Absorbable Versus Non-Absorbable Sutures for Facial Skin Closure: A Systematic Review and Meta-Analysis of Clinical and Aesthetic Outcomes

Abstract

Introduction When repairing facial wounds, it is crucial to possess a thorough understanding of suitable suture materials and their evidence base. The absence of high-quality and comprehensive systematic reviews poses challenges in making informed decisions. In this study, we conducted a review of the existing literature and assessed the quality of the current evidence pertaining to the clinical, aesthetic, and patient-reported outcomes associated with absorbable and non-absorbable sutures for facial skin closure. Methods The study was registered on PROSPERO. We conducted searches on EMBASE, OVID, and PUBMED/MEDLINE databases. Only randomized controlled trials (RCTs) were eligible for inclusion in this study. Additionally, the risk of bias in the randomized studies was assessed using Cochrane's Risk of Bias Tool. Results The study included a total of nine RCTs involving 804 participants with facial injuries. Among these injuries, absorbable sutures were utilized in 50.2% (403 injuries), while non-absorbable sutures were employed in 49.8% (401 injuries). The analysis of cosmesis scales revealed no statistically significant difference between absorbable and non-absorbable sutures regarding infections (p = 0.72), visual analog scale (p = 0.69), wound dehiscence (p = 0.08), and scarring (p = 0.46). The quality of the included studies was determined to have a low risk of bias. Conclusion Absorbable sutures can be considered a suitable alternative to non-absorbable sutures, as they demonstrate comparable aesthetic and clinical outcomes. Future high-quality studies with a level I evidence design and cost-effectiveness analysis are necessary to enhance clinician-patient shared decision-making and optimize the selection of suture materials.