Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2024 Aug 13;166(1):336.
doi: 10.1007/s00701-024-06227-3.

Wound healing after intracutaneous vs. staple-assisted skin closure in lumbar, non-instrumented spine surgery: a multicenter prospective randomized trial

Alexander Romagna  1   2 , Jens Lehmberg  3 , Michael Meier  3 , Michael Stelzer  3 , Arwin Rezai  4 , Jürgen Volker Anton  4 , Albert Eckert  4 , Christoph J Griessenauer  4 , Maximilian-Niklas Bonk  5 , Bjoern Sommer  5 , Ehab Shiban  5   6 , Christian Blume  7 , Martin Geroldinger  8   9 , Christoph Schwartz  4
Affiliations
Randomized Controlled Trial

Wound healing after intracutaneous vs. staple-assisted skin closure in lumbar, non-instrumented spine surgery: a multicenter prospective randomized trial

Alexander Romagna et al. Acta Neurochir (Wien). .

Abstract

Purpose: Superficial surgical site infection (SSSI) is a prominent problem in spine surgery. Intracutaneous sutures and staple-assisted closure are two widely used surgical techniques for skin closure. Yet, their comparative impact on wound healing and infection rates is underexplored. Our goal was to address this gap and compare wound healing between these two techniques.

Methods: This study was a multicenter international prospective randomized trial. Patient data were prospectively collected at three large academic centers, patients who underwent non-instrumented lumbar primary spine surgery were included. Patients were intraoperatively randomized to either intracutaneous suture or staple-assisted closure cohorts. The primary endpoint was SSSI within 30 days after surgery according to the wound infection Centers for Disease Control and Prevention (CDC) classification system.

Results: Of 207 patients, 110 were randomized to intracutaneous sutures and 97 to staple-assisted closure. Both groups were homogenous with respect to epidemiological as well as surgical parameters. Two patients (one of each group) suffered from an A1 wound infection at the 30-day follow up. Median skin closure time was faster in the staple-assisted closure group (198 s vs. 13 s, p < 0,001).

Conclusion: This study showed an overall low superficial surgical site infection rate in both patient cohorts in primary non instrumented spine surgery.

Keywords: Intracutaneous suture; Lumbar spine surgery; Staples; Superficial surgical site infection; Wound healing.

PubMed Disclaimer

References

    1. Aguilar OJM, Sida KKA, Betancourt LÁ, Olvera MD, Bernaldez GIL, López RL, Oropeza EO, Ornelas HAT (2022) Variability in wound closure technique in midline posterior lumbar fusion surgery. International survey and standardized closure technique proposal. Surg Neurol Int 13:534. https://doi.org/10.25259/SNI_872_2022 - DOI - PubMed - PMC
    1. Anderson PA, Savage JW, Vaccaro AR, Radcliff K, Arnold PM, Lawrence BD, Shamji MF (2017) Prevention of surgical site infection in spine surgery. Neurosurgery 80:S114–S123. https://doi.org/10.1093/neuros/nyw066 - DOI - PubMed
    1. Ando M, Tamaki T, Yoshida M, Sasaki S, Toge Y, Matsumoto T, Maio K, Sakata R, Fukui D, Kanno S, Nakagawa Y, Yamada H (2014) Surgical site infection in spinal surgery: a comparative study between 2-octyl-cyanoacrylate and staples for wound closure. Eur Spine J 23:854–862. https://doi.org/10.1007/s00586-014-3202-5 - DOI - PubMed - PMC
    1. Johnston SS, Fortin SP, Pracyk JB, Tommaselli GA, Elangovanraaj N, Chen BP (2021) Economic and clinical outcomes of spinal fusion surgeries with skin closure through skin staples plus waterproof wound dressings versus 2-octyl cyanoacrylate plus polymer mesh tape. Spine J 21:45–54. https://doi.org/10.1016/j.spinee.2020.08.017 - DOI - PubMed
    1. Krishnan RJ, Crawford EJ, Syed I, Kim P, Rampersaud YR, Martin J (2019) Is the risk of infection lower with sutures than with staples for skin closure after orthopaedic surgery? A meta-analysis of randomized trials. Clin Orthop Relat Res 477:922–937. https://doi.org/10.1097/CORR.0000000000000690 - DOI - PubMed - PMC

Publication types

LinkOut - more resources