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辛基氰基丙烯酸酯皮肤粘合剂在脊柱后路手术中用于伤口闭合有效,且不会增加伤口并发症的风险。

Octyl-cyanoacrylate skin adhesive is effective for wound closure in posterior spinal surgery without increased risk of wound complications.

作者信息

Howard Brian M, Eshraghi Sheila R, Holland Christopher M, Refai Daniel

机构信息

School of Medicine, Emory University, Atlanta 30322, USA; Department of Neurological Surgery, Emory University, Atlanta 30322, USA.

School of Medicine, Emory University, Atlanta 30322, USA; Department of Neurological Surgery, Emory University, Atlanta 30322, USA.

出版信息

Clin Neurol Neurosurg. 2014 Oct;125:137-42. doi: 10.1016/j.clineuro.2014.07.026. Epub 2014 Aug 2.

Abstract

OBJECTIVE

Few published studies have examined the complication profile after posterior spinal surgery wherein absorbable, subcuticular suture and cyanoacrylate skin adhesives (CSA) were used for incision closure. The purpose of this report is to compare the rate and profile of wound complications in a large number of patients who underwent posterior spinal surgery with CSA skin closure to rates of similar complications with standard nylon closure techniques.

METHODS

The prospective database of all surgical cases maintained by the senior author was retrospectively reviewed. Three hundred eighty-two patients underwent posterior spinal surgery for degenerative, oncologic and traumatic pathology. Wound-related complications, including cerebrospinal fluid leak, wound infection and dehiscence were analyzed in all patients.

RESULTS

These data establish that the incisions in patients who undergo posterior spinal surgery can be safely and successfully closed with subcuticular Monocryl™ and CSA without increased risk of CSF leak, wound infection or dehiscence. Rates of these complications were similar between the study population, a small subset of patients treated with traditional closure techniques and those in the established literature.

CONCLUSIONS

CSA is a safe method to achieve ultimate skin closure in patients who undergo posterior spinal surgery without increased risk of wound-related complications, even in those patients undergoing intradural procedures.

摘要

目的

很少有已发表的研究探讨过在脊柱后路手术中使用可吸收皮下缝线和氰基丙烯酸酯皮肤粘合剂(CSA)进行切口闭合后的并发症情况。本报告的目的是比较大量接受脊柱后路手术并采用CSA皮肤闭合的患者的伤口并发症发生率及情况与采用标准尼龙闭合技术的类似并发症发生率。

方法

对资深作者维护的所有手术病例的前瞻性数据库进行回顾性研究。382例患者因退行性、肿瘤性和创伤性病变接受了脊柱后路手术。分析了所有患者的伤口相关并发症,包括脑脊液漏、伤口感染和裂开。

结果

这些数据表明,接受脊柱后路手术的患者的切口可以使用皮下Monocryl™缝线和CSA安全、成功地闭合,而不会增加脑脊液漏、伤口感染或裂开的风险。在研究人群、一小部分采用传统闭合技术治疗的患者以及现有文献中的患者中,这些并发症的发生率相似。

结论

CSA是一种安全的方法,可用于接受脊柱后路手术的患者实现最终的皮肤闭合,且不会增加伤口相关并发症的风险,即使是那些接受硬膜内手术的患者。

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