JAAD OnlineThe three-point buried corner stitch: A method to prevent depression of the flap tip and railroad marks
Section snippets
Challenge
When placing random flaps such as transpositional or advancement flaps, corner fixation of the flap tips is performed using three-point corner stitches (ie, Gillies corner stitches); these are half-buried, horizontal mattress sutures.1,2 However, often, the tips are deeper than the surrounding tissue. A modified corner stitch with an additional vertical mattress suture created superficial to the previous, half-buried, horizontal mattress suture has been suggested,2 but the disadvantages include
Solution
We, therefore, modified the three-point corner stitch as follows. First, the suture is placed through the dermis of the flap tip. Next, the suture is pulled through the horizontal plane of the wound base, followed by placing a buried vertical mattress suture on the wound edge opposite the flap tip; this closes the wound (Figs 1 and 2). The advantages of this three-point buried corner stitch are as follows: there is no need to switch the suture material from an absorbable type to a nonabsorbable
Conflicts of interest
None disclosed.
References (2)
- et al.
The effect of stitch type on flap tip blood flow
J Am Acad Dermatol
(2001) - et al.
A modified corner stitch for fixation of flap tips
Dermatol Surg
(2007)
Cited by (0)
Funding sources: This study was supported by the Research Fund of Seoul St. Mary's Hospital, The Catholic University of Korea.
IRB approval status: Reviewed and approved by the institutional review board at Seoul St. Mary's Hospital, The Catholic University of Korea (KC21ZISI0500).