Mini-incision Hemithyroidectomy—Incision Closure with Subcuticular Suture Versus No Suture of Subcutaneous Tissue and Skin

Minimally invasive thyroid surgery techniques (MIT) have the advantage of reduction of tissue trauma, early hospital discharge, and better neck wound cosmetic appearance, while maintaining the same surgical outcome as traditional thyroidectomy. In addition to MIT, methods of skin closure contribute to the overall aesthetic outcome and patient’s satisfaction. Methods of skin closure depends largely on the surgeon’s choice based upon the need for a rapid, economic, and reproducible technique. The aim of the study is to compare the quality of resulting scar at 6 weeks after mini-incision hemithyroidectomy with subcuticular absorbable sutures or no subcuticular or skin sutures for the closure of the incision. Methods. There are 102 patients undergoing mini-incision hemithyroidectomy. Fifty two patients were randomly assigned to closure with approximation of subcutaneous tissue and skin by bringing the wound edges together by pressing with forceps and the other 50 with subcuticular absorbable suture. Post-operatively patients were assessed for pain and it was observed that pain was less in group treated without skin or subcutaneous sutures. At 6 weeks, the scar was evaluated by the patient after viewing in the mirror and graded as 1-5. Results. Pain during the postoperative period was significantly less in patients without subcutaneous or skin sutures. Assessment of scar appearance by the patients showed a statistically significant difference in favor of no skin or subcutaneous suture (n=48) as compared to subcuticular suture (n=40). Conclusion. Incision closure of mini –incision hemithyroidectomy without subcuticular or skin sutures and only by approximation had less pain postoperatively as compared to subcuticular suture. Scar assessment by patients revealed better satisfaction by this method.