Tags

Type your tag names separated by a space and hit enter

Dermal suture only vs layered closure: a randomized split wound comparative effectiveness trial.

Abstract

BACKGROUND

Layered closure of cutaneous wounds is a commonly used surgical practice. However, there are studies to suggest the additional layer of epidermal sutures may not be necessary.

OBJECTIVES

To compare scar outcome of single layer of sutures placed in the dermis to the traditional layered closure when performing primary closure of cutaneous wounds.

METHODS

A total of 49 patients were enrolled in a prospective, randomized, evaluator-blinded, split scar study to compare the results of conventional bilayered closure versus a single layer of buried dermal suturing of wounds closed primarily. The primary outcome measure was the mean sum Patient and Observer Scar Assessment Scale (POSAS) scores.

RESULTS

At 3-month follow-up, there was a statistically significant difference for the mean total POSAS scores for both blinded observer and patient with preference for the traditional layered closure side. However, at 12-month follow-up, this difference was lost with the exception of scar color, which was significantly more noticeable on the side with only dermal sutures.

LIMITATIONS

Single-center study CONCLUSIONS: At 3-months following surgery, the layered closure technique resulted in a slightly better scar than dermal sutures alone. At 12-months follow-up, this difference diminished with scars for both sides appearing similar.

Authors+Show Affiliations

Department of Dermatology, University of California Davis Medical Center, Sacramento, CA; Sacramento VA Medical Center, Mather, CA.Laser & Skin Surgery Center of Northern California, Sacramento, CA.Sacramento VA Medical Center, Mather, CA; Department of Dermatology, University of New Mexico, Albuquerque, NM.Department of Dermatology, University of California Davis Medical Center, Sacramento, CA.Department of Dermatology, University of Southern California, Los Angeles, CA.Department of Dermatology, University of California Davis Medical Center, Sacramento, CA.Department of Dermatology, University of California Davis Medical Center, Sacramento, CA; Department of Biological Sciences, California State University, Sacramento, CA.Department of Dermatology, University of California Davis Medical Center, Sacramento, CA. Electronic address: deisen123@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31442535

Citation

Joo, J S., et al. "Dermal Suture Only Vs Layered Closure: a Randomized Split Wound Comparative Effectiveness Trial." Journal of the American Academy of Dermatology, 2019.
Joo JS, Zhuang AR, Tchanque-Fossuo C, et al. Dermal suture only vs layered closure: a randomized split wound comparative effectiveness trial. J Am Acad Dermatol. 2019.
Joo, J. S., Zhuang, A. R., Tchanque-Fossuo, C., Tartar, D., Armstrong, A. W., King, T. H., ... Eisen, D. B. (2019). Dermal suture only vs layered closure: a randomized split wound comparative effectiveness trial. Journal of the American Academy of Dermatology, doi:10.1016/j.jaad.2019.08.040.
Joo JS, et al. Dermal Suture Only Vs Layered Closure: a Randomized Split Wound Comparative Effectiveness Trial. J Am Acad Dermatol. 2019 Aug 20; PubMed PMID: 31442535.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dermal suture only vs layered closure: a randomized split wound comparative effectiveness trial. AU - Joo,J S, AU - Zhuang,A R, AU - Tchanque-Fossuo,C, AU - Tartar,D, AU - Armstrong,A W, AU - King,T H, AU - Sivamani,R K, AU - Eisen,D B, Y1 - 2019/08/20/ PY - 2019/08/05/received PY - 2019/08/14/accepted PY - 2019/8/24/entrez PY - 2019/8/24/pubmed PY - 2019/8/24/medline KW - scar KW - skin surgery KW - suture technique KW - wound closure JF - Journal of the American Academy of Dermatology JO - J. Am. Acad. Dermatol. N2 - BACKGROUND: Layered closure of cutaneous wounds is a commonly used surgical practice. However, there are studies to suggest the additional layer of epidermal sutures may not be necessary. OBJECTIVES: To compare scar outcome of single layer of sutures placed in the dermis to the traditional layered closure when performing primary closure of cutaneous wounds. METHODS: A total of 49 patients were enrolled in a prospective, randomized, evaluator-blinded, split scar study to compare the results of conventional bilayered closure versus a single layer of buried dermal suturing of wounds closed primarily. The primary outcome measure was the mean sum Patient and Observer Scar Assessment Scale (POSAS) scores. RESULTS: At 3-month follow-up, there was a statistically significant difference for the mean total POSAS scores for both blinded observer and patient with preference for the traditional layered closure side. However, at 12-month follow-up, this difference was lost with the exception of scar color, which was significantly more noticeable on the side with only dermal sutures. LIMITATIONS: Single-center study CONCLUSIONS: At 3-months following surgery, the layered closure technique resulted in a slightly better scar than dermal sutures alone. At 12-months follow-up, this difference diminished with scars for both sides appearing similar. SN - 1097-6787 UR - https://www.unboundmedicine.com/medline/citation/31442535/Dermal_suture_only_vs_layered_closure:_a_randomized_split_wound_comparative_effectiveness_trial L2 - https://linkinghub.elsevier.com/retrieve/pii/S0190-9622(19)32615-5 DB - PRIME DP - Unbound Medicine ER -