{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T01:40:10Z","timestamp":1746150010867,"version":"3.40.4"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n            <jats:title>Summary:<\/jats:title>\n            <jats:p>Following neurosurgical repair of spinal dysraphism defects, soft-tissue reconstruction is often required to obtain robust coverage of the dura. Layered closure utilizing local muscle and muscle fascia has proven reliable for this purpose, but it often results in significant dead space necessitating closed suction drainage. Progressive-tension sutures have been reported as an alternative to drains for prevention of fluid collection in several other procedures. In this study, the use of progressive-tension sutures for eliminating subcutaneous dead space and obtaining tension-free skin closure was prospectively evaluated in pediatric patients undergoing soft-tissue reconstruction for congenital spinal anomalies. Primary outcomes of interest included wound breakdown, seroma, hematoma, and cerebrospinal fluid leak. Patients were excluded if a lumbar, submuscular, or subcutaneous drain was placed during the index procedure. Over a 3-year period, 45 patients underwent muscle flap reconstruction for coverage of dural defects. The primary diagnoses were myelomeningocele (10 patients), lipomyelomeningocele (eight patients), myelocystocele (three patients), tethered cord release (15 patients), meningocele (three patients), spinal tumor (two patients), and hardware exposure following spinal instrumentation (three patients). During the follow-up period, three patients (6.7 percent) had postoperative wound complications. One patient had superficial dehiscence, one had cerebrospinal fluid leak requiring operative revision, and one had a surgical site infection necessitating operative drainage. No patients developed hematomas, seromas, cerebrospinal fluid fistulae, or wound breakdown requiring operative revision. The use of progressive-tension sutures is an effective method for eliminating subcutaneous dead space in pediatric soft-tissue reconstruction and eliminates the need for drain placement.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CLINICAL QUESTION\/LEVEL OF EVIDENCE:<\/jats:title>\n            <jats:p>Therapeutic, IV.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/prs.0000000000009331","type":"journal-article","created":{"date-parts":[[2022,6,8]],"date-time":"2022-06-08T15:02:36Z","timestamp":1654700556000},"page":"435e-438e","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Progressive-Tension Sutures in Reconstruction of Posterior Trunk Defects in Pediatric Patients: A Prospective Series"],"prefix":"10.1097","volume":"150","author":[{"given":"Christopher S.","family":"Crowe","sequence":"first","affiliation":[{"name":"From the Craniofacial Center, Division of Plastic and Craniofacial Surgery, and Department of Neurosurgery, Seattle Children\u2019s Hospital."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason S.","family":"Hauptman","sequence":"additional","affiliation":[{"name":"From the Craniofacial Center, Division of Plastic and Craniofacial Surgery, and Department of Neurosurgery, Seattle Children\u2019s Hospital."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Lee","sequence":"additional","affiliation":[{"name":"From the Craniofacial Center, Division of Plastic and Craniofacial Surgery, and Department of Neurosurgery, Seattle Children\u2019s Hospital."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard G.","family":"Ellenbogen","sequence":"additional","affiliation":[{"name":"From the Craniofacial Center, Division of Plastic and Craniofacial Surgery, and Department of Neurosurgery, Seattle Children\u2019s Hospital."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Russell E.","family":"Ettinger","sequence":"additional","affiliation":[{"name":"From the Craniofacial Center, Division of Plastic and Craniofacial Surgery, and Department of Neurosurgery, Seattle Children\u2019s Hospital."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srinivas M.","family":"Susarla","sequence":"additional","affiliation":[{"name":"From the Craniofacial Center, Division of Plastic and Craniofacial Surgery, and Department of Neurosurgery, Seattle Children\u2019s Hospital."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,6,9]]},"reference":[{"key":"R1-20250502","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1002\/bjs.18004620012","article-title":"The use of rotation flaps following excision of lumbar myelo-meningoceles: An aid to the closure of large defects.","volume":"46","author":"Patterson","year":"1959","journal-title":"Br J Surg"},{"key":"R2-20250502","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1097\/00006534-198503000-00015","article-title":"Wound closure of the myelomeningocoele defect.","volume":"75","author":"Luce","year":"1985","journal-title":"Plast Reconstr Surg"},{"key":"R3-20250502","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1016\/j.bjps.2012.03.029","article-title":"Extradural myelomeningocele reconstruction using local turnover fascial flaps and midline linear skin closure.","volume":"65","author":"Patel","year":"2012","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"R4-20250502","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1007\/s00381-010-1099-9","article-title":"Local and regional flap closure in myelomeningocele repair: A 15-year review.","volume":"26","author":"Lien","year":"2010","journal-title":"Childs Nerv Syst"},{"key":"R5-20250502","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1055\/s-0031-1275492","article-title":"Closure of large myelomeningocele by lumbar artery perforator flaps.","volume":"27","author":"El-Sabbagh","year":"2011","journal-title":"J Reconstr Microsurg"},{"key":"R6-20250502","doi-asserted-by":"crossref","first-page":"2729","DOI":"10.1007\/s00586-017-4983-0","article-title":"The