Types of suturing techniques and when to use each

Simple interrupted

Individual stitches, each tied separately. Forgiving and adjustable — if one fails, the rest hold. The default for most lacerations, especially irregular or contaminated wounds.

Simple continuous

One running thread along the wound. Faster and spreads tension evenly, but a single break can loosen the whole line. Best for long, straight, clean wounds.

Vertical mattress

A far–far, near–near stitch that everts wound edges well. Useful where edges tend to invert, such as on the back of the hand or in loose skin.

Horizontal mattress

Spreads tension across a wider area and can help with haemostasis. Useful for higher-tension wounds and fragile skin, but can compromise edge blood supply if tied too tight.

Subcuticular (intradermal)

A running suture placed just under the skin surface, leaving no track marks. Offers excellent cosmetic results on clean, low-tension wounds, but takes more skill and time.

How to choose

• Contaminated or irregular wound → simple interrupted
• Long, straight, clean wound → continuous or subcuticular
• Edges inverting → vertical mattress
• High tension or fragile skin → horizontal mattress, often with deep sutures
• Cosmetically sensitive area → fine interrupted or subcuticular

Common questions

What is the most common suturing technique?

Simple interrupted sutures are the most widely used for skin closure because they are versatile and allow each stitch to be adjusted independently.

Which suture technique leaves the least scarring?

Subcuticular sutures typically give the best cosmetic result on suitable wounds because they avoid cross-hatch marks on the skin surface.