<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT02997306</url>
  </required_header>
  <id_info>
    <org_study_id>H16-01802</org_study_id>
    <nct_id>NCT02997306</nct_id>
  </id_info>
  <brief_title>COEBICS: Comparison of Erythema Between Interrupted and Continuous Sutures</brief_title>
  <acronym>COEBICS</acronym>
  <official_title>COEBICS: Comparison of Erythema Between Interrupted and Continuous Sutures</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>University of British Columbia</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>University of British Columbia</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
  </oversight_info>
  <brief_summary>
    <textblock>
      This is a randomized, controlled, prospective study which relies on computer-assisted skin&#xD;
      image processing of scar photographs, to establish whether simple interrupted or running&#xD;
      sutures are associated with the greatest degree of erythema when used to repair surgical&#xD;
      defects arising from Moh's micrographic surgery (MMS) of facial skin cancers. Furthermore,&#xD;
      through the use of the customized software that the investigators have developed for this&#xD;
      purpose, an effort will be made to better understand the evolution (including progression and&#xD;
      subsequent regression) of erythema over time in these scars.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Purpose: This is a randomized, controlled, prospective split-scar study which employs&#xD;
      computer-assisted image processing to establish whether simple interrupted or running sutures&#xD;
      cause the greatest degree of erythema in the surgical scars resulting from Moh's micrographic&#xD;
      surgery (MMS), and to better understand the evolution (including progression and subsequent&#xD;
      regression) of erythema over time in these scars.&#xD;
&#xD;
      Hypothesis: Based on the literature review and the clinical experience of the investigators,&#xD;
      it is hypothesized that the quantified difference in persisting erythema that is caused by&#xD;
      each suturing technique will be minimal and not statistically significant.&#xD;
&#xD;
      Justification: The cosmetic appearance of scars is an important concern for patients&#xD;
      undergoing Moh's micrographic surgery (MMS), a specialized therapeutic procedure that is used&#xD;
      for high risk skin cancers on the face. Many factors influence the aesthetics of a surgical&#xD;
      scar; suturing technique is among the most significant. Simple interrupted stitches and&#xD;
      running (continuous) stitches are the two most frequently used suturing techniques. Anecdotal&#xD;
      opinions favor one technique over the other. Some authors consider simple interrupted&#xD;
      stitches to be more time consuming but allows more precise wound approximation. Other&#xD;
      surgeons feel running stitches decrease suture marks. A recent literature search looking at&#xD;
      the influence of suturing technique on the cosmetic outcome of scars could not draw any&#xD;
      conclusion as to which stitching method should be recommended for facial repair because of&#xD;
      the lack of comparative studies. The need for prospective randomized trials in this field is&#xD;
      required. Multiple scales have been reported in the literature which can be utilized for&#xD;
      cosmetic assessment of healing surgical scars. Persistent scar erythema/dilated peri-scar&#xD;
      telangiectasias are a relatively common finding associated with facial surgery and are&#xD;
      included as a component in only one of the aforementioned scar evaluation scales.&#xD;
      Furthermore, it is only the presence of erythema that is gauged by the scale, and not its&#xD;
      intensity or area as these parameters would be challenging to objectively assess. To address&#xD;
      this issue, the investigators have developed a software that is capable of quantifying the&#xD;
      intensity and area involving erythema in scars. As such, this study has been designed to&#xD;
      determine whether simple interrupted or running sutures would cause the greatest degree of&#xD;
      erythema and to what extent (both in terms of intensity and area) in the resulting facial MMS&#xD;
      scars.&#xD;
&#xD;
      Objectives:&#xD;
&#xD;
        1. To determine whether simple interrupted or running sutures cause the greatest degree of&#xD;
