Influence of suturing technique on wound healing and patient morbidity after connective tissue harvesting. A randomized clinical trial.

ABSTRACT

OBJECTIVES: The aims of this randomized clinical trial were to investigate the influence of the suturing technique and the thickness of the pre- and postoperative palatal and flap mucosa on the early healing of the palate after harvesting a connective tissue graft. Furthermore, patient pain perception was evaluated. MATERIAL AND METHODS: A subepithelial connective tissue graft was obtained from the palate with a single horizontal incision technique. Patients were randomly assigned to continuous interlocking suture group or criss-cross suture group. The thickness of the palatal mucosa and residual palatal flap was measured; however, these variables were not randomized. One week postoperatively, the donor site wound healing was recorded by the modified rate of early healing index (EHI). Patient's pain perception was assessed by a visual analogue scale. RESULTS: Thirty-six patients were evaluated. No statistically significant differences were found between suturing technique and wound healing (p = 0.215). Statistically significant differences were found between postoperative flap thickness and EHI at 1, 3 and 6 mm from the incision line (p < 0.001). Negative correlations reaching statistical significance were found between the number of days of discomfort and residual flap thickness measured at 1, 3 and 6 mm. CONCLUSIONS: No association between the suture technique and the EHI was observed. Moreover, postoperative palatal flap thickness was associated with early wound healing of the donor site. Finally, the greater the postoperative palatal flap thickness, the less intensity of the pain perceived by patients.