International, prospective cohort study comparing non-absorbable versus absorbable sutures for skin surgery: CANVAS service evaluation
Author:
Lee Alice12, Stanley Guy H M34ORCID, Wade Ryckie G56ORCID, Berwick Daniele7, Vinicombe Victoria8, Salence Brogan K9, Musbahi Esra10, De Poli Anderson R C S11, Savu Mihaela12, Batchelor Jonathan M13, Abbott Rachel A14, Gardiner Matthew D1516, Wernham Aaron1718ORCID, Veitch David18, Ghaffar S A, Adams H, Afzal B, Akingbola C, Haddabi A Al, Arthur L, Ashraf I, Athanasiadou M, Athavale P, Berwick D, Bhatti D, Birnie A, Blair R, Bloom O, Bodger W, Bray A P J J, Brindley L, Brown A, Campbell A, Chamberlain G, Chan W I, Chew P, Chin K Y, De Poli A R C S, Couves A, Cross N, Daly A, DeGiovanni C, Devadoss A, Dickason A, Downes E, Drummond S, Dunphy B, Ebadian M, Egail M, Eldeeb O, Faiz J, Felstead A, Findlay M, Fordyce A, Gaborit L, Gan A, Geh J, Ghazavi M, Ghini F, Green D, Harper-Machin A, Hendrix N, Herstell L, Hill N, Holden A, Holt D, Horwitz M D, Hughes I, Jagun O, James L, Jerrom R, Karia C, Kaur H, Khalid A, Knight J, Kuo O, Lam M, Long M, Lowe A, Magill H, Mann J, Mann N, Marsden N, McDonald C, Mcgrath E, McGregor J, McMahon M E, Mohamed A, Morriss S, Musbahi E, Narang I, Newlands C, Nicholas R, Nolan G, O’Donovan D, O’Neill J, Oliver M, Pasternak-Albert N, Patel P, Patel R R, Perkins W, Pinder R, Potter S, Prabhu D, Rahman K, Rayner A, Salence B, Savu M, Shakespeare D, Shastri M, Shum K W, Soh J Y, Spencer A, Strauss R, Taibjee S, Taylor M, Thandi C S, Thomas H, Thomson M, Tso S, Vaingankar N, Vinicombe V, Wachsmuth R, Wilkinson J E, Wilson M, Yii N,
Affiliation:
1. Department of Plastic Surgery and Burns, Stoke Mandeville Hospital , Aylesbury , UK 2. Department of Surgery and Cancer, Imperial College London , London , UK 3. Department of Plastic Surgery, Fiona Stanley Hospital , Perth, Western Australia , Australia 4. Burns Injury Research Unit, University of Western Australia , Perth, Western Australia , Australia 5. Leeds Institute for Medical Research, University of Leeds , Leeds , UK 6. Department of Plastic and Reconstructive Surgery, Leeds General Infirmary , Leeds , UK 7. Department of Plastic Surgery and Burns, Queen Victoria Hospital , East Grinstead , UK 8. Department of Dermatology, Dorset County Hospital NHS Foundation Trust , Dorchester , UK 9. Department of Dermatology, Oxford University Hospitals NHS Foundation trust , Oxford , UK 10. Department of Dermatology, University Hospitals Sussex NHS Foundation Trust , Sussex , UK 11. Department of Dermatology, Luton and Dunstable University Hospital, Bedfordshire Hospitals NHS Foundation Trust , Luton , UK 12. Department of Dermatology, Yeovil District Hospital , Yeovil , UK 13. Department of Dermatology, Beckenham Beacon , Beckenham , UK 14. Department of Dermatology, Welsh Institute of Dermatology, University Hospital of Wales , Cardiff , UK 15. Department of Plastic Surgery, Wexham Park Hospital, Frimley Health NHS Foundation Trust , Slough , UK 16. Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford , Oxford , UK 17. Department of Dermatology, Leicester University Hospitals NHS Trust , Leicester , UK 18. Department of Dermatology, Walsall Healthcare NHS Trust , Walsall , UK
Abstract
Abstract
Background
Absorbable or non-absorbable sutures can be used for superficial skin closure following excisional skin surgery. There is no consensus among clinicians nor high-quality evidence supporting the choice of suture. The aim of the present study was to determine current suture use and complications at 30 days after excisional skin surgery.
Methods
An international, prospective service evaluation of adults undergoing excision of skin lesions (benign and malignant) in primary and secondary care was conducted from 1 September 2020 to 15 April 2021. Routine patient data collected by UK and Australasian collaborator networks were uploaded to REDCap©. Choice of suture and risk of complications were modelled using multivariable logistic regression.
Results
Some 3494 patients (4066 excisions) were included; 3246 (92.9 per cent) were from the UK and Ireland. Most patients were men (1945, 55.7 per cent), Caucasian (2849, 81.5 per cent) and aged 75–84 years (965, 27.6 per cent). The most common clinical diagnosis was basal cell carcinoma (1712, 42.1 per cent). Dermatologists performed most procedures, with 1803 excisions (44.3 per cent) on 1657 patients (47.4 per cent). Most defects were closed primarily (2856, 81.9 per cent), and there was equipoise in regard to use of absorbable (2127, 57.7 per cent) or non-absorbable (1558, 42.2 per cent) sutures for superficial closure. The most common complications were surgical-site infection (103, 2.9 per cent) and delayed wound healing (77, 2.2 per cent). In multivariable analysis, use of absorbable suture type was associated with increased patient age, geographical location (UK and Ireland), and surgeon specialty (oral and maxillofacial surgery and plastic surgery), but not with complications.
Conclusion
There was equipoise in suture use, and no association between suture type and complications. Definitive evidence from randomized trials is needed.
Funder
National Institute for Health Research Ian Potter Foundation
Publisher
Oxford University Press (OUP)
Cited by
1 articles.
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