title: Modified Subcutaneous Buried Horizontal Mattress Suture Compared With Vertical Buried Mattress Suture.
abstract: BACKGROUND
  Wound tension reduction is still a challenge to surgeons. Over the years, many techniques have been proposed to avoid this issue. In this paper, we present a new suture technique.
  
  
  OBJECTIVE
  To investigate the tension-reduction effectiveness of the modified subcutaneous buried horizontal mattress suture compared with the vertical buried mattress suture technique.
  
  
  METHODS
  Two suture techniques, the vertical buried mattress suture (group A) and the modified subcutaneous buried horizontal mattress suture (group B), were performed on paired samples of symmetrical skin flaps. An equal pulling force was applied to each paired sutured flap, and the dehiscences of the samples in the two groups were compared. Then, after the periodic mechanical pulling force was recorded, the dehiscences were compared again.
  
  
  RESULTS
  The dehiscences of the vertical buried mattress suture samples (group A) were much wider than their corresponding samples. Modified subcutaneous buried horizontal mattress suture samples (group B) remained well closed with no or minimal dehiscence, under various tensions, even after mechanical pulling force was applied.
  
  
  CONCLUSIONS
  The modified subcutaneous buried horizontal mattress suture greatly decreased the tension on the dermis and subcutaneous tissue in our in vitro experiment.
authors.affiliation: From the Department of *Aesthetic Plastic, and Burn Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China; †General and Specialist Surgery Department, Plastic Surgery Division, University of Siena, Siena, Italy; and Departments of ‡Pharmacy and §Plastic, and Burn Surgery, Tengzhou Central People's Hospital, Tengzhou City, Shandong Province, China.
authors.forename: Fanjun
authors.initials: F
authors.lastname: Meng
authors.forename: Sisti
authors.initials: S
authors.lastname: Andrea
authors.forename: Shenling
authors.initials: S
authors.lastname: Cheng
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wang
authors.forename: Ran
authors.initials: R
authors.lastname: Huo
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D062109:Dermatologic Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D013529:Surgical Wound Dehiscence / Q000517:prevention & control; D013536:Suture Techniques; D013718:Tensile Strength