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Media Gallery

Diagram of a needle.
Needle is placed vertically and longitudinally perpendicular to needle holder.
Needle holder is held through loops between thumb and fourth finger, and index finger rests on fulcrum of instrument.
Needle holder is held in palm, allowing greater dexterity.
Knot tying.
Simple interrupted suture placement. Bottom right image shows a flask-shaped stitch, which maximizes eversion.
Line of interrupted sutures.
Running suture line.
Running locked suture.
Vertical mattress suture.
Pulley stitch, type 1.
Far-near near-far modification of vertical mattress suture, creating pulley effect.
Horizontal mattress suture.
Half-buried horizontal suture (tip stitch, three-point corner stitch).
Subcuticular stitch. Skin surface remains intact along length of suture line.
Anatomy of needle.
Commonly used suture needles, with cross-sections of needles shown at point, body, and swage. (A) Taper-point needle. (B) Conventional cutting needle. (C) Reverse cutting needle.
Interaction between needle holder and suture needle. (A) Needle holder of appropriate size for needle. (B) Needle holder that is too large for needle—pressure applied by needle holder leads to inadvertent straightening of suture needle. (C) Needle holder that is too small for needle—needle rotates around long axis of needle holder.
Poster for Biogel Puncture Indication System.

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Author

Desiree Ratner, MD Clinical Professor of Dermatology, NYU Langone Health

Desiree Ratner, MD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Medical Association, American Society for Dermatologic Surgery, Phi Beta Kappa

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Regeneron<br/>Serve(d) as a speaker or a member of a speakers bureau for: Genentech<br/>Received income in an amount equal to or greater than $250 from: Genentech; Regeneron.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Julian Mackay-Wiggan, MD, MS Assistant Professor, Department of Dermatology, Columbia University-New York Presbyterian Hospital

Julian Mackay-Wiggan, MD, MS is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology, American Medical Association

Disclosure: Nothing to disclose.

Divya R Sambandan Columbia University College of Physicians and Surgeons

Divya R Sambandan is a member of the following medical societies: Phi Beta Kappa

Disclosure: Nothing to disclose.

Acknowledgements

Daniel G Becker, MD Assistant Professor, Department of Otorhinolaryngology-Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, University of Pennsylvania School of Medicine

Daniel G Becker, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American College of Surgeons

Disclosure: Nothing to disclose.

Dominique Dorion, MD, MSc, FRCSC, FACS Deputy Dean and Associate Dean of Resources, Professor of Surgery, Division of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Université de Sherbrooke, Canada

Disclosure: Nothing to disclose.

Richard F Edlich, MD, PhD, FACS, FASPS, FACEP Distinguished Professor Emeritus of Plastic Surgery, Biomedical Engineering and Emergency Medicine, University of Virginia Health Care System

Richard F Edlich, MD, PhD, FACS, FASPS, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Association of Plastic Surgeons, American Burn Association, American College of Emergency Physicians, American College of Surgeons, American Society of Plastic and Reconstructive Surgery, American Spinal Injury Association, American Surgical Association, American Trauma Society, Plastic Surgery Research Council, Society ofUniversity Surgeons, and Surgical Infection Society

Disclosure: Nothing to disclose.

Stephen Y Lai, MD, PhD Associate Professor, Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center

Stephen Y Lai, MD, PhD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Association for Cancer Research, American Head and Neck Society, and Society of University Otolaryngologists-Head and Neck Surgeons

Disclosure: GlaxoSmithKline Grant/research funds None; Neoprobe Grant/research funds clinical trial

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Axis Three Corporation Ownership interest Consulting; Medvoy Ownership interest Management position; Cerescan Imaging Honoraria Consulting

Anthony P Sclafani, MD Director of Facial Plastic Surgery and Surgeon Director, New York Eye and Ear Infirmary; Professor of Otolaryngology, New York Medical College

Anthony P Sclafani, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American College of Surgeons

Disclosure: Contura None Board membership; Aesthetic Factors, Inc. Salary Consulting; Meditech Medical Enterprises Consulting fee Independent contractor

Shobana Sood, MD Assistant Professor, Department of Dermatology, University of Pennsylvania Hospital

Shobana Sood, MD is a member of the following medical societies: American Academy of Dermatology and American Society for Dermatologic Surgery

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Michael J Wells, MD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Suturing Techniques Questions & Answers

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