What it means for a patient
- If your surgeon uses a hemostatic net, this study found no measurable loss of blood flow to the skin from the net stitches.
- No patient in the study had marks or scars from the stitches.
- The study has only 8 patients, and they had skin cancer reconstruction, not cosmetic facelifts. Results in a facelift may differ.
Why this paper matters
It gives an objective blood-flow measurement to answer a common concern about the hemostatic net: that its stitches reduce skin perfusion. The small sample limits how far the result can be applied.
Overview
The hemostatic net was first described to lower hematoma rates after facelift and neck lift. Some surgeons worry that stitches passed through the skin could cut off blood supply to the lifted skin. The authors measured flap blood flow with laser-assisted angiography before and after placing the net in 8 patients who had face and neck flap reconstruction after skin cancer removal.
Findings
- 8 patients; cervicofacial flap reconstruction of skin cancer defects, followed by a hemostatic net.
- Blood flow was measured with laser-assisted angiography (LAA) before and after the net.
- Average absolute change in relative perfusion after the net: +6.41% (zone 1), +0.31% (zone 2), +3.28% (zone 3).
- No statistical difference in relative tissue perfusion after net placement.
- No delayed healing, infections, ischemia, necrosis or hematoma.
- 1 patient developed a seroma after the net was removed.
- No patient had scarring or residual track marks from the stitches.
Terms
- Hemostatic net: rows of temporary stitches through the skin that press lifted skin onto the tissue below to prevent blood collecting.
- Perfusion: blood flow through a tissue.
- Laser-assisted angiography (LAA): a scan that uses a dye and a camera to show blood flow in the skin.
- Cervicofacial flap: a large section of face and neck skin moved to close a wound.
- Ischemia: too little blood reaching a tissue.
- Necrosis: death of tissue.
- Seroma: a pocket of clear fluid under the skin.
- Transcutaneous sutures: stitches that pass through the full thickness of the skin.