Skin closure in vascular neurosurgery: A prospective study on absorbable intradermal suture versus nonabsorbable suture.
BACKGROUND
The craniotomy performed with minimal hair removal and closure with intradermal suture alone is an option in neurosurgical procedures, which can help faster psychological recovery of the patient, as it allows a better cosmetic result. This study is aimed at evaluating if such method is safe and effective, compared with continuous skin sutures with 2-0 nylon.


METHODS
We analyzed the sutures in 117 patients undergoing craniotomies for cerebral aneurysm clipping. In the case group (n = 49), closure of the scalp was performed only with intradermal absorbable sutures using wire Monocryl(®) 2-0. In the control group (n = 68), closure was performed with continuous suture using 2-0 nylon.


RESULTS
The case group was composed of 49 patients in whom just intradermal suture was performed. One (2.2%) patient developed wound infection and was given proper medical treatment. No cases of dehiscence or cerebrospinal fluid leaks were observed. The control group was composed of 68 patients in whom the skin was closed with 2-0 nylon continuous suture. Three (5.3%) patients developed wound infection and were given proper medical treatment. There were no cases of wound dehiscence. The overall infection rate in the control group was 4%. There was no statistically significant difference in the number of wound infections between the two groups (P = 0.73).


CONCLUSIONS
The closure with intradermal suture alone in craniotomies is as safe as the traditional skin closure with nylon sutures, besides eliminating the need for suture removal and providing a cosmetic advantage.
Department of Neurosurgery, Santa Casa Hospital of Belo Horizonte, MG, Brazil.
Julio Leonardo Barbosa
JL
Pereira
Gerival
G
Vieira
Lucas Alverne Freitas
LA
de Albuquerque
George de Albuquerque Cavalcanti
Gde A
Mendes
Ludmila Rezende
LR
Salles
André Felipe Ferreira
AF
de Souza
Marcos
M
Dellaretti
Atos Alves
AA
de Sousa