Improved scar formation after using a medical surgical zipper for wound closure under tension

Background and Objective. The objective of the study was to evaluate the use of a medical surgical zipper (Medizip(TM)) for wound closure under tension in comparison to conventional cutaneous sutures. The surgical zipper is supposed to reduce wound tension by approximating of the wound edges via epidermal traction. Patients/Methods. This prospective study included patients with a wound diameter of more than 1 cm. 45 patients were treated with the surgical zipper, 38 were randomized into a control group with conventional wound closure. Scars were assessed after 6-18 months focusing on aesthetic and functional aspects. Results. The average length of the scars in both groups was 9 cm, but after a observation time of at least 6 month, there were differences in the width of the scars. The group with the surgical zipper showed significantly thinner scars (2,74 mm versus 4,24 mm, p=0,0008). Only 17% of the Medizip(TM) patients developed unaesthetic rope ladder-like scars versus 65% in the control group. This observation was statistically significant (p<0,0001). Conclusions. Wound stabilization by approximation of the wound edges via surgical zipper results in improved scar formation in wounds with moderate tension. Using the Medizip(TM) in wounds under heavy tension is not recommended because of the possible development of to tension bullae under the zipper.