Mun Junho, Hyun Seung-Jae, Lee Jae-Koo, An Sungjae, Kim Ki-Jeong
Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Department of Neurosurgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
Neurospine. 2023 Sep;20(3):981-988. doi: 10.14245/ns.2346534.267. Epub 2023 Sep 30.
Multilevel or revisional posterior spinal surgery is prone to infection and delayed wound healing, related with the wound closure time and suture strength. Knotless barbed suture is an innovative self-locking, multianchor suture. This study aims to evaluate the safety and efficacy of the knotless barbed suture and self-adhering mesh with polymeric glue in multilevel or revisional posterior spinal surgery.
This is a single-center retrospective matched cohort study. Patients were divided into 2 groups based on the wound closure method: barbed suture group with novel wound closure, and conventional suture group with conventional wound closure, 1:1 matched by the level of surgery and sex, resulting in 120 subjects each. Total operation time and wound closure time were measured intraoperatively, and perioperative clinical outcome parameters including postoperative wound complication were investigated for the first 3 months postoperatively. The distribution of continuous variables was assessed for normality by Shapiro-Wilk test, then parametric or nonparametric tests were applied accordingly (paired t-test or Wilcoxon signed-rank test).
Wound closure time was significantly shorter with the novel barbed suture than with conventional suture in all subgroups divided by the level of spinal surgery: 3-5, 6-9, ≥ 10 levels (p < 0.001). The 2 groups showed no significant differences in surgical complications (p = 1.000). Specially, total operation time and wound-closing time were significantly shorter in revisional subgroup.
Absorbable knotless barbed suture and self-adhering mesh with polymeric glue can shorten spinal wound closure time with noninferiority in complications for multilevel or revisional spinal surgery.
多节段或翻修后路脊柱手术容易发生感染和伤口愈合延迟，这与伤口闭合时间和缝合强度有关。免打结倒刺缝线是一种创新的自锁、多锚定缝线。本研究旨在评估免打结倒刺缝线和含聚合胶的自粘网片在多节段或翻修后路脊柱手术中的安全性和有效性。
这是一项单中心回顾性匹配队列研究。根据伤口闭合方法将患者分为两组：采用新型伤口闭合的倒刺缝线组和采用传统伤口闭合的传统缝线组，根据手术节段和性别进行1:1匹配，每组各120例。术中测量总手术时间和伤口闭合时间，并在术后前3个月调查围手术期临床结局参数，包括术后伤口并发症。通过Shapiro-Wilk检验评估连续变量分布的正态性，然后相应地应用参数检验或非参数检验（配对t检验或Wilcoxon符号秩检验）。
在按脊柱手术节段划分的所有亚组中：3 - 5节段、6 - 9节段、≥10节段，新型倒刺缝线的伤口闭合时间明显短于传统缝线（p < 0.001）。两组在手术并发症方面无显著差异（p = 1.000）。特别地，翻修亚组的总手术时间和伤口闭合时间明显更短。
可吸收免打结倒刺缝线和含聚合胶的自粘网片可缩短脊柱伤口闭合时间，在多节段或翻修脊柱手术的并发症方面不劣于传统方法。
