Background: Wound edge eversion has been hypothesized to improve aesthetic outcomes after cutaneous wound closure. Data supporting this assertion are sparse.
Objective: We sought to determine if wound eversion, achieved with interrupted subcuticular sutures, improves aesthetic outcome compared with planar closures.
Methods: We undertook a prospective, randomized, split-scar intervention in patients who underwent cutaneous surgery. Half of the wound was randomized to an everted or planar repair; the other side received the opposite one. At 3- and 6-month follow-up, both the patient and 2 blinded observers evaluated the wound using the Patient Observer Self-Assessment Scale (POSAS).
Results: The total observer POSAS score for the everted (13.59, 12.26) and planar (12.91, 12.98) sides did not differ significantly at 3 or 6 months, respectively. Similarly, there was not a significant difference in patient assessment between the everted (16.23, 12.84) and planar (15.07, 12.79) sides at 3 or 6 months, respectively. Finally, there was no significant difference between the 2 closure methods in terms of scar height or width at follow-up.
Limitations: This was a single-center trial, which used a validated but still subjective scar assessment instrument.
Conclusion: Wound eversion was not significantly associated with improved overall scar assessments by blinded observers or patient assessment.
Keywords: Patient Observer Self-Assessment Scale; cosmesis; eversion; inverted vertical mattress suture; set-back suture; surgical scars.
Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.