Wound Closure Techniques Research Articles

Injectable Hydrogel Based on Modified Gelatin and Sodium Alginate for Soft-Tissue Adhesive.

To assist or replace the traditional suture techniques for wound closure, soft-tissue adhesives with excellent adhesion strength and favorable biocompatibility are of great significance in biomedical applications. In this study, an injectable hydrogel tissue adhesive containing adipic acid dihydrazide–modified gelatin (Gel-ADH) and oxidized sodium alginate (OSA) was developed. It was found that this tissue adhesive possessed a uniform structure, appropriate swelling ratio, good injectability, and excellent hemocompatibility and cytocompatibility. The adhesion capacity of the developed adhesive with optimized component and concentration was stronger than that of the commercial adhesive Porcine Fibrin Sealant Kit. All these results suggested that the developed hydrogel was a promising candidate for a soft-tissue adhesive.

Comparing the running subcuticular technique versus the Donati technique in open carpal tunnel release: a randomized controlled trial

BackgroundThere are various skin suture techniques for wound closure following carpal tunnel release, and well-performed suturing will result in low post-operative scar tenderness. The aim of this study was to compare the Donati suture technique and running subcuticular technique in terms of surgical scar, post-operative pain and functional outcome in open carpal tunnel release.MethodsOne-hundred forty-two patients were randomized using a computer-generated random number table into two groups receiving either running subcuticular suturing or Donati suturing after surgical intervention. We evaluated postoperative scarring using the Patient and Observer Scar Assessment Scale (POSAS), pain intensity using a verbal numerical rating scale, and functional outcomes using the Thai version of the Boston Carpal Tunnel Questionnaire after surgical decompression for carpal tunnel syndrome at 2, 6, and 12 weeks. Continuous data are reported as mean ± SD while normally distributed or as median (interquartile range) when the distribution was skewed.ResultsLower scores at 2 weeks were given by the patients receiving the running subcuticular suture technique than the Donati suture technique (15.3 ± 4.8 vs 17 ± 4.6, respectively, P < 0.05) while the observer scores were not significantly different (15.6 ± 5.8 vs 16.7 ± 5.2, respectively, P = 0.15). At both 6 and 12 weeks post-surgical decompression both patient and observer scores were not significantly different. There were no differences between the groups in terms of VNRS pain scores and functional Boston Carpal Tunnel Scores at all time points.ConclusionsThis randomized controlled trial found that although scarring assessments were slightly better in the earliest period following wound closure after surgical decompression in carpal tunnel syndrome using the running subcuticular suture, the final results at 3 months postoperative were not significantly different.Trial registrationThe study was registered at https://www.thaiclinicaltrials.org/ (TCTR20191204002).

A Comparative Study Using Interrupted Figure of Eight Suture Versus Conventional Continuous Suturing for Closure of Emergency Midline Laparotomy

Wound infections continue to represent a major medical problem, both in terms of how they affect the outcome of surgical procedures (surgical site infections), and for their impact on the length of hospital stay and medical costs. Many otherwise successful surgical operations fail because of the development of wound infections. A major SSI is defined as a wound that either discharges significant quantities of pus spontaneously or needs a secondary procedure to drain it Wound infection predisposes the patient to wound dehiscence. Acute wound failure is defined as postoperative separation of the abdominal musculoaponeurotic layers, within 30 days after operation. Most surgical wound infections become apparent within 7 to 10 days postoperatively. Objectives of the study 1. To assess local wound complication in emergency midline laparotomy wounds with interrupted figure of eight technique over conventional continuous closure . 2. To Compare the operative time for interrupted figure of eight closure and Conventional layered closure of laparotomy wounds. 3. To determine the factors affecting wound dehiscence. Materials and Methods: A prospective study was performed at Victoria hospital and Bowring and Lady Curzon hospital , Bangalore during November 2017 – May 2019. A sample of 100 cases were considered. Each Group consisted of 50. Group 1 underwent Interupted figure of Eight suture technique and Group 2 underwent continuous conventional suturing technique. Results: The incidence of burst abdomen in current study was 8%. There were two burst abdomen seen in conventional continuous closure technique and none in the interrupted figure of eight technique group. Conclusion: All the patients with generalized peritonitis in emergency setting need special attention regarding the wound closure. This newer technique of midline emergency laparotomy wound closure, especially in our part of the world significantly reduces the incidence of wound infection and wound dehiscence.

