Single-layer versus double-layer closure of facial lacerations: a randomized controlled trial

Area of Science:

• Dermatology
• Plastic Surgery
• Wound Healing

Background:

• Facial lacerations are common injuries requiring closure.
• The choice of suturing technique can impact cosmetic outcomes.
• Comparing single-layer and double-layer closure is essential for optimizing treatment.

Purpose of the Study:

• To compare the cosmetic results of facial lacerations closed with single-layer versus double-layer sutures.
• To evaluate scar width and overall aesthetic appearance at 90 days post-closure.

Main Methods:

• A randomized study involving patients aged 1 year and older with simple, non-gaping facial lacerations.
• Patients received either single-layer 6-0 polypropylene sutures or a double-layer closure (6-0 polypropylene plus 5-0 polyglactin deep dermal sutures).
• Outcomes were assessed at 90 days using visual analogue scales for cosmetic appearance and wound evaluation scores.

Main Results:

• Single-layer closure was significantly faster, saving an average of 7 minutes per procedure.
• No differences were observed in patient or practitioner cosmetic assessments between the two groups.
• Scar width and wound evaluation scores were comparable at 90 days, with no infections or dehiscences reported.

Conclusions:

• Single-layer suture closure is a more time-efficient method for treating minor facial lacerations.
• The cosmetic outcome and scar width are similar regardless of whether deep dermal sutures are used in addition to superficial closure.
• This suggests single-layer closure is a viable and efficient option for simple facial wounds.