E-ISSN: 1019-5157
ISSN: 2651-5024
Research
Heart-Shaped Suturing to Improve Scar Formation in Pediatric Tethered Cord Syndrome Surgery
Gang Shen✉ ,
Wenwen Tang ,
Yuan Dong ,
Yingqun Xu ,
Hong Huang ,
Mengyan Yu ,
Yue Yang ,
Jun Zhu
DOI: 10.5137/1019-5149.JTN.49559-25.2
Article in Press
Corresponding Author:
Gang Shen (shengang338338@vip.163.com)
Abstract
Aim
To evaluate the clinical efficacy of heart-shaped suturing in improving postoperative scar formation in pediatric patients undergoing tethered cord syndrome (TCS) surgery.
Material and Methods
Seventy-two pediatric patients diagnosed with TCS between April and December 2023 were retrospectively analyzed and included, 36 in the observation group (heart-shaped suturing) and 36 in the control group (conventional suturing). The Vancouver Scar Scale (VSS), Visual Analogue Scale (VAS), Patient Scar Assessment Scale (PSAS), and Observer Scar Assessment Scale (OSAS) were used to assess scar outcomes and postoperative complications. The Modified Objective Pain Scale (MOPS) was used to evaluate postoperative pain levels.
Results
There was no statistically significant difference in suturing time or length of hospital stay between the two groups (p>0.05). However, the incidence of postoperative complications was significantly lower in the observation group (p<0.05). The observation group also exhibited significantly lower VSS, VAS, and PSAS scores and narrower scar widths (p<0.05). Furthermore, OSAS scores, including those for pigmentation, thickness, roughness, pliability, surface area, vascularity, and total scores, were significantly lower in the observation group at 3, 6, and 22 months postoperatively (p<0.05). The observation group also showed significantly reduced pruritus and pain levels than the control group (p<0.05).
Conclusion
Heart-shaped suturing in pediatric TCS surgery improves scar formation, particularly in reducing long-term scar hyperplasia, and alleviates postoperative pain, which benefits patient/parental acceptance of TCS surgery. Thus, this technique should be considered and promoted in clinical practice.
To evaluate the clinical efficacy of heart-shaped suturing in improving postoperative scar formation in pediatric patients undergoing tethered cord syndrome (TCS) surgery.
Material and Methods
Seventy-two pediatric patients diagnosed with TCS between April and December 2023 were retrospectively analyzed and included, 36 in the observation group (heart-shaped suturing) and 36 in the control group (conventional suturing). The Vancouver Scar Scale (VSS), Visual Analogue Scale (VAS), Patient Scar Assessment Scale (PSAS), and Observer Scar Assessment Scale (OSAS) were used to assess scar outcomes and postoperative complications. The Modified Objective Pain Scale (MOPS) was used to evaluate postoperative pain levels.
Results
There was no statistically significant difference in suturing time or length of hospital stay between the two groups (p>0.05). However, the incidence of postoperative complications was significantly lower in the observation group (p<0.05). The observation group also exhibited significantly lower VSS, VAS, and PSAS scores and narrower scar widths (p<0.05). Furthermore, OSAS scores, including those for pigmentation, thickness, roughness, pliability, surface area, vascularity, and total scores, were significantly lower in the observation group at 3, 6, and 22 months postoperatively (p<0.05). The observation group also showed significantly reduced pruritus and pain levels than the control group (p<0.05).
Conclusion
Heart-shaped suturing in pediatric TCS surgery improves scar formation, particularly in reducing long-term scar hyperplasia, and alleviates postoperative pain, which benefits patient/parental acceptance of TCS surgery. Thus, this technique should be considered and promoted in clinical practice.
Keywords
Tethered Cord Syndrome
Heart-shaped Suturing
Scar Formation
Pediatric Neurosurgery