Additional Relaxing Suturing Using Absorbable Symmetric Barbed Sutures to Help Close Scalp Defects

Area of Science:

• Plastic Surgery
• Dermatology
• Pediatric Surgery

Background:

• Scalp wound closure is challenging due to limited skin extensibility, often resulting in significant hairless scarring.
• High-tension scalp areas require secure closure methods to prevent complications and minimize aesthetic defects.

Purpose of the Study:

• To evaluate the efficacy of a novel relaxing suture technique using an absorbable symmetric barbed suture for closing wide scalp defects in pediatric patients.
• To assess the technique's ability to achieve tension-free closure and minimize post-operative hairless alopecia.

Main Methods:

• A relaxing suture technique was employed in 7 pediatric patients with scalp defects, utilizing a 3-0 absorbable symmetric barbed suture (Stratafix Symmetric).
• The galea was sutured using a running subcutaneous technique, with wound edges approximated by pulling the barbed suture.
• Wound closure was completed with galeal and superficial suturing.

Main Results:

• The technique successfully approximated wide wound edges by pulling alone in all 7 patients, enabling tension-free closure.
• The mean width of the post-operative hairless scar was 3.3 ± 0.8 mm.
• No complications were observed during the follow-up period.

Conclusions:

• The absorbable symmetric barbed suture relaxing technique provides an effective and safe method for closing challenging scalp defects in pediatric patients.
• This innovative approach significantly minimizes hairless scarring and scalp alopecia, improving aesthetic outcomes.
• The technique offers a valuable adjunct for reconstructive surgery in high-tension scalp areas.