A sutureless wound closure technique led to less scarring and better cosmesis than subcuticular technique in external dacryocystorhinostomy procedures.
Fifty patients scheduled for external dacryocystorhinostomy for nasolacrimal duct obstruction were randomized into two groups in this prospective randomized control study. The control group underwent wound closure in two layers: subcutaneous interrupted suture with 6-0 Vicryl and superficial skin with 6-0 Prolene continuous subcuticular sutures. The study group received interrupted subcutaneous sutures with 6-0 Vicryl with Steristrip for skin apposition.
“The presence of a cutaneous scar has been reported as the major disadvantage of an [external dacryocystorhinostomy] from the patient’s perspective,” the study authors wrote. “Various modifications are being studied extensively to reduce scarring and improve the cosmetic appearance postoperatively.”
Patients were evaluated at 2, 6 and 12 weeks after surgery, when they each received a scar assessment using still photographs taken at approximately 30 cm distance and graded by two observers unaware of the techniques used.
In the sutureless group, 28% of patients had markedly visible scar in the second week, with no visible scar being identified by week 12, compared to a visual scar observed in 68% of the control group in week 2, with that percentage dropping to 8% in week 12.
“Comparing the scar grade of subcuticular technique with sutureless technique, we found that the sutureless technique was more aesthetic with a scar significantly less visible at 12 weeks of follow-up with early recovery and satisfaction to the patients,” the study authors wrote. – by Rebecca L. Forand
Disclosures: The authors report no relevant financial disclosures.