Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Neurosurg Rev. 2024 Aug 17;47(1):438. doi: 10.1007/s10143-024-02671-y.
Wound closure is an integral part of every spinal procedure. Effective and secure wound closure is paramount in the prevention of infection, wound dehiscence and the preservation of cosmesis. Barbed suture technologies such as STRATAFIX™ Symmetric have been studied and are used in a variety of specialties, including obstetrics and orthopedic surgery, but is underutilized in neurosurgery. This study aims to assess the time and rate of closure using STRATAFIX™ Symmetric technology for fascial closure and compare this method to the more traditionally used method of fascial closure using braided absorbable sutures below the epidermis. 20 patients were recruited for the study. 10 patients underwent fascial approximation with braided absorbable sutures and definitive fascial closure with STRATAFIX™ Symmetric. In the control group, fascial closure was completed entirely with interrupted braided absorbable stitches. Patients assigned to STRATAFIX™ Symmetric group had shorter mean time for fascial closure, faster rate of average fascial closure, and lower number of total sutures used. The use of barbed suture technology such as STRATAFIX™ Symmetric may reduce the time to closure in thoracolumbar spine surgery without increasing the risk of adverse events. This pilot study forms the framework for a larger randomized, controlled trial appropriately powered for such an analysis.
伤口闭合是每个脊柱手术的重要组成部分。有效且安全的伤口闭合对于预防感染、伤口裂开和保持美容效果至关重要。带倒刺的缝合技术，如 STRATAFIX™ Symmetric，已经在许多专业领域进行了研究和应用，包括产科和骨科手术，但在神经外科中的应用较少。本研究旨在评估使用 STRATAFIX™ Symmetric 技术进行筋膜闭合的时间和速度，并将这种方法与传统的使用表皮下编织可吸收缝线进行筋膜闭合的方法进行比较。本研究招募了 20 名患者。10 名患者接受编织可吸收缝线进行筋膜吻合，并用 STRATAFIX™ Symmetric 进行确定性筋膜闭合。在对照组中，筋膜闭合完全采用间断编织可吸收缝线。接受 STRATAFIX™ Symmetric 治疗的患者的筋膜闭合时间更短，平均筋膜闭合速度更快，使用的缝线总数更少。使用带倒刺的缝合技术，如 STRATAFIX™ Symmetric，可能会减少胸腰椎手术的闭合时间，而不会增加不良事件的风险。这项初步研究为一项更大的随机对照试验奠定了基础，该试验具有适当的分析能力。
