This technique is similar to the vertical mattress suture, but starts with the “near-near” needle throw, allowing for more controlled wound edge apposition for improved cosmetic outcomes.
Technique
Enter the tissue approximately 3mm from the wound edge.
Exit at approximately the same distance on the opposite wound edge.
Reload needle and use a “backhand” approach.
Use your non-dominant hand to lift the tail and the needle end’s extra suture material, pulling up on both wound edges.
Pass the needle backhanded, entering approximately 6mm from the wound edge.
Exit at approximately the same distance on the opposite wound edge.
Instrument tie.
Common Pitfalls
The “far-far” bite is placed blindly and can cause damage to blood vessels, nerves, or other surrounding structures.