Volume 4, Issue 7, Pages (August 2018)

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Volume 4, Issue 7, Pages 655-661 (August 2018) The use of a suture retention device to enhance tissue expansion and healing in the repair of scalp and lower leg wounds Collin M. Blattner, DO, Benjamin Perry, DO, John Young, MD, William Lear, MD JAAD Case Reports Volume 4, Issue 7, Pages 655-661 (August 2018) DOI: 10.1016/j.jdcr.2018.06.004 Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 A large (1.0 cm or greater) bite-sized percutaneous retention suture is used on each side of wound with a large caliber suture (for example, USP 1 nylon). A dressing can optionally be placed under the device to absorb exudate. The retention suture is secured with either a clamp or knot to place the wound under tension. The device has flexible skin contact portions and a soft silicone covering to reduce the skin pressure of a high tension retention suture. JAAD Case Reports 2018 4, 655-661DOI: (10.1016/j.jdcr.2018.06.004) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 BCC on left temporal scalp. Defect was 2.3 cm × 2.0 cm. JAAD Case Reports 2018 4, 655-661DOI: (10.1016/j.jdcr.2018.06.004) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Suture retention device secured with USP 1 nylon retention suture over Xeroform. JAAD Case Reports 2018 4, 655-661DOI: (10.1016/j.jdcr.2018.06.004) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 Wound measures 0.5 cm wide (75% reduction). JAAD Case Reports 2018 4, 655-661DOI: (10.1016/j.jdcr.2018.06.004) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 5 BCC on left frontal scalp. Defect was 1.8 cm × 1.8 cm. JAAD Case Reports 2018 4, 655-661DOI: (10.1016/j.jdcr.2018.06.004) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 6 Two suture retention devices secured with two USP 1 nylon retention sutures over Xeroform. JAAD Case Reports 2018 4, 655-661DOI: (10.1016/j.jdcr.2018.06.004) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 7 Final linear closure with 3-0 nylon sutures performed immediately after removal of suture retention device. JAAD Case Reports 2018 4, 655-661DOI: (10.1016/j.jdcr.2018.06.004) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 8 BCC on left shin. Defect was 2.5 cm wide × 3.7 cm long. JAAD Case Reports 2018 4, 655-661DOI: (10.1016/j.jdcr.2018.06.004) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 9 Two suture retention devices were used for 90 minutes with 2 USP 1 nylon retention sutures. The defect was reassessed and found to be 1.5 cm wide (32% reduction). JAAD Case Reports 2018 4, 655-661DOI: (10.1016/j.jdcr.2018.06.004) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 10 Malignant melanoma in situ of the left lower leg. Defect was 2.5 cm wide × 2.7 cm long. JAAD Case Reports 2018 4, 655-661DOI: (10.1016/j.jdcr.2018.06.004) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 11 Two suture retention devices secured with two USP 1 nylon retention sutures over Xeroform and incrementally closed over 5 minutes. JAAD Case Reports 2018 4, 655-661DOI: (10.1016/j.jdcr.2018.06.004) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 12 Two suture retention devices were left in place for two days while awaiting histological clearance of MMIS. JAAD Case Reports 2018 4, 655-661DOI: (10.1016/j.jdcr.2018.06.004) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 13 After removal of suture retention devices on postoperative day 2, the wound had reduced in size to 0.9 cm (64% reduction). JAAD Case Reports 2018 4, 655-661DOI: (10.1016/j.jdcr.2018.06.004) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 14 After 90 minutes of tissue expansion with the suture retention device on a left posterior auricular skin defect, there was no visible damage to underlying skin. JAAD Case Reports 2018 4, 655-661DOI: (10.1016/j.jdcr.2018.06.004) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions