Skin Glue for Wounds Closure in Brain Surgery: Our Updated Experience.


Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
Jan 2019
Historique:
received: 30 07 2018
revised: 02 10 2018
accepted: 03 10 2018
pubmed: 20 10 2018
medline: 3 1 2019
entrez: 19 10 2018
Statut: ppublish

Résumé

Traditional wound closure techniques include skin sutures and metal clips. Cyanoacrylate has good neovascularization, epithelialization, and antimicrobial activity properties and a fast application procedure. This study presents our long-term experience. We retrospectively selected 362 patients who underwent brain surgery from January 2007 to March 2017. Exclusion criteria were applied for repeat surgeries, emergency/posttraumatic procedures, wound infections, wounds longer than 16 cm, skull base cases, and postoperative patients who stayed in the intensive care unit more than 1 day. We collected data from 250 cases of supratentorial procedures and 112 cases of infratentorial procedures. The median wound length was 11 cm (range, 4-15 cm); the median age was 51 years. We followed-up all patients for 1, 3, and 12 months focusing on wound complications, cosmetic results, based on the Hollander Wound Evaluation Scale (HWES), and patient satisfaction using a visual analog scale. Cosmetic results were very good (HWES score of 5-6) in 99.5% of cases at 12 months. Patient satisfaction reached almost 100% at 12 months. We experienced 2 cases of wound dehiscence and 2 others with poor cosmetic results. The main complaint was a feeling of discomfort, during the first 2 weeks after surgery, because of the dried glue along the wound's edges. With additional research, we can confirm that cyanoacrylate glue may be a valid and useful alternative to traditional techniques for wound closure in brain surgery, carrying several advantages. However, a randomized controlled trial with a large number of patients is warranted to confirm our findings.

Sections du résumé

BACKGROUND BACKGROUND
Traditional wound closure techniques include skin sutures and metal clips. Cyanoacrylate has good neovascularization, epithelialization, and antimicrobial activity properties and a fast application procedure. This study presents our long-term experience.
METHODS METHODS
We retrospectively selected 362 patients who underwent brain surgery from January 2007 to March 2017. Exclusion criteria were applied for repeat surgeries, emergency/posttraumatic procedures, wound infections, wounds longer than 16 cm, skull base cases, and postoperative patients who stayed in the intensive care unit more than 1 day. We collected data from 250 cases of supratentorial procedures and 112 cases of infratentorial procedures. The median wound length was 11 cm (range, 4-15 cm); the median age was 51 years. We followed-up all patients for 1, 3, and 12 months focusing on wound complications, cosmetic results, based on the Hollander Wound Evaluation Scale (HWES), and patient satisfaction using a visual analog scale.
RESULTS RESULTS
Cosmetic results were very good (HWES score of 5-6) in 99.5% of cases at 12 months. Patient satisfaction reached almost 100% at 12 months. We experienced 2 cases of wound dehiscence and 2 others with poor cosmetic results. The main complaint was a feeling of discomfort, during the first 2 weeks after surgery, because of the dried glue along the wound's edges.
CONCLUSIONS CONCLUSIONS
With additional research, we can confirm that cyanoacrylate glue may be a valid and useful alternative to traditional techniques for wound closure in brain surgery, carrying several advantages. However, a randomized controlled trial with a large number of patients is warranted to confirm our findings.

Identifiants

pubmed: 30336296
pii: S1878-8750(18)32316-7
doi: 10.1016/j.wneu.2018.10.023
pii:
doi:

Substances chimiques

Tissue Adhesives 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e940-e946

Informations de copyright

Copyright © 2018 Elsevier Inc. All rights reserved.

Auteurs

Leonello Tacconi (L)

Neurosurgical Unit, Azienda Ospedaliera Universitaria Integrata, Triestei, Italy. Electronic address: leonello.tacconi@asuits.sanita.fvg.it.

Roberto Spinelli (R)

Neurosurgical Unit, Azienda Ospedaliera Universitaria Integrata, Triestei, Italy.

Francesco Signorelli (F)

Neurosurgical Unit, Azienda Ospedaliera Universitaria, Bari, Italy.

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