A comparison of aesthetic outcome between tissue adhesive and subcuticular suture in thyroidectomy wound closure in a multiracial country: A randomized controlled trial

Teoh, Li-Ying; Chong, Shun-Siang; Hoh, Siew-Yep; Teoh, Mei-Shi; Ng, Khoon-Leong

doi:10.1016/j.asjsur.2018.09.014

Cited by 18 publications

(20 citation statements)

References 19 publications

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“…1 ) 34–51 . In these studies, there were data from 1416 patients and six closure methods (that is adhesive (28.5 per cent, 404 patients, 10 RCTs) 35–38 , 40 , 42 , 44 , 45 , 49 , 50 , absorbable subcuticular suture (ASCS) (18.1 per cent, 257 patients, 7 RCTs) 35 , 37 , 39 , 41 , 44 , 47 , 50 , non-absorbable subcuticular suture (NASCS) (16.8 per cent, 238 patients, 6 RCTs) 34 , 43 , 46 , 48 , 49 , 51 , staples (26.3 per cent, 372 patients, 11 RCTs) 34 , 36 , 38 , 40–43 , 45–47 , 51 , steristrips (8.1 per cent, 115 patients, 3 RCTs) 39 , 46 , 48 , and CS (2.1 per cent, 30 patients, 1 RCTs) 51 . Of the 18 RCTs included in this analysis, 44.4 per cent were conducted in European surgical research institutions (8/18) 35–37 , 39–43 .…”

Section: Resultsmentioning

confidence: 99%

“…There was a low-to-moderate risk of bias among the included RCTs. Overall, 3 of the RCTs had a low risk of bias (18.8 per cent) 36 , 39 , 44 , 13 of the RCTs included some concerns for bias (75.0 per cent) 34 , 35 , 37 , 38 , 40 , 42 , 43 , 45–50 , and 2 RCTs were considered to have a high risk of bias (6.2 per cent) 41 , 51 . Risk-of-bias assessment is illustrated in Table S3 .…”

Section: Resultsmentioning

confidence: 99%

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Optimal primary wound closure methods after thyroid and parathyroid surgery: network meta-analysis of randomized clinical trials

et al. 2023

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Background At present, there is no consensus on optimal neck wound closure methods after thyroid and parathyroid surgery. The aim of this study was to perform a systematic review and network meta-analysis of RCTs evaluating the optimal neck closure method after thyroid and parathyroid surgery. Methods A frequentist random-effects network meta-analysis was performed for RCTs comparing at least two closure methods according to PRISMA-network meta-analysis guidelines. Analysis was performed using R packages and Shiny. Results Eighteen RCTs evaluating six closure methods (that is adhesive (28.5 per cent, 404 patients), absorbable subcuticular suture (18.1 per cent, 257 patients), non-absorbable subcuticular suture (16.8 per cent, 238 patients), staples (26.3 per cent, 372 patients), steristrips (8.1 per cent, 115 patients), and conventional suture (2.1 per cent, 30 patients)) in 1416 patients were included. At network meta-analysis, there was no difference in complication, infection, dehiscence, or haematoma rates irrespective of closure method used. Staples reduced closure duration versus absorbable subcuticular suture (mean difference (MD) 8.50, 95 per cent c.i. 6.90 to 10.10) and non-absorbable subcuticular suture (MD 0.30, 95 per cent c.i. 0.23 to 0.37), whereas adhesives (MD −1.05, 95 per cent c.i. −1.31 to −0.79) reduced closure time relative to staples. Cosmesis was improved after non-absorbable subcuticular suture (odds ratio (OR) 3.41, 95 per cent c.i. 1.66 to 7.00) relative to staples. Staples reduced patient satisfaction (OR 0.04, 95 per cent c.i. 0.00 to 0.33) and ability to shower (OR 0.04, 95 per cent c.i. 0.00 to 0.33) relative to adhesives. Conclusion Despite staples decreasing closure times, this advantage is offset by reduced patient satisfaction, ability to shower, and cosmesis compared with patients with wounds closed using adhesives, absorbable subcuticular suture, and non-absorbable subcuticular suture. Therefore, these closure methods are favourable for closing neck wounds due to more acceptable patient-reported outcomes, without compromising the safety of the procedure.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Optimal primary wound closure methods after thyroid and parathyroid surgery: network meta-analysis of randomized clinical trials

et al. 2023

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“…Several studies have been published to date, but most of them reported that there were no differences of aesthetic outcome in suture methods. [1][2][3][4]17 However, these studies designed the subcuticular group to use common mono-or multifilament absorbable sutures, such as Caprosyn or Vicryl suture. In contrast, we used a barbed suture material developed for soft-tissue approximation in this study.…”

