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How To Repair a Laceration With a Subcuticular Running Suture
Relevant Anatomy for Subcuticular Running Sutures
The subcutis or hypodermis refers to the subcutaneous layer of tissue lying beneath the dermal layer. However, subcuticular sutures are placed intradermally. The epidermis and dermis are grossly indistinguishable, and intradermal sutures are typically placed 1 to 2 mm deep to the skin surface. The upper subcutis may be distinguished from the dermis by the decreased resistance to needle insertion in the loose subcutaneous tissue. Minimizing tension on the epidermal layer (and aligning and everting the wound edges) are key to achieving the best wound result. Consider whether lacerations are subject to dynamic skin tension before closure (see figure Representative Minimal Skin Tension Lines ). Direction of force is along each line. Cuts perpendicular to these lines are thus under greatest tension and most likely to widen. 