Difference between revisions of "Sutures"

(Technique)
Line 690: Line 690:
 
*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 sup and deep layers: contraindication to deeps
 
+
==Types==
*Types
+
*Absorbable
**Absorbable for deeps
+
**Use for deep sutures
***Never if high risk for infection
+
**Never place if high risk for infection
***Good for hard to reach places (kid's mouth)
+
**Good for hard to reach places (e.g. kid's mouth)
**Vicryl
+
**Types
**Lasts longer
+
***Vicryl
**Chromic
+
****Lasts longer
***Faster, good for oral mucosa
+
***Chromic
 +
****Faster, good for oral mucosa
 
**Braided
 
**Braided
 
***Stronger but higher infection risk
 
***Stronger but higher infection risk

Revision as of 02:12, 28 March 2012

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


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"