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The purpose of this study is to determine whether undermining during cutaneous surgery improves scar cosmesis compared to wound closure without undermining.
The purpose of this study is to determine whether undermining during cutaneous surgery improves scar cosmesis compared to wound closure without undermining. Our aims are to compare outcomes using a split wound model, where half the wound is undermined and the other half is not. This will be measured via the physician observer scar assessment scale, a validated scar instrument and via wound width. Our hypothesis is that wound undermining will result in cosmetically superior wound outcomes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Wound Closure with Undermining | Active Comparator | The side assigned to undermining will have undermining performed prior to wound closure in the subcutaneous plane. The amount of undermining will range from 1 cm for wounds with low tension to 2 cm for those with moderate tension. Since wound diameter will be 3 cm or less and exclude the scalp, high tension wounds are not anticipated. |
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| Wound Closure without Undermining | Active Comparator | One side of the wound will remain un-undermined. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Wound Closure with Undermining | Procedure | The side assigned to undermining will have undermining performed prior to wound closure in the subcutaneous plane. The amount of undermining will range from 1 cm for wounds with low tension to 2 cm for those with moderate tension. Since wound diameter will be 3 cm or less and exclude the scalp, high tension wounds are not anticipated. |
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of Scar on the Patient and Observer Scar Assessment Scale | After surgical procedure, half of the subject's wound will be closed after undermining, while the other half is closed without undermining. After 3 months, subjects will return to clinic for evaluation of the cosmesis of both types of closure techniques. | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Measurement of Scar Width | The width of the scar will be measured 1 centimeter from the midline on both sides. There is no defined width that is considered satisfactory or not satisfactory. The measurements will be compared between subjects. | 3 months |
| Assessment of Complications |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Daniel Eisen, M.D. | University of California, Davis | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34546436 | Derived | Joo J, Pourang A, Tchanque-Fossuo CN, Armstrong AW, Tartar DM, King TH, Sivamani RK, Eisen DB. Undermining during cutaneous wound closure for wounds less than 3 cm in diameter: a randomized split wound comparative effectiveness trial. Arch Dermatol Res. 2022 Sep;314(7):697-703. doi: 10.1007/s00403-021-02280-5. Epub 2021 Sep 21. |
| Label | URL |
|---|---|
| University of California-Davis Department of Dermatology Clinical Research | View source |
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| Wound Closure without Undermining | Procedure | One side of the wound will remain un-undermined. |
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Noting the presence or absence of bleeding, dehiscence, infection or spitting sutures. |
| 3 months |