ArticleJournal of orthopaedic surgery and research2023
Close orthopedic surgery skin incision with combination of barbed sutures and running subcuticular suturing technique for less dermal tension concentration: a finite element analysis.
Article in Journal of orthopaedic surgery and research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 10 citations in OpenAlex.
- Enhanced Closed Incisional Negative Pressure Therapy for Treating Infectious Scars.Plastic and reconstructive surgery. Global open · 2025Article
- Biomechanical mechanism and clinical management progress of surgical wound tension.Frontiers in surgery · 2025Review
- Application of Remote Buried Dermal Super-Tension-Reducing Sutures for Incisional Scar Prevention.Clinical, cosmetic and investigational dermatology · 2025Article
- How I do it: using physics and progressive defect tensioning to close large hernia defects during MIS ventral hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundMechanical forces have an important role in the initiation and progression of orthopedic surgical incisions complications. To avoid incision complications with the reduction of dermal tension, surgeons may choose a buried continuous suture technique other than the traditional interrupted vertical mattress suture. Absorbable barbed sutures are widely used in orthopedics due to their convenience and reducing wound tension. The aim of this research is to compare and explain the advantages of running subcuticular suturing technique with absorbable barbed sutures for orthopedic surgical incisions closure.
methodsFinite element models of layered skin and two different suture techniques, running subcuticular suture and intradermal buried vertical mattress suture, ware constructed. The mechanical property difference between standard sutures and barbed sutures was modelled using different contact friction coefficient. Pulling the skin wound was simulated, and the sutures' pressure on the skin tissue was determined.
resultsCompared with traditional smooth sutures, the barbed sutures effectively increased the contact force for subepidermal layers, which led the less force variation between different layers. The results also suggested that subcuticular suture caused less stress concentration compared with intradermal buried vertical mattress suture.
conclusionsIn conclusion, our study indicated that running subcuticular suturing technique with absorbable barbed sutures for orthopedic surgical incisions closure results in more uniform stress distribution in the dermis. We recommend this combination as the preferred method of skin closure in orthopedic surgery unless contraindicated.
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