title: Intracutaneous butterfly suture with absorbable synthetic suture material. Technique, tissue reactions, and results.
abstract: BACKGROUND
  Tension on surgical wound edges is often an obstacle to proper closure and good cosmetic results in dermatologic surgery.
  
  
  OBJECTIVE
  A buried, butterfly-shaped, interrupted suture has been developed to remedy this. The suture is anchored very broadly in the corium, the knot is below the corium. The butterfly suture can be supplemented by a temporary running suture or by close-set, superficially placed interrupted sutures.
  
  
  METHODS
  This technique was studied in a follow-up of 876 operations, with histologic study of 60 scars resulting from the suture. In particular, the specific advantages and disadvantages of two synthetic suture materials were compared: monofilament (polydioxanon) and polyfilament (polyglactin 910).
  
  
  RESULTS
  Polydioxanon sutures were found to be clinically superior. It was important, however, that the suture knot be deeply anchored and that the surgeon be experienced.
  
  
  CONCLUSIONS
  Cosmetic results of 18,000 procedures with this suture over a period of 6 years were found to be clearly better than those of surgery with conventional sutures.
authors.affiliation: University of Tübingen Dermatological Clinic, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Breuninger
authors.forename: J
authors.initials: J
authors.lastname: Keilbach
authors.forename: U
authors.initials: U
authors.lastname: Haaf
mesh_terms: D000042:Absorption; D017439:Cicatrix, Hypertrophic / Q000209:etiology; D062109:Dermatologic Surgical Procedures; D004954:Esthetics; D015743:Giant Cells, Foreign-Body / Q000473:pathology; D006098:Granulocytes / Q000473:pathology; D006801:Humans; D016687:Polydioxanone / Q000009:adverse effects / Q000737:chemistry; D011098:Polyglactin 910 / Q000009:adverse effects / Q000737:chemistry; D012867:Skin / Q000473:pathology; D013314:Stress, Mechanical; D013499:Surface Properties; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013536:Suture Techniques / Q000009:adverse effects; D013537:Sutures / Q000009:adverse effects
chemical_list: D016687:Polydioxanone; D011098:Polyglactin 910