Randomized clinical trial of platysma muscle suture <i>versus</i> no suture for wound closure after thyroid surgery

Senne, Moritz; Zein, Rami; Falch, Claudius; Kirschniak, Andreas; Koenigsrainer, Alfred; Müller, Stephan

doi:10.1002/bjs.10829

Cited by 12 publications

(17 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nonetheless, the overall incidence of these complications was obtained as 14.5%, which was higher with 6% of post-thyroidectomy ulceration complications in another study (10). The average hospitalization length was 2 days in both groups, which was consistent with the findings of Senne et al studies, and there was no difference between the two groups (9).…”

Section: Discussionsupporting

confidence: 77%

Application of platysma muscle suture after thyroidectomy

2020

View full text Add to dashboard Cite

Introduction: Thyroidectomy is a common surgery in the neck area, in which the application of platysma muscle suture after thyroidectomy is still being discussed. This study was conducted to compare the application (currently common) or non-application of suture for platysma muscle. Methods: In this retrospective cross-sectional study, 117 patients underwent thyroidectomy, among which 63 cases without suturing platysma (control group) and 54 subjects with suturing platysma (Intervention group ) were examined in terms of postoperative pain based on visual analogue scale score measured 24 h post-operation. The samples were also investigated regarding hematoma and seroma, wound infection, length of hospitalization, scarring (1 year after surgery), duration of surgery, and the number of cases using opioids during the hospitalization. Patients with diabetes, previous neck surgery, coagulopathy, and radiation history were excluded from the study. The gathered data were analyzed statistically in SPSS software (version 18) using the Chi-square test and the Mann–Whitney U test. A p-value of less than (0.05) was considered significant. Results: Based on the findings, the mean age of the patients in the Intervention group was calculated at 51 years, of which 41 and 13 cases were females and males, respectively. In the Intervention group, 34 patients underwent complete thyroidectomy and 20 patients had hemithyroidectomy. The mean age score of subjects in the control group was calculated at 50 years, of which 44 and 19 patients were respectively female and male. No significant difference was revealed considering wound infection, length of hospitalization, created scarring, the amount of opioid use (opioids), and postoperative pain. However, only the length of surgery was different between the groups (P-value<0.05). Conclusions: There was no difference between wound and surgical complications and cosmetic results between both groups; nevertheless, due to the duration of the surgery and other benefits, such as consuming less thread, not suturing the platysma is recommended.

show abstract

Section: Discussionsupporting

confidence: 77%

Application of platysma muscle suture after thyroidectomy

2020

View full text Add to dashboard Cite

show abstract

“…Therefore, more and more research is now focused on preventing or at least diminishing the surgical pain whenever possible 12,14 . A recent study claimed that non-suturing of platysma was associated with significantly lesser pain in the post-operative period and recommend it in future practice 15 .…”

Section: Discussionmentioning

confidence: 99%

Comparative effects of suture and non-suture surgical techniques on platysma after Thyroid surgery

Wasay¹,

Jameel²,

Anwar³

et al. 2021

PJMHS

View full text Add to dashboard Cite

Background: Thyroidectomy is a routine general surgical procedure and pain after thyroidectomy is responsible for prolongation of hospital stay and increased risk of respiratory complications. Platysma is routinely sutured at the end of thyroidectomy before wound closure. This randomized controlled trial was conducted to compare the outcome of suturing platysma muscle versus not suturing in thyroid surgery patients. Aim: To compare the outcome of suturing platysma muscle versus not suturing in thyroid surgery patients. Place and duration of study: Dept. of Surgery at Sh. Zayed Hospital, Lahore from 26-12-2019 to 25-06-2020. Methodology: It is a randomized controlled trial study which consists of 92 patients, between 18 to 70 years of age in both gender and planned for thyroidectomy for nodular thyroid enlargement. Patients were randomly allocated into two treatment groups. After excision of thyroid, platysma was sutured as per conventional practice in one group while in the other group platysma was not sutured. For pain assessment Visual Analogue Scale (VAS) was used to 24 hours after surgery. Results: The mean age was 36.4±13.4 years. The mean VAS score for post-operative pain measured 24 hours after the surgery was significantly lower in patients undergoing thyroidectomy without platysmal suture as compared to those with conventional suturing of platysma during thyroidectomy (2.37±0.97 vs. 3.67±1.28; p <0.001). Similar significant difference was also noted between groups and subgroups which based on patient’s age, gender, BMI and educational status. Conclusion: Avoiding the suturing of platysma significantly reduced the post-operative pain which advocates a change in current practice and encourages non-suturing of platysma to decrease the morbidity of patients in post-operative period. Keywords: Thyroidectomy, Platysma, Suture, No Suture, Pain

show abstract

Section: Discussionmentioning

confidence: 99%

“…For all studies comparing closure method with staples, the authors reported closure of platysma and/or subcutaneous tissue before final epidermal layer closure with either staples, suture or glue. A recent study suggested that including platysma closure does not influence cosmetic results 17. Postoperative haemorrhage formation occurs between 0.36% and 4.3% of cases, and a rapidly expanding haematoma can cause sudden airway compromise 18.…”

mentioning

confidence: 99%

Optimal wound closure techniques for thyroid and parathyroid surgery: A systematic review of cosmetic outcomes

Lee

Ward

Oremule

et al. 2019

Clinical Otolaryngology

View full text Add to dashboard Cite

Objectives Cosmesis after surgical wound closure is an important outcome. This is relevant after thyroid and parathyroid surgery as anterior neck scars are visible and often of concern to patients. We aimed to investigate whether wound closure method influences cosmetic outcome in thyroid and parathyroid surgery, in particular using sutures, staples, steri‐strips and glue. Design We performed a systematic review of MEDLINE, PubMed, EMBASE, CINAHL and Cochrane focusing on wound cosmesis following thyroid and parathyroid surgery. Searches were conducted using combinations of the search terms: thyroid/parathyroid surgery, wound/skin closure and suture, staples, clips, glue and steri‐strips, using appropriate MESH terms and Boolean operators. Main outcome measures Primary outcome was wound cosmesis. Secondary measures were also extracted. Results Initial search found 304 papers and after systematic review, a total of 10 studies compared different closure methods and cosmetic outcomes. There were nine randomised controlled trials and one cohort study, with a total of 712 patients. Three studies compared staples vs glue; three compared sutures vs clips; two compared suture vs steri‐strips and two studies for suture vs glue. In general, short‐term cosmesis was better with subcuticular sutures compared to glue or clips, long‐term cosmetic outcomes were not influenced by closure method. Conclusions We found closure with subcuticular suture or steri‐strips produced superior short‐term cosmetic outcomes. Although long‐term cosmetic outcome is not influenced by closure method, given the superior cosmetic outcome and advantage of not needing removal, we recommend subcuticular sutures should be performed for wound closure in thyroid and parathyroid surgery.

show abstract

Randomized clinical trial of platysma muscle suture versus no suture for wound closure after thyroid surgery

Cited by 12 publications

References 16 publications

Application of platysma muscle suture after thyroidectomy

Application of platysma muscle suture after thyroidectomy

Comparative effects of suture and non-suture surgical techniques on platysma after Thyroid surgery

Optimal wound closure techniques for thyroid and parathyroid surgery: A systematic review of cosmetic outcomes

Contact Info

Product

Resources

About