Skin closure at laparoscopy.

Abstract

STUDY OBJECTIVE: To discern the best method of wound closure after laparoscopy based on patient acceptability of pain, complications, and cosmetic result. DESIGN: Randomized, prospective study. SETTING: A university-affiliated hospital. PATIENTS: Fifty-four women. Interventions. The women received interrupted 3-0 nylon sutures, subcuticular 3-0 polyglactin 910 sutures, or adhesive strips for skin closure. At the umbilical port site the rectus sheath was closed with a single 0 polyglactin suture and then one of the three materials for skin closure. The lateral ports were closed with a combination of these materials, allowing each patient to act as her own control. MEASUREMENTS AND MAIN RESULTS: Pain was significantly less in wounds closed by subcuticular technique than in those closed by either transcutaneous suture or adhesive strips. This was seen for the 5-mm, 10-mm, and umbilical port sites. There was no statistically significant difference in the rate of reported complications or patient satisfaction between subcuticular and transcutaneous wound sites. CONCLUSION: We believe these results support subcuticular methods of wound closure after laparoscopic procedures.