Difference between revisions of "Sutures"

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'''Note: Favor absorable sutures for facial repair especially in children'''  
 
'''Note: Favor absorable sutures for facial repair especially in children'''  
  
{| class="wikitable sortable"
+
 
 +
== 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==
 +
*{| class="wikitable sortable"
 
|+ Absorbable Sutures
 
|+ Absorbable Sutures
 
|-
 
|-
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| Prolene (Polypropylene)||Moderate||Low||Monofilament stiff
 
| 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 ==
 
== See Also ==
  

Revision as of 23:04, 5 February 2014

Chart

Suture Usage
Area Size Type Days to Removal
Scalp Staples or 4-0 or 5-0 non absorable 7
Ear 6-0 non absorable 5-7
Eyelid 6-0 or 7-0 absorable or nonabsorbable 5-7
Eyebrow 5-0 or 6-0 absorable or nonabsorbable 5-7
Nose 6-0 absorable or nonabsorbable 5-7
Lip 6-0 absorable NA
Oral mucosa 5-0 absorable NA
Other face / forehead 6-0 absorable or nonabsorbable 5
Chest/abdomen 4-0 or 5-0 non absorable 12-14
Back 4-0 or 5-0 non absorable 7-10
Extremities 4-0 or 5-0 non absorable 7-10
Hand 5-0 non absorable 7-10
Foot / Sole 4-0 non absorable 12-14
Joint (Extensor) 4-0 non absorable 10-14
Joint (Flexor) 4-0 non absorable 7-10
Vagina 4-0 absorable NA
Penis 5-0 non absorable 7-10
Scrotum 5-0 non absorable 7-10

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: Favor absorable sutures for facial repair especially in children


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

  • {| class="wikitable sortable"

Absorbable Sutures

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

Non Absorbable Sutures
Suture Type Tensile Stength Body Reactivity Filliment
Nylon High Low Monofilament
Silk Low High multifilament
Prolene (Polypropylene) Moderate Low Monofilament stiff

See Also

Laceration Repair

Source

Tajirian Ani et al. A review of sutures and other skin closure materials. Journal of Cosmetic and Laser Therapy. 2010 Dec;12(6):296-302.