Subcuticular Closure of Thoracic Incisions

The recent report by Murray and Blaisdell in the Archives (113:477-480, 1978) defines the advantages of continuous synthetic absorbable suture material in the closure of abdominal and thoracic incisions. These are a reduction in the time required for closure and a probable reduction in wound infection and dehiscence. We have noted a third distinct benefit. For the past year, we have closed many of our median sternotomy and lateral thoracotomy incisions with continuous polyglycolic acid sutures not only in the muscle, fascia, and subcutaneous layers, but also subcuticularly in the skin. This latter is facilitated by using No. 00 suture on a large C-23 needle that penetrates the thick skin of the chest much better than the smaller cutting needles used by plastic surgeons to close thin skin. We have used the same technique to close incisions in the legs for saphenous vein harvest. With practice, the subcuticular closure takes