Dr. Mike Publishes Study on Suture Material Selection to Reduce Skin Cancer Scars

A suture is a stitch or row of stitches holding together the edges of a wound or surgical incision. Sutures can tear through tissue, but little data exists on the relative ability of different suture gauges and suture types to cut into the skin. Waccamaw Dermatology’s Mohs surgeons devote 100% of their time to skin surgery, and were adamant to reduce track marks and scars involved with sutures. Dr. Mike, an expert on suture material dynamics, examines the correlation of suture diameter with its ability to cut through an artificial skin model in an effort to reduce skin cancer scars with the proper suture selection.

Methods and Materials

When the stitching skin wound edges together, the percutaneous suture is looped through the epidermis and dermis on each side and then knotted. If the knot is tied too tightly or if subsequent wound swelling occurs, the suture can cut into the epidermis. This epidermal cutting can leave small scars and perhaps suture track marks. Proper suture selection is very important for good cosmetic outcomes and to prevent track marks, scars, or skin cancer scars. The following suture materials were analyzed: 3-0 and 5-0 polypropylene (Prolene; Ethicon, NY), 3-0 and 5-0 polyglactin 910 (Vicryl; Ethicon), 3-0 and 5-0 nylon(Ethilon; Ethicon), and 3-0 and 5-0 poliglecaprone 25(Monocryl; Ethicon.) Each suture method and gauge’s diameter was measured with two methods: precision caliper micrometer and an eyepiece micrometer with the microscope. Suture diameter is correlated with its ability to cut through the skin. The smaller the suture diameter, the more likely it is that a given suture will cut into tissue.

Conclusion

Dr. Mike concluded that all 5-0 suture types required less force to cut into and tear through the skin substitute than their 3-0 counter-parts. Among each suture gauge, there was no significant difference in tear-through force regardless of the suture type. Compared with larger gauge sutures, smaller gauge sutures more easily cut into and tear through the skin substitute, reducing skin cancer scars, as evidenced in the table below.

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