Horizontal Mattress Sutures with Gauze Support for the Closure of Primary Non-closable Skin Defects: A Simple and Inexpensive Technique

Abstract

INTRODUCTION: The study examined the feasibility of a suturing technique involving the use of horizontal mattress sutures with gauze support, which is based on the distribution of tensile forces over a wider area and the use of mechanical creep and stress relaxation of skin, for primary or staged closure of skin defects. METHODS: A total of 15 wounds of eight patients were included. Direct wound closure was not possible in any of these wounds and all wounds were closed using horizontal sutures supported by gauzes where a gauze was placed between suture material and skin to spread the pressure over a wider area. Defects were closed either primarily or gradually. RESULTS: Size of the wounds ranged between 1.5 x 1.5 cm and 17 x 11cm. Successful skin edge apposition could be successfully accomplished in all fifteen wounds using the technique described herein. In one patient, skin apposition failed subsequently, and the patient was managed with skin grafting; thus, conventional methods including skin grafts/flaps or secondary healing could be avoided in the remaining patients. No scar-related complications occurred during follow-up (mean duration, 8 months) after wound healing. DISCUSSION AND CONCLUSION: Preliminary results of this simple technique suggest that the technique has the potential to be used for the closure of primary non-closable wounds with low complication rate.

Keywords

• large skin defect
• horizontal mattress suture
• suture support
• wound dehiscence
• primary closure
• suture failure