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If you like the horizontal mattress suture but can’t imagine taking the time to apply it over and over again for a longer wound, consider this variation.

Running the suture, as outlined in the video above, increases efficiency of placement for longer wounds. It can be used as an initial layer for a longer, higher-tension wound in order to create a lower tension environment for closing the wound with deep dermal sutures within the wound followed by either simple interrupted or running percutaneous sutures closer to the wound margins.

One practical tip from Dr. Jon Kantor, a practicing dermatologist and author of The Atlas of Suturing Techniques: when applied in reality, this technique can make it difficult to remove the suture material.  He thus recommends placement of intermittent simple loops which cross the wound margin (similar to a standard running percutaneous suture) in order to facilitate easier removal of the suture.

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