           persistent erythema in the scars resulting from MMS facial defect repair.&#xD;
&#xD;
        2. To determine the percentage difference in the degree of persisting erythema (including&#xD;
           intensity and area) caused by each suturing technique.&#xD;
&#xD;
        3. To quantitatively assess the evolution of erythema over time in simple interrupted and&#xD;
           running sutures to better characterize its patterns of progression and subsequent&#xD;
           regression.&#xD;
&#xD;
      Research Design: Prospective randomized controlled split-scar study.&#xD;
&#xD;
      Research Methods: Subjects will be recruited at the Dermatologic Surgery Centre at the VGH&#xD;
      Skin Care Centre. They will be offered the option to participate in this study prior to&#xD;
      beginning their MMS procedure. All patients/accompanying family members will have adequate&#xD;
      time to read the protocol and consent document prior to entering the surgical area. All&#xD;
      surgeries will be performed by an experienced dermatologic surgeon and/or an MMS Fellow. The&#xD;
      same procedure will be followed for each patient. After ensuring that the length of the scar&#xD;
      will be &gt;4cm, patients will be randomized (using computer generated sealed envelope method)&#xD;
      to epidermal suturing technique. Depending on randomization, either the superior/medial or&#xD;
      inferior/lateral half of the scar will be sutured with running stitches, whereas the other&#xD;
      half will be closed with interrupted stitches. All other aspects of the procedures, including&#xD;
      post-operative wound care and follow-up, will be similar as those for patients who are not in&#xD;
      the study. The subjects will be seen again for follow up at 1 week, 8 weeks, and 6 months&#xD;
      following their procedure, which are regularly scheduled for all patients who undergo MMS as&#xD;
      part of their ongoing oncologic evaluation and wound care. No additional follow up&#xD;
      appointments will be scheduled specifically for the purpose of this study. During each follow&#xD;
      up appointment, close-up photographs of the scars will be taken using preset aperture (14),&#xD;
      shutter speed (1/60 seconds), and flash settings (+1/3 exposure compensation) on a Canon EOS&#xD;
      Digital Rebel XT, CanonMR-14EX ring flash, and Canon EFS 60mmf/2.8 macro lens. All&#xD;
      photographs will be taken in the same follow-up room under closely matched lighting&#xD;
      parameters and camera angles. Following their final reassessment at 6 months, all interval&#xD;
      photos will be processed using the customized software to quantify intensity and area of&#xD;
      erythema for each visit.&#xD;
&#xD;
      Statistical analysis: Power calculations have been performed. To detect a difference of 10%&#xD;
      in the degree of erythema between the two study arms, with a power of 80%, 100 patients will&#xD;
      be recruited. The two study arms are paired since each patient's scar is split into two&#xD;
      parts. Subsequently, comparative paired t-tests will be performed on the software-generated&#xD;
      values of erythema intensity and area for simple interrupted and running sutures from each&#xD;
      interval MMS scar photograph.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Not yet recruiting</last_known_status>
  <start_date>January 2017</start_date>
  <completion_date type="Anticipated">December 2017</completion_date>
  <primary_completion_date type="Anticipated">October 2017</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Single (Outcomes Assessor)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Change in the Intensity of Scar Erythema</measure>
    <time_frame>1 week, 8 weeks, and 6 months post-operatively</time_frame>
    <description>The degree of scar erythema post-operatively will be assessed in each half of each patient's scar by quantifying both the intensity and the surface area of erythema. This will be achieved digitally by employing the customized software developed by the investigators for this purpose.</description>
  </primary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Anticipated">100</enrollment>
  <condition>Surgical Scar Erythema</condition>
  <arm_group>
