Difference between revisions of "Sutures"

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| align="center" style="background:#f0f0f0;"|'''Suture Type'''
 
| align="center" style="background:#f0f0f0;"|'''Suture Type'''
 
| align="center" style="background:#f0f0f0;"|'''Days of Tensile Strength'''
 
| align="center" style="background:#f0f0f0;"|'''Days of Tensile Strength'''
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| align="center" style="background:#f0f0f0;"|'''Suture Type'''
 
| align="center" style="background:#f0f0f0;"|'''Suture Type'''
 
| align="center" style="background:#f0f0f0;"|'''Tensile Stength'''
 
| align="center" style="background:#f0f0f0;"|'''Tensile Stength'''
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| Prolene (Polypropylene)||Moderate||Low||Monofilament stiff
 
| Prolene (Polypropylene)||Moderate||Low||Monofilament stiff
 
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== Technique ==
 
== Technique ==

Revision as of 21:33, 5 February 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"