Dermatological surgery: an update on suture materials and techniques. Part 2.

This is the second part of a two-part series summarizing the latest evidence related to suture materials and wound closure techniques in dermatological surgery. We critically appraised evidence focusing on the following consequences of suture choice: scar/cosmesis, pain, patient satisfaction, cost, infection and wound complications. We searched the databases MEDLINE, PubMed and Embase using the keywords 'skin surgery', 'dermatological surgery', 'sutures', 'braided sutures', 'monofilament sutures' and 'antibacterial sutures' to identify relevant English-language articles. This part of the review assesses the evidence for different types of buried sutures, including braided vs. monofilament sutures, longer-absorbing sutures and antibacterial sutures. The majority of trials were noted to be of poor quality, single-centre (thus lacking external validity) and underpowered, which presents challenges in comparing suture techniques in skin surgery. Future large-scale, multicentre, randomized trials are needed, with both surgeon and patient-assessed validated outcomes.

Endoscopic vacuum assisted closure (E-VAC) of upper gastrointestinal leakages

Objectives Endoscopic vacuum-assisted closure (E-VAC) of leaks of the upper gastrointestinal tract is an increasingly applied endoscopic technique. Data on indication, clinical success, complications and prognostic factors are still sparse. Methods Patients treated with E-VAC between 2012 and 2019 at a tertiary referral center have been retrospectively analyzed. Results Overall, 116 patients treated with E-VAC were identified. Indication for E-VAC placement was postoperative leakage in 94/116 (81%), iatrogenic perforations 7/116 (6%) and others 15/116 (13%). In 92/116 (79%) of the patients E-VAC therapy showed successful wound closure. The first E-VAC after detection of insufficiency was significantly more often placed intracavitary in patients with E-VAC failure (p = .031). There was a trend for longer intensive care unit treatment for patients with E-VAC failure (p = .069). Complications occurred significantly more often in patients with E-VAC failure (p = .009). Platelet count was significantly higher in patients with E-VAC success at day of insufficiency detection (257/Thsd/µL (interquartile range [IQR], 185–362) vs. 195 (IQR, 117–309); p = .039). Platelet count (375 Thsd/µL (IQR, 256–484) vs. 190 (IQR, 129–292)), hemoglobin (9.5 g/dL (IQR, 8.8–10.1) vs. 8.7 g/dL (IQR, 8.15-9.35)) and C-reactive protein level (79 mg/L (IQR, 39.7-121.9) vs. 152 mg/L (IQR, 73.7-231)) at day 14 differed significantly. The 30 days mortality rate was 33.3% (8/24) in E-VAC failure compared with 2.2% in patients with E-VAC success (p = .001). Conclusions E-VAC is an emerging highly effective interventional endoscopic technique for gastrointestinal wound closure even in highly selected patients.

Current practice of thyroid surgery in Germany: a nationwide survey.

Due to the lack of perioperative standards in thyroid surgery, this study aimed to evaluate the perioperative management and wound closure techniques used in a nationwide survey. A questionnaire evaluating preferred technique in thyroid resection, postoperative management, and the occurrence of complications was sent to all hospitals in Germany performing more than 50 thyroid operations p.a. (N.=362, response rate 78% [N.=283]). Subsequently, hospitals were subdivided into university and maximum care hospitals (Category A, N.=54) and tertiary hospitals and basic care hospitals (Category B, N.=229). According to our results, 10.6% of the hospitals were certified as a center for thyroid surgery, with a significantly higher percentage in Category A (20.4% vs. 8.3%; P<0.01). Concerning the surgical techniques, Kocher's incision was the favored cervical approach in 96% of the hospitals. A minimally invasive approach was performed in 30.1%, with a significantly more common description in Category A; 97.8% of all clinics stated that they perform a platysma muscle suture, primarily as a single stitch interrupted. Skin closure was predominantly performed via intracutaneous suture in 84.5% using absorbable suture material in 63.1%. There was no difference in the technology used in terms of hospital size. The mean in-hospital stay was significantly shorter in Category A hospitals (P=0.035). The suture technique used in thyroid surgery in Germany is a simple interrupted suture technique for platysma and a continuous suture with absorbable skin closure material. Maximum care hospitals are characterized by shorter in-hospital stays and improved quality assurance.

Dermatological surgery: an update on suture materials and techniques. Part 1.

