Stapling and Suturing

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• Stapling, suturing or other suitable alternative may be used
  
• Remove all air bubbles
  
• Fix sheets independently and/or affix adjacent sheets together to minimize gaps, reducing granulation tissue formation
  
• Interrupted stapling (i.e., leaving a 1-2 centimeter space between staples) can be used to
  seal edges
  
• Plan staple lines carefully, follow Langer's Lines

Application Techniques

• Place INTEGRA™ Bilayer Matrix Wound Dressing following normal "Z Plasty" techniques to relieve tension over joints and minimize dislodgement
  
• After initial stapling check for pulling or creases in the INTEGRA™ Bilayer Matrix Wound Dressing sheets - particularly when over joints

      - Cut to release tension

      - "Seal" the new cut edges with interrupted staples placed close together

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