Aesthetic Outcome of Intra-dermal Versus Transcutaneous Purse-string Closure: a Randomized Evaluator-blinded Split-wound Comparative Effectiveness Trial
University of California, Davis
Summary
The purpose of this study is to determine whether intra-dermal versus transcutaneous purse-string closures have similar scar cosmesis and post-operative complications. The investigators will use a split wound model, where half of the wound will be closed with intra-dermal purse-string sutures and the other half will be closed with a transcutaneous purse-string sutures. Three-months post-surgery, the scar will be evaluated via the patient observer scar assessment scale (POSAS), a validated scar instrument, as well as the trace-to-tape method, an objective outcome measure for linear postoperative scars. Any adverse events will also be recorded.
Description
The purse-string closure is a versatile technique that utilizes circumferential tissue advancement for partial or complete closure of circular cutaneous surgical defects. First reported in the 1950s for closure of a malar defect, the purse-string closure is now routinely used for umbilical, urethral, and breast defects as well as for cutaneous surgical defects either alone or in conjunction with top sutures, local flaps, or grafts. Though the purse-string closure was initially described with circumferentially placed intradermal sutures, various modifications to this technique have been publis…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * 18 years of age or older * Able to give informed consent themselves * Patient scheduled for cutaneous surgical procedure on the head, neck, trunk, or extremities with predicted purse-string closure. * Willing to return for follow up visit Exclusion Criteria: * Incarceration * Under 18 years of age * Pregnant Women
Interventions
- ProcedureIntra-dermal purse-string closure
Sutures are placed below the skin surface around a circular surgical wound, and the ends are cinched together like a coin purse.
- ProcedureTranscutaneous purse-string closure
Sutures are placed through the skin surface around a circular surgical wound, and cinched together like a coin purse.
Location
- University of California, Davis - Dermatology DepartmentSacramento, California