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Cosmetic outcomes of absorbable versus nonabsorbable sutures in pediatric facial lacerations
Raemma P Luck1, Robert Flood, Dalit Eyal
1Department of Pediatrics, Temple University School of Medicine, Philadelphia, PA 19140, USA. Raemma.Paredes-Luck@tuhs.temple.edu
Insights
Fast-absorbing catgut sutures are a safe and effective alternative to nonabsorbable sutures for closing pediatric facial lacerations. Cosmetic outcomes and complication rates were comparable between the two suture types, ensuring high parental satisfaction.
Area of Science:
- Pediatric Emergency Medicine
- Dermatologic Surgery
- Wound Healing
Background:
- Facial lacerations are common in children.
- Suture choice impacts cosmetic outcomes and patient satisfaction.
- Long-term data on absorbable sutures for pediatric facial lacerations are limited.
Purpose of the Study:
- To compare long-term cosmetic outcomes of absorbable versus nonabsorbable sutures for pediatric facial lacerations.
- To evaluate complication rates and parental satisfaction in both groups.
Main Methods:
- Randomized controlled trial in a pediatric emergency department.
- Comparison of fast-absorbing catgut versus nylon sutures.
- Blinded observer and parental assessment of cosmetic outcomes using a visual analogue scale (VAS) at 3 months.
Main Results:
- No significant difference in cosmetic outcomes between catgut and nylon sutures (mean VAS difference < 15 mm).
- Comparable parental VAS scores and satisfaction rates between groups.
- No significant differences in infection, dehiscence, or keloid formation.
Conclusions:
- Fast-absorbing catgut suture is a viable alternative to nonabsorbable suture for pediatric facial laceration repair.
- Offers comparable cosmetic results and safety profile.
- Supports the use of absorbable sutures to potentially improve patient and parent experience.
Objectives:
We sought to compare the long-term cosmetic outcomes of absorbable versus nonabsorbable sutures for facial lacerations in children and to compare the complication rates and parental satisfaction in the 2 groups.
Design/Methods:
Healthy patients presenting to a pediatric emergency department with facial lacerations were randomized to repair using fast-absorbing catgut or nylon suture. Patients were followed up at 5 to 7 days and at 3 months. Three blinded observers, using a previously validated 100-mm cosmesis visual analogue scale (VAS) as the primary instrument, rated photographs of the wound taken at 3 months. For this noninferiority study, a VAS score of 15 mm or greater was considered to be the minimal clinically important difference. Parents also rated the wound using the VAS and completed a satisfaction survey.
Results:
Of the 88 patients initially enrolled, 47 patients completed the study: 23 in the catgut group and 24 in the nylon group. There were no significant differences in age, race, sex, wound length, number of sutures, and layered repair rates in the 2 groups. The observers' mean VAS for the catgut group was 92.3 (95% confidence interval [CI], 89.1-95.4) and that for the nylon group was 93.7 (95% CI, 91.4-96.0), with a difference of the means of 1.4 (95% CI, -5.31 to 8.15), which was less than the minimal clinically important difference of 15 mm (power, >90%). The mean parental VAS score for the catgut group was 86.3 (95% CI, 78.4-94.1) and that for the nylon group was 91.2 (95% CI, 86.9-95.4), with a difference of the means of 4.9 (95% CI, 2.41-7.41), also less than 15 mm. There were no significant differences in the rates of infection, wound dehiscence, keloid formation, and parental satisfaction.
Conclusions:
The use of fast-absorbing catgut suture is a viable alternative to nonabsorbable suture in the repair of facial lacerations in children.
