Avoiding stitch abscesses in subcuticular skin closures: the L-stitch.

A potential problem with the standard method of skin closure in pediatric surgery is the development of a skin abscess. To avoid this problem, we introduce a new stitch--the L-stitch. The technique involves passing the suture subcuticularly at the end of the incision and redirecting the needle at a 90 degree angle from the previous suture, before bringing it out to the skin surface. This stitch can be used in place of the initial and finishing knot of a running suture. It takes less time to perform than a square or a surgeon's knot and is less bulky. This technique is straightforward and, when used in conjunction with adhesive skin closure strips, provides strong, reliable skin closure, yielding excellent cosmetic results.