    <arm_group_label>Superior/Medial Running Sutures</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>In this cohort, the running sutures will be randomized to be oriented on Superior/Medial half of the scar, and the remaining half of the scar will be closed with simple interrupted sutures.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Inferior/Lateral Running Sutures</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>In this cohort, the running sutures will be randomized to be oriented on Inferior/Lateral half of the scar, and the remaining half of the scar will be closed with simple interrupted sutures.</description>
  </arm_group>
  <intervention>
    <intervention_type>Procedure</intervention_type>
    <intervention_name>Superior/Medial Running Sutures</intervention_name>
    <description>Simple interrupted stitches and running (continuous) stitches are the two most frequently used suturing techniques. The erythema secondary to these suturing techniques will be compared by utilizing them side-by-side for closure of post-Moh's surgical defect repair in each patient. This intervention consists of running sutures being used for closure of the Superior/Medial half of the incision, and interrupted sutures being used on the Inferior/Lateral half of the incision.</description>
    <arm_group_label>Superior/Medial Running Sutures</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Procedure</intervention_type>
    <intervention_name>Inferior/Lateral Running Sutures</intervention_name>
    <description>Simple interrupted stitches and running (continuous) stitches are the two most frequently used suturing techniques. The erythema secondary to these suturing techniques will be compared by utilizing them side-by-side for closure of post-Moh's surgical defect repair in each patient. This intervention consists of running sutures being used for closure of the Inferior/Lateral half of the incision, and interrupted sutures being used on the Superior/Medial half of the incision.</description>
    <arm_group_label>Inferior/Lateral Running Sutures</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
        Subjects will be included only if the following conditions are all met:&#xD;
&#xD;
          1. The subject is 18 years of age or older.&#xD;
&#xD;
          2. The subject is presenting with a facial surgical defect after MMS that requires a&#xD;
             repair resulting in a scar of more than 4 cm in length.&#xD;
&#xD;
          3. The subject is willing and capable of cooperating to the extent and degree required by&#xD;
             the protocol.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
        Subjects will be excluded if any of the following conditions are met:&#xD;
&#xD;
          1. The subject has a history of keloidal scarring.&#xD;
&#xD;
          2. The subject will require radiation therapy after surgery.&#xD;
&#xD;
          3. The subject is participating in another investigational drug or device study within 30&#xD;
             days of proposed study enrolment.&#xD;
&#xD;
          4. The subject is not able to fully understand the protocol and consent documents.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>David Zloty, MD, FRCPC</last_name>
    <role>Principal Investigator</role>
    <affiliation>Department of Dermatology and Skin Science, University of British Columbia</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>David Zloty, MD, FRCPC</last_name>
    <phone>604-875-4888</phone>
    <email>David.Zloty@vch.ca</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Ali Majdzadeh</last_name>
    <phone>778-887-4040</phone>
    <email>amajdzadeh@alumni.ubc.ca</email>
  </overall_contact_backup>
  <location>
    <facility>
      <name>Dermatologic Surgery Centre at the Vancouver General Hospital Skin Care Centre</name>
      <address>
        <city>Vancouver</city>
        <state>British Columbia</state>
        <zip>V5Z 4E8</zip>
        <country>Canada</country>
      </address>
    </facility>
    <contact>
      <last_name>David Zloty, MD, FRCPC</last_name>
      <phone>604-875-4888</phone>
      <email>David.Zloty@vch.ca</email>
    </contact>
    <investigator>
      <last_name>David Zloty, MD, FRCPC</last_name>
      <role>Principal Investigator</role>
    </investigator>
    <investigator>
      <last_name>Ali Majdzadeh</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Ardalan Akbari, BSc</last_name>
      <role>Sub-Investigator</role>
