Purpose: To compare the degree of satisfaction of patients and observers about scars secondary to skin incisions in oculoplastic surgery performed with cold blade versus Colorado microcautery needle.
Methods: A cross-sectional noninferiority comparative study was performed. Eighty patients undergoing surgery for blepharoptosis repair, lateral tarsal strip, or dacryocystorhinostomy with cold blade or Colorado needle between January 2011 and July 2011 were included. Groups were paired by sex and surgery type. Scars were assessed between January 2012 and July 2012 using 2 validated scales (Patient and Observer Scar Assessment Scale [POSAS] and Vancouver Scar Scale [VSS]) by the patient and 2 trained observers. Sample size was predetermined, and 38 patients were needed in each group to detect differences of at least 8 points in the POSAS with 90% power.
Results: Patients operated with Colorado needle were 7.3 years older than those operated with cold blade (p = 0.007). No statistically significant differences between both techniques were observed either in the individual items or in the composite scores, correcting for age (POSAS, p = 0.518; VSS, p = 0.367). Multiple linear regression analysis showed that patients undergoing dacryocystorhinostomy had significantly lower scores in OSAS (p= 0.034) and VSS (p = 0.034), independent of the other variables in the model. No association between the surgical instrument and the final score was observed for any of the analyzed scales.
Conclusions: Esthetic results of periocular scars secondary to skin incisions performed with cold blade or Colorado needle are clinically similar in Spanish patients. Esthetic result of dacryocystorhinostomy scars showed lower scores in OSAS and VSS.