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Novel approach to decreasing tension when approximating wound edges in advancement flaps: the ImPli stitch.

Subcutaneous stitches are placed in an effort to close dead space and aid in tissue edge approximation when repairing a surgical defect, but overcoming tension to approximate wound edges in surgical defects may be particularly difficult to accomplish in situations such as extreme defect width, location of the defect over a convex surface, inelasticity or rigidity of tissue, and excessive recoil of tissue being approximated.