Comparison of absorbable with nonabsorbable sutures in closure of facial skin wounds

There is long-standing disagreement among facial plastic surgeons as to the ideal suture material for closing skin wounds of the face. Many surgeons believe that nonabsorbable suture material is preferable, as it is easier to tie, is unlikely to break prematurely, and elicits a minimal inflammatory response. Others feel that these issues are of minor importance and prefer absorbable sutures because they do not have to be removed, thus saving the surgeon time and decreasing patient anxiety and discomfort.

Facial skin cancers were removed from 41 patients. The length of closure ranged from 3.5 to 12.0 cm. All wounds were closed with rotational advancement flaps. Deep tissues were closed with 4-0 poliglecaprone 25 (Monocryl; Ethicon Inc, Somerville, NJ). One half of each wound was randomly closed with 5-0 coated polypropylene (Prolene; Ethicon Inc), while the other half was closed with 5-0 coated irradiated polyglactin 910 (Vicryl Rapide; Ethicon Inc). No wound infections or premature rupture of sutures occurred. All patients were followed up for 6 months after surgery. The photographs of the results were reviewed, and no difference was noted in scar formation.

In adults with clean wounds of the face or neck, there is no difference in long-term cosmetic results of repairs with permanent or absorbable suture material. We prefer absorbable sutures, as they do not have to be removed, saving the surgeon time and lessening patient anxiety and discomfort.