Significant variation exists in the surgical suture materials and techniques used for dermatological surgery. Many wound-closure techniques are now practised, including use of sutures, staples and topical adhesives. The focus of our review article is to summarize the latest evidence relating to suture materials and wound-closure techniques, considering the following areas: scar/cosmesis, pain, patient satisfaction, cost, infection and wound complications. We searched the databases Medline, PubMed and Embase using the keywords 'skin surgery', 'dermatologic surgery', 'sutures', 'suture techniques', 'suturing techniques' and 'surgical techniques' to identify relevant English-language articles. Absorbable superficial sutures may be a preferred alternative to nonabsorbable sutures by both patients and surgeons. Subcuticular sutures may be preferable to simple interrupted sutures for superficial wound closure, and there may also be a role for skin staples in dermatological surgery, particularly on the scalp. However, there remains limited evidence specific to dermatological surgery supporting the use of particular suture materials and suturing techniques. Further high-quality research is required, including multicentre randomized trials with larger cohorts.

Wound Management following Total Knee Arthroplasty: An Updated Review.

Optimal wound closure techniques following total knee arthroplasty (TKA) have focused on enhancing healing potential, preventing infection, yielding satisfactory cosmesis, and allowing early ambulation and functionality. An appropriate layered closure and management of the TKA typically involves addressing the (1) deep fascial layer; (2) subdermal layer; (3) intradermal layer, including the subcuticular region; and (4) final application of a specific aseptic dressing, each of which are covered here in detail. This focused critical review of the literature discusses traditional techniques used in all layers of wound closure following TKA while introducing several emerging popular techniques. For example, absorbable barbed skin sutures and occlusive dressings have the potential to reduce operative time, limit the need for early postoperative visits, obviate the need for suture or staple removal, and safely promote patient communication via telemedicine. As novel wound closure techniques continue to emerge and traditional approaches are improved upon, future comparative studies will assist in elucidating the key advantages of various options. In an extremely important field that has tremendous variability, these efforts may enable the reaching of a classically elusive standard of care for these techniques.

Plastic surgery wound closure following resection of spinal metastases

ObjectiveSurgical site infection and dehiscence are devastating complications of surgery for spinal metastases. Wound closure involving plastic surgeons has been proposed as a strategy to lower post-operative complications. Here we investigated whether plastic surgery closure is associated with lower rates of wound complications, wound infection, and wound reoperation compared to simple closure by spine surgeons. MethodsPatients surgically treated for metastatic tumors at a single comprehensive cancer center between April 2013–2020 were retrospectively identified. Primary pathology, demographic information, clinical characteristics, pre-operative laboratory values, tumor location, operative characteristics, and post-operative outcomes were collected. Univariable analyses used student t-tests for continuous variables and χ2 tests for categorical variables. Multivariable regressions were performed to control for confounders. ResultsWe included 317 patients, of which 56 underwent closure by plastic surgeons and 291 by neurosurgeons. Patients in the plastic surgery cohort were more likely to have received prior radiation to the surgical site, more often on long-term corticosteroid therapy, and more likely to have sacrococcygeal tumors. Operations involving plastic surgeons were more likely to be revision surgeries, corpectomies, and to involve a staged approach. Additionally, patients in the plastic surgery cohort had longer incision lengths, longer surgeries, greater intraoperative blood loss (IOBL), were more likely to receive transfusions, and had longer hospitalizations. Local paraspinous advancement flaps were the most common complex wound closure technique. Plastic surgery closure was not significantly associated with a difference in rates of post-operative wound complications, wound infection, or wound-related reoperations compared to simple wound closure. ConclusionWe identified that patients undergoing plastic surgery wound closure had worse baseline risk, longer surgeries, greater IOBL, and longer hospitalizations compared to patients receiving simple closure. Despite their increased risk, complex wound closure did not significantly alter the rates of post-operative wound complications, wound infection, or wound-related reoperations. Consideration may be given to plastic surgery closure in patients at high risk of wound complications or with extensive wound defects.

Practice of wound closure techniques among emergency physicians and surgeons in Makkah City Hospitals in Saudi Arabia.

