The research progress of tension-reducing suture of deep layer skin_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Liangliang ¹ ,  DENG Chengliang ^1,2

1. Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi Guizhou, 563003, P. R. China;
2. Collaborative Innovation Center for Tissue Damage Repair and Regenerative Medicine, Zunyi Guizhou, 563003, P. R. China;

Corresponding author：

DENG Chengliang, Email: cheliadeng@sina.com

Keywords：

Deep tension-reducing sutures; incision tension; scar

DOI：

10.7507/1002-1892.202201042

Video：

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Objective To provide systematic information for deep understanding and improvement of tension-reducing suture of deep layer skin. Methods The related literature over the years was extensively collected and precisely processed to summarize the characteristics and applications of different tension-reducing suture of deep layer skin. Results Throughout the development of plastic surgery, tension-reducing suture of deep layer skin mainly includes vertical mattress suture and its modified styles, horizontal mattress suture and its modified styles, and some special types of suture technique, and each one of them has its own characteristics and is suitable for wounds with different tension and shape. Conclusion Clinically, surgeons need to select appropriate tension-reducing suture techniques according to specific factors such as wound location and tension, so as to fully reduce the tension of the wound, which can achieve good wound healing and prevent the pathological scaring.

Citation： WANG Liangliang, DENG Chengliang. The research progress of tension-reducing suture of deep layer skin. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(5): 648-652. doi: 10.7507/1002-1892.202201042 Copy

