NESTR1: Comparative Effectiveness of Alternative Approaches for Wound Closure

There are three methods for closure of wounds that result from surgeries or trauma: sutures, staples, and skin adhesives. The purpose of this project is to compare each of these skin closure approaches in terms of the types of skin wounds and the patient populations they are used for along with short-term outcomes, such as need for additional procedures, wound dehiscence, and health services use. Our scientific team of physicians, patients, informaticians, and researchers will: define a set of surgical procedures and trauma-related lacerations in order to characterize a study cohort; specify a set of clinical features to describe the cohort; define each of the wound closure comparator methods; and, specify the clinical features for the outcomes. Once these scientific specifications are developed, the PEDSnet data science team will craft a statistical query based on the PCORnet common data model to evaluate as many of the clinical criteria as possible. The query will then be executed in the PEDSnet and OneFlorida data networks that include analysis-ready electronic health records, and results will be evaluated by the scientific team. We will then develop case abstraction forms that will be used for chart reviews of samples of adults and children from the overall cohort. We expect that chart review will be necessary to define the type of skin closure and details for some of the outcomes. Results of this study will provide novel information on the effects of alternative skin closure methods for different types of procedures.