Which suture pattern is U-shaped and used for loose skin to prevent invagination and eliminate dead space without burial?

Which suture pattern is U-shaped and used for loose skin to prevent invagination and eliminate dead space without burial?

• A. Purse-string
• B. Vertical mattress
• C. Running subcuticular
• D. Simple interrupted

Answer: (B)

The technique described is the vertical mattress suture. This pattern is designed for loose or excess skin because it uses paired bites that go deep on one side and shallow near the edge on the same side, then repeats on the opposite side. The result is a distinctive U-shaped path that spreads tension away from the wound edge and into the deeper tissue, which helps prevent invagination and reduces dead space without burying the knot. By everting the skin edges and anchoring deeper tissue, it provides durable closure even when there’s redundancy or laxity in the surrounding skin, and the knot can be placed on the exterior surface rather than buried. In contrast, pursestring closes circular defects by drawing edges inward, running subcuticular sits beneath the skin and isn’t aimed at addressing dead space or edge eversion, and simple interrupted doesn’t offer the same distribution of tension or edge eversion for loose skin.

The technique described is the vertical mattress suture. This pattern is designed for loose or excess skin because it uses paired bites that go deep on one side and shallow near the edge on the same side, then repeats on the opposite side. The result is a distinctive U-shaped path that spreads tension away from the wound edge and into the deeper tissue, which helps prevent invagination and reduces dead space without burying the knot. By everting the skin edges and anchoring deeper tissue, it provides durable closure even when there’s redundancy or laxity in the surrounding skin, and the knot can be placed on the exterior surface rather than buried. In contrast, pursestring closes circular defects by drawing edges inward, running subcuticular sits beneath the skin and isn’t aimed at addressing dead space or edge eversion, and simple interrupted doesn’t offer the same distribution of tension or edge eversion for loose skin.