Stefani Kappel1, Rebecca Kleinerman2, Thomas H King3, Raja Sivamani3, Sandra Taylor4, UyenThao Nguyen4, Daniel B Eisen3. 1. Laser and Skin Surgery Center of Northern California, Sacramento, California. 2. Schweiger Dermatology, New York, New York. 3. Department of Dermatology, University of California, Davis, Sacramento, California. 4. Clinical and Translational Science Center, University of California, Davis, Sacramento, California.
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. LIMITATIONS: This was a single-center trial, which used a validated but still subjective scar assessment instrument. CONCLUSION: Wound eversion was not significantly associated with improved overall scar assessments by blinded observers or patient assessment.
RCT Entities:
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. LIMITATIONS: This was a single-center trial, which used a validated but still subjective scar assessment instrument. CONCLUSION: Wound eversion was not significantly associated with improved overall scar assessments by blinded observers or patient assessment.
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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