Scar after Intradermal Mattress versus Subcuticular Continuous Sutures: A comparative study
Abstract
IntroductionSubcuticular continuous technique and buried mattress suture produce good results. The study compared results following these techniques using POSAS.
Methods
Patients were enrolled on out-patient basis and grouped into I for Intradermal Buried Vertical Mattress Suture (IBVMST) and II for Subcutaneous Continuous with absorbable suture techniques (SCAST) and followed up to six months. Suture time, number of sutures and POSAS items were evaluated, correlated and analyzed.
Results
Included were 63 patients. No significant difference was noted in Total OSAS as well as in Overall Opinion Scores between both groups, although group I scars were significantly better in relief and pliability, with p value of 0.019 and 0.018, respectively. In group I, category 1-2cm wounds needed more repair time; significant correlation was found between number of stitches and total POSAS; surface area and vascularity were significantly related with Observer Opinion and more scars were smooth, flexible, thinner and less vascular. In group II, category >5cm wounds needed more closure time; surface area was significantly related to Observer Opinion and scars were less expanded. In both groups, colour was significantly correlated with Patient Opinion. Total POSAS difference between the two groups was insignificant 0.9305, indicating no technique was superior, despite favourable group I results.
Conclusion
No group was superior but revealed differences. The scars from IBVMST were favoured by observer opinions while scars from SCAST by patient opinions. More of IBVMST scars were smooth, flexible, thinner and less vascular but more of SCAST scars were less expanded. Lastly, short wounds closure are quicker with IBVMST while long wounds closure are quicker with SCAST.
References
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13. Gatt D, Quick CR, Owen-Smith MS. Staples for wound closure: a controlled trial. Ann R Coll Surg Engl. 1985;67(5):318-20.
14. Consorti F, Mancuso R, Piccolo A, Pretore E, Antonaci A. Quality of scar after total thyroidectomy: a single blinded randomized trial comparing octyl-cyanoacrylate and subcuticular absorbable suture. ISRN Surg. 2013;2013:270953.
15. Alicandri-Ciufelli M, Piccinini A, Grammatica A, Molteni G, Spaggiari A, Di Matteo S, et al. Aesthetic comparison between synthetic glue and subcuticular sutures in thyroid and parathyroid surgery: a single-blinded randomised clinical trial. Acta Otorhinolaryngologica Italica. 2014;34(6):406-11.
16. Patel K, Rabari M, Jain AP, Saxena AK. Comparison between interrupted vertical mattress suture versus skin stapler versus subcuticular suture for skin closure in clean surgery. Int J Res Med. 2014;3(3):164-8.
17. Iqbal MA, Shabbir MN, Ahmed I, Najam MS. Cosmetic effects of different types of skin closure techniques after thyroidectomy on scar formation: metal clips versus subcuticular sutures. Pak J Surg. 2014;30(01):27-9.
18. Switzer EF, Dinsmore RC, North JH, Jr. Subcuticular closure versus Dermabond: a prospective randomized trial. Am Surg. 2003;69(5):434-6.
19. Shin TM, Bordeaux JS. How suture technique affects the cosmetic outcome of cutaneous repairs. J Drugs Dermatol. 2014;13(8):967-9.
20. Hohenleutner U, Egner N, Hohenleutner S, Landthaler M. Intradermal buried vertical mattress suture as sole skin closure: evaluation of 149 cases. Acta derm Venereol.Sep-Oct 2000;80(5):344-7.
21. Zitelli JA, Moy RL. Buried vertical mattress suture. J Dermatol Surg Oncol. 1989;15(1):17-9.
22. Lipman K, Wang M, Berthiaume E, Holloway J, Da Lio A, Ting K, et al. Evaluating Current Scar Assessment Methods. Ann Plast Surg. 2020;84(2):222-31.
23. Draaijers LJ, Tempelman FR, Botman YA, Tuinebreijer WE, Middelkoop E, Kreis RW, et al. The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluation. Plast Reconstr Surg. 2004;113(7):1960-5.
24. van de Kar AL, Corion LU, Smeulders MJ, Draaijers LJ, van der Horst CM, van Zuijlen PP. Reliable and feasible evaluation of linear scars by the Patient and Observer Scar Assessment Scale. Plast Reconstr Surg. 2005;116(2):514-22.
2. Kaminer MS, Kenneth A. Arndt, Jeffrey S. Dover, Rohrer TE, Zachary CB. Atlas of Cosmetic Surgery. 2nd illustrated ed. Philadelphia, PA, USA: Elsevier Health Sciences; 2009. 422 p.
3. Niamtu J. Cosmetic Facial Surgery. 2nd illustrated ed. St. Louis, Missouri, USA: Elsevier Health Sciences; 2018. 227 p.
4. Fisher GT, Fisher JB, Stark RB. Origin of the use of subcuticular sutures. Annals of plastic surgery. 1980;4(2):144-8.
