The single layer closure of a wound is the technique of choice for repairing most of the lacerations that are treated in an emergency department.

Most lacerations of the extremities, trunk, and scalp require only one layer of suturing. Single layer closure is usually not used on the face.

Before starting to repair the wound, decide how far the sutures should be placed from each other and how far they should be from the edge of the wound. When there are definite landmarks (eyebrows, lip, etc.), place the sutures so that the landmark is brought into alignment. Use one of these two methods of suturing:

(1) Start at one end of the wound and work to the other end of the wound.

(2) Continually bisect the wound until the wound is closed.

CAUTION: The second technique listed can cause the tissue to buckle. This is referred to as “dog-eared.”