title: Stretch of the minimally invasive incision during thyroid and parathyroid surgery.
abstract: OBJECTIVE
  Identify and quantify changes in length of the skin incision following minimally invasive thyroid and parathyroid surgery and determine whether these changes persist postoperatively.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Tertiary care teaching hospital.
  
  
  METHODS
  Between July 2012 and June 2013, a prospective, nonrandomized study was performed on 44 consecutive patients undergoing open cervical minimally invasive thyroidectomy (incision approximately 6 cm or less) or minimally invasive parathyroidectomy (incision approximately 3 cm or less). Incision length was measured following initial incision, immediately after wound closure, and on postoperative follow-up at 2-week and 14-week visits.
  
  
  RESULTS
  Thirty-one patients underwent minimally invasive thyroidectomy or parathyroidectomy with initial incision lengths ranging from 20 mm to 60 mm. Seven patients (21%) underwent total thyroidectomy with a mean length of 45 ± 8 mm, 15 patients (44%) underwent unilateral thyroid lobectomy with a mean length of 37 ± 5 mm, and 9 patients (26%) underwent parathyroidectomy with a mean length of 28 ± 2 mm. On average, the skin incision lengthened by 3.0 ± 0.9 mm during surgery representing an intraoperative stretch of 8.0% (P < .0001). Incision lengths decreased by an average of 0.3 mm at 2-week postoperative follow-up (ns) and 6.3 mm at 14-week postoperative follow-up (P < .0001).
  
  
  CONCLUSIONS
  Significant intraoperative incision stretch is likely to occur during minimally invasive thyroid and parathyroid surgery. Postoperative follow-up data suggest that the increase in incision length is not permanent and resolves upon postoperative follow-up.
authors: University of Missouri School of Medicine, Columbia, Missouri, USA.
authors: Nan
authors: N
authors: Chen
authors: University of Missouri School of Medicine, Columbia, Missouri, USA.
authors: Lauren A
authors: LA
authors: Stephenson
authors: Department of Otolaryngology-Head and Neck Surgery, University of Missouri School of Medicine, Columbia, Missouri, USA.
authors: Jeffrey B
authors: JB
authors: Jorgensen
authors: Department of Otolaryngology-Head and Neck Surgery, University of Missouri School of Medicine, Columbia, Missouri, USA zitschr@health.missouri.edu.
authors: Robert P
authors: RP
authors: Zitsch
mesh_terms: D015331:Cohort Studies; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D010279:Parathyroid Diseases / Q000473:pathology / Q000601:surgery*; D016105:Parathyroidectomy / Q000379:methods*; D013536:Suture Techniques; D013959:Thyroid Diseases / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D013997:Time Factors; D014945:Wound Healing
keywords: cosmesis; incision; minimally invasive; parathyroidectomy; stretch; thyroidectomy