Original articleAesthetic outcome of simple cuticular suture distance from the wound edge on the closure of linear wounds on the head and neck: A randomized evaluator blinded split-wound comparative effect trial
Section snippets
Methods
This single-center, randomized, dual evaluator blinded, split-wound study was conducted at the UC Davis dermatology clinic from December 19, 2019, to November 6, 2020 (Fig 1, ClinicalTrials.gov Identifier: NCT04870008). Ethical approval was obtained through the UC Davis Institutional Review Board before study commencement, and all patients provided verbal and written informed consent to enrollment. Patients 18 years of age or older who could give informed consent, willing to return for a
Results
Fifty patients were enrolled in the study (Table I). One patient was lost to follow-up. No statistically significant difference in any outcome was seen between sutures placed 2 mm versus 5 mm from the wound edge in our cohort of patients (Table II). No significant difference in the primary outcome measure, the mean sum of the POSAS scores of masked viewers was seen, with a mean (SD) of 16.06 (6.49) on the 2-mm side and 15.82 (6.83) on the 5-mm side (P = .807). Similarly, no significant
Discussion
Suture distance from the wound edge between 2 mm and 5 mm does not directly impact scar outcomes. Although 3 patients had suture reactions on the 2-mm side and none were isolated to the 5-mm side; these reactions were to the dermal sutures and unlikely related to the epidermal suture spacing. The strengths of this study include randomization, blinding of the observers, and objective quantification of scar width using the trace-to-tape method. Moreover, the split-scar model controls for
Conclusion
Epidermal sutures placed 2 or 5 mm from the wound edge failed to demonstrate different cosmetic outcomes on primary linear closures on the head and neck. Surgeons may continue placing sutures at either distance without apparent consequence.
Conflicts of interest
None disclosed.
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Funding sources: None.
IRB approval status: Approved by UC Davis IRB.
Reprints not available from the authors.