Background: Postoperative wound dehiscence is a major complication following spinal metastasis surgery, particularly in patients who receive preoperative radiotherapy or molecular-targeted therapy; however, preventive strategies remain limited.Objective: In this study, we aimed to identify the risk factors for postoperative wound dehiscence and evaluate the clinical utility of a novel curved skin incision (CSI) technique, designed to avoid irradiated areas, in comparison with the conventional midline incision (MI) technique.Methods: Logistic regression analysis was conducted on 107 patients who underwent MI between 2013 and 2018. Based on the results, we developed the CSI technique. Propensity score matching was performed to compare postoperative wound dehiscence in 29 matched pairs of patients treated with either CSI or MI from 2019 to 2021.Results: Preoperative radiotherapy and molecular-targeted therapy were found to be significant risk factors for wound dehiscence. CSI, which circumvents irradiated skin, was associated with a substantially lower rate of wound dehiscence than MI.Conclusions: The CSI technique offers a simple, reproducible, and effective surgical approach to reduce postoperative wound complications in high-risk patients. Its clinical benefit, especially for those with prior radiotherapy, suggests that it may serve as a valuable addition to standard spinal metastasis surgery.
背景：术后伤口裂开是脊柱转移瘤手术后的主要并发症，尤其在接受术前放疗或分子靶向治疗的患者中更为常见，但目前预防策略仍较为有限。 目的：本研究旨在识别术后伤口裂开的风险因素，并评估一种新型弧形皮肤切口（CSI）技术的临床实用性。该技术旨在避开放射区域，并与传统中线切口（MI）技术进行比较。 方法：对2013年至2018年间接受MI的107例患者进行逻辑回归分析。基于分析结果，我们开发了CSI技术。通过倾向评分匹配，比较了2019年至2021年间接受CSI或MI治疗的29对匹配患者的术后伤口裂开情况。 结果：术前放疗和分子靶向治疗被确定为伤口裂开的显著风险因素。与MI相比，CSI技术通过避开放射区域，显著降低了伤口裂开的发生率。 结论：CSI技术为高风险患者提供了一种简单、可重复且有效的手术方法，以减少术后伤口并发症。其临床益处，尤其对于既往接受放疗的患者，表明该技术可作为标准脊柱转移瘤手术的有价值补充。
肿瘤(癌症)患者之家