Modified Buried Vertical Mattress Suture Versus Buried Intradermal Suture: A Prospective Split-Scar Study

Split-level folding, step-type tension-relieving suture technique, and the evaluation on scar minimization

BACKGROUND

Prevailing tension-reducing suture methods have a spectrum of issues. This study presents a straightforward yet highly efficacious suture technique known as the Split-level Folding, Step-type Tension-relieving Suture technique, which could play a pivotal role in preempting incisional scarring.

AIMS

To introduce Split-level Folding, Step-type Tension-relieving Suture technique and assess its effect on scar minimization.

METHODS

A retrospective analysis of 64 patients who underwent treatment utilizing the proposed suturing methodology. Assessment parameters included the Patient and Observer Scar Assessment Scale (POSAS), the Vancouver Scar Scale (VSS), scar width, complications, and all evaluated at 6- and 12-month postoperatively.

RESULTS

At 12-month follow-up, the POSAS and VSS scores in the normal suture group (32.58 ± 5.43, 3.58 ± 1.39) were considerably higher than the step-type suture group (29.75 ± 3.56, p = 0.0007; 2.78 ± 1.17, p = 0.0006). Moreover, the step-type suture group showcased a significantly narrower average incision scar width (1.62 ± 0.36) than the normal suture group (1.87 ± 0.42, p = 0.0004). This novel tension-relieving suture technique that effectively circumvents the occurrence of persistent localized eversion and other complications often associated with traditional tension-relieving sutures.

CONCLUSIONS

The Split-level Folding, Step-type Tension-relieving Suture technique emerges as a highly promising option for averting incisional scarring. This suture method works well for incisions on the chest, back, and extremities, resulting in significantly better long-term outcomes.

Absorbable vs. non-absorbable suture: which one gives better results?

BACKGROUND

There is no ideal suture material or ideal sewing technique. The type of suture material affects the quality of the scars. Patient and surgeon satisfaction with the quality and comfort of the scar is one of the main goals of modern surgery.

AIMS

This study aims to compare the quality of scars and patient satisfaction after using two different types of sutures.

METHODS

This research was conducted as a prospective study that included 64 patients whose surgical wounds were closed with intradermal suture using different suturing materials according to which the patients were divided into two groups: absorbable - Monocryle (32) and non-absorbable - DemeLENE suture (32). POSAS scale and an ultrasound machine were used to assess the scars. The doctor and the patient evaluated seven parameters on two occasions, after 2 and 6 weeks after the surgery.

RESULTS

The statistically significant advantage was found after 2 weeks in scars sewn with non-resorptive suture in terms of elasticity, doctor's general impression, pain, itching, color, stiffness, thickness, irregularity, and patient's general impression. After 6 weeks, statistically significantly better results were shown on scars sewn with non-resorptive thread for the parameters doctor's general impression, itching, irregularity, and patient's general impression.

CONCLUSIONS

Non-resorptive sutures show statistically significantly better results, especially after 2 weeks from the patient's point of view so we consider them more comfortable and convenient to use.