Background: Wound suturing is a procedure performed by medical and surgical specialists. While there are many different suturing techniques and materials used to treat patients, the choice of which to employ depends on different variables that affect the outcome of the procedure.Design and Methods: This is a cross-sectional study conducted to provide descriptive data regarding the practice of wound closure techniques, and to develop an awareness of scar formation factors. A total of 172 general surgery (GS) surgeons and emergency (EM) physicians in Makkah city hospitals in Saudi Arabia participated in the study.Results: More than 50% of the practitioners favored the simple interrupted technique for the treatment of all types of studied wounds. The other most common techniques among participants were the subcuticular and vertical mattress methods, respectively, while the use of a stapler was limited to certain wound types. Regarding suturing material, polyglycolic acid was the most frequent material used by 50.1% of participants, whereas only 22% of the participants selected nylon material for wound suturing. However, this study showed a good level of awareness among participants, with significant p-values (p<0.05) of strongly agree and agree regarding the essential factors affecting wound healing and scar formation.Conclusions: The result provides insight into the most common suture techniques and materials used in wound closure. There are wide variations in selecting these techniques and materials among the participants. Also, we found that there is good awareness amongparticipants about factors that lead to scar formation. Significance for public health The main contribution of this study that it has been shown areas for improvement and the need for intensive education and awareness regarding the proper use of techniques and materials in skin suturing and wound closure. This contribution will lead to acquire the optimum outcomes in any wound closure procedure which include the decrease in wound complication, increase speed of repair, cosmoses, patient and physician satisfaction, better cost of repair, and other intended outcomes.

TGF-β expression on different suturing technique for abdominal skin wound closure in rats

BackgroundThe method of closing the abdominal wall, as well as, the choice of material for stitching are important aspects of efficient incision closure. Generally, transforming growth factor-beta (TGF-β) is involved in the wound healing process. Suturing procedures also play a part in the wound dehiscence occurrence. This study aimed to compare TGF-β expressions in rats after using the large stitch vs. small stitch technique for abdominal skin wound closure. MethodsA total of twenty Wistar rats (Rattus norvegicus) were used in this experiment. Small tissue bites of 5 mm were obtained by the small stitch group and the large stitch group received large bites of 10 mm. Abdominal skin incisions were closed by running sutures. On days 4 and 7, the animals were euthanized. For TGF-β expressions, histological parts of the tissue-embedded sutures were analyzed. With significance set at p < 0.05, two-way ANOVA showed that on days 4 and 7, the TGF-β expressions of the rats in the small stitch group were nearly identical to those in the large stitch groups. ResultsAfter including twenty rats in this study, results showed the TGF-β expressions on days 4 and 7 in rats in the small stitch group were equivalent to those in the large stitch group. (p = 0.45). ConclusionsBetween the small and the large stitch groups, the TGF-β expressions are similar, suggesting that the suturing methods do not have any significantly different beneficial impact on the frequency of wound dehiscence.

Does port type or wound closure technique influence cosmetic outcomes in laparoscopic pediatric urology procedures?

Does port type or wound closure technique influence cosmetic outcomes in laparoscopic pediatric urology procedures?

A Comparative Study between Conventional Sutures, Staples and Adhesive Glue for Clean Elective Surgical Skin Closure

Background: A surgeon's signature is 'scar' [1]. On a regular basis, surgeons face various kinds of wounds which must be healed. The healing process and cosmetic result can be influenced by wound and incision closure techniques.&#x0D; The Goal of this Research is to Compare 3 Skin Closure Techniques: conventional skin sutures, adhesive glue, surgical stapler. These methods will be used to determine which of them is superior in terms of wound healing and cosmetic outcome in clean elective surgeries.&#x0D; Objectives:&#x0D; &#x0D; To compare duration between closure by 3 methods.&#x0D; To compare prices amongst the 3 methods.&#x0D; A comparison of the cosmetic appearances of the skin after closure.&#x0D; A comparison of post-operative pain between the 3 methods.&#x0D; To assess surgical site infections after closure with these 3 methods&#x0D; &#x0D; Methodology: 90 patients, undergoing clean elective surgeries, will be included in this study. 30 patients will be included in every group. Hospitalised under Department of General Surgery in Datta Meghe Institute Of Medical Sciences, Wardha. The study will be conducted between October 2020 to October 2022.&#x0D; Results: The result would be undertaken in SPSS software.&#x0D; Conclusion: Conclusion will be based on findings of study protocol.

