Step by Step Article
When the suture is tied, a portion of skin is advanced toward the center of the wound because of skin elasticity (schematic above). It is helpful to have an assistant surgeon stretch the skin into place as you tie the suture. The assistant surgeon should place a thumb over the first suture bite area in the skin and use his or her thumb and other fingers to stretch the skin. As the assistant surgeon holds the area of the first bite down with his or her thumb against the area of the second suture bite, tie the suture.