5. Halstead W. The radical cure of hernia. Bull John Hopkins Hosp. 1889;1:12.
6. Davis JS. Plastic Surgery—Its Principles and Practice. Philadelphia, PA, USA: P. Blakiston's sons and Co.; 1919. 26-30 p.
7. Shah F, Porecha M, Gandhi M, Metha P, Prajapa B. Evaluation of different types of skin closure techniques. The internet Journal Of Surgery. 2012;28:3.
8. Nagpal BM, Kumar G, Nagi GS, Singh P. Sutureless closure of Operative Skin Wounds. Med J Armed Forces India. 2004;60(2):131-3.
9. Farion KJ, Osmond MH, Hartling L, Russell KF, Klassen TP, Crumley E, et al. Tissue adhesives for traumatic lacerations: a systematic review of randomized controlled trials. Acad Emerg Med. 2003;10(2):110-8.
10. Singer AJ, Hollander JE, Valentine SM, Turque TW, McCuskey CF, Quinn JV. Prospective, randomized, controlled trial of tissue adhesive (2-octylcyanoacrylate) vs standard wound closure techniques for laceration repair. Stony Brook Octylcyanoacrylate Study Group. Acad Emerg Med. 1998;5(2):94-9.
11. Osmond MH, Klassen TP, Quinn JV. Economic comparison of a tissue adhesive and suturing in the repair of pediatric facial lacerations. J Pediatr. 1995;126(6):892-5.
12. Beam JW. Tissue adhesives for simple traumatic lacerations. J Athl Train. 2008;43(2):222-4.
13. Gatt D, Quick CR, Owen-Smith MS. Staples for wound closure: a controlled trial. Ann R Coll Surg Engl. 1985;67(5):318-20.
14. Consorti F, Mancuso R, Piccolo A, Pretore E, Antonaci A. Quality of scar after total thyroidectomy: a single blinded randomized trial comparing octyl-cyanoacrylate and subcuticular absorbable suture. ISRN Surg. 2013;2013:270953.
15. Alicandri-Ciufelli M, Piccinini A, Grammatica A, Molteni G, Spaggiari A, Di Matteo S, et al. Aesthetic comparison between synthetic glue and subcuticular sutures in thyroid and parathyroid surgery: a single-blinded randomised clinical trial. Acta Otorhinolaryngologica Italica. 2014;34(6):406-11.
16. Patel K, Rabari M, Jain AP, Saxena AK. Comparison between interrupted vertical mattress suture versus skin stapler versus subcuticular suture for skin closure in clean surgery. Int J Res Med. 2014;3(3):164-8.
17. Iqbal MA, Shabbir MN, Ahmed I, Najam MS. Cosmetic effects of different types of skin closure techniques after thyroidectomy on scar formation: metal clips versus subcuticular sutures. Pak J Surg. 2014;30(01):27-9.
18. Switzer EF, Dinsmore RC, North JH, Jr. Subcuticular closure versus Dermabond: a prospective randomized trial. Am Surg. 2003;69(5):434-6.
19. Shin TM, Bordeaux JS. How suture technique affects the cosmetic outcome of cutaneous repairs. J Drugs Dermatol. 2014;13(8):967-9.
20. Hohenleutner U, Egner N, Hohenleutner S, Landthaler M. Intradermal buried vertical mattress suture as sole skin closure: evaluation of 149 cases. Acta derm Venereol.Sep-Oct 2000;80(5):344-7.
21. Zitelli JA, Moy RL. Buried vertical mattress suture. J Dermatol Surg Oncol. 1989;15(1):17-9.
22. Lipman K, Wang M, Berthiaume E, Holloway J, Da Lio A, Ting K, et al. Evaluating Current Scar Assessment Methods. Ann Plast Surg. 2020;84(2):222-31.
23. Draaijers LJ, Tempelman FR, Botman YA, Tuinebreijer WE, Middelkoop E, Kreis RW, et al. The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluation. Plast Reconstr Surg. 2004;113(7):1960-5.
24. van de Kar AL, Corion LU, Smeulders MJ, Draaijers LJ, van der Horst CM, van Zuijlen PP. Reliable and feasible evaluation of linear scars by the Patient and Observer Scar Assessment Scale. Plast Reconstr Surg. 2005;116(2):514-22.
Published
2022-02-02
How to Cite
MANANDHAR, Krishna.
Scar after Intradermal Mattress versus Subcuticular Continuous Sutures: A comparative study.
J Soc Surg Nep, [S.l.], v. 24, n. 2, p. 58-63, feb. 2022.
ISSN 2392-4772.
Available at: <https://jssn.org.np/index.php?journal=jssn&page=article&op=view&path%5B%5D=448>. Date accessed: 03 dec. 2024.
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Original Article
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