Papers of The 8th Japan Scar Workshop

20. Visual analyses of facial tensile reduction suture

Satoshi Akaishi1, Rei Ogawa1, Masataka Akimoto2, Hiko Hyakusoku1
1:Department of Plastic and Reconstructive Surgery, Nippon Medical School, Tokyo, Japan
2:Department of Plastic and Reconstructive Surgery, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan

Even if keloids are removed with subsequent radiation, the recurrence rate can still be high. To prevent a recurrence after keloid excision, we reported a new technique for wound closure in 2009, which is the superficial and deep fascia suture technique for tensile reduction. To clarify the efficacy of this facial tensile reduction suture, we used the finite element method (FEM).
All data analysis was performed using a personal computer (Core i7 : 2.67 GHz with 4 GB RAM) equipped with DISCUS drawing software (version 3.01, rexsoftware, Osaka, Japan) and ADINA analytical software (version 8.3, ADINA R&D, Inc., Watertown, MA, USA). The human skin wound model was analyzed using dermis, fat and fascia elements in two dimensions.
In the dermis suture, high stress in the dermis decreases remarkably when superficial and deep fascia sutures were used together. Moreover, there are no differences in dermal skin tension between the superficial fascia suture and the two fascia sutures. However, it has been accepted that very strong stress in a superficial fascia is applied only with a superficial fascia suture.
These findings clearly demonstrate that stress applied to the dermis with fascia sutures decreases visually by the finite element method. High stretching tension and its recurrent rate after keloid removal can be decreased by using superficial fascia suture alone or both superficial and deep fascia sutures.
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