How are dermal-subdermal sutures placed?

Updated: Mar 05, 2020
  • Author: Desiree Ratner, MD; Chief Editor: Dirk M Elston, MD  more...
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A dermal-subdermal suture is placed by inserting the needle parallel to the epidermis at the junction of the dermis and the subcutis. The needle curves upward and exits in the papillary dermis, again parallel to the epidermis. The needle is inserted parallel to the epidermis in the papillary dermis on the opposing edge of the wound, curves down through the reticular dermis, and exits at the base of the wound at the interface between the dermis and the subcutis and parallel to the epidermis.

The knot is tied at the base of the wound to minimize the possibility of tissue reaction and extrusion of the knot. If the suture is placed more superficially in the dermis at 2-4 mm from the wound edge, eversion is increased.

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