文档介绍：HOW WE DO IT Novel Surgical Approach to Subcutaneous Closure: The Subcutaneous Inverted Cross Mattress Stitch (SICM Stitch) C YNDI Y AG -H OWARD , MD, FAAD ! P lacement of subcutaneous stitches minimizes the distance between wound edges, diminishes the tension on the wound when percutaneous or running subcutaneous stitches are placed; and, when placed properly, assists in wound edge eversion 1Yet certain factors, such as extreme defect width, convexity of skin surface, tissue inelasticity, and low coefficient of friction associated with certain suture material, may make proper placement of typical subcutaneous su- tures difficult. To effortlessly and effectively over- come these obstacles, this article describes the utility of the novel subcutaneous inverted cross mattress (SICM) stitch, which, to the author’s knowledge, has not yet been described in the literature. Technique The SICM stitch is bination of the pragmatic buried vertical mattress stitch, which Drs. Zitelli and Moy first described in the literature in 1989, 2 and the buried pulley stitch, attributed to Mu ¨ hlsta ¨ dt and colleagues in 2008. 3It uses the buried vertical mattress’s ability to evert wound edges for better approximation and bines it with the buried pulley stitch’s ability to decrease tension at the wound edge. The blending of these two features creates a stitch that has e a workhorse stitch in the a