    </investigator>
  </location>
  <location_countries>
    <country>Canada</country>
  </location_countries>
  <reference>
    <citation>Chuang GS, Leach BC, Wheless L, Lang PG, Cook J. Preoperative expectations and values of patients undergoing Mohs micrographic surgery. Dermatol Surg. 2011 Mar;37(3):311-9. doi: 10.1111/j.1524-4725.2011.01878.x. Epub 2011 Feb 22.</citation>
    <PMID>21342309</PMID>
  </reference>
  <reference>
    <citation>McLean NR, Fyfe AH, Flint EF, Irvine BH, Calvert MH. Comparison of skin closure using continuous and interrupted nylon sutures. Br J Surg. 1980 Sep;67(9):633-5. doi: 10.1002/bjs.1800670908.</citation>
    <PMID>7000234</PMID>
  </reference>
  <reference>
    <citation>Moy LS. Management of acute wounds. Dermatol Clin. 1993 Oct;11(4):759-66.</citation>
    <PMID>8222359</PMID>
  </reference>
  <reference>
    <citation>Moy RL, Waldman B, Hein DW. A review of sutures and suturing techniques. J Dermatol Surg Oncol. 1992 Sep;18(9):785-95. doi: 10.1111/j.1524-4725.1992.tb03036.x.</citation>
    <PMID>1512311</PMID>
  </reference>
  <reference>
    <citation>Quinn JV, Drzewiecki AE, Stiell IG, Elmslie TJ. Appearance scales to measure cosmetic outcomes of healed lacerations. Am J Emerg Med. 1995 Mar;13(2):229-31. doi: 10.1016/0735-6757(95)90100-0.</citation>
    <PMID>7893315</PMID>
  </reference>
  <reference>
    <citation>Singer AJ, Arora B, Dagum A, Valentine S, Hollander JE. Development and validation of a novel scar evaluation scale. Plast Reconstr Surg. 2007 Dec;120(7):1892-1897. doi: 10.1097/01.prs.0000287275.15511.10.</citation>
    <PMID>18090752</PMID>
  </reference>
  <reference>
    <citation>Sclafani AP, Sclafani JA, Sclafani AM. Successes, revisions, and postoperative complications in 446 Mohs defect repairs. Facial Plast Surg. 2012 Jun;28(3):358-66. doi: 10.1055/s-0032-1312691. Epub 2012 Jun 21.</citation>
    <PMID>22723239</PMID>
  </reference>
  <verification_date>December 2016</verification_date>
  <study_first_submitted>December 7, 2016</study_first_submitted>
  <study_first_submitted_qc>December 15, 2016</study_first_submitted_qc>
  <study_first_posted type="Estimate">December 20, 2016</study_first_posted>
  <last_update_submitted>December 15, 2016</last_update_submitted>
  <last_update_submitted_qc>December 15, 2016</last_update_submitted_qc>
  <last_update_posted type="Estimate">December 20, 2016</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>University of British Columbia</investigator_affiliation>
    <investigator_full_name>David Zloty</investigator_full_name>
    <investigator_title>Clinical Professor</investigator_title>
  </responsible_party>
  <keyword>Moh's Surgery</keyword>
  <keyword>Erythema</keyword>
  <keyword>Face</keyword>
  <keyword>Simple Interrupted Sutures</keyword>
  <keyword>Running Sutures</keyword>
  <keyword>Image Processing</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Erythema</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT02997306
org study id: H16-01802
nct id: NCT02997306
lead sponsor: 
has dmc: No
This is a randomized, controlled, prospective study which relies on computer-assisted skin
      image processing of scar photographs, to establish whether simple interrupted or running
      sutures are associated with the greatest degree of erythema when used to repair surgical
      defects arising from Moh's micrographic surgery (MMS) of facial skin cancers. Furthermore,
      through the use of the customized software that the investigators have developed for this
      purpose, an effort will be made to better understand the evolution (including progression and
      subsequent regression) of erythema over time in these scars.
Purpose: This is a randomized, controlled, prospective split-scar study which employs
      computer-assisted image processing to establish whether simple interrupted or running sutures
      cause the greatest degree of erythema in the surgical scars resulting from Moh's micrographic
      surgery (MMS), and to better understand the evolution (including progression and subsequent
      regression) of erythema over time in these scars.

      Hypothesis: Based on the literature review and the clinical experience of the investigators,
      it is hypothesized that the quantified difference in persisting erythema that is caused by
      each suturing technique will be minimal and not statistically significant.

