Closure of skin lacerations under tension: comment 1.

We read with interest the article advocating the use of adhesive strips as a means of reinforcing fragile wound edges in the closure of wounds under tension. However, one wonders if there may be an element of false economy. Although direct closure is achieved at the time of surgery, there are no reported outcomes following suture removal. It would be particularly interesting to know the rates of wound dehis-cence and hypertrophic scar formation, complications that often require further treatment. In order to achieve the optimal functional and cosmetic result, laboratory and clinical studies suggest that alternative options on the reconstructive ladder should be consid-ered when the dermis cannot be opposed directly without undue tension.1,2 In the absence of any substantial new data to the contrary, it is important that this principle is adhered to when managing the vast majority of wounds in the accident and emergency department and operating theatre.