How To Repair a Laceration With Horizontal Mattress Sutures By Matthew J Streitz, MD, San Antonio Uniformed Services Health Education Consortium Reviewed / Revised Mar 2021 | Modified Sep 2022 View Patient Education Indications Contraindications Complications Equipment Additional Considerations Positioning Step-by-Step Description of Procedure Aftercare Warnings and Common Errors Tips and Tricks Topic Resources Horizontal mattress suture Flap laceration repair The horizontal mattress suture uses a simple suture bite followed by a reverse bite adjacent to the first to create a single broad suture that achieves wound approximation and epidermal eversion without constricting the wound edge.