Skin closure methods after single port laparoscopic surgery: a randomized clinical trial

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Cosmetic Surgery Outcomes

Background:

• Single-port laparoscopic surgery (SP-LS) offers cosmetic advantages but requires careful umbilical incision closure.
• Optimizing cosmetic results after SP-LS is crucial for patient satisfaction.

Purpose of the Study:

• To compare the postoperative cosmetic outcomes of different umbilical closure techniques following SP-LS.
• To evaluate the impact of subcuticular skin sutures on scar appearance and patient satisfaction.

Main Methods:

• 138 women undergoing elective SP-LS were randomized into two groups: subcutaneous suture only (case) or subcutaneous plus subcuticular skin suture (control).
• Scar cosmesis was assessed at 1 and 3 months post-surgery using the Vancouver Scar Scale (VSS), Patient and Observer Scar Assessment Scale, and Visual Analog Scale (VAS).
• Patient satisfaction with scar appearance was also measured using VAS.

Main Results:

• No significant differences were observed in scar assessments or overall satisfaction between the two groups.
• The group receiving both suture types experienced a higher incidence of wound discharge (5.7%).
• Scar assessment scores and patient satisfaction improved over time in both groups, with no significant difference between them.

Conclusions:

• Fascial and subcutaneous layer approximation appears sufficient for umbilical incision closure in SP-LS.
• The addition of subcuticular skin sutures did not enhance cosmetic outcomes and may potentially impair wound healing.
• Further large-scale randomized trials are recommended to validate these findings and explore diverse closure techniques.