Deep Wound Closure

■ Three concealed 2.0 Monocryl interrupted sutures are used as deep fixation sutures, which connect the lower dermis with the fascia. This suturing is important to achieve a stable, lower boundary to the infra-mammary fold and to avoid a later sinking or slipping of the implant in a caudal direction. Consequently, the sutures must be deep and complete, protecting the implant, so that no dehiscence can occur. The Redon drain should not lie under the suturing but rather should, prior to this, be pushed under the implant in the direction of the sternum. For suturing the assistant should hold the implant away in the cranial direction using a Langenbeck retractor to ensure that there is no accidental puncturing of the prosthesis by the sutures.

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