What angle does the running suture typically travel across the lesion?

• A. 30 degrees
• B. 45 degrees
• C. 60 degrees
• D. 90 degrees

Answer: (B)

The idea is to cross the wound with a suture at about 45 degrees to the edge. This angle hits enough tissue to hold the edges securely while distributing tension along the length of the wound, which helps the edges come together smoothly and reduces the risk of tissue strangulation or edge necrosis. A shallower angle (closer to 30 degrees) risks shallow bites that don’t capture enough tissue, leading to poor approximation. A steeper angle (around 60 degrees or more) increases the depth of tissue captured and can concentrate pressure at the margins, potentially causing distortion or impaired perfusion. A perpendicular (90-degree) path concentrates stress at a single point and is less favorable for even apposition. Therefore, about 45 degrees is the best standard for a running suture across a lesion.