Double-Loop Dermal Suture: A Technique for High-Tension Wound Closure.

Abstract

Direct closure of gaping wounds, which is common in body contouring surgery, is challenging for all surgeons regardless of their level of experience. Although multilayer suture techniques may help achieve even distribution of tension, the initial stitches often require considerable technical effort. Modified suturing techniques, such as the buried pulley technique that combines 2 or more crossing stitches, facilitate high-tension wound closure.1,2 These suture techniques utilize multiple crossing stitches to distribute tension throughout a large area, making wound closure easier. However, the multiple stitches and large amount of suture material inside the wound increase the risk of infection and suture spitting.3 Moreover, these modified techniques produce an extended area of undue tension in the wound margins, which may negatively impact the wound-healing process.4 Although traditional manual knot tying is effective for closing wounds that require high tension, it wastes a large amount of suture material, which is problematic economically. Techniques in which a surgical assistant secures the initial knot with a needle holder, and the tie is completed without tension on the suture tails, may be useful but require assistance from another person. The double-loop dermal …