Comperative analysis of unilateral cleft lip closure using absorbable and nonabsorbable sutures: a randomised clinical study

Abstract

Aim: Patients with cleft lip usually undergo multiple procedures that require hospitalization resulting in emotional stress to their family members. Young patients often require sedation or general anesthesia (GA) for suture removal on a sensitive area to prevent disruption of the repair. In this study, we compared absorbable and nonabsorbable sutures for primary cleft lip repair.

Methods: Patients with cleft lip who presented to Smile Train Unit, Child Hospital and Research Institute, Nagpur, India, were randomly assigned to two groups and underwent surgical repair using either Vicryl Rapid suture (Group 1) or Prolene suture (Group 2). Patients were followed up at 1 month, 6 months, and 1 year. Photographs of the patients were obtained at these visits and rated using a validated 100-mm cosmesis visual analogue scale (VAS) by three people (social worker, surgeon, and patient’s mother). A VAS score of 15 mm or greater was considered as clinically important difference.

Results: A total of 60 patients were enrolled in this study, and they were equally divided into two groups. There was no difference in age, race, sex, wound length, number of sutures, and layered repair rates between the groups. The average age of the patient was 3 months. There was no significant difference in the rates of infection which was 6% in this study, wound dehiscence, and hypertrophic scar formation. No significant difference was found in cosmetic outcome in both the mean VAS score of 90.3 in Group 1 and 91.7 in Group 2.

Conclusion: Absorbable sutures are a viable alternative to nonabsorbable sutures in the repair of primary cleft lip repair. We prefer absorbable sutures because they do not require removal under GA or sedation.

Keywords

Absorbable sutures / primary cleft lip / visual analogue scale

References

[1] Sandberg DJ,Denk MJ.Neonatal cleft lip and cleft palate repair..AORN J2002;75:490-8

[2] Firth HV.Clinical approach. In: Genetics.2006;OxfordOxford Medical Press74-7

[3] Marcusson A,Paulin G.Quality of life in adults with repaired complete cleft lip and palate..Cleft Palate Craniofac J2001;38:379-85

[4] Parell GJ.Comparison of absorbable with nonabsorbable sutures in closure of facial skin wounds..Arch Facial Plast Surg2003;5:488-90

[5] Draaijers LJ,Botman YA,Middelkoop E,van Zuijlen PP.The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluation..Plast Reconstr Surg2004;113:1960-5

[6] Erel E,Ahmed O.Absorbable versus non-absorbable suture in carpal tunnel decompression..J Hand Surg Br2001;26:157-8

[7] Luck RP,Eyal D,Hayes C.Cosmetic outcomes of absorbable versus nonabsorbable sutures in pediatric facial lacerations..Pediatr Emerg Care2008;24:137-42

[8] Luck R,Gerard J,Krug L.Comparison of cosmetic outcomes of absorbable versus nonabsorbable sutures in pediatric facial lacerations..Pediatr Emerg Care2013;29:691-5

[9] Holger JS,Hale DB.Cosmetic outcomes of facial lacerations repaired with tissue-adhesive, absorbable, and nonabsorbable sutures..Am J Emerg Med2004;22:254-7

[10] Karounis H,Eisman H,Pelletier H.A randomized, controlled trial comparing long-term cosmetic outcomes of traumatic pediatric lacerations repaired with absorbable plain gut versus nonabsorbable nylon sutures..Acad Emerg Med2004;11:730-5

[11] Al-Abdullah T,Fergusson D.Absorbable versus nonabsorbable sutures in the management of traumatic lacerations and surgical wounds: a meta-analysis..Pediatr Emerg Care2007;23:339-44

[12] Shinohara H,Kikuchi N.Absorbable and nonabsorbable buried sutures for primary cleft lip repair..Ann Plast Surg1996;36:44-6

[13] Choudhary S.Cleft lip repair: rub off the sutures, not the smile!.Plast Reconstr Surg2000;105:1566

[14] Collin TW,Hodgkinson PD.Cleft lip repair without suture removal..J Plast Reconstr Aesthet Surg2009;62:1161-5