c. Vertical Mattress Suture. The vertical mattress suture involves placing a
double line of suture material across the wound. The skin is entered and exited twice,
instead of only once which is normal with simple sutures. The result is that two lines of
suture lie one above the other.
(1) Technique. Begin as you would for a simple suture. Enter and exit the
wound, however, a generous distance from the wound edge. Then, reenter the skin
about one to two millimeters from the wound edge. Tie the suture normally.
(2) Advantages. The vertical mattress suture ensures wound edge
eversion. This type of suture is useful in areas where the wound edges have a
tendency to invert.
(3) Disadvantages. There are twice as many suture marks as with simple
sutures. The reason is that most vertical mattress sutures require four points of skin
entry and exit.
Figure 2-11. The vertical mattress suture.