Pediatric emergency medicine trisk 3380 3380

FIGURE 110.2 Suturing technique for wound edge eversion.

Superficial or percutaneous sutures are passed through the dermis and
epidermis and leave the knot visible at the skin surface. Skin should be closed
with a minimal amount of tension. Sutures should be pulled tightly enough to
approximate the wound edges, but not so tightly that they cause tissue necrosis.
Sutures that seem well placed initially may begin to cut into the tissue in the next
few days because of swelling and inflammation. There is no need to tightly close
the skin if other layers have been well sutured. Scalp wounds are an exception.
They are under considerable tension, and the knots in this location should be
pulled firmly to keep the skin together. The wound will be hidden by hair, so the