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- Presentation
The Pinch Stitch Technique for Closing High-Tension Wounds
Description
Anna Sutherland presented the pinch stitch technique as a simple method for closing wounds under high tension. She reviewed why knot security matters: deep sutures and secure knots help prevent wound dehiscence, improve cosmetic alignment, reduce widened scars, aid hemostasis, and lower infection risk by minimizing dead space and fluid buildup. She noted that knot security can be reduced in high-tension areas like the back, shoulders, and lower legs, with monofilament sutures, surgeon technique, and fewer throws also contributing. The pinch stitch, described as an alternative to assistant skin pinching, towel clamps, pulley or sikkim stitches, and slip knots, is quick, simple, and preserves sterility. The technique involves placing a deep suture, tying and cinching a surgeon’s knot, lifting the suture ends, having an assistant pinch close to the knot to maintain tension, then completing the next throw so it slides between the fingers and locks the knot securely.
Conclusions
- The pinch technique appears to be a simple, quick, and sterile-field-preserving method for improving wound edge approximation under high tension.
- By helping maintain tension during knot tying, the pinch stitch likely improves knot security and reduces the risk of wound dehiscence.
- The technique may be especially useful in difficult high-tension areas such as the back, shoulders, and lower legs, where knot security is harder to achieve.
- The pinch stitch offers a practical alternative to other methods of holding wound edges together, such as towel clamps, assistant pressure alone, pulley sutures, and slip knots.
- Overall, the presentation suggests the pinch technique can improve closure quality, cosmetic alignment, hemostasis, and potentially lower infection risk by reducing dead space and fluid accumulation.
- Morley et al., JAAD, description of the pinch stitch technique.