Audrey S Wang1, Rebecca Kleinerman2, April W Armstrong3, Sarah Fitzmaurice4, Anabella Pascucci4, Smita Awasthi4, Mondhipa Ratnarathorn4, Raja Sivamani4, Thomas H King1, Daniel B Eisen5. 1. Department of Dermatology, University of California-Davis, Sacramento, California; Department of Dermatology, Department of Veterans Affairs, Northern California Healthcare System, Mather, California. 2. Schweiger Dermatology, New York, New York. 3. Department of Dermatology, University of Colorado-Denver, Aurora, Colorado. 4. Department of Dermatology, University of California-Davis, Sacramento, California. 5. Department of Dermatology, University of California-Davis, Sacramento, California. Electronic address: dbeisen@ucdavis.edu.
Abstract
BACKGROUND: The set-back suture, an absorbable dermal suturing technique, purportedly improves wound eversion and cosmetic outcomes. OBJECTIVE: We sought to conduct a split-wound, prospective, randomized study to compare the cosmetic outcome and wound eversion achieved with the set-back suture and the buried vertical mattress suture (BVMS). METHODS: A total of 46 surgical elliptical wounds were randomized to subcuticular closure with the set-back suture on half and the BVMS on the other. Maximum eversion height and width were measured immediately postoperatively. At 3 months, 2 blinded observers evaluated each scar using a 7-point Likert physician global scar assessment scale. Subjects and observers also completed the validated Patient and Observer Scar Assessment Scale, where a score of 6 represents normal-appearing skin and 60 represents worst imaginable scar. RESULTS: In all, 42 subjects completed the study. The set-back suture provided statistically significant wound eversion. On the Likert scale, observers rated the set-back suture side 1 point better than the BVMS side. Both patient and observer total Patient and Observer Scar Assessment Scale scores were significantly lower for the set-back suture side (subject mean 13.0 ± 8.7 vs 16.2 ± 12.0 [P = .039]; observer mean 24.5 ± 10.4 vs 27.7 ± 13.6 [P = .028], respectively). LIMITATIONS: Single institution experience and relatively short follow-up are limitations. CONCLUSION: The set-back suture provides superior wound eversion and better cosmetic outcomes than the BVMS.
RCT Entities:
BACKGROUND: The set-back suture, an absorbable dermal suturing technique, purportedly improves wound eversion and cosmetic outcomes. OBJECTIVE: We sought to conduct a split-wound, prospective, randomized study to compare the cosmetic outcome and wound eversion achieved with the set-back suture and the buried vertical mattress suture (BVMS). METHODS: A total of 46 surgical elliptical wounds were randomized to subcuticular closure with the set-back suture on half and the BVMS on the other. Maximum eversion height and width were measured immediately postoperatively. At 3 months, 2 blinded observers evaluated each scar using a 7-point Likert physician global scar assessment scale. Subjects and observers also completed the validated Patient and Observer Scar Assessment Scale, where a score of 6 represents normal-appearing skin and 60 represents worst imaginable scar. RESULTS: In all, 42 subjects completed the study. The set-back suture provided statistically significant wound eversion. On the Likert scale, observers rated the set-back suture side 1 point better than the BVMS side. Both patient and observer total Patient and Observer Scar Assessment Scale scores were significantly lower for the set-back suture side (subject mean 13.0 ± 8.7 vs 16.2 ± 12.0 [P = .039]; observer mean 24.5 ± 10.4 vs 27.7 ± 13.6 [P = .028], respectively). LIMITATIONS: Single institution experience and relatively short follow-up are limitations. CONCLUSION: The set-back suture provides superior wound eversion and better cosmetic outcomes than the BVMS.
Authors: Trenton Custis; April W Armstrong; Thomas H King; Victoria R Sharon; Daniel B Eisen Journal: JAMA Dermatol Date: 2015-08 Impact factor: 10.282
Authors: Jayne Joo; Aunna Pourang; Catherine N Tchanque-Fossuo; April W Armstrong; Danielle M Tartar; Thomas H King; Raja K Sivamani; Daniel B Eisen Journal: Arch Dermatol Res Date: 2021-09-21 Impact factor: 3.033