Wound closure refers to the medical process of bringing the edges of a wound together to promote healing, reduce infection risk, and optimize functional and cosmetic outcomes. The method used depends on multiple factors such as wound type, size, contamination, tension, and patient-specific factors.
Technique | Use Case | Comments |
---|---|---|
Sutures | Most common method | Absorbable for deep layers; non-absorbable for skin |
Staples | Scalp, trunk, extremities | Fast technique, may leave track marks |
Adhesive strips | Small, low-tension wounds | Non-invasive, often used in children |
Tissue adhesives | Clean facial wounds | Excellent cosmetic results in low-tension areas |
Skin grafts/flaps | Large or complex wounds | Requires surgical expertise |
Sealing incisions with sutures and staples is the gold-standard of wound closure.
Wound closure is the final step of surgical intervention. There are two major types of wound closure: primary and secondary. In primary closure, the skin is closed at the end of the surgery, whereas in secondary closure the wound is left open at the end of surgery and heals by granulation and contraction.
Biological glues have challenged this technique. While neurosurgical wounds, particularly those made in the dura, are less dynamic and under less fluid pressure than those of the pulmonary and cardiovascular system, biological glues that increase the reliability and resilience of these closures would significantly reduce morbidity from postoperative cerebrospinal fluid leak. Currently, the only Food and Drug Administration (FDA) approved dural sealant is DuraSeal (Integra, Waltham, Massachusetts), a polyethylene glycol hydrogel, which has both cranial and spinal formulations, and has been demonstrated to be safe and effective 1).