Prospective randomised comparison of subcutaneous closures after neck dissection in head and neck carcinomas: V-Loc wound closure device versus classical interrupted wound closure

Introduction The uni- or bilateral neneck dissection is part of the surgical therapy of head and neck carcinomas. Usually the wound closure is performed in several layers with resorbable subcutaneous closure followed by the suture of the skin. Aim was to compare the subcutaneous closure with Vicryl interrupted stitches versus running subcutaneous suture with the V-Loc device.

Material and Methods In 71 Patients undergoing bilateral neck dissections the subcutaneous closure was performed randomised on one side with Vicryl and on the other with V-Loc. The final skin suture for both sides was done with suture clips. We documentet time and length for each suture intraoperatively. On day two, five and ten ocurrence of dehiscence, drainage insuffisancy, blood crusts, step formation or fistulas were recorded. 3-6 months afterwards the scar on each side was rated by the patient and the investigator.

Results The mean age of the included patients was 61,94 (±11) years. The mean length oft he cut was 13,53 (±1,95) cm. There is a significant difference in average suture speed (p=0,044) between the V-Loc device 2,19 (±0,66) cm/min and Vicryl 1,98 (±0,78) cm/min while no significant difference showed fort he wound healing process as well as the aesthetic outcome after three months.

Conclusion The subcutaneous wound closure via V-loc device saves a significant amount of time in comparison to Vicryl while showing a similar safety and aesthetic outcome. An important aspect that should not be left unmentioned is the higher price of the V-loc device itself.

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Artikel online veröffentlicht:
24. Mai 2022