Convert high-tension V-shaped wounds to a lower-tension
Indications
Large avulsion flaps or other V-shaped lacerations.
Technique Description
Measure and mark two points at equal distances from the apex of the wound.
Place a corner stitch by driving your needle through one point to the side of the apex
Next take a parallel bite of the flap’s subcuticular tissue
Finally pass the needle through the other side of the apex to exit at the second marked point.
Instrument tie.
This stitch will pull the flap towards the wound apex, creating a Y-shaped wound.
Then repair the arms of the Y with simple interrupted, running sutures, or mattress sutures as needed.
Common Pitfalls
Unequal wound edges can lead to dog ear flaps. Additionally, some wounds may have so much tension that they will require undermining of the wound edges and/or deep dermal sutures to relieve tension prior to approximating the flap using the Corner stitch.