<p>Simple interrupted suturing is a foundational surgical skill, yet the expert micro-behaviors that support efficient performance remain undercharacterized, particularly in open surgery at the level of individual stitches. This study examined expert gaze–action coupling during simple interrupted suturing and developed an empirically derived behavioral framework to translate these patterns into structured training guidance. Eight board-certified surgeons performed 335 standardized simple interrupted sutures on artificial skin while wearing Tobii Pro Glasses 3. Gaze and video streams were synchronized and segmented into stitch-level motor events. Analyses were conducted at both the stitch and subject levels using mean comparison tests and mixed-effects models. Four reproducible expert micro-behaviors were identified. First, surgeons typically directed initial fixation toward functional instrument tips rather than handles. Second, the right-to-left insertion pattern was more frequently used and was associated with shorter insertion times than the right-middle-left pattern, whereas wound-edge squeezing showed a descriptive stitch-level association that did not remain significant in mixed-effects analysis. Third, complete three-wrap knots were associated with efficient knot tying, while additional wraps and incomplete knots prolonged execution. Fourth, re-grasping efficiency was associated more strongly with technique than with needle placement location, with Gather-in-Hand and Designated Needle Placement supporting faster transitions than Slide-and-Secure. These findings were synthesized into the Suture–Action–Gaze Efficiency (SAGE) framework. SAGE should be interpreted as an observational, expert-derived behavioral guide rather than a validated causal training model.</p>