Both vertical and horizontal mattress patterns are everting – they force the cut edges outward. NFFN patterns are appositional and bring tissue layers into direct contact with the same layer on the opposite side.
you can start with the far bite or with the near bites
Horizontal mattress with stents – clinical case
With a mattress suture placed to relieve tension, you can also place a simple continuous pattern across the skin margins. With this approach, you can remove the larger suture used for the mattress pattern after the skin stretches (3-4 days), leaving the more cosmetic simple continuous suture to finish the job.
NFFN between stents – clinical case
You can change the letters around too
G Kelmer et al. Simple techniques to decrease tension on sutured wounds in horses, Equine vet. Educ. (2022) 34 (2) 67-72