Comparison of scar outcomes of alar base and columella using irradiated polyglactin 911: a single-blind study

Year 2023, , 125 - 129, 27.03.2023

Mehmet Emrah Ceylan , Taşkın Yücel

https://doi.org/10.38053/acmj.1249691

Abstract

Aim: The formation of scars on the face after open septorhinoplasty (SRP) with alar base reduction may disturb the patient due to cosmetic concerns. This study aimed to compare scar outcomes of the columella and alar base in patients undergoing SRP.
Material and Method: Twenty-seven patients who underwent alar base reduction during primary open SRP were divided into two groups according to the intervened area as the Columella (CLM) group (n=27) and the Alar Base (AB) group (n=27). Irradiated polyglactin 911 was used in all patients. The modified Stony Brook Scar Evaluation Scale (SBSES) and a questionnaire form were used to measure scar outcomes and patient satisfaction. Columellar and alar base scar outcomes were compared.
Results: Patient satisfaction and scar outcomes were better in the CLM group. There was no significant difference, except for the first month total SBSES scores, between the CLM and AB groups. There was no significant difference in patient questionnaire scores between groups. In the early period, there were more signs of inflammation in the alar base than in the columella, without statistical significance.
Conclusion: Patient satisfaction and scar outcomes in the columellar area were favorable. Scar outcome on the alar base was statistically significantly worse than columella in the early period. There was no statistically significant difference between both areas in the long-term. Irradiated rapid vicryl can be used for closure of the alar base and columella, considering its advantages and disadvantages, in patients undergoing open septorhinoplasty with alar base reduction.

Keywords

polyglactin 911, rhinoplasty, cicatrix, surveys and questionnaires, septorhinoplasty

Supporting Institution

none

Project Number

none

References

• Hudise JY, Aldhabaan SA, Nassar RS, Alarfaj AM. Evaluation of scar outcome after alar base reduction using different surgical approaches. J Oral Maxillofac Surg 2020; 78: 2299.e1-2299.e8.
• Warner JP, Chauhan N, Adamson PA. Alar soft-tissue techniques in rhinoplasty: algorithmic approach, quantifiable guidelines, and scar outcomes from a single surgeon experience. Arch Facial Plast Surg 2010; 12: 149-58.
• Carniol ET, Adamson PA. Surgical Tips for the Management of the Wide Nasal Base. Facial Plast Surg 2018; 34: 29-35.
• Aksu I, Alim H, Tellioğlu AT. Comparative columellar scar analysis between transverse and inverted-V incision in open rhinoplasty. Aesthetic Plast Surg 2008; 32: 638-40
• Sajid MS, McFall MR, Whitehouse PA, Sains PS. Systematic review of absorbable vs non-absorbable sutures used for the closure of surgical incisions. World J Gastrointest Surg 2014; 6: 241-7.
• Aldhabaan S, Hudise JY, ALqarny M, Alarfaj A. Catgut versus polypropylene sutures for transcolumellar incision closure in open rhinoplasty: a retrospective cohort study. Cureus 2020; 12: e9769.
• Kilavuz AE, Bayram AA, Serin GM. Comparison of absorbable and nonabsorbable sutures in columellar incision closure in rhinoplasty and their effects to postoperative scar. Facial Plast Surg 2017; 33: 661-4.
• Kridel RW, Castellano RD. A simplified approach to alar base reduction: a review of 124 patients over 20 years. Arch Facial Plast Surg 2005; 7: 81-93.
• Erol O, Buyuklu F, Koycu A, Jafarov S, Gultekin G, Erbek SS. Comparison of rapid absorbable sutures with nonabsorbable sutures in closing transcolumellar incision in septorhinoplasty: short-term outcomes. Aesthetic Plast Surg 2020; 44: 1759-65.
• Ceylan ME, Balıkçı HH. Comparison of scar outcomes of alar flare region using absorbable and non-absorbable sutures: a single-blind study. Braz J Otorhinolaryngol 2022; 88: 133-9.
• Inanli S, Sari M, Yanik M. A new consideration of scar formation in open rhinoplasty. J Craniofac Surg 2009; 20: 1228-30.
• Gamboa M, Shayani P, Schmid R, Bobadilla E, Blackwell S. Anatomic basis of notch deformity in open rhinoplasty. Ann Plast Surg 2003; 50: 282-5.
• Rohrich RJ, Hoxworth RE, Thornton JF, Pessa JE. The pyriform ligament. Plast Reconstr Surg 2008; 121: 277-81.
• Daniel RK, Glasz T, Molnar G, Palhazi P, Saban Y, Journel B. The lower nasal base: an anatomical study. Aesthet Surg J 2013; 33: 222-32.
• Parell GJ, Becker GD. Comparison of absorbable with nonabsorbable sutures in closure of facial skin wounds. Arch Facial Plast Surg 2003; 5: 488-90.
• Gazivoda D, Pelemiš D, Vujašković G, Djurdjević S. Influence of suturing material on wound healing - An experimental study on dogs. Vojnosanit Pregl 2015; 72: 397-404.
• Brackeen AR, Wells MJ, Freed JM. Irradiated polyglactin 910 (Vicryl Rapide) for placement of full-thickness skin grafts. Dermatol Surg 2005; 31: 1707-9.
• Gartti-Jardim EC, de Souza AP, Carvalho AC, Pereira CC, Okamoto R, Magro Filho O. Comparative study of the healing process when using Vicryl®, Vicryl Rapid®, Vicryl Plus®, and Monocryl® sutures in the rat dermal tissue. Oral Maxillofac Surg. 2013; 17: 293-8.
• Niessen FB, Spauwen PH, Kon M. The role of suture material in hypertrophic scar formation: Monocryl vs. Vicryl-rapide. Ann Plast Surg 1997; 39: 254-60