title: Skin tension related to tension reduction sutures.
abstract: The aim of this study was to compare the skin tension of several fascial/subcutaneous tensile reduction sutures. Six upper limbs and 8 lower limbs of 4 fresh cadavers were used. At the deltoid area (10 cm below the palpable acromion) and lateral thigh (midpoint from the palpable greater trochanter to the lateral border of the patella), and within a 3 × 6-cm fusiform area of skin, subcutaneous tissue defects were created. At the midpoint of the defect, a no. 5 silk suture was passed through the dermis at a 5-mm margin of the defect, and the defect was approximated. The initial tension to approximate the margins was measured using a tensiometer.The tension needed to approximate skin without any tension reduction suture (S) was 6.5 ± 4.6 N (Newton). The tensions needed to approximate superficial fascia (SF) and deep fascia (DF) were 7.8 ± 3.4 N and 10.3 ± 5.1 N, respectively. The tension needed to approximate the skin after approximating the SF was 4.1 ± 3.4 N. The tension needed to approximate the skin after approximating the DF was 4.9 ± 4.0 N. The tension reduction effect of approximating the SF was 38.8 ± 16.4% (2.4 ± 1.5 N, P = 0.000 [ANOVA, Scheffé]). The tension reduction effect of approximating the DF was 25.2% ± 21.9% (1.5 ± 1.4 N, P = 0.001 [ANOVA, Scheffé]). The reason for this is thought to be that the SF is located closely to the skin unlike the DF. The results of this study might be a basis for tension reduction sutures.
authors.affiliation: From the *Department of Plastic Surgery, Inha University School of Medicine, Incheon; †Department of Anatomy, College of Medicine, Chung-Ang University, Seoul; and ‡Inha Research Institute for Medical Science, Incheon, Korea.
authors.forename: Kun
authors.initials: K
authors.lastname: Hwang
authors.forename: Han Joon
authors.initials: HJ
authors.lastname: Kim
authors.forename: Kyung Yong
authors.initials: KY
authors.lastname: Kim
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Han
authors.forename: Se Jin
authors.initials: SJ
authors.lastname: Hwang
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D002102:Cadaver; D002921:Cicatrix / Q000517:prevention & control; D062109:Dermatologic Surgical Procedures; D000071938:Fasciotomy; D006801:Humans; D008875:Middle Aged; D012782:Shoulder / Q000601:surgery; D047011:Silk; D012871:Skin Diseases / Q000601:surgery; D012879:Skin Physiological Phenomena; D013314:Stress, Mechanical; D040521:Subcutaneous Tissue / Q000601:surgery; D013536:Suture Techniques; D013537:Sutures / Q000145:classification*; D013848:Thigh / Q000601:surgery
chemical_list: D047011:Silk