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Introduction: In medicine, sutures have been used for thousands of years to close wounds. However, despite the great advances that have been made in technology, little progress has taken place in suturing techniques and most surgeons continue to use the same two classical techniques (continuous suture or interrupted suture). This paper proposes a suturing technique (“double diabolo”) in which a pattern of eight 45-degree angles is formed, in the view that this achieves a notable reduction in the tension exerted (30% at each angle), thereby increasing the overall strength of the suture. Material and Method: In this study, we compare the physical tensions exerted on the suture thread and its entry/exit points, on the one hand by the two techniques most often used – interrupted suture (Type 1) and continuous suture (Type 2) – and on the other, by the proposed “double-diabolo” suture (Type 3). Results: The Type 3 suturing method produced the lowest levels of tension on the thread, almost 65% less than those of Type 1 and 50% less than those of Type 2. The tension on the wound was also considerably lower, with reductions of 33% and 50% in comparison with Types 1 and 2, respectively. Conclusions: The results obtained in this study corroborate our hypothesis that the proposed double-diameter suture method exerts less tension on the thread and on the entry/exit points than conventional techniques. Theoretically it would be recommended for cases in which the suture must withstand significant tension as laparotomy closure

In recent years the incidence of both amputations as total joint replacement surgery of lower limbs has been increased. So it is not rare to fi nd both circumstances in the same patient. We discuss about the technical problem of this eventuality.