• Alice Lee, Guy H M Stanley, Ryckie G Wade, Daniele Berwick, Victoria Vinicombe, Brogan K Salence, Esra Musbahi, Anderson R C S De Poli, Mihaela Savu, Jonathan M Batchelor, Rachel A Abbott, Matthew D Gardiner, Aaron Wernham, David Veitch, and CANVAS collaborative.
• Department of Plastic Surgery and Burns, Stoke Mandeville Hospital, Aylesbury, UK.
• Br J Surg. 2023 Mar 30; 110 (4): 462470462-470.

BackgroundAbsorbable or non-absorbable sutures can be used for superficial skin closure following excisional skin surgery. There is no consensus among clinicians nor high-quality evidence supporting the choice of suture. The aim of the present study was to determine current suture use and complications at 30 days after excisional skin surgery.MethodsAn international, prospective service evaluation of adults undergoing excision of skin lesions (benign and malignant) in primary and secondary care was conducted from 1 September 2020 to 15 April 2021. Routine patient data collected by UK and Australasian collaborator networks were uploaded to REDCap©. Choice of suture and risk of complications were modelled using multivariable logistic regression.ResultsSome 3494 patients (4066 excisions) were included; 3246 (92.9 per cent) were from the UK and Ireland. Most patients were men (1945, 55.7 per cent), Caucasian (2849, 81.5 per cent) and aged 75-84 years (965, 27.6 per cent). The most common clinical diagnosis was basal cell carcinoma (1712, 42.1 per cent). Dermatologists performed most procedures, with 1803 excisions (44.3 per cent) on 1657 patients (47.4 per cent). Most defects were closed primarily (2856, 81.9 per cent), and there was equipoise in regard to use of absorbable (2127, 57.7 per cent) or non-absorbable (1558, 42.2 per cent) sutures for superficial closure. The most common complications were surgical-site infection (103, 2.9 per cent) and delayed wound healing (77, 2.2 per cent). In multivariable analysis, use of absorbable suture type was associated with increased patient age, geographical location (UK and Ireland), and surgeon specialty (oral and maxillofacial surgery and plastic surgery), but not with complications.ConclusionThere was equipoise in suture use, and no association between suture type and complications. Definitive evidence from randomized trials is needed.© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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