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Finding the Optimal Surgical Incision Pattern—A Biomechanical Study

Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, 81377 Munich, Germany
Centre of Plastic, Aesthetic, Hand and Reconstructive Surgery, University of Regensburg, 93053 Regensburg, Germany
Department of Orthopaedics and Sports Orthopaedics, University Hospital Rechts der Isar, School of Medicine, Technical University of Munich, 81675 Munich, Germany
Institute for Machine Tools and Industrial Management, School of Engineering and Design, Technical University of Munich, 85748 Garching, Germany
Department of Neurosurgery, Hospital of the University of Munich, 81377 Munich, Germany
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editors: Roberto Cuomo and Franco Bassetto
J. Clin. Med. 2022, 11(9), 2600;
Received: 12 March 2022 / Revised: 25 April 2022 / Accepted: 1 May 2022 / Published: 5 May 2022
(This article belongs to the Special Issue Clinical Application of Tissue Perfusion and Organ Regeneration)
The closure of wounds and subsequent optimal wound healing is essential to any successful surgical intervention. Especially on parts of the body with limited possibilities for local reconstruction, optimal distribution of load is essential. The aim of the present study was therefore to examine three different incision patterns, conventional straight, Lazy-S and Zigzag, with regard to their biomechanical stability and mode of failure on a porcine skin model. Our results demonstrate the superior biomechanical stability of Lazy-S and Zigzag incision patterns with perpendicular suture placement. This holds true, in particular, for Zigzag incisions, which showed the highest values for all parameters assessed. Moreover, the observed superior stability of Lazy-S and Zigzag incision patterns was diminished when sutures were placed in tensile direction. The conventional straight incision represents the standard access for a large number of surgical procedures. However, we were able to demonstrate the superior biomechanical stability of alternative incision patterns, in particular the Zigzag incision. This is most likely caused by an improved distribution of tensile force across the wound due to the perpendicular placement of sutures. Moreover, this technique offers additional advantages, such as a better overview of the operated area as well as several cosmetic improvements. We therefore advocate that the surgeon should consider the use of a Zigzag incision over a conventional straight incision pattern. View Full-Text
Keywords: surgical incision; wound healing; zigzag incision surgical incision; wound healing; zigzag incision
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MDPI and ACS Style

Wachtel, N.; Heidekrueger, P.I.; Brenner, C.; Endres, M.; Burgkart, R.; Micheler, C.; Thon, N.; Ehrl, D. Finding the Optimal Surgical Incision Pattern—A Biomechanical Study. J. Clin. Med. 2022, 11, 2600.

AMA Style

Wachtel N, Heidekrueger PI, Brenner C, Endres M, Burgkart R, Micheler C, Thon N, Ehrl D. Finding the Optimal Surgical Incision Pattern—A Biomechanical Study. Journal of Clinical Medicine. 2022; 11(9):2600.

Chicago/Turabian Style

Wachtel, Nikolaus, Paul I. Heidekrueger, Carolin Brenner, Maximilian Endres, Rainer Burgkart, Carina Micheler, Niklas Thon, and Denis Ehrl. 2022. "Finding the Optimal Surgical Incision Pattern—A Biomechanical Study" Journal of Clinical Medicine 11, no. 9: 2600.

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