Complex Linear Wound Closure | Optimal Wound Closure
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SUTUREGARD® MEDICAL INC. Blog

 
"When I want to eliminate patient post-op visits for suture removal, I have been using the HEMIGARD device with the retention suture, followed by deeps and top fast gut sutures." Stephanie Howerter, DO, FACMS
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Surgical wound dehiscence is one of the most dreaded & costly of surgical complications. It is disturbing & frightening for the patient, who begins to mistrust or doubt the skill of the surgeon, for the physician who must continue to manage the doctor patient relationship & the challenging wound.
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Suture retention bridges support the primary closure location & reduce the risk of wound dehiscence. SUTUREGARD works to allow for both patients and surgeons easily recover with the SUTUREGARD intraoperative skin relaxation (ISR) and HEMIGARD adhesive suture retention device.
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Our research has demonstrated that the middle suture in an elliptical wound is under approximately six times more force than any subsequent suture. That is why we use the HEMIGARD™ Adhesive Retention Suture device for that middle suture, providing rip-resistant support for healing wounds.
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SUTUREGARD® is pleased to announce CEO, Dan Ladizinsky, MD, will be presenting for the second time at the American Society of Plastic Surgery Annual Meeting, March 12-14, 2020. Ladizinsky is eager to return with the SUTUREGARD® IRS Retention Suture Device and introduce the HEMIGARD™ Device!
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We have previously discussed skin grafts and flaps (link to those posts). The major distinction in a skin flap and skin graft is blood supply. Skin flaps have a connected blood supply. Skin grafts do not have connected blood supply. Recall that the lack of a connected blood supply limits the potential thickness of a skin graft. If the graft is too thick, the blood supply from the wound base may be inadequate and result in partial or total loss of the graft.
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You may recall that a skin graft involves taking a piece of skin from one area of the body and using that skin to cover the original wound (link to blog post Oct 4). The graft relies on the blood supply of the wound bed to get nutrition. During the first few days after the grafted skin is placed, the graft will “drink” from the wound bed, hence the term imbibition. By day 3 to 5, the graft has usually created adhesions to the wound bed.
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First, let’s back up. Tissue is sent for pathology to answer one of two questions: “what is it?” or “did I get it all?” The question of “what is it?” is answered with the initial sampling, or biopsy. A piece of skin (or other tissue) is removed from a patient, preserved (or “fixed”) in formalin, sliced into thin pieces, stained so that cellular detail can be seen and then examined under the microscope. In dermatology, biopsies are performed to diagnose rashes as well as to evaluate for ...
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Usually, excisional wounds are created with an ellipse: where the length of the wound is about 2-4 times longer than the width. This allows the wound to be closed without “bunching” of the ends. When closing these elliptical wounds, the initial suture is usually placed in the middle, widest and most difficult portion of the wound to close. This is known as the rule of halves:
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Newly published research in the Journal of Clinical Biomechanics supports using novel devices, such as the SUTUREGARD® ISR Retention Suture Device and the HEMIGARD™ Adhesive Retention Suture Device, to initiate approximation of high-tension surgical wounds. Learn more about Suturegard devices!
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