¹

Researchers reported that Xkin is effective in reducing scarring, pain, and risk of infection. In comparison to stapling, the device yielded significantly lower vascularity, pliability, and modified Vancouver Scar Scale (mVSS) scores.

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Background and Methods

Wound closure methods such as surgical sutures and metallic stapling, though widely-used, are often time consuming in nature, and additional cost and staff are commonly required.² Zip-type closures have risen to popularity since the early 2000s,² though studies on the efficacy of such devices in wound healing domains have lacked analysis of the wound itself, according to authors of the present study.

In a randomized, controlled, single-center, open-label trial, researchers Jung et al sought to compare the efficacy of traditional stapling versus the Xkin device.

From November 2022 to February 2023, adults scheduled for robot-assisted radical prostatectomy procedures for prostate cancer were recruited for participation. Patients were required to have a prostate size less than 60 cc and were excluded from participation if they presented with uncontrolled medical diseases and infections or were currently on medications that may have affected inflammation and wound healing.

Randomization involved 50 patients assigned in a 1:1 ratio to either the Xkin closure group or the stapling group. Both groups had a prostate specimen removed through an incision 3 cm above the navel, with peritoneum-fascia-subcutaneous layers closed uniformly using the same suture material. Skin incisions were closed using either Xkin or stapling device with postoperative dressings applied identically in both groups.

Researchers conducted post-procedure visits occurred at 2, 6, and 12 weeks, during which they conducted assessments of wound dehiscence, infection, and localized adverse effects.

Findings

In total, 46 patients, or 23 in each group, completed the study. Researchers did not report any significant differences in body mass index, diabetes, hypertension, console time, estimated blood loss, and time for skin closure between treatment groups.

Researchers found that the Xkin group had significantly lower mVSS scores at the 12-week follow-up compared to the stapling group. Sub-scores for vascularity and pliability were also significantly better in the Xkin group, with no significant differences in scar height and depth observed between the groups.

Photographs taken of the wound at follow up also demonstrated significantly better cosmetic outcomes in patients whose wounds were closed with Xkin.

Neither treatment group had any reported wound dehiscence or severe complications to note.

Conclusions

According to researchers, this is the first known study to demonstrate the efficacy of Xkin in scar healing in a randomized, controlled trial setting.

As such, potential limitations may have implications on its results, such as its small sample size and short follow-up period, for example.

"Our results demonstrate that Xkin is an effective wound closure method for improving scar outcomes," according to Jung et al.

Researchers also recommended that future studies explore aspects of Xkin that the present study did not, such as objective measures of pain, Xkin's use in different wound areas and sizes, and the device's cost effectiveness.

References

1. Jung G, Song SH, Kim BR, Shin JM, H CH, Lee S. Comparison of the wound healing and complications of zipper type closure adhesive tape and stapler for surgical wound suture: a randomized control, single-centre, open-label trial. Int Wound J. July 23, 2024. https://doi.org/10.1111/iwj.70004
2. Azmat CE, Council M. Wound closure techniques. StatPearls [Internet]. StatPearls Publishing. January 2024. Updated June 26, 2024. https://www.ncbi.nlm.nih.gov/books/NBK470598/