Simple running suture
Christoffer Bing Madsen, MD, Magnus Balslev Avnstorp MD, Specialist Plastic Surgery
Used for epidermal approximation. Can be used both as a stand-alone but mostly as a second layer to aid after dermal/other deep sutures
Suture material choice
On the face/eyelids a thickness of 6-0 monofilament will most likely work. 6-0 monofilament can also be used on extremities as well. Otherwise 4.0 – 5.0 in case of moderate tension.
Step by step guide
- The needle is inserted perpendicular to the epidermis
- Rotate needle through dermis so the needle tip exits the skin on the contralateral side
- Grasp needle body (not tip!) with forceps and pull upward
- Release needle body from driver
- Tie off gently and aim to minimize tension
- Now start proximal from the prior knot you tied and repeat step 1-4
- Instead of tying a knot, simply repeat steps 1-4 until the wound edge is reached
- When the wound edge is reached load the needle with a backhand and insert in the skin with a perpendicular angle in a mirror image of the previous throws
- The suture is only partly moved through the tissue, leaving a loop of suture!
- Tie using an instrument tie with the help of the loop.