Impact of Suture Type on Pigment Disturbances in Patients of Skin of Color: A Prospective, Randomized Split-wound Study

What this Trial Is About

Researchers are evaluating whether dissolvable (fast gut) or non-dissolvable (polypropylene) epidermal sutures result in better cosmetic outcomes regarding pigment changes and scarring in patients with skin of color. This study uses a split-wound design where each patient receives both types of sutures on different halves of the same wound. Measurements of pigmentation and scarring will be taken at 7 or 10 days depending on the wound location, and again at 3 months after surgery. During surgery, patients will undergo standard elliptical excision with a wound length of at least 3 cm. A single buried intradermal suture will be placed centrally using polyglactin 910, with additional sutures placed symmetrically if needed. The wound will be divided into two halves, randomly assigned to receive either 5-0 fast gut or 5-0 polypropylene epidermal sutures, applied with a running technique. Sutures on the polypropylene side will be removed at 7 days for head and neck wounds, or 10 days for trunk and extremities, while residual fast gut sutures will be removed to keep observers blinded. Participants will have photos taken and scars assessed using the Patient and Observer Scar Assessment Scale (POSAS) at suture removal and again at 3 months post-surgery. Scar width, pain during suture removal, and skin hyperpigmentation index scores from dermatoscopic images will also be recorded. Clinical complications will be monitored, and patients unable to attend the 3-month visit will complete assessments remotely. All collected data will be analyzed to compare the cosmetic outcomes of the two suture types.

Impact of Suture Type on Pigment Disturbances in Patients of Skin of Color