Comparison of Skin Closure Techniques in Oncological Neurosurgical Procedures: Intradermal Running Suture Versus Transdermal Interrupted Sutures

• Absorbable running intradermal suture (Other): Absorbable sutures used to perform continuous/running intradermal skin closure.
• Non-absorbable interrupted transdermal suture (Other): Non-absorbable sutures used to perform interrupted transdermal skin closure.

Primary outcomes

• Occurrence of surgical wound healing complication. [From enrollment to the final wound assessment time point - 90 days postoperatively.]: The primary outcome of this trial is the occurrence of surgical wound healing complication including wound dehiscence (defined as separation of wound edges longer than 1 cm), surgical site infection or external cerebrospinal fluid leak.

Secondary outcomes

• Aesthetic quality of wound healing - observer perspective. [From enrollment to the final wound assessment time point - 90 days postoperatively.]: Aesthetic quality of postoperative wound/scar, evaluated using the Patient and Observer Scar Assessment Scale (from 9 to 45 points for Observer score) where higher scores indicate worse healing outcomes.
• Aesthetic quality of wound healing - patient perspective. [From enrollment to the final wound assessment time point - 90 days postoperatively.]: Aesthetic quality of postoperative wound/scar, evaluated using the Patient and Observer Scar Assessment Scale (from 17 to 85 points for Patient score) where higher scores indicate worse healing outcomes.
• Aesthetic quality of wound healing - observer perspective. [From enrollment to the final wound assessment timepoint - 90 days postoperatively.]: Aesthetic quality of postoperative wound/scar using Visual Analogue Scale (from 1 to 10 pints) in observer's perspective where higher score indicates better wound healing outcomes.
• Aesthetic quality of wound healing - patient perspective. [From enrollment to the final wound assessment timepoint - 90 days postoperatively.]: Aesthetic quality of postoperative wound/scar using Visual Analogue Scale (from 1 to 10 points) in patient's perspective where higher score indicates better wound healing outcomes.
• Pain or discomfort related to sutures removal [At the time of non-absorbable sutures removal - typically 7-10 days postoperatively.]: Pain/discomfort during sutures removal assessed using Visual Analogue Scale (from 1 to 10 points) among subjects receiving non-absorbable sutures where higher score stands for the worst pain ever felt.
• Incidence and nature of additional interventions - invasive interventions - sutures. [From enrollment to the final wound assessment timepoint - 90 days postoperatively.]: Incidence and nature of additional invasive interventions due to suboptimal wound/scar formation: \- placement of additional sutures within the wound. Amount of sutures added and timing of sutures placement after primary surgical intervention.
• Incidence and nature of additional interventions - invasive interventions - lumbar drainage. [From enrollment to the final wound assessment timepoint - 90 days postoperatively.]: Incidence and nature of additional invasive interventions due to suboptimal wound/scar formation: \- lumbar drainage placement Timing of lumbar drainage placement after primary surgical intervention and it's duration.
• Incidence and nature of additional interventions - invasive interventions - secondary surgical intervention. [From enrollment to the final woun assessment timepoint - 90 days postoperatively.]: Incidence and nature of additional invasive interventions due to suboptimal wound/scar formation: \- secondary surgical intervention (re-operation). Timing of secondary surgical intervention after primary surgical intervention.
• Incidence and nature of additional interventions - conservative management [From enrollment to the final wound assessment timepoint - 90 days postoperatively]: Incidence and nature of additional conservative management interventions due to suboptimal wound/scar formation, such as: antibiotic therapy and/or pharmacologic therapy - type of drugs used for management and it's duration.
• Incidence of external cerebrospinal fluid leak [From enrollment to the final wound assessment timepoint - 90 days postoperatively.]: Incidence of cerebrospinal fluid leakage through the wound margins.
• Surgical site infections - deep infections. [From enrollment to the final wound assessment timepoint - 90 days postoperatively.]: Incidence of deep surgical site infections, based on clinical and/or radiologic evaluation, such as epidural/subdural empyema, intracranial abscess.
• Surgical site infections - superficial infections requiring hospitalization. [From enrollment to the final wound assessment timepoint - 90 days postoperatively.]: Incidence of superficial surgical site infections, based on clinical and/or radiologic evaluation such as skin erythema, swelling, tenderness, purulent/serous discharge skin necrosis that require hospitalization. Evaluation of timing of infections diagnoses after primary surgical intervention.
• Surgical site infections - superficial infections not requiring hospitalization. [From enrollment to the final wound assessment timepoint - 90 days postoperatively.]: Incidence of superficial surgical site infections, based on clinical and/or radiologic evaluation such as skin erythema, swelling, tenderness, purulent/serous discharge skin necrosis that do not require hospitalization. Evaluation of timing of infections diagnoses after primary surgical intervention.
• Economic Evaluation - cost of materials used for interrupted skin closure. [From enrollment to the final wound assessment timepoint - 90 days postoperatively.]: Cost of materials used in patients whose skin was closed using interrupted non-absorbable sutures.
• Economic Evaluation - cost of materials used for continuous skin closure. [From enrollment to the final wound assessment timepoint - 90 days postoperatively.]: Costs of skin closure materials used in patients whose skin was closed using using the continuous absorbable suture.

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Male or female at least 18 years old
* Qualified for a craniotomy due to supratentorial intracranial tumor

Exclusion Criteria:

* Revision surgery due to recurrent brain tumor
* Emergency neurosurgical procedure
* Scalp incision involving glabrous skin (e.g. forehead) or facial regions (e.g. eyebrow)

• Michał Senger, M.D., Principal investigator, Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland
• Tomasz A Dziedzic, M.D. Phd, Principal investigator, Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland