- this pattern allows a tube to be firmly secured to the skin by a single point
- force is redistributed along a series of crosses and knots applied around the tube.
- the point of skin attachment can be either a simple interrupted suture or a purse string suture (see video)
- For additional security and to help the tube lie flat along the body, a second point of skin attachment can be made by taking a bite of skin just before the last knot.
- 2-0 or larger size is often selected because finer suture tends to break