title: Octyl-cyanoacrylate skin adhesive is effective for wound closure in posterior spinal surgery without increased risk of wound complications.
abstract: OBJECTIVE
  Few published studies have examined the complication profile after posterior spinal surgery wherein absorbable, subcuticular suture and cyanoacrylate skin adhesives (CSA) were used for incision closure. The purpose of this report is to compare the rate and profile of wound complications in a large number of patients who underwent posterior spinal surgery with CSA skin closure to rates of similar complications with standard nylon closure techniques.
  
  
  METHODS
  The prospective database of all surgical cases maintained by the senior author was retrospectively reviewed. Three hundred eighty-two patients underwent posterior spinal surgery for degenerative, oncologic and traumatic pathology. Wound-related complications, including cerebrospinal fluid leak, wound infection and dehiscence were analyzed in all patients.
  
  
  RESULTS
  These data establish that the incisions in patients who undergo posterior spinal surgery can be safely and successfully closed with subcuticular Monocryl™ and CSA without increased risk of CSF leak, wound infection or dehiscence. Rates of these complications were similar between the study population, a small subset of patients treated with traditional closure techniques and those in the established literature.
  
  
  CONCLUSIONS
  CSA is a safe method to achieve ultimate skin closure in patients who undergo posterior spinal surgery without increased risk of wound-related complications, even in those patients undergoing intradural procedures.
authors.affiliation: School of Medicine, Emory University, Atlanta 30322, USA; Department of Neurological Surgery, Emory University, Atlanta 30322, USA. Electronic address: brian.howard@emory.edu.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Howard
authors.affiliation: School of Medicine, Emory University, Atlanta 30322, USA; Department of Neurological Surgery, Emory University, Atlanta 30322, USA.
authors.forename: Sheila R
authors.initials: SR
authors.lastname: Eshraghi
authors.affiliation: School of Medicine, Emory University, Atlanta 30322, USA; Department of Neurological Surgery, Emory University, Atlanta 30322, USA.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Holland
authors.affiliation: School of Medicine, Emory University, Atlanta 30322, USA; Department of Neurological Surgery, Emory University, Atlanta 30322, USA; The Emory Spine Center, Emory University, Atlanta 30322, USA; Department of Orthopedic Surgery, Emory University, Atlanta 30322, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Refai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003487:Cyanoacrylates / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011446:Prospective Studies; D012306:Risk; D012867:Skin / Q000187:drug effects; D013131:Spine / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology*; D013536:Suture Techniques; D014014:Tissue Adhesives / Q000627:therapeutic use*; D058106:Wound Closure Techniques; D055815:Young Adult
chemical_list: D003487:Cyanoacrylates; D014014:Tissue Adhesives
keywords: Cyanoacrylate skin adhesives; Spine surgery; Surgical site infection; Wound closure; Wound complication