A systematic review and meta-analysis: Do absorbable or non-absorbable suture materials differ in cosmetic outcomes in patients requiring primary closure of facial wounds?

Introduction: Surgeons are often judged based on the cosmetic appearance of any scar after surgery rather than the functional outcome of treatment, especially when considering facial wounds. Objective: We performed a systematic review of the literature to determine whether absorbable or non-absorbable suture materials result in different cosmetic outcomes for patients requiring primary closure of facial wounds. Methods: An extensive systematic review was carried out to identify studies meeting our inclusion criteria. Risk of bias in each study was assessed using the Cochrane risk of bias assessment tool. Data were extracted from those articles that met our inclusion criteria, and statistical analysis was carried out using the Cochrane RevMan. Results: We found no significant difference in any aspect of our analysis including Visual Analogue Cosmesis scale, Visual Analogue Satisfaction scale, infection, dehiscence, erythema or stitch marks. Most authors concluded that they prefer to use absorbable sutures. However, the overall quality of evidence is poor, and significant variation exists regarding the methods of assessment between papers. Conclusion: Use of absorbable suture material appears to be an acceptable alternative to non-absorbable suture material for the closure of facial wounds as they produce similar cosmetic results.