SUTUREGARD^® MEDICAL INC. Blog

JAAD Case Reports recently published, “Use of a novel adhesive suture retention wound closure device to prevent follow-up visits during the COVID-19 pandemic”; a case study demonstrating patient self-removal of sutures after wound closure repair.

Bill Lear, MD, Mohs surgeon now but 5-year emergency physician previously, talks with Dr. Mark Plaster of Emergency Physician Monthly about how being an ER doc nurtured his inventive skills which eventually led to his development of the HEMIGARD ARS device. The HEMIGARD ARS device manages lateral wound tension to close excisions, lacerations, and incisions in fragile or high tension or at-risk wounds. 

SUTUREGARD® has recently announced how to document the use of HEMIGARD® ARS and SUTUREGARD® ISR devices for your complex repairs in EMA with Modernizing Medicine. EMA has clickable boxes to simplify your documentation and coding when using the HEMIGARD® ARS and SUTUREGARD® ISR devices for your closures.

"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

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.

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.

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.

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 ...

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:

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!