There are many methods to start a subcuticular suture. Here we explain what we believe is the easiest way. The stitch is passed through the skin 1 cm from the apex and is brought out at the angle of the wound. The first suture is passed along one wound edge. Without pulling the stitch through completely, the needle is passed through the loop twice (Fig. 1) forming a knot. The other end is cut flush with the skin. The suture is continued as normal and completed with a buried Aberdeen knot. No problems have been experienced with the subcuticular knot.
Figure 1.
Steps in a subcuticular suture.