Evaluation of a new wound closure device for linear surgical incisions: 3M Steri-Strip S Surgical Skin Closure versus subcuticular closure.
BACKGROUND
Technological innovations are often adopted before scientific comparison to an accepted standard. The authors' study compared suture with a new coaptive film device, 3M Steri-Strip S Surgical Skin Closure, on linear incisions.


METHODS
Patients undergoing Wise-pattern breast reduction or abdominal procedures had paired incisions randomly assigned to Steri-Strip S or suture closure. Key outcome measures were closure time, patient comfort, and scar quality at 6 months by patients and surgeons using a new scar evaluation tool, visual assessment of linear scars. Statistical differences between the two closure techniques were assessed by Wilcoxon signed rank test.


RESULTS
Of 59 patients, eight were excluded from randomization (a surgeon judged Steri-Strip S to be a nonviable closure technique for mismatched wound edges). Fifty-one patients (breast, n = 24; abdomen, n = 27) were randomized. Operative time with Steri-Strip S for breast was 2.0 minutes (SD = 1.1) versus suture closure at 4.6 minutes (SD = 1.5; p < 0.001). Similarly, Steri-Strip S versus suture for the abdomen was faster (p < 0.001; 4.9 minutes, SD = 2.3 versus 10.1 minutes, SD = 3.4). Comfort scores did not differ between closures [5.8 (SD = 2.7) versus 6.9 (SD = 2.0), respectively, on breast (p = 0.142) and 7.7 (SD = 1.8) versus 7.7 (SD = 2.3) on abdomen (p = 0.903)]. Complication rates did not differ between closure types. Patients' visual assessment of linear scars rating of breasts was 3.8 (SD = 2.9) for Steri-Strip S and better at 2.6 (SD = 2.9) for suture (p = 0.008). One surgeon rated breast Steri-Strip S scars worse than suture scars (4.3 versus 3.7; p = 0.014). For abdominal scars, there was no difference in the patient or surgeon ratings.


CONCLUSIONS
Steri-Strip S permits faster wound closure than suture. On the basis of patient reports of comfort and scar quality, surgeons increase efficiency and maintain quality with the use of Steri-Strip S on abdominal wounds but not on breast wounds.
Kerrigan
Carolyn L
CL
Lebanon, N.H. From the Section of Plastic Surgery and the Dartmouth-Hitchcock Leadership Preventive Medicine Residency Program, Dartmouth Hitchcock Medical Center.
Homa
Karen
K
D000005:Abdomen / Q000601:surgery; D000009:Abdominal Muscles / Q000601:surgery; D001458:Bandages; D002921:Cicatrix; D002983:Clinical Competence; D004867:Equipment Design; D005260:Female; D006801:Humans; D016462:Mammaplasty; D008422:Materials Testing; D013537:Sutures; D013997:Time Factors; D014014:Tissue Adhesives / Q000627:therapeutic use*; D014945:Wound Healing
D014014:Tissue Adhesives