Intracutaneous butterfly suture with absorbable synthetic suture material. Technique, tissue reactions, and results

J Dermatol Surg Oncol. 1993 Jul;19(7):607-10. doi: 10.1111/j.1524-4725.1993.tb00398.x.

Abstract

Background: Tension on surgical wound edges is often an obstacle to proper closure and good cosmetic results in dermatologic surgery.

Objective: A buried, butterfly-shaped, interrupted suture has been developed to remedy this. The suture is anchored very broadly in the corium, the knot is below the corium. The butterfly suture can be supplemented by a temporary running suture or by close-set, superficially placed interrupted sutures.

Methods: This technique was studied in a follow-up of 876 operations, with histologic study of 60 scars resulting from the suture. In particular, the specific advantages and disadvantages of two synthetic suture materials were compared: monofilament (polydioxanon) and polyfilament (polyglactin 910).

Results: Polydioxanon sutures were found to be clinically superior. It was important, however, that the suture knot be deeply anchored and that the surgeon be experienced.

Conclusion: Cosmetic results of 18,000 procedures with this suture over a period of 6 years were found to be clearly better than those of surgery with conventional sutures.

MeSH terms

  • Absorption
  • Cicatrix, Hypertrophic / etiology
  • Dermatologic Surgical Procedures
  • Esthetics
  • Giant Cells, Foreign-Body / pathology
  • Granulocytes / pathology
  • Humans
  • Polydioxanone* / adverse effects
  • Polydioxanone* / chemistry
  • Polyglactin 910* / adverse effects
  • Polyglactin 910* / chemistry
  • Skin / pathology
  • Stress, Mechanical
  • Surface Properties
  • Surgical Wound Dehiscence / etiology
  • Suture Techniques* / adverse effects
  • Sutures* / adverse effects

Substances

  • Polydioxanone
  • Polyglactin 910