Background: The cosmetic appearance of head and neck surgical scars can have a major impact on body image and quality of life. Numerous wound closure methods such as staples, sutures, adhesives and surgical tape are available, and our aim is to investigate whether one closure method offers superior cosmetic outcomes over the others. Objectives: The primary outcome was patient and clinician reported cosmetic appearance. Secondary outcome measures such as post-operative complications were also measured. Design: A systematic review was undertaken of Pubmed, Web of Science and the Cochrane database. Searches were performed using the MeSH terms “tissue adhesives”, “wound closure techniques”, “surgical tape” and “sutures”, combined with various head and neck operations using Boolean operators. Results: The initial search found 2753 papers, of which 2,721 were excluded after removal of duplicates and screening. 32 papers underwent full text review and 7 were included in the review. The studies did not show any significant difference in cosmesis or wound complications. Surgical staples and tissue adhesives had significantly shorter wound closure time than sutures. No studies reported on head and neck scar’s impact on quality of life or body image. Conclusions: From the studies presented here, there is no significant difference in short term wound cosmesis using tissue adhesives, sutures, or surgical staples. However, the papers included are generally of poor quality and contained a moderate to high risk of bias, and thus further studies are needed to establish the cosmetic and quality of life impact of varying wound closure techniques following head and neck surgery.

Objectives: Salivary gland malignancies are an uncommon and heterogeneous group of cancers. We report our experience of clinicopathological variables that affect survival in patients treated by curative intent with surgery at a UK institution over a period of 15 years. Design: Retrospective cohort study Setting: Single centre study Participants We included 108 patients with malignant salivary gland tumours treated by curative intent with surgery from 2004 to 2019. Main outcome measures: The association between clinicopathological factors and their impact on overall survival (OS) and disease-free survival (DFS). Results: 77 (71.3%) presented with early pT classification and 81 (75%) of were node-negative. The parotid was the commonest site of malignancy (86, 79.6%). Perineural invasion (PNI) was present in 40 (37%) and lymphovascular invasion (LVI) was present in 20 (18.5%). 63 (58.3%) underwent adjuvant therapy. Median follow up was 36 months. Five-year OS and DFS were 81.7% and 71%. Age 50, pT classification 3-4, high tumour grade, PNI, and advanced TNM stage were all associated with worse OS and DFS, and LVI with worse DFS. There was no survival difference between a close (1-<5 mm) or negative (≥5 mm) resection margin. Conclusions: Age >50 years, advanced TNM stage, PNI and LVI are predictors of poor DFS. There was no difference in OS or DFS between patients with negative and close resection margins, indicating that close margins may be adequate for maintaining good oncologic outcomes in this group of patients.