{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T06:52:19Z","timestamp":1768891939228,"version":"3.49.0"},"reference-count":14,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nSurgical wound complications represent an important risk factor, particularly in multilevel lumbar fusions. However, the literature regarding optimal wound closure techniques for these procedures is limited.<\/jats:p>\n<\/jats:sec>\n\nMethods: <\/jats:title>\nWe performed an online survey of 61 spinal surgeons from 11 countries, involving 25 different hospitals. The study included 26 neurosurgeons, 21 orthopedists, and 14 residents (Neurosurgery \u2013 6 and orthopedics 8). The survey contained 17 questions on demographic information, closure techniques, and the use of drainage in posterior lumbar fusion surgery. We then developed a \u201cconsensus technique.\u201d<\/jats:p>\n<\/jats:sec>\n\nResults: <\/jats:title>\nThe proposed standardized closure techniques included: (1) using subfascial gravity drainage (i.e., without suction) with drain removal for <50 ml\/day or a maximum duration of 48 h, (2) paraspinal muscle, fascia, and supraspinous ligament closure using interrupted-X stitches 0 or 1 Vicryl or other longer-lasting resorbable suture (i.e., polydioxanone suture), (3) closure of subcutaneous tissue with interrupted inverted Vicryl 2-0 sutures in two planes for subcutaneous tissue greater >25 mm in depth, and (4) skin closure with simple interrupted nylon 3-0 sutures.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nThere is great variability between closure techniques utilized for multilevel posterior lumbar fusion surgery. Here, we have described various standardized\/evidence-based proven techniques for the closure of these wounds.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_872_2022","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T06:46:52Z","timestamp":1668754012000},"page":"534","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Variability in wound closure technique in midline posterior lumbar fusion surgery. International survey and standardized closure technique proposal"],"prefix":"10.25259","volume":"13","author":[{"given":"Oscar Josue Montes","family":"Aguilar","sequence":"first","affiliation":[{"name":"Department of Spine surgery, Spine Clinic \u201cDr. Manuel Dufoo Olvera,\u201d Specialty Hospital- National Medical Center \u201cLa Raza\u201d, Mexico City, Mexico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karmen Karina Alaniz","family":"Sida","sequence":"additional","affiliation":[{"name":"Department of Neuroanesthesiology, Specialty Hospital- National Medical Center \u201cLa Raza\u201d, Mexico City, Mexico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonardo \u00c1lvarez","family":"Betancourt","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Specialty Hospital- National Medical Center \u201cLa Raza\u201d, Mexico City, Mexico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel Dufoo","family":"Olvera","sequence":"additional","affiliation":[{"name":"Department of Spine surgery, Spine Clinic \u201cDr. Manuel Dufoo Olvera,\u201d Specialty Hospital- National Medical Center \u201cLa Raza\u201d, Mexico City, Mexico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillermo Ivan Ladewig","family":"Bernaldez","sequence":"additional","affiliation":[{"name":"Department of Spine surgery, Spine Clinic \u201cDr. Manuel Dufoo Olvera,\u201d Specialty Hospital- National Medical Center \u201cLa Raza\u201d, Mexico City, Mexico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ram\u00f3n L\u00f3pez","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Specialty Hospital- National Medical Center \u201cLa Raza\u201d, Mexico City, Mexico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edith Oropeza","family":"Oropeza","sequence":"additional","affiliation":[{"name":"Department of Spine surgery, Spine Clinic \u201cDr. Manuel Dufoo Olvera,\u201d Specialty Hospital- National Medical Center \u201cLa Raza\u201d, Mexico City, Mexico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e9ctor Alonso Tirado","family":"Ornelas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Specialty Hospital- National Medical Center \u201cLa Raza\u201d, Mexico City, Mexico."