Department of Neurosciences, Monash Medical Centre, Monash University, Melbourne, Australia.
J Neurosurg. 2009 Dec;111(6):1175-8. doi: 10.3171/2009.5.JNS081481.
In this prospective randomized clinical trial, investigators looked at wound healing after craniotomy. The hypothesis was that the self-closing plastic scalp clips used for hemostasis on the skin edge might lead to localized microscopic tissue damage and subsequent delayed wound healing.
The trial consisted of 2 arms in which different methods were used to secure scalp hemostasis: 1) the routinely used plastic clips (Scalpfix, Aesculap); and 2) the older method of artery forceps placed on the galea. Participants were restricted to those > 16 years of age undergoing craniotomies expected to last > 2 hours. Repeat operations were not included. One hundred fifty patients were enrolled. They were visited at 3 and 6 weeks postoperatively by an observer blinded to the method used, and the wounds were assessed for macroscopic epithelial closure, signs of infection, and hair regrowth by using a predefined assessment scale.
The results showed no significant difference in wound healing between the 2 groups at either 3 weeks (OR 0.55, 95% CI 0.27-1.11; p = 0.09) or 6 weeks (OR 0.79, 95% CI 0.39-1.58; p = 0.50). The length of operation was found to be a significant factor affecting wound healing at 6 weeks (OR/hour 0.68, 95% CI 0.51-0.92; p = 0.01).
The use of Aesculap Scalpfix self-retaining plastic scalp clips on the skin edge during craniotomy surgery does not appear to affect wound healing significantly to the postoperative 6-week mark.
在这项前瞻性随机临床试验中，研究者观察了开颅术后的伤口愈合情况。假设用于止血的自封闭塑料头皮夹可能导致局部微观组织损伤，并随后导致伤口愈合延迟。
该试验包括 2 个组，其中使用不同的方法来固定头皮止血：1）常规使用的塑料夹（Scalpfix，Aesculap）；2）置于帽状腱膜上的旧动脉夹。参与者限于年龄> 16 岁、预计开颅手术时间> 2 小时的患者。不包括重复手术。共纳入 150 例患者。术后 3 周和 6 周，由一名对使用方法不知情的观察者对患者进行访视，并使用预先确定的评估量表评估伤口的宏观上皮闭合、感染迹象和毛发生长情况。
结果显示，在术后 3 周（OR 0.55，95%CI 0.27-1.11；p = 0.09）或 6 周（OR 0.79，95%CI 0.39-1.58；p = 0.50）时，两组之间的伤口愈合无显著差异。手术时间被发现是影响 6 周时伤口愈合的一个显著因素（OR/小时 0.68，95%CI 0.51-0.92；p = 0.01）。
在开颅手术中，于皮肤边缘使用 Aesculap Scalpfix 自固位塑料头皮夹似乎不会显著影响术后 6 周的伤口愈合。
