Which of the following tissues contain significant collagen useful for placing sutures to allow the prolonged tension necessary to maintain tissue approximation?

a. Dermis

b. Intestinal submucosa

c. Muscular fascia

d. Blood vessel wall

It takes at least three weeks for collagen to undergo sufficient remodeling and cross linking to attain moderate strength. Since most skin sutures are removed at one to two weeks, the wound has only a small fraction of its eventual strength and may therefore disrupt with even modest stress. Therefore, deep sutures are placed in collagen containing structures to maintain the prolonged tension necessary. Dermis, intestinal submucosa, muscular fascia, tendon, ligament, Scarpa’s fascia, and blood vessel wall represent a partial list of tissues with high collagen content.