Continuous
sutures and interrupted
sutures have been widely applied to skin closure after non-
obstetric surgery or traumatic
wounds. Usually, continuous
sutures were divided into transdermal or subcuticular
sutures according to whether the stitches were placed through or below the epidermal layer. Interrupted
sutures, on the other hand, involved penetration of the loose connective tissue beneath the skin layers, with stitches placed through the external skin layer. Complications including
infection, dehiscence, and poor cosmetic appearance were not rare after suturing. Whether a
suture method is a suitable option for rapid wound healing and long-term cosmetic appearance remains controversial. To examine the potential benefits and harms of continuous skin
sutures vs interrupted skin
sutures in non-
obstetric surgery or traumatic
wounds. Searching websites such as PubMed, the Cochrane Central Library, Web of Science and Embase, and ClinicalTrials.gov were systematically searched up to 5 January 2022 and were assessed and guided by Preferred Reporting Items for Systematic Reviews and Meta-analysis rules as well as guidelines. All relevant randomised controlled studies comparing continuous
sutures with interrupted
sutures of skin closure were analysed. The
suture techniques and material used in each trial were recorded. The transdermal and subcuticular continuous
sutures were separately compared with interrupted
sutures in the subgroup analysis of dehiscence and cosmetic appearance because the visual appearance of these two continuous suturing techniques was significantly different. Ten studies including 1181 participants were analysed. Subcuticular continuous
sutures had comparatively higher visual analogue scale (VAS) scores among patients and doctors than interrupted
sutures (OR = 0.27, 95% Confidence Intervals [CI] = 0. 07-0.47, P < .01). Similarly, priority was found regarding transdermal continuous
sutures and interrupted
sutures (OR = 0.40, 95% CI = 0.21-0.60, P < .01). Five randomised controlled trials (RCTs) demonstrated relevant data about dehiscence events. The incidence of continuous
suture was significantly lesser than that of interrupted
suture (OR = 0.16, 95% CI = 0.07-0.37, P < .01). There was no significant difference between the
infection events rates of two
suture methods (OR = 0.69, 95% CI = 0.40-1.21, P = .62, I2 = 0%). This systematic review indicated the superiority of both transdermal and subcutaneous continuous
sutures over interrupted
sutures in skin closure in terms of wound healing and cosmetic appearance.