Polyglactin 910 3-0 sutures in closing skin incision in gynecological laparoscopy cases: Prospective randomized controlled study

Aim: In this study; Two suture materials, Polyglactin 910 and Polyglecaprone 25, which are frequently used for closure of skin incisions in gynecological laparoscopy cases, were compared in terms of wound healing parameters and cosmetic result, and it was investigated which suture had better results. Materials and Methods: Between March 2022 and July 2022, 137 patients aged 18-60 years, who were scheduled for laparoscopic surgery in the Department of Obstetrics and Gynecology of Akdeniz University Hospital, who underwent lower abdominal port access, who could come for control 7-12 days and 3 months after the operation and accepted informed consent, were included in the study. Using ready-made randomization programs, the patients included in the study were divided into 2 groups. Results: The mean age of the patients who completed the 3-month follow- up was 41.73±8.57 years, and the mean BMI was 26.34±4.36 kg/m 2 . 25 patients (24.8%) were smokers. 42.6% of the patients had at least one concomitant disease and a history of previous abdominal surgery. The mean wound length was calculated as 61.01±1.25. Cosmetic VAS score (p=0.697) and HWES score (p=0.369) were statistically similar in Polyglecaprone 25 and Polyglactin 910 groups. Hyperpigmented scar formation was found to be statistically higher in patients in the Polyglactin 910 group than in the patients in the Polyglecaprone 25 group (70.4% vs 44.7%; p=0.009). Although the swelling on the wound surface was higher in the Polyglactin 910 group, it was not statistically significant (9.3% vs. 2.1%; p=0.211). In the first control performed on the postoperative 7-12 th days, it was observed that the wound sites in both groups were closed. No discharge or dehiscence was observed in the Polyglecaprone 25 group. In contrast, dehiscence 57 was observed in 1 patient and wound discharge was observed in 3 patients in the Polyglactin 910 group. In addition, at the first control, hyperemia was observed at the wound site of 54 patients, 24 in the Polyglecaprone 25 and 30 in the Polyglactin 910 group. In the 3 rd month control, wound sites in both groups were closed and there was no dehiscence, discharge and hyperemia at any wound site. In addition, 24 patients, 8 in the Polyglecaprone 25 and 16 in the Polyglactin 910 group, had hyperemia at the wound site. Pain scores in both controls were similar between the two groups. Although it was observed that hyperpigmentation development was more common in the 3 rd month control in the wound sites that were hyperemic in the postoperative 7-12 th day control, this difference was not found to be statistically significant (61% vs 42.9%; p=0.071). In our study, it was determined that the use of Polyglactin 910 independently increased the risk of developing hyperpigmentation in the postoperative period (OR: 2.626; 95% CI: 1.093-6.307; p=0.031). Trocar port closure incisions of the patients in the first group were sutured with the transcutaneous technique with Polyglactin 910 3-0 and in the other group with Polyglecaprone 25 3-0. Wound sites were evaluated at routine controls 7-12 days and 3 months after the operation. The left lower abdominal trocar site was included in the evaluation in 99 patients, and the suprapubic trocar site was included in 2 patients. The cosmetic result was evaluated by the patient with the visual analogue scale (VAS) and by the researchers with the HWES. 36 patients who did not attend at least one of the controls were excluded from the study. 101 patients, 47 in the Polyglecaprone 25 and 54 in the Polyglactin 910 group, completed the controls and their results were analyzed. Conclusion: It was concluded that the use of Polyglactin 910 causes more wound complications and hyperpigmented scar formation in the postoperative period. Key Words: Polyglactin 910, Polyglecaprone 25, Laparoscopy, Wound Healing, Cosmetic Outcome