Deep Dermal Sutures

Simple interrupted dermal sutures (more commonly referred to as deep dermal sutures) are sutures placed within the dermal layer to reduce the static tension on a gaping wound with poor edge apposition.

In contrast to the epidermal layer, where you will most often be using non-absorbable suture material like nylon or silk, the dermal layer should be closed with absorbable sutures since you won’t be able to remove them later.  Ideally, a suture material with minimal tissue reactivity but a longer period of effective wound support is best. I typically use vicryl sutures for this purpose, size 3-0 or 4-0 depending on how much tensile strength I anticipate will be needed.

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3 thoughts on “Deep Dermal Sutures”

  1. I was trained to pull my knots tight perpendicular to the wound for deep dermal sutures. This would be at a 90 degree angle to that demonstrated in this video. This accomplishes two goals. One it pulls the wound edges closer together thus taking even less tension off the wound edges. Two it buries the knot deeper in further from the skin surface again making stitch abscess less likely. Hope this tip is useful thanks for the great sight!

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