In elliptical incision, length to width ratio should be 3:1. PRINCIPLES OF SUTURING & ANASTOMOSES Each suture should be separated by a gap that is twice the thickness of the skinQ. When knots are cut sho, the free ends or 'ears' should be left at least 1-2 mm longQ. This is paicularly impoant with monofilament non-absorbablesQ. It has been suggested by Jenkins that a suture length to wound length ratio of 4:1 indicates the optimum size of tissue bites and of suture spacingQ. Anastomosis of vessels was pioneered by CarrelQ. Elliptical incisions must be at least 3 times of the width for the wound to heal without tension (Length to width ratio: 3:1Q)