BACKGROUND Patients are often concerned about the cosmetic appearance of scars following Mohs micrographic surgery (MMS), including residual erythema. However, few studies have compared the cosmetic outcomes between different suturing techniques. OBJECTIVE To compare the erythema intensity (EI) associated with interrupted sutures (IS) and continuous sutures (CS), and the degree of its reduction over time. MATERIALS AND METHODS Mohs micrographic surgery patients were randomized to have half of their defect repaired with IS and the other half with CS. Postoperatively, subjects were assessed at 1 week, 2 months, and 6 months and close-up photographs of their scars were taken. Computer-assisted image analysis was utilized to quantify the EI in each half-scar. RESULTS The average EI of IS was greater than that of CS by 9.3% at 1 week (p < .001) and 7.2% at 2 months (p < .021) but comparable at 6 months. These differences were clinically detectable, but EI differences resolved by 6 months in most cases. At 6 months, EI regressed by 33.5% in IS and 26.3% in CS. CONCLUSION Continuous sutures are associated with less erythema during early scar maturation but are comparable to IS at 6 months. These results may guide the choice of suturing technique to improve early cosmetic outcomes and overall patient satisfaction.
Background: Although many hair disorders can be readily diagnosed based on their clinical appearance, their progression and response to treatment are often difficult to monitor, particularly in quantitative terms. We introduce an innovative technique utilizing a smartphone and computerized image analysis to expeditiously and automatically measure and compute hair density and diameter in patients in real time.Methods: A smartphone equipped with a dermatoscope lens wirelessly transmits trichoscopy images to a computer for image processing. A black-and-white binary mask image representing hair and skin is produced, and the hairs are thinned into single-pixel-thick fiber skeletons. Further analysis based on these fibers allows morphometric characteristics such as hair shaft number and diameters to be computed rapidly. The hair-bearing scalps of fifty participants were imaged to assess the precision of our automated smartphone-based device in comparison with a specialized trichometry device for hair shaft density and diameter measurement. The precision and operation time of our technique relative to manual trichometry, which is commonly used by hair disorder specialists, is determined.Results: An equivalence test, based on two 1-sided t tests, demonstrates statistical equivalence in hair density and diameter values between this automated technique and manual trichometry within a 20% margin. On average, this technique actively required 24 seconds of the clinician's time whereas manual trichometry necessitated 9.2 minutes. Conclusion: Automated smartphone-based trichometry is a rapid, precise, and clinically feasible technique which can significantly facilitate the assessment and monitoring of hair loss. Its use could be easily integrated into clinical practice to improve standard trichoscopy.
BACKGROUNDA common concern among patients following Mohs micrographic surgery (MMS) is scar appearance and residual erythema. However, few studies have quantitatively compared scar erythema between different suture materials.OBJECTIVETo quantify erythema intensity (EI) associated with use of percutaneous nylon, irradiated polyglactin-910 (IPG) and fast-absorbing gut (FG) sutures on facial sites.METHODSAfter undergoing MMS, 210 patients were randomized to one of 2 groups. Patients in the first group (n = 105) had their defects repaired half with continuous IPG sutures and the other half with nylon sutures; the second group (n = 105) received IPG and FG sutures. Standardized photographs of scars were taken at 1 week, 2 months, and 6 months postoperatively and computer-assisted image analysis was used to quantify EI.RESULTSThe average EI was comparable between all 3 suture materials at 1 week, 2 months, and 6 months. From 1 week to 2 months, EI in nylon, IPG, and FG sutures decreased by 24.8%, 12.8%, and 17.9% (p < .05), respectively. There was no statistically significant difference in EI among suture types between 2 and 6 months.CONCLUSIONErythema decreased significantly during early scar maturation in all groups and was comparable between all suture materials at 1 week, 2 months, and 6 months.
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