What are the essential rules in the application of a suture?

The concept that the surgical suture is a means of approach and not of restraint must be clear.
The essential rules in the application of a surgical suture are:

• It is necessary to reconstruct the tissues respecting the various anatomical planes (muscle, fascia, subcutis, skin);
• Do not traumatize the edges of the wound to respect its vitality;
• Avoid the formation of steps, overlapping of the flaps (overlapping) and introflections of the skin;
• Surgical suture stitches must be close to the edges of the wound;
• In the detached points, the needle must enter perpendicular to the skin plane and the entry and exit points of the needle must be equidistant from the edge of the wound and at the same depth on the two flaps;
• Restore the morphology of the affected structures (eg wounds of the lip, eyebrow);
• If necessary to counteract the tensile strength of the tissues, after removing the stitches, apply sterile plasters (Steri-strips);