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“Minding the ends”: a simple technique for repair of lower eyelid lacerations
  1. S N Ali,
  2. P G Budny
  1. Department of Plastic Surgery, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire, UK
  1. Correspondence to:
 Mr S N Ali
 Department of Plastic Surgery, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire HP21 8AL, UK;

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It is a common observation in suturing lower eyelid wounds that the cut ends of sutures cause a nuisance. When cut short they tend to irritate the cornea. Cut long they need to be controlled, but tape dressings often become detached because of epiphora or ointment application, as well as being a nuisance to replace.

There are many different methods of repair described in the literature1–3 but there are no accounts of any technique describing helpful management of suture ends. The technique we use is both simple and effective and can aid in suture removal as well. Starting from the tarsal end of the laceration, the suture ends are cut long (about 1 cm) (fig 1A). When the next suture is tied the ends of the first one is taken into the loop and thus kept in place (fig 1B). Similarly with the next suture, the ends of the suture above it are held down (fig 1C). Every stitch in turn holds the cut edges of a stitch or two above it. It is important in placing the ends to avoid them being incorporated in the wound margin. Suture removal is started from the bottom end (fig 1D). With removal of each stitch the ends of one above it are freed for easy control.

Figure 1

Schematic view of the technique.