[Resorbable suture material in the human skin: tissue reaction and modified suture technic]

Two-stage excision of skin tumors provided an opportunity for histological evaluation of implanted PDS or Vicryl suture material. Our findings showed a weak or absent tissue response to PDS sutures that was detectable for up to 100 days and a moderately pronounced tissue response to Vicryl that, in rare cases, was evident for up to 80 days. The tissue response to both materials depended on the depth of the implanted suture material. A persistent inflammatory reaction was provoked particularly by Vicryl, a polyfilament suture, when it was embedded near the skin surface. Contact between parts of the suture and the skin surface, which is encouraged by the wick effect of the Vicryl suture, frequently led to suture infection. To avoid infections it is important to place the knot of the stich below the dermis, since the suture ends of the knot decrease the surface-suture distance. A more-or-less horizontal, butterfly-shaped interrupted suture that extends upward is recommended to ensure secure placement of the knot at the lower border of the corium.