International, prospective cohort study comparing non-absorbable versus absorbable sutures for skin surgery: CANVAS service evaluation

Lee, A; Stanley, G.H.M; Wade, R.G; Berwick, D; Vinicombe, V; Salence, B.K; Musbahi, E; De Poli, A.R.C.S; Savu, M; Batchelor, J.M; Abbott, R.A; Gardiner, M.D; Wernham, A; Veitch, D

International, prospective cohort study comparing non-absorbable versus absorbable sutures for skin surgery: CANVAS service evaluation

Authors

Lee, A

Stanley, G.H.M

Wade, R.G

Berwick, D

Vinicombe, V

Salence, B.K

Musbahi, E

De Poli, A.R.C.S

Savu, M

Batchelor, J.M

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Issue Date

2023

Type

Scientific Paper

Keywords

Research Subject Categories::MEDICINE::Surgery , Research Subject Categories::MEDICINE::Dermatology and venerology,clinical genetics, internal medicine::Dermatology and venerology

Abstract

Background Absorbable 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. Methods An 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. Results Some 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. Conclusion There was equipoise in suture use, and no association between suture type and complications. Definitive evidence from randomized trials is needed. Metadata Authors/Creators: Lee, A Stanley, GHM Wade, RG ORCID logo https://orcid.org/0000-0001-8365-6547 Berwick, D Vinicombe, V Salence, BK Musbahi, E De Poli, ARCS Savu, M Batchelor, JM Abbott, RA Gardiner, MD Wernham, A Veitch, D On behalf of the Canvas Collaborative Copyright, Publisher and Additional Information: © The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. This is a pre-copyedited, author-produced version of an article accepted for publication in British Journal of Surgery following peer review. The version of record 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, the CANVAS collaborative, International, prospective cohort study comparing non-absorbable versus absorbable sutures for skin surgery: CANVAS service evaluation, British Journal of Surgery, 2023;, znad008, https://doi.org/10.1093/bjs/znad008 is available online at: .British Journal of Surgery, znad008, https://doi.org/10.1093/bjs/znad008 Dates: Accepted: 31 December 2022 Published (online): 8 February 2023 Published: 8 February 2023 Institution: The University of Leeds Depositing User: Symplectic Publications Date Deposited: 27 Mar 2023 09:34 Last Modified: 08 Feb 2024 01:13 Published Version: http://dx.doi.org/10.1093/bjs/znad008 Status: Published Publisher: Oxford University Press (OUP) Identification Number: https://doi.org/10.1093/bjs/znad008 Related URLs: Author Download Accepted Version Filename: CANVAS manuscript _050422_AL.pdf CLICK TO DOWNLOAD[img] Export RDF+XML Statistics 17 7 View details on Altmetric's website 1CITATION1 citation on Dimensions. 1 Total citation 1 Recent citation n/a Field Citation Ratio n/a Relative Citation Ratio View citation information on the Dimensions website 78 Showing total views of full content and records for this item - [Total_Item_Investigations]. For an explanation of Metric_Types please see the IRUS guide.

Citation

Lee A, Stanley G, Batchelor JM, et al. An international clinician survey CompAring Nonabsorbable Vs. Absorbable sutures for Skin surgery: the CANVAS study. The British Journal of Dermatology. 2022 Sep;187(3):445-447. DOI: 10.1111/bjd.21062. PMID: 35191028; PMCID: PMC9545085