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Updated: Jan 20, 2026
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Published on: May 5, 2020
Quantification of Erythema Associated With Continuous Versus Interrupted Nylon Sutures in Facial Surgery Repair: A
Ali Majd1, Ardalan Akbari2, David Zloty1
1Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.
Background:
Patients are often concerned about the cosmetic appearance of scars following Mohs micrographic surgery (MMS), including residual erythema. However, few studies have compared the cosmetic outcomes between different suturing techniques.
Objective:
To compare the erythema intensity (EI) associated with interrupted sutures (IS) and continuous sutures (CS), and the degree of its reduction over time.
Materials And Methods:
Mohs micrographic surgery patients were randomized to have half of their defect repaired with IS and the other half with CS. Postoperatively, subjects were assessed at 1 week, 2 months, and 6 months and close-up photographs of their scars were taken. Computer-assisted image analysis was utilized to quantify the EI in each half-scar.
Results:
The average EI of IS was greater than that of CS by 9.3% at 1 week (p < .001) and 7.2% at 2 months (p < .021) but comparable at 6 months. These differences were clinically detectable, but EI differences resolved by 6 months in most cases. At 6 months, EI regressed by 33.5% in IS and 26.3% in CS.
Conclusion:
Continuous sutures are associated with less erythema during early scar maturation but are comparable to IS at 6 months. These results may guide the choice of suturing technique to improve early cosmetic outcomes and overall patient satisfaction.
Insights
Continuous sutures show less scar redness in early healing after Mohs surgery compared to interrupted sutures. Scar erythema intensity becomes comparable between both suturing techniques by six months post-procedure.
Area of Science:
- Dermatology
- Plastic Surgery
- Wound Healing
Background:
- Patient concerns regarding scar appearance after Mohs micrographic surgery (MMS) are common.
- Residual erythema is a frequent cosmetic concern following MMS.
- Limited research compares cosmetic outcomes of different suturing techniques.
Purpose of the Study:
- To compare erythema intensity (EI) between interrupted sutures (IS) and continuous sutures (CS).
- To assess the reduction of scar erythema over time with different suturing techniques.
Main Methods:
- Mohs surgery defects were randomized for repair with either IS or CS.
- Scar photographs were taken at 1 week, 2 months, and 6 months post-surgery.
- Computer-assisted image analysis quantified erythema intensity in each scar half.
Main Results:
- IS exhibited higher average EI than CS by 9.3% at 1 week (p < .001) and 7.2% at 2 months (p < .021).
- EI differences were clinically detectable but resolved by 6 months for most patients.
- At 6 months, EI reduced by 33.5% for IS and 26.3% for CS.
Conclusions:
- Continuous sutures result in less erythema during early scar maturation compared to interrupted sutures.
- Suturing technique differences in erythema intensity become comparable by 6 months.
- Choosing CS may enhance early cosmetic outcomes and patient satisfaction after Mohs surgery.
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