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CompletedNCT03330041Updated May 12, 2021Results posted

Suturing Distance From the Wound Edge, 2 mm vs 5 mm

An interventional study of Fast absorbing gut suture in Cutaneous Sutures and Scar Cosmesis, sponsored by University of California, Davis. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-05-12.

Sponsored by University of California, Davis · Not applicable, Interventional, and Other

Phase
Not applicable
Study type
Interventional
Enrollment
50
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study aims to investigate whether the spacing of the interrupted cutaneous sutures affects surgical wound cosmesis on the face and neck. In other words, the investigators would like to determine which of the following yields a more cosmetically appealing scar: many closely approximated sutures or fewer, more widely spaced sutures. The investigators wish to compare the effects of two versus five millimeter spacing between sutures.

Read the detailed description

Sutures are the standard of care in repairing cutaneous wounds. The majority of surgical reconstructions following a Mohs micrographic surgery and standard surgical excisions require two layers of sutures: a deep (subcutaneous) layer and a top (cutaneous) layer. The deep layer dissolves naturally whereas the top layer may necessitate removal if non-absorbable sutures are used. This study aims to investigate whether the spacing of the interrupted cutaneous sutures affects surgical wound cosmesis on the face and neck. In other words, the investigators would like to determine which of the following yields a more cosmetically appealing scar: many closely approximated sutures or fewer, more widely spaced sutures. The investigators wish to compare the effects of two versus five millimeter spacing between sutures. It is possible that fewer, more widely spaced sutures may leave more open space in the wound, leaving more tension to pull on those few sutures, possibly encouraging the wound to dehisce and make it harder to approximate the wound edges yielding a less cosmetically appealing scar compared to placing many closely approximated sutures which would decrease the tension and likely better approximate the wound edges yielding a more cosmetically appealing scar. On the other hand, the investigators may find that suture spacing has no effect on wound cosmesis and that placing fewer, more widely spaced sutures is much more time efficient. The investigators may also find that the effect of suture spacing on wound cosmesis is dependent on wound tension. For example, perhaps the suture pacing would have no effect on the cosmesis of a wound under no tension, however, for a wound under high tension, it is possible that many closely approximated sutures would yield better cosmetic results for the reasons listed above.

02

Conditions studied

  • Cutaneous Sutures and Scar Cosmesis

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Keywords

  • Cutaneous Sutures
  • Scar Cosmesis
  • Linear Wound Closure
  • Wound Cosmesis
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • 18 years of age or older
  • Able to give informed consent themselves
  • Patient scheduled for cutaneous surgical procedure on the trunk and extremities with predicted primary closure
  • Willing to return for follow up visit.

Exclusion criteria

Exclusion Criteria:

  • Mentally handicapped
  • Unable to understand written and oral English
  • Incarceration
  • Under 18 years of age
  • Pregnant Women
  • Wounds with predicted closure length less than 4 cm
04

Study design

Phase
Not applicable
Primary purpose
Other
Allocation
Randomized
Intervention model
Single group
Masking
Single (Outcomes assessor)
Enrollment
50 participants (actual)

Study arms

  • Experimental
    Fast absorbing gut suture placed 2 mm apart

    Wound closed with sutures spaced 2 millimeters apart will be treated in a simple, interrupted cutaneous suture pattern

    Device: Fast absorbing gut suture

  • Experimental
    Fast absorbing gut suture placed 5 mm apart

    Wound closed with sutures spaced 5 millimeters apart will be treated in a simple, interrupted cutaneous suture pattern

    Device: Fast absorbing gut suture

Interventions

  • DeviceFast absorbing gut suture

    Fast absorbing surgical gut suture is a strand of collagenous material

05

What researchers measure

Primary outcomes

  1. Patient Posas Score

    Scale name: Patient Observer Scar Assessment Score. Scale measures six parameters of scars, each using a 10-point scoring system (the six categories are summed to achieve the POSAS score - totals range from 6 to 60), with 1 representing normal skin \& 10 representing the most severe scar imaginable.

