V-shaped laceration repair

V-shaped skin injuries and lacerations can be tricky. The V flap may have decreased vascularity so you want to limit needle sticks and tension as to to strangulate the tissue and impair healing. Sometimes a simple interrupted suture can be used to tack this down at the apex. Line this up first then do the sides of the wound. You can also use a modified horizontal mattress suture, going into the dermal layer to bring the apex into alignment.