Piezo1 Promotes Osteogenesis Through CaMKII Signalling in a Rat Maxillary Expansion Model.

OBJECTIVES: Rapid maxillary expansion (RME) is a widely used technique to treat maxillary transverse deficiency. Piezo1 is a cation channel that is activated by mechanical force and regulates bone formation. This study aims to elucidate the role of Piezo1 in bone remodelling during the RME process. MATERIALS AND METHODS: In this study, the periosteal-derived stem cells (PDSCs) were cultured and stretched by the Flexcell system. The effects of Piezo1 on osteogenesis were assessed via RNA sequencing, real-time quantitative PCR, and western blot analyses. Moreover, for in vivo analyses, the rat RME model was established. The function of Piezo1 in mid-palatal suture bone remodelling was evaluated using micro-CT, haematoxylin-eosin (HE) staining, and immunohistochemistry analyses. RESULTS: It was revealed that under tension force, the osteogenic factors (Runt-related transcription factor 2, Osterix, and Alkaline Phosphatase) and Ca2+/calmodulin -dependent protein kinase (CaMKII) were significantly enhanced in PDSCs over time. Furthermore, these were also upregulated in the RME model with the expansion of the mid-palatal suture. However, Piezo1 inhibition by Grammostola spatulata mechanotoxin 4 downregulated the levels of these factors in the RME model. CONCLUSIONS: This study indicated that Piezo1 is associated with the osteogenesis of PDSCs and bone remodelling in the RME process. CaMKII might also participate in this process.

Reconstruction of deep and perforating corneal defects in dogs-A review (Part III/III): The use of corneal sutures and reporting of ocular discomfort.

The surgical reconstruction of severe corneal disease is a common and crucial component of the clinical practice of veterinary ophthalmology. The first part of the present review described procedures that utilize autogenous ocular tissues, homologous donor tissues, and heterologous donor tissues in dogs, while the second part reviewed the use of biomaterials and keratoprosthetics in this species. This third part is dedicated to the review of the use of corneal sutures including suture type and suture pattern in corneal reconstruction of small animals including dogs and cats. The review also focused on the way studies report postoperative ocular discomfort/pain and how this is treated. Lastly, the author briefly presents the simple but effective techniques available to bury corneal knots for corneal reconstructive surgery in small animal patients, such as the "tugging" and "deep-superficial-superficial-deep" methods for simple interrupted sutures, and the adaptation of the latter for simple continuous sutures.

The small incisions combined with interrupted buried suture blepharoplasty: flexible-rigid fixation.

Background: The traditional full incision blepharoplasty is the most commonly used in Asia. However, it has significant drawbacks like long recovery period, excessive surgical marks etc. We offer a new suture idea and combine it with interrupted suture buried blepharoplasty to improve these disadvantages. Methods: In our procedure, the orbital septum is opened and separating the levator aponeurosis-the retro-orbital septum complex under this 3-5 millimeters small incision, a flexible-rigid fixation would be made: suture fixation was made to the tarsus-the complex-lower lip orbicularis oculi muscle. We interrupted bury the sutures in the uncut skin between the two small incisions. Results: This paper included 333 patients divided into small incision groups using flexible-rigid fixation (n = 244, 73.3%) and full incision groups using rigid fixation (n = 89, 26.7%). Both at 6-month and at 5-year postoperative follow-up, the satisfaction of small incision group was statistically higher than the full incision group. The overall postoperative complication rate was statistically significantly less in the small incision. The permanence was not statistically different. For Assignment of Postoperative Effort Score (PES) results, at 6 months postoperatively, the mean score was 8.29 ± 1.32 in the small incision group, 7.86 ± 1.54 in the full incision group. At 5 years postoperatively, the mean score was 7.48 ± 1.45 in the small incision group, 7.51 ± 1.73 in the full incision group. None were statistically different. Conclusion: The small incisions group achieves a higher level of patient satisfaction and more mild trauma in the surgical area, has a low complication rate, and a decent degree of durability.

