title: Running combined simple and vertical mattress suture: a rapid skin-everting stitch.
abstract: BACKGROUND
  Vertical mattress sutures are used in skin surgery to produce eversion of the wound edges, which produces a better, cosmetically acceptable scar. The disadvantages of this closure include the risk of wound hypereversion if tied too tightly, longer time to perform the stitch, and difficulties with grasping the externalized loops during suture removal.
  
  
  OBJECTIVE
  To examine and discuss the new modification of running vertical mattress sutures, which can overcome the disadvantages.
  
  
  METHODS
  Running combined simple and vertical mattress suture techniques are presented in a series of schematic diagrams that follow.
  
  
  RESULTS
  The running combined simple and vertical mattress is easier and quicker to close the wound than the classic interrupted or running vertical mattress suture. Whereas the mattress suture everts the wound edges, the simple suture coapts the sides, preventing undue inversion or hypereversion of the wound. Suture removal is less uncomfortable for the patient and is performed faster by the medical staff owing to a reduction in the number of externalized loops by half compared with the classic vertical mattress stitch.
  
  
  CONCLUSIONS
  Alternation of the vertical mattress and simple running suture saves the surgeon's time without lessening the advantages of good wound eversion and hence the formation of a less apparent, cosmetically more appealing scar after wound contraction.
authors.affiliation: Department of Dermatology, University of Illinois College of Medicine, 502 Park Avenue, River Forest, IL 60305, USA. sasakrun@hotmail.com
authors.forename: Aleksandar L
authors.initials: AL
authors.lastname: Krunic
authors.forename: Sarah
authors.initials: S
authors.lastname: Weitzul
authors.forename: R Stan
authors.initials: RS
authors.lastname: Taylor
mesh_terms: D062109:Dermatologic Surgical Procedures; D004954:Esthetics; D006801:Humans; D013536:Suture Techniques; D014945:Wound Healing