Suture placement during laceration repair

To ensure proper apposition of the wound without excess tissue on one side (also called a "dog ear"), the clinician places the first stitch at the midline of the wound. The next two stitches go on each side of the first stitch, midway between the center stitch and the wound corners. Additional bisecting stitches are placed until the wound is properly aligned. The number of sutures needed to close a wound varies depending upon the length, shape, and location of the laceration. In general, sutures are placed just far enough from each other so that no gap appears in the wound edges.