Hypodermic Needle–Guided Wide-Bite Buried Dermal Suture: A Tension-Offloading Technique

In this technical note, we describe a simple and reproducible hypodermic needle–guided wide-bite dermal suture technique designed to effectively offload tension in high-tension wounds. By using a hypodermic needle preloaded with absorbable suture material, this method enables the placement of wider and deeper dermal–subcutaneous bites through a single epidermal entry point, minimizing surface trauma while redistributing tension away from the epidermis. This facilitates stable wound approximation and allows subsequent layered closure under significantly reduced tension.
We believe this technique offers a practical, cost-effective solution that can be easily adopted in routine dermatologic surgical practice, particularly in resource-limited settings. It has the potential to improve wound stability and cosmetic outcomes while reducing the need for more invasive reconstructive procedures.