ABSTRACT
The desire for improved esthetics is at times the sole indication for plastic surgical procedures, and the utmost attention must be given to handling the skin atraumatically in order to optimize scar cosmesis. Continuous intradermal suturing is a useful method for the primary closure of long wounds (e.g., abdominoplasty, reduction mammaplasty), as it preserves the integrity of the epidermis at the wound edge and buries the suture material. Traditionally, toothed forceps are used to grasp the skin and steady it for passage of the needle through the dermis. However, excessive force applied through the teeth of Adson’s forceps devitalizes cutaneous tissues, which predisposes to wound infection and the formation of poor scars (1). Such indelicate handling occurs most often when the wound lies under tension, but may also occur during the placement of subcuticular sutures when toothed forceps are used to evert the skin edge. The skin hook is perhaps the least injurious instrument to the skin, as it elevates the dermal layer without breaching the epidermis (2). Its use is impractical for the suturing of long wounds, however, as it involves the repeated exchange of instruments. A modified skin forceps has been designed to allow for the rapid placement of subcuticular sutures without compromise of the wound margins.
