Die coriale Flaschenzugnaht

The closure of larger incisional defects in dermatosurgery requires different techniques according to the localization of the defect and the texture of the skin. Depending on the localization, defects up to 5 cm diameter can easily be closed by extension plastic while larger defects often require VY- or double WY-plastics. A crucial point for the esthetical outcome of the procedure is the choice of the corial suture technique. Defects in localizations with thin to moderately thick corium can be closed with the horizontal butterfly suture. However, in localizations with thicker corium, the corial pulley suture is more advantageous. Two vertical suture loops, knotted centrally produce a block and tackle effect which allows atraumatic approximation of the wound margins, leaves minimal foreign material in the wound and places the knot in depth of the wound thus avoiding granuloma formation. Altogether the cosmetical results of this simple technique are excellent. The advantages of a corial running suture are combined with the increased security of a multiple knot approach.