Polypropylene versus Polyglactin in Upper Limb Subcuticular Skin Closure
Background and Rationale Although previous studies have compared absorbable and non-absorbable sutures, most did not specifically evaluate standardized scar outcomes for subcuticular closure in the upper limb. While upper limb wounds may not carry the same aesthetic priority as facial wounds, scars in this region are highly visible and can adversely affect patients' psychological well-being. Subcuticular suturing is commonly used to improve cosmetic outcomes and reduce wound complications. Both Polypropylene (non-absorbable) and Polyglactin (absorbable) are widely used materials, yet their comparative performance in subcuticular skin closure remains controversial. Aim and Objectives Primary objective: \- To compare cosmetic outcomes of subcuticular skin closure using Polypropylene and Polyglactin Secondary objectives: * To compare postoperative wound complication rates (including infection, wound dehiscence, and hematoma formation) between polypropylene and polyglactin sutures * To assess patient-reported discomfort and satisfaction associated with each suture material * To assess the influence of the nature of surgery (elective vs trauma) on wound healing outcomes for each suture type
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
100
Upper limb wounds subcuticular skin closure
Upper limb wounds subcuticular skin closure with Polyglactin
Shebin El Koum teaching Hospital
Menoufia Governorate, Egypt
RECRUITINGCosmetic outcome measured using the Patient and Observer Scar Assessment Scale (POSAS) total score (range 6-60)
Scar quality will be evaluated using the Patient and Observer Scar Assessment Scale (POSAS), which includes both patient-reported and observer-reported components. Each item is scored from 1 to 10, with total scores ranging from 6 to 60, where lower scores indicate better cosmetic outcome.
Time frame: Baseline
Incidence of surgical site infection (SSI) (number and percentage of patients)
Surgical site infection will be assessed based on clinical criteria including the presence of purulent discharge, localized swelling, erythema, warmth, or wound dehiscence, with or without positive bacterial culture. The outcome will be reported as the number and percentage of patients who develop SSI during the follow-up period.
Time frame: Baseline
Incidence of wound dehiscence (number and percentage of patients)
Wound dehiscence will be defined as partial or complete separation of the surgical wound edges after closure. The outcome will be assessed clinically during follow-up visits and reported as the number and percentage of patients who develop wound dehiscence.
Time frame: Baseline
Incidence of hematoma formation (number and percentage of patients)
Hematoma formation will be defined as a localized collection of blood at the surgical site, identified clinically by swelling, discoloration, or tension, with or without the need for evacuation. The outcome will be assessed during follow-up and reported as the number and percentage of patients who develop a hematoma.
Time frame: Baseline
Patient satisfaction measured using a 5-point Likert scale (score range 1-5)
Patient satisfaction will be assessed using a 5-point Likert scale, where 1 indicates very dissatisfied and 5 indicates very satisfied. The outcome will be reported as a numerical score reflecting the patient's overall satisfaction with the surgical result.
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Time frame: Baseline