1.	Gibson JAG, Ackling E, Bisson JI, et al. The association of affective disorders and facial scarring: Systematic review and meta-analysis. J Affect Disord, 2018, 239: 1-10.
2.	Cihan A, Cihan E. Interrelation between appearance anxiety and sexual functions in women: The role of surgical scars, morphologic features, and accompanying depression. J Sex Med, 2019, 16(11): 1769-1778.
3.	Wong VW, Akaishi S, Longaker MT, et al. Pushing back: wound mechanotransduction in repair and regeneration. J Invest Dermatol, 2011, 131(11): 2186-2196.
4.	Li K, Nicoli F, Xi WJ, et al. The 1470 nm diode laser with an intralesional fiber device: a proposed solution for the treatment of inflamed and infected keloids. Burns Trauma, 2019, 7: 5. doi: 10.1186/s41038-019-0143-6.
5.	Kazmer DO, Eaves FF. Force modulating tissue bridges for reduction of tension and scar: finite element and image analysis of preclinical incisional and nonincisional models. Aesthet Surg J, 2018, 38(11): 1250-1263.
6.	Barnes LA, Marshall CD, Leavitt T, et al. Mechanical forces in cutaneous wound healing: Emerging therapies to minimize scar formation. Adv Wound Care (New Rochelle), 2018, 7(2): 47-56.
7.	Adams B, Levy R, Rademaker AE, et al. Frequency of use of suturing and repair techniques preferred by dermatologic surgeons. Dermatol Surg, 2006, 32(5): 682-689.
8.	Daneshpazhooh M, Behjati J, Hashemi P, et al. Thyroid autoimmunity and pemphigus vulgaris: is there a significant association? J Am Acad Dermatol, 2010, 62(2): 349-351.
9.	Yag-Howard C. Novel surgical approach to subcutaneous closure: the subcutaneous inverted cross mattress suture (SICM suture). Dermatol Surg, 2011, 37(10): 1503-1505.
10.	Jeon IK, Kim JH, Roh MR, et al. The subcutaneous inverted cross mattress suture (SICM suture) in our experience. Dermatol Surg, 2013, 39(5): 794-795.
11.	Yag-Howard C. Zipper suture: a novel aesthetic subcutaneous closure. Dermatol Surg, 2013, 39(9): 1400-1402.
12.	Maher IA, Bingham J, Mellette R. A running modification of the percutaneous buried vertical mattress. Dermatol Surg, 2012, 38(9): 1560-1562.
13.	Zhang X, Diao JS, Guo SZ, et al. Wedge-shaped excision and modified vertical mattress suture fully buried in a multilayered and tensioned wound closure. Aesthetic Plast Surg, 2009, 33(3): 457-460.
14.	Liu Z, Tang Z, Hao X, et al. Modified buried vertical mattress suture versus buried intradermal suture: A prospective split-scar study. Dermatol Surg, 2021, 47(3): e75-e80.
15.	Wang AS, Kleinerman R, Armstrong AW, et al. Set-back versus buried vertical mattress suturing: results of a randomized blinded trial. J Am Acad Dermatol, 2015, 72(4): 674-680.
16.	Kantor J. The pulley set-back dermal suture: an easy to implement everting suture technique for wounds under tension. J Am Acad Dermatol, 2015, 72(1): e29-e30.
17.	Kantor J. The running set-back dermal suture. J Am Acad Dermatol, 2015, 72(6): e163-e164.
18.	Kantor J. The percutaneous set-back dermal suture. J Am Acad Dermatol, 2015, 72(2): e61-62.
19.	Kantor J. The running percutaneous set-back dermal suture. J Am Acad Dermatol, 2015, 73(2): e57-e58.
