Adhesive Retention Suture Device
Closing acute wounds under tension is challenging. Suture can rip through the skin, second intent healing can
take months with frequent dressing changes, and flaps and grafts have a high rate of complications, such as
The HEMIGARD® ARS device was created to address these problems.
The HEMIGARD® bolsters skin strength to enable high tension linear wound closure without skin ripping.
The HEMIGARD® has 3 zones of action: (1) a rigid and waterproof zone with that faces the wound and
will not rip under high tension, (2) a middle zone that is less stiff, but still waterproof, and (3) a trailing
zone with low stiffness to lessen the risk of shear-induced blistering at the trailing edge.
HEMIGARD® ARS device
How it works
The HEMIGARD® ARS is intended to be used to close surgical wounds surrounded by clean and dry skin
with minimal hair. After preparing the skin, one HEMIGARD® ARS strip is laid on each side of the
wound with holes facing the wound, about 10mm or more from the edge of the wound. Then, a retention suture is
placed by piecing its needle down through the hole on one of the HEMIGARD® ARS strips. The same
needle is then pierced up through the hole of the second HEMIGARD® ARS strip on the other side of the
wound. Two holes are in each strip allowing surgeons to suture with a simple interrupted pattern (one hole) or
vertical mattress pattern (two holes).
Next, the surgeon applies tension by pulling the suture so that the wound edges come together. To facilitate
placement of dermal sutures, it is helpful to leave a gap of 2-3mm between wound edges. After adequate tension
has been applied, the retention suture is knotted and remains in place until suture removal.
Dermal sutures are performed next, prior to completion of a superficial closure (e.g. sutures, staples,
Patients are given wound care instructions, which encourage keeping the HEMIGARD® ARS strips clean and
dry. Also, if the lateral zones start to peel off the skin, they should be taped down with bandages, rather than
For most leg wounds, it is advisable to have patients restrict activity, elevate the leg and, unless there are
contraindications, use some form of external compression to mitigate swelling. The patient’s overall, vascular
and skin health must be considered when choosing any dressings and/or external compression.
The HEMIGARD® ARS can be retained for up to two weeks to provide postoperative protection from skin
tearing. At removal, the retention suture is first cut, removed and discarded. Then, the rigid inner zone of
each HEMIGARD® ARS strip is lifted off the skin. Grasp that portion and gently pull directly opposite
to the wound. If there is resistance, place warm soaks on the HEMIGARD® ARS strips for several
minutes prior to re-attempting.
Remove and discard both HEMIGARD® devices. If appropriate, remove any residual non-absorbable wound
supports. Provide patient with instructions on further wound care (e.g. steristrips, when to return to
Clean and thoroughly DRY a 6cm long area for the HEMIGARD® ARS strips on each side of the wound.
Place HEMIGARD® ARS strips so that the hole closer to the wound is 10mm from the wound edge. Ensure
adhesion of the strips to skin.
Suture 2-0 nylon (or similar) suture through the holes of the HEMIGARD® ARS and full thickness skin prior
to closing the wound.
After placing additional dermal or percutaneous sutures, staples, or glue, ensure that the HEMIGARD® ARS
strips remain DRY for AT LEAST 5-7 days.
*Please refer to the Instructions for use for additional
How HEMIGARD®® ARS
Makes Standard Sutures Better
2. Improved perfusion versus suture alone
In this laser speckle contrast analysis (LASCA) perfusion image of a human excisional wound closure under
tension (RED represents the highest perfusion; BLUE represents the lowest perfusion), there is higher
perfusion with HEMIGARD® ARS and a standard suture (at left) versus a standard suture alone (at right).
In a clinical study, there was a 25% improvement in perfusion versus suture alone.
Enhanced perfusion of elliptical wound closures using a novel adhesive suture retention device
4. Reduced postoperative dehiscence in lower extremity closures under tension
How is HEMIGARD® ARS better than suturing through other retention tapes or film dressings?
Those materials may work well for select cases in which fragile wounds are closed under minimal tension. However,
they may fail intraoperatively and postoperatively. They also lack the zonal advantages of the
HEMIGARD® ARS in providing a stiff, rip resistant advancing edge with stretchy trail edge to prevent
What minimum size of retention suture do you recommend?
At minimum, 2-0 nylon. We offer a custom 0 nylon with 24mm needle.