This stitch is great for everting skin edges and precise approximation of wound edges with little tension.

• A. Vertical mattress
• B. Simple interrupted
• C. Subcuticular running
• D. Continuous running/baseball

Answer: (A)

To evert skin edges and achieve precise edge alignment with minimal tension, you need a stitch that grabs tissue at multiple depths on each side and pulls the edges outward as it is tied. The vertical mattress accomplishes this by taking deep, far bites coupled with superficial, near bites (the far–far and near–near pattern). When tightened, these bites draw the skin edges together while also everting them slightly and distributing tension along the wound. This combination gives excellent control over edge apposition and helps prevent inversion or trenching, which is especially helpful in areas of tension or with thicker skin.

Other patterns don’t provide this combination. A simple interrupted suture can close the wound but doesn’t reliably evert edges or distribute tension as effectively. A subcuticular running suture is intended for deep, cosmetic closure beneath the skin and does not address external skin edge eversion. A continuous running or baseball-type closure is fast but offers less precise edge control and can concentrate tension, making it harder to maintain proper eversion and precise alignment.