Comparison of Incision Closure in Hand Plastic Surgery Using Non-absorbable Versus Absorbable Sutures: A Systematic Review of Randomized Controlled Trials

Introduction: Surgeons prioritize scar appearance after surgery, making suture choice crucial. Traditionally, non-absorbable sutures were standard but require removal, causing patient discomfort and extra visits. Absorbable sutures, while offering convenience, might raise concerns about scar quality. This study aims to provide an overview of the plastic surgery literature and clinically based evidence of the efficacy and outcome of absorbable and non-absorbable sutures. Methods: A systematic review of search databases in MEDLINE, EMBASE and the Cochrane Library was made to identify studies related to absorbable and non-absorbable sutures. The inclusion criteria for this study included RCTs comparing AS and NAS in plastic hand surgery, without any limitations of age or sex on recruited patients. Results: A total of 532 hands were treated with a combined sample size of 517 patients undergoing plastic hand surgery. Two hundred seventy-three (51%) of patients had their wound closed with non-absorbable sutures, and 259 (49%) had absorbable sutures. Overall patient satisfaction among the studies that reported number of patients satisfied with the wound closure appearance was 64 (64%) in non-absorbable sutures cohort and 58 (59%) in absorbable sutures. Wound inflammation happened in 8 (3%) of wounds closed with non-absorbable sutures and in 9 (3.4%) of wounds closed with absorbable sutures. Conclusion: In both patients cohorts, the overall patient satisfaction and complication rates were not significantly different. Non-absorbable sutures appeared to have slightly higher patient satisfaction rates. However, absorbable sutures may offer some benefits in terms of convenience with lower risk of wound dehiscence. Level of Evidence III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.