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Expanded applications of knotless tissue control devices in neurosurgical cranial and spinal applications
Letter/Communication   Peer reviewed

Expanded applications of knotless tissue control devices in neurosurgical cranial and spinal applications

Samuel A. Tenhoeve, Clayton Rawson, Dora R. Tabachnick, Mohammed A. Azab, Omowumi Oladipo and Michael Karsy
Journal of clinical neuroscience, v 134, 111108
Apr 2025
DOI: https://doi.org/10.1016/j.jocn.2025.111108
PMID: 39923434
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Incision closure Knotless STRATAFIX Suture Neurosurgery
•Knotless suturing may provide effective closure for a variety of cranial and spinal cases.•Effective closure of cerebrospinal fluid compartments may be performed with knotless suture.•Additional techniques with knotless suture can expand the versatility of incision closure in neurosurgery. Effective wound closure is essential to neurosurgical procedures. Historical rates of neurosurgical wound complications range from 7 to 14 %. Knotless suturing with barbed sutures may offer effective closure rates but has had limited evaluation of safety in neurosurgical applications. Consecutive patients undergoing cranial, spinal, and peripheral nerve neurosurgical procedures from 12/2022 until 7/2024 were included in a quality improvement initiative. A retrospective review of demographics, past medical history, and operative and postoperative variables was undertaken. The primary outcome of interest was wound complications, including surgical site infection (SSI), dehiscence, or CSF leak. A cost analysis of suture treatment was also compared. A comparison to historical control rates (7%) was performed (one-sample proportional z-test). A total of 195 consecutive patients were identified, with 10 wound-related complications including 3 superficial dehiscence treated with washout, 2 pseudomeningoceles, 2 cerebrospinal fluid leaks with meningitis, and 1 each of deep dehiscence with washout, superficial dehiscence with antibiotics, and epidural hematoma. A total of 53 (27.2 %) underwent cranial, 140 (71.8 %) spine, and 3 (1.0 %) peripheral nerve procedures. Ten patients (5.1 %) had incision complications with no difference to historical controls (p = 0.3). Cost analysis showed a range 0.35–3.03X cost differences using the knotless suture technique for different neurosurgical applications. Knotless suture techniques can be an effective closure method for a variety of neurosurgical techniques comparable to expected wound complication rates. We expand on the potential applications of this technology compared with prior studies. Further studies will be necessary to confirm these findings.

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Clinical Neurology
Neurosciences
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