Yang Cassie, Qiu Theophilus, Chee Cheong Reuben Soh, Ou Yang Youheng
Orthopaedic Surgery, Singapore General Hospital, Singapore, SGP.
Yong Loo Lin School of Medicine, National University Singapore, Singapore, SGP.
Cureus. 2024 Aug 26;16(8):e67859. doi: 10.7759/cureus.67859. eCollection 2024 Aug.
Background Skin adhesive tapes (SATs) are hypoallergenic adhesive tapes commonly used for wound closure in percutaneous vertebroplasty (PVP). Vertebral body stenting (VBS) is a metallic balloon-expandable stent used to treat vertebral body fractures. Its balloon and stent deployment involves a larger stab incision and pedicle bore tract than PVP, increasing the risk of bleeding and wound complications. This study evaluated the outcome and complications of VBS wound closure with SAT and the reasons for conversion to conventional suture closure (SC). Material and methods A retrospective series of patients who underwent VBS from May 2019 to March 2021 were identified from review of computerized medical records. Data were collected for wound closure method, reason for SC, number of operative levels, postoperative wound complications of contact dermatitis, tension blisters, tape dislodgement, surgical site infection, wound dehiscence, symptomatic hematoma and return to operating theater. The wounds were assessed for complete healing and cosmesis at outpatient follow-up visits. Results A total of 36 patients were identified. SAT closure was performed in 33 (91.6%) patients, while SC was performed in three (8.3%) patients. Unplanned conversion to SC was required in two (5.5%) patients due to continued intraoperative wound bleeding, while one (2.7%) patient had planned SC as part of a staged operation. Uneventful closures occurred in 32 (97.0%) of SAT closures. One (3%) SAT closure patient developed postoperative blood-soaked dressings and tape dislodgement, requiring reapplication of the SATs at the ward with uneventful recovery thereafter. No patient with SAT closure developed contact dermatitis, tension blisters, surgical site infection, wound dehiscence, symptomatic hematoma, or required return to theater. All SAT closure patients had complete wound healing at outpatient follow-up at six weeks. No SAT closure was found to be cosmetically unacceptable or required wound revision for any reason at up to one year postoperatively. Conclusion SATs are a safe and reliable means of wound closure for VBS. Conversion to SC due to continued intraoperative wound site bleeding is rarely required.
背景 皮肤粘合带（SATs）是常用于经皮椎体成形术（PVP）伤口闭合的低过敏性胶带。椎体支架置入术（VBS）是一种用于治疗椎体骨折的金属球囊扩张支架。其球囊和支架置入涉及比PVP更大的穿刺切口和椎弓根通道，增加了出血和伤口并发症的风险。本研究评估了使用SAT闭合VBS伤口的结果和并发症，以及转为传统缝合闭合（SC）的原因。
材料与方法 通过回顾计算机化病历，确定了2019年5月至2021年3月期间接受VBS的一系列回顾性患者。收集伤口闭合方法、转为SC的原因、手术节段数、术后伤口并发症如接触性皮炎、张力性水泡、胶带移位、手术部位感染、伤口裂开、有症状血肿以及返回手术室等数据。在门诊随访时评估伤口的完全愈合情况和美观程度。
结果 共确定36例患者。33例（91.6%）患者采用SAT闭合，3例（8.3%）患者采用SC闭合。2例（5.5%）患者因术中伤口持续出血而需要意外转为SC闭合，1例（2.7%）患者作为分期手术的一部分计划采用SC闭合。32例（97.0%）SAT闭合患者伤口顺利愈合。1例（3%）SAT闭合患者术后出现敷料被血浸湿和胶带移位情况，但在病房重新应用SAT后恢复顺利。采用SAT闭合的患者均未发生接触性皮炎、张力性水泡、手术部位感染、伤口裂开、有症状血肿或需返回手术室的情况。所有采用SAT闭合的患者在六周门诊随访时伤口均完全愈合。术后长达一年，未发现任何SAT闭合在美观上不可接受或因任何原因需要伤口修复的情况。
结论 SATs是VBS伤口闭合的一种安全可靠的方法。因术中伤口部位持续出血而转为SC的情况很少见。
