Abstract
When repairing facial wounds, it is crucial to possess a thorough understanding of
suitable suture materials and their evidence base. The absence of high-quality and
comprehensive systematic reviews poses challenges in making informed decisions. In
this study, we conducted a review of the existing literature and assessed the quality
of the current evidence pertaining to the clinical, aesthetic, and patient-reported
outcomes associated with absorbable and nonabsorbable sutures for facial skin closure.
The study was registered on Prospective Register of Systematic Reviews. We conducted
searches on Embase, Ovid, and PubMed/MEDLINE databases. Only randomized controlled
trials (RCTs) were eligible for inclusion in this study. Additionally, the risk of
bias in the randomized studies was assessed using Cochrane's Risk of Bias Tool.
The study included a total of nine RCTs involving 804 participants with facial injuries.
Among these injuries, absorbable sutures were utilized in 50.2% (403 injuries), while
nonabsorbable sutures were employed in 49.8% (401 injuries). The analysis of cosmesis
scales revealed no statistically significant difference between absorbable and nonabsorbable
sutures regarding infections (p = 0.72), visual analog scale (p = 0.69), wound dehiscence (p = 0.08), and scarring (p = 0.46). The quality of the included studies was determined to have a low risk of
bias.
Absorbable sutures can be considered a suitable alternative to nonabsorbable sutures,
as they demonstrate comparable aesthetic and clinical outcomes. Future high-quality
studies with a level I evidence design and cost-effectiveness analysis are necessary
to enhance clinician–patient shared decision-making and optimize the selection of
suture materials.
Level of evidence is I, risk/prognostic study.
Keywords
absorbable - nonabsorbable - facial wounds - suture material - patient-reported outcomes
- skin closure - satisfaction
