Aesthetic result of thyroidectomy: evaluation of different kinds of skin suture

AIM: The aesthetic results of thyroidectomy have been evaluated in a prospective single-blinded randomized study MATERIAL OF STUDY: 140 patients undergoing thyroid surgery were randomized for skin closure into 4 groups: (1) intradermal non-absorbable suture; (2) intradermal non-absorbable double layer suture; (3) staples; (4) tissue adhesive. 136 out of the 140 patients were followed up at 3 months postoperatively. Scars were evaluated by a blinded plastic surgeon using the mVSS tool (modified Vancouver Scar Scale). Patients completed the PSAS form (Patient Scar Assessment Scale). RESULTS: Assessment of wound cosmesis with the mVSS revealed no statistical difference between group (1), (2) and (3); a statistically significant difference in the results with the group (4) (p = 0.0020) was found. The analysis of the results of PSAS showed very good subjective outcomes in all groups. However, the median values of PSAS at 3 months are better (p = 0.0001) for the group (1): follow results of group (2), (3) and (4). In some cases, the subjective rating in the group of women has been even higher than that reported by the blinded specialist. DISCUSSION: (1) still represents the gold standard in thyroidectomy. Conceptually the ideal technique should be (2): removing the suture (after two weeks from surgery) all problems related to the stimulus from foreign body are eliminated. CONCLUSIONS: The choice of suture technique to use depends on the skill and experience of the single surgeon. All four types of suture, if performed correctly, have given very attractive subjective and objective results.