The effect of skin closure without suturing subcutaneous fat level on preventing fat liquefaction in patients undergoing posterior lumbar decompression and instrumentation

English Keywords:Lumbar  Internal fixation  Fat liquefaction

English Abstract:

  【Abstracts】 Objectives: To investigate the effect of skin closure without suturing subcutaneous fat level on preventing fat liquefaction in patients undergoing posterior lumbar decompression and instrumentation. Methods: A total of 91 patients with lumbar spinal stenosis undergoing posterior lumbar decompression and instrumentation from September 2014 to July 2015 in our institution were included. All these subjects were divided into 2 groups according to the type of skin closure. There were 63 patients(34 males and 29 females with an average of 54.7±12.4 years old, range, 27-72 years old) receiving skin closure without suturing subcutaneous fat level in group A and 28 patients(15 males and 13 females with an average of 53.2±14.4 years old, range, 25-79 years old) receiving conventional multilayer closure in group B. No significant differences with respect to average age, sex distribution, smoking or drinking ratio, average instrumentation level, mean operation time and mean blood loss were noted between these 2 groups(P>0.05). The duration of skin closure and incidence of fat liquefaction were compared between these 2 groups. Results: The average duration of skin closure was 16.4±1.8 minutes in group A. All the patients in group A had primary healing of the incision. Neither redness and swelling of incisions nor fat liquefaction occurred in group A. The average duration of skin closure was 25.7±5.7 minutes in group B. Six patients in group B had redness and swelling of incision. Among these 6 patients, 3 patients had fat liquefactions. Both the incidence of fat liquefaction and duration of skin closure were significantly higher in group B than those in group A(P<0.05). Conclusions: The skin closure without suturing subcutaneous fat level is superior to conventional multilayer closure in preventing fat liquefaction in patients undergoing posterior lumbar decompression and instrumentation, which deserves wide popularization.