Multiple origins of dorsal ecdysial sutures in trilobites and their relatives.

Euarthropods are an extremely diverse phylum in the modern, and have been since their origination in the early Palaeozoic. They grow through moulting the exoskeleton (ecdysis) facilitated by breaking along lines of weakness (sutures). Artiopodans, a group that includes trilobites and their non-biomineralizing relatives, dominated arthropod diversity in benthic communities during the Palaeozoic. Most trilobites - a hyperdiverse group of tens of thousands of species - moult by breaking the exoskeleton along cephalic sutures, a strategy that has contributed to their high diversity during the Palaeozoic. However, the recent description of similar sutures in early diverging non-trilobite artiopodans means that it is unclear whether these sutures evolved deep within Artiopoda, or convergently appeared multiple times within the group. Here, we describe new well-preserved material of Acanthomeridion, a putative early diverging artiopodan, including hitherto unknown details of its ventral anatomy and appendages revealed through CT scanning, highlighting additional possible homologous features between the ventral plates of this taxon and trilobite free cheeks. We used three coding strategies treating ventral plates as homologous to trilobite-free cheeks, to trilobite cephalic doublure, or independently derived. If ventral plates are considered homologous to free cheeks, Acanthomeridion is recovered sister to trilobites, however, dorsal ecdysial sutures are still recovered at many places within Artiopoda. If ventral plates are considered homologous to doublure or non-homologous, then Acanthomeridion is not recovered as sister to trilobites, and thus the ventral plates represent a distinct feature to trilobite doublure/free cheeks.

Assessment of the Mechanical Properties of Different Suture Materials for Oral Surgery: An In Vitro Tensile Strength Study.

BACKGROUND: Sutures are essential components of wound closure in oral surgery, and the mechanical properties of suture materials play a crucial role in determining surgical outcomes. Understanding the tensile strengths of various suture materials is vital for selecting the most appropriate material for specific clinical applications. OBJECTIVE: This study aimed to assess the tensile strength of suture materials commonly used in oral surgery through an in vitro tensile strength study. METHODS: A total of 192 samples of six commonly used suture materials (polyglycolic acid (PGA), polyglactin 910 (PGLA), polylactic acid (PLA), polydioxanone (PDO), silk, and nylon) were subjected to tensile strength testing using a universal testing machine. Descriptive statistics were used to summarize the tensile strength of each suture material. A comparative analysis was conducted using appropriate statistical tests to identify any significant differences in the tensile strength among the different materials. RESULTS: Significant variability in tensile strength was observed among the suture materials in newtons (N). PGLA exhibited the highest mean tensile strength (38.7 N), followed closely by PDO (37.1 N), whereas silk displayed the lowest tensile strength (32.8 N). Comparative analysis revealed significant differences in the tensile strength among the materials (p < 0.001). CONCLUSION: This study provides valuable insights into the mechanical properties of the suture materials commonly used in oral surgery. These findings underscore the importance of considering tensile strength when selecting suture materials for specific clinical scenarios, thereby optimizing wound closure techniques and improving patient outcomes.

Composite suture material based on polylactide accelerates the healing of surgical wounds in in vivo experiment.

In laboratory conditions, composite sutures based on polylactide (PLA) containing chitin nanofibrils modified with polyethylene glycol (CN-PEG) and poviargol (silver nanoparticles stabilized with poly(N-vinylpyrrolidone)) were obtained, studied, and used as a prototype. Surgical sutures threads with the addition of CN-PEG have stable mechanical properties both in air and in a buffer simulating the environment of a living organism. The yield strength of oriented threads decreased by an average of 15%, whereas for non-oriented threads the decrease was 3-4 times. The strength values in simple units of unfilled PLA, PLA containing 5 wt % CN-PEG, and PLA with 1 wt % Poviargol were on average 50% higher than the national standard 31620-2012. The results of in vivo experiments on albino rats (cross-linking skin and muscle tissue in the linea alba area) showed that composite sutures are best for suturing muscle tissue, whereas unfilled PLA sutures are more suitable for suturing skin. When suturing muscle tissue, suturing with composite sutures increased the number of collagen fibers of different diameters.