20.	Yang XY, Zhou TT, Cao L. A simple positioning technique for set-back suture. J Am Acad Dermatol, 2020. doi: 10.1016/j.jaad.2020.11.031.
21.	Parietti M, Susca S, Ribero S. A new suture technique for flap closure in dermatologic surgery. J Am Acad Dermatol, 2020. doi: 10.1016/j.jaad.2020.11.024.
22.	Namazi MR. A novel suture for closure of wounds having dead space to eliminate the risk of hematoma and seroma formation. J Am Acad Dermatol, 2019, 81(6): e167-e168.
23.	Zuber TJ. The mattress sutures: vertical, horizontal, and corner suture. Am Fam Physician, 2002, 66(12): 2231-2236.
24.	See A, Smith HR. Partially buried horizontal mattress suture: modification of the Haneke-Marini suture. Dermatol Surg, 2004, 30(12 Pt 1): 1491-1492.
25.	Alam M, Goldberg LH. Utility of fully buried horizontal mattress sutures. J Am Acad Dermatol, 2004, 50(1): 73-76.
26.	Meng F, Andrea S, Cheng S, et al. Modified subcutaneous buried horizontal mattress suture compared with vertical buried mattress suture. Ann Plast Surg, 2017, 79(2): 197-202.
27.	Eleftheriou LI, Weinberger CH, Endrizzi BT, et al. The victory suture: a novel running v-shaped horizontal mattress suturing technique. Dermatol Surg, 2011, 37(11): 1663-1665.
28.	Breuninger H, Keilbach J, Haaf U. Intracutaneous butterfly suture with absorbable synthetic suture material. Technique, tissue reactions, and results. J Dermatol Surg Oncol, 1993, 19(7): 607-610.
29.	Kantor J. The running butterfly suture: A novel, everting alternative to the running subcuticular technique. J Am Acad Dermatol, 2016, 74(1): e19-e20.
30.	Starr J. Surgical pearl: the vertical mattress tip suture. J Am Acad Dermatol, 2001, 44(3): 523-524.
31.	Chan JL, Miller EK, Jou RM, et al. Novel surgical technique: placement of a deep tip suture. Dermatol Surg, 2009, 35(12): 2001-2003.
32.	Kim BY, Chun SH, Kim IH. The modified purse-string suture: A useful technique for the repair of cutaneous surgical wounds. J Am Acad Dermatol, 2017, 77(5): e131-e132.
33.	McCue J, Kalliainen LK. Use of a purse-string suture to reduce skin graft requirements. Ann Surg Oncol, 2018, 25(2): 471-474.
34.	Wu W, Chavez-Frazier A, Migden M, et al. The buried half horizontal, half vertical mattress suture: A novel technique for wound edges of unequal lengths. Dermatol Surg, 2016, 42(12): 1391-1393.
35.	陈珺, 章一新. 章氏超减张缝合在闭合高张力创面中的临床应用效果. 中华烧伤杂志, 2020, 36(5): 339-345.
36.	常树森, 莫小金, 魏在荣, 等. 遵义缝合法在股前外侧皮瓣供区缝合中的应用研究. 中国修复重建外科杂志, 2021, 35(4): 477-482.
37.	Kim OJ. William Stewart Halsted in the history of American surgery. Uisahak, 2003, 12(1): 66-87.
38.	Yag-Howard C. Sutures, needles, and tissue adhesives: a review for dermatologic surgery. Dermatol Surg, 2014, 40 Suppl 9: S3-S15.
39.	Summers BK, Siegle RJ. Facial cutaneous reconstructive surgery: general aesthetic principles. J Am Acad Dermatol, 1993, 29(5 Pt 1): 669-681.
40.	Smith TO, Sexton D, Mann C, et al. Sutures versus staples for skin closure in orthopaedic surgery: meta-analysis. BMJ, 2010, 340: c1199. doi: 10.1136/bmj.c1199.

