Eversion in Dermatologic Surgery: Is Cosmetic Appearance Improved?

Study Overview
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Brief Summary
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The investigators hypothesize that everting wound edges while suturing surgical sites will result in more aesthetic scars. Additionally, we also hypothesize that small to moderate wound irregularities present at 3 months will resolve by 6 months after surgery with no intervention

Official Title
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Eversion in Dermatologic Surgery: Is Cosmetic Appearance Improved?

Conditions
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Basal Cell Carcinoma, Squamous Cell Carcinoma, Melanoma

Intervention / Treatment
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* Procedure: Everted suture technique
* Procedure: Non-everted suture technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Over 18 years of age Able to give informed consent themselves Willing to return for follow up visits Exclusion Criteria: Mentally handicapped Unable to understand written and oral English Incarceration Under 18 years of age Unwilling to return for follow up Pregnant Women Wounds less than 3 cm in length

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Everted suture technique<br>Technique that everts the skin; the edges will sit up against each other in a little peak, raised above the surrounding skin. | Procedure: Everted suture technique<br> <br> |
| Active Comparator: Non-everted suture technique<br>Surgical wound will be approximated such that the suture line is flat relative to the surrounding skin. | Procedure: Non-everted suture technique<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Everted versus non-everted suturing techniques | Primary outcome measures for this study are the post operative scar width measured at 1 cm from the midline on both sides of the scar. | 3 and 6 months | 
| Mean score of sum of 2 blinded observers POSAS scores | The mean summed total of two blinded reviewers Physician Observer Scar Assessment Scale (POSAS) scores for each side of the wound. | 3 and 6 months | 
| Scar measurements (height, width, length) | Scar volume will be measured in centimeters on both sides of the wound | 3 and 6 months | 
| Scar induration | Scar induration area will be measured in centimeters for both sides of the wound | 3 and 6 months | 
| Scar erythema | Scar erythema area will be measured in centimeters for both sides of the wound | 3 and 6 months | 
| Wound contour irregularities | Wound contour irregularities will be measured in terms of volume in cubic centimeters via a length, width and height measurement | 3 and 6 months | 
| Stand cone volume | The volume of standing cones will be measured via length, width and height measurements in centimeters | 3 and 6 months | 
| Uneven edge measurement | The area of uneven edges will be measured via a length x height measurement in centimeters | 3 and 6 months | 
| Hyperpigmentation area | areas of hyperpigmentation will be measured via a length x width measurement in centimeters | 3 and 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Infection | Infections occurring anytime during the study period will be recorded | up to 6 months | 
| wound dehiscence | incidence of wound infection will be recorded anytime during the study period | up to 6 months | 
| spitting sutures | spitting sutures will be counted for each side of the wound at 3 and 6 months | 3 and 6 months |