title: Comparison of cosmetic outcomes of absorbable versus nonabsorbable sutures in pediatric facial lacerations.
abstract: OBJECTIVE
  We sought to compare cosmetic outcomes, complication rates, and patient/caregiver satisfaction of absorbable versus nonabsorbable sutures in children.
  
  
  METHODS
  Healthy patients, 1 to 18 years old, with facial lacerations 1 to 5 cm, were randomized to repair with fast-absorbing catgut (FAC) or nylon (NYL) sutures. Patients returned in 4 to 7 days and in 3 to 4 months, at which time photographs and caregiver surveys were completed. Unlike part I, all FAC sutures were permitted to absorb rather than be removed. Using a 100-mm visual analog scale (VAS), a noninferiority (NI) design was applied, with a difference of less than 15 mm considered clinically equivalent. Caregivers and 3 blinded physicians independently rated the scars via photographs.
  
  
  RESULTS
  Ninety-eight patients were enrolled, 76 caregiver surveys were completed, and 61 (29 FAC, 32 NYL) had photographs scored by physicians. The mean physician VAS scores for FAC and NYL were 57.6 and 67.6, respectively (difference, -10.0; 95% confidence interval, -19.1 to -0.4); thus, NI could not be established. The mean caregiver VAS scores for the FAC and NYL groups were 93.8 and 86.6, respectively (difference, 7.2; 95% confidence interval, -4.9 to 13.9); thus, NI of FAC was established. There were no significant differences in rates of infection, wound dehiscence, or keloid formation. In terms of future preference, caregivers favored FAC (33/33) over NYL (26/36) (P < 0.01).
  
  
  CONCLUSIONS
  Caregiver VAS scores showed NI of FAC, which were also preferred by the caregivers. However, NI for FAC could not be demonstrated by blinded physicians with respect to cosmetic outcomes.
authors.affiliation: Division of Pediatric Emergency Medicine, Department of Pediatrics, Temple University Hospital, Philadelphia, PA, USA.
authors.forename: Raemma
authors.initials: R
authors.lastname: Luck
authors.forename: Trevor
authors.initials: T
authors.lastname: Tredway
authors.forename: James
authors.initials: J
authors.lastname: Gerard
authors.forename: Dalit
authors.initials: D
authors.lastname: Eyal
authors.forename: Lauren
authors.initials: L
authors.lastname: Krug
authors.forename: Robert
authors.initials: R
authors.lastname: Flood
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D001741:Black or African American; D001458:Bandages / Q000706:statistics & numerical data; D017028:Caregivers / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000453:epidemiology / Q000517:prevention & control; D003258:Consumer Behavior; D004954:Esthetics; D005151:Facial Injuries / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007627:Keloid / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control; D022125:Lacerations / Q000628:therapy*; D008297:Male; D010820:Physicians / Q000523:psychology; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D016037:Single-Blind Method; D013529:Surgical Wound Dehiscence / Q000453:epidemiology / Q000517:prevention & control; D013537:Sutures; D014014:Tissue Adhesives / Q000627:therapeutic use; D016896:Treatment Outcome; D058106:Wound Closure Techniques
chemical_list: D014014:Tissue Adhesives