4 Clinical Trials for Various Conditions
We will be recruiting patients requiring excisions of skin cancer and comparing aesthetic and functional differences of suture repair of excisional defects using polyglactin 910 vs poliglecaprone 25 with a split-scar model. Excision sites will be on either the trunk or extremities. Standard dermatological excision and repair methods will be used for removal of lesions and repair of the wound by surgeons; training courses will be used to limit inter-surgeon variation in technique. Excisional defects will be repaired with deep polyglactin 910 sutures, followed by randomly assigned subcuticular closure of one half of the defect with polyglactin 910 sutures and the other half with poliglecaprone 25 sutures. The patient will follow-up at 6 months and fill out a patient self-assessment evaluation survey of the scar. Photographs will also be taken of the scars at the follow-up at 6 months, which will be then be assigned to a set of blinded observers to evaluate the wound using a modified Patient Observer Self-Assessment Scale (mPOSAS). These observers will rate each scar on the mPOSAS scale and values will be averaged between observers. Total duration of participation will be 6 months, with 2 total visits (excision visit and follow-up visit).
The investigators wish to determine how suture spacing (5 mm vs. 10 mm) affects cosmetic outcome and development of "train tracking" in wounds. Linear wounds with sutures spaced closer together may not be as cosmetically appealing when compared to those that have larger spacing between sutures. Suturing closer together constricts blood flow and increases tension that ultimately results in more tissue necrosis and a less appealing outcome. The investigators also aim to conclude if 5 mm or 10 mm suture spacing results in less complications.
There are a variety of techniques utilized to close lacerations, including but not limited to, traditional sutures, staples, adhesive strips, and skin glue. While closing open wounds and preventing infection are the primary goals of laceration repair, physicians are also concerned with minimizing scar formation and providing the best cosmetic outcomes for the patient. Specifically, the skin on the face is a sensitive area where cosmetic outcome is of high importance, and several laceration repair techniques have been devised for closing facial wounds. Sutures have traditionally been used to close wounds in various types of tissue, and it is still very commonly used in the clinical setting. Adhesive strips (also known under the brand names of Steri-Strips, Curi-strips, Nichi-Strips, and Suture Strips) are another method to repair lacerations superficially. Due to their superficial application and ease of use, adhesive strips may help minimize scar formation and may result in less pain and complications for the patient when compared to conventional sutures. Therefore, the aim of this study is to determine whether repair of small, simple facial lacerations with adhesive strips results in better patient experiences and better cosmetic outcomes than sutures. The investigators hypothesize that wounds repaired with adhesive strip will have higher patient satisfaction scores and better cosmetic outcomes.
It is standard teaching that the top layer of sutures should be placed 3-5mm from the wound edge. However, there is lack of data regarding the most optimal placement of sutures from the wound edge for the best cosmetic outcome. The research team wish to determine if sutures placed closer to the wound edge (2mm) or farther from the wound edge (5mm) makes a difference in the cosmetic outcome of the scar.