Wound closure techniques and postoperative wound management in aesthetic surgery: an evidence-based narrative review
DOI:
https://doi.org/10.18203/2349-2902.isj20260338Keywords:
Aesthetic surgery, Layered wound closure, Progressive tension sutures, Scar management, Topical wound therapy, PirfenidoneAbstract
Optimal wound closure and postoperative wound management are critical determinants of outcomes in aesthetic surgery, where success is defined not only by complication avoidance but also by scar quality and patient satisfaction. This narrative review synthesizes current evidence on layered closure strategies, suture materials and techniques, tension-reducing methods such as progressive tension sutures, and postoperative topical wound and scar management. Particular attention is given to topical agents commonly used in Latin American clinical practice, including acexamic-acid–based formulations (Recoveron®/Recoveron N®) and pirfenidone-based topical therapy (commercially aligned with Kitoscell-Q®).
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Luo W, Tao Y, Wang Y, Ouyang Z, Huang J, Long X. Comparing running vs interrupted sutures for skin closure: A systematic review and meta-analysis. Int Wound J. 2023;20(1):210-20. DOI: https://doi.org/10.1111/iwj.13863
Kerin EP, Davey MG, Mkabaah LB, Donlon NE. Optimal port site skin closure method following minimally-invasive surgery: A systematic review and network meta-analysis of randomised clinical trials. Am J Surg. 2025;248:116542. DOI: https://doi.org/10.1016/j.amjsurg.2025.116542
Andrades P, Prado A, Danilla S, Guerra C, Benitez S, Sepulveda S, et al. Progressive tension sutures in the prevention of postabdominoplasty seroma: a prospective, randomized, double-blind clinical trial. Plast Reconstr Surg. 2007;120(4):935-46. DOI: https://doi.org/10.1097/01.prs.0000253445.76991.de
Rubin JP, Hunstad JP, Polynice A, Gusenoff JA, Schoeller T, Dunn R, et al. A Multicenter Randomized Controlled Trial Comparing Absorbable Barbed Sutures Versus Conventional Absorbable Sutures for Dermal Closure in Open Surgical Procedures. Aesthet Surg J. 2014;34(2):272-83. DOI: https://doi.org/10.1177/1090820X13519264
Chittoria RK, Padi TR. A prospective, randomized, placebo controlled, double blind study of silicone gel in prevention of hypertrophic scar at donor site of skin grafting. J Cutan Aesthet Surg. 2013;6(1):12-6. DOI: https://doi.org/10.4103/0974-2077.110090
Warner JP, Gutowski KA. Abdominoplasty With Progressive Tension Closure Using A Barbed Suture Technique. Aestht Surg J. 2009;29(3):221-5. DOI: https://doi.org/10.1016/j.asj.2009.01.009
Chen PJ, Hua YM, Toh HS, Lee MC. Topical antibiotic prophylaxis for surgical wound infections in clean and clean-contaminated surgery: a systematic review and meta-analysis. BJS Open. 2021;5(6):zrab125. DOI: https://doi.org/10.1093/bjsopen/zrab125
Rahman MM, Alam Tumpa MA, Zehravi M, Sarker MT, Yamin MD, Islam MR, et al. An overview of antimicrobial stewardship optimization: the use of antibiotics in humans and animals to prevent resistance. Antibiotics. 2022;11(5):667. DOI: https://doi.org/10.3390/antibiotics11050667
Armendariz-Borunda J, Lyra-Gonzalez I, Medina-Preciado D, Gonzalez-García I, Martinez-Fong D, Miranda RA, et al. A controlled clinical trial with pirfenidone in the treatment of pathological skin scarring caused by burns in pediatric patients. Ann Plast Surg. 2012;68(1):22-8. DOI: https://doi.org/10.1097/SAP.0b013e31821b6d08
Janka-Zires M, Almeda-Valdes P, Uribe-Wiechers AC, Juárez-Comboni SC, López-Gutiérrez J, Escobar-Jiménez JJ, et al. Topical Administration of Pirfenidone Increases Healing of Chronic Diabetic Foot Ulcers: A Randomized Crossover Study. J Diabetes Res. 2016;2016:7340641. DOI: https://doi.org/10.1155/2016/7340641
Prakash AJ, Jeevanandam V, Murtada M, Ali MA, Jameela H. Advances in Wound Closure Techniques: Integrating Functional Preservation and Aesthetic Outcomes. Junior Res. 2025;3(5):183-9. DOI: https://doi.org/10.52340/jr.2025.03.05.15
Belkin D, Wysong A. Wound Closure Technique. Pediatr Dermatol Surg. 2019;105-14. DOI: https://doi.org/10.1002/9781118769836.ch10
Pedaprolu AS, Rewale VM. Advances in soft tissue wound care: A comprehensive review of facial traumatic injuries. Multidisc Rev. 2024;7(7):2024131. DOI: https://doi.org/10.31893/multirev.2024131
Nambi GK, King MW. A review of barbed sutures—evolution, applications and clinical significance. Bioeng. 2023:10(4):419. DOI: https://doi.org/10.3390/bioengineering10040419
Byrne M, Aly A. The surgical suture. Aesthet Surg J. 2019;39:S67-72. DOI: https://doi.org/10.1093/asj/sjz036
Mulholland RS, Paul MD. Lifting and wound closure with barbed sutures. Clin Plastic Surg. 2011;38(3):521-35. DOI: https://doi.org/10.1016/j.cps.2011.06.002
Jenkins LE, Davis LS. Comprehensive review of tissue adhesives. Dermatol Surg. 2013;44(11):1367-72. DOI: https://doi.org/10.1097/DSS.0000000000001576
Martín-Ballester A, García-Cerdá D, Prieto-Moure B, Martín-Martínez JM, Lloris-Carsí JM. Use of cyanoacrylate adhesives in dermal lesions: a review. J Adhesion Sci Technol. 2014;28(6):573-97. DOI: https://doi.org/10.1080/01694243.2013.852784
Shalaby SW, Shalaby WS. Cyanoacrylate-based systems as tissue adhesives. Absorb Biodegrad Polymers. 2003;73-90. DOI: https://doi.org/10.1201/9780203493014.ch5
Pabst A, Becker P, Kuchen R, Schumann S, Kasaj A. A comparative study of cyanoacrylate-based tissue adhesive and surgical sutures on marginal flap stability following coronally advanced flap. Clin Oral Investig. 2023;28(1):5. DOI: https://doi.org/10.1007/s00784-023-05390-8
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