Mario Donati and the Vertical Mattress Suture of the Skin

Abstract

Mario Donati (1879-1946) was one of the foremost European surgeons of the early 20th century. During an impressive carrier as surgeon, teacher, and innovator he authored more than 200 scientific works. Already as a young teacher he won the admiration of his colleagues: "His lectures were models of clarity and conviction, his originality and brilliance as a surgeon have well earned [him] a place among the most famous of the clinical masters of surgery of all eras" (Mario Donati. J. Int. Coll. Surg. 1946;9:739). The present review offers a brief biographical sketch of Donati's life and career, presents an eyewitness account of the origin of the Donati stitch, and discusses a possible precursor of this suture technique in the Middle Ages. On the occasion of the 60th anniversary of the end of World War II, the authors would like to pay a special homage to Mario Donati, who due to his Jewish ancestry was removed from his office as Professor of Surgery at the University of Milan in 1938 and died shortly after his return from exile in Switzerland.

A Prospective Study Evaluating Incision Placement and Wound Healing for Tibial Plafond Fractures

“…No self-retaining retractors were used. Finally, the skin closure was optimized with a combination of the Allgower modification of the Donati stitch (14) with full-length steri-strips to minimize the skin closure tension.…”

“…For anterolateral approaches, repair of the extensor retinaculum was completed to prevent bowstringing of the extensor tendons. Skin was closed using the Allgower modification of the Donati stitch 14 with the knots placed opposite the at-risk skin bridge. Elastic steri-strips were then applied between each suture to achieve additional incisional support without further cutaneous disruption.…”

Early repair of open abdomen with a tailored two-component mesh and conditioning vacuum packing: a safe alternative to the planned giant ventral hernia

“…For vacuum conditioning, a polyurethane sponge (KCI-Medical, USA) was tucked laterally beneath the subcutaneous tissue. The skin of the proximal and distal wound poles was closed with strong Donati sutures (e.g., with PP 2-0 USP) [15, 16]. The wound was sealed over the polyurethane sponge with adhesive foil, the “suction cup” affixed and continual vacuum therapy begun at 125 mmHg (Fig.…”

Distance of insertion points in a mattress suture from the wound margin for ideal primary closure in alveolar mucosa: an in vitro experimental study

“…The vertical mattress suture technique has frequently been recommended for various oral regenerative surgical procedures, such as in guided tissue regeneration [ 1 ], minimally invasive surgery [ 2 ], and guided bone regeneration [ 3 4 ]. This suture technique was initially introduced for dermal tissue based on the advantages of precise adaptation, an everting wound margin, and movement of the tension away from the margin [ 5 ]. The vertical mattress suture is also used in dentistry for the same purposes; that is, resisting muscle pulling, everting the wound margins, and firmly adapting the tissue flaps to underlying structures such as bones, regenerative membranes, and implants [ 6 7 ].…”

“…In addition, the farther insertion points in a mattress suture cannot be used to apply force in an appropriate direction for ensuring margin adaptation by tightening the suture. Further, it has been suggested that the near-near insertion point should be as superficial as possible [ 5 ], and that when the near-near insertion point is far from the wound margin, healing is delayed and/or compromised due to an “eversion-inversion phenomenon” at the 2 wound margins that remain unsupported [ 16 ]. However, there has been no systematic assessment of how the distance of the insertion point from the wound margin in the vertical mattress suture influences the pattern of primary wound closure in gingival and oral mucosal incisional wounds.…”