Where a triangular flap has to be inset, it is often difficult to get the tip of the flap to lie in position, yet multiple sutures placed through the full thickness of the dermis are apt to strangulate the tissue at the tip and produce necrosis. In such a situation the three-point suture helps to avoid necrosis while holding the tip in place.
As frequently illustrated the suture tends to bunch the tip of the flap, and a minor variation is recommended which is theoretically sound and effective in practice in holding the tip with-out bunching.
The points to be noted in inserting the suture are to make sure that the suture leaves and enters the reception side of the wound at the same level in the dermis as its placement in the tip of the V flap and to make the suture emerge well back on the reception side of the wound. The principle of the three-point suture can be extended for use where two flaps are being approximated to the third side of a wound.