Linear Repairs

  • Reason Wilken
  • Farzam Gorouhi
  • Samantha Ellis
  • Daniel B. EisenEmail author


For surgeons, there are multiple factors informing the decision of which techniques and epidermal closure materials should be used when closing specific defects in the skin. Major factors include the functionality and appearance of the scar, as well as the incidence of complications (e.g., infection, wound dehiscence, suture abscesses) among different surgical techniques. Other important considerations include the time taken to perform the closure, the cost of materials, and patient-specific factors, such as differences in postoperative care regimens and the need to return for removal of non-absorbable sutures.


Epidermal closure Adhesive strips Polyglactin 910 Tissue adhesive Cuticular closure Group Patients Sutures 


  1. 1.
    Singer AJ, Gulla J, Hein M, Marchini S, Chale S, Arora BP. Single-layer versus double-layer closure of facial lacerations: a randomized controlled trial. Plast Reconstr Surg. 2005;116(2):363–8. discussion 369-370PubMedCrossRefGoogle Scholar
  2. 2.
    Sadick NS, D’Amelio DL, Weinstein C. The modified buried vertical mattress suture. A new technique of buried absorbable wound closure associated with excellent cosmesis for wounds under tension. J Dermatol Surg Oncol. 1994;20(11):735–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Ling N, Martin A. Three suturing techniques for closing fusiform excisions. A randomised controlled study. Australas J Dermatol. 2016;57(4):271–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Kannan S, Mehta D, Ozog D. Scalp Closures With Pulley Sutures Reduce Time and Cost Compared to Traditional Layered Technique-A Prospective, Randomized, Observer-Blinded Study. Dermatol Surg. 2016;42(11):1248–55.PubMedCrossRefGoogle Scholar
  5. 5.
    Wang AS, Kleinerman R, Armstrong AW, et al. Set-back versus buried vertical mattress suturing: results of a randomized blinded trial. J Am Acad Dermatol. 2015;72(4):674–80.PubMedCrossRefGoogle Scholar
  6. 6.
    Regan T, Lawrence N. Comparison of poliglecaprone-25 and polyglactin-910 in cutaneous surgery. Dermatol Surg. 2013;39(9):1340–4.PubMedCrossRefGoogle Scholar
  7. 7.
    Kia KF, Burns MV, Vandergriff T, Weitzul S. Prevention of scar spread on trunk excisions: a rater-blinded randomized controlled trial. JAMA Dermatology. 2013;149(6):687–91.PubMedCrossRefGoogle Scholar
  8. 8.
    Kappel S, Kleinerman R, King TH, et al. Does wound eversion improve cosmetic outcome?: Results of a randomized, split-scar, comparative trial. J Am Acad Dermatol. 2015;72(4):668–73.PubMedPubMedCentralCrossRefGoogle Scholar
  9. 9.
    Rosenzweig LB, Abdelmalek M, Ho J, Hruza GJ. Equal cosmetic outcomes with 5-0 poliglecaprone-25 versus 6-0 polypropylene for superficial closures. Dermatol Surg. 2010;36(7):1126–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Moody BR, McCarthy JE, Linder J, Hruza GJ. Enhanced cosmetic outcome with running horizontal mattress sutures. Dermatol Surg. 2005;31(10):1313–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Alam M, Posten W, Martini MC, Wrone DA, Rademaker AW. Aesthetic and functional efficacy of subcuticular running epidermal closures of the trunk and extremity: a rater-blinded randomized control trial. Arch Dermatol. 2006;142(10):1272–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Kanegaye JT, Vance CW, Chan L, Schonfeld N. Comparison of skin stapling devices and standard sutures for pediatric scalp lacerations: a randomized study of cost and time benefits. J Pediatr. 1997;130(5):808–13.PubMedCrossRefGoogle Scholar
  13. 13.
    Orlinsky M, Goldberg RM, Chan L, Puertos A, Slajer HL. Cost analysis of stapling versus suturing for skin closure. Am J Emerg Med. 1995;13(1):77–81.PubMedCrossRefGoogle Scholar
  14. 14.
    Corporation BB. Histoacryl® topical skin adhesives: indications. Accessed 18 Dec 2016.
  15. 15.
