Timing of Suture Removal to Reduce Scarring in Skin Surgery

NCT ID: NCT05036785

Last Updated: 2024-10-24

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-12-07

Study Completion Date

2022-10-26

Brief Summary

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This is a single centre prospective randomized assessor blinded parallel group feasibility study that will be undertaken in the Royal Devon and Exeter Dermatology department.

The investigators will be looking at whether timing of percutaneous suture removal after skin surgery impacts on the incidence of suture marks and overall scar cosmesis.

Detailed Description

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Stitch marks (also known as suture marks or track marks) are permanent marks left in the skin where the stitch has caused local tissue damage and scarring. The risk of these marks is in part thought to be related to the length of time that the stitches are left in place before removal. Stitches are normally left in place for longer on sites where the skin is under greater tension such as the chest or back because there is a concern that the wound may be more likely to open up on these sites. On the chest or back, stitches may be left in place for up to 14 days even though the chest or back is a common site for stitch marks to form.

The investigators are conducting a single centre prospective randomized assessor blinded parallel group feasibility study to estimate a sample size required for a properly powered RCT, and also to provide some preliminary data on the incidence of wound complications and overall scar cosmesis in each group.

All patients attending the dermatology department for wide local excision as part of their skin cancer treatment and primary closure of the subsequent wound will be considered for entry into the trial. Clinicians will identify potential participants during routine practice at their clinic visit. Patients who fulfil the entry criteria will be invited at that appointment to take part.

On the date of participants skin surgery, they will be consented and randomized to either 'suture removal at 7 days' or 'suture removal at 10 days'. Participants will then be booked for a 3 month follow up where the scar site will be evaluated from a patient and clinician perspective to assess suture marks and overall cosmesis.

Conditions

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Suture Related Complication

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Single centre prospective randomized assessor blinded parallel group feasibility study
Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Investigators

Study Groups

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Suture removal at 7 days

Suture removal at 7 days post skin surgery

Group Type ACTIVE_COMPARATOR

Timing of suture removal

Intervention Type OTHER

Patients will either be randomized to have their sutures removed at 7 or 10 days post skin surgery

Suture removal at 10 days

Suture removal at 10 days post skin surgery

Group Type ACTIVE_COMPARATOR

Timing of suture removal

Intervention Type OTHER

Patients will either be randomized to have their sutures removed at 7 or 10 days post skin surgery

Interventions

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Timing of suture removal

Patients will either be randomized to have their sutures removed at 7 or 10 days post skin surgery

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients of 18 years old or above who had capacity to consent to surgery who were willing to attend follow-up appointments within the department

* Patients undergoing wide local excision as part of their skin cancer treatment pathway
* Lesions excised from the anterior chest or back
* Post-operative wound \>/= 10mm width
* Wound could be closed with primary intention healing

Exclusion Criteria

* Inability to provide valid informed consent and/or unwilling to attend for follow-up

* Wounds where the edges could not be closely adhered with dermal sutures alone.
* Wounds requiring a flap or graft for closure.
* Patients requiring further treatment following original excision eg. Further WLE, radiotherapy etc.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Royal Devon and Exeter NHS Foundation Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Emily McGrath, BMedSci BMBS

Role: PRINCIPAL_INVESTIGATOR

Royal Devon and Exeter NHS Trust

Locations

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Royal Devon and Exeter Heavitree Hospital

Exeter, , United Kingdom

Site Status

Countries

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United Kingdom

References

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Weitemeyer MB, Bramsen P, Klausen TW, Holmich LR, Gjorup CA. Patient-and observer-reported long-term scar quality of wide local excision scars in melanoma patients. J Plast Surg Hand Surg. 2018 Dec;52(6):319-324. doi: 10.1080/2000656X.2018.1493388. Epub 2018 Oct 31.

Reference Type BACKGROUND
PMID: 30380964 (View on PubMed)

Prowse, Phoebe & Shokrollahi, Kayvan. (2014). Leaving our mark - are suture marks acceptable?. Bulletin of The Royal College of Surgeons of England. 96. 264-266. 10.1308/147363514X14042954768637.

Reference Type BACKGROUND

CRIKELAIR GF. Skin suture marks. Am J Surg. 1958 Nov;96(5):631-9. doi: 10.1016/0002-9610(58)90464-1. No abstract available.

Reference Type BACKGROUND
PMID: 13583327 (View on PubMed)

Moy RL, Waldman B, Hein DW. A review of sutures and suturing techniques. J Dermatol Surg Oncol. 1992 Sep;18(9):785-95. doi: 10.1111/j.1524-4725.1992.tb03036.x.

Reference Type BACKGROUND
PMID: 1512311 (View on PubMed)

Hasan Z, Gangopadhyay AN, Gupta DK, Srivastava P, Sharma SP. Sutureless skin closure with isoamyl 2-cyanoacrylate in pediatric day-care surgery. Pediatr Surg Int. 2009 Dec;25(12):1123-5. doi: 10.1007/s00383-009-2485-9. Epub 2009 Sep 17.

Reference Type BACKGROUND
PMID: 19760198 (View on PubMed)

Hohenleutner U, Egner N, Hohenleutner S, Landthaler M. Intradermal buried vertical mattress suture as sole skin closure: evaluation of 149 cases. Acta Derm Venereol. 2000 Sep-Oct;80(5):344-7. doi: 10.1080/000155500459277.

Reference Type BACKGROUND
PMID: 11200831 (View on PubMed)

Wolf R. Serial replacement of sutures for preventing suture marks. J Dermatol Surg Oncol. 1993 Dec;19(12):1131. doi: 10.1111/j.1524-4725.1993.tb02477.x. No abstract available.

Reference Type BACKGROUND
PMID: 8282914 (View on PubMed)

Kobayashi S, Ito M, Yamamoto S, Kinugasa Y, Kotake M, Saida Y, Kobatake T, Yamanaka T, Saito N, Moriya Y. Randomized clinical trial of skin closure by subcuticular suture or skin stapling after elective colorectal cancer surgery. Br J Surg. 2015 Apr;102(5):495-500. doi: 10.1002/bjs.9786. Epub 2015 Feb 26.

Reference Type BACKGROUND
PMID: 25727933 (View on PubMed)

Viechtbauer W, Smits L, Kotz D, Bude L, Spigt M, Serroyen J, Crutzen R. A simple formula for the calculation of sample size in pilot studies. J Clin Epidemiol. 2015 Nov;68(11):1375-9. doi: 10.1016/j.jclinepi.2015.04.014. Epub 2015 Jun 6.

Reference Type BACKGROUND
PMID: 26146089 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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2011060

Identifier Type: -

Identifier Source: org_study_id

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