This is a discussion and demonstration of a Subcuticular or Intracuticular suturing. What is a running Subcuticular stitch? Its the last layer of closure of a wound after closing the dermal layer. It precisely aligns the tissue edges to promote optimal healing.
I typically use 4-0 or 5-0 Monocryl suture to perform this closure.
Key points with a subcuticular closure are placing the needle parallel to the skin after presenting a small segment of the dermis to yourself with your forceps.
Bites are typically 1/3 the curvature of the needle.
Be careful not to travel too much as you traverse the wound.
Let the needle and instruments work for and with you.
Many times I see students fighting the instruments to power the needle through the skin. With a proper set up the needle should easily traverse the dermis.
Make sure to stay at the same level of the dermis as you traverse the skin. This will make sure edges are of even height and help with the healing and cosmesis of the incision.
You can bury the beginning or ending knots however I typically bury the knot on the outside of the skin. There are instances where I bury the knot however. |