Abstract：
Spinal surgeries are increasingly performed in the United States, but complication rates can be unacceptably high at up to 26%. Consequently, plastic surgeons (PS) are sometimes recruited by spine surgeons (SS) for intraoperative assistance with soft tissue closures. An electronic multidatabase literature search was systematically conducted to determine whether spinal wound closure performed by PS minimizes postoperative wound healing complications when compared to closure by SS (neurosurgical or orthopedic), with the hypothesis that closures by PS minimizes incidence of complications. All published studies involving patients who underwent posterior spinal surgery with closure by PS or SS at index spine surgery were identified. Filtering by exclusion criteria identified 10 studies, 4 of which were comparative in nature and included both closures by PS and SS. Of these 4, none reported significant differences in postoperative outcomes between the groups. Across all studies, PS were involved in cases with higher baseline risk for wound complications and greater comorbidity burden. Closures by PS were significantly more likely to have had prior chemotherapy in 2 of the 4 (50%) studies (P = 0.014, P < 0.001) and radiation in 3 of the 4 (75%) studies (P < 0.001, P < 0.01, P < 0.001). In conclusion, closures by PS are frequently performed in higher risk cases, and use of PS in these closures may normalize the risk of wound complications to that of the normal risk cohort, though the overall level of evidence of the published literature is low.
摘要：
脊柱手术在美国越来越多，但并发症的发生率可能高达26%，高得令人无法接受。因此,脊柱外科医生（SS）有时会招募整形外科医生（PS）进行术中软组织闭合的辅助。系统地进行了电子多数据库文献检索，以确定与SS（神经外科或骨科）闭合相比，PS进行的脊柱伤口闭合是否可最大程度地减少术后伤口愈合并发症。假设通过PS关闭可最大程度地减少并发症的发生率。确定了所有已发表的研究，这些研究涉及在索引脊柱手术中接受后路脊柱手术并通过PS或SS闭合的患者。通过排除标准过滤确定了10项研究，其中四个具有比较性质，包括PS和SS的封闭。在这四个人中,两组间术后结局无显著差异.在所有研究中，PS涉及伤口并发症基线风险较高和合并症负担较大的病例。在四个（50％）研究中的两个（p=0.014，p<0.001）和四个（75％）研究中的三个（p<0.001，p<0.01，p<0.001）中，通过PS进行的封闭明显更有可能进行过化疗。总之,PS关闭通常在较高风险的情况下进行，在这些封闭中使用PS可以使伤口并发症的风险正常化，使正常风险队列的风险恢复正常，尽管已发表文献的证据总体水平较低。