      Justification: The cosmetic appearance of scars is an important concern for patients
      undergoing Moh's micrographic surgery (MMS), a specialized therapeutic procedure that is used
      for high risk skin cancers on the face. Many factors influence the aesthetics of a surgical
      scar; suturing technique is among the most significant. Simple interrupted stitches and
      running (continuous) stitches are the two most frequently used suturing techniques. Anecdotal
      opinions favor one technique over the other. Some authors consider simple interrupted
      stitches to be more time consuming but allows more precise wound approximation. Other
      surgeons feel running stitches decrease suture marks. A recent literature search looking at
      the influence of suturing technique on the cosmetic outcome of scars could not draw any
      conclusion as to which stitching method should be recommended for facial repair because of
      the lack of comparative studies. The need for prospective randomized trials in this field is
      required. Multiple scales have been reported in the literature which can be utilized for
      cosmetic assessment of healing surgical scars. Persistent scar erythema/dilated peri-scar
      telangiectasias are a relatively common finding associated with facial surgery and are
      included as a component in only one of the aforementioned scar evaluation scales.
      Furthermore, it is only the presence of erythema that is gauged by the scale, and not its
      intensity or area as these parameters would be challenging to objectively assess. To address
      this issue, the investigators have developed a software that is capable of quantifying the
      intensity and area involving erythema in scars. As such, this study has been designed to
      determine whether simple interrupted or running sutures would cause the greatest degree of
      erythema and to what extent (both in terms of intensity and area) in the resulting facial MMS
      scars.

      Objectives:

        1. To determine whether simple interrupted or running sutures cause the greatest degree of
           persistent erythema in the scars resulting from MMS facial defect repair.

        2. To determine the percentage difference in the degree of persisting erythema (including
           intensity and area) caused by each suturing technique.

        3. To quantitatively assess the evolution of erythema over time in simple interrupted and
           running sutures to better characterize its patterns of progression and subsequent
           regression.

      Research Design: Prospective randomized controlled split-scar study.

      Research Methods: Subjects will be recruited at the Dermatologic Surgery Centre at the VGH
      Skin Care Centre. They will be offered the option to participate in this study prior to
      beginning their MMS procedure. All patients/accompanying family members will have adequate
      time to read the protocol and consent document prior to entering the surgical area. All
      surgeries will be performed by an experienced dermatologic surgeon and/or an MMS Fellow. The
      same procedure will be followed for each patient. After ensuring that the length of the scar
      will be >4cm, patients will be randomized (using computer generated sealed envelope method)
      to epidermal suturing technique. Depending on randomization, either the superior/medial or
      inferior/lateral half of the scar will be sutured with running stitches, whereas the other
      half will be closed with interrupted stitches. All other aspects of the procedures, including
      post-operative wound care and follow-up, will be similar as those for patients who are not in
      the study. The subjects will be seen again for follow up at 1 week, 8 weeks, and 6 months
      following their procedure, which are regularly scheduled for all patients who undergo MMS as
      part of their ongoing oncologic evaluation and wound care. No additional follow up
      appointments will be scheduled specifically for the purpose of this study. During each follow
      up appointment, close-up photographs of the scars will be taken using preset aperture (14),
      shutter speed (1/60 seconds), and flash settings (+1/3 exposure compensation) on a Canon EOS
      Digital Rebel XT, CanonMR-14EX ring flash, and Canon EFS 60mmf/2.8 macro lens. All
      photographs will be taken in the same follow-up room under closely matched lighting
      parameters and camera angles. Following their final reassessment at 6 months, all interval
      photos will be processed using the customized software to quantify intensity and area of
      erythema for each visit.

      Statistical analysis: Power calculations have been performed. To detect a difference of 10%
      in the degree of erythema between the two study arms, with a power of 80%, 100 patients will
      be recruited. The two study arms are paired since each patient's scar is split into two
      parts. Subsequently, comparative paired t-tests will be performed on the software-generated
      values of erythema intensity and area for simple interrupted and running sutures from each
      interval MMS scar photograph.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Treatment
masking: Single (Outcomes Assessor)
measure: Change in the Intensity of Scar Erythema
time frame: 1 week, 8 weeks, and 6 months post-operatively
description: The degree of scar erythema post-operatively will be assessed in each half of each patient's scar by quantifying both the intensity and the surface area of erythema. This will be achieved digitally by employing the customized software developed by the investigators for this purpose.
