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Comparison of wound closure techniques in median sternotomy scars in children: subcuticular suture versus

Annekatrien L van de Kar1,2, David R Koolbergen3,4, Janne P H van Avendonk1

  • 1a Department of Plastic, Reconstructive and Hand Surgery , Amsterdam University Medical Centers, location AMC , Amsterdam , The Netherlands.

Journal of Plastic Surgery and Hand Surgery
|January 29, 2019
PubMed

Insights

Subcuticular sutures provide better cosmetic outcomes for pediatric median sternotomy scars compared to Steri-Strip™ S closures. While wound healing is similar, subcuticular sutures result in thinner, more pliable scars with a smaller surface area.

Area of Science:

  • Pediatric surgery
  • Wound healing research
  • Surgical closure techniques

Background:

  • Median sternotomy is a common surgical approach in pediatric cardiac procedures.
  • Effective wound closure is crucial for minimizing complications and optimizing cosmetic outcomes.
  • Comparing different wound closure methods is essential for improving patient care.

Purpose of the Study:

  • To compare the efficacy of subcuticular sutures versus Steri-Strip™ S for closing pediatric median sternotomy incisions.
  • To evaluate differences in wound healing and scar formation between the two closure methods.

Main Methods:

  • A retrospective study involving 53 children and adolescents who underwent median sternotomy.
  • Wound closure was performed using either running subcuticular sutures or Steri-Strip™ S.
  • Scars were assessed using the Patient and Observer Scar Assessment Scale (POSAS), with secondary outcome measures including scar dimensions and wound problems.

Main Results:

  • Subcuticular sutures showed significantly better results in scar thickness, pliability, surface area, and overall POSAS observer scores.
  • No significant differences were observed in POSAS patient scale scores.
  • Wider scar widths were noted in the Steri-Strip™ S group, but no significant differences in wound problems were found between groups.

Conclusions:

  • Both subcuticular sutures and Steri-Strip™ S are comparable in terms of median sternotomy wound healing in children.
  • Subcuticular sutures lead to superior scar formation and better final cosmetic results compared to Steri-Strip™ S.
  • The findings suggest subcuticular sutures are preferable for achieving optimal aesthetic outcomes in pediatric sternotomy closures.
Abstract

Keywords:
Sternotomyadolescentchildsurgical tapesutureswound closure techniques

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