Sutures In Surgery Research Articles

Comparison of the Effects of Using Nylon Sutures versus Vicryl Sutures on Inflammation after Pterygium Surgery

Introduction: Until now, many surgical sutures have been used for pterygium surgery, but it has not yet been determined which suture thread is preferable for pterygium surgery. In this study, we compared the results of using two surgical sutures, Nylon and Vicryl.
 Methods: This study was conducted as a Randomized Clinical Trial (RCT) at Shahid Sadoughi Hospital. Seventy patients who were referred and met the criteria for pterygium surgery were assigned to two groups, A and B, each consisting of 35 individuals. Group A utilized the Nylon sutures while Group B utilized the Vicryl sutures. The examinations were performed in terms of study variables according to a questionnaire pre-determined by an ophthalmologist's assistant on the 1st day, 7th day, 4th, and 8th week after operation. The collected data were entered into STATA14 software and considering the qualitative nature of most dependent variables, the collected data were analyzed using Chi-square test.
 Results: According to all the obtained results, it could be concluded that a certain sutures could not be chosen especially better than other suture, because each one had its own advantages and disadvantages. But on a case-by-case basis, Vicryl suture could be recommended for patients who had come to the hospital from far away cities because it did not need to be pulled by the doctor and it created the feeling of the presence of a foreign body in the patient's eye, because it reduced the need to return to the hospital.
 Conclusion: In this study, we compared vicryl and nylon sutures in pterygium surgery, and for the first time among other similar studies, we investigated the rate of knot untying of the sutures, and came to the conclusion that each of the nylon sutures and Vicryl has its advantages and disadvantages, but due to the fact that in the Vicryl thread group, the presence of a body was felt less and it did not need to be pulled, we recommended it for the patients visiting from distant cities. It is suggested to compare vicryl and silk sutures in order to find the most suitable suture for pterygoid surgery.

Hysteroscopic suture of levonorgestrel-releasing intrauterine system: learning curve for in vitro simulation training.

To simulate hysteroscopic suturing in vitro and analyze the learning curve of gynecologists with different experience levels. Three gynecologists were trained on uterine models in a circulating water box. The posterior uterine wall was sutured 10 times under hysteroscopy for 5 consecutive days, and the time of each suture procedure was recorded. Doctors A, B, and C completed 50 posterior uterine sutures. After Dr. C completed 50 sutures on the posterior wall, he added 50 sutures on the anterior wall (Group D). The mean suturing time was 71.54 ± 68.158 s in Group A, 50.10 ± 28.060 s in Group B, 34.04 ± 10.457 s in Group C, and 30.38 ± 8.734 s in Group D. The difference between Groups C and B and between Groups B and A was statistically significant. There was no statistically significant difference between Groups C and D. Simulation curves were created using the number of features as the abscissa and cumulative sum as the coordinate, with peak curves of 19, 27, and 18 cases for Group A, B, and C, respectively. Doctors with experience in single-hole laparoscopic surgery or hysteroscopic suture surgery can significantly shorten the hysteroscopic suturing time.

Barbed vs. Conventional Sutures in Bariatric Surgery: Early and Late Outcomes

The implementation of barbed sutures appears to enhance the process of suturing and knot tying, particularly in the field of bariatric surgery, where they can offer significant advantages. The objective of this study is to evaluate the safety and effectiveness of utilising barbed sutures for gastric pouch-jejunal anastomosis (GPJA) and jejuno-jejunal anastomosis (JJA) anastomosis in Roux-en-Y Gastric Bypass (RYGB). Data from patients who underwent primary RYGB between January 2012 and October 2018 were retrospectively collected using Propensity Score Matching (PSM) to randomise groups (barbed sutures—BS-G and conventional sutures—CS-G). The primary outcome was postoperative early complications. The secondary outcomes were late complications (internal hernias and small bowel obstructions), operative time and postoperative hospital stay. A total of 969 patients were included. After PSM, 322 (161 in BS-G vs. 161 in CS-G) patients were compared (chi-square 0.287, p = 0.862). Postoperative early and late complications were comparable between the two groups. BS-G had a significantly shorter median operative time (65 vs. 95 min p < 0.001). Median postoperative hospital stay was significantly shorter for BS-G (2 vs. 5 days, p < 0.001). Barbed sutures effectively reduce the operation duration and are as safe as conventional sutures for closing anastomotic defects during RYGB.

Differences in Exposure to Minimally Invasive Surgery in a Sample of United States Obstetrics and Gynecology Residents.

