Use of 5-0 Fast Absorbing Gut versus 6-0 Fast Absorbing Gut during cutaneous wound closure on the head and neck: A randomized evaluator-blinded split-wound comparative effectiveness trial

J Am Acad Dermatol. 2019 Jul;81(1):213-218. doi: 10.1016/j.jaad.2019.02.037. Epub 2019 Feb 21.


Background: Absorbable suture material (Fast Absorbing Gut [FG], Ethicon, Somerville NJ) is often used for patient convenience; however, the optimal diameter of FG sutures is debatable.

Objective: To determine whether the use of 6-0 FG during repair of linear cutaneous surgery wounds on the head and neck improves scar cosmesis compared with the use of 5-0 FG.

Methods: This was a prospective, randomized, split-scar intervention in patients undergoing repair of linear cutaneous wounds on the head and neck. The scar was assessed 3 months after surgery via the Physician Observer Scar Assessment Scale (POSAS), a validated instrument.

Results: The difference in the sum of the POSAS component scores for 6-0 FG (12.03) compared with that for 5-0 FG (13.11) was not statistically significant (P = .26). Observer overall opinion was similar for both interventions, at 2.49 for 6-0 FG vs 2.64 for 5-0 FG (P = .54). The difference in the number of complications in the 5-0 FG group (15) vs the 6-0 FG group (10) was not statistically significant (P = .40).

Limitations: Single-center study with wounds limited to the head and neck in white individuals, with a predominance of men.

Conclusion: For linear repair of cutaneous wounds, 6-0 FG was not statistically different for cosmetic outcomes, scar width, and complications compared with 5-0 FG.

Keywords: 5-0; 6-0; Fast Absorbing Gut; cutaneous closure technique; cutaneous surgery; scar evaluation; suture caliber; suture diameter; suture size.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Catgut / adverse effects
  • Catgut / statistics & numerical data*
  • Cicatrix / prevention & control*
  • Dermatologic Surgical Procedures / methods
  • Female
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Male
  • Middle Aged
  • Mohs Surgery / methods*
  • Observer Variation
  • Single-Blind Method
  • Skin Neoplasms / pathology
  • Skin Neoplasms / surgery*
  • Suture Techniques
  • Sutures / adverse effects
  • Wound Healing / physiology*