current state of the evidence for the use of drains in spinal surgery: Systematic review.","volume":"26","author":"Patel","year":"2017","journal-title":"Eur Spine J"},{"key":"R7-20250502","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1097\/00002517-199610000-00006","article-title":"Efficacy of closed wound suction drainage after single-level lumbar laminectomy.","volume":"9","author":"Payne","year":"1996","journal-title":"J Spinal Disord"},{"key":"R8-20250502","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1097\/00007632-198709000-00014","article-title":"Cauda equina syndrome following lumbar spinal stenosis surgery.","volume":"12","author":"Boccanera","year":"1987","journal-title":"Spine (Phila Pa 1976)"},{"key":"R9-20250502","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1097\/00007632-200405150-00003","article-title":"A randomized study of closed wound suction drainage for extensive lumbar spine surgery.","volume":"29","author":"Brown","year":"2004","journal-title":"Spine (Phila Pa 1976)"},{"key":"R10-20250502","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1007\/s00586-004-0801-6","article-title":"The role of closed-suction drainage in preventing epidural fibrosis and its correlation with a new grading system of epidural fibrosis on the basis of MRI.","volume":"14","author":"Sen","year":"2005","journal-title":"Eur Spine J"},{"issue":"Suppl 1","key":"R11-20250502","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.1089\/sur.2006.7.s1-7","article-title":"Risk factors for surgical site infection.","volume":"7","author":"Cheadle","year":"2006","journal-title":"Surg Infect (Larchmt)"},{"key":"R12-20250502","doi-asserted-by":"crossref","first-page":"2583","DOI":"10.1097\/00006534-200006000-00047","article-title":"Progressive tension sutures: A technique to reduce local complications in abdominoplasty.","volume":"105","author":"Pollock","year":"2000","journal-title":"Plast Reconstr Surg"},{"key":"R13-20250502","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/S1090-820X(98)70073-1","article-title":"Seroma: How to avoid it and how to treat it.","volume":"18","author":"Baroudi","year":"1998","journal-title":"Aesthet Surg J"},{"key":"R14-20250502","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1097\/00006534-200102000-00057","article-title":"Progressive tension sutures to reduce complications in abdominoplasty.","volume":"107","author":"Mladick","year":"2001","journal-title":"Plast Reconstr Surg"},{"key":"R15-20250502","first-page":"440","article-title":"Does the addition of progressive tension sutures to drains reduce seroma incidence after abdominoplasty? A systematic review and meta-analysis.","volume":"37","author":"Jabbour","year":"2017","journal-title":"Aesthet Surg J"},{"key":"R16-20250502","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/S1090-820X(03)90020-3","article-title":"Management of face lifts with progressive tension sutures.","volume":"23","author":"Pollock","year":"2003","journal-title":"Aesthet Surg J"},{"key":"R17-20250502","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.asj.2007.05.011","article-title":"Subcutaneous brow lift with precise suture fixation and advancement.","volume":"27","author":"Pollock","year":"2007","journal-title":"Aesthet Surg J"},{"key":"R18-20250502","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.1097\/01.PRS.0000090542.68560.69","article-title":"Progressive tension sutures to prevent seroma formation after latissimus dorsi harvest.","volume":"112","author":"Rios","year":"2003","journal-title":"Plast Reconstr Surg"},{"key":"R19-20250502","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.ijsu.2016.03.004","article-title":"Prevention of postoperative seromas with dead space obliteration: A case-control study.","volume":"29","author":"Aho","year":"2016","journal-title":"Int J Surg"},{"key":"R20-20250502","doi-asserted-by":"crossref","first-page":"e2089","DOI":"10.1097\/GOX.0000000000002089","article-title":"Reconstruction of lumbar spinal defects: Case series, literature review, and treatment algorithm.","volume":"7","author":"Daly","year":"2019","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"R21-20250502","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1097\/SAP.0b013e31822f9ada","article-title":"Outcomes of tethered cord repair with a layered soft tissue closure.","volume":"70","author":"Levi","year":"2013","journal-title":"Ann Plast Surg"},{"key":"R22-20250502","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1097\/SAP.0000000000002374","article-title":"A simplified approach to myelomeningocele defect repair.","volume":"86","author":"Brown","year":"2021","journal-title":"Ann Plast Surg"},{"key":"R23-20250502","doi-asserted-by":"crossref","first-page":"337","DOI":"10.21037\/jss.2019.09.02","article-title":"Pediatric tethered cord release: An epidemiological and postoperative complication analysis.","volume":"5","author":"Bhimani","year":"2019","journal-title":"J Spine Surg"},{"key":"R24-20250502","doi-asserted-by":"crossref","first-page":"416","DOI":"10.3171\/2016.1.PEDS15674","article-title":"Thirty-day outcomes after postnatal myelomeningocele repair: A National Surgical Quality Improvement Program Pediatric database analysis.","volume":"18","author":"Cherian","year":"2016","journal-title":"J Neurosurg Pediatr"}],"container-title":["Plastic &amp; Reconstructive Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PRS.0000000000009331","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T01:01:37Z","timestamp":1746147697000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PRS.0000000000009331"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,9]]},"references-count":24,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1097\/prs.0000000000009331","relation":{},"ISSN":["0032-1052"],"issn-type":[{"type":"print","value":"0032-1052"}],"subject":[],"published":{"date-parts":[[2022,6,9]]}}}