Sutures

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"