After all bleeding points are controlled, the wound should be thoroughly washed with saline. The chances for primary healing are greatly enhanced if the field is absolutely dry. If unexpected infection has been encountered, the wound should be packed open. In uncomplicated sinuses, the wound is closed after all bleeding is controlled. Rather than bury sutures, the skin can be closed and the dead space eliminated by a series of interrupted vertical mattress sutures (Figure 9). The suture is introduced 1 cm or a little more than the margins of the wound to include the full thickness of the mobilized flap of skin and subcutaneous tissue. A second bite includes the fascia in the bottom of the wound (Figure 9). The suture is then continued deep into the opposite flap. The suture is directed back to the original side as it passes back through the skin margins (Figure 10). When tied, this obliterates the dead space and accurately approximates the skin margins (Figure 11). The sutures should be placed at intervals of not more than 1 cm. Skin approximation must be very accurate, since even a small overlap may be surprisingly slow to heal in this area. A pressure dressing is applied with great care, and the sutures are allowed to remain in place for 10 to 14 days.