Letter to the editor: Prospective analysis of STRATAFIX™ symmetric PDS plus suture for fascial closure in spinal surgery: a pilot study.

Spine surgery is essential for restoring alignment, stability, and function in patients with cervical spine injuries, especially when instability, pain, deformity, or progressive nerve damage is present. Effective wound closure is vital in these procedures, aiming to promote rapid healing, reduce infection risks, enable early mobilization, and ensure satisfactory cosmetic results. However, there is limited evidence on the optimal wound closure technique for posterior spine surgery, highlighting the need for innovative approaches. A study by Glener et al. evaluated the effectiveness of STRATAFIX™ Symmetric barbed sutures compared to traditional braided absorbable sutures in spinal surgery. In a randomized trial involving 20 patients, the STRATAFIX™ group demonstrated a shorter mean closure time and significantly fewer sutures used, though without a statistically significant reduction in closure time. No significant differences were observed in postoperative complications between the groups during a six-month follow-up. While the findings suggest potential cost savings and efficiency improvements with STRATAFIX™, the study's small sample size and short follow-up period limit its generalizability. Furthermore, AI-based models, such as the Xception deep learning model, show promise in improving suture training accuracy for medical students, which could enhance surgical outcomes and reduce complications. Despite the promising results, further research with larger sample sizes, extended follow-up periods, and multi-center trials is necessary to validate the effectiveness of barbed sutures like STRATAFIX™ in neurosurgery. The integration of AI in surgical training and continued exploration of innovative techniques are essential to advancing the field and optimizing patient care in spinal surgery.

Suture-based techniques versus manual compression for femoral venous haemostasis after electrophysiology procedures.

BACKGROUND AND AIMS: Methods for femoral venous haemostasis following electrophysiology (EP) procedures include manual compression (MC) and suture-based techniques such as a figure-of-eight suture secured with a hand-tied knot (Fo8HT) or a modified figure-of-eight suture secured with a 3-way stopcock (Fo8MOD). We hypothesised that short-term bleeding outcomes using the Fo8MOD approach would be superior to MC. We additionally compared outcomes between Fo8MOD and Fo8HT approaches. METHODS: We studied consecutive patients undergoing EP procedures at our institution between March and December 2023. Patients were categorised into three haemostasis groups: MC, Fo8HT and Fo8MOD. Access site complications were classified as major (requiring intervention or blood transfusion, delaying discharge or resulting in death) or minor (bleeding/haematoma requiring additional compression). RESULTS: 1089 patients were included: MC 718 (65.9%); Fo8HT 105 (9.6%); Fo8MOD 266 (24.4%). Procedures were most commonly for atrial fibrillation (52.4%), atrial flutter (10.9%), and atrioventricular nodal re-entrant tachycardia (10.1%). In patients receiving periprocedural anticoagulation (865, 79.4%), Fo8MOD associated with fewer complications than MC or Fo8HT (major: MC 2.2%, Fo8HT 6.0%, Fo8MOD 0.8%, p = .01; minor: MC 16.5%, Fo8HT 12.0%, Fo8MOD 7.4%, p = .002). In patients not receiving periprocedural anticoagulation, complications did not differ between haemostasis methods (total major and minor complications 5.8%, p = .729 for between groups rates). On multivariable logistic regression, Fo8MOD was associated with a significantly lower risk of access site complications (OR 0.29 [95% CI 0.17-0.48], p < .001), whilst intraprocedural heparinisation (OR 5.25 [2.88-9.69], p < .001) and larger maximal sheath size (OR 1.06 [1.00-1.11], p = .04) were associated with a higher risk of complications. CONCLUSION: Femoral haemostasis with Fo8MOD associates with fewer access site complications than MC and Fo8HT following EP procedures that need periprocedural anticoagulation.

