Closing 5mm trocar holes

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Interestingly just rotated through plastic surgery and found that a number of my attendings had recently started putting all their knots on the outside for just about everything. Running subcuticular with monocryl and just tying the knots outside. Then, just pulling out the knots/cutting them if they were still there on the first post-op visit. They claimed that a number of plastic surgeons were discussing this method favorably at meetings.

Initially the results seemed pretty good to me.

or no knots at all. Bring the suture out through each end of the wound and tape it down with a steri strip. At the first visit take off the steri strip and cut the end of the monocryl off. A thousand ways to get things done. But like some of the others have said, a lot of it goes into good planning but a lot of it is out of our control.

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or no knots at all. Bring the suture out through each end of the wound and tape it down with a steri strip. At the first visit take off the steri strip and cut the end of the monocryl off. A thousand ways to get things done. But like some of the others have said, a lot of it goes into good planning but a lot of it is out of our control.

I had an attending who did this with prolene. He would do a running subcuticular with prolene and then SteriStrips along the wound + free ends of the suture. At the 1 week post-op visit, he would pull the suture and leave the line of Steris.
 
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or no knots at all. Bring the suture out through each end of the wound and tape it down with a steri strip. At the first visit take off the steri strip and cut the end of the monocryl off. A thousand ways to get things done. But like some of the others have said, a lot of it goes into good planning but a lot of it is out of our control.
That how I close all my breast incisions - Monocryl without knots; also keeps patients from pulling the Steri-strips off before I tell them too as it pulls on the suture and hurts (although I need not mention that it doesn't work for some non-compliant types or "pickers").
 
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