title: Cosmetic outcomes of absorbable versus nonabsorbable sutures in pediatric facial lacerations.
abstract: OBJECTIVE
  We sought to compare the long-term cosmetic outcomes of absorbable versus nonabsorbable sutures for facial lacerations in children and to compare the complication rates and parental satisfaction in the 2 groups.
  
  
  METHODS
  Healthy patients presenting to a pediatric emergency department with facial lacerations were randomized to repair using fast-absorbing catgut or nylon suture. Patients were followed up at 5 to 7 days and at 3 months. Three blinded observers, using a previously validated 100-mm cosmesis visual analogue scale (VAS) as the primary instrument, rated photographs of the wound taken at 3 months. For this noninferiority study, a VAS score of 15 mm or greater was considered to be the minimal clinically important difference. Parents also rated the wound using the VAS and completed a satisfaction survey.
  
  
  RESULTS
  Of the 88 patients initially enrolled, 47 patients completed the study: 23 in the catgut group and 24 in the nylon group. There were no significant differences in age, race, sex, wound length, number of sutures, and layered repair rates in the 2 groups. The observers' mean VAS for the catgut group was 92.3 (95% confidence interval [CI], 89.1-95.4) and that for the nylon group was 93.7 (95% CI, 91.4-96.0), with a difference of the means of 1.4 (95% CI, -5.31 to 8.15), which was less than the minimal clinically important difference of 15 mm (power, >90%). The mean parental VAS score for the catgut group was 86.3 (95% CI, 78.4-94.1) and that for the nylon group was 91.2 (95% CI, 86.9-95.4), with a difference of the means of 4.9 (95% CI, 2.41-7.41), also less than 15 mm. There were no significant differences in the rates of infection, wound dehiscence, keloid formation, and parental satisfaction.
  
  
  CONCLUSIONS
  The use of fast-absorbing catgut suture is a viable alternative to nonabsorbable suture in the repair of facial lacerations in children.
authors.affiliation: Department of Pediatrics, Temple University School of Medicine, Philadelphia, PA 19140, USA. Raemma.Paredes-Luck@tuhs.temple.edu
authors.forename: Raemma P
authors.initials: RP
authors.lastname: Luck
authors.forename: Robert
authors.initials: R
authors.lastname: Flood
authors.forename: Dalit
authors.initials: D
authors.lastname: Eyal
authors.forename: John
authors.initials: J
authors.lastname: Saludades
authors.forename: Ciana
authors.initials: C
authors.lastname: Hayes
authors.forename: John
authors.initials: J
authors.lastname: Gaughan
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D004954:Esthetics; D005151:Facial Injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D022125:Lacerations / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome