Dermatological surgery: an update on suture materials and techniques. Part 2

Area of Science:

• Dermatological Surgery
• Wound Healing
• Surgical Materials Science

Background:

• Suture selection is critical in dermatological surgery, influencing outcomes like scarring, pain, and infection.
• This review critically appraises evidence on various suture materials and wound closure techniques.
• Part two focuses on buried sutures, comparing braided versus monofilament, longer-absorbing, and antibacterial options.

Purpose of the Study:

• To critically evaluate the evidence regarding the impact of different buried suture types on dermatological surgery outcomes.
• To assess the quality of existing research on suture materials and wound closure techniques.
• To identify gaps in the literature and recommend future research directions.

Main Methods:

• Systematic literature search of MEDLINE, PubMed, and Embase databases.
• Inclusion of English-language articles focusing on skin/dermatological surgery, sutures, and specific suture types (braided, monofilament, antibacterial).
• Critical appraisal of evidence concerning scar cosmesis, pain, patient satisfaction, cost, infection, and wound complications.

Main Results:

• The majority of included trials were of poor quality, single-centre, and underpowered.
• Comparing braided versus monofilament, longer-absorbing, and antibacterial sutures revealed significant limitations in current evidence.
• Challenges exist in comparing suture techniques due to the heterogeneity and low quality of available studies.

Conclusions:

• Current evidence on buried suture materials in dermatological surgery is largely based on low-quality trials.
• Further high-quality, large-scale, multicentre, randomized trials are essential for definitive comparisons.
• Future research should incorporate validated surgeon and patient-assessed outcomes for robust evaluation.