Polypropylene versus Polyglactin in Upper Limb Subcuticular Skin Closure

Background and Rationale Although previous studies have compared absorbable and non-absorbable sutures, most did not specifically evaluate standardized scar outcomes for subcuticular closure in the upper limb. While upper limb wounds may not carry the same aesthetic priority as facial wounds, scars in this region are highly visible and can adversely affect patients' psychological well-being. Subcuticular suturing is commonly used to improve cosmetic outcomes and reduce wound complications. Both Polypropylene (non-absorbable) and Polyglactin (absorbable) are widely used materials, yet their comparative performance in subcuticular skin closure remains controversial.

Aim and Objectives

Primary objective:

- To compare cosmetic outcomes of subcuticular skin closure using Polypropylene and Polyglactin

Secondary objectives:

• To compare postoperative wound complication rates (including infection, wound dehiscence, and hematoma formation) between polypropylene and polyglactin sutures
• To assess patient-reported discomfort and satisfaction associated with each suture material
• To assess the influence of the nature of surgery (elective vs trauma) on wound healing outcomes for each suture type

Inclusion Criteria:

• Adults aged ≥18 years
• Patients undergoing any surgical procedure involving the upper limb
• Procedures performed in either elective or emergency settings
• Wounds suitable for primary subcuticular skin closure
• Ability to provide informed consent

Exclusion Criteria:

• Heavily contaminated or infected wounds
• Patients with uncontrolled diabetes mellitus, chronic steroid use, immunosuppression or peripheral vascular disease
• Crush injuries and wounds with significant tissue loss
• Known allergy to suture material
• Delayed primary closure wounds