Adhesive Strips Do Not Improve Outcomes of Dermal Suture Wound Closure

By Will Boggs MD

April 22, 2015

NEW YORK (Reuters Health) - Adhesive strips do not improve overall scar formation when added to dermal sutures for wound closure, researchers report.

"With well-placed dermal sutures, patients can still have excellent cosmetic results without the added expense or time required to place adhesive strips," Dr. Daniel B. Eisen, from the University of California, Davis, School of Medicine, Sacramento, told Reuters Health by email.

Adhesive strips have been shown to perform at least as well as other cuticular closure methods, but whether they improve outcomes compared with simple subcuticular wound closure with buried vertical mattress sutures alone has been unclear.

Dr. Eisen and colleagues compared outcomes following primary wound closure after cutaneous surgery of dermal sutures with or without adhesive strips in a split-wound comparison trial of 48 patients, 45 of which were available at the 3-month follow-up visit. One randomly selected half of each wound was covered with a supplemental adhesive, while the other half received only sutures.

"Our hypothesis was that the strips would make no difference," Dr. Eisen said. "This was based upon our own anecdotal experience where we found excellent results in patients where the strips had fallen off early or were not used in hair-bearing areas."

Mean scores on the 60-point Patient Observer Scar Assessment Scale (POSAS) from reviewers blinded to treatment assignment did not differ for the two closure techniques for vascularity, pigmentation, thickness, relief, pliability, surface area, and overall opinion.

Similarly, patient POSAS scores did not differ between the sides of the scars for pain, itching, color, stiffness, thickness, irregularity, and overall opinion, according to the April 15 JAMA Dermatology online report.

Scar width at three months averaged the same (1.1 mm) on both sides of the wound.

The researchers documented no infections, hematomas, or seromas, and adverse events did not differ significantly between the treatment groups.

"Our results do not support the use of adhesive strips as a means to improve cosmetic outcomes or reduce scar width," the researchers conclude.

"I still use them in situations where I'm worried about the patient touching or manipulating the wound," Dr. Eisen said. "They can serve as an additional barrier where that is a concern. They are also helpful to reflect the ear when one is operating on the posterior auricular and mastoid areas."

The National Center for Advancing Translational Sciences partially supported this research. The authors made no disclosures.

SOURCE: https://bit.ly/1G3W0R3

JAMA Dermatol 2015.

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