Platysma Incision Cosmesis
Condition: Wound Heal
Study type: Interventional

Summary: 
      The anterior cervical fusion and decompression (ACDF) surgery provides direct access to
      symptomatic areas of the cervical spine. Cosmesis, including factors like wound healing, is
      an important issue for patients who undergo surgery on anterior neck structures. One
      significant factor that impacts cosmetic healing in patients who undergo the ACDF surgery is
      whether a vertical or transverse incision of the platysma muscle in the neck was used to
      access the cervical spine.

      The purpose of the present study is to compare cosmetic outcomes in vertical versus
      transverse platysmal incisions for anterior cervical spine exposures. Researchers intend to
      analyze this effect with a prospective comparative study model. A targeted number of 100
      patients who undergo anterior cervical surgery, as part of their standard of care, will be
      randomized to receive either a transverse or vertical platysmal incision during the exposure
      part of their procedure. Informed consent for inclusion in the study, as approved by the
      Institutional Review Board, will be obtained from all patients in addition to consent for the
      surgical procedure. Regardless of the platysmal incision, all patients will receive a
      standard transverse skin incision, as is done routinely in anterior cervical exposures. After
      the surgery, all closures will be done in a standard manner.

      These patients will be followed up in the clinic at two weeks, three months, six months, and
      one year. They will be evaluated for wound healing and incision cosmesis using a modification
      of The Hollander Wound Evaluation Scale. Clinical photographs of the patients' necks will be
      captured during these visits in a manner that does not reveal any patient identifiers in any
      way. The incisions and overall cosmesis will be graded using the scale mentioned above. The
      data will be analyzed to determine if a transverse platysmal incision offers better cosmetic
      results than a vertical platysmal incision, or vice versa, and will also be used to validate
      the modified wound evaluation scale.
    


Intervention name(s): Anterior Cervical Decompression and Fusion; Vertical Platysma Incision; Transverse Platysma Incision
Intervention type(s): Procedure; Procedure; Procedure
Intervention description(s): Patients will receive the anterior cervical decompression and fusion as part of their standard of care. They will be randomized to either receive the vertical or transverse platysma incision.; A vertical platysma Incision will be used for the anterior cervical decompression and fusion surgical procedure; A transverse platysma incision will be used for the anterior cervical decompression and fusion surgical procedure
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: There are two groups. One group will have the vertical platysma incision and the other group will have the transverse incision.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Cosmesis; Wound Healing; Anterior Cervical Decompression and Fusion; ACDF; Platysma