Wound healing after intracutaneous vs. staple-assisted skin closure in lumbar, non-instrumented spine surgery: a multicenter prospective randomized trial.

IF 1.9 3区医学 Q3 CLINICAL NEUROLOGY

Acta Neurochirurgica Pub Date : 2024-08-13 DOI:10.1007/s00701-024-06227-3

Alexander Romagna, Jens Lehmberg, Michael Meier, Michael Stelzer, Arwin Rezai, Jürgen Volker Anton, Albert Eckert, Christoph J Griessenauer, Maximilian-Niklas Bonk, Bjoern Sommer, Ehab Shiban, Christian Blume, Martin Geroldinger, Christoph Schwartz

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Abstract

Purpose: Superficial surgical site infection (SSSI) is a prominent problem in spine surgery. Intracutaneous sutures and staple-assisted closure are two widely used surgical techniques for skin closure. Yet, their comparative impact on wound healing and infection rates is underexplored. Our goal was to address this gap and compare wound healing between these two techniques.

Methods: This study was a multicenter international prospective randomized trial. Patient data were prospectively collected at three large academic centers, patients who underwent non-instrumented lumbar primary spine surgery were included. Patients were intraoperatively randomized to either intracutaneous suture or staple-assisted closure cohorts. The primary endpoint was SSSI within 30 days after surgery according to the wound infection Centers for Disease Control and Prevention (CDC) classification system.

Results: Of 207 patients, 110 were randomized to intracutaneous sutures and 97 to staple-assisted closure. Both groups were homogenous with respect to epidemiological as well as surgical parameters. Two patients (one of each group) suffered from an A1 wound infection at the 30-day follow up. Median skin closure time was faster in the staple-assisted closure group (198 s vs. 13 s, p < 0,001).

Conclusion: This study showed an overall low superficial surgical site infection rate in both patient cohorts in primary non instrumented spine surgery.

Abstract Image

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腰椎非器械手术中经皮与缝合线辅助皮肤闭合后的伤口愈合：一项多中心前瞻性随机试验。

目的：浅表手术部位感染（SSSI）是脊柱外科的一个突出问题。皮内缝合和订书钉辅助缝合是两种广泛使用的皮肤缝合手术技术。然而，这两种技术对伤口愈合和感染率的影响还没有得到充分的研究。我们的目标是填补这一空白，比较这两种技术的伤口愈合情况：本研究是一项多中心国际前瞻性随机试验。方法：这项研究是一项多中心国际前瞻性随机试验，在三个大型学术中心前瞻性地收集了患者数据，纳入了接受非器械腰椎初级手术的患者。患者在术中被随机分为经皮缝合组和缝合钉辅助组。根据美国疾病控制和预防中心（CDC）的伤口感染分类系统，主要终点是术后30天内的SSSI：在 207 名患者中，110 人被随机分配到皮内缝合组，97 人被随机分配到缝合钉辅助组。两组患者在流行病学和手术参数方面均无差异。在 30 天的随访中，有两名患者（每组各一名）发生了 A1 级伤口感染。缝合钉辅助缝合组的中位皮肤缝合时间更快（198 秒 vs. 13 秒，P 结论：缝合钉辅助缝合组的中位皮肤缝合时间更短，但缝合钉辅助缝合组的中位皮肤缝合时间更长：这项研究表明，在初级非器械脊柱手术中，两组患者的浅表手术部位感染率总体较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Neurochirurgica 医学-临床神经学

CiteScore

4.40

自引率

4.20%

发文量

342

审稿时长

1 months

期刊介绍： The journal "Acta Neurochirurgica" publishes only original papers useful both to research and clinical work. Papers should deal with clinical neurosurgery - diagnosis and diagnostic techniques, operative surgery and results, postoperative treatment - or with research work in neuroscience if the underlying questions or the results are of neurosurgical interest. Reports on congresses are given in brief accounts. As official organ of the European Association of Neurosurgical Societies the journal publishes all announcements of the E.A.N.S. and reports on the activities of its member societies. Only contributions written in English will be accepted.