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International, prospective cohort study comparing non-absorbable versus absorbable sutures for skin surgery: CANVAS
Alice Lee1,2, Guy H M Stanley3,4, Ryckie G Wade5,6
1Department of Plastic Surgery and Burns, Stoke Mandeville Hospital, Aylesbury, UK.
The British Journal of Surgery
|February 8, 2023
Summary
Suture choice for skin surgery remains uncertain, with no clear link between absorbable or non-absorbable sutures and complications. More research is needed to guide clinical decisions on wound closure.
Area of Science:
- Dermatology and surgical research.
- Wound healing and closure techniques.
Background:
- Superficial skin closure after excisional surgery can utilize absorbable or non-absorbable sutures.
- Current clinical practice lacks consensus and high-quality evidence for suture selection.
Purpose of the Study:
- To evaluate current suture usage patterns in excisional skin surgery.
- To determine the complication rates associated with different suture types within 30 days post-surgery.
Main Methods:
- International prospective service evaluation of adult patients undergoing skin lesion excision.
- Data collected from UK and Australasian networks, analyzed using multivariable logistic regression.
- Included 3494 patients and 4066 excisions from September 2020 to April 2021.
Main Results:
- Equitable use of absorbable (57.7%) and non-absorbable (42.2%) sutures for superficial closure.
- Most common complications were surgical-site infection (2.9%) and delayed wound healing (2.2%).
- No significant association found between suture type and complication risk in multivariable analysis.
Conclusions:
- Current practice shows equipoise in absorbable versus non-absorbable suture use for skin closure.
- Suture type was not associated with increased risk of complications at 30 days.
- High-quality randomized controlled trials are required to establish definitive evidence.
