Use of 5-0 Fast Absorbing Gut versus 6-0 Fast Absorbing Gut during cutaneous wound closure on the head and neck: A randomized evaluator-blinded split-wound comparative effectiveness trial - 18/05/19

Doi : 10.1016/j.jaad.2019.02.037

Aunna Pourang, MD ^a, Milene K. Crispin, MD ^b, Ashley K. Clark, MD ^a, April W. Armstrong, MD, MPH ^c, Raja K. Sivamani, MD, MS, AP ^a,^d,^e, Daniel B. Eisen, MD ^a,^⁎
^a Department of Dermatology, University of California, Davis, Sacramento, California
^b California Skin Institute, Carmel, California
^c Department of Dermatology, Keck School of Medicine at University of Southern California, Los Angeles, California
^d Department of Biological Science, California State University, Sacramento, California
^e Pacific Skin Institute, Sacramento, California

^∗Reprint requests: Daniel B. Eisen, MD, Department of Dermatology, University of California, Davis, School of Medicine, 3301 C St, Ste 1400, Sacramento, CA 95816.Department of DermatologyUniversity of California, DavisSchool of Medicine3301 C St, Ste 1400SacramentoCA95816

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Abstract

Background

Absorbable suture material (Fast Absorbing Gut [FG], Ethicon, Somerville NJ) is often used for patient convenience; however, the optimal diameter of FG sutures is debatable.

Objective

To determine whether the use of 6-0 FG during repair of linear cutaneous surgery wounds on the head and neck improves scar cosmesis compared with the use of 5-0 FG.

Methods

This was a prospective, randomized, split-scar intervention in patients undergoing repair of linear cutaneous wounds on the head and neck. The scar was assessed 3 months after surgery via the Physician Observer Scar Assessment Scale (POSAS), a validated instrument.

Results

The difference in the sum of the POSAS component scores for 6-0 FG (12.03) compared with that for 5-0 FG (13.11) was not statistically significant (P = .26). Observer overall opinion was similar for both interventions, at 2.49 for 6-0 FG vs 2.64 for 5-0 FG (P = .54). The difference in the number of complications in the 5-0 FG group (15) vs the 6-0 FG group (10) was not statistically significant (P = .40).

Limitations

Single-center study with wounds limited to the head and neck in white individuals, with a predominance of men.

Conclusion

For linear repair of cutaneous wounds, 6-0 FG was not statistically different for cosmetic outcomes, scar width, and complications compared with 5-0 FG.

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Key words : 5-0, 6-0, cutaneous closure technique, cutaneous surgery, Fast Absorbing Gut, scar evaluation, suture caliber, suture diameter, suture size

Abbreviations used : FG, POSAS

Plan

Methods

Study design, registration, training, and ethical consent

Patient eligibility and a priori power analysis

Randomization, allocation, concealment, and interventions

	Drs Pourang and Crispin contributed equally to this article.
	Funding sources: This project was supported by the National Center for Advancing Translational Sciences and National Institutes of Health grant UL1-TR-000002, funding the REDCap database used for management of the study's data.
	Conflicts of interest: The authors have no relevant financial interests to report. Dr Armstrong served as an investigator or consultant, or both, to AbbVie, Janssen, Lilly, Pfizer, UCB, Dermira, Ortho Dermatologics, Sanofi Genzyme, Regeneron, BMS, Dermavant, Science 37, and Modernizing Medicine. Dr Sivamani serves as a scientific advisor to Dermveda and LearnSkin and as a consultant to Burt's Bees and Dermala. Drs Pourang, Crispen, Clark, and Eisen have no conflicts of interest to disclose.