Aesthetic Comparison of Abdominal Donor Site Scar Between Absorbable Dermal Staple and Subcutaneous Suture after Autolog
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ORIGINAL ARTICLE
BODY CONTOURING
Aesthetic Comparison of Abdominal Donor Site Scar Between Absorbable Dermal Staple and Subcutaneous Suture after Autologous Breast Reconstruction: A Prospective Randomized Controlled, Double-Blinded Study Jae-Ho Chung1 • Hyung-Kyu Kim2 • Yun-Hwan Lee2 • Hyung-Chul Lee1 Hi-Jin You2 • Deok-Woo Kim2
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Received: 29 June 2020 / Accepted: 7 September 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Abstract Background Abdominal tissue transfer has become the most commonly used tool for breast reconstruction. However, a secondary operator is often responsible for donor closure, which leaves dissatisfaction to patients due to inconsistent donor scars. Now, an absorbable dermal stapler is popularized worldwide and currently used for wound closure in many surgical fields. In this study, we aim to evaluate the abdominal donor site scar in using an absorbable dermal staple compared to a conventional suture. Methods This is a prospective, randomized controlled and double-blinded study. Between January 2018 and April 2019, a total of 30 patients who underwent breast reconstruction using abdominal flap were included. Donor sites were divided into equal halves, and the each dermal layer was sutured with either dermal staples or traditional suturing, respectively. At 1, 3 and 6 months after operation, the scar was evaluated by two blinded plastic surgeons by using the modified Manchester scar scale (MSS). Results An averaged sum of modified MSS was lower for the side sutured with a dermal stapler at the first month (11.76 ± 2.12 vs. 12.28 ± 2.03, p = 0.097), third month (12.17 ± 1.86 vs. 12.62 ± 2.31, p = 0.301) and sixth month (11.28 ± 2.63 vs. 12.14 ± 2.76, p = 0.051). Also, the dermal stapler side scored significantly higher for
& Deok-Woo Kim [email protected] 1
Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
2
Department of Plastic and Reconstructive Surgery, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do 15355, Republic of Korea
patient satisfaction than did the suture side (4.03 ± 0.98 vs 3.66 ± 0.97, p \ 0.05). Conclusion The objective outcome of the scar closed by an absorbable dermal stapler was not statistically superior to conventional suturing. (p [ 0.05) In the subjective outcome, however, it showed a significantly higher patients’ satisfaction (p \ 0.05). Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. Keywords Absorbable dermal staples Breast reconstruction Abdominal flap Donor site Scar
Introduction Recently, increasing numbers of patients are choosing to undergo autologous breast reconstruction in the USA [1]. Among them, an abdominal tissue transfer, such as free transvers
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