Dermatological surgery: An update on suture materials and techniques: Part 2.

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This is the second part of a two-part series which summarises the latest evidence related to suture materials and wound closure techniques in dermatological surgery. We critically appraised evidence focusing on the following consequences of suture choice: scar/cosmesis, pain, patient satisfaction, cost, infection, and wound complications. We searched the databases Medline, PubMed and Embase using the keywords: ‘skin surgery’, ‘dermatologic surgery’, ‘sutures’, ‘braided sutures’, ‘monofilament sutures’ and ‘antibacterial sutures’ to identify relevant English-language articles. This part of the review assesses the evidence for different types of buried suture including braided versus monofilament sutures, longer-absorbing sutures and antibacterial sutures. The majority of trials were noted to be of poor quality, single-centre (thus lacking external validity) and underpowered, which presents challenges in comparing suture techniques in skin surgery. Future multi-centre large scale randomised trials are needed, with both surgeon and patient-assessed validated outcomes.

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Authors: E Butt, I Ashraf, D Veitch, A Wernham