Question about running subcuticular sutures.

Hi, If a surgeon is using running subcuticular sutures for a scar revision on the cheek(4cmx0.5cm), should he/she also use deep dermal sutures to take away any tension before using the running subcuticular sutures? Also, is to a good idea to use dermabond on top of the incision as a last layer just to strengthen the closure even more so? So, in this case 3 layer closure consisting of: deep dermal sutures, running subcuticular sutures, and lastly dermabond. Best regards,

Doctor Answers 3

Layered closure

There are many ways to perform esthetic closure of facial wounds or incisions. It is preferable to use layered closure to prevent tension, but I generally don't use a running subcuticular for skin incisions. Depending on the location, I like to use fast resorbing 6-0 plain gut or 6-0 nylon that can be removed in 5 days. A few interupted subcuticular sutures (resorbable) can help relieve any tension on the incision. Also, ask your surgeon about the possibility of using a CO2 laser minimize the scar once it has healed. Good luck. 

Sutures and scar revision

You are correct in that the best way to minimize a scar is to reduce tension on the healing skin edges. If necessary and possible, a surgeon can add deeper sutures to relieve tension on the overlying subcuticular suture. Dermabond is quick and can add strength, however there are pros and cons to using any type of skin clue. Dermabond can be occlusive and waterproof but  possibly trap bacteria or fluid. It may also be irritating to the skin. Generally speaking, it is expected that multi-layer closures result in stronger and better healing than single layer when warranted. Hope this helps!


Johnson C. Lee, MD Plastic Surgery

Johnson C. Lee, MD
Beverly Hills Physician
5.0 out of 5 stars 12 reviews

Running subcuticular suture

I would typically use buried sutures first to close the wound and take tension off the surface sutures.  However, I don't typically use a running subcuticular suture on the face.  Standard simple interrupted sutures on the face typically do not leave track marks as long as there is minimal tension on the sutures and they are removed within 5-7 days maximum.  I do use running subcuticular sutures on the trunk and sometimes leave them in for up to two weeks there.   I don't use glue on top of sutures as I don't think it's necessary if you do a good layered closure.

Regards,

Dr. Ort

Richard Ort, MD
Lone Tree Dermatologic Surgeon
5.0 out of 5 stars 22 reviews

You might also like...

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.