A Single-Center Randomized Prospective Study Investigating the Efficacy of Various Wound Closure Devices in Reducing Postoperative Wound Complications

BackgroundSutures and staples are the mainstay wound closure techniques in total joint arthroplasty. Newer techniques such as zipper devices and novel skin adhesives have emerged because of their potential to decrease operative time and possibly minimize complications. The aim of this study is to compare these newer techniques against conventional sutures with respect to wound complications, closure time, and costs. MethodsA single-center randomized control trial was conducted on 160 patients (52 zipper, 55 suture, 53 mesh) who underwent primary total hip or knee arthroplasty between February 2017 and May 2018. Patients were divided into 3 closure groups: zipper device, monofilament suture plus adhesive, and monofilament plus polyester mesh with adhesive. The primary endpoint was closure time (superficial skin layer). Secondarily we collected perioperative complication rates, including infection, persistent (14-day) wound drainage, 90-day readmission, and emergency room visit rates as well as compared material costs. ResultsThere were no differences in baseline characteristics between groups for age, body mass index, and American Society of Anesthesiologists classification. There was a trend toward decreased time to closure for the suture group. There were no significant differences between groups for our secondary endpoint, complications. ConclusionsOur study shows that the suture group trended toward shorter closure time but suggests that each of the closure methods after total joint arthroplasty has equivalent complication rates. With small differences in closure time and no significant differences in complications, the decision to use one wound closure device or technique over another should be driven by institutional costs and provider familiarity.

Efficacy of Platelet-Rich Plasma in Reduction of Post-Operative Split-Thickness Skin Graft Loss and Hematoma Formation: A Meta-Analysis.

Split-thickness skin grafting is a very popular technique of wound closure, especially for large wounds. The success rate of a split-thickness skin graft (STSG) has consistently been in the range of 70-90%. Multiple techniques have been introduced to further improve graft survival, for example, the use of autologous platelet-rich plasma (PRP), thrombin gel, platelet-rich fibrin matrix, and negative pressure wound therapy. We evaluated the impact of PRP use on the survival of STSG through a meta-analysis. We conducted the analysis in accordance with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) protocol and performed a literature search using the following databases: PubMed, Cochrane, and ClinicalTrials.gov. A total of 126 articles were yielded by the search, out of which four randomized controlled trials (RCTs) were included according to our eligibility criteria and irrelevant articles were excluded. The intervention group received PRP application to the wound bed before applying the graft while the control group received treatment with conventional fixation procedures (sutures and staples). We estimated the pooled odds ratio with a 95% confidence interval (CI). The total number of participants in the analysis was 460. The participants had wounds of varying etiology. Post-operative graft loss and hematoma formation were taken to be the primary and secondary outcome measures, respectively. Thirty-four participants suffered graft loss of differing extent in the control group while three participants suffered graft loss in the intervention group. The pooled odds ratio for graft loss was 0.15 (95% CI: 0.05-0.49; I2=38%; p=0.184) signifying that PRP use decreased the odds of graft loss by 85%. For our secondary outcome measure, 440 participants were studied. Forty-four participants suffered hematoma formation in the control group versus 11 in the intervention group. The pooled odds ratio for hematoma formation was calculated as 0.21 (95% CI: 0.09-0.50; I2=0%; p=0.869) signifying that PRP use decreased the odds of hematoma formation by 79%. PRP appears to significantly impact graft survival, and further studies are needed to strengthen the evidence base for its use in split-thickness skin grafting.

934 Remote one-to-one virtual surgical skills training: Evolving the delivery of operative skills training in the UK

IntroductionCOVID-19 has had an unprecedented effect on surgical training, including prerequisite entry-level courses to speciality training. We describe the implementation of a virtual, one-to-one training programme aimed at the acquisition and retention of operative skills.MethodsEnrolment commenced 8th May 2020 for wound closure techniques or an extended programme including tendon repairs, delivered by Specialist Registrars in Plastic Surgery using Zoom® (v. 5.0.5) via mobile device. Participant feedback was collected retrospectively using a 5-point scale following course completion.Results5 participants completed the wound closure programme, and 3 the extended programme, over an average of 5 weeks, with 2 sessions per week. 5 participants were male, 3 female and were of the following grades: 2 CT2, 4 FY2, 1 FY1 and 1 medical student. A total of 103.5 hours of training was recorded to 7 September 2020.Participants reported that all virtual skills taught were readily transferable to the theatre environment. Following the course, all participants felt confident to complete the skills learnt independently, rating the course as excellent.ConclusionsThe COVID-19 crisis has placed insurmountable obstacles in the face of surgical training. With further validation, we aim to develop surgical skills training with virtual, easily reproducible, cost-effective, trainee centred programmes.