Extraction Basket Entangled in Surgical Sutures in Common Bile Duct Forty-Five Years After Hepatobiliary Surgery: A Bizarre Adverse Event of Endoscopic Retrograde Cholangiopancreatography.

Endoscopic retrograde cholangiopancreatography (ERCP) is an important technique for treating biliary obstruction. A case report of a 75-year-old male with diagnosed choledocholithiasis and cholangitis was presented. He had a history of hepatic surgery 45 years ago, and during the ERCP, an unusual clinical scenario was encountered. Retained extraction basket during ERCP is a rare but known complication and there are no standard recommendations to manage it. To our knowledge, this is the first case report described in the literature with retention of an extraction basket in surgical sutures at ERCP and the longest period from surgery to stone formation in the biliary system. This case report aims to emphasize that in patients with a history of hepatobiliary surgery, postoperative material can cause complications during ERCP.

Comparing cranial suture interdigitation in humans and non-human primates: unearthing links to osteopathic cranial concept.

CONTEXT: Since William Garner Sutherland's inception of osteopathic cranial manipulative medicine (OCMM), osteopathic physicians have practiced with the knowledge that cranial sutures exhibit motion. We hypothesize that the complexity of suture interdigitation in humans may provide clues to elucidate the concept of OCMM. OBJECTIVES: We compared the interdigitation of sagittal, coronal (left and right), and lambdoid (left and right) sutures in computed tomography (CT) scans of humans and five nonhuman primate species (Gorilla gorilla, Pongo pygmaeus, Pan troglodytes, Hylobates lar, and Nasalis larvatus). METHODS: Human ages are evenly distributed between 10 and 65 years of age, with an equal number of males (n=16) and females (n=16) in the sample. Nonhuman primates are all females, and the sample includes juveniles (n=6) and adults (n=34). Sutures were evaluated on a scale ranging from 0 to 3 (0: fused sutures; 1: no interdigitation; 2: low complexity; and 3: representing the highest degree of interdigitation and complexity). RESULTS: Based on ordinary least squares linear regression, we found no significant relationship between suture interdigitation and age in humans. Chi-square tests were utilized to assess sex differences within humans, species-level differences, and differences between humans and nonhuman primates across all five sutures. Humans exhibited a statistically significant greater degree of suture complexity than all five nonhuman species across all five sutures. CONCLUSIONS: These findings indicate that human suture interdigitation is more complex than their closest living relatives (African apes) and other primates (Asian monkeys and apes). We theorize that this would enable subtle movement and serve to transmit forces at the cranial sutures from dietary or ethological behaviors, similar to the pattern observed in other mammals. While humans have a softer diet compared to other living primates, the uniqueness of human craniofacial growth and extended developmental period could contribute to the necessity for complex cranial sutures. More studies are needed to understand variation in human and nonhuman sutural complexity and its relationship to cranial motion.

Robotic purse-string suture technique for intracorporeal anastomosis using double-stapling technique in robotic resection of rectal and sigmoid colon cancer: a propensity score-matched analysis.

