Coaptive film versus subcuticular suture: comparing skin closure time after posterior spinal instrumented fusion in pediatric patients with spinal deformity

Abstract

Study design: A prospective, randomized trial comparing skin closure time between coaptive film and subcuticular Monocryl sutures in children undergoing posterior instrumented spinal fusion.

Objective: To prospectively compare skin closure time, complication rate and cosmetic result between coaptive film and subcuticular Monocryl wound closures in pediatric spine surgery.

Summary of background data: Posterior instrumented spinal fusions for spinal deformity in children are time-consuming ventures that are demanding on both the patient and physician. Minimizing the time for skin closure at the end of prolonged surgery diminishes the physical burden on the surgeon, the operating room personnel, and reduces operating room costs.

Methods: Twenty-five children (mean age, 14.1 year) underwent posterior instrumented spinal fusion. Twenty-five incisions in 25 patients (12 closed with 3-0 subcuticular Monocryl sutures, 13 closed with coaptive film [Steri Strip S; 3 M company]) were evaluated. The method of skin closure was randomized before beginning the procedure and the surgeon informed just before skin closure. Closure time was recorded. A blinded plastic surgeon using a visual analogue scale assessed the cosmetic results at a minimum 3-month follow-up.

Results: Incisions closed with coaptive film required less time to complete than incisions closed with subcuticular suture. The mean time for skin closure using coaptive film was 290.62 seconds compared to the mean time of 674.75 seconds using Monocryl sutures (P < 0.000001). The average length of incisions closed with coaptive film was similar to the corresponding incisions that were closed with subcuticular Monocryl sutures (30.8 and 34.0 cm, respectively, P = 0.22). There was no significant difference in the cosmetic results or the number of wound complications using either technique.

Conclusion: Coaptive film is a time-saving option for skin closure following pediatric spine surgery with comparable cosmetic results and no difference in complication rates.