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Erroneous terminology for an intradermal suture
Journal of Plastic, Reconstructive & Aesthetic Surgery (2013) 66, e300
CORRESPONDENCE AND COMMUNICATION Erroneous terminology for an intradermal suture* Dear Sir, We write with regards to the erroneous description of an ‘intradermal’ suture as a ‘subcuticular’ suture. The terms subcuticular, intracuticular and intradermal are used by various authors to describe the same type of suture. Such interchangeable descriptions are confusing, particular for the less surgically experienced reader. A Pubmed search of the literature using the terms ‘subcuticular’ þ ‘intradermal’ þ ‘suture’ in the [title/abstract] field returned 5 results. Within these articles, we noted that Knote and Bohmert1 and Pineros-Fernandez et al. use the terms interchangeably,2 whilst Smoot uses the term ‘subcuticular, intradermal’ as a single nomenclature.3 Meinke uses the term intradermal to describe a particular technique for subcuticular closure to the extent where the author considers an intradermal suture to be a subgroup of a subcuticular suture.4 Mosby’s medical dictionary defines a subcuticular suture from its latin roots as : [sub- beneath, cutis-skin] with the definition of a suture that is placed to bring together tissues immediately beneath the skin, rather than through the skin.5 Although the term subcuticular seems to be in more common use, we feel the term intradermal is more accurate as this type of suture, when properly performed, just traverses the dermal layer of the skin. The word ‘subcuticular’ could potentially misguide readers as to the methodology used in an article, or even worse lead junior surgical trainees to place their suture in the wrong (and unsecure) layer when asked to perform a ‘subcuticular suture’. We therefore urge future publications to ensure that accurate terms are used within their literature. This would improve the interpretation of the methodology used with literature particularly for the less surgically experienced reader.
Conflict of interest None.
Funding None.
References 1. Knote G, Bohmert H. Prolene and vicryl as synthetic sutures for intradermal suture techniques. Fortshritte der Medizin 1978; 96:276e80. 2. Pineros-Fernandez A, Salopek LS, Rodeheaver PF, Rodeheaver G. The influence of absorbable subcuticular staples, continuous subcuticular absorbable suture, and percutaneous metal skin staples on infection in contaminated wounds. J Long-term Effects Med Implants 2012;22:145e55. 3. Smoot EC. Method of securing a subcuticular suture with minimal buried knot. Plast Reconstr Surg 1998;102:2446e9. 4. Meinke AK. An initial evaluation of subcuticular skin closure with absorbable intradermal pins. Conneticut Med 1996;60:199e202. 5. Mosby’s medical, nursing & allied health dictionary. 7th ed. St. Louis: Mosby; 2006.
Karl Walsh Stephanie Hili Philip Gilbert Department of Plastic Surgery, Queen Victoria Hospital, East Grinstead RH19 3DZ, UK E-mail address: [email protected]
23 April 2013
* Work attributed to: Department of Plastic Surgery, Queen Victoria Hospital, East Grinstead. RH19 3DZ.
1748-6815/$ - see front matter ª 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.bjps.2013.05.008
CORRESPONDENCE AND COMMUNICATION Erroneous terminology for an intradermal suture* Dear Sir, We write with regards to the erroneous description of an ‘intradermal’ suture as a ‘subcuticular’ suture. The terms subcuticular, intracuticular and intradermal are used by various authors to describe the same type of suture. Such interchangeable descriptions are confusing, particular for the less surgically experienced reader. A Pubmed search of the literature using the terms ‘subcuticular’ þ ‘intradermal’ þ ‘suture’ in the [title/abstract] field returned 5 results. Within these articles, we noted that Knote and Bohmert1 and Pineros-Fernandez et al. use the terms interchangeably,2 whilst Smoot uses the term ‘subcuticular, intradermal’ as a single nomenclature.3 Meinke uses the term intradermal to describe a particular technique for subcuticular closure to the extent where the author considers an intradermal suture to be a subgroup of a subcuticular suture.4 Mosby’s medical dictionary defines a subcuticular suture from its latin roots as : [sub- beneath, cutis-skin] with the definition of a suture that is placed to bring together tissues immediately beneath the skin, rather than through the skin.5 Although the term subcuticular seems to be in more common use, we feel the term intradermal is more accurate as this type of suture, when properly performed, just traverses the dermal layer of the skin. The word ‘subcuticular’ could potentially misguide readers as to the methodology used in an article, or even worse lead junior surgical trainees to place their suture in the wrong (and unsecure) layer when asked to perform a ‘subcuticular suture’. We therefore urge future publications to ensure that accurate terms are used within their literature. This would improve the interpretation of the methodology used with literature particularly for the less surgically experienced reader.
Conflict of interest None.
Funding None.
References 1. Knote G, Bohmert H. Prolene and vicryl as synthetic sutures for intradermal suture techniques. Fortshritte der Medizin 1978; 96:276e80. 2. Pineros-Fernandez A, Salopek LS, Rodeheaver PF, Rodeheaver G. The influence of absorbable subcuticular staples, continuous subcuticular absorbable suture, and percutaneous metal skin staples on infection in contaminated wounds. J Long-term Effects Med Implants 2012;22:145e55. 3. Smoot EC. Method of securing a subcuticular suture with minimal buried knot. Plast Reconstr Surg 1998;102:2446e9. 4. Meinke AK. An initial evaluation of subcuticular skin closure with absorbable intradermal pins. Conneticut Med 1996;60:199e202. 5. Mosby’s medical, nursing & allied health dictionary. 7th ed. St. Louis: Mosby; 2006.
Karl Walsh Stephanie Hili Philip Gilbert Department of Plastic Surgery, Queen Victoria Hospital, East Grinstead RH19 3DZ, UK E-mail address: [email protected]
23 April 2013
* Work attributed to: Department of Plastic Surgery, Queen Victoria Hospital, East Grinstead. RH19 3DZ.
1748-6815/$ - see front matter ª 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.bjps.2013.05.008