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An Aid to Closing Wound Edges of Different Lengths for Correction of Skin Irregularity and Surplus
Ian Chow, MD; Ernest K. Manders, MD
University of Pittsburgh Medical Center Department of Plastic Surgery
2018-02-13
Presenter: Ian Chow, MD
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature.
Director Name: Vu T. Nguyen, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background: A major challenges facing plastic surgeons when performing surgeries with large skin and soft tissue resections is closing wound edges of two different lengths. Discrepancies in incision length may result in skin irregularity and bunching of tissue that mar the appearance of the final closure. We present a novel approach whereby a sine wave incision is utilized to lengthen the shorter edge of an incision in order to achieve a more cosmetic wound closure.
Methods: This technique was first tested in female-to-male transgender surgery via an inframammary skin resection as a large skin and soft tissue resection is required. The superior skin incision is marked and a silk suture is laid along the line of the incision. The marked length of suture is then brought along the IMF and the redundant suture is used to approximate a sine wave centered along a line in the IMF, thereby lengthening the shorter incision to match the longer superior incision.
Results: This technique effectively eliminates irregularities associated with skin excess obviating the need to wait weeks to determine whether a revision will be required. Significant improvements in scar contour and appearance were noted at the time of final closure and post-operative follow-up.
Conclusions: We describe a novel technique using a sine wave incision in order to aid in the closure of wound edges of different lengths. This technique can be utilized to improve the aesthetic appearance of any wound closure where two wound edges of different lengths needs to be approximated.
