A randomized trial between different suture materials (polydioxanone vs. poliglecaprone 25) and different suturing techniques (running subcuticular suture alone vs. with running horizontal mattress) in prevention of hypertrophic scar development in median sternotomy wound.
Bibliographic record
Abstract
BACKGROUND: Hypertrophic scar development after median sternotomy wound in cardiac surgery patients is quite common in surgical practice and becomes a major concern nowadays. OBJECTIVE: To compare cosmetic outcome between different suture materials and different suture techniques for skin closure in median sternotomy wound. MATERIAL AND METHOD: A randomized clinical trial was conducted in 80 patients who underwent cardiac surgery in Thammasat University Hospital, Thailand. In respect of the materials and the techniques used to suture the skin, the patients were randomly allocated to four groups. In group 1, the skin was closed with subcuticular running 4-0 Poliglecaprone 25 (Monocryl). In group 2, the skin was closed with subcuticular running 4-0 Polydioxanone (PDS). In group 3, the skin was closed with subcuticular running 4-0 Poliglecaprone 25 (Monocryl) and running horizontal mattress 6-0 Nylon. In group 4, the skin was closed with subcuticular running 4-0 Polydioxanone (PDS) and running horizontal mattress 6-0 Nylon. Postoperative evaluation was performed at 2 and 6 weeks, 3 and 6 months follow-up visits. The scar was analyzed in three parts: upper, middle and lower one third of the sternal wound. The outcome measures for surgical wound were width, height and overall appearance of the scar using the Vancouver scar scale (VSS). A linear visual analogue score (VAS) was preformed to assess pain and itch. RESULTS: At 6 months, there were no significant differences between 4 groups ofpatients in every parameters (width, height, VSS, pain score and itch score) at three different wound sites (upper middle and lower). There was a statistically significant and progressive increase in scar stretching, height and total VSSfrom top to bottom of the sternum with the same pattern in all groups ofpatients (p<0. 05). At 6 months, scar showed a statistically significant difference in width when compares to6 weeks and 3 months (p<O.001).Female had a statistically significant difference ofscar stretching at upper two third of the sternum (p<0. 05). Female scar width was approximately 2folds greater than male patient. Duringfollow-up in group 3, two patients died postoperatively due to multi-organ failure and one patient developed wound infection. CONCLUSION: There were no significant differences in cosmetic outcomes between different suture materials and different suture techniques.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".