A comparative study on primary wound closure by subcuticular suture using different suture materials with emphasis on complications, cosmesis and cost-effectiveness

Background and Purpose

There are different methods and materials for closing a surgical wound by subcuticular stitch but controversy prevails as concerns the appropriate material for this stitch. This study aims to investigate the different suture materials and compare their technical accessibility, usefulness, complication rates, patient satisfaction and, above all, the general outcome.

Methodology

Over a period of 8 months (June 2011–January 2012), 160 patients underwent wound repair by subcuticular stitch in our unit. A prospective analysis of patients’ case notes was performed. Results: Each type of thread has its own and specific type of complications which is distinct from other types of threads. Among patients on whom polyglactin sutures were used, 15.79% and 14.29% (respectively) developed complications in the presence and absence of complicating comorbid factors. Specifically, 20% of <3 cm wounds, 10% of 3–6 cm wounds, and 20% of >6 cm wounds sutured with polyglactin developed complications. The corresponding complication rates for poliglecaprone sutures were less at 9%, 5.9%, and 8.3%, respectively. The number of patients who are very happy and satisfied with poliglecaprone sutures is much greater than that of those on whom polyglactin sutures were used; the difference is statistically significant. In terms of cost, nylon is the cheapest thread whereas polypropylene is the costliest.

Conclusion

Poliglecaprone seems to be the thread of choice with minimal complication rates both in the presence and absence of comorbid factors in < 3 cm and 3–6 cm wounds. However, nylon appears to be more useful for wounds > 6cm since minimal complication rates are reported.