J Surg Res. 2025 Dec 9;317:138-146. doi: 10.1016/j.jss.2025.11.034. Online ahead of print.
ABSTRACT
INTRODUCTION: Suturing often receives limited attention in undergraduate medical education. Many students graduate with inadequate proficiency, particularly in handling aesthetically sensitive wounds. In several countries, general practitioners frequently serve as first-line providers for trauma care and wound closure, yet often lack formal training in cosmetic or tension-free techniques. As a result, patients may suffer long-term physical disfigurement and psychological distress due to poorly executed wound repair. Principles emphasized in plastic surgery, including precision, tissue preservation, wound edge approximation, edge eversion, symmetry, and scar minimization, provide an effective framework for teaching high-quality suturing from the undergraduate level.
METHODS: This educational intervention enrolled 71 final-year international MBBS and BDS students who had previously received basic suturing instruction but had not been taught the principles of aesthetic wound closure. All participants attended a 3-4 h suturing workshop designed on plastic surgery principles of wound closure. The session included didactic instruction and hands on training using silicone skin models, focusing on layered closure, tension-free repair, edge eversion, and aesthetic alignment. Competency was assessed using a validated seven-domain, 35-point scorecard before and after training. A passing score of ≥28 was determined by expert consensus.
RESULTS: Seventy students completed the full assessment. The mean score increased from 14.8 ± 5.65 to 29.26 ± 3.21 (P < 0.001), with a large effect size (Cohen's d = 2.56). Passing rates improved from 1.4% to 80%, with significant gains across all technical and aesthetic domains.
CONCLUSIONS: A single-structured suturing workshop incorporating aesthetic wound closure principles significantly improved both technical and cosmetic competency. Integrating these principles into undergraduate curricula may help raise the standard of wound management and strengthen students' confidence for future clinical practice.
PMID:41370872 | DOI:10.1016/j.jss.2025.11.034