BACKGROUND: Robotic three-dimensional magnified visual effects and field of view stabilization have enabled precise surgical operations. Intracorporeal anastomosis in right-sided colorectal cancer surgery is expected to shorten operation times, avoid paralytic ileus, and shorten wound lengths; however, there are few reports of intracorporeal anvil fixation for intestinal anastomosis in left-sided colorectal cancer surgery. Herein, we introduce a simple, novel procedure for using robotic purse-string suture (RPSS) in intracorporeal anastomosis with the double-stapling technique in rectal and sigmoid cancer surgery and report short-term outcomes. METHODS: From September 2022 to April 2024, 105 consecutive patients underwent robotic surgery with double-stapling technique anastomosis for rectal or sigmoid colon cancer at our institution. Their data were retrospectively analyzed. Intracorporeal anastomosis with the double-stapling technique using RPSS was performed in 26 patients (the RPSS group), while the double-stapling technique anastomosis with extracorporeal anvil fixation was performed in 79 patients (the EC group). A 1:1 propensity score-matched analysis was performed (matching criteria: sex, age, body mass index (BMI), tumor location and tumor size) using a caliper 0.3. In the RPSS group, after tumor-specific or total mesorectal excision, specimens were extracted from the umbilical wound with simultaneous anvil placement in the body cavity. The oral colonic stump was robotically excised and robotically circumferentially stitched with 3-0 Prolene in all layers. After anvil insertion into the stump, the bowel wall of the colon was completely sewn onto the central rod of the anvil. Reconstructions were anastomosed using the double-stapling technique. RESULTS: The matched cohort contained 23 patients in each group. The RPSS group had significantly less bleeding than the EC group (p = 0.038). Super-low anterior resection (SLAR) in the RPSS group had shorter total operative times than those in the EC group (p = 0.045). The RPSS group experienced no perioperative complications greater than Clavien-Dindo grade III or any anastomosis-related complications. CONCLUSIONS: The RPSS technique can be performed safely without any anastomosis-related complications and reduces the total operative times in SLAR and blood loss through total robotic surgery. This may be a useful modality for robotic colorectal surgery.

Concave-to-convex curve conversion of fiber cells correlates with Y-shaped suture formation at the poles of the rodent lens.

The eye lens contains convexly curved fiber cells that align in concentric layers around the lens anterior-posterior pole axis. For lens fiber differentiation at the equator, cells elongate with their apical and basal tips migrating towards the anterior and posterior poles, respectively. At each pole, the fiber tips meet opposing tips of other fiber cells, to form a suture. Although umbilical or point sutures are observed in fish and birds, line, Y- or star-shaped sutures are detected in other vertebrate lenses. Sutures that do not converge at the point are thought to result from intricate movements of the fiber tips, rather than a straightforward migration along a meridional path. The triggers that give rise to these variations are currently not understood. Our findings revealed that in the mouse embryo, the early-stage lens contains only concave curved fibers, and later, a zone of concave-to-convex curve conversion develops. At this point, a nascent suture in a linear shape appears at the posterior pole and subsequently progresses into a V-shape. This V-shape appears to further develop into a Y-shape as a branch extends from the apex of the V-shape. In lens of zebrafish and Xenopus larvae that form point sutures, this curve-conversion zone is not observed. In lens of adult birds (e.g. zebra finch) that form a point suture, these too also lack a curve-conversion zone. In our previous studies, we demonstrated that murine lens fibers undergoing curve conversion extend membrane protrusions, or lamellipodia, at their basal membranes. In line with this, we did not observe protrusions at the basal tips of fibers in the non-mammalian lenses of zebrafish, Xenopus, and zebra finch in which curve conversion does not occur. We propose that the concave-to-convex conversion in rodent lenses introduces defined paths for fiber cell tips, leading to a more elaborate and complex suture formation, compared to the simple point suture of lower vertebrates.

Posterior Cruciate Ligament Avulsion Fracture of Tibia: Fixation with Screw and Augmentation Using Ethibond Suture for Improved Clinical Outcomes.

