학술논문

Set-back versus buried vertical mattress suturing: Results of a randomized blinded trial
Document Type
article
Source
Journal of the American Academy of Dermatology. 72(4)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Clinical Research
Clinical Trials and Supportive Activities
Aged
Cicatrix
Dermatologic Surgical Procedures
Diagnostic Self Evaluation
Esthetics
Female
Follow-Up Studies
Humans
Learning Curve
Male
Middle Aged
Observer Variation
Patient Acceptance of Health Care
Prospective Studies
Severity of Illness Index
Single-Blind Method
Surveys and Questionnaires
Suture Techniques
Sutures
Treatment Outcome
Wound Healing
buried vertical mattress suture
cutaneous surgery
scar evaluation
set-back suture
subcuticular closure technique
wound eversion
Dermatology & Venereal Diseases
Clinical sciences
Language
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. © 2014 American Academy of Dermatology, Inc.