Implications for future research
Further studies with a more robust design may help in determining a best
possible closure method in head and neck operations. The optimal trial
design would be prospective, randomised with a longer follow-up to
accommodate for wound remodelling. Studies could compare not only
sutures and staples, but the overlooked tissue adhesives and surgical
tape, using subcuticular sutures as a control group. Scar appearance
should be analysed by a clinician and patient using validated
questionnaires such as the patient and observer scar assessment scale
(POSAS) or the PSAQ. This could be corroborated with the impact on a
patient’s QOL and body image using assessments such as the body image
questionnaire.
Research into minimal access robotic and open thyroidectomy has
suggested wound location does not impact upon a patient’s opinion of
their scar. Nevertheless, it could be presumed some incisions, such as
those for neck dissection, may be more disfiguring than more subtle
salivary gland scars. Avoidance of this mismatch could be achieved
through comparison of a single operation, studying matched cohorts, or
performing sub-group analysis.