    Goktas N, Karcioglu O, Coskun F, Karaduman S, Menderes A. Comparison of tissue adhesive and suturing in the repair of lacerations in the emergency department. Eur J Emerg Med. 2002;9(2):155–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Quinn JV, Drzewiecki A, Li MM, et al. A randomized, controlled trial comparing a tissue adhesive with suturing in the repair of pediatric facial lacerations. Ann Emerg Med. 1993;22(7):1130–5.PubMedCrossRefGoogle Scholar
  17. 17.
    Kim J, Singh Maan H, Cool AJ, Hanlon AM, Leffell DJ. Fast Absorbing Gut Suture versus Cyanoacrylate Tissue Adhesive in the Epidermal Closure of Linear Repairs Following Mohs Micrographic Surgery. J Clin Aesthet Dermatol. 2015;8(2):24–9.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Tierney EP, Moy RL, Kouba DJ. Rapid absorbing gut suture versus 2-octylethylcyanoacrylate tissue adhesive in the epidermal closure of linear repairs. J Drugs Dermatol. 2009;8(2):115–9.PubMedGoogle Scholar
  19. 19.
    Toriumi DM, O’Grady K, Desai D, Bagal A. Use of octyl-2-cyanoacrylate for skin closure in facial plastic surgery. Plast Reconstr Surg. 1998;102(6):2209–19.PubMedCrossRefGoogle Scholar
  20. 20.
    Wang R, Lagakos SW, Ware JH, Hunter DJ, Drazen JM. Statistics in medicine–reporting of subgroup analyses in clinical trials. N Engl J Med. 2007;357(21):2189–94.PubMedCrossRefGoogle Scholar
  21. 21.
    Plotner AN, Mailler-Savage E, Adams B, Gloster HM Jr. Layered closure versus buried sutures and adhesive strips for cheek defect repair after cutaneous malignancy excision. J Am Acad Dermatol. 2011;64(6):1115–8.PubMedCrossRefGoogle Scholar
  22. 22.
    Custis T, Armstrong AW, King TH, Sharon VR, Eisen DB. Effect of Adhesive Strips and Dermal Sutures vs Dermal Sutures Only on Wound Closure: A Randomized Clinical Trial. JAMA Dermatology. 2015;151(8):862–7.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Sniezek PJ, Walling HW, JR DB 3rd, et al. A randomized controlled trial of high-viscosity 2-octyl cyanoacrylate tissue adhesive versus sutures in repairing facial wounds following Mohs micrographic surgery. Dermatol Surg. 2007;33(8):966–71.PubMedGoogle Scholar
  24. 24.
    Singer AJ, Hollander JE, Valentine SM, Turque TW, McCuskey CF, Quinn JV. Prospective, randomized, controlled trial of tissue adhesive (2-octylcyanoacrylate) vs standard wound closure techniques for laceration repair. Stony Brook Octylcyanoacrylate Study Group. Acad Emerg Med. 1998;5(2):94–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Singer AJ, Quinn JV, Thode HC Jr, Hollander JE. Determinants of poor outcome after laceration and surgical incision repair. Plast Reconstr Surg. 2002;110(2):429–35. discussion 436-427PubMedCrossRefGoogle Scholar
  26. 26.
    Mattick A, Clegg G, Beattie T, Ahmad T. A randomised, controlled trial comparing a tissue adhesive (2-octylcyanoacrylate) with adhesive strips (Steristrips) for paediatric laceration repair. Emerg Med J. 2002;19(5):405–7.PubMedPubMedCentralCrossRefGoogle Scholar
  27. 27.
    Singer AJ, Giordano P, Fitch JL, Gulla J, Ryker D, Chale S. Evaluation of a new high-viscosity octylcyanoacrylate tissue adhesive for laceration repair: a randomized, clinical trial. Acad Emerg Med. 2003;10(10):1134–7.PubMedCrossRefGoogle Scholar
  28. 28.
    Kuo F, Lee D, Rogers GS. Prospective, randomized, blinded study of a new wound closure film versus cutaneous suture for surgical wound closure. Dermatol Surg. 2006;32(5):676–81.PubMedGoogle Scholar
  29. 29.
    Mitwalli H, Dolan C, Bacigalupi R, Khorasani H. A randomized, controlled, prospective clinical study comparing a novel skin closure device to conventional suturing. J Am Acad Dermatol. 2016;74(1):173–4.PubMedCrossRefGoogle Scholar
  30. 30.
    Ek L, Hogstedt B, Herrstrom P. Scar area and cosmetic outcome after circular and elliptical excision of small skin lesions. J Cutan Med Surg. 2004;8(1):11–5.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Reason Wilken
    • 1
  • Farzam Gorouhi
    • 1
    • 2
  • Samantha Ellis
    • 1
  • Daniel B. Eisen
    • 1
    Email author
  1. 1.Department of DermatologyUniversity of California Davis Medical CenterSacramentoUSA
  2. 2.Department of DermatologySouth Sacramento Kaiser PermanenteSacramentoUSA

Personalised recommendations