Aesthetic outcome and complications of simple interrupted versus running subcuticular sutures in facial surgery: A randomized controlled trial

Xiaomeng Liu*, Patty J. Nelemans, Lisa D. S. Frenk, Helma Sengers, Stephania M. H. Tuinder, Peter M. Steijlen, Klara Mosterd, Nicole W. J. Kelleners-Smeets

*Corresponding author for this work

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Background: The suturing technique and its associated complications could affect cosmetic outcome after facial surgery. Literature on this topic is limited.

Objective: To compare the cosmetic results 12 months after treatment and complications associated with simple interrupted sutures (SIS) versus running subcuticular sutures (RSS) in facial surgery.

Methods: A randomized, controlled multicenter trial was performed. Adults receiving dermatologic surgery on the face were randomized to receive SIS or RSS for wound closure. The primary outcome was the overall opinion score on the Patient and Observer Scar Assessment Scale (POSAS) 12 months after surgery. Secondary outcomes were the complication rates and scores according to alternative methods for assessment of cosmetic outcome. The observer of cosmetic outcome was blinded to treatment assignment.

Results: 142 patients were randomized to receive SIS (n = 73) or RSS (n = 69). Twelve months after surgery, the median score of the overall opinion on the POSAS was 2.0 (range 1-8) according to the patients and 3.0 (range 1-8) according to the observer in both groups. In the RSS group, hyper-or hypoesthesia was reported more often.

Limitations: The cosmetic result was assessed by 1 observer.

Conclusion: SIS and RSS in facial surgery resulted in comparable cosmetic outcomes. RSS was more often associated with hyper-or hypoesthesia.

Original languageEnglish
Pages (from-to)911-919
Number of pages9
JournalJournal of the American Academy of Dermatology
Issue number5
Publication statusPublished - Nov 2017


  • aesthetic outcome
  • complications
  • cosmetic result
  • dermatologic surgery
  • running subcuticular suture
  • simple interrupted suture
  • suturing technique
  • wound healing

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