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2022,11,18]]},"reference":[{"key":"10.25259\/SNI_872_2022\/ref-1","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1007\/s00586-022-07130-0","article-title":"Lumbar surgical drains do not increase the risk of infections in patients undergoing spine surgery","volume":"31","author":"Buser","year":"2022","journal-title":"Eur Spine J"},{"key":"10.25259\/SNI_872_2022\/ref-2","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.cjtee.2016.01.008","article-title":"Subfascial drainage for management of cerebrospinal fluid leakage after posterior spine surgery-a prospective study based on Poiseuille\u2019s law","volume":"19","author":"Fang","year":"2016","journal-title":"Chin J Traumatol"},{"key":"10.25259\/SNI_872_2022\/ref-3","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2022.08.006","article-title":"Biomechanical considerations of the posterior surgical approach to the lumbar spine","author":"Haupt","year":"2022","journal-title":"Spine J"},{"key":"10.25259\/SNI_872_2022\/ref-4","first-page":"e6366","article-title":"Reattachment of the multifidus tendon in lumbar surgery to decrease postoperative back pain: A technical note","volume":"11","author":"Klinger","year":"2019","journal-title":"Cureus"},{"key":"10.25259\/SNI_872_2022\/ref-5","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1177\/2192568217699378","article-title":"Incidence, impact, and risk factors for 30-day wound complications following elective adult spinal deformity surgery","volume":"7","author":"Lee","year":"2017","journal-title":"Global Spine J"},{"key":"10.25259\/SNI_872_2022\/ref-6","doi-asserted-by":"crossref","first-page":"1652","DOI":"10.1097\/BRS.0b013e318241b186","article-title":"2012 young investigator award winner: The distribution of body mass as a significant risk factor for lumbar spinal fusion postoperative infections","volume":"37","author":"Mehta","year":"2012","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.25259\/SNI_872_2022\/ref-7","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1186\/s13018-016-0451-5","article-title":"Two-month longitudinal study of mechanical properties of absorbable sutures used in orthopedic surgery","volume":"11","author":"M\u00fcller","year":"2016","journal-title":"J Orthop Surg Res"},{"key":"10.25259\/SNI_872_2022\/ref-8","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1097\/01.bsd.0000190560.20872.a7","article-title":"Are drains useful for lumbar disc surgery? A prospective randomized clinical study","volume":"19","author":"Mirzai","year":"2006","journal-title":"J Spinal Disord Tech"},{"key":"10.25259\/SNI_872_2022\/ref-9","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1089\/sur.2019.212","article-title":"Nylon skin sutures carry a lower risk of post-operative infection than metal staples in open posterior spine surgery: A retrospective case-control study of 270 patients","volume":"21","author":"Shani","year":"2020","journal-title":"Surg Infect (Larchmt)"},{"key":"10.25259\/SNI_872_2022\/ref-10","doi-asserted-by":"publisher","DOI":"10.1177\/21925682211013770","article-title":"Which criterion for wound drain removal is better following posterior 1-level or 2-level lumbar fusion with instrumentation: Time driven or output driven?","author":"Shi","year":"2021","journal-title":"Global Spine J"},{"key":"10.25259\/SNI_872_2022\/ref-11","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1002\/bjs.11573","article-title":"Standardization in surgery: Friend or foe?","volume":"107","author":"Skjold-\u00d8degaard","year":"2020","journal-title":"Br J Surg"},{"key":"10.25259\/SNI_872_2022\/ref-12","doi-asserted-by":"crossref","first-page":"358","DOI":"10.21037\/jss.2019.08.01","article-title":"Watertightness of wound closure in lumbar spine-a comparison of different techniques","volume":"5","author":"Suter","year":"2019","journal-title":"J Spine Surg"},{"key":"10.25259\/SNI_872_2022\/ref-13","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1177\/2192568218774323","article-title":"Is there an optimal wound closure technique for major posterior spine surgery? A systematic review","volume":"8","author":"Yilmaz","year":"2018","journal-title":"Global Spine J"},{"key":"10.25259\/SNI_872_2022\/ref-14","first-page":"e3595","article-title":"Wound closure after posterior multilevel lumbar spine surgery: An anatomical cadaver study and technical note","volume":"10","author":"Yilmaz","year":"2018","journal-title":"Cureus"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/variability-in-wound-closure-technique-in-midline-posterior-lumbar-fusion-surgery-international-survey-and-standardized-closure-technique-proposal\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/variability-in-wound-closure-technique-in-midline-posterior-lumbar-fusion-surgery-international-survey-and-standardized-closure-technique-proposal\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T06:46:57Z","timestamp":1668754017000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/variability-in-wound-closure-technique-in-midline-posterior-lumbar-fusion-surgery-international-survey-and-standardized-closure-technique-proposal\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,18]]},"references-count":14,"alternative-id":["10.25259\/SNI_872_2022"],"URL":"https:\/\/doi.org\/10.25259\/sni_872_2022","relation":{},"ISSN":["2152-7806"],"issn-type":[{"value":"2152-7806","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,18]]},"article-number":"534"}}