Walking sutures: Step 3A (large photo)
Take the second suture bite toward the center of the wound (B in photo above and schematic in Step 3B). To ascertain precisely where to take the second bite, pinch the area of the first bite between your thumb and forefinger, with your thumb on the dermal skin surface and your forefinger on the epidermal surface. Stretch the skin toward the center of the wound as far as possible, and place the first suture bite down against the underlying tissue. Take the second suture bite at this point, incorporating the dense muscle fascia. If the bite is being placed in granulation tissue with secondary wound closure, place it deeply so it can pass through the dense collagenous base of this tissue.