Section: Discussionmentioning

confidence: 99%

“…3 Moreover, remote access, such as robotic surgery via an intraoral approach or endoscopic surgery via a postauricular approach, have been popularized, because they leave no visible scar on the neck, and therefore are deemed to yield superior cosmetic result. 4 However, these procedures have been still conducted by few facilities, and conventional collar neck incision is still considered as a common surgical approach.…”

Section: Introductionmentioning

confidence: 99%

Current Protocol for Aesthetic Scar Management in Thyroid Surgery

et al. 2021

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Objectives/Hypothesis: We compared the scar quality when different protocols were applied, and eventually aim to find the optimal scar management protocol.Study Design: We conducted a prospective, randomized, and blinded comparison of different scar management protocols in a single center.Methods: We allocated 126 patients who underwent thyroidectomy via collar neck incision randomly into three groups. Patients in group A were treated with tissue adhesive only. Patients in group B were treated by means of subcuticular suturing and early scar management with a non-ablative fractional laser (NAFL) and intralesional triamcinolone injection (ILI). Patients in group C had skin closure with tissue adhesive and early scar management. At 6 months after the operation, the Patient and Observer Scar Assessment Scale (POSAS) and the width of the final scar were compared.Results: Comparing the sum of PSAS, groups B and C showed significant higher satisfaction than did group A (22.81 ± 11.66 in group A, 10.9 ± 5.14 in group B, and 15.19 ± 9.98 in group C). In the sum of OSAS, group B also showed a significant difference than did groups A and C (17.74 ± 6.75 in group A, 10.26 ± 3.60 in group B, and 14.52 ± 6.48 in group C). Also, group B showed a narrower scar width than did groups A and C.Conclusions: Our finding suggests that subcuticular suturing using barbed suture material and early treatment with a combination therapy using NAFL and ILI showed a favorable aesthetic outcome for both patients and operators. Based on our algorithmic approach for thyroidectomy scar, we anticipate an optimal aesthetic outcome.

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“…Correspondingly, scar elevation was qualitatively rated (no elevation, elevation present, or prominent elevation) in SBSES or mSBSES, scales intentionally developed for short‐ and long‐term evaluation of post‐surgical scars 46 . SBSES was already widely adopted for surgical incisions of thyroidectomy 41,42,70–72 and torso operations, 44,73 displaying some strengths on assessing large and linear surgical wounds. It has an advantage of using digital photographic images, and the interrater reliability demonstrated good agreement, ranging from 0.73 to 0.85 46 .…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of botulinum toxin type A for postoperative scar prevention and wound healing improvement: A systematic review and meta‐analysis

Huang

2021

J of Cosmetic Dermatology

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Postoperative wound healing is permanently of great concern to both surgeons and patients because pathological scars, including hypertrophic scars and keloids, profoundly affect an individual's physical and psychological well-being by causing pruritus, ulceration, pain, and contractures. Normal scar formation is an overlapping and orderly process involving hemostasis, inflammation, proliferation, and remodeling phases. 1 Although the pathogenesis of abnormal scar formation remains obscure, it is believed to be attributed to an

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A comparison of aesthetic outcome between tissue adhesive and subcuticular suture in thyroidectomy wound closure in a multiracial country: A randomized controlled trial

Cited by 18 publications

References 19 publications

Optimal primary wound closure methods after thyroid and parathyroid surgery: network meta-analysis of randomized clinical trials

Optimal primary wound closure methods after thyroid and parathyroid surgery: network meta-analysis of randomized clinical trials

Current Protocol for Aesthetic Scar Management in Thyroid Surgery

Efficacy and safety of botulinum toxin type A for postoperative scar prevention and wound healing improvement: A systematic review and meta‐analysis

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