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

Suture selection

In contrast to the epidermal layer, where you will most often be using non-absorbable suture material, 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. Options include polyglactin (vicryl) or braided lactomer (polysorb). Size 3-0 or 4-0 is generally appropriate depending on the body location and how much tensile strength is needed.


Modified from original diagram by Riley Grosso, MD on TamingTheSru

  1. Enter from deep to superficial, exiting at the dermo-epidermoid junction
  2. Rearm the needle driver
  3. On the opposite side, enter from superficial to deep, existing at the reticulo-dermal layer
  4. Instrument tie, cut close to the knot