Subcuticular vs horizontal mattress suture: Which is preferable for wound closure?

In the closure of linear wounds of the trunk and extremities, running subcuticular (SQ) suturing technique is preferred by patients and evaluators alike over running horizontal mattress (HM) in terms of aesthetic outcome, reports a recent study. 

However, no difference is seen in the sum of Patient and Observer Scar Assessment Scale (POSAS) components between the two techniques.

In this randomized, evaluator-blinded study, the investigators compared cosmetic outcomes between a running HM and a running SQ technique in a split scar model following linear closure of defects. Fifty patients were included.

One side of the surgical wound received one intervention, while the other received the alternative intervention. POSAS score a minimum of 3 months postsurgery was the primary outcome.

Observer POSAS sum of components was 19.49 for HM and 17.76 for SQ (p=0.14). Among patients, the mean score for their overall opinion was 4.71 for the HM technique and 3.50 for the SQ technique. Among evaluators, the overall scores were 3.87 and 3.29 for HM and SQ, respectively (p=0.03).

“Although there was no significant difference in the sum of POSAS components between HM and SQ, both patients and evaluators had a superior overall opinion of the SQ-treated side,” the investigators said.

This study was limited by its relatively homogenous population.