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Three suturing techniques for closing fusiform excisions. A randomised controlled study.

Nicholas Ling1, Andrew Martin2

  • 1Coffs Central Medical Centre, Coffs Harbour, Australia.

The Australasian Journal of Dermatology
|July 8, 2015
PubMed
Summary

One-layer closure is acceptable for elliptical excisions, while modified two-layer closure offers superior cosmetic results and reduced erythema compared to standard closure. Factors like age and wound infection influence scar width.

Keywords:
FixomullMaxonadhesive tapeclinical trialellipticalpolyglyconaterandomisedskin cancerskin excisionsuture technique

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Area of Science:

  • Dermatology
  • Surgical Techniques
  • Wound Healing

Background:

  • Over one million skin excisions are performed annually in Australia.
  • Limited randomized trials exist for wound repair following skin excisions.
  • Simple elliptical excisions are common dermatological procedures.

Purpose of the Study:

  • To compare two suture techniques against a control for simple elliptical excisions.
  • To evaluate wound width and cosmetic outcomes at 6 months.
  • To identify predictors of scar width and patient-rated outcomes.

Main Methods:

  • Prospective, randomized, single-blinded study design.
  • Comparison of one-layer closure (nylon sutures), modified two-layer closure (adhesive tape), and standard two-layer closure.
  • Primary outcome: wound width at 6 months; Secondary outcome: cosmesis.

Main Results:

  • No significant difference in wound width at 6 months between techniques.
  • Modified two-layer closure showed superior cosmesis and reduced erythema versus standard closure.
  • Younger age, infection, and truncal location predicted wider scars; older age, erythema, and male gender predicted poorer outcomes.

Conclusions:

  • One-layer closure is a viable option for elliptical excision wound closure.
  • Modified two-layer closure may be preferred over standard two-layer closure for elliptical wounds.
  • Predictors of scar width and patient satisfaction vary based on patient and wound characteristics.