Scientific basis for the selection of skin closure techniques
Richard F Edlich1, K Gubler, Anne G Wallis
1Biomedical Engineering and Emergency Medicine, University of Virginia Health System, Charlottesville, VA, USA. richardedlich@gmail.com
Summary
This guide details suture and needle selection for skin wound repair. It recommends specific sutures like polybutester (VASCUFIL™) for non-absorbable needs and MAXON™ for absorbable dermal closure, emphasizing continuous techniques.
Area of Science:
- Surgical Innovation
- Biomaterials Science
- Wound Healing Research
Background:
- Suture and needle selection are critical for effective skin incision repair.
- Understanding wound strength gain influences decisions on suture removal and patient activity.
- Sterile surgical practices, including double-gloving with hole indication systems, are essential.
Purpose of the Study:
- To educate on the scientific basis of suture and needle choice for wound repair.
- To illustrate appropriate surgical techniques for skin incision closure.
- To guide selection between absorbable and nonabsorbable sutures based on degradation rates.
Main Methods:
- Categorization of sutures based on in vivo degradation (absorbable vs. nonabsorbable).
- Evaluation of suture mechanical performance in vitro and in vivo.
- Assessment of continuous versus interrupted suture closure techniques.
Main Results:
- Polybutester suture (VASCUFIL™) is favored for nonabsorbable skin closure.
- Synthetic monofilament MAXON™ is recommended for absorbable dermal closure, with complete absorption in 90-110 days.
- Continuous percutaneous suture closure offers advantages over interrupted methods.
Conclusions:
- MAXON™ monofilament absorbable suture with a SURGALLOY™ reverse cutting needle is ideal for continuous dermal closure.
- Proper suture and needle selection, alongside technique, optimizes wound repair outcomes.
- Adherence to sterile protocols, including advanced glove systems, is paramount in surgical settings.
