Difference between revisions of "Sutures"

(Types)
(Technique)
Line 91: Line 91:
 
**Useful for high tension wounds
 
**Useful for high tension wounds
 
*Vertical Mattress
 
*Vertical Mattress
**Great for wound eversion, closure of both sup and deep layers: contraindication to deeps
+
**Great for wound eversion, closure of both superior and deep layers: contraindication to deeps
  
 
== See Also ==
 
== See Also ==

Revision as of 22:12, 28 June 2016

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

Types

Absorbable Sutures
Suture Type Days of Tensile Strength Complete Absorption Descriptions
Chromic Gut 7-21 days 90 days Chromium treated to decrease tissue reactivity
PDS (Polydioxone) 14 days 180-240 days Monofilament synthetic absorbable suture
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

Technique

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

See Also

Laceration Repair

References

  • 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.