Assessment of Materials to Prevent Sutures Cutting Through Atrophic Skin

Sutures can tear through thin skin, especially in the elderly. To reinforce thin skin, several materials have been suggested through which sutures may be placed.

To evaluate the relative tear-through resistance to suture provided by various materials applied to a skin substitute.

We measured the force needed for 3-0 polypropylene suture to tear through an artificial skin substitute, both alone and after various materials were applied. These materials included wound closure tapes, nonwoven polyester tape, hydrocolloid dressing, polyethylene film, and cyanoacrylate glue. The Student t-test and one-way analysis of variance were used to determine differences in the mean forces.

Reinforced wound closure tape and nonwoven polyester tape were superior to the other materials, and provided a 3.1-fold and 3.6-fold increase in tear-through resistance, respectively, compared with skin substitute alone (p < .001). Orientation of wound closure tape and nonwoven polyester tape with their reinforcing fibers placed parallel to the skin substitute edge provided increased tear-through resistance compared with perpendicular placement. Affixing these latter materials with liquid adhesive also improved holding strength.

Reinforced wound closure tape and nonwoven polyester tape, when applied to a skin substitute, provide significantly increased tear-through resistance to suture compared with skin substitute alone.