"Unshaved Intradermal Running Suture for Elective Cranial Neurovascular Surgeries"

In this paper, we analyze the experience and propose a method of incision and stitching of the postoperative scalp wound without shaving hair in elective neurosurgical interventions.

Between January 2021 and May 2022, 44 patients with various neurovascular pathologies were included in the study. The age of the patients varied from 28 to 58 years. All patients underwent elective surgical interventions with intradermal cosmetic sutures without shaving hair. The results of published observational series of neurosurgical patients with unshaved hair were also analyzed.

Treatment of the surgical field, scalp, and incision were performed without shaving hair in 44 cases. The technique of intradermal suture without shaving hair was used in 31 cases of the classical pterional approach, in 11 cases of minipteronal, in 1 case of parasagittal, and in 1 case of retrosigmoid suboccipittal approaches. The mean age of the patients was 47.5 years (±8.82). The average length of stay in the clinic was 8.02 days (±2.04). The sutures were removed on the fifth-eighth day. All cases were operated on for elective neurovascular interventions: aneurysms without rupture (95.4%), arteriovenous malformations (2.3%), and cavernous angiomas (2.3%). All but one patient (2.3%) had no wound complications-the suture ruptured at the stage of its removal from the skin.

Our results also show that the use of a nonresorbable intradermal suture combined with hair preservation does not affect the risk of infection.