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A Prospective Comparative Study Between Subcuticular and Sutureless Technique of Skin Closure Following External Dacryocystorhinostomy

Rizvi, Syed Ali Raza M.S., F.I.C.O.*; Sabah, Mehnaz M.S.; Saquib, Mohammmed M.S.; Mahmood, Faizan M.S., D.N.B., F.I.C.O.; Alam, Md Shahid M.S.

Ophthalmic Plastic & Reconstructive Surgery: July/August 2019 - Volume 35 - Issue 4 - p 318–321
doi: 10.1097/IOP.0000000000001235
Original Investigations

Purpose: To compare the cosmetic outcome of the surgical scar of external dacryocystorhinostomy by the subcuticular versus sutureless technique.

Methods: This was a prospective interventional randomized control study conducted at tertiary level hospital. Fifty patients of primary-acquired nasolacrimal duct obstruction were included in this study. The control group patients underwent the technique of wound closure in 2 layers, subcutaneous interrupted suture with 6-0 vicryl and superficial skin with 6-0 prolene continuous subcuticular sutures. In the case group, interrupted subcutaneous sutures with 6-0 vicryl with Steristrip for skin apposition was used. The surgical scars were assessed and graded by still photographs on a computer screen by 2 independent observers unaware of the surgical technique used at 2, 6 and 12 weeks postoperatively.

Results: The mean scar assessment score by the 2 observers were 2.60 (0.57), 2.04 (0.64), and 1.16 (0.89) in control group and 2.02 (0.65), 1.44 (0.70), and 0.44 (0.61) in case group at 2, 6, and 12 weeks, respectively. Scar grades were analyzed using chi-square test between the 2 group and Wilcoxon signed rank test within the group. The difference between the 2 groups were found to be statistically significant at 2, 6, and 12 weeks (P < 0.05). Thus, the technique of wound closure with steristrip lead to comparatively less scarring as compared with subcuticular technique.

Conclusion: The authors recommend the sutureless technique of wound closure using steristrip in Ext DCR as it has superior cosmetic results as compared with subcuticular technique of external dacryocystorhinostomy.

Sutureless technique of skin closure is a much easier and time-saving novel technique with a significantly improved cosmesis as compared with subcuticular sutured technique of external dacryocystorhinostomy (Ext-DCR).

*Oculoplasty and Ocular Oncology Services, Department of Ophthalmology, AlNahdha Hospital, Ministry of Health, Sultanate of Oman

Institute of Ophthalmology, Jawaharlal Nehru Medical, College, AMU, Aligarh, UP, India

Orbit Oculoplasty Reconstructive and Aesthetic Services, Aditya Birla Sankara Nethralaya, Kolkata, India.

Accepted for publication August 9, 2018.

The authors have no financial or conflicts of interest to disclose.

Presented, in part, in 69th Annual Conference of Delhi Ophthalmological Society, April 6–8, 2018, New Delhi.

Address correspondence and reprint requests to Syed Ali Raza Rizvi, M.S., F.I.C.O., Oculoplasty and Ocular Oncology Services, Department of Ophthalmology, AlNahdha Hospital, Ministry of Health, Sultanate of Oman. E-mail:

© 2019 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.