Abstract
Background: The cosmetic appearance of head and neck surgical
scars can have a major impact on body image and quality of life.
Numerous wound closure methods such as staples, sutures, adhesives and
surgical tape are available, and our aim is to investigate whether one
closure method offers superior cosmetic outcomes over the others.
Objectives: The primary outcome was patient and clinician
reported cosmetic appearance. Secondary outcome measures such as
post-operative complications were also measured.
Design: A systematic review was undertaken of Pubmed, Web of
Science and the Cochrane database. Searches were performed using the
MeSH terms “tissue adhesives”, “wound closure techniques”,
“surgical tape” and “sutures”, combined with various head and neck
operations using Boolean operators.
Results: The initial search found 2753 papers, of which 2,721
were excluded after removal of duplicates and screening. 32 papers
underwent full text review and 7 were included in the review. The
studies did not show any significant difference in cosmesis or wound
complications. Surgical staples and tissue adhesives had significantly
shorter wound closure time than sutures. No studies reported on head and
neck scar’s impact on quality of life or body image.
Conclusions: From the studies presented here, there is no
significant difference in short term wound cosmesis using tissue
adhesives, sutures, or surgical staples. However, the papers included
are generally of poor quality and contained a moderate to high risk of
bias, and thus further studies are needed to establish the cosmetic and
quality of life impact of varying wound closure techniques following
head and neck surgery.
MeSH Keywords: wound closure techniques, surgical stapling,
suture techniques, Otorhinolaryngologic Surgical Procedures