arm group label: Superior/Medial Running Sutures
arm group type: Experimental
description: In this cohort, the running sutures will be randomized to be oriented on Superior/Medial half of the scar, and the remaining half of the scar will be closed with simple interrupted sutures.
arm group label: Inferior/Lateral Running Sutures
arm group type: Experimental
description: In this cohort, the running sutures will be randomized to be oriented on Inferior/Lateral half of the scar, and the remaining half of the scar will be closed with simple interrupted sutures.
intervention type: Procedure
intervention name: Superior/Medial Running Sutures
description: Simple interrupted stitches and running (continuous) stitches are the two most frequently used suturing techniques. The erythema secondary to these suturing techniques will be compared by utilizing them side-by-side for closure of post-Moh's surgical defect repair in each patient. This intervention consists of running sutures being used for closure of the Superior/Medial half of the incision, and interrupted sutures being used on the Inferior/Lateral half of the incision.
arm group label: Superior/Medial Running Sutures
intervention type: Procedure
intervention name: Inferior/Lateral Running Sutures
description: Simple interrupted stitches and running (continuous) stitches are the two most frequently used suturing techniques. The erythema secondary to these suturing techniques will be compared by utilizing them side-by-side for closure of post-Moh's surgical defect repair in each patient. This intervention consists of running sutures being used for closure of the Inferior/Lateral half of the incision, and interrupted sutures being used on the Superior/Medial half of the incision.
arm group label: Inferior/Lateral Running Sutures
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: No
last name: David Zloty, MD, FRCPC
role: Principal Investigator
affiliation: Department of Dermatology and Skin Science, University of British Columbia
last name: David Zloty, MD, FRCPC
phone: 604-875-4888
email: David.Zloty@vch.ca
last name: Ali Majdzadeh
phone: 778-887-4040
email: amajdzadeh@alumni.ubc.ca
facility: 
contact: 
investigator: 
investigator: 
investigator: 
country: Canada
citation: Chuang GS, Leach BC, Wheless L, Lang PG, Cook J. Preoperative expectations and values of patients undergoing Mohs micrographic surgery. Dermatol Surg. 2011 Mar;37(3):311-9. doi: 10.1111/j.1524-4725.2011.01878.x. Epub 2011 Feb 22.
PMID: 21342309
citation: McLean NR, Fyfe AH, Flint EF, Irvine BH, Calvert MH. Comparison of skin closure using continuous and interrupted nylon sutures. Br J Surg. 1980 Sep;67(9):633-5. doi: 10.1002/bjs.1800670908.
PMID: 7000234
citation: Moy LS. Management of acute wounds. Dermatol Clin. 1993 Oct;11(4):759-66.
PMID: 8222359
citation: Moy RL, Waldman B, Hein DW. A review of sutures and suturing techniques. J Dermatol Surg Oncol. 1992 Sep;18(9):785-95. doi: 10.1111/j.1524-4725.1992.tb03036.x.
PMID: 1512311
citation: Quinn JV, Drzewiecki AE, Stiell IG, Elmslie TJ. Appearance scales to measure cosmetic outcomes of healed lacerations. Am J Emerg Med. 1995 Mar;13(2):229-31. doi: 10.1016/0735-6757(95)90100-0.
PMID: 7893315
citation: Singer AJ, Arora B, Dagum A, Valentine S, Hollander JE. Development and validation of a novel scar evaluation scale. Plast Reconstr Surg. 2007 Dec;120(7):1892-1897. doi: 10.1097/01.prs.0000287275.15511.10.
PMID: 18090752
citation: Sclafani AP, Sclafani JA, Sclafani AM. Successes, revisions, and postoperative complications in 446 Mohs defect repairs. Facial Plast Surg. 2012 Jun;28(3):358-66. doi: 10.1055/s-0032-1312691. Epub 2012 Jun 21.
PMID: 22723239
responsible party type: Principal Investigator
investigator affiliation: University of British Columbia
investigator full name: David Zloty
investigator title: Clinical Professor
mesh term: Erythema
sharing ipd: No