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 nonabsorbable sutures for facial skin closure. The study was registered on Prospective Register of Systematic Reviews. 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. 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 nonabsorbable sutures were employed in 49.8% (401 injuries). The analysis of cosmesis scales revealed no statistically significant difference between absorbable and nonabsorbable 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. Absorbable sutures can be considered a suitable alternative to nonabsorbable 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. Level of evidence is I, risk/prognostic study.

The aim of this study was to compare the surgical results and the complications of absorbable suture (AS) versus permanent suture (PS) in sacrocolpopexy (SCP).
We systematically searched PubMed, Embase, ClinicalTrials.gov, and the Cochrane Library Central Register of Controlled Trials for articles in which researchers compared AS with PS in SCP. The primary outcomes were the surgical success rate and suture-related complications (suture exposure/erosion, mesh erosion, and suture removal). All analyses were performed with Review Manager 5.3.
Four articles involving 689 patients were ultimately included. Our findings demonstrated that AS had similar surgical success rates to those of PS (OR=1.34; 95% CI, 0.60-2.96) and no significant differences in failure rates were noted between the two groups (OR=0.75; 95% CI, 0.34-1.66). Subgroup analyses in patients with anatomical failure revealed no significant differences in recurrent posterior prolapse (OR=0.33; 95% CI, 0.05-2.10) or in recurrent apical (OR=0.64; 95% CI, 0.03-13.66) or anterior prolapse (OR=0.45; 95% CI, 0.13-1.57). However, the AS group were at a lower risk of suture exposure/erosion (OR=0.18; 95% CI, 0.06-0.58) and a lower suture removal rate (OR=0.14; 95% CI, 0.03-0.61) and retreatment (OR=0.36; 95% CI, 0.16-0.82), but the mesh erosion was not significantly different (OR=1.00; 95% CI, 0.49-2.08).
The data showed that AS had a similar success rate, less exposure/erosion, and were less likely to be removed and require retreatment than PS, which supported the notion that AS is as effective as PS but safer.

OBJECTIVE: Recent randomized controlled trials have demonstrated an association between uterine closure technique at the time of cesarean delivery and short- and long-term operative outcomes with varied results. This systematic review and meta-analysis aimed to examine types of suture material used for cesarean delivery.
METHODS: Scopus, PubMed, Cochrane Central Register of Controlled Trials, Ovid, and ClinicalTrials.gov were searched from inception of each database to October 2021.
METHODS: All randomized controlled trials that compared types of suture materials used for hysterotomy closure during low-transverse cesarean delivery at ≥24 weeks\' gestation and examined maternal outcomes were included for this review. The primary outcome was estimated blood loss. Secondary outcomes included additional surgical complications.
METHODS: Results were summarized as mean difference or risk ratio with associated 95% confidence intervals. The quality of studies was evaluated with the Cochrane Handbook for Systematic Reviews of Interventions for judging risk of bias. Heterogeneity was measured using I-squared (Higgins I2).
RESULTS: This review included 7 randomized controlled trials, of which 3 compared multifilament with barbed suture (136 vs 136 participants), 3 compared multifilament with conventional monofilament suture (245 vs 244 participants), and 1 trial compared multifilament with chromic suture (4590 vs 4595 participants). Primary analysis showed no difference in estimated blood loss between the multifilament and the barbed suture group (mean difference, 46.2 mL; 95% confidence interval, -13.6 to 105.9), nor in change in hemoglobin concentration between the multifilament and the conventional monofilament group (mean difference, -0.1%; 95% confidence interval, -0.5 to 0.3). Secondary outcomes showed a reduction in operative time with barbed vs multifilament suture (mean difference, 1.9 minutes; 95% confidence interval, 0.03-3.8). Analysis also demonstrated an increased uterine scar thickness with use of conventional monofilament vs multifilament suture (mean difference, -1.05 mm; 95% confidence interval, -1.9 to -0.2).
CONCLUSIONS: This meta-analysis does not support a specific type of suture material for uterine closure at cesarean delivery because of insufficient data. Although barbed suture was associated with an overall decrease in operative time, and use of conventional monofilament suture was associated with an increase in uterine scar thickness, the clinical utility of these differences is not clear. Further adequate randomized controlled trials are warranted for evaluation of different suture materials for hysterotomy closure.

BACKGROUND: Surgeons are often judged based on the cosmetic appearance of any scar after surgery rather than the functional outcome of treatment, especially when considering facial wounds.
OBJECTIVE: We performed a systematic review of the literature to determine whether absorbable or non-absorbable suture materials result in different cosmetic outcomes for patients requiring primary closure of facial wounds.
METHODS: An extensive systematic review was carried out to identify studies meeting our inclusion criteria. Risk of bias in each study was assessed using the Cochrane risk of bias assessment tool. Data were extracted from those articles that met our inclusion criteria, and statistical analysis was carried out using the Cochrane RevMan.
RESULTS: We found no significant difference in any aspect of our analysis including Visual Analogue Cosmesis scale, Visual Analogue Satisfaction scale, infection, dehiscence, erythema or stitch marks. Most authors concluded that they prefer to use absorbable sutures. However, the overall quality of evidence is poor, and significant variation exists regarding the methods of assessment between papers.
CONCLUSIONS: Use of absorbable suture material appears to be an acceptable alternative to non-absorbable suture material for the closure of facial wounds as they produce similar cosmetic results.