More formally known as the half-buried horizontal mattress suture, the corner stitch is an invaluable technique for closure of stellate lacerations. It is most suitable for “Y” shaped lacerations with a flap edge, but variations can also be employed for “V” and “X” shaped lacerations. When employed, the corner stitch should be placed first in order to preserve landmarks for the rest of the repair.
Technique
Modified from original illustration by Rory R Mayer, Larry Kravitz, Kevin Elwood, and Madison Cole in “A modified corner-stitch for V-laceration repair” accessed from Open Access Text
Modified from original illustration by Rory R Mayer, Larry Kravitz, Kevin Elwood, and Madison Cole in “A modified corner-stitch for V-laceration repair” accessed from Open Access Text
Identify the most “flap-like” edge
Enter percutaneously through either of the lateral (non flap-like) edges, pull through into the lacerated space
Place a subcuticular suture along the dermal layer (without piercing the epidermis)
Exit from dermis to epidermis at the opposite edge, an equal distance across the wound from the initial entry point
Instrument tie
Remainder of laceration can be repaired with other techniques as needed