Optimal closure of surgical wounds in forefoot surgery: are adhesive strips beneficial?

A subcuticular suture is an ideal closure method of surgical wounds where the aim is healing by primary intention. The addition of adhesive strips over the subcuticular suture appears to be based on anecdotal, rather than experimental evidence. We performed a prospective study to compare the postoperative wound complications of combination closure with subcuticular closure alone. The wounds of 60 consecutive patients undergoing foot surgery were assessed clinically for wound complications at one week postoperatively. Patients who had a combined closure were more likely to develop wound complications. They were also twice as likely to return to clinic for a further wound check. The addition of adhesive strips to such a closure appears to offer no clinical benefit, and can be detrimental to wound healing. We recommend meticulous closure of surgical wounds with continuous, absorbable, subcuticular suture without adhesive strips, for an optimal outcome.