Surgery Book

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Corner Stitch

Aka: Corner Stitch, Half-buried Horizontal Mattress Suture
  1. See Also
    1. Suture
    2. Local Anesthesia
    3. Laceration Repair
  2. Indications: Skin flap closure (no vascular compromise)
    1. Y-shaped Laceration corners (90 degree angle)
    2. X-shaped Laceration
  3. Advantages
    1. Does not compromise blood supply to tip of corner
  4. Technique: Y-shaped lesion
    1. Background
      1. Use non-Absorbable Suture
      2. Draw line perpendicular from corner tip (forms Y)
      3. Four landmark sites (2 on each side of the wound)
        1. Point 1 along left base of Y (6-8 mm from corner)
        2. Point 2 at left upper arm of Y (4 mm from corner)
        3. Point 3 at right upper arm of Y (4 mm from corner)
        4. Point 4 along right base of Y (6-8 mm from corner)
      4. Images
        1. sutureHalfBuriedHorizontalMattressLabel.jpg
    2. Step 1: Skin entry to base of flap
      1. Enter at point 1 on left side of wound
      2. Needle passes deep, below Dermis
      3. Exits subcutaneously near Point 2
      4. Exits at point 2 on left side of wound
    3. Step 2: Subcuticular stitch through flap
      1. Continue stitch started in Step 1
      2. Enter wound at point 2 on left side of wound
      3. Pass subcuticular stitch in flap to point 3
    4. Step 3: Flap to skin exit
      1. Enter near point 3 still subcutaneously
      2. Exit skin at Point 4
    5. Step 4: Tie knot
      1. Knot is between point 1-4 across base of Y
      2. Tie snugly, but avoid tying too tightly
        1. See complications below
    6. Step 4: Final appearance
      1. Suture exposed between point 1 and 4
  5. References
    1. Mortiere (1996) Wound Management, p. 50-5
    2. Snell in Pfenninger (1994), Mosby, p. 12-9
    3. Zuber (2002) Am Fam Physician 66(12):2231-6 [PubMed]

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