title: A prospective study of two methods of closing surgical scalp wounds.
abstract: OBJECTIVE
  Scalp wounds are commonly closed in two layers, although single layer closure is feasible. This study prospectively compared the two methods of closing scalp wounds.
  
  
  METHODS
  Patients with non-traumatic scalp wounds were allocated to either the single layer closure group or the multilayer closure group. We obtained relevant data from the patients. The primary outcome measures were wound edge related complications, rate of suturing and cost of sutures used for suturing.
  
  
  RESULTS
  Thirty-one wounds were in the single layer closure group and 30 were in the multilayer closure group. Age range was 1-80 years. The most common indication for making a scalp incision was subdural hematoma, representing 27.8% of all the indications. The most common surgery was burr hole drainage of subdural hematoma. Polyglactin acid suture was used for the inner layer and polyamide -00- for the final layer in the multilayer closure group. Only the latter suture was used for the single layer closure method. Total cost of suturing per wound in the single layer closure group was N= 100 (0.70USD) and N= 800 (5.30USD) in the multilayer group. The mean rate of closure was 0.39 ± 1.89 mm/sec for single layer closure and 0.23 ± 0.89 mm/sec in multilayer closure. The difference was statistically significant. Wound edge related complication rate was 19.35% in the single layer closure group and 16.67% in the multilayer closure method group. The difference was not statistically significant (z: 0.00, p value: 1.000; Pearson chi-squared (DF = 1)= 0.0075, p = 0.0785).
  
  
  CONCLUSIONS
  The study shows that closing the scalp in one layer is much faster and more cost effective compared to the multilayer closure method. We did not observe significant difference in the complication rates in the two methods of closure. Long-term outcome, especially cosmetic outcome, remains to be determined in this preliminary study.
authors: Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile Ife, Nigeria. adeoluaa@yahoo.com
authors: A A
authors: AA
authors: Adeolu
authors: J K
authors: JK
authors: Olabanji
authors: E O
authors: EO
authors: Komolafe
authors: A O
authors: AO
authors: Ademuyiwa
authors: A O
authors: AO
authors: Awe
authors: A O
authors: AO
authors: Oladele
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011098:Polyglactin 910 / Q000191:economics / Q000627:therapeutic use; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012535:Scalp / Q000293:injuries / Q000601:surgery*; D013536:Suture Techniques / Q000191:economics*; D013537:Sutures / Q000191:economics*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult
chemical_list: D011098:Polyglactin 910