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Undermining

Cartoon diagram of undermining, from Roberts & Hedges text Clinical Procedures in Emergency Medicine, 5th edition.

Undermining is one of the most underutilized, but superbly useful techniques in high tension laceration repair.  Undermining refers to the technique of using sterile scissors to bluntly dissect the dermal layer away from the underlying connective tissue.  Through the use of this technique, you can take away some of the connective tissue adhesions which anchor the skin in place and remove static tension on the wound.

A video demonstration of the technique is seen here:

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