Wound Closure in Nonidiopathic Scoliosis: Does Closure Matter?

James P. Ward, David S. Feldman, Justin Paul, Debra A. Sala, Thomas J. Errico, Norman Y. Otsuka, Michael S. Margiotta

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Background: Postoperative wound complications after posterior spinal fusion are difficult to manage. The incidence in the nonidiopathic patient population is significantly higher than the adolescent idiopathic population. A comparison of wound complications after posterior spinal fusion for nonidiopathic scoliosis between the utilization of the orthopaedic surgical team at the time of closure performing a nonstandardized wound closure versus a plastic surgeon with a plastic multilayered closure technique and rotational flap coverage when needed had not previously been evaluated. The purpose of this study was to compare the complication rate between nonstandardized and plastic multilayered closure of the surgical incision in patients undergoing posterior spinal fusion for nonidiopathic scoliosis. Methods: The charts of 76 patients with a primary diagnosis of scoliosis associated with a syndrome or neuromuscular disease and who underwent a posterior spinal fusion were reviewed. Forty-two patients had their incisions closed using the nonstandardized technique and 34 using the plastic multilayered technique. These 2 groups were compared for age, sex, primary diagnosis, number of levels fused, estimated blood loss, number of units transfused, operating room time, wound complication, and return to operating room. Results: The wound complication rate in the nonstandardized closure group was 19% (8/42) compared with 0% (0/34) in the plastic multilayered closure group (P=0.007). The unanticipated return to the operating room rate was 11.9% (5/42) for the nonstandardized closure patients versus 0% (0/34) for the plastic multilayered closure patients (P=0.061). Conclusions: The use of the plastic multilayered closure technique in this patient population is important in an effort to decrease postoperative wound complications. The ability of the surgical team to decrease the infection rate of nonidiopathic scoliosis cannot be overstated. The method of wound closure plays a major role in lowering this incidence. Level of Evidence: Level III-therapeutic.

Original languageEnglish (US)
Pages (from-to)166-170
Number of pages5
JournalJournal of Pediatric Orthopaedics
Issue number3
StatePublished - 2017
Externally publishedYes


  • closure
  • flap
  • fusion
  • infection
  • neuromuscular scoliosis
  • nonidiopathic scoliosis
  • plastic multilayered
  • plastic surgery
  • wound

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine


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