or PS) is often used for repairs on the face A small needle (e.g., P3) should be used for wounds that require fine cosmesis Needles come in various sizes such as 3/8 and 1/2 circle Clinicians may develop a preference for a specific needle However, in general, a 3/8 reverse cutting needle satisfies most needs Closure Techniques Two of the most important goals of suturing are to match the layers of the injured tissues and to create eversion of the wound margins so they will flatten as the wound heals Layers on one side of a wound should be sutured to the corresponding, matching layers on the other side First, all layers of skin that have been injured should be identified Then, an attempt to oppose each layer (muscles, fascia, subcutaneous tissue, and skin) as nearly as possible back to its original location should be made This is achieved by carefully matching the depth of the bite taken on each side of the wound when suturing Proper suture placement should result in slight eversion of the wound so there is not a depressed scar when remodeling takes place Eversion may be achieved by slight thumb pressure on the wound edge as the needle is entering the opposite side Sutures should take equal bites from both wound edges so one margin does not overlap the opposite margin when the knot is tied Wound edge eversion is best achieved by taking proper bites while suturing, not by pulling the knot tightly ( Fig 110.2 ) Suture placement may be deep or superficial Deep sutures reapproximate the dermal layers of skin and not penetrate the epidermis They help relieve skin tension and improve the cosmetic appearance by reducing the width of the scar They should be avoided in wounds prone to infection because they will further increase this risk To place a deep suture, the needle is placed at the depth of the wound and removed at a more superficial level The needle is then inserted superficially into the opposite side of the wound and exits deeply so the knot is buried within the wound The needle end and free end of the suture should be on the same side of the loop before the knot is tied ( Fig 110.3 ) The simple interrupted technique (described next) with absorbable suture material should be used