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Vertical mattress suture.

Vertical mattress suture.
Vertical mattress suture.

The first pass of the needle is the same as a large simple suture, but instead of tying off, another smaller bite is taken back across the wound to end on the starting side. Both ends are pulled up to closely align (approximate) the wound edges. Points A and B must be at the same depth, as must points C and D; this placement results in correct vertical alignment.

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