Enhanced Cosmetic Outcome with Running Horizontal Mattress Sutures

• Published in: Dermatologic surgery 2005-10, Vol.31 (10), p.1313-1316
• Main Authors: Moody, Brent R, McCarthy, John E, Linder, Jennifer, Hruza, George J
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Dermatologic Surgical Procedures; Dermatology; Face; Humans; Medical sciences; Mohs Surgery - adverse effects; Skin Neoplasms - surgery; Skin plastic surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery, Plastic; Suture Techniques; Treatment Outcome
• ISSN: 1076-0512; 1524-4725
• DOI: 10.1097/00042728-200510000-00009

BACKGROUNDCutaneous sutures should provide good wound eversion, firm closure, and cosmetically elegant results. Simple running sutures are commonly employed in cutaneous surgery but may not always be effective in achieving wound eversion. OBJECTIVEWe compared the cosmetic results of simple running nonabsorbable sutures with running horizontal mattress sutures in primary closures of facial defects. METHODSFifty-five patients with facial Mohs surgery defects appropriate for primary multilayer repair were randomized into one of two arms. Either the superior or the inferior half of the wound was closed with a running horizontal mattress suture. The other half of the wound was closed with a traditional simple running suture. At 1 week, 6 weeks, and 6 months, the cosmetically superior half of the wound, if any, was blindly determined by the investigators. RESULTSThe running horizontal mattress suture was significantly more cosmetically pleasing than the simple running suture. Forty-seven patients completed the study. At the 6-month follow-up, 25 patients did better with the horizontal suture and 5 did worse, and with 17 patients, there was no clinically perceptible difference. The 6-week scores predicted the outcome at 6 months, but the 1-week scores did not. CONCLUSIONSIn primary closures of the face, the running horizontal mattress suture is a cosmetically elegant alternative to a traditional running cutaneous suture. The final scar appears smoother and flatter than those produced by traditional simple running sutures.