This technique provides the best cosmetic outcome, but is more time-consuming and has less tensile strength than other approaches.
Linear lacerations with intact wound edges.
Non-linear lacerations, or lacerations with contamination or tension.
Place a deep dermal suture at one end of the wound and secure it with four to five throws. Cut the short tail only.
Next, drive the needle under the knot in line with the wound, exiting at the apex of the laceration.
Take a bite of subcuticular tissue at the epidermal-dermal junction in parallel to the wound.
Continue to take bites on alternating sides of the wound in this manner until you reach the other end of the wound.
On your last throw of the needle, do not pull the suture material all the way through. The slack will form a loop, which you can use to tie an Aberdeen knot or an instrument tie.
The Aberdeen knot is secured by holding the needle-end of the suture material in one hand, and reaching through the loop with the other hand to grab the needle-end and pull the bottom edge of the suture material through the loop while holding the top end secured. This creates a new loop and the process is repeated four to five times. For the final knot, the needle is passed through the loop and pulled tight. Then drive the needle under the knot in line with the wound, exiting one centimeter from the apex of the wound. Cut the suture at the skin surface to complete your repair.