The horizontal mattress stitch is a suture technique used to close

wound A wound is any disruption of or damage to living tissue, such as skin, mucous membranes, or organs. Wounds can either be the sudden result of direct trauma (mechanical, thermal, chemical), or can develop slowly over time due to underlying diseas ...

s. It everts skin well and spreads tension along the wound edge. This makes it ideal for holding together fragile skin as well as skin under high tension such as the distant edges of a large

laceration A wound is any disruption of or damage to living tissue, such as skin, mucous membranes, or organs. Wounds can either be the sudden result of direct trauma (mechanical, thermal, chemical), or can develop slowly over time due to underlying diseas ...

or as the initial holding suture in complicated repairs. The horizontal mattress is so secure that it can compromise blood supply to the tissue contained within the stitch. This can be helpful to prevent wound bleeding, but it can cause strangulation and skin

necrosis Necrosis () is a form of cell injury which results in the premature death of cells in living tissue by autolysis. The term "necrosis" came about in the mid-19th century and is commonly attributed to German pathologist Rudolf Virchow, who i ...

if tied too tightly. Sometimes cushioning materials can be placed within the stitch to mitigate this effect. Like other mattress stitches, the horizontal mattress can sometimes leave small skin scars called "railroad marks;" for this reason it is rarely used on the face, and is removed promptly even when placed elsewhere. The

knot A knot is an intentional complication in Rope, cordage which may be practical or decorative, or both. Practical knots are classified by function, including List of hitch knots, hitches, List of bend knots, bends, List of loop knots, loop knots, ...

is parallel adjacent to the

edge. A variation of the horizontal mattress stitch is the figure-of-eight suture. Instead of turning the needle around, the second simple bights are in the same direction as the first. Like the horizontal mattress stitch, it is useful for skin under high tension. It also has the benefit of helping with hemostasis.

References

{{reflist Surgical stitches