Brief Summary

Occasionally patients present with parallel wounds in close proximity. The following techniques demonstrate rapid closure of multiple parallel wounds. Methods 1 and 2 are for two parallel wounds. Method 3 can be used for numerous parallel wounds.

Indications

Linear, parallel wounds of approximately the same size.

Method 1: Simple Interrupted

Illustration of parallel laceration repair with simple interrupted suture. Image from Closing the Gap

  1. Throw the needle through the epidermis on the far side of the farther wound, entering the “tissue island” between the parallel wounds at the dermis
  2. Exit through the dermis on the near side of the island and reload the needle.
  3. Pass the needle through the near wound’s closest edge, exiting through the epidermis.
  4. Instrument Tie

Method 2: Horizontal Mattress

Illustration of parallel laceration repair with horizontal mattress suture. Image from Closing the Gap

  1. Throw the needle through the epidermis on the far side of the farther wound, entering the “tissue island” between the parallel wounds at the dermis
  2. Exit through the dermis on the near side of the island and reload the needle.
  3. Pass the needle through the near wound’s closest edge, exiting through the epidermis.
  4. Using a backhand technique, drive the needle through the near wound’s closest edge and passing through the dermis of the tissue island
  5. Reload the needle and drive it through the far side of the farther wound, approximately the same distance from the wound edge and along the plane of the wound creating a square of entry/exit points
  6. Instrument Tie

Method 3: Figure of Eight

Illustration of parallel laceration repair with figure-of-eight method. Image from Closing the Gap

  1. Throw the needle through the epidermis on the far side of the farthest wound, exiting the far “tissue island” through the epidermis
  2. Reload the needle and drive it through the epidermis of the next tissue island, continuing in the same fashion until you exit the near wound’s closest edge
  3. Using a backhand technique, pass the needle from the near wound’s closest edge and exit through the tissue island
  4. Continue passing the needle in a backhand fashion through each tissue island until you exit the far side of the farthest wound
  5. Instrument tie

Common Pitfalls

Beware of compression of the “tissue islands” in the middle of the parallel lacerations. The mattress suture method in method 2 can cause puckering in the wound.