Vol.97 No.2 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 97 No. 2 February 2004
Synthetic Absorbable Suture for the Neck Skin Closure
Shinji Suzuki, Kazuhiko Shoji, Satoshi Ikegami, Miyuki Marumo,
Yo Kishimoto and Tsuyoshi Kojima
(Tenri Hospital)
Shinichi Takagita
(Kyoto National Hospital)
Yasutaka Kawata
(Shizuoka General Hospital)
In neck surgery, the exposed scars of the primary suture should be fine for favorable cosmetic results. We previously used subcuticular and epithelial nylon sutures, but recently we have been using monofilament synthetic absorbable sutures (Polydioxanone; PDS-II®) in subcuticular closure to avoid indurations beneath the skin and late foreign body reactions. The scars of surgical incisions closed with PDS-II® were not inferior to those with nylon sutures, and we report below.
In the prevention of hypertrophic scars, providing tensile relief and eliminating level differences of the skin are most important. The tensile strength of PDS-II® is retained for about 2 months, which is not long enough. Thus, subcuticular PDS-II® sutures require sufficient eversion to reduce scar stretching by providing dermal support for longer terms. We call this technique "hypereversion". This technique does not require the control of degree of eversion according to patient age, and allows uniform sutures.
Moreover, to get fine scars without suture marks, we are using film dressing
(Op-site®) for wound fixation instead of epithelial suture in the early post operative period. When epithelial suturing is eliminated, level differences of the skin must be avoided in the subcuticular closure.
Key words : neck surgery, PDS-II®, hypereversion