Is Subcutaneous Suture Necessary

Introduction: It is most often advised to repair subcutaneous soft tissue using absorbable sutures at the end of surgery before skin closure. We purposed to evaluate the outcome of post operative wound in the instances of avoiding subcutaneous suturs. Materials and methods: We conducted a single blind randomized clinical trial during 1382-88 on all patients who attended for orthopedic surgeries in Sina hospital. Patients with secondary closure or cutaneous or myocutaneous graft/flap are axcluded from study. After categorizing patients based on upper/lower limb and fascia repair, the patients were divided into two groups with or without subcutaneous repair using computerized random numbers chart. The patients were assessed for probable complications (wound dehiscence, infection, fluid collection, inflammation and skin necrosis) at 1 st , and 2 nd weeks as well as the 1 st and 3 rd months postoperatively. Results: After administering inclusion and exclusion criteria, 14953 patients (1662 female, 13291 male; mean age 40.6±4.9 years) were enrolled in the study 6120 had subcutaneous repair. The observed complications in patients without subcutaneous sutures in comparison to the others with subcutaneous sutures besides other parameters (upper or lower extremity and fascia repair) were not statistically significant regarding wound inflammation, infection, fluid collection, necrosis and dehiscence. Discussion: It seems that omitting subcutaneous soft tissue repair will not lead to major complications in several cases of orthopedic surgery. It shortens the time of surgery and may also reduce the costs because of suture materials.