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How we do it: retraction suture for interphalangeal joint surgery Dear Sir, The placing of a suture to retract wound edges during hand surgery is commonplace, whether an assistant is unavailable, or when the surgeon wishes to free up the assistant to perform another task. An oft-used method is to suture the wound edge to adjacent skin with a single interrupted suture. We present a technique for placing of retraction sutures for interphalangeal joint procedures, which provides both excellent retraction and prevents drying of the tissues, as well as avoiding passing sutures through healthy adjacent skin that would not otherwise be involved in the operation. As only a single knot is needed for this method it has the additional benefit of being quicker to perform

Figure 3.  Suture is secured to the free end.

Figure 4.  The resulting exposure of the proximal phalangeal joint.

Figure 1.  Placement of the suture through the folded skin flap.

Following the raising of skin flaps, they are folded (deep surface to deep surface). A single long suture is passed through the folded skin flap (Figure 1), before passing both ends around the ventral aspect of the digit (Figure 2). It is then passed through the opposite side skin flap in the same manner and secured to the free suture end (Figure 3). The resulting retraction (Figure 4) provides exposure of the surgical field, in this case for a proximal interphalangeal joint fusion. Conflict of interests None declared.

D. Burchette, A. Gulati and I. McNab Nuffield Orthopaedic Centre, Oxford, UK. Corresponding author: [email protected]

Figure 2.  Passing the suture under the ventral aspect of the digit.

© The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav doi: 10.1177/1753193413518710 available online at http://jhs.sagepub.com

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How we do it: retraction suture for interphalangeal joint surgery.

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