The objective of this study was to assess the exposure to minimally invasive gynecologic surgery (MIGS) techniques among senior (third and fourth year) Obstetrics and Gynecology residents in the United States. We conducted an online cross-sectional survey among senior residents who completed a 19-item questionnaire regarding their exposure to laparoscopic and robotic cases and techniques and their access to their simulation. We performed a comparison among these residents, grouped based on the four geographical regions of the United States. Senior residents, on average, performed 4.0 MIGS cases (standard deviation (SD) ±2.5), 1.0 two-handed laparoscopy (SD ±1.0), and 1.5 robotic cases (SD ±1.5) per week. The exposure to challenging skills such as extracorporeal and intracorporeal suturing and laparoendoscopic single site (LESS) surgery per week was minimal and did not vary across the nation (p=0.99, p=0.06, p=0.52, respectively). Access to dual consoles increased the number of robotic cases performed per week (p=0.01). While residents of all regions had equal access to laparoscopic box trainers (p=0.81) and laparoscopic simulators (p=0.22), residents of the southern region had less access to robotic simulators (p=0.04). The number of MIGS cases performed by residents did not differ nationwide. However, exposure to advanced aspects of endoscopy training was minimal. The presence of a fellowship or type of teaching environment did not alter the number of cases performed by residents. Residents performed a greater number of robotic cases with the presence of dual consoles.

Training in microvascular anastomosis - A randomized comparative study between chicken thigh specimen and live rat

Training in microsurgical techniques on live rats is the gold standard, but raises ethical issues related to animal welfare and cost. The aim of this study was to compare acquisition of microsurgical techniques with primary training on chicken thigh specimens. Seventy six students were randomly assigned: 23 to exclusive rat training and 53 to primary chicken-leg training. Both groups were then evaluated on aortic suture and jugular aortic bypass surgery in live rats. The primary criterion for successful anastomosis was the patency test. The survival of the rat, the number of severe vascular wounds and the quality of the dissection were also assessed. Aortic anastomoses were of significantly better quality in the chicken group (p = 0.041). There was no significant difference in the number of serious injuries, rat mortality, or quality of dissection (p > 0.05). For jugular aortic bypass surgery, dissection quality (p = 0.02) and patency test (p = 0.05) were better in the chicken-leg group. There was no significant difference in number of severe wounds or rat mortality (p > 0.05). Students who started their microsurgical training on a chicken leg did not perform worse than those with exclusive live rat training. Initial training on chicken thigh specimens seems to be a reliable alternative to training on live models. Level of evidenceLevel II – Randomized controlled trial.

Self-Curing Glass Ionomer Cement Covered by Photopolymerizable Adhesive for Protection of Mucoperiosteal or Gingival Flap Sutures in Canine Oral Surgery.

Periodontal disease is one of the main affections of the oral cavity of dogs. Its main complication is the formation of periapical abscess, which, when affecting the maxillary canine teeth, can lead to the formation of oronasal fistulae. The objective of this study was to evaluate the efficiency of self-curing glass ionomer cement, covered by photopolymerizable adhesive, as a protective element for mucoperiosteal or gingival flap sutures in oral surgery of dogs. We studied 15 dogs from the clinical routine of the dental service of a teaching veterinary hospital, which needed oral surgeries to correct oronasal fistulae, defects or oral cavity communications, regardless of the causal agent. Group one (G1) was composed of seven animals that presented oronasal fistulae after the extraction of maxillary canine teeth compromised by severe periodontal disease. These fistulae were reduced by the double-mucoperiosteal-flap technique, 15 days after the dental extraction. Group two (G2) was composed of five other dogs that presented oronasal fistulae after the extraction of maxillary canine teeth compromised by severe periodontal disease. In this group, the fistulae were reduced by the single-flap technique, immediately after the dental extraction. Group three (G3) was composed of three animals, two of which presented oronasal fistulae due to maxillary fracture and the third one after excision of oral neoplasia. In all groups, simple interrupted sutures were used with 3.0 nylon, and a thin layer of self-curing glass ionomer cement was applied immediately over the operated area. After cement's settling time, a thin layer of photopolymerizable adhesive was applied to the already polymerized cement. In G1, the protective cement was removed on average at 15 (±2) postoperative days, in G2 at 6 (±1) days and in G3 at 11 (±9) days. In the postoperative period, the animals received antibiotics and anti-inflammatory drugs, and they received their usual dry dog food diet. No Elizabethan collar or any other protective measure was used for suturing or the surgical wound. The result was healing of 100% of the oronasal fistulae, without suture dehiscence or the need for new surgical interventions. Thus, it was concluded that the use of self-curing glass ionomer cement covered by photopolymerizable adhesive was fully satisfactory, providing protection of sutures and surgical wounds and showing the potential for routine use in oral surgery in dogs.

