Many elderly patients have fragile, atrophic skin. Tears can occur easily in such skin when you are suturing margins together or when the area is under stress (eg, around a joint). To prevent such tears, apply mastic gum liquid adhesive to each margin edge, fan dry until tacky, then apply a butterfly strip the length of each margin; insert the needle through the butterfly strip and close. The resultant suture will have reinforced edges that won't tear or dehisce.
|Terrell R. Wallace Jr, PA-C
Warner Robins, Ga