Abstract
Dear Sir,
I appreciate the authors’ work and have several questions:
The authors claim that there were cost savings for the absorbable sutures in both the article’s abstract and conclusion. However, the article does not state how these cost savings were measured. Were the absorbable sutures less costly than the non-absorbable sutures? Was the time needed to remove non-absorbable sutures considered to be an added cost compared with the time of a routine follow-up visit without suture removal? Perhaps the absorbable sutures were more costly than the non-absorbables, but there was a net savings when suture cost differential was combined with the suture removal time savings? Additionally, are the authors implying that they did not review their absorbable suture patients at 14 days and thus were able to save the costs of that visit for both their institution and their patients? In these troubled economic times, a further explanation of what data were used to prove cost savings would be appreciated.
The authors used the Patient and Observer Scar Assessment Scale (POSAS) scoring system to assess scar appearance and pain. They assumed that this scoring system was interval based and that statistical significance could be ascertained using a parametric test. However, the POSAS scoring system is not interval based, but ordinal based. A POSAS score of six is not twice the value of score of three. The developers of POSAS knew that it was only an interval-based system because, when they validated it in comparison with visual analogue scale scores, they used a Spearman’s rho, a nonparametric test, rather than Pearson’s r, the correlation test for parametric samples (van de Kar et al., 2005). The authors used the Student’s t-test, which is a parametric test. I suggest that the authors use a nonparametric test, determine if there was any statistical significance in pain between the groups, and inform us of their findings.