Absorbable versus nonabsorbable sutures to prevent postoperative stretching of wound area

In surgery it is not uncommon to demand considerable tensile strength of sutures, at least for the time it takes the scar to gain sufficient strength to resist wound-shearing forces without the help of sutures. There is controversial thinking as to whether absorbable or nonabsorbable sutures should be used in this situation. By tattooing two pairs of marks on each side of the wound after a midline sagittal excision of the scalp for correction of androgenetic alopecia and suturing 13 patients with Dexon (polyglycolic acid) and 8 with Prolene (polypropylene), the authors were able to measure a 48 to 59 percent larger postoperative stretching of the wound area in the Dexon group 2 months postoperatively. In addition, the scar width was 60 to 76 percent larger in the Dexon group 3 months postoperatively. These differences were highly significant. Differences in scar depression also supported the idea of more stretching in the Dexon group. This indicates the importance of careful choice of suture material in situations where problems are to be expected, such as in wide scars or wound failure.