Improved outcomes of scar revision with use of polydioxanone suture in comparison to polyglactin 910: A randomized controlled trial

Publication date: Available online 16 April 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Deepti Gupta, Upendra Sharma, Shashank Chauhan, Shamendra Anand Sahu
Scars have multiple cosmetic and functional sequelae and revision surgeries are an attempt to ameliorate these effects. Reduction of spread of the revised scar is one of the main objectives of revision procedures. Provision of prolonged dermal support to wound can theoretically reduce spread of the scar. We carried out a randomized controlled trial and objectively evaluated the impact of two commonly used absorbable sutures, Polyglactin 910 and Polydioxanone on scar spread and quality. Sixty patients with post traumatic scars of one year duration were enrolled in the study and randomly divided into two groups of 30 each. After noting the demographic data and baseline scar characteristics, revision of the scar was carried out by elliptical excision and primary suturing. In Group1, Polyglactin 910 6-0 suture (Vicryl, Ethicon, Johnson and Johnson Ltd, India) was used for dermal suturing, whereas, in Group 2, Polydioxanone 6-0 suture (PDS II, Ethicon, Johnson and Johnson Ltd, India) was used. The scar spread in terms of scar width and scar quality with Vancouver Scar Scale (VSS) was evaluated at one, three and four months post-operatively. The two groups were well matched for demographics and baseline scar characteristics. On follow up, the mean scar width in Group 1 was significantly more than in Group 2. VSS score was significantly lower in Group 2 at third and fourth month follow up, signifying better scar quality. Suture extrusion was noticed in three cases in Group 1.Polydioxanone sutures, when used for intradermal suturing in revision of facial scars, result in a significantly decreased scar spread and better scar quality, than Polyglactin 910.