Sutures

Revision as of 13:33, 6 July 2011 by Megankirch (talk | contribs)

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 for deeps
      • Never if high risk for infection
      • Good for hard to reach places (kid's mouth)
    • 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"