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Primary healing occurs when both edges of the adjacent incision wound meet. To achieve primary healing, bringing the wound edges closer is generally done by suturing. At present comes one of the methods of skin incision closure without involving sutures called zip surgical skin closure. As an indicator of commonly used wound healing, tensile strength is produced by collagen that involves TGF-β in its production. This study was aimed to observe the expression of TGF-β and tensile strength of the skin incision-post wound using simple interrupted suturing or zip surgical skin closure. An experimental laboratory, this study used Sprague Dawley rats with the predetermined inclusion criteria. Thirty-six rats were applied with 3 cm-dorsal skin incisions after which they were divided into 2 groups, group 1 received simple interrupted suturing and group 2 received zip surgical skin closure. TGF-β examination was performed with BS-0086R polyclonal antibodies and wound tensile strength was observed on day 3, 7 and 14. The independent t-test showed that the tensile strength of the zip surgical skin closure group was higher and was significant as observed on day 7 (p = 0.000) than that of the simple interrupted suturing group. TGF-β expression in the zip surgical skin closure group was found more numerous and significant on day 7 and 14 than that of in the simple interrupted group, (p = 0.025) and (p = 0.032) respectively. Conclusion. Skin incision-post wound healing with zip surgical skin closure is better and shows higher tensile strength and more numerous TGF-β expressions than simple interrupted suturing., Highlights • Primary healing, especially healing that occurs immediately after closing edge wound. • Tensile strength is as an indicator of commonly used wound healing produced by collagen that involves TGF-β in its production. • The tensile strength of wound healing increases along with to the number of collagen produced and the bond between collagen matrices. ∙ TGF-β is a multifunctional growth factor, known as fibrogenic cytokines which are the key factor in stimulating the synthesis of ECM and inhibiting the process of matrix degradation

Background Odontectomy is one of the most common surgical procedures in oral and maxillofacial surgery. Flap design influences the post operative complications. Triangular flap is the most widely used flap design but it has many shortages such as dehiscence, alveolar osteitis, reactionary bleeding, and periodontal disruption distal of second molar. The aim of this study is to introduce an alternative flap design in the surgical removal of impacted mandibular third molars – reversed triangular flap – and to compare this flap design with the triangular flap in case of dehiscence, reactionary bleeding, and clinical attachment loss. Material and Methods This prospective, split-mouth study involved 15 patients with bilateral partially impacted mandibular third molars with similar impaction classification. One impacted tooth was removed using a triangular flap and the other using a reversed triangular flap. Post operative complications such as dehiscence, reactionary bleeding, and clinical attachment loss were recorded 1, 3, 7, 14, and 30 days post odontectomy. Results Chi square test result shows that there were fewer incidences of dehiscence seven days post surgery using the reversed triangular flap (p=0.032). Mann Whitney-U test result shows that the reversed triangular flap exhibited less bleeding score on day 1 (p=0.002) and day 2 (p=0.035) post surgery. There were no statistically significant differences according to Mann Whitney-U test between the flap designs for the clinical attachment loss on distal of second molar on day 14 (p=0.512) and day 30 (p=0.902) post surgery. Conclusions The reversed triangular flap design is preferable to triangular flap for impacted third molar surgery, escpecially in terms of wound dehisence and reactionary bleeding. Key words:Flap design, third molar impaction, odontectomy, post odontectomy complications.