SUture StudY (SUSY): Randomised controlled trial to compare tissue reactions and scarring with polypropylene vs. polyglactin 910 sutures in periocular skin
Author: Tessa Fayers
Base Hospital / Institution: Imperial College Healthcare NHS Trust
ePoster presentation
Abstract ID: 24-409
Purpose
The aim of this double masked randomised clinical study was to compare histological and clinical scarring produced by Polyglactin 910 (Vicryl) and Polypropylene (Prolene) sutures in eyelid skin.
Methods
Participants with involutional entropion were randomised to receiving 6/0 Vicryl or 6/0 Prolene everting sutures. After 4 weeks patients underwent definitive surgery with a wedge excision and retractor plication. During this procedure one of the everting sutures was removed within the wedge and sent for histological analysis.
Clinical scarring was assessed at 2 weeks and 6 months using The Patient and Observer Scar Assessment Scale (POSAS) and clinical photography.
Results
47 patients were recruited across two sites.
There was a difference in the primary outcome measure of inflammatory reaction diameter (IRD) on histological assessment, with an IRD of 0.56mm surrounding Vicryl sutures and 0.39mm surrounding Prolene sutures, however this did not reach statistical significance (p=0.19).
There were more giant cells around Vicryl than Prolene sutures (Prolene mean 1 (range 0-3) vs Vicryl mean 4 (range 3-8) and this was statistically significant (p=0.03)
Mean histological grade sum (measuring inflammation) was also higher for Vicryl (40) than Prolene (32) but this was not statistically significant (p=0.23).
POSAS scores and clinical photography assessment were similar between the two groups and there was high patient satisfaction with the scar and grading of the scar by masked observers with both sutures.
Conclusion
Prolene caused less of a histological inflammatory scarring reaction than Vicryl but this did not reach statistical significance in most cases, perhaps due to the small sample size.
In terms of clinical scarring both Vicryl and Prolene sutures fared well and resulted in similarly good scarring in eyelid skin following entropion repair. Patient satisfaction with the scar was high with both sutures.
Considering these results, other factors such as patient or surgeon preference, ease and convenience of suture removal, suture availability and cost can guide choice of suture in surgical planning.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| john | Vekinis | Imperial College Healthcare NHS Trust |
| Laura | Ah-Kye | Imperial College Healthcare NHS Trust |
| David | Parham | University Hospitals Southampton NHS Foundation Trust |
| Priscilla | Anketell | Imperial College Healthcare NHS Trust |
| Roger | A’Hern | Imperial College Healthcare NHS Trust |
| Ben | Parkin | University Hospitals Dorset NHS Foundation Trust |
