Postaural incision closure in single layer versus multiple layers: A comparison

Abstract

IntroductIonBy tradition, the postaural incision is closed in two or three layers. The layers consisting of periosteum, soft-tissue, and skin, each layer being closed separately. It not only consumes more of suture material, but also plenty of surgeon's time, sometimes the time for suturing equals or exceeds the time taken for mastoidectomy or tympanoplasty. The postaural incision closure can also be done in a single layer. Here, only the soft tissues and skin are sutured in a single layer. It saves both time and suture material, thereby reducing the cost of surgery as well. We did a random search on the internet to find out the efficacy of either of the procedures and to our surprise did not find any. Hence this study was undertaken to study and compare the efficacy of closing the postaural incision in a single layer versus closing in multiple layers.Data was sourced from patients who attended the outpatient department of Otorhinolaryngology, Fr. Muller Medical College Hospital, and who were diagnosed to have chronic suppurative otitis media, either tubo-tympanic or attico-antral type.Background: By tradition, the postaural incision is closed in single or multiple layers. In this study single layer closure is compared with multiple layer closure. Materials and Methods: Two hundred patients with Chronic suppurative otitis media undergoing ear surgery by post aural approach at our department were included in the study. Results: It was observed that time taken for single layer closure was far less compared with time taken for multiple layer closure, which was of statistical significance. Conclusion: single layer closure is as effective as multiple layer closure of postaural incision, with the distinct advantages of reduced closure time and lesser cost of suture material.

Merits and demerits of transcanal tympanoplasty: an observational study

“…This is in contrast to the outcome of Moras et al, who found postoperative morbidity of 4% accounted for by wound infection and dehiscence in their cases. 15 Review of literature did not reveal any study mentioning all post-operative morbidities of either approach, only mentioning some significant complications though we feel from the patients' point of view, any morbidity is significant because it affects their ability to go for work as well as quality of life which is a major issue in all studies on surgical or other treatment modalities in the present era. Investigating cutaneous sensory deficit, Kang et al found that the sensation of the pinna returned to baseline within 3 months for sulcus incisions.…”

“…This compared well with the results of Moras et al, in their study on postaural incision closure. 15 In comparison, the transcanal group had a 2-2.5 cm incision above the root of pinna within the hairline with the graft accessed easily and closure with 3-4 sutures in a single layer which took a maximum of 10 minutes. The materials used for both approaches have also been noted, with transcanal approach requiring only half a 3.0 monocryl while postaural approach required 1 vicryl 3.0 and 1 monocryl 3.0.…”

Single-Layer vs. Double-Layer Donor Scalp Wound Closure in Strip Harvest.

“…The average time taken in double-layer closure was more than the singlelayer closure (3.7 minutes vs. 4.7 minutes). However, the time was saved in single-layer wound closure [18,19].…”