Excision: vertical mattress suture

This demonstrates placement of the vertical mattress suture that is used to close the upper layer of the dermis and the epidermis.The first pass the needle enters the right side of the wound about 2 mm from the wound, penetrates the full thickness of the dermis and exits 2 mm from the wound edge on the left side. The needle is then reversed in the needle holder, and the needle enters the left side of the wound about 1 mm away from the wound edge, penetrates only about 1 mm into the dermis, and exits the right side of the wound about 1 mm away from the wound edge. This suture technique closes dead space and everts the wound. I use it a great deal in both single or multilayered closures to insure wound eversion. I use it to close all punch biopsies.