Sutures: Difference between revisions
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==Technique== | ==Technique== | ||
[[File:Simple_Interrupted_Suture.png|thumb|Simple Interrupted]] | |||
[[File:Horizontal mattress suture.svg|thumb|Horizontal mattress]] | [[File:Horizontal mattress suture.svg|thumb|Horizontal mattress]] | ||
[[File:Vertical mattress suture.svg|thumb|Vertical mattress]] | [[File:Vertical mattress suture.svg|thumb|Vertical mattress]] | ||
[[File:Suture, before and after, RMO.jpg|thumb|Wound before and after suture closure. The closure incorporates five simple interrupted sutures and one vertical mattress suture (center) at the apex of the wound.]] | [[File:Suture, before and after, RMO.jpg|thumb|Wound before and after suture closure. The closure incorporates five simple interrupted sutures and one vertical mattress suture (center) at the apex of the wound.]] | ||
*Simple Interrupted | |||
**Less potential for causing wound edema or impaired circulation | |||
**Allows for alignment adjustments | |||
*Horizontal Mattress | *Horizontal Mattress | ||
**Spreads tension over wound | **Spreads tension over wound |
Revision as of 01:02, 1 September 2021
Chart
Laceration Areas and Their Common Suture Type and Duration
Area | Size | Type | Days to Removal |
---|---|---|---|
Scalp | Staples or 4-0 or 5-0 | non absorbable | 7 |
Ear | 6-0 | non absorbable (absorbable for cartilage repair) | 5-7 |
Eyelid | 6-0 or 7-0 | absorbable or nonabsorbable | 5-7 |
Eyebrow | 5-0 or 6-0 | absorbable or nonabsorbable | 5-7 |
Nose | 6-0 | absorbable or nonabsorbable | 5-7 |
Lip | 6-0 | absorbable | NA |
Oral mucosa | 5-0 | absorbable | NA |
Other face / forehead | 6-0 | absorbable or nonabsorbable | 5 |
Chest/abdomen | 4-0 or 5-0 | non absorbable | 12-14 |
Back | 4-0 or 5-0 | non absorbable | 7-10 |
Extremities | 4-0 or 5-0 | non absobrable | 7-10 |
Hand | 5-0 | non absorbable | 7-10 |
Foot / Sole | 4-0 | non absorable | 12-14 |
Joint (Extensor) | 4-0 | non absorable | 10-14 |
Joint (Flexor) | 4-0 | non absorbable | 7-10 |
Vagina | 4-0 | absorbable | NA |
Penis | 5-0 | non absorbable | 7-10 |
Scrotum | 5-0 | non absorbable | 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 absorbable sutures for facial repair especially in children
Types
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 |
Suture Type | Tensile Strength | Body Reactivity | Filament |
---|---|---|---|
Nylon | High | Low | Monofilament |
Silk | Low | High | Multifilament |
Prolene (Polypropylene) | Moderate | Low | Monofilament stiff |
Technique
- Simple Interrupted
- Less potential for causing wound edema or impaired circulation
- Allows for alignment adjustments
- Horizontal Mattress
- Spreads tension over wound
- Useful for high tension wounds
- Vertical Mattress
- Great for wound eversion, closure of both superior and deep layers
- Useful when there is a contraindication to deep sutures
See Also
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.