Optimal Wound Closure Techniques for Thyroid and Parathyroid Surgery: A Systematic Review of Cosmetic Outcomes
Kristina Lee Nicholas Ward Babatunde Oremule Navin Mani
First published: 30 May 2019 https://doi.org/10.1111/coa.13382
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1111/coa.13382
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Abstract
Objectives
Cosmesis after surgical wound closure is an important outcome. This is relevant after thyroid and parathyroid surgery as anterior neck scars are visible and often of concern to patients. We aimed to investigate whether wound closure method influences cosmetic outcome in thyroid and parathyroid surgery, in particular using sutures, staples, steri‐strips and glue.
Design
We performed a systematic review of MEDLINE, PubMed, EMBASE, CINAHL and Cochrane focusing on wound cosmesis following thyroid and parathyroid surgery. Searches were conducted using combinations of the search terms: thyroid/parathyroid surgery, wound/skin closure and suture, staples, clips, glue and steri‐strips, using appropriate MESH terms and Boolean operators.
Main outcome measures
Primary outcome was wound cosmesis. Secondary measures were also extracted.
Results
Initial search found 304 papers and after systematic review, a total of 10 studies compared different closure methods and cosmetic outcomes. There were nine randomised controlled trials and one cohort study, with a total of 712 patients. Three studies compared staples versus glue; three compared sutures versus clips; two compared suture versus steri‐strips and two studies for suture versus glue. In general, short‐term cosmesis was better with subcuticular sutures compared to glue or clips, long‐term cosmetic outcomes were not influenced by closure method.
Conclusions
We found closure with subcuticular suture or steri‐strips produced superior cosmetic outcomes short‐term. Although long‐term cosmetic outcome is not influenced by closure method, given the superior cosmetic outcome and advantage of not needing removal, we recommend subcuticular sutures should be performed for wound closure in thyroid and parathyroid surgery.
This article is protected by copyright. All rights reserved.
Kristina Lee Nicholas Ward Babatunde Oremule Navin Mani
First published: 30 May 2019 https://doi.org/10.1111/coa.13382
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1111/coa.13382
ePDFPDFTOOLS SHARE
Abstract
Objectives
Cosmesis after surgical wound closure is an important outcome. This is relevant after thyroid and parathyroid surgery as anterior neck scars are visible and often of concern to patients. We aimed to investigate whether wound closure method influences cosmetic outcome in thyroid and parathyroid surgery, in particular using sutures, staples, steri‐strips and glue.
Design
We performed a systematic review of MEDLINE, PubMed, EMBASE, CINAHL and Cochrane focusing on wound cosmesis following thyroid and parathyroid surgery. Searches were conducted using combinations of the search terms: thyroid/parathyroid surgery, wound/skin closure and suture, staples, clips, glue and steri‐strips, using appropriate MESH terms and Boolean operators.
Main outcome measures
Primary outcome was wound cosmesis. Secondary measures were also extracted.
Results
Initial search found 304 papers and after systematic review, a total of 10 studies compared different closure methods and cosmetic outcomes. There were nine randomised controlled trials and one cohort study, with a total of 712 patients. Three studies compared staples versus glue; three compared sutures versus clips; two compared suture versus steri‐strips and two studies for suture versus glue. In general, short‐term cosmesis was better with subcuticular sutures compared to glue or clips, long‐term cosmetic outcomes were not influenced by closure method.
Conclusions
We found closure with subcuticular suture or steri‐strips produced superior cosmetic outcomes short‐term. Although long‐term cosmetic outcome is not influenced by closure method, given the superior cosmetic outcome and advantage of not needing removal, we recommend subcuticular sutures should be performed for wound closure in thyroid and parathyroid surgery.
This article is protected by copyright. All rights reserved.
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