    Time frame: 3 months following procedure

Secondary outcomes

  1. Width of Scar

    A secondary endpoint will include the width of the scar 1 cm from midline on each side. This measurement will be reported in mm

    Time frame: 3 months following procedure

  2. Erythema

    If one half of the scar has more associated erythema, this will be noted number of people with erythema after treatment will be reported

    Time frame: 3 months following procedure

06

Results

Posted Jan 21, 2020

Participant flow

This randomized clinical trial was conducted at the University of California, Davis dermatology clinic from November 28, 2017, to June 15, 2018.

Participant flow — Overall Study
MilestoneAll Participants
Started50
Completed48
Not completed2

Outcome measures

PrimaryPatient Posas Score

Scale name: Patient Observer Scar Assessment Score. Scale measures six parameters of scars, each using a 10-point scoring system (the six categories are summed to achieve the POSAS score - totals range from 6 to 60), with 1 representing normal skin \& 10 representing the most severe scar imaginable.

Time frame:
3 months following procedure
Reported as:
Mean · score on a scale
Patient Posas Score
score on a scaleFast Absorbing Gut Suture Placed 2 mm ApartFast Absorbing Gut Suture Placed 5 mm Apart
Patient Posas Score10.2 ± 4.711.5 ± 6.4
SecondaryWidth of Scar

A secondary endpoint will include the width of the scar 1 cm from midline on each side. This measurement will be reported in mm

Time frame:
3 months following procedure
Reported as:
Mean · mm
Width of Scar
mmFast Absorbing Gut Suture Placed 2 mm ApartFast Absorbing Gut Suture Placed 5 mm Apart
Width of Scar0.9 ± 0.60.8 ± 0.4
SecondaryErythema

If one half of the scar has more associated erythema, this will be noted number of people with erythema after treatment will be reported

Time frame:
3 months following procedure
Reported as:
Count of participants · Participants
Erythema
ParticipantsFast Absorbing Gut Suture Placed 2 mm ApartFast Absorbing Gut Suture Placed 5 mm Apart
Erythema00

Adverse events

Collected over At 3-Month Follow-up. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Fast Absorbing Gut Suture Placed 2 mm Apart0/50 (0%)0/50 (0%)0/50 (0%)
Fast Absorbing Gut Suture Placed 5 mm Apart0/50 (0%)0/50 (0%)0/50 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(years)Fast Absorbing Gut Suture Placed 2 mm and 5 Mmapart
Mean71.1 ± 11.4
Sex: Female, Male
Sex: Female, Male(Participants)Fast Absorbing Gut Suture Placed 2 mm and 5 Mmapart
Female7
Male43
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Fast Absorbing Gut Suture Placed 2 mm and 5 Mmapart
American Indian or Alaska Native0
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American0
White50
More than one race0
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(participants)Fast Absorbing Gut Suture Placed 2 mm and 5 Mmapart
United States50
07

Study locations

1 site
  • University of California, Davis, Department of Dermatology
    Sacramento, California 95816, United States
08

References and documents

Publications

  • Sklar LR, Pourang A, Armstrong AW, Dhaliwal SK, Sivamani RK, Eisen DB. Comparison of Running Cutaneous Suture Spacing During Linear Wound Closures and the Effect on Wound Cosmesis of the Face and Neck: A Randomized Clinical Trial. JAMA Dermatol. 2019 Mar 1;155(3):321-326. doi: 10.1001/jamadermatol.2018.5057. PubMed 30649154 ↗

Study documents

  • Protocol and statistical analysis plan · Oct 30, 2017

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT03330041
Lead sponsor
University of California, Davis
Responsible party
Sponsor
First posted
Nov 6, 2017
Start date
Oct 3, 2017
Primary completion
Aug 9, 2018
Completion
Aug 9, 2018
Results posted
Jan 21, 2020
Last update
May 12, 2021

Study contacts

Daniel Eisen, M.D.
principal investigator · University of California, Davis

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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