Implications for future research
Further studies with a more robust design may help in determining a best possible closure method in head and neck operations. The optimal trial design would be prospective, randomised with a longer follow-up to accommodate for wound remodelling. Studies could compare not only sutures and staples, but the overlooked tissue adhesives and surgical tape, using subcuticular sutures as a control group. Scar appearance should be analysed by a clinician and patient using validated questionnaires such as the patient and observer scar assessment scale (POSAS) or the PSAQ. This could be corroborated with the impact on a patient’s QOL and body image using assessments such as the body image questionnaire.
Research into minimal access robotic and open thyroidectomy has suggested wound location does not impact upon a patient’s opinion of their scar. Nevertheless, it could be presumed some incisions, such as those for neck dissection, may be more disfiguring than more subtle salivary gland scars. Avoidance of this mismatch could be achieved through comparison of a single operation, studying matched cohorts, or performing sub-group analysis.