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"Running pleated" suture technique opposes wound edges of unequal lengths
David J Kouba1, Stanley J Miller
1Department of Dermatology, University of Maryland, Baltimore, and The Kenilworth Surgery Center, Towson, Maryland 21204, USA.
Background:
Cutaneous advancement flaps, such as the T-plasty or H-plasty, are commonly used in order to relocate standing cones away from critical structures. In this process, what would have been the tips of a standard elliptical closure are displaced laterally as Burrow's triangles. This method creates additional terminal incision lines, perpendicular to the force vector of the flap.
Objective:
To describe a suture technique commonly employed in our practice that eliminates the need for such Burrow's triangles, hence minimizing suture lines and enhancing cosmesis.
Materials And Methods:
Through the described "running pleated" suture technique, excess tissue created by flap advancement is distributed equally along the entire length of the incision.
Results:
All patients did well postoperatively with excellent wound healing and superior cosmetic outcomes.
Conclusion:
The "running pleated" suture technique obviates the need for large, laterally displaced Burrow's triangles that are normally created during the construction of flaps such as the T-plasty and H-plasty and can be a powerful tool in the armamentarium of any dermatologic surgeon.
