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Aim: The aesthetic results of thyroidectomy have been evaluated in a prospective single-blinded randomized study, Material of Study: 140 patients undergoing thyroid surgery were randomized for skin closure into 4 groups: (1) intradermal non-absorbable suture; (2) intradermal non-absorbable double layer suture; (3) staples; (4) tissue adhesive. 136 out of the 140 patients were followed up at 3 months postoperatively. Scars were evaluated by a blinded plastic surgeon using the mVSS tool (modified Vancouver Scar Scale). Patients completed the PSAS form (Patient Scar Assessment Scale)., Results: Assessment of wound cosmesis with the mVSS revealed no statistical difference between group (1), (2) and (3); a statistically significant difference in the results with the group (4) (p = 0.0020) was found. The analysis of the results of PSAS showed very good subjective outcomes in all groups. However, the median values of PSAS at 3 months are better (p = 0.0001) for the group (1): follow results of group (2), (3) and (4). In some cases, the subjective rating in the group of women has been even higher than that reported by the blinded specialist., Discussion: (1) still represents the gold standard in thyroidectomy. Conceptually the ideal technique should be (2): removing the suture (after two weeks from surgery) all problems related to the stimulus from foreign body are eliminated., Conclusions: The choice of suture technique to use depends on the skill and experience of the single surgeon. All four types of suture, if performed correctly, have given very attractive subjective and objective results.

The aim of the study was to draw up a management protocol in thyroid surgery promoted by the Italian Association of Endocrine Surgery Units (Club delle UEC), shared by the experts and applied by the operators in the sector. The management protocols already presented in February 2002 and drawn up by the first Author of the present publication on the occasion of the current review were examined by the I Consensus Conference called on the topic by the Italian Endocrine Surgery Units. The conference comprised two distinct sessions, the first on 18 June 2005 within the framework of the 4th National Congress of the Club delle UEC in Naples, and the second on 17 September 2005 within the framework of the 8th Multidisciplinary Scanno Prize Meeting. A selected board of endocrinologists and endocrine surgeons, chaired by Aldo Pinchera and comprising the first nine Authors of this paper, examined the individual chapters in close collaboration with the other Authors, comparing their findings with the opinions of the experts cited in the text and submitting the consensus text for the approval of all those present. The diagnostic, therapeutic and healtcare management protocols in thyroid surgery approved by the I Consensus Conference are officially those proposed by the Italian Association of Endocrine Surgery Units (Club delle UEC) and are subject to review by October 1, 2007.