Equal cosmetic outcomes with 5-0 poliglecaprone-25 versus 6-0 polypropylene for superficial closures.
BACKGROUND
Cutaneous sutures should provide an aesthetically pleasing result. After placing subcutaneous sutures, enough absorbable suture often remains for the superficial closure. Mohs surgeons often use a nonabsorbable suture to close the superficial layer to obtain cosmetically elegant results, but using this additional suture is less cost effective than using the remaining absorbable suture.


OBJECTIVE
To compare the cosmetic results of simple running sutures using an absorbable suture material (5-0 poliglecaprone-25) with those of a nonabsorbable suture (6-0 polypropylene) in primary closures of suitable facial Mohs defects.


METHODS
Fifty-two patients with 57 facial Mohs surgery defects appropriate for multilayer primary repair had the defects prospectively randomized into a side-by-side comparison. After closure of the deep layers with 5-0 poliglecaprone-25 sutures, half of the wound was closed with a 5-0 poliglecaprone-25 simple running suture, and the other half of the wound was closed with a 6-0 polypropylene simple running suture. The investigators blindly determined the cosmetically superior side of the closure at 1 week and 4 months after suture removal.


RESULTS
Forty-four patients (48 total defects) completed the study. At the 4-month follow-up, 85% (41/48) did not show any difference between poliglecaprone-25 and polypropylene, 4% (2/48) had better outcomes with poliglecaprone-25, and 10% (5/48) had better outcomes with polypropylene. There was no statistically significant cosmetic difference between the two closure types. Wound complications such as infection, hematoma, and dehiscence did not occur in any of the patients.


CONCLUSIONS
In primary closures of facial defects, using 5-0 poliglecaprone-25 or 6-0 polypropylene for the superficial closure did not affect the cosmetic result. Therefore, 5-0 poliglecaprone-25 provides a comparable and cost-effective alternative to nonabsorbable sutures for epidermal approximation in layered closures.
Rosenzweig
Laura B
LB
Laser and Dermatologic Surgery Center, Chesterfield, Missouri 63017, USA. laurarosenzweig@yahoo.com
Abdelmalek
Mark
M
Ho
Julia
J
Hruza
George J
GJ
D004146:Dioxanes; D004311:Double-Blind Method; D005153:Facial Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D015580:Mohs Surgery; D011091:Polyesters; D011126:Polypropylenes; D019651:Plastic Surgery Procedures; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome; D014945:Wound Healing
D004146:Dioxanes; D011091:Polyesters; D011126:Polypropylenes; C095495:glycolide E-caprolactone copolymer