Absorbable Sutures: An Even Easier Way to Manage Full-Thickness Skin Grafts

Sir: I read with great interest the article by Patterson and Wong entitled “Quilting and Chloromycetin Ointment: An Easier Way to Manage Full-Thickness Skin Grafts” (Plast. Reconstr. Surg. 118: 1551, 2006). It is good to have some evidence base for my own practice, as I am also an enthusiast of the quilting technique. The conventional tie-over does little to prevent hematoma formation or shearing, as the compressive effect is quickly lost due to the natural creep of the peripheral margin skin to which the tie-over sutures are anchored. I would merely like to add that equal success can be achieved using absorbable sutures throughout. I use 5-0 Vicryl Rapide for both the graft margin and the quilting sutures. This gives the added advantage of not having to set specific times for follow-up, as no sutures have to be removed. Care should be taken to ensure that the suture ends are of sufficient length to avoid knots unraveling with the application of the chloromycetin. I also use a deep dermal and subcuticular absorbable suture (Monocryl) for donor-site closure, again, in an effort to simplify postoperative follow-up. DISCLOSURE The author has no financial interest in any of the products, devices, or drugs mentioned in this communication. Sam Norton, M.R.C.S.(Ed.) Department of Plastic Surgery The Royal London Hospital Whitechapel, London E1 1BB, United Kingdom [email protected]