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To begin, let us consider the suturing of a simple laceration or incision on a flat area of the body with normal skin thickness and adequate blood supply. Sutures are usually placed 3/8 to 1/2 inch apart on an extremity, the trunk, or back. The distance between each suture should be more or less equal to the span of the suture itself. Simple sutures are used for skin edges that are not likely to turn under (invert), and are applicable to thicker areas of the body’ s surface. Around the face or in areas where unusual delicacy is required, very fine sutures of silk or nylon are placed 1/8 to 3/16 inches apart, and left in only three to five days. On larger areas of the body, the sutures are left in place approximately one week—for example, the upper extremities, chest, or abdomen. Leave sutures intact for ten days to two weeks in the lower extremities, back, or other areas where blood supply may be compromised. It is important not to tie the sutures too tight nor compress the skin edges so closely that free circulation is impaired. On the other hand, the suture should not be so loose to allow the skin edges to gape and thereby delay healing, as well as leaving open a route for infection. During healing, sutures should be kept clean and dry. After three to four days showers are usually permitted, including shampooing of the hair after scalp injuries. Prolonged soaking, however, is inadvisable. Wet dressings should never be permitted to remain over sutures. Silk and cotton sutures especially should be kept dry, as they may act as a “wick” to allow the entrance of germs resident on the skin surface. Nylon and subcuticular (buried) sutures are less likely to become infected. The latter type involves a special technique, comprising a back and forth sewing motion beneath the skin to “bury” the suture. This enables it to heal with scarring. Subcuticular sutures are particularly valuable in the perineum after childbirth, in the face to reduce scarring, and in children, where their removal several days later would be unduly traumatic. Chromic, Dexon, or other absorbable material will provide a subcuticular closure with no necessity to remove sutures later. Properly done, this technique produces a very nice healed surface with minimal of scarring. Nylon is not as suitable for subcuticular closure. When it or other nonabsorbable material is used, the ends must be left exposed outside the skin, and the suture removed after appropriate cleansing and at the proper time. Skin edges that are prone to invert should be repaired using a vertical mattress technique. This enables the suture to encircle the deeper layers of the wound, as well as bring together (approximate) the skin edges. This is the usual method used to close abdominal incisions. Less often used in acute trauma, it is nevertheless appropriate in locations where careful attention to cosmetic results are indicated.