Mattress Suture is strong and can be used to close relatively large wounds. There are two basic types of mattress suture: vertical and horizontal. Mattress Suture is a common suture used to close wounds. Mattress Suture is a cut stitch, meaning each stitch is tied before forming the next stitch.
In fact, vertical mattress suture has excellent tensile strength as it has two diameters along the same linear path in both deep and shallow penetration. A good surgeon will make smooth, symmetrical stitches while piercing the tissue through the wound with the same depth and width. Irregular stitches can cause additional problems.
Vertical Mattress Suture
Vertical mattress suture includes two deep penetrations perpendicular to the wound on the same vertical line. The suture enters the tissue, passes under the tissue surface and through the wound and exits on the other side. First, two shallow entrances are made, then the process is followed by deep stitches. This suture then returns to the end of the wound where the needle first entered so the ends can be tied. Both vertical and horizontal Mattress Suture are typically tied using a square knot.
Rectangular mattress suture requires four deep penetrations that mark the corners of each stitch rectangle. It is sometimes used as a support suture to keep the tissue in a suitable position so that other cut stitches can be made. In such a case, after the other stitches are placed, the horizontal bed stitch is taken.
Horizontal Mattress Suture
A variation of the horizontal mattress suture is the semi-sunken horizontal stitch. Horizontal mattress suture is often used to close angled wounds. In this case, the suture enters the tissue outside the wound, exits from the tissue near the entry point, following a curved path covering the entry point and sides. The seam forms a circle shape under the tissue with only the ends connected to the outside.
If both horizontal and vertical mattress suture are tied too tightly, there is a risk of problems. Supporting the seams with small pieces can reduce the risk of trouble as well as cutting the seams as early as possible. The tightness of the cut stitches can be adjusted at the seam of each suture; this is especially important for irregular cuts.
It is common to leave some scar on the mattress suture. The stitch creates a line-like scar with needle marks where the needle enters and leaves the tissue. If possible, mattress suture will be removed within five to seven days to reduce scars.