• Nicole Look, Francisco Rodriguez Fontan, Todd H Baldini, and Bennie Lindeque.
• Department of Orthopedics, University of Colorado Anschutz Medical Campus, Denver, CO, 13001 E. 17th Place, Aurora, CO 80045-2581, United States.
• Injury. 2022 Nov 1; 53 (11): 3613-3616.

BackgroundThe suture material and pattern utilized to maintain the skin edges in proximity allows for successful primary wound healing. No prior studies have evaluated the tensile strength of different suture patterns on human cadaveric skin. This study evaluates the tensile strength of four single suture patterns: simple (S), horizontal-mattress (HM), vertical-mattress (VM), and a novel stich termed Lindeque locking (LL).MethodsFour skin closure patterns were tested on human cadaveric skin using 3-0 nylon - S, HM, VM, LL - totaling four groups with twelve samples each. A tensioning device applied 1 N of force/second in a linear fashion. The primary outcome measures were: (i) wound dehiscence force, and (ii) ultimate load to failure. Statistics included one-way ANOVA with post-hoc Tukey tests.ResultsThe LL stitch had the greatest dehiscence force (198.60 N) and ultimate load to failure force (211.13 N) but was only significantly greater on both outcomes versus HM (104.81 N; 95% confidence interval [CI], 65.7 to 121.9; p< 0.001) and (120.79 N; 95% CI, 63.5 to 117.2; p < 0.001), respectively. There was no significant difference between LL and S for dehiscence, nor for the ultimate load to failure (186.90 N and 195.08 N, respectively). The LL pattern was significantly greater for an ultimate load to failure, but not for dehiscence when compared to VM (173.9 N and 171.1 N, respectively). Of all patterns, HM had significantly less withstanding force.ConclusionsThe Lindeque Locking stitch demonstrated the greatest dehiscence force and tensile strength. It may decrease the risk of wound dehiscence for high tension wounds.Copyright © 2022. Published by Elsevier Ltd.

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