Skin Adhesive Tapes are an effective wound closure method for Percutaneous Vertebral Body Stenting, A Retrospective Cohort Study

Abstract

Abstract Background: Percutaneous Vertebral Body Stenting (VBS) is performed via a balloon-expandable metallic stent introduced through a stab incision to reduce and maintain the reduction of vertebral body fractures and minimise bone cement extravasation. The delivery of the balloon and stent involves a larger skin incision, soft tissue trauma and pedicle bore tract compared to traditional vertebroplasty (PVP) systems (4.7mm vs 2.59mm diameter), thus increasing the risk of bleeding and wound complications. Skin Adhesive Tapes (SATs) are a common method of wound closure for PVP. This study aims to evaluate the use of SATs in closure of larger VBS wounds. Methods: A retrospective cohort of patients who underwent percutaneous VBS (DePuy Synthes, USA) was obtained from electronic medical records at a tertiary hospital from May 2019 to March 2021. Data was collected for wound closure method (conventional non-absorbable suture, SAT), number of operative levels, postoperative skin-related complications, wound dehiscence, wound infection, bleeding, symptomatic haematomas and return to operating theatre. At follow-up post-discharge, the wounds were reviewed for complete healing and unsightly scarring requiring wound revision. SAT closure was performed by applying 3 strips of SATs to loosely oppose the wound edges. Results: 36 patients were identified with 45 levels of VBS performed. 3 (8.3%) patients received conventional suture closure, 33 (91.6%) received SAT closure. Conventional suture closure was performed due to ongoing bleeding at the wound site for 2 patients who had coagulopathy. The remaining patient received a planned suture closure in view of surgical expediency as part of a staged procedure.