Topical lyophilized thrombin application improves wound healing for posterior spinal surgery

Area of Science:

• Anesthesiology
• Surgical Innovation
• Wound Healing Research

Background:

• Erector spinae plane block (ESPB) is utilized for postoperative pain management in posterior spinal surgery.
• Concerns exist regarding ESPB potentially increasing surgical incisional wound exudate and impairing wound healing.
• Topical lyophilized thrombin application is explored as a method to mitigate these adverse effects.

Purpose of the Study:

• To evaluate the impact of ESPB on surgical wound healing after posterior spinal surgery.
• To investigate the efficacy of topical lyophilized thrombin in improving wound healing in patients undergoing posterior spinal surgery with ESPB.

Main Methods:

• A retrospective study involving 89 patients who underwent posterior spinal surgery.
• Patients were divided into three groups: general anesthesia (Group A), general anesthesia with ESPB (Group B), and general anesthesia with ESPB and topical thrombin (Group C).
• Outcomes assessed included dressing change frequency, suture removal duration, and incisional wound healing quality.

Main Results:

• Group B (ESPB) showed significantly more dressing changes and longer suture removal times compared to Group A.
• Poor wound healing occurred in 25.0% of patients in Group B.
• Topical thrombin application in Group C significantly improved these outcomes, with no instances of poor wound healing reported.

Conclusions:

• ESPB may be associated with increased postoperative wound complications, including more frequent dressing changes and poorer healing.
• Topical lyophilized thrombin application demonstrates potential in improving surgical wound healing and reducing complications following posterior spinal surgery when used with ESPB.