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Cosmetic Outcomes of Absorbable Versus Nonabsorbable Sutures in Pediatric Facial Lacerations

Luck, Raemma P. MD, MBA; Flood, Robert MD; Eyal, Dalit DO; Saludades, John MD; Hayes, Ciana BS; Gaughan, John PhD

doi: 10.1097/PEC.0b013e3181666f87
Original Articles

Objectives: We sought to compare the long-term cosmetic outcomes of absorbable versus nonabsorbable sutures for facial lacerations in children and to compare the complication rates and parental satisfaction in the 2 groups.

Design/Methods: Healthy patients presenting to a pediatric emergency department with facial lacerations were randomized to repair using fast-absorbing catgut or nylon suture. Patients were followed up at 5 to 7 days and at 3 months. Three blinded observers, using a previously validated 100-mm cosmesis visual analogue scale (VAS) as the primary instrument, rated photographs of the wound taken at 3 months. For this noninferiority study, a VAS score of 15 mm or greater was considered to be the minimal clinically important difference. Parents also rated the wound using the VAS and completed a satisfaction survey.

Results: Of the 88 patients initially enrolled, 47 patients completed the study: 23 in the catgut group and 24 in the nylon group. There were no significant differences in age, race, sex, wound length, number of sutures, and layered repair rates in the 2 groups. The observers' mean VAS for the catgut group was 92.3 (95% confidence interval [CI], 89.1-95.4) and that for the nylon group was 93.7 (95% CI, 91.4-96.0), with a difference of the means of 1.4 (95% CI, −5.31 to 8.15), which was less than the minimal clinically important difference of 15 mm (power, >90%). The mean parental VAS score for the catgut group was 86.3 (95% CI, 78.4-94.1) and that for the nylon group was 91.2 (95% CI, 86.9-95.4), with a difference of the means of 4.9 (95% CI, 2.41-7.41), also less than 15 mm. There were no significant differences in the rates of infection, wound dehiscence, keloid formation, and parental satisfaction.

Conclusions: The use of fast-absorbing catgut suture is a viable alternative to nonabsorbable suture in the repair of facial lacerations in children.

Department of Pediatrics, Temple University School of Medicine, Philadelphia, PA.

Supported by Internal Pediatric departmental grant of $1500.

All authors do not have any financial or any other conflict of interest in the research submitted. The authors are not on any speakers' bureau, nor do we own any stocks of Ethicon or Johnson & Johnson.

Address correspondence and reprint requests to Raemma P. Luck, MD, MBA, Department of Pediatrics, Boyer Pavilion, Temple University Hospital, 3509 North Broad St, Philadelphia, PA 19140. E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.