Method for securing a subcuticular suture with minimal buried knot

Subcuticular, intradermal suturing with retained suture has been performed with a variety of techniques requiring bulky buried knots. This report outlines a new method for closing a skin wound under light to moderate tension with fewer problems of buried knot bulkiness and gapping of the wound ends. The suture method was developed in a porcine model and has been used in clinical suturing with 3-0, 4-0, and 5-0 suture material. Outcomes for 23 cases have been satisfactory with no dehiscences and no exposure of knot material. This technique provides the surgeon with an excellent way to approximate skin wounds with a retained sucuticular suture. A modified technique for small 3- to 10-mm wounds is also described.