[Ideal suture methods for skin, subcutaneous tissues and sternum].

Non-absorbable sternal closure methods such as stainless steel wiring have been widely used, but biocompatibility and osteoconductivity of absorbable materials have advantages in acceleration of wound healing. Combined use of stainless steel wires with absorbable materials may contribute to minimizing sternal complications.Fascial tension reduction sutures, where the tension is placed on the layer of deep fascia and superficial fascia, are recommended for skin/subcutaneous closure. This means that the use of dermal sutures is minimized;indeed, dermal sutures can be avoided altogether if the wound edges can be joined naturally under very small tension. We prefer 0, 2-0 polydioxanone sutures (PDS II) for deep/superficial fascia sutures, 4-0 or 5-0 PDS II for dermal sutures (if they are necessary), and 6-0 or 7-0 polypropylene or nylon sutures (Proline or Ethilon) for superficial sutures. The consequence of such suturing is that the wound edges are elevated smoothly with minimal tension on the dermis that appears to prevent the development of large scars.