Adjustable horizontal mattress suture: Step 1 (large photo)

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After administering general anesthesia, prepare the skin around the lesion for aseptic surgery. Then inject a local long-acting analgesic agent (e.g. bupivacaine) around the lesion.

Using 2-0 nonabsorbable synthetic monofilament suture material (polypropylene or nylon) with a swaged cutting needle, pass the first suture bite through the full thickness of skin on one side of one end of the wound.

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