Introduction: The posterior cruciate ligament (PCL) is a vital structure in knee biomechanics, and its avulsion fractures present a unique challenge. This prospective cohort study was conducted at Grant Government Medical College and JJ Hospital, Mumbai, aimed to assess the clinical outcomes of open reduction and internal fixation (ORIF) utilizing cancellous screws and ethibond suture augmentation for PCL avulsion fractures. PCL avulsion fractures often result from traumatic incidents, such as road traffic accidents, and are associated with complications if left untreated. Materials and Methods: Patients aged 20-45 years with isolated PCL avulsion fractures, confirmed by clinical and radiological assessments, were included. Seven eligible patients underwent ORIF, and outcomes were evaluated through clinical assessments, radiological imaging, and the Lysholm knee scoring system. Follow-ups were conducted for a mean time of 13.2 months, assessing stability, range of motion, and complications. Results: The study demonstrated a mean post-operative Lysholm score of 93.8, significantly improved from the pre-operative score of 49.6. Post-operative knee flexion averaged 125.2°. Fracture healing was observed in all cases, and complications were minimal. The study provides evidence of the effectiveness of ORIF with ethibond suture augmentation for PCL avulsion fractures. Conclusion: The study concludes that the proposed surgical technique yields positive outcomes, including enhanced knee functionality, successful fracture healing, and minimal complications. This approach, combining cancellous screws and ethibond suture augmentation, presents a promising option for the management of PCL avulsion fractures, contributing to the diverse landscape of effective treatment modalities.

Age estimation from median palatine suture using computed tomography reconstructed 3D images: a comparison of Northern and Southwestern Chinese populations.

To investigate the potential of computed tomography (CT) images of median palatine suture (MP) for adult age estimation in the Northern and Southwestern Chinese populations. A total of 1110 cranial CT scans from individuals aged 10-79 years, including 557 northern Chinese and 553 southwestern Chinese, were collected for analysis. After volume reformation and multiplanar reconstruction, a total of 20 slices of median palatine suture were selected from each individual. The closure of sutures was analyzed into four stages, and the cumulative scores of 20 slices were recorded as the suture closure score (SCS). The correlations between SCS and age were compared among the two Chinese populations residing in diverse geographic regions. Regression models were established for age estimation. The estimation accuracy was evaluated based on the test set. The mean absolute error (MAE) and the correlation between predicted age and chronological age were calculated to evaluate estimation accuracy. The SCS of MP exhibited a significant correlation with age (0.613, northern male; 0.678, southwestern male; 0.730, northern female; 0.704, Southwestern female; 0.662, total). Furthermore, there were statistically significant differences in SCS among different regions and sex groups (p < 0.001). The cubic regression model had the highest R2 value in all subjects, especially among Northern females and Southwestern males, while the power and quadratic regression models showed the highest R2 value in Northern males and Southwestern females, respectively. In the test set, the Northern cohort demonstrated a lower MAE (9.06 ± 7.32 years, males; 9.17 ± 5.28 years, females) compared to the Southwestern cohort (9.19 ± 7.49 years, male; 10.61 ± 6.83 years, female). Additionally, it was observed that males exhibited a lower MAE than females in both regional groups. This study demonstrated the potential utility of CT images of the MP for age estimation in Chinese populations, emphasizing the significance of incorporating regional and sex factors within this context.

Comparison of the safety and efficacy of three superficial skin closure methods for multi-layer wound closure in total knee arthroplasty: a multicenter, prospective, randomized controlled trial.

