Dermatologic Therapy, Vol. 28, 2015, 339–340 Printed in the United States All rights reserved
C 2015 Wiley Periodicals, Inc. V
DERMATOLOGIC THERAPY ISSN 1396-0296
THERAPEUTIC HOTLINE: LETTERS A proposal for a self removal suture (DZ suture) in dermatologic surgery A. Zucchi* & M. Zucchi† *Surgical Dermatology, Department of Clinical and Experimental Medicine, University of Parma, and †Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Emilia-Romagna, Italy
After a wound is sutured, a minimal scar and no need to return for suture removal would be ideal (1). Most patients are willing to remove, and capable of removing, their own sutures. This has been demonstrated in patients discharged from emergency department (2) and patients have also showed satisfaction (3). It is proposed the use of a new self removal suture applied to vertical mattress suture trapping one end of the wire with the loop of the wire itself (FIGS. 1 and 2). With this simple and fast technique, we have the eversion of the wound edges and no node (FIG. 3). It is recommended, whenever possible and especially in the areas subjected to a great tension, to make the subcutaneous suture before the DZ suture. All dermatologic surgeons know that it is difficult to remove the stitches of a standard vertical mattress suture, especially when the knots are deep set into the skin due, for example, to an unexpected and too rapid wound healing or noncompliance by the patient of the times set for removal of sutures. In this proposed variant
Address correspondence and reprint requests to: Prof. A. Zucchi, Surgical Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy, or email: [email protected].
FIG. 1. Scheme of the self removal suture.
FIG. 2. Wire movement.
339
Zucchi & Zucchi
Immediately after the self removal suture and after disinfection, the dermatologist surgeon applies a transparent polyurethane film dressing so that the patient can control the wound and also wash quietly. The removal of the stitches can be made by the patient at home, on the recommended day, with a tweezer for eyelashes.
References FIG. 3. Surgical wound after 10 days.
vertical mattress suture, the knot does not exist and, therefore, the above problem.
340
1. Thomas JA, Saleeby ER. The Aberdeen knot: a sliding knot for dermatology. Dermatol Surg 2012: 38: 121–123. 2. Macdonald P, Primiani N, Lund A. Are patients willing to remove, and capable of removing, their own non absorbable sutures? CJEM 2012: 14 (4): 218–223. 3. Doto TA, Killick SR. The use of a self-removal prolene suture after daycase laparoscopic surgery. Surg Laparosc Endosc Percutan Tech 2006: 16: 334–337.
C 2015 Wiley Periodicals, Inc. V
DERMATOLOGIC THERAPY ISSN 1396-0296
THERAPEUTIC HOTLINE: LETTERS A proposal for a self removal suture (DZ suture) in dermatologic surgery A. Zucchi* & M. Zucchi† *Surgical Dermatology, Department of Clinical and Experimental Medicine, University of Parma, and †Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Emilia-Romagna, Italy
After a wound is sutured, a minimal scar and no need to return for suture removal would be ideal (1). Most patients are willing to remove, and capable of removing, their own sutures. This has been demonstrated in patients discharged from emergency department (2) and patients have also showed satisfaction (3). It is proposed the use of a new self removal suture applied to vertical mattress suture trapping one end of the wire with the loop of the wire itself (FIGS. 1 and 2). With this simple and fast technique, we have the eversion of the wound edges and no node (FIG. 3). It is recommended, whenever possible and especially in the areas subjected to a great tension, to make the subcutaneous suture before the DZ suture. All dermatologic surgeons know that it is difficult to remove the stitches of a standard vertical mattress suture, especially when the knots are deep set into the skin due, for example, to an unexpected and too rapid wound healing or noncompliance by the patient of the times set for removal of sutures. In this proposed variant
Address correspondence and reprint requests to: Prof. A. Zucchi, Surgical Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy, or email: [email protected].
FIG. 1. Scheme of the self removal suture.
FIG. 2. Wire movement.
339
Zucchi & Zucchi
Immediately after the self removal suture and after disinfection, the dermatologist surgeon applies a transparent polyurethane film dressing so that the patient can control the wound and also wash quietly. The removal of the stitches can be made by the patient at home, on the recommended day, with a tweezer for eyelashes.
References FIG. 3. Surgical wound after 10 days.
vertical mattress suture, the knot does not exist and, therefore, the above problem.
340
1. Thomas JA, Saleeby ER. The Aberdeen knot: a sliding knot for dermatology. Dermatol Surg 2012: 38: 121–123. 2. Macdonald P, Primiani N, Lund A. Are patients willing to remove, and capable of removing, their own non absorbable sutures? CJEM 2012: 14 (4): 218–223. 3. Doto TA, Killick SR. The use of a self-removal prolene suture after daycase laparoscopic surgery. Surg Laparosc Endosc Percutan Tech 2006: 16: 334–337.
