Interrupted Subdermal Suture Spacing During Linear Wound Closures and the Effect on Wound Cosmesis
| Status: | Recruiting |
|---|---|
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 11/21/2018 |
| Start Date: | September 20, 2017 |
| End Date: | August 26, 2019 |
| Contact: | Daniel Eisen, MD |
| Email: | dbeisen@ucdavis.edu |
| Phone: | 916-734-6479 |
Interrupted Subdermal Suture Spacing During Linear Wound Closures and the Effect on Wound Cosmesis: a Randomized Evaluator Blinded Split Wound Comparative Effectiveness Trial
This study aims to investigate whether the spacing of the interrupted deep (subdermal)
sutures affects surgical wound cosmesis on the trunk and extremities. In other words, the
investigator would like to determine which of the following yields a more cosmetically
appealing scar: many closely approximated subdermal sutures or fewer, more widely spaced
subdermal sutures. The investigator wishes to compare the effects of one versus two
centimeter spacing between sutures.
sutures affects surgical wound cosmesis on the trunk and extremities. In other words, the
investigator would like to determine which of the following yields a more cosmetically
appealing scar: many closely approximated subdermal sutures or fewer, more widely spaced
subdermal sutures. The investigator wishes to compare the effects of one versus two
centimeter spacing between sutures.
Sutures are the standard of care in repairing cutaneous wounds. The majority of surgical
reconstructions following a Mohs micrographic surgery and standard surgical excisions require
two layers of sutures: a deep layer and a top layer. The deep layer dissolves naturally
whereas the top layer must be removed.
This study aims to investigate whether the spacing of the interrupted deep (subdermal)
sutures affects surgical wound cosmesis on the trunk and extremities. In other words, the
investigator would like to determine which of the following yields a more cosmetically
appealing scar: many closely approximated subdermal sutures or fewer, more widely spaced
subdermal sutures. The investigator wishes to compare the effects of one versus two
centimeter spacing between sutures. It is possible that fewer, more widely spaced sutures may
leave more open space in the wound, leaving more tension to pull on those few sutures,
possibly encouraging the wound to dehisce and make it harder to approximate the wound edges
yielding a less cosmetically appealing scar compared to placing many closely approximated
sutures which would decrease the tension and likely better approximate the wound edges
yielding a more cosmetically appealing scar. On the other hand, we may find that suture
spacing has no effect on wound cosmesis and that placing fewer, more widely spaced sutures is
much more time efficient. The investigator may also find that the effect of suture spacing on
wound cosmesis is dependent on wound tension. For example, perhaps the suture pacing would
have no effect on the cosmesis of a wound under no tension, however, for a wound under high
tension, it is possible that many closely approximated sutures would yield better cosmetic
results for the reasons listed above.
reconstructions following a Mohs micrographic surgery and standard surgical excisions require
two layers of sutures: a deep layer and a top layer. The deep layer dissolves naturally
whereas the top layer must be removed.
This study aims to investigate whether the spacing of the interrupted deep (subdermal)
sutures affects surgical wound cosmesis on the trunk and extremities. In other words, the
investigator would like to determine which of the following yields a more cosmetically
appealing scar: many closely approximated subdermal sutures or fewer, more widely spaced
subdermal sutures. The investigator wishes to compare the effects of one versus two
centimeter spacing between sutures. It is possible that fewer, more widely spaced sutures may
leave more open space in the wound, leaving more tension to pull on those few sutures,
possibly encouraging the wound to dehisce and make it harder to approximate the wound edges
yielding a less cosmetically appealing scar compared to placing many closely approximated
sutures which would decrease the tension and likely better approximate the wound edges
yielding a more cosmetically appealing scar. On the other hand, we may find that suture
spacing has no effect on wound cosmesis and that placing fewer, more widely spaced sutures is
much more time efficient. The investigator may also find that the effect of suture spacing on
wound cosmesis is dependent on wound tension. For example, perhaps the suture pacing would
have no effect on the cosmesis of a wound under no tension, however, for a wound under high
tension, it is possible that many closely approximated sutures would yield better cosmetic
results for the reasons listed above.
Inclusion Criteria:
- 18 years of age or older
- Able to give informed consent themselves
- Patient scheduled for cutaneous surgical procedure on the trunk and extremities with
predicted primary closure
- Willing to return for follow up visit.
Exclusion Criteria:
- Mentally handicapped
- Unable to understand written and oral English
- Incarceration
- Under 18 years of age
- Pregnant Women
- Wounds with predicted closure length less than 4 cm
We found this trial at
1
site
Sacramento, California 95816
Phone: 916-734-6479
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