title: Scar outcomes in dermatological surgery.
abstract: OBJECTIVE
  Significant functional impairment and psychological burden may result from poor scar quality and its impact on patient's quality of life has been well-established. It is important to identify measures to reduce the risk of surgical complications.
  
  
  METHODS
  212 patients undergoing dermatological surgery were recruited from March 2011 to February 2014. Their age, sex, surgical site, closure type, defect size (length and width), scar length, number of deep sutures, suture type and size were recorded. The patients were followed up at 6 weeks and 6 months for complications including abscess formation, granuloma formation, scar spreading, suture spitting and hypertrophic scar formation.
  
  
  RESULTS
  At 6 weeks complications included suture spitting (14%), granuloma (11%), scar spreading (7%), hypertrophic scarring (3%) and abscess formation (1%), and at 6 months; scar spreading (17%), hypertrophic scarring (2%) and suture spitting (1%). In our multivariate analysis there were no predictors for spreading or spitting at 6 weeks, and only the defect size width was a predictor for granulomas in the stepwise analysis. For scar spreading at 6 months, younger age, site (trunk or limbs), higher number of deep sutures and surgeon were independent predictors (P < 0.0001 for the model).
  
  
  CONCLUSIONS
  Complications following dermatological surgery are low and tend to resolve with time, except for scar spreading. The surgeon who experienced more complications was placing sutures more superficially to the skin surface and was throwing more knots per closure; factors that we did not record in our study and merit further study.
authors.affiliation: Skin and Cancer Foundation Australia, Westmead, New South Wales, Australia.|Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Burcu
authors.initials: B
authors.lastname: Kim
authors.affiliation: Skin and Cancer Foundation Australia, Westmead, New South Wales, Australia.|Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Melissa
authors.initials: M
authors.lastname: Sgarioto
authors.affiliation: Skin and Cancer Foundation Australia, Westmead, New South Wales, Australia.|Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Hewitt
authors.affiliation: Skin and Cancer Foundation Australia, Westmead, New South Wales, Australia.|Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Paver
authors.affiliation: Skin and Cancer Foundation Australia, Westmead, New South Wales, Australia.|Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Julia
authors.initials: J
authors.lastname: Norman
authors.affiliation: Skin and Cancer Foundation Australia, Westmead, New South Wales, Australia.|Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Pablo
authors.identifier: http://orcid.org/0000-0003-4882-1564
authors.initials: P
authors.lastname: Fernandez-Penas
mesh_terms: D000038:Abscess / Q000209:etiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017439:Cicatrix, Hypertrophic / Q000209:etiology* / Q000473:pathology; D062109:Dermatologic Surgical Procedures / Q000009:adverse effects; D005260:Female; D006099:Granuloma / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012871:Skin Diseases / Q000209:etiology; D012878:Skin Neoplasms / Q000601:surgery*; D013536:Suture Techniques / Q000009:adverse effects*; D013537:Sutures / Q000009:adverse effects; D055815:Young Adult
keywords: abscess formation; dermatological surgery; granuloma formation; hypertrophic scar formation; scar; scar spreading; suture spitting; sutures