A technique for subcutaneous knot inversion following running subcuticular closures

Area of Science:

• Surgical technique
• Wound closure
• Dermatologic surgery

Background:

• Standard subcuticular closures often result in the completion knot being too close to the epidermis.
• This proximity can lead to complications such as stitch abscesses and suture extrusion.
• These complications can negatively impact patient recovery and cosmetic outcomes.

Purpose of the Study:

• To describe a simple technique for subcutaneous placement of completion knots in subcuticular sutures.
• To demonstrate how this technique can reduce the incidence of stitch abscesses and suture extrusion.
• To offer an improved method for subcuticular wound closure.

Main Methods:

• A technique involving the deliberate placement of the completion knot in the subcutaneous tissue is detailed.
• This method is applied following the completion of standard subcuticular suturing.
• The focus is on ensuring the knot is not exposed to the epidermal layer.

Main Results:

• The described technique leads to fewer instances of stitch abscesses compared to standard methods.
• Suture extrusion is also significantly reduced by burying the completion knot.
• This results in a cleaner and potentially more aesthetically pleasing wound closure.

Conclusions:

• Subcutaneous placement of completion knots is a simple yet effective modification for subcuticular sutures.
• This technique minimizes common complications associated with epidermal knot placement.
• It offers a valuable improvement for surgeons performing wound closure procedures.