Distancia de suturas

Published in Dermatology

Journal Scan / Research · November 18, 2019

Effect of Simple Interrupted Suture Spacing on Aesthetic and Functional Outcomes of Skin Closures

Journal of cutaneous medicine and surgery

TAKE-HOME MESSAGE

• In this prospective study, half of the elliptical surgical wounds of the trunk and extremities was repaired with simple interrupted sutures spaced 5 mm apart, and the other half was repaired with simple interrupted sutures 10 mm apart. There were no significant differences in minor wound complications between high-density and low-density suture spacing. At 3 months post-surgery, physicians and patients preferred the cosmesis of the low-density suture placement, but this preference disappeared by 6 months.

• While no functional and complication differences were observed between 5-mm versus 10-mm suture placement, placing sutures farther apart may result in better initial cosmesis and help conserve time and suture material.

– InYoung Kim, MD, PhD

Abstract

BACKGROUND

Dermatologic surgeons are trained in fundamental wound closure techniques that minimize wound tension and tissue ischemia to optimize healing and create discrete scars. These include orienting excisions along resting skin tension lines, handling tissue edges with care, and avoiding strangulation while tying suture. Another variable that may affect wound healing and cosmetic outcomes is the spacing between sutures.

OBJECTIVE

This prospective, single-centre, randomized, split-scar comparison trial was designed to explore how suture spacing distance affects wound complication rate and scar cosmesis.

METHODS

Elliptical surgical wounds of the trunk and extremities were repaired with simple interrupted sutures with varying suture spacing. One half of each wound was repaired with high-density suture spacing (approximately 5 mm apart) and the other with low-density suture spacing (approximately 10 mm apart). Wounds were evaluated at 2-week suture removal for complications, and then reevaluated at 3 and 6 months for cosmesis using the Patient and Observer Scar Assessment Scale score.

RESULTS

Results revealed no significant difference in minor wound complications during the early healing process between high- and low-density suture spacing. At 3 months postoperatively, physicians and patients alike preferred the aesthetics of the low-density suture placement. By 6 months postoperatively, this preference disappeared.

CONCLUSIONS

These results suggest that suture spacing may affect early scar formation. Additionally, placing sutures farther apart results in fewer total puncture wounds, decreases tissue trauma, and saves surgical time while conserving suture material. Therefore, dermatologic surgeons should consider placing fewer percutaneous sutures during wound repair.

Journal of cutaneous medicine and surgery

Effect of Simple Interrupted Suture Spacing on Aesthetic and Functional Outcomes of Skin Closures

J Cutan Med Surg 2019 Jul 04;[EPub Ahead of Print], A Stoecker, CM Blattner, S Howerter, W Fancher, J Young, W Lear 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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