Comparison of Traditional Superficial Cutaneous Sutures Versus Adhesive Strips in Layered Dermatologic Closures on the Back-A Prospective, Randomized, Split-Scar Study

BACKGROUND: Bilayered suture repairs have become the standard of care in dermatologic surgery. However, the benefit of superficial sutures for fine epidermal alignment on high-tension areas remains unclear. OBJECTIVE: To compare the overall cosmetic outcome of traditional epidermal sutures with adhesive strips in layered dermatologic repairs on the back. METHODS: A total of 10 patients underwent standard elliptical excision on the back followed by subcutaneous closure with 4-0 polyglactin 910 buried sutures. Each half of the wound was then randomized to either 4-0 polypropylene running sutures or 1/4″ Steri-Strip films for epidermal approximation. Postoperative evaluations were completed in person at 2 weeks, 3 months, and 6 months using the Patient and Observer Scar Assessment Scale. RESULTS: The adhesive strip group had superior appearance and greater patient satisfaction at 2 weeks. Evaluation at 3 months and 6 months revealed no statistically significant difference in overall scar cosmesis. CONCLUSION: Adhesive strips result in equivalent long-term scar outcome when compared with traditional epidermal sutures and should be viewed as a time-saving alternative in layered dermatologic repairs on the back. This finding further corroborates that undermining and placement of deep buried sutures are the primary determinants of wound appearance