Let’s take a look at some basic information on deep dermal sutures. Thanks to Cincinnati Children’s Hospital Medical Center resident Drew Saylor. Before moving on to the quick hits let’s take a look at an excellent video from Closing the Gap.
What are the indications for a deep buried dermal suture?
Large wounds that:
- Are in need of tension reduction
- Have deep spaces that may collect blood or fluids
What are the contraindications of deep buried dermal sutures?
- Inadequate subcutaneous tissue to perform the technique
- Contaminated wounds
Note that there is not a higher risk of infection with these types of sutures as long as the wound is clean and uncontaminated.
Advantages
- Closes dead space
- Stops subcutaneous bleeding
- Reduces hematoma and seroma formation
- Takes essentially all the tension off the skin sutures and skin edges
- The final healing scar width will be reduced —> can remove the superficial skin sutures earlier because wound eversion is maintained longer
Most common suture materials:
- Chromic Gut
- Polyglactin (Vicryl)
- Polyglycoric (Dexon)
- Polyglyconate (Maxon)
All of these sutures are absorbable and do not need to be removed
What are some complications of deep buried dermal sutures?
- Bleeding
- Infection
- Scar formation
- Possible strangulation and necrosis of tissue
- Promotion of infection
- Prolonged inflammation as the result of the presence of foreign material