Functionalized hydrogels in neural injury repairing.

Repairing injuries to the nervous system has always been a prominent topic in clinical research. Direct suturing and nerve displacement surgery are the primary treatment options, but they may not be suitable for long nerve injuries and may require sacrificing the functionality of other autologous nerves. With the emergence of tissue engineering, hydrogel materials have been identified as a promising technology with clinical translation potential for repairing nervous system injuries due to their excellent biocompatibility and ability to release or deliver functional ions. By controlling their composition and structure, hydrogels can be Functionalized and almost fully matched with nerve tissue and even simulate nerve conduction function and mechanical properties. Thus, they are suitable for repairing injuries to both the central and peripheral nervous systems. This article provides a review of recent research progress in functionalized hydrogels for nerve injury repair, highlighting the design differences among various materials and future research directions. We strongly believe that the development of functionalized hydrogels has great potential for improving the clinical treatment of nerve injuries.

Clinical outcomes of the use of unidirectional barbed sutures in gastrointestinal surgery for dogs and cats: A retrospective study.

To report the clinical outcomes of gastrointestinal surgery using unidirectional barbed sutures in single-layer appositional closure in dogs and cats. Retrospective and descriptive study. Twenty-six client-owned dogs; three client-owned cats. Medical records of dogs and cats that received gastrointestinal surgery closed with unidirectional barbed sutures were reviewed to collect information on signalment, physical examinations, diagnostics, surgical procedures, and complications. Short- and long-term follow-up information was collected from the medical records, the owners, or the referring veterinarians. Six gastrotomies, 21 enterotomies, and nine enterectomies were closed with a simple continuous pattern with unidirectional barbed glycomer 631 sutures. Nine dogs had multiple surgical sites closed with unidirectional barbed sutures. None of the cases in the study developed leakage, dehiscence, or septic peritonitis during the 14-day short-term follow up. Long-term follow up information was collected for 19 patients. The median long-term follow-up time was 1076 days (range: 20-2179 days). Two dogs had intestinal obstruction due to strictures at the surgical site 20 and 27 days after surgery. Both were resolved with an enterectomy of the original surgical site. Unidirectional barbed suture was not associated with a risk of leakage or dehiscence after gastrointestinal surgery in dogs and cats. However, strictures may develop in the long term. Unidirectional barbed sutures can be used during gastrointestinal surgery in client-owned dogs and cats. Further investigation of the role of unidirectional barbed sutures leading to abscess, fibrosis, or stricture is necessary.

A comparative study on the use of fibrin glue versus sutures in pterygium surgery with conjunctivolimbal autograft and its impact on higher-order aberrations

A comparative study on the use of fibrin glue versus sutures in pterygium surgery with conjunctivolimbal autograft and its impact on higher-order aberrations

Changes in functional neuroimaging measures as novices gain proficiency on the fundamentals of laparoscopic surgery suturing task.

As trainees practice fundamental surgical skills, they typically rely on performance measures such as time and errors, which are limited in their sensitivity. The goal of our study was to evaluate the use of portable neuroimaging measures to map the neural processes associated with learning basic surgical skills. Twenty-one subjects completed 15 sessions of training on the fundamentals of laparoscopic surgery (FLS) suture with intracorporeal knot-tying task in a box trainer. Functional near infrared spectroscopy data were recorded using an optode montage that covered the prefrontal and sensorimotor brain areas throughout the task. Average oxy-hemoglobin (HbO) changes were determined for repetitions performed during the first week of training compared with the third week of training. Statistical differences between the time periods were evaluated using a general linear model of the HbO changes. Average performance scores across task repetitions increased significantly from the first day to the last day of training ( ). During the first day of training, there was significant lateral prefrontal cortex (PFC) activation. On the final day, significant activation was observed in the PFC, as well as the sensorimotor areas. When comparing the two periods, significant differences in activation ( ) were found for the right medial PFC and the right inferior parietal gyrus. While gaining proficiency, trainees activated the perception-action cycle to build a perceptual model and then apply the model to improve task execution. Learners engaged the sensorimotor areas more substantially as they developed skill on the FLS suturing task. These findings are consistent with findings for the FLS pattern cutting task and contribute to the development of objective metrics for skill evaluation.

