Threaded tapes for the sutureless closure of skin wounds

THREADED

By D.

TAPES

FOR THE SUTURELESS SKIN WOUNDS

DIOGUARDI, M.D.,

CLOSURE

OF

and A. MUSAJO~OMMA, M.D.’

The Department of Plastic Surgery and the Burns Unit, Polyclinic University Hospital, Bari, Italy ONE of the earliest methods of closing skin wounds was to fix adhesive tape on each side of the wound and suture the tapes rather than the skin (Fig. I). While Part’s work was still unknown to us we designed the device shown in Figure 2. It consists of 4 pieces of adhesive tape with their paper protective backings and 2 nylon threads of about 3/o thickness laced back and forth through the folded-over edges of the tapes.

FIG. I.

Method of closing a skin wound by adhesive tapes sutured together.

(From Par&

1602.)

1 A Smith and Nephew Fellow, Plastic Surgery and Jaw Injuries Centre, Queen Victoria Hospital, East Grinstead, Sussex, 1976. 202

THREADED

FIG. 2.

TAPES FOR SUTURELESS

CLOSURE OF SKIN WOUNDS

203

How the threaded tapes are applied and tightened until the wound is closed with the desired tension. Inset: wound edges are easily adjusted between the threads.

IN USE

The deeper layers of the wound are closed by sutures close to the dermis and with the knots tied deeply. The skin around the wound is dried, swabbed with ether and then painted with Tinct Benz Co. The paper protection is removed from the lower tapes which are stuck down with the thread-bearing edges at least 3 mm from the wound edges. The paper protection is removed from the upper tapes, which are then pulled in opposite directions until the wound edges are brought together with the exact degree of tension required; the upper tapes are then stuck down. If careless application causes overlapping of the skin edges or a final eversion is necessary, exact alignment may be achieved with toothed forceps inserted between the threads (Fig. 2 inset).

BRITISH

204

FIG. 3.

FIG. 4.

Some prototype

JOURNAL

threaded tapes.

(a) and (b), immediately

OF PLASTIC

SURGERY

The largest on the upper right measures overall 12 x 4 cm.

postoperative

and I week postoperative cut forehead.

sutureless

closure of a child’s

THREADED

TAPES

FOR SUTURELESS

CLOSURE

OF SKIN

WOUNDS

205

The threaded tapes can be made in a variety of widths so that any length of wound may be closed in this way (Fig. 3). The advantages of the technique include: Speed of application especially valuable in children (Fig. 4); resistance to traction across the wound which simply closes the wound tighter; unhampered observation of the wound at all times; suitability for any surface contour; ease of removal; and wound fixation obtainable for long periods, as is occasionally required for “thigh lifts”, by first sticking adhesive vapour permeable drapes’ around the wound and sticking the tapes on top. A Patent 162829 in the United States of America and other countries is pending and a feasibility evaluation is being carried out by Smith and Nephew Ltd. We thank Miss Sandra M. Carella, medical student, who has m&e all the prototype threaded tapes, for her skill and suggestions. We are grateful to Miss K. Joy Graham of the Department of Medical Illustration, Queen Victoria Hopsital, East Grinstead, for her line drawings. REFERENCE PAR& A. (1602).

“Les Oeuvres d’.”

* Opsite, Smith and Nephew Ltd.

Sixth French Edition.

Paris: Buon.