Suture Pattern Comparison: Are buried sutures strong enough for traumatic wound closure?

Purpose Prior research has shown that an inverted, buried wound closure may offer potential benefit to wound healing in terms of increase blood flow and superior scar formation. It has been suggested that this might be beneficial in traumatic applications where compromised blood flow could negatively impact wound healing. Anecdotally, it is often stated in the literature that this type of suture pattern has insufficient strength for trauma applications, however a literature search yielded no empiric evidence to support this view. The objective of this study is to compare suture pattern strength to determine if a buried, intradermal vertical mattress suture has sufficient strength for trauma applications, with the added benefit of improved capillary blood flow and superior scar formation. Materials/Methods A freshly butchered porcine specimen was used. Several incisions will be made along the flanks and sutured with 3.0 monocryl suture, using 3 standard suture patterns and a buried inverted vertical mattress pattern. The wound margins were then distracted using and industrial grade tensiometer (Imada DS2-44). Data about suture pattern failure was gathered at varying intervals of lbs. of distraction and to failure. Failure was standardized with ultimate monocryl failure strength determined by breakage point of monocryl suture, and will be reported as failure of suture or of soft tissue. Results were then compared to determine comparative failure points of each suture pattern. Conclusion/Discussion Within tension limits facilitating adequate capillary blood flow, we believe the buried suture pattern will have a similar strength profile to other suture patterns. This provides for a method of suturing traumatic wounds that has been proven to increase capillary blood flow and is potentially beneficial in traumatized, devitalized wound margins; thus potentially increasing the wounds capacity for healing.