Comparison of Plastic Surgeon and Spine Surgeon Closure in Revision Short Segment Thoracolumbar Spinal Fusions

Zhong, Judy; Balouch, Eaman; O'Malley, Nicholas; Maglaras, Constance; Stickley, Carolyn; León, Carlos; O’Connell, Brooke K.; Fischer, Charla R.; Protopsaltis, Themistocles S.; Buckland, Aaron J.

doi:10.1097/brs.0000000000003984

Cited by 4 publications

(1 citation statement)

References 22 publications

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“… 18 They found lower wound dehiscence rates, wound infection rates and readmission rates in their cohort compared with the comparison cohort. In contrast, Zhong et al 19 reviewed 357 spine surgeon closures compared with 52 PMCs, with PMC having increased odds for seroma formation (OR 7.8). They found no difference in complication rates, surgical site infection and return to the OR.…”

Section: Discussionmentioning

confidence: 99%

Plastic multilayered closure versus orthopedic surgeon closure after spinal instrumentation in pediatric neuromuscular scoliosis

Ezeokoli

Tamma

Borici

et al. 2023

World Jnl Ped Surgery

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ObjectiveTo compare wound complication rates between orthopedic closure (OC) and plastic multilayered closure (PMC) in patients undergoing primary posterior spinal fusion for neuromuscular scoliosis (NMS). We hypothesize that multilayered closure will be associated with better postoperative outcomes.MethodsWe collected data on pediatric patients diagnosed with NMS who underwent first time spinal instrumentation between 1 January 2018 and 31 May 2021. Patient demographics, length of surgery, spinal levels fused and operative variables, wound complication rate, treatments, and need for wound washout were reviewed in depth and recorded.ResultsIn total, 86 patients were reviewed: 46 with OC and 40 with PMC. There was a significant increase in operating room (OR) time with PMC compared with OC (6.7±1.2 vs 7.3±1.3, p=0.016). There was no difference in complication rate, mean postoperative day of complication or unplanned return to the OR for OC and PMC, respectively. There was a slightly significant increase in the number of patients going home with a drain in the PMC cohort compared with the OC cohort (2.1% vs 15%, p=0.046).ConclusionsPMC demonstrated longer OR times than OC and did not demonstrate a statistically significant reduction in wound complications or unplanned returns to the OR. However, other studies have demonstrated statistical and clinical significance with these variables. Surgical programs should review internal patient volumes and outcomes for spinal fusion in NMS patients and consider if PMC after spinal fusions in pediatric patients with NMS or other scoliosis subtypes is an appropriate option in their institution to minimize postoperative wound complications.

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Section: Discussionmentioning

confidence: 99%

Plastic multilayered closure versus orthopedic surgeon closure after spinal instrumentation in pediatric neuromuscular scoliosis

Ezeokoli

Tamma

Borici

et al. 2023

World Jnl Ped Surgery

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Systematic Review of Prophylactic Plastic Surgery Closure to Prevent Postoperative Wound Complications Following Spine Surgery

Guo,

Rivera Perla,

Leary

et al. 2024

World Neurosurgery

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The Value of Plastic Surgery Closure in Adults Undergoing Scoliosis Surgery

Nathaniel,

Doan,

Oleru

et al. 2023

Plast Surg (Oakv)

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Introduction: Surgical treatment for scoliosis can be done for functional and esthetic concerns. Surgical intervention may be associated with a complication rate of up to 40% in patients with non-idiopathic scoliosis, and 3% in patients with idiopathic scoliosis. In the present study, the authors sought to evaluate patients undergoing surgery for scoliosis with closure by the plastic and reconstructive surgery service. Methods: A retrospective cohort study was performed by extracting data, including demographics, surgical characteristics, and outcomes, from the electronic medical records of a single, large, tertiary care hospital and from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Data was collected for patients aged 18 to 75 undergoing spinal surgery for scoliosis from 2012 to 2020. Data collected from institutional records included only patients whose incision was closed by plastic and reconstructive surgery, while data from NSQIP was collected from all scoliosis surgery patients regardless of closure type. Results: A total of 98 scoliosis patients were identified who underwent closure by the plastic and reconstructive surgery service. These were compared to 1390 scoliosis patients in NSQIP for whom no specific closure details were noted. At 30-day post-operatively, readmission rates were 2.04% and 7.34% for the institutional and NSQIP cohorts, respectively ( P = 0.041), reoperation rates were 1.04% and 5.83% for the institutional and NSQIP cohorts, respectively ( P = 0.0384), and overall complication rates were 2.04% and 12.52% for the institutional and NSQIP cohorts, respectively ( P = 0.0005). Conclusion: Surgical intervention for scoliosis may benefit from closure by the plastic and reconstructive surgery service, which may yield potential lower rates of readmission, reoperation, and post-operative complication.

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Comparison of Plastic Surgeon and Spine Surgeon Closure in Revision Short Segment Thoracolumbar Spinal Fusions

Abstract: Ã Residual neurological compression reoperations include return to OR for stenosis, radiculopathy, or myelopathy within 90 days.Bold indicates statistically significant ( p<0.05).

Cited by 4 publications

References 22 publications

Plastic multilayered closure versus orthopedic surgeon closure after spinal instrumentation in pediatric neuromuscular scoliosis

Plastic multilayered closure versus orthopedic surgeon closure after spinal instrumentation in pediatric neuromuscular scoliosis

Systematic Review of Prophylactic Plastic Surgery Closure to Prevent Postoperative Wound Complications Following Spine Surgery

The Value of Plastic Surgery Closure in Adults Undergoing Scoliosis Surgery

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