Vertical Mattress Stitch - Advantages and Disadvantages

Advantages and Disadvantages

The vertical mattress stitch is superior to all other stitches due to its quadruple ability to achieve deep and superficial wound closure, edge eversion and precise vertical alignment of the superficial wound margins. However, its advantage of precise control also means that the vertical mattress stitch is unforgiving of operator error, particularly in regard to poor vertical alignment of edges. As mentioned above, the vertical mattress stitch is prone to dig into skin, like a cheese cutter wire, so is more likely than other suture types to leave "railroad marks" - small scars along the main wound. Bolstering reduces this problem but necessarily increases the complexity of the stitch. Overall, the propensity of the vertical mattress suture to create railroad marks limits its use in cosmetically sensitive areas, such as the face, and it remains imperative to remove it as early as possible when it is used elsewhere on the body.