d by passing the tip of the needle through thedermis perpendicular to the initial exit point (Figure 1b). The knot is formed by passing the whole suture needle through the loop ina direction that is towards the distal end of the wound. Tightening of the knot is achieved by holding the distal end of the suture (located outside the wound 1cm away from the proximal wound edge) and pulling the needle (Figure 1c). This prevents slippage of the knot and allows it to be buried within the dermis. Fig1a: Creation ofa retention knot : proximal Wound edge. Dotted ling represents movement of needle and suture through the dermis. The needle with suture emerges from the dermis at the wound apex. Fig1b: The needle is passed through he dermis perpendicular to the initial suture exit point creating a loop.
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