J Neurosurg 111:1175–1178, 2009.(DOI: 10.3171/2009.5.JNS081481)
Object. In this prospective randomized clinical trial, investigators looked at wound healing after craniotomy. The hypothesis was that the self-closing plastic scalp clips used for hemostasis on the skin edge might lead to local ized microscopic tissue damage and subsequent delayed wound healing.
Methods. The trial consisted of 2 arms in which different methods were used to secure scalp hemostasis: 1) the routinelyusedplasticclips (Scalpfix,Aesculap); and 2)the older method of artery forceps placed on the galea. Participants were restricted to those > 16 years of age undergoing craniotomies expected to last > 2 hours. Repeat operations were not included. One hundred fifty patients were enrolled.They were visited at 3 and 6 weeks postoperativel by an observer blinded to the method used, and the wounds were assessed for macroscopic epithelial closure, signs ofinfection, and hair regrowth by using a predefined assessment scale.
Results.The results showed no significant difference in wound healing between the 2 groups at either 3 weeks (OR 0.55, 95% CI 0.27–1.11; p = 0.09) or 6 weeks (OR 0.79, 95% CI 0.39–1.58; p = 0.50). The length of operation was found to be a significant factor affecting wound healing at 6 weeks (OR/hour 0.68,95%CI 0.51–0.92; p=0.01)
Conclusions.The use of Aesculap Scalpfix self-retaining plastic scalp clips on the skin edge during craniotomy surgery does not appear to affect wound healing significantly to the postoperative 6 week mark.