Surgical site infection in spinal surgery: a comparative study between 2-octyl-cyanoacrylate and staples for wound closure

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• 作者：Muneharu Ando (1)
  Tetsuya Tamaki (1)
  Munehito Yoshida (2)
  Shunji Sasaki (1)
  Yasushi Toge (1)
  Takuji Matsumoto (1)
  Kazuhiro Maio (1)
  Ryosuke Sakata (1)
  Daisuke Fukui (1)
  Seiji Kanno (3)
  Yukihiro Nakagawa (2)
  Hiroshi Yamada (2)
  
• 关键词：Surgical site infection ; Spinal surgery ; Wound closure ; 2 ; Octyl ; cyanoacrylate ; Staples
• 刊名：European Spine Journal
• 出版年：2014
• 出版时间：April 2014
• 年：2014
• 卷：23
• 期：4
• 页码：854-862
• 全文大小：277 KB
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• 作者单位：Muneharu Ando (1)
  Tetsuya Tamaki (1)
  Munehito Yoshida (2)
  Shunji Sasaki (1)
  Yasushi Toge (1)
  Takuji Matsumoto (1)
  Kazuhiro Maio (1)
  Ryosuke Sakata (1)
  Daisuke Fukui (1)
  Seiji Kanno (3)
  Yukihiro Nakagawa (2)
  Hiroshi Yamada (2)
  
  1. Department of Orthopedic Surgery, Wakayama Rosai Hospital, 93-1 Kinomoto, Wakayama, Wakayama, 640-8505, Japan
  2. Department of Orthopedic Surgery, Wakayama Medical University, Wakayama, Japan
  3. Department of Orthopedic Surgery, The Cancer Institute Hospital of JFCR, Tokyo, Japan
  
• ISSN：1432-0932

文摘

Background Surgical site infection (SSI) after spinal surgery is a devastating complication. Various methods of skin closure are used in spinal surgery, but the optimal skin-closure method remains unclear. A recent report recommended against the use of metal staples for skin closure in orthopedic surgery. 2-Octyl-cyanoacrylate (Dermabond; Ethicon, NJ, USA) has been widely applied for wound closure in various surgeries. In this cohort study, we assessed the rate of SSI in spinal surgery using metal staples and 2-octyl-cyanoacrylate for wound closure. Methods This study enrolled 609 consecutive patients undergoing spinal surgery in our hospital. From April 2007 to March 2010 surgical wounds were closed with metal staples (group 1, n?=?294). From April 2010 to February 2012 skin closure was performed using 2-octyl-cyanoacrylate (group 2, n?=?315). We assessed the rate of SSI using these two different methods of wound closure. Prospective study of the time and cost evaluation of wound closure was performed between two groups. Results Patients in the 2-octyl-cyanoacrylate group had more risk factors for SSI than those in the metal-staple group. Nonetheless, eight patients in the metal-staple group compared with none in the 2-octyl-cyanoacrylate group acquired SSIs (p?<?0.01). The closure of the wound in length of 10?cm with 2-octyl-cyanoacrylate could save 28?s and $13.5. Conclusions This study reveals that in spinal surgery, wound closure using 2-octyl-cyanoacrylate was associated with a lower rate of SSI than wound closure with staples. Moreover, the use of 2-octyl-cyanoacrylate has a more time saving effect and cost-effectiveness than the use of staples in wound closure of 10?cm in length.