title: Does wound eversion improve cosmetic outcome?: Results of a randomized, split-scar, comparative trial.
abstract: BACKGROUND
  Wound edge eversion has been hypothesized to improve aesthetic outcomes after cutaneous wound closure. Data supporting this assertion are sparse.
  
  
  OBJECTIVE
  We sought to determine if wound eversion, achieved with interrupted subcuticular sutures, improves aesthetic outcome compared with planar closures.
  
  
  METHODS
  We undertook a prospective, randomized, split-scar intervention in patients who underwent cutaneous surgery. Half of the wound was randomized to an everted or planar repair; the other side received the opposite one. At 3- and 6-month follow-up, both the patient and 2 blinded observers evaluated the wound using the Patient Observer Self-Assessment Scale (POSAS).
  
  
  RESULTS
  The total observer POSAS score for the everted (13.59, 12.26) and planar (12.91, 12.98) sides did not differ significantly at 3 or 6 months, respectively. Similarly, there was not a significant difference in patient assessment between the everted (16.23, 12.84) and planar (15.07, 12.79) sides at 3 or 6 months, respectively. Finally, there was no significant difference between the 2 closure methods in terms of scar height or width at follow-up.
  
  
  CONCLUSIONS
  This was a single-center trial, which used a validated but still subjective scar assessment instrument.
  
  
  CONCLUSIONS
  Wound eversion was not significantly associated with improved overall scar assessments by blinded observers or patient assessment.
authors.affiliation: Laser and Skin Surgery Center of Northern California, Sacramento, California.
authors.forename: Stefani
authors.initials: S
authors.lastname: Kappel
authors.affiliation: Schweiger Dermatology, New York, New York.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Kleinerman
authors.affiliation: Department of Dermatology, University of California, Davis, Sacramento, California.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: King
authors.affiliation: Department of Dermatology, University of California, Davis, Sacramento, California.
authors.forename: Raja
authors.initials: R
authors.lastname: Sivamani
authors.affiliation: Clinical and Translational Science Center, University of California, Davis, Sacramento, California.
authors.forename: Sandra
authors.initials: S
authors.lastname: Taylor
authors.affiliation: Clinical and Translational Science Center, University of California, Davis, Sacramento, California.
authors.forename: UyenThao
authors.initials: U
authors.lastname: Nguyen
authors.affiliation: Department of Dermatology, University of California, Davis, Sacramento, California.
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Eisen
mesh_terms: D000368:Aged; D002921:Cicatrix / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D062109:Dermatologic Surgical Procedures / Q000009:adverse effects*; D059026:Diagnostic Self Evaluation; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D011446:Prospective Studies; D012720:Severity of Illness Index; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D014945:Wound Healing
keywords: Patient Observer Self-Assessment Scale; cosmesis; eversion; inverted vertical mattress suture; set-back suture; surgical scars