Comparison of 2 methods of incision closure in patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion surgery.
METHODS
A prospective, randomized, and controlled clinical trial.


OBJECTIVE
To compare surgical zipper with subcuticular Monocryl sutures in terms of incision closure time, cosmetic results, and the complication rate in patients with adolescent idiopathic scoliosis (AIS) undergoing posterior spinal fusion (PSF) surgery.


BACKGROUND
In previous literatures, the application of surgical zipper to incision closure has been reported to be associated with a favorable outcome. However, in the PSF surgery of patients with AIS, the use of surgical zipper has not been described.


METHODS
Ninety female patients with AIS undergoing PSF were assigned randomly to 2 incision closure groups either using surgical zipper or using the 4-0 absorbable subcuticular suture. The incision outcome was evaluated with the Hollander Incision Evaluation Score at 7 days, 2 weeks, 6 months, and 1 year after surgery, respectively. Besides, a visual analogue scale was allocated to each patient to rate the cosmetic result of the incision. The 2 groups were compared to determine the differences in terms of incision closure time, the complication rate, and cosmetic results.


RESULTS
The incision closure using surgical zipper consumed significantly less time than that using subcuticular suture (45.3 vs. 540.5 s, P < 0.001). As for the cosmetic results, no significant differences of Hollander Incision Evaluation Score scores between the 2 suturing groups were found. Besides, patients' satisfaction with cosmetic outcome on a linear visual analogue scale also revealed similar results between the 2 groups. As for postoperative complications, we found 1 case of mild blister due to allergy to the tape of the dressings and 2 cases of incisional pain in the Monocryl suture group.


CONCLUSIONS
The application of surgical zipper in PSF surgery is a safe and effective method. The ease and the speed of application make surgical zipper an attractive option for incision closure in patients with AIS undergoing PSF.


METHODS
4.
From The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
Leilei
L
Xu
Feng
F
Zhu
Zezhang
Z
Zhu
Zhen
Z
Liu
Xu
X
Sun
Jun
J
Qiao
Saihu
S
Mao
Yong
Y
Qiu
D000293:Adolescent; D002648:Child; D002681:China; D004146:Dioxanes; D005260:Female; D006801:Humans; D011091:Polyesters; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D012600:Scoliosis / Q000175:diagnosis / Q000601:surgery*; D013123:Spinal Fusion; D013536:Suture Techniques / Q000009:adverse effects / Q000295:instrumentation; D013537:Sutures; D013997:Time Factors; D016896:Treatment Outcome; D058106:Wound Closure Techniques / Q000009:adverse effects / Q000295:instrumentation; D014945:Wound Healing
D004146:Dioxanes; D011091:Polyesters; C095495:glycolide E-caprolactone copolymer