Purse-String Suture vs Second Intention Healing

Joo, Jayne S; Custis, Trenton; Armstrong, April W.; King, Thomas H.; Omlin, Kenny; Kappel, Stefani T.; Eisen, Daniel B.

doi:10.1001/jamadermatol.2014.2313

Cited by 31 publications

(12 citation statements)

References 29 publications

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“…The fascia was stitched around the catheter with a purse-string suture to prevent the catheter from sliding out during the study. 27–29 The rat was then rolled on to its right side, and a small incision was made into the skin at the upper back. The catheter was subcutaneously routed through this opening and any extra length was trimmed so the end of the catheter was even with the back incision (Figure 4b).…”

Section: Methodsmentioning

confidence: 99%

Preliminary Evaluation of the Viability of Peritoneal Drainage Catheters Implanted in Rats for Extended Durations

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Kreikemeier-Bower

et al. 2018

Journal of Investigative Surgery

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Section: Methodsmentioning

confidence: 99%

Preliminary Evaluation of the Viability of Peritoneal Drainage Catheters Implanted in Rats for Extended Durations

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Kreikemeier-Bower

et al. 2018

Journal of Investigative Surgery

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“…The total score ranges from 6 to 60 with a lower score representing more normal appearing skin on the scale. The POSAS has been validated when 2 independent observers are used [18] and has been used in numerous surgical studies [12,13,17,[19][20][21][22][23][24][25]. The scar outcome was evaluated in person by the patient and 2 blinded observers who were not present during the intervention.…”

Section: Assessmentsmentioning

confidence: 99%

Undermining during cutaneous wound closure for wounds less than 3 cm in diameter: a randomized split wound comparative effectiveness trial

et al. 2021

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Undermining is thought to improve wound outcomes; however, randomized controlled data regarding its efficacy are lacking in humans. The objective of this randomized clinical trial was to determine whether undermining low to moderate tension wounds improves scar cosmesis compared to wound closure without undermining. Fifty-four patients, 18 years or older, undergoing primary linear closure of a cutaneous defect with predicted postoperative closure length of ≥ 3 cm on any anatomic site were screened. Four patients were excluded, 50 patients were enrolled, and 48 patients were seen in follow-up. Wounds were divided in half and one side was randomized to receive either no undermining or 2 cm of undermining. The other side received the unselected intervention. Three months, patients and 2 masked observers evaluated each scar using the Patient and Observer Scar Assessment Scale (POSAS). A total of 50 patients [mean (SD) age, 67.6 (11.5) years; 31 (64.6%) male; 48 (100%) white] were enrolled in the study. The mean (SD) sum of the POSAS observer component scores was 12.0 (6.05) for the undermined side and 11.1 (4.68) for the non-undermined side (P = .60). No statistically significant difference was found in the mean (SD) sum of the patient component for the POSAS score between the undermined side [15.9 (9.07)] and the non-undermined side [13.33 (6.20)] at 3 months. For wounds under low to moderate perceived tension, no statistically significant differences in scar outcome or total complications were noted between undermined wound halves and non-undermined halves.Trail Registry: Clinical trials.gov Identifier NCT02289859. https://clinicaltrials.gov/ct2/show/NCT02289859.

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“…Patient and clinician preference for scar outcomes were determined based on statistically significant (P < .05) higher scar ratings for 1 intervention compared with other studied interventions. Studied interventions included method of surgical skin incision, 13,14 type of procedure, [15][16][17][18][19][20][21][22] method of wound closure, [23][24][25] suturing technique, 25 or postoperative wound care. 23 Key findings for each study were transcribed and later compared with recorded patient and clinician ratings to ensure accuracy of scar rating determination.…”

Section: Data Extractionmentioning

confidence: 99%

“…Twenty-one studies [15][16][17][18][19][20][21][22][23][24][25]28,29,31,33,34,36,38,[40][41][42] assessed patient and physician scar ratings from various surgical skin closure methods (Table 2 and Figure 2). Patient and physician agreement was seen in 15 studies [16][17][18][19][21][22][23][24][25]31,33,34,[40][41][42] and disagreement in 6 studies.…”

Section: Skin Closurementioning

confidence: 99%

“…15,20,28,29,36,38 In the studies that demonstrated disagreement in scar ratings, patients were more likely to prefer the scar from a given surgical closure method compared with physicians (4 of 6 [67%]). A significant proportion of studies [16][17][18][19][22][23][24][25]31,33,42 with patient and physician agreement showed indifference by both groups to the interventions that were studied.…”

Section: Skin Closurementioning

confidence: 99%

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Patient and Physician Assessment of Surgical Scars

Zhang

Miller

O’Malley

et al. 2018

JAMA Facial Plast Surg

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pproximately 230 million surgical procedures are performed worldwide every year. 1 Cutaneous scarring is common after surgical manipulation of the skin. Surgical scarring may affect patients' lives by distracting the gaze of onlookers, 2 disrupting social interactions, 3 and impairing psychosocial health. [4][5][6] Physicians may fail to recognize what features of the scar are most important to patients. 7 The majority of validated instruments evaluate scars exclusively from the perspective of the clinician. For example, the Hollander wound evaluation scale, 8 Manchester scar scale, 9 and the Vancouver scar scale 10 all require the clinician, but not the patient, to rate scars based on various physical characteristics, such as color and texture. By contrast, more recent validated instruments, such as the Patient and Observer Scar Assessment Scale 11,12 (POSAS), combine scar ratings from both patients and clinicians.Balancing the perspectives of patients and physicians may aid in the development of instruments that measure the most clinically relevant aspects of scars. We conducted a systematic review to investigate rates of patient-physician agreement in the evaluation of surgical scars, as well as the factors associated with patientphysician disagreement. Methods Search MethodologyA comprehensive systematic review of English-language articles was performed on studies retrieved from the Ovid/Medline, PubMed, and EMBASE electronic databases on August 1, 2015. The query terms "(surgical scar) AND (patient satisfaction OR patient assessment)" IMPORTANCE Surgical scarring affects patients by distracting the gaze of onlookers, disrupting social interactions, and impairing psychosocial health. Patient and physician agreement regarding ideal scar characteristics is important in developing congruent expectations after surgery. OBJECTIVE To summarize published studies assessing patient and physician ratings of surgical scars, rates of patient and physician agreement in scar assessment, and elements of cutaneous scar assessment that differ between patients and physicians.

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Purse-String Suture vs Second Intention Healing

Abstract: clinicaltrials.gov Identifier: NCT02062866.

Cited by 31 publications

References 29 publications

Preliminary Evaluation of the Viability of Peritoneal Drainage Catheters Implanted in Rats for Extended Durations

Preliminary Evaluation of the Viability of Peritoneal Drainage Catheters Implanted in Rats for Extended Durations

Undermining during cutaneous wound closure for wounds less than 3 cm in diameter: a randomized split wound comparative effectiveness trial

Patient and Physician Assessment of Surgical Scars

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