Evaluation Of Different Types Of Skin Closure Techniques

The scar is the signature of the surgeon. Apart from cosmetically good scars it is also necessary that the skin closure technique should be technically easy, acceptable, speedy and economical. AIMS: To evaluate different techniques viz simple interrupted closure, vertical mattress closure, subcuticular stitches, glue application and staple closure in terms of time taken, acceptability, cost and cosmetic outcome. MATERIALS AND METHODS: This study was carried out in 100 patients (20 in each group). RESULTS: Simple suture, though speedy and economical, was not favoured by paediatric patients. It was evident that in smaller wounds (5cm) simple suture, glue and staples were faster than other types of closure while subcuticular closure was slowest. Glue application had higher acceptability. As the wound size increased, the vertical mattress technique was used; however, it was slower than simple and staple closure. In larger wounds (>10 cm), stapling was significantly faster than vertical mattress. There was only one major wound infection with glue closure. Simple suture had the cheapest per centimetre cost while glue had highest cost in smaller wounds. In larger wounds, simple closure did remain cheapest; however, vertical mattress and stapling had identical cost. Cosmesis was excellent in glue and subcuticular stitches while in other cases it was mostly good. CONCLUSION: Newer methods of skin closure like staples and glue are as good as traditional methods of suture closure and both are cosmetically better, have better patient acceptability and are speedy, operator friendly and cost-effective, too.