BACKGROUND: Good wound healing is critical to infection prophylaxis and satisfactory rehabilitation in Total Knee Arthroplasty (TKA). Currently, two techniques, i.e., barbed continuous subcuticular suture without skin adhesive or combined use skin adhesive (n-butyl-2) are being used for superficial wound closure of TKA. While a new skin adhesive (2-octyl) with self-adhesive mesh has been employed as an alternative to conventional surgical skin closure in TKA, its superiority, especially in reducing wound complications and improving wound cosmetic outcomes has not been investigated. This study aimed to compare 2-octyl, n-butyl-2, and no skin adhesive in terms of safety and efficacy in TKA superficial wound closure. METHODS: We conducted a multicenter, prospective, randomized controlled study in 105 patients undergoing primary TKA between May 2022 and October 2023. Each patient's knee was randomized to receive 2-octyl, n-butyl-2, or no skin adhesive skin closure with all using barbed continuous sutures in deep tissue. Wounds were followed 1, 3, 5 days, 2, 6 weeks, and 3 months after surgery. Wound discharge, complications, cosmetic outcomes, patient satisfaction, and wound-related costs were compared among these three methods. RESULTS: Wound discharge was less in 2-octyl group and n-butyl-2 group than in non-adhesive group at 1 day, with the discharge only being less in 2-octyl group than in the non-adhesive group at day 3 and day 5 days (P < 0.05). There was no statistical difference in the incidence of other wound complications among the groups (P > 0.05). The 2-octyl group achieved better cosmetic effects than the other two groups in 6 weeks and 3 months (P < 0.05). Compared to the non-adhesive group, 2-octyl group scored higher in overall patient satisfaction score in 2 weeks and incurred lower costs (P < 0.05). CONCLUSIONS: Skin closure in TKA using 2-octyl adhesive material showed superiority when compared to no skin adhesive or n-butyl-2, in reducing wound discharge, improving the cosmetic outcomes, without increasing wound complications. In addition, the use of 2-octyl yielded better patient satisfaction and also was less costly compared to no skin adhesive. Our study exhibited that 2-octyl was a safe and effective wound closure technique for patients undergoing TKA. TRIAL REGISTRATION: This study has been registered at Clinical Trials. Gov (No. ChiCTR210046442).

Endoscopic Through-the-Scope X-Tack Helix Suturing System for Complete Closure of a Large Full-Thickness After Surgical Gastric Perforation.

Gastric perforation is considered a surgical emergency managed operatively; however, endoscopic repair techniques have gained popularity as they are cost-effective, improve mortality, and decrease hospital stay and recurrence. With increased prevalence of gastric defects postoperatively and after invasive endoscopic procedures, various endoscopic techniques were developed over the years, but special consideration should be given to the defect type, size, and location. Our case highlights the use of X-Tack through-the-scope suturing for closing a large, full-thickness gastric perforation in a difficult location where OverStitch is not feasible.

Effect of trapezoidal excision combined with modified embedded vertical mattress suture technique on postoperative scar formation after cesarean section.

To study the impact of modified embedded vertical mattress suture technique in conjunction with trapezoidal resection on the formation of scars after cesarean section. This retrospective study involved 339 pregnant women who had cesarean sections at the Department of Obstetrics and Gynecology, the First Affiliated Hospital of Xiamen University from September 2020 to August 2023. Among them, 150 patients who received traditional subcutaneous fat layer discontinuous suture during September 2020 and June 2022 were assigned to the control group, and 152 patients who received improved buried vertical mattress suture technique and trapezoidal resection between July 2022 and August 2023 were assigned to the observation group. The therapeutic effect, surgical parameters and cosmetic effects in the two groups were compared. The suture time of the observation group was longer than that of the control group (t=27.858, P<0.001). The grade A healing rate (96.05%) and cosmetic satisfaction rate (94.08%) in the observation group were significantly higher than those (76.00% and 74.00%) in the control group (all P<0.001); while the incidences of suture reaction (12.05%), complication (1.96%), and hypertrophic scar (5.26%) were significantly lower than those in the control group (38.00%, 22.00%, and 27.33%, respectively) (all P<0.001). The visual analogue scale (VAS) score in the observation group was lower than that of the control group (intergroup effect: F=1434.000, P<0.001; time effect: F=91.091, P<0.001; interaction effect: F=2.409, P=0.091). The postoperative VSS score and scar width in the observation group were lower than those in the control group (all P<0.001). Multivariate analysis showed that complications (P=0.006) and suture method (P=0.016) were independent influencing factors for the occurrence of hypertrophic scars in pregnant women. Trapezoidal resection combined with improved buried vertical mattress suture technique can promote incision healing, reduce suture reaction, incision pain, adverse complications and the incidence of hyperplastic scar, and improve the cosmetic effect of surgery.