Scalp Closures With Pulley Sutures Reduce Time and Cost Compared to Traditional Layered Technique-A Prospective, Randomized, Observer-Blinded Study
Recommended Citation
Kannan S, Mehta D, Ozog DM. Scalp Closures With Pulley Sutures Reduce Time and Cost Compared to Traditional Layered Technique-A Prospective, Randomized, Observer-Blinded Study. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 2016; 42(11):1248-1255.
Document Type
Article
Publication Date
11-1-2016
Publication Title
Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
Keywords
Adult, Aged, Aged, 80 and over, Female, Head and Neck Neoplasms, Humans, Male, Middle Aged, Mohs Surgery, Prospective Studies, Scalp, Skin Neoplasms, Suture Techniques, Time Factors, Treatment Outcome, Wound Closure Techniques
Abstract
BACKGROUND: Reconstruction of postsurgical scalp defects can be difficult and time-consuming using a conventional bilayered technique. A specialized closure using a pulley suture can assist in closing wounds under high tension and can decrease time and cost for the surgeon.
OBJECTIVE: To determine if closing scalp defects with a single-layered closure using pulley sutures would result in decreased time but equivalent scar cosmesis compared to bilayered closures.
MATERIALS AND METHODS: A total of 21 patients with postsurgical scalp defects were randomized to a bilayered or a pulley group, and time was measured for each closure. Scar appearance was assessed using the Patient and Observer Scar Assessment Scale at 2 weeks, 2 months, and 6 months postsurgery. Before and after photographs were also assessed by a blinded dermatologist using the visual analog scale.
RESULTS: Compared to a bilayered closure, the pulley technique resulted in significantly reduced closure time (p < .001). Even though patient overall scores at 2 weeks and observer total score at 6 months were superior in the pulley group, the visual analog scale scores were similar between the 2 groups.
CONCLUSION: Scalp reconstructions using a single layer of pulley sutures result in time and cost reduction and similar scar appearance compared to bilayered closures.
Medical Subject Headings
Adult; Aged; Aged, 80 and over; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Mohs Surgery; Prospective Studies; Scalp; Skin Neoplasms; Suture Techniques; Time Factors; Treatment Outcome; Wound Closure Techniques
PubMed ID
27598452
Volume
42
Issue
11
First Page
1248
Last Page
1255
