The Use of Dermabond Versus Standard Staple for Wound Closure in Children With Neuromuscular Scoliosis Undergoing Spinal Deformity Correction Surgery

• Difference in the cosmetic result of the wound closure as measured by the Hollander wound evaluation scale [ Time Frame: 12 weeks after surgery ] [ Designated as safety issue: No ]
  To explore whether there is a difference in the cosmetic result of the wound closure as measured by the Hollander wound evaluation scale. Our hypothesis is that the Dermabond group will have a better cosmetic result.
• Difference in the time for final wound closure [ Time Frame: Day of surgery ] [ Designated as safety issue: No ]
  To explore whether there is a difference in the time for final wound closure. Our hypothesis is that the Dermabond group will have a shorter time for final wound closure.
• Difference in mean caregiver/parental satisfaction scores as measured by a visual analog scale [ Time Frame: 12 weeks after surgery ] [ Designated as safety issue: No ]
  To explore whether there is a difference in mean caregiver/parental satisfaction scores as measured by a visual analog scale. Our hypothesis is that parental satisfaction will be higher in the Dermabond group.

• Difference in the cosmetic result of the wound closure as measured by the Hollander wound evaluation scale [ Time Frame: 4 days after surgery ] [ Designated as safety issue: No ]
  To explore whether there is a difference in the cosmetic result of the wound closure as measured by the Hollander wound evaluation scale. Our hypothesis is that the Dermabond group will have a better cosmetic result.
• Difference in the time for final wound closure [ Time Frame: 4 days after surgery ] [ Designated as safety issue: No ]
  To explore whether there is a difference in the time for final wound closure. Our hypothesis is that the Dermabond group will have a shorter time for final wound closure.
• Difference in mean caregiver/parental satisfaction scores as measured by a visual analog scale [ Time Frame: 4 days after surgery ] [ Designated as safety issue: No ]
  To explore whether there is a difference in mean caregiver/parental satisfaction scores as measured by a visual analog scale. Our hypothesis is that parental satisfaction will be higher in the Dermabond group.

This is a prospective, Phase II (hypothesis generating) randomized pilot study investigating the efficacy of using Dermabond as a method of final wound closure as compared to the standard staple method in children with Neuromuscular Scoliosis undergoing spinal deformity correction surgery.

1. To explore whether there is a difference in the incidence of wound infection in the Dermabond group vs. the skin staple group as measured by microbiological culture four days post-operatively. Wound infection is defined as prolonged sterile discharge (>4 days), positive wound cultures, or cellulitis four or more days post-operatively.
2. To explore whether there is a difference in the cosmetic result of the wound closure as measured by the Hollander wound evaluation scale. Our hypothesis is that the Dermabond group will have a better cosmetic result. Secondary outcome
3. To explore whether there is a difference in the time for final wound closure. Our hypothesis is that the Dermabond group will have a shorter time for final wound closure. Secondary outcome
4. To explore whether there is a difference in mean caregiver/parental satisfaction scores as measured by a visual analog scale. Our hypothesis is that parental satisfaction will be higher in the Dermabond group. Secondary outcome

• Device: 2-octylcyanoacrylate (Dermabond) closure
  Standard procedure for closure of adipose/ subcutaneous layers. The subcuticular layer will be closed with a continuous 2-0 vicryl suture which will then be followed by Dermabond closure.
• Device: Standard staple closure
  Standard procedure for closure of adipose/ subcutaneous layers followed by staple closure

• Experimental: 1
  2-octylcyanoacrylate (Dermabond) closure
  Intervention: Device: 2-octylcyanoacrylate (Dermabond) closure
• Active Comparator: 2
  Standard staple closure
  Intervention: Device: Standard staple closure

Inclusion Criteria:

• male or female 19 years or younger
• neuromuscular scoliosis
• undergoing posterior spinal instrumentation and fusion (one stage)

Exclusion Criteria:

• other non-neuromuscular causes of scoliosis
• previous history of spinal surgery
• previous incision over the operative site
• history of keloid formation
• allergy to superglue
• use of anticoagulation therapy