Absorbable versus nonabsorbable sutures in the management of traumatic lacerations and surgical wounds: a meta-analysis.

OBJECTIVES: To complete a systematic review of randomized controlled trials (RCTs) that compare the cosmetic outcomes and complications of traumatic lacerations and surgical incisions closed with absorbable sutures versus nonabsorbable sutures.

DESIGN/METHODS: We searched MEDLINE, EMBASE, and Cochrane Central to identify all RCTs comparing absorbable versus nonabsorbable sutures that assessed cosmetic outcomes or complications. Reference lists of all identified trials were also searched. Two independent reviewers screened abstracts for eligibility, extracted study data, and assessed trial quality. Disagreements were resolved by consensus or a third party.

RESULTS: Three hundred thirty-eight citations were retrieved, of which 7 met inclusion criteria. Studies were heterogeneous with respect to specific interventions and outcome measures; sample sizes ranged from 44 to 166. There was no statistically significant difference between absorbable and nonabsorbable sutures in short- or long-term cosmetic score, scar hypertrophy, infection rate, wound dehiscence, and wound redness/swelling.

CONCLUSIONS: Our meta-analysis suggests a lack of large, methodologically sound RCTs evaluating the effectiveness of absorbable versus nonabsorbable sutures. Although our analysis demonstrates that nonabsorbable sutures seem to be no better than absorbable sutures in the management of wound repair, a large methodologically sound RCT is needed to adequately answer this question.