Comparing the closure of hepatocaval ligament using stapler or suturing in liver surgery

Objectives: Hepatocaval ligament is localized on the posterior and lateral side of the retrohepatic Inferior Vena Cava (IVC) , above the right adrenal vein. Bleeding due to retro-hepatic cava injury could sometimes occur during the dissection and closure of hepatocaval ligament (HCL). We aim to determine closing meth- ods of HCL in terms of cost, ease of application and safety. Methods: The study population included 90 recipient hepatectomy patients who had cadaveric and live-donor liver transplantation at Organ Transplant Center of Acıbadem Hospital between 2017 and 2019. The patients were divided into two groups. The first group contained 40 patients who were closed with 25 mm EndoTA 30 stapler. The second group contained 50 patients who were closed by continuous double- layer suturing with 5/0 propylene. Results: In the group closed by endovascular stapler, reinforcement suturing was performed in eight patients (20%) using 5/0 propylene suture due to mild blood leakage in the closing line. In two patients (5%), on the other hand, the staple device could not be used due to the fact that HCL was very close to the right hepatic vein and the distance between the liver and the vena cava was short. There were no perioperative and postoperative HCL-associated liver and vena cava bleeding complications in both groups. However, the cost was significantly higher in the stapler group than in the suturing group. Conclusions: The present study is the first to compare the stapler or suturing techniques for closing HCL in the receiver hepatectomy of liver transplantation. The results indicated that the closure with suturing was at least as useful and convenient in terms of cost, ease of application and safety.

A Suture Tips Applied to Rotating Flaps in Reconstructing Facial Defects to Optimize Scarring: A Retrospective Study

Background: Local flap reconstruction is the most common method to repair facial defects. In this study, authors have explored and introduced a modified suture technique with rotation flap to repair facial defects that makes scarring more discreet and easier to perform. Methods: Patients with facial defects who underwent surgical treatment of the rotation flaps reconstructions and were admitted to our department between October 2014 and October 2019 were included in this retrospective study. The rotating flap is designed along the Relaxed Skin Tension Line (RSTLs) and contour lines, parts of patients received modified suture depending on the shape and size of the defect. Observe the flaps’ survival and complications. Assessments of the scars with Vancouver Scar Scale (VSS) regularly and follow-ups. Results: This five-year retrospective study evaluated a total of 56 patients; of these, 45 patients underwent modified suture surgery, the average defects were 19.7±4.5×25.5±5.2mm, and the average duration of follow-up was 13.8±5.0 months. Scar appearance was evaluated using the VSS score, range from 0-5, with an average of 1.6±1.1, and mainly reflected in pigmentation and vascularity. Postsurgical scar concealment is made afterward, and all flaps survive. No hemodynamic disorder or necrosis was found. Conclusion: The rotation flap was designed based on RSTLs/ contour lines to repair the facial defect and make the scarring well concealed. The modified suture method makes the flap line consistent with the RSTLs/ contour line of the facial skin to the maximum extent and leads to better facial aesthetics results.

Comparative study between skin suture versus skin stapler in abdominal surgery

Background: Through the age’s man sought for methods of binding wounds to promote healing. In olden days various things were used by surgeons but the secret to achieve a good wound healing lies in meticulous tissue dissection followed by selection of suture material, methods of wound closure and postoperative complications. Staplers were originally developed to address the perceived problem of patency i.e., security against leaks of blood or bowel contents in anastomosis in particular but now. It is widely accepted that both sutures and staples can achieve the basic goals of skin wound closure. Methods: Patients admitted under various surgical units from December 2020 to June 2022 at Mamata Medical College and Hospital, Khammam. A study was carried out with 50 patients undergoing laparotomy electively and emergency. Results: Skin approximation was much faster with staple as compared to sutures. Post-operative SSI was more common with skin suture group as compared with staples. Cosmetic appearance of the scar was found to be superior in staple group in comparison to conventional suturing group. Conclusions: The results of the study indicate that skin closure by stapler can be preferred over conventional skin suture.

Clinical and microbiological comparison of knotless/barbed and silk sutures for impacted third-molar surgery.