Clinical Evaluation of Efficacy of Cyanoacrylate Glue and Conventional Polypropylene Suturing in Cutaneous Wounds-A Comparitive Study

Introduction: The benefits of assisting closure by holding the opposing edges of a wound together have been recognized in the last 5000 years. There are several well-proven techniques of skin closure using a variety of materials like braided or monofilament material, absorbable and nonabsorbable conventional suture materials, metal clips and adhesive tapes. Conventional skin suturing techniques do have certain disadvantages. From the past three decades, many new biomaterials have been discovered in the medical field. Bio-adhesives are one among them. These materials when applied on the incised tissues possess the ability to bind them together. This group of adhesives are called Cyanoacrylates. The purpose of the study was to compare the efficacy and clinical outcome of the two techniques of wound closure by using conventional polypropylene suturing and cyanoacrylate glue.

Cable Tie Dynamic Wound Closure: Alternative Technique for Secondary Wound Closure

Background: Wound closure by secondary intention has always been a norm in clinical practice for large infected wounds at our institution. The aim is to prevent recurrent infection while waiting for wound closure. This study investigates the use of cable tie for dynamic wound closure in infected wounds to accelerate healing process as an alternative technique. Materials and Methods: Ten patients with infected wounds were recruited. The time to wound closure, complications, length, and cost of treatment were evaluated over 4 to 6 weeks. Result: All infected wounds were closed within 9.9 days with no documented complications. Conclusion: Cable tie used for dynamic wound closure in infected wounds is cheap and an effective alternative to wound healing by secondary intention. Level of Evidence: Level IV.

Primary Versus Delayed Wound Closure Technique in Infected Laparotomy Wounds

Background: Contaminated laparotomy wounds have garnered little attention with high incidence of woundinfections. Many techniques have been proposed for their management. The aim of this study is to comparethe infection rates of laparotomy wounds using primary closure vs delayed closure in cases of peritonitis.The purpose is to identify a better wound closure technique for their management.Method: This study included 105 patients, who were divided into two groups. Group A underwent primaryclosure and Group B underwent delayed closure, in which the wound was left open without suturing andsaline irrigation was given to be sutured once the wound is clean. The wound infection was assessed usingSouthampton scoring system.Results: A total of 54 patients, 30 (55.6%) males and 24 (44.4%) females were included. Group A, 27 patientswith 55.6% males and 44.4% females. In Group B, 27 patients with 55.5% males and 44.4% females. Themean age in A was 39.4 ± 11.8 while that in B was 37.02 ± 12.5. Group A had an infection .rate of 77.4%whereas Group B had infection rate of only 34%. The duration of hospital stay for Group B was 9.8 and forGroup A was 11.7.Conclusions: The delayed closure is an effective technique for wound closure in contaminated wounds, likeperforation. Peritonitis, as it reduces wound infection rates and hospital stay

Postoperative astigmatism after small-incision cataract surgery with sclera tunnel suturing and without scleral tunnel suturing: A comparative study

Background and aimCataract represents a significant socioeconomic burden and a public health concern, as it is the leading cause of blindness worldwide. Small-incision cataract surgery (SICS) is one of the cataract surgical techniques commonly used in developing countries. There have been many improvements and changes in SICS's technique since its development, including changes in the site and size of the incision.Patients and methodsThis study was conducted aiming to study postoperative astigmatism after SICS with or without scleral tunnel suturing. This study was performed on 100 eligible eyes in 59 consecutive patients. Identical surgical methods were used in all cases except for wound closure technique as patients were allocated into two groups, where SICS was performed with scleral tunnel suturing in the group A and without scleral tunnel suturing in the group B. Patients were assessed preoperatively and were followed up for 3 months.Results and conclusionThe study revealed a highly statistically improvement in visual acuity at 3 months postoperatively in both groups. Meanwhile, SICS performed either with or without scleral tunnel suturing was not associated with significant preoperative and postoperative astigmatism changes. In addition, in terms of postoperative visual acuity or refraction, no statistically significant differences were observed between the two classes. Therefore, according to anterior chamber's stability and close closure of the scleral tunnel and conjunctival wounds, it is a case-specific situation and acceptable for each case.