Intradermal buried vertical mattress suture as sole skin closure: evaluation of 149 cases

Various buried suture techniques have been reported for dermatological surgery, but in most cases, superficial non-absorbable sutures are placed additionally. The aim of this study was to evaluate whether the intradermal buried vertical mattress suture can be safely used without additional skin suturing. Following 149 procedures in 126 patients, the colour and dehiscence of the scar and the presence of hypertrophy, granulomas or keloids were analysed. The cosmetic results were excellent to good in 78.5%, satisfactory in 19.5% and poor in 2%. Single additional superficial sutures had to be placed in only 14.7%. Suture marks were absent. Hypertrophic scarring was significantly more frequent in scars sutured with polyglactine than in scars sutured with polydioxanone. Early wound dehiscence, secondary wound healing and infection due to missing superficial skin sutures did not occur. This suture technique is safe, easy and fast to perform, and achieves good cosmetic results without leaving suture marks.