Tape Buttress Technique to Appose and Evert Defect Edges in Atrophic Skin

December 2016 | Volume 15 | Issue 12 | Features | 1578 | Copyright © December 2016

Cyndi Yag-Howard MD FAAD

Yag-Howard Dermatology Center, Naples, FL Department of Dermatology, University of South Florida Morsani College of Medicine,Tampa, FL



Repairing surgical defects on atrophic skin, especially when wound edges are under tension, is challenging. The thin, atrophic dermis prohibits placement of buried vertical mattress1 or subcutaneous inverted cross mattress (SICM)2 stitches that are desirable for defect edge apposition and wound edge eversion. If transepidermal stitches alone are used to appose these atrophic defect edges, it results in skin tearing and rolling of the defect edges, thus impairing defect edge apposition. To overcome these challenges, the author uses a tape buttress technique to repair surgical defects in atrophic skin. The tape buttress technique is a variant of the suture/steri-strip combination technique described by Davis et al3 and the horizontal technique described by Lin.4 Both Davis and Lin use surgical strips to reinforce the skin so that suture can be sewn through the taped skin without resultant tearing. Davis places simple interrupted stitches through strips placed perpendicular to the surgical line, while Lin places the strips parallel to the surgical line, but not adjacent to it. As opposed to these techniques, the tape buttress technique uses horizontal mattress stitches sewn through strips placed directly adjacent and Figure 1Figure 2Figure 3Figure 4