Abstract:BACKGROUND
The modified buried vertical mattress suture (MBVMS) is believed to provide excellent outcomes by relieving the tension on wound edges. However, clinical data on the topic remain sparse and inadequate.
OBJECTIVE
To compare the cosmetic results of the MBVMS and the buried intradermal suture (BIS) in chest wounds using a split-scar model.
MATERIALS AND METHODS
Twenty patients participated in the stu… Show more
“…The modified buried vertical mattress suture (heart-shaped suture) is currently commonly used in obstetrics and other professions, and is gaining popularity in orthopedics, but its biomechanical benefits are rarely reported [ 27 ]. Because of the larger bite of dermis in a single stitch, its decompression effect should be superior to that of the intradermal buried vertical mattress suture (Fig.…”
Section: Discussionmentioning
confidence: 99%
“… Fig. 6 Cross-sectional view depicting the modified buried vertical mattress suture (heart-shaped suture) before (a) and after (b) knotting and the buried intradermal suture before (c) and after (d) knotting [ 27 ] …”
Background
Mechanical forces have an important role in the initiation and progression of orthopedic surgical incisions complications. To avoid incision complications with the reduction of dermal tension, surgeons may choose a buried continuous suture technique other than the traditional interrupted vertical mattress suture. Absorbable barbed sutures are widely used in orthopedics due to their convenience and reducing wound tension. The aim of this research is to compare and explain the advantages of running subcuticular suturing technique with absorbable barbed sutures for orthopedic surgical incisions closure.
Methods
Finite element models of layered skin and two different suture techniques, running subcuticular suture and intradermal buried vertical mattress suture, ware constructed. The mechanical property difference between standard sutures and barbed sutures was modelled using different contact friction coefficient. Pulling the skin wound was simulated, and the sutures’ pressure on the skin tissue was determined.
Results
Compared with traditional smooth sutures, the barbed sutures effectively increased the contact force for subepidermal layers, which led the less force variation between different layers. The results also suggested that subcuticular suture caused less stress concentration compared with intradermal buried vertical mattress suture.
Conclusions
In conclusion, our study indicated that running subcuticular suturing technique with absorbable barbed sutures for orthopedic surgical incisions closure results in more uniform stress distribution in the dermis. We recommend this combination as the preferred method of skin closure in orthopedic surgery unless contraindicated.
“…The modified buried vertical mattress suture (heart-shaped suture) is currently commonly used in obstetrics and other professions, and is gaining popularity in orthopedics, but its biomechanical benefits are rarely reported [ 27 ]. Because of the larger bite of dermis in a single stitch, its decompression effect should be superior to that of the intradermal buried vertical mattress suture (Fig.…”
Section: Discussionmentioning
confidence: 99%
“… Fig. 6 Cross-sectional view depicting the modified buried vertical mattress suture (heart-shaped suture) before (a) and after (b) knotting and the buried intradermal suture before (c) and after (d) knotting [ 27 ] …”
Background
Mechanical forces have an important role in the initiation and progression of orthopedic surgical incisions complications. To avoid incision complications with the reduction of dermal tension, surgeons may choose a buried continuous suture technique other than the traditional interrupted vertical mattress suture. Absorbable barbed sutures are widely used in orthopedics due to their convenience and reducing wound tension. The aim of this research is to compare and explain the advantages of running subcuticular suturing technique with absorbable barbed sutures for orthopedic surgical incisions closure.
Methods
Finite element models of layered skin and two different suture techniques, running subcuticular suture and intradermal buried vertical mattress suture, ware constructed. The mechanical property difference between standard sutures and barbed sutures was modelled using different contact friction coefficient. Pulling the skin wound was simulated, and the sutures’ pressure on the skin tissue was determined.
Results
Compared with traditional smooth sutures, the barbed sutures effectively increased the contact force for subepidermal layers, which led the less force variation between different layers. The results also suggested that subcuticular suture caused less stress concentration compared with intradermal buried vertical mattress suture.
Conclusions
In conclusion, our study indicated that running subcuticular suturing technique with absorbable barbed sutures for orthopedic surgical incisions closure results in more uniform stress distribution in the dermis. We recommend this combination as the preferred method of skin closure in orthopedic surgery unless contraindicated.
“… 33 The premise of WE-MBVMS is that wedge-shaped excision is performed first and then the needle is inserted in the subcutaneous tissue obliquely, enters the middermis repeatedly along an arc track, and involves the dermis as much as possible (Figure 3 D). 34 Current clinical trials have verified its good cosmetic effect and safety in high-tension wound closure. Liu's split-scar model showed that WE-MBVMS significantly increased wound eversion both immediately and postoperatively and performed significantly better on the scar assessment at the end of the 3-month follow-up period than intradermal buried sutures.…”
Section: Methodsmentioning
confidence: 99%
“…Liu's split-scar model showed that WE-MBVMS significantly increased wound eversion both immediately and postoperatively and performed significantly better on the scar assessment at the end of the 3-month follow-up period than intradermal buried sutures. 34,35 Similar to other subcuticular sutures, it is not useful for extremely thin dermis or tiny wounds. [19][20][21] Set-Back Suture Another super-tension-reduction suture was invented by Kantor in 2010, namely, the set-back suture.…”
Section: Wedge-section and Modified Buried Vertical Mattress Suturementioning
BACKGROUND
Subcuticular suture is an important technique for achieving optimum wound closure, and there has been no comprehensive summary of subcuticular sutures to date.
OBJECTIVE
To summarize the origin and development of interrupted subcuticular suture to help clinicians improve their wound closure skills.
MATERIALS AND METHODS
A comprehensive review of subcuticular suture techniques was conducted in PubMed to summarize the advantages and disadvantages of various methods and clinical indications.
RESULTS
Buried suture is the oldest subcuticular suture technique, followed by buried vertical mattress suture, intracutaneous butterfly suture, modified/variant buried vertical mattress suture, intradermal buried vertical mattress suture, buried horizontal mattress suture, wedge-section and modified buried vertical mattress suture, set-back suture, and modified buried horizontal mattress suture, which have gradually been applied in clinical practice. Buried vertical mattress suture is currently the most widely used subcuticular suture technique.
CONCLUSION
Patients can certainly benefit from the appropriate application of subcuticular suture. There is also no single ideal method for achieving optimal results in all cases. Fully understanding the history of subcuticular suture can help doctors improve their wound closure technique.
“…To the Editor, To reduce dead space, inhibit scar hyperplasia, and improve aesthetic outcomes, modified buried vertical mattress sutures 1 are commonly used to close wounds. However, the method is most suitable for suturing low-tension wounds.…”
Section: Multi-gradient Buried Vertical Mattress Suture An Effective ...mentioning
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