BACKGROUND Hair-sparing techniques in cranial neurosurgery have gained traction in recent years and previous studies have shown no difference in infection rates, yet limited data exists evaluating the specific closure techniques utilized during hair-sparing craniotomies. Therefore, it was the intention of this study to evaluate the rate of surgical site infections (SSIs) and perioperative complications associated with using an absorbable intradermal barbed suture for skin closure in hair-sparing supratentorial craniotomies for tumor in order to prove non-inferiority to traditional methods. METHODS A retrospective review of supratentorial craniotomies for tumor by a single surgeon from 2011 to 2017 was performed. All perioperative adverse events and wound complications, defined as a postoperative infection, wound dehiscence, or CSF leak, were compared between three different groups: (1) hair shaving craniotomies + transdermal polypropylene suture/staples for scalp closure, (2) hair-sparing craniotomies + transdermal polypropylene suture/staples for scalp closure, and (3) hair-sparing craniotomies + absorbable intradermal barbed suture for scalp closure. RESULTS Two hundred sixty-three patients underwent hair shaving + transdermal polypropylene suture/staples, 83 underwent hair sparing + transdermal polypropylene suture/staples, and 100 underwent hair sparing + absorbable intradermal barbed suture. Overall, 2.9% of patients experienced a perioperative complication and 4.3% developed a wound complication. In multivariable analysis, the use of a barbed suture for scalp closure and hair-sparing techniques was not predictive of any complication or 30-day readmission. Furthermore, the absorbable intradermal barbed suture cohort had the lowest overall rate of wound complications (4%). CONCLUSIONS Hair-sparing techniques using absorbable intradermal barbed suture for scalp closure are safe and do not result in higher rates of infection, readmission, or reoperation when compared with traditional methods.

中文翻译：

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在幕上开颅手术中使用可吸收皮内倒刺缝合线的留毛技术与传统闭合方法的比较。

背景技术近年来，颅神经外科中的留毛技术受到关注，之前的研究表明感染率没有差异，但评估留毛开颅手术中使用的特定闭合技术的数据有限。因此，本研究的目的是评估手术部位感染 (SSI) 的发生率和与使用可吸收皮内倒刺缝线缝合皮肤在留毛幕上开颅手术中相关的围手术期并发症的发生率，以证明其非劣效性。传统方法。方法回顾性分析2011年至2017年由一名外科医生对肿瘤幕上开颅手术的情况。所有围手术期不良事件和伤口并发症，定义为术后感染、伤口裂开或脑脊液漏，在三个不同组之间进行比较：（1）剃须开颅术+用于头皮闭合的经皮聚丙烯缝合线/钉书钉，（2）留毛开颅术+用于头皮闭合的经皮聚丙烯缝合线/钉钉，以及（3）留毛开颅术+可吸收的用于头皮闭合的皮内倒钩缝合。结果 263例患者接受了剃毛+透皮聚丙烯缝合线/钉，83例接受了留毛+透皮聚丙烯缝合线/钉，100例接受了留毛+可吸收皮内倒刺缝合线。总体而言，2.9% 的患者出现围手术期并发症，4.3% 的患者出现伤口并发症。在多变量分析中，使用倒钩缝合头皮闭合和留发技术不能预测任何并发症或 30 天再入院。此外，可吸收皮内倒刺缝合线队列的伤口并发症总体发生率最低 (4%)。结论 与传统方法相比，使用可吸收皮内倒刺缝合线缝合头皮的留发技术是安全的，不会导致更高的感染率、再入院率或再次手术率。