Difference between revisions of "Sutures"

(Technique)
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Note: consider use of Fast Absorbing Gut (5-0/6-0) on Ear, Eyelid, Eyebrow, Nose, Lip and Face if anticipated difficulty with suture removal
 
Note: consider use of Fast Absorbing Gut (5-0/6-0) on Ear, Eyelid, Eyebrow, Nose, Lip and Face if anticipated difficulty with suture removal
  
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{| {{table}}
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| align="center" style="background:#f0f0f0;"|'''Suture Type'''
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| align="center" style="background:#f0f0f0;"|'''Days of Tensile Strength'''
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| align="center" style="background:#f0f0f0;"|'''Complete Absorption'''
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| align="center" style="background:#f0f0f0;"|'''Descriptions'''
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|-
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| Chromic Gut||7-21 days||90 days||Chromium treated to decrease tissue reactivity
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|-
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| Vicryl (Polyglactin)||21 days||90 days||Synthetic
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|-
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| Vicryl Rapid||10 days||42 days||Synthetic with radiation treatment for increased absorption
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|}
  
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{| {{table}}
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| align="center" style="background:#f0f0f0;"|'''Suture Type'''
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| align="center" style="background:#f0f0f0;"|'''Tensile Stength'''
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| align="center" style="background:#f0f0f0;"|'''Body Reactivity'''
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| align="center" style="background:#f0f0f0;"|'''Filliment'''
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|-
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| Nylon||High||Low||Monofilament
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|-
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| Silk||Low||High||multifilament
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|-
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| Prolene (Polypropylene)||Moderate||Low||Monofilament stiff
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|}
  
 
== Technique ==
 
== Technique ==

Revision as of 21:13, 12 January 2014

Chart

Area
Percutaneous (Skin)
Deep (Dermal)
Days to Removal
(Percutaneous Only)
Scalp
Staples or 4-0 or 5-0 Prolene/Ethilon
4-0 Vicryl/Chromic Gut
5-8
Ear
6-0 Prolene/Ethilon
see note below

5-7
Eyelid

6-0 or 7-0 Prolene/Ethilon

If low on lid, consult ophtho


5-7
Eyebrow
5-0 or 6-0 Prolene/Ethilon
5-0 Vicryl/Chromic Gut
5-7
Nose

6-0 Prolene/Ethilon

see note below

5-0 Vicryl/Chromic Gut 5-7
Lip
6-0 Prolene/Ethilon 5-0 Vicryl/Chromic Gut 5-7
Oral mucosa
N/A
4-0 or 5-0 Vicryl/Chromic Gut N/A
Other face / forehead
6-0 Prolene/Ethilon 5-0 Vicryl/Chromic Gut 4-5
Chest/abdomen 4-0 or 5-0 Prolene/Ethilon 3-0 Vicryl/Chromic Gut 8-10
Back 4-0 or 5-0 Prolene/Ethilon 3-0 Vicryl/Chromic Gut 12-14
Extremities 4-0, 5-0 or 5-0 Prolene/Ethilon 4-0 Vicryl/Chromic Gut 8-10
Hand
5-0 or 6-0 Chromic 5-0 Vicryl/Chromic Gut

8-10

10-12 (fingertip)

Foot / Sole
3-0 or 4-0 Prolene/Ethilon 4-0 Vicryl/Chromic Gut 12-14
Joint (Extensor) 3-0 or 4-0 Prolene/Ethilon
10-14
Joint (Flexor) 4-0 or 5-0 Prolene/Ethilon
8-10
Vagina
N/A
4-0 Vicryl/Chromic Gut N/A
Penis
5-0 Prolene/Chromic N/A
7
Scrotum
N/A
5-0 Vicryl/Chromic Gut N/A

Note: consider use of Fast Absorbing Gut (5-0/6-0) on Ear, Eyelid, Eyebrow, Nose, Lip and Face if anticipated difficulty with suture removal

Suture Type Days of Tensile Strength Complete Absorption Descriptions
Chromic Gut 7-21 days 90 days Chromium treated to decrease tissue reactivity
Vicryl (Polyglactin) 21 days 90 days Synthetic
Vicryl Rapid 10 days 42 days Synthetic with radiation treatment for increased absorption
Suture Type Tensile Stength Body Reactivity Filliment
Nylon High Low Monofilament
Silk Low High multifilament
Prolene (Polypropylene) Moderate Low Monofilament stiff

Technique

  • Horizontal Mattress
    • Spreads tension over wound
    • Useful for high tension wounds
  • Vertical Mattress
    • Great for wound eversion, closure of both sup and deep layers: contraindication to deeps

Types

  • Absorbable
    • Use for deep sutures
    • Never place if high risk for infection
    • Good for hard to reach places (e.g. kid's mouth)
    • Types
      • Vicryl
        • Lasts longer
      • Chromic
        • Faster, good for oral mucosa
    • Braided
      • Stronger but higher infection risk

See Also

Laceration Repair

Source

Lampe

Cincinnati Children's Hospital "The Pocket"