Several types of suture materials are available for oral surgery. However, the most used non-resorbable suture in oral surgery is 3/0 silk. The aim of the present study was to compare the effectiveness of knotless/barbed sutures with silk sutures during the postoperative period after the third molar surgery in terms of clinical and microbiological parameters. The study comprised 38 patients who underwent surgical extraction of a mandibular impacted third molar. The patients were divided into two groups. The mucoperiosteal flap was closed using 3/0 knotless/barbed sutures for the test group and 3/0 silk sutures for the control group. The duration of suturing was recorded during surgery. Pain level, postoperative edema, and trismus were measured at 3 and 7 days after surgery. The status of plaque formation on the sutures was scored using the Plaque Index at 3 and 7 days after the surgery. At 7 days, the suture materials were removed and submitted to the laboratory for microbiological analysis. The level of pain during suture removal was also recorded by a Visual Analog Scale. The duration of suturing in the barbed sutures group was found significantly lower than in silk sutures (P<0.05). There was no significant difference between the suture types in terms of trismus and edema at 3 and 7 days after surgery (P>0.05). On the third day after surgery and during suture, removal pain scores were statistically significantly lower in the barbed suture group than in the silk suture group (P<0.05). The Plaque Index values of the barbed sutures were statistically significantly lower than that of the silk sutures at 3 and 7 days after surgery (P<0.05). Aerobic, anaerobic, and aerobic/anaerobic mean colony forming units (CFUs) were statistically significantly lower in the barbed suture group than in the silk suture group (P<0.05). Barbed sutures increase the ease of operation and patient comfort with less postoperative pain than silk sutures. Additionally, less plaque accumulation and lower bacterial colonization were found on the barbed/knotless sutures than on the silk sutures.

Design and Performance Evaluation of a Novel Automatic Stapling Device for Knotless Barbed Suture in Laparoscopic Surgery.

This study developed a novel automatic stapling device for improving the speed and stability of suturing in laparoscopic surgery. The stapling device included 3 components: driver module, actuator module, and transmission module. A negative water leakage test of the in vitro intestinal defect model preliminarily demonstrated the safety of the new automatic stapling device. The suturing time for skin and peritoneal defects through the automatic stapling device was significantly shorter than that through the ordinary needle-holder suture (P < .05). These 2 suture methods had good tissue alignment. The automatic suture showed less inflammatory cell infiltration and lower inflammatory response scores at the tissue incision on days 3 and 7 after surgery compared with the ordinary needle-holder suture, with statistically significant differences (P < .05). In the future, the device needs to be further optimized and the experimental needs to be supplemented to provide some evidence for clinical use. This novel automatic stapling device for knotless barbed suture designed in this study has advantages of shorter suturing time and milder inflammatory responses than the ordinary needle-holder suture, safe and feasible in laparoscopic surgery.

Development of biotissue training models for anastomotic suturing in pancreatic surgery

BackgroundAnastomotic suturing is the Achilles heel of pancreatic surgery. Especially in laparoscopic and robotically assisted surgery, the pancreatic anastomosis should first be trained outside the operating room. Realistic training models are therefore needed. MethodsModels of the pancreas, small bowel, stomach, bile duct, and a realistic training torso were developed for training of anastomoses in pancreatic surgery. Pancreas models with soft and hard textures, small and large ducts were incrementally developed and evaluated. Experienced pancreatic surgeons (n = 44) evaluated haptic realism, rigidity, fragility of tissues, and realism of suturing and knot tying. ResultsIn the iterative development process the pancreas models showed high haptic realism and highest realism in suturing (4.6 ± 0.7 and 4.9 ± 0.5 on 1–5 Likert scale, soft pancreas). The small bowel model showed highest haptic realism (4.8 ± 0.4) and optimal wall thickness (0.1 ± 0.4 on −2 to +2 Likert scale) and suturing behavior (0.1 ± 0.4). The bile duct models showed optimal wall thickness (0.3 ± 0.8 and 0.4 ± 0.8 on −2 to +2 Likert scale) and optimal tissue fragility (0 ± 0.9 and 0.3 ± 0.7). ConclusionThe biotissue training models showed high haptic realism and realistic suturing behavior. They are suitable for realistic training of anastomoses in pancreatic surgery which may improve patient outcomes.

