Vertical mattress

This suture allows you to apply more tension for closure, while keeping the skin edges everted.

But there is a bigger risk of excess tension causing compression and necrosis of skin edges so use this judiciously. With good needle path technique in a simple interrupted suture, you can usually avoid using this method.

http://www.youtube.com/watch?v=GHxSKryRTeY -- this short video shows the steps well.

**insert link back to node showing crosssectional diagram of standard needle path, with overshoot etc.