Subcuticular

Subcuticular is an anatomical and surgical term describing something located just beneath the cuticle or epidermis. In medical contexts it is often used to refer to a wound closure technique in which sutures are placed within the dermal layer, beneath the surface of the skin, so the incision line lies flat and remains hidden.

Subcuticular suturing is a common method for closing skin wounds and surgical incisions. It typically uses buried sutures that do not cross the skin surface, which can reduce visible scarring and eliminate the need for external suture removal. Techniques include a continuous running subcuticular suture or interrupted buried sutures, with knots tied and buried to minimize surface irritation.

Materials used for subcuticular closure are usually absorbable sutures, such as polyglycolic acid, polyglactin, poliglecaprone, or polydioxanone. The choice of material depends on the wound, tissue tension, and surgeon preference. Non-absorbable sutures can be used in some cases but may require later removal.

Indications for subcuticular closure include clean, well-approximated wounds with low to moderate tension, cosmetic considerations, and situations where external suture marks are undesirable. Limitations include higher technique sensitivity, potential for tissue reaction with certain suture materials, and reduced effectiveness in highly contaminated or high-tension wounds.

Etymology derives from Latin sub- meaning under and cuticula meaning skin or epidermis. The term is used across dermatology, surgery, and pathology to describe both the anatomical area beneath the epidermis and the method of burying sutures just under the skin surface.