Achilles Tendon Injury Treatment: the History and Current State of the Art

RELEVANCE The overall incidence of Achilles tendon rupture has been increasing in recent decades due to population aging, the growing prevalence of obesity and increased participation in sports. Achilles tendon ruptures are common injuries of the musculoskeletal system, and according to various authors, they account for 47% of all ruptures of human tendons and muscles, about 18 cases per 100 thousand people per year. Despite the abundance of various options of tendon suture in surgery, a wide choice of suture material and the use of precision techniques in tendon reconstruction, the proposed methods of macroscopic reconstruction of the tendon apparatus do not solve the problem of tendon suture failure.CONCLUSION Despite the abundance of proposed accesses to the Achilles tendon, the optimal one for all types of injuries has not yet been developed. Currently, there are no clear recommendations for choosing a specific method of treating an Achilles tendon rupture.

SKIN GLUE AS A EMERGING ALTERNATIVE IN SKIN CLOSURE-A COMPARATIVE STUDY

Introduction:Traditional wound closure techniques include skin sutures and metal clips. The ideal incision closure should be simple, effective, safe, rapid, inexpensive, painless, cosmetic, and bactericidal. Cyanoacrylate glue has good neovascularization, epithelialization,and fasterApplication.Soit can be considered an alternative for skin closures. Methods:A study was conducted on 50 individuals undergoing elective surgery in the department of general surgery. They were randomized into 2 groups. In group A skin closure was done with skin glue and in group B skin closure was done with sutures. Post-op pain was assessed with VAS and cosmesis was assessed with a modified Hollander cosmesis scale. The time taken for closure was assessed using a stopwatch. Results:Skin closure with skin glue was quicker than traditional closure. The average time for skin closure with glue was 1 minute and 14 seconds while it was 3 minutes and 47 seconds in the suture group. The postoperative pain was comparatively less in people who had closure with glue. Cosmesis was better in patients who had closure with glue compared to sutures.The overall satisfaction level was better in people who had closure with glue compared to those who had closure with sutures. Conclusion:According to this study, using skin glue for skin closure in clean surgery reduces thewound closure time with a superior cosmetic effect. The usage of skin glue can greatly save healthcare expenses and is favored by patients due to the simplicity of postoperative wound care. The study established the efficacy and advantages of this unique technique.The broad adoption of this innovative approach may drastically reduce the need for sutures in clean surgery.

Patellar development after patella instability and early reduction in growing rabbits

BackgroundPatella-shaped disorder has been considered as a predisposing factor for patella instability. But the influence of early patella reduction for patellar development remains unclear. This study aimed to evaluate whether early operation in patella instability could improve patella morphology in growing rabbits.MethodsFifty rabbits (1-month-old) were included in the study. The control group underwent no surgical procedures. The two experimental groups (reduction group and non-reduced group), underwent medial soft tissue restraint release surgery. The reduction group, rabbits underwent the medial soft tissue sutura surgery in order to stabilize the patella 2 months after release surgery. The non-reduced group, rabbits did not undergo suture surgery. Computed Tomography (CT) scans analysis in two experimental endpoints (2, 5 months after release surgery) were selected to evaluate the transverse diameter, thickness, Wiberg index and Wiberg angle. Gross observation was conducted to assess morphological changes of the patella.ResultsCT scans showed significant difference in the mean transverse diameter, Wiberg angle between the two experimental groups and the control group 2 months after release surgery. 5 months after release surgery, the indices of patella were found no statistically difference in the reduction group versus the control group. However, the transverse diameter, Wiberg angle in the non-reduced group were significantly differences than that in the reduction group (P < 0.05). Gross observation showed a flattened articular surface of the patella in the non-reduced group.ConclusionsThe results indicated that patella instability may lead to patella-shaped disorder, showing a flattened morphology. Early patella reduction can improve the patella morphology in growing rabbits.

Engineering edgeless human skin with enhanced biomechanical properties.

Despite the advancements in skin bioengineering, 3D skin constructs are still produced as flat tissues with open edges, disregarding the fully enclosed geometry of human skin. Therefore, they do not effectively cover anatomically complex body sites, e.g., hands. Here, we challenge the prevailing paradigm by engineering the skin as a fully enclosed 3D tissue that can be shaped after a body part and seamlessly transplanted as a biological clothing. Our wearable edgeless skin constructs (WESCs) show enhanced dermal extracellular matrix (ECM) deposition and mechanical properties compared to conventional constructs. WESCs display region-specific cell/ECM alignment, as well as physiologic anisotropic mechanical properties. WESCs replace the skin in full-thickness wounds of challenging body sites (e.g., mouse hindlimbs) with minimal suturing and shorter surgery time. This study provides a compelling technology that may substantially improve wound care and suggests that the recapitulation of the tissue macroanatomy can lead to enhanced biological function.