Photographic Assessment of Cosmetic Outcome in Postsurgical Facial Scars Favors Rapidly Absorbable Polyglactin 910 Over Fast Absorbing Gut: A Blinded Randomized Clinical Trial.
Summary
In a blinded randomized split-scar trial of 105 Mohs surgery patients, rapidly absorbable polyglactin 910 yielded superior photographic cosmesis at 6 months versus fast absorbing gut on multiple scar scales. Differences were statistically significant for dermatologist ratings (VAS, SBSES, WES), with concordant but nonsignificant trends from the plastic surgeon.
Key Findings
- Blinded split-scar RCT (n=105) comparing 5-0 Vicryl Rapide vs 5-0 fast absorbing gut for facial epidermal closure
- Dermatologist ratings favored polyglactin 910: VAS 76.5 vs 73.2 (p=.05); SBSES 4.4 vs 4.0 (p=.006); WES 5.4 vs 5.1 (p=.05)
- Plastic surgeon ratings trended in favor of polyglactin 910 but were not statistically significant at 6 months
Clinical Implications
For facial epidermal closure after cutaneous surgery, consider prioritizing rapidly absorbable polyglactin 910 to enhance cosmetic outcomes at 6 months.
Why It Matters
This adequately powered, blinded RCT provides direct, clinically actionable evidence for suture selection to optimize facial scar aesthetics.
Limitations
- Outcomes based on photographic ratings from two experts; patient-reported outcomes were not reported
- Single follow-up time point (6 months); durability beyond this period is unknown
Future Directions
Multicenter trials including patient-reported outcomes, longer follow-up, scar complication rates, and cost-effectiveness analyses could refine suture selection algorithms.
Study Information
- Study Type
- RCT
- Research Domain
- Treatment
- Evidence Level
- I - Blinded randomized split-scar clinical trial with adequate sample size
- Study Design
- OTHER