Surgical Wound Cosmesis Clinical Trial
Official title:
Use of 6-0 Fast Absorbing Gut Versus 5-0 Fast Absorbing Gut for Linear Cutaneous Wound Closure: a Randomized Evaluator Blind Split Wound Comparative Effectiveness Trial.
Traditionally, dermatologic surgeons close wounds with stitches. Fast absorbing gut is a dissolvable stitch that is very commonly used. Some surgeons believe that using a thinner size of this stitch causes less skin reaction and improves the cosmetic outcome of the scar. Other surgeons believe that using a thicker size of this stitch reduces the tension on the scar and improves the cosmetic outcome of the scar in that manner. The investigator wishes to determine whether the thickness of the fast absorbing gut suture that is used makes a difference in the cosmetic outcome of the scar.
The purpose of this study is to determine whether the use of 6-0 fast absorbing gut during
repair of linear cutaneous surgery wounds on the face or neck improves scar cosmesis compared
to wound closure with 5-0 fast absorbing gut. The investigator will use a split wound model,
where half of the wound is repaired with 6-0 fast absorbing gut and the other half is
repaired with 5-0 fast absorbing gut. Three-months post-surgery, the scar will be measured
via the patient observer scar assessment scale, a validated scar instrument. The scar width,
and adverse events will also be recorded.
This study aims to investigate whether 5-0 versus 6-0 fast absorbing gut suture leads to
better surgical wound cosmesis on the head and neck. The 5-0 fast absorbing gut suture has a
large diameter, and therefore greater tensile strength. The greater tensile strength would
provide better support of the healing scar during the first 5-7 days after surgery and for
this reason, could potentially lead to improved scar cosmesis. However, the greater diameter
could also lead to track marks that are larger and more visible. Furthermore, fast absorbing
gut has a high degree of tissue reactivity to begin with, and it is known that larger
diameter sutures generate more tissue reactivity compared to smaller diameter sutures of the
same material; therefore, it is also possible that the 6-0 fast absorbing gut suture would
provide better scar cosmesis by virtue of its lower tissue reactivity3,4.
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