1. Gibson JAG, Ackling E, Bisson JI, et al. The association of affective disorders and facial scarring: Systematic review and meta-analysis. J Affect Disord, 2018, 239: 1-10.
2. Cihan A, Cihan E. Interrelation between appearance anxiety and sexual functions in women: The role of surgical scars, morphologic features, and accompanying depression. J Sex Med, 2019, 16(11): 1769-1778.
3. Wong VW, Akaishi S, Longaker MT, et al. Pushing back: wound mechanotransduction in repair and regeneration. J Invest Dermatol, 2011, 131(11): 2186-2196.
4. Li K, Nicoli F, Xi WJ, et al. The 1470 nm diode laser with an intralesional fiber device: a proposed solution for the treatment of inflamed and infected keloids. Burns Trauma, 2019, 7: 5. doi: 10.1186/s41038-019-0143-6.
5. Kazmer DO, Eaves FF. Force modulating tissue bridges for reduction of tension and scar: finite element and image analysis of preclinical incisional and nonincisional models. Aesthet Surg J, 2018, 38(11): 1250-1263.
6. Barnes LA, Marshall CD, Leavitt T, et al. Mechanical forces in cutaneous wound healing: Emerging therapies to minimize scar formation. Adv Wound Care (New Rochelle), 2018, 7(2): 47-56.
7. Adams B, Levy R, Rademaker AE, et al. Frequency of use of suturing and repair techniques preferred by dermatologic surgeons. Dermatol Surg, 2006, 32(5): 682-689.
8. Daneshpazhooh M, Behjati J, Hashemi P, et al. Thyroid autoimmunity and pemphigus vulgaris: is there a significant association? J Am Acad Dermatol, 2010, 62(2): 349-351.
9. Yag-Howard C. Novel surgical approach to subcutaneous closure: the subcutaneous inverted cross mattress suture (SICM suture). Dermatol Surg, 2011, 37(10): 1503-1505.
10. Jeon IK, Kim JH, Roh MR, et al. The subcutaneous inverted cross mattress suture (SICM suture) in our experience. Dermatol Surg, 2013, 39(5): 794-795.
11. Yag-Howard C. Zipper suture: a novel aesthetic subcutaneous closure. Dermatol Surg, 2013, 39(9): 1400-1402.
12. Maher IA, Bingham J, Mellette R. A running modification of the percutaneous buried vertical mattress. Dermatol Surg, 2012, 38(9): 1560-1562.
13. Zhang X, Diao JS, Guo SZ, et al. Wedge-shaped excision and modified vertical mattress suture fully buried in a multilayered and tensioned wound closure. Aesthetic Plast Surg, 2009, 33(3): 457-460.
14. Liu Z, Tang Z, Hao X, et al. Modified buried vertical mattress suture versus buried intradermal suture: A prospective split-scar study. Dermatol Surg, 2021, 47(3): e75-e80.
15. Wang AS, Kleinerman R, Armstrong AW, et al. Set-back versus buried vertical mattress suturing: results of a randomized blinded trial. J Am Acad Dermatol, 2015, 72(4): 674-680.
16. Kantor J. The pulley set-back dermal suture: an easy to implement everting suture technique for wounds under tension. J Am Acad Dermatol, 2015, 72(1): e29-e30.
17. Kantor J. The running set-back dermal suture. J Am Acad Dermatol, 2015, 72(6): e163-e164.
18. Kantor J. The percutaneous set-back dermal suture. J Am Acad Dermatol, 2015, 72(2): e61-62.
19. Kantor J. The running percutaneous set-back dermal suture. J Am Acad Dermatol, 2015, 73(2): e57-e58.
20. Yang XY, Zhou TT, Cao L. A simple positioning technique for set-back suture. J Am Acad Dermatol, 2020. doi: 10.1016/j.jaad.2020.11.031.
21. Parietti M, Susca S, Ribero S. A new suture technique for flap closure in dermatologic surgery. J Am Acad Dermatol, 2020. doi: 10.1016/j.jaad.2020.11.024.
22. Namazi MR. A novel suture for closure of wounds having dead space to eliminate the risk of hematoma and seroma formation. J Am Acad Dermatol, 2019, 81(6): e167-e168.
23. Zuber TJ. The mattress sutures: vertical, horizontal, and corner suture. Am Fam Physician, 2002, 66(12): 2231-2236.
24. See A, Smith HR. Partially buried horizontal mattress suture: modification of the Haneke-Marini suture. Dermatol Surg, 2004, 30(12 Pt 1): 1491-1492.
25. Alam M, Goldberg LH. Utility of fully buried horizontal mattress sutures. J Am Acad Dermatol, 2004, 50(1): 73-76.
26. Meng F, Andrea S, Cheng S, et al. Modified subcutaneous buried horizontal mattress suture compared with vertical buried mattress suture. Ann Plast Surg, 2017, 79(2): 197-202.
27. Eleftheriou LI, Weinberger CH, Endrizzi BT, et al. The victory suture: a novel running v-shaped horizontal mattress suturing technique. Dermatol Surg, 2011, 37(11): 1663-1665.
28. Breuninger H, Keilbach J, Haaf U. Intracutaneous butterfly suture with absorbable synthetic suture material. Technique, tissue reactions, and results. J Dermatol Surg Oncol, 1993, 19(7): 607-610.
29. Kantor J. The running butterfly suture: A novel, everting alternative to the running subcuticular technique. J Am Acad Dermatol, 2016, 74(1): e19-e20.
30. Starr J. Surgical pearl: the vertical mattress tip suture. J Am Acad Dermatol, 2001, 44(3): 523-524.
31. Chan JL, Miller EK, Jou RM, et al. Novel surgical technique: placement of a deep tip suture. Dermatol Surg, 2009, 35(12): 2001-2003.
32. Kim BY, Chun SH, Kim IH. The modified purse-string suture: A useful technique for the repair of cutaneous surgical wounds. J Am Acad Dermatol, 2017, 77(5): e131-e132.
33. McCue J, Kalliainen LK. Use of a purse-string suture to reduce skin graft requirements. Ann Surg Oncol, 2018, 25(2): 471-474.
34. Wu W, Chavez-Frazier A, Migden M, et al. The buried half horizontal, half vertical mattress suture: A novel technique for wound edges of unequal lengths. Dermatol Surg, 2016, 42(12): 1391-1393.
35. 陈珺, 章一新. 章氏超减张缝合在闭合高张力创面中的临床应用效果. 中华烧伤杂志, 2020, 36(5): 339-345.
36. 常树森, 莫小金, 魏在荣, 等. 遵义缝合法在股前外侧皮瓣供区缝合中的应用研究. 中国修复重建外科杂志, 2021, 35(4): 477-482.
37. Kim OJ. William Stewart Halsted in the history of American surgery. Uisahak, 2003, 12(1): 66-87.
38. Yag-Howard C. Sutures, needles, and tissue adhesives: a review for dermatologic surgery. Dermatol Surg, 2014, 40 Suppl 9: S3-S15.
39. Summers BK, Siegle RJ. Facial cutaneous reconstructive surgery: general aesthetic principles. J Am Acad Dermatol, 1993, 29(5 Pt 1): 669-681.
40. Smith TO, Sexton D, Mann C, et al. Sutures versus staples for skin closure in orthopaedic surgery: meta-analysis. BMJ, 2010, 340: c1199. doi: 10.1136/bmj.c1199.

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