Photographic Assessment of Cosmetic Outcome in Postsurgical Facial Scars Favors Rapidly Absorbable Polyglactin 910 Over Fast Absorbing Gut: A Blinded Randomized Clinical Trial

BACKGROUND No adequately powered, randomized studies have compared different absorbable suture types used for epidermal closure on facial scar cosmesis. OBJECTIVE To assess postsurgical facial scar appearance using rapidly absorbable polyglactin 910 or fast absorbing gut for epidermal closure. MATERIALS AND METHODS Randomized, blinded, split-scar clinical trial of 5-0 rapidly absorbable polyglactin 910 (Vicryl Rapide) and 5-0 fast absorbing gut. Patients with facial wounds resulting from Mohs micrographic surgery ( n = 105) were assigned for epidermal closure. One dermatologist and 1 plastic surgeon, blinded to original suture location, evaluated photographs of each healed scar at 6 months after surgery and graded each half of the scar using the visual analog scale (VAS), Stony Brook Scar Evaluation Scale (SBSES), and wound evaluation scale (WES). RESULTS At 6 months, mean (SD) scores from the dermatologist all statistically favored rapidly absorbable polyglactin 910: VAS 76.5(14.5) versus 73.2(15.2), p = .05; SBSES 4.4(0.9) versus 4.0(1.1), p = .006; WES 5.4(1.0) versus 5.1(1.1), p = .05. Scores from the plastic surgeon also favored rapidly absorbable polyglactin 910 but were not statistically significant. CONCLUSION Rapidly absorbable polyglactin 910, placed through the epidermis, was the favored absorbable suture material for facial epidermal closure.