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

Suture Type	Days of Tensile Strength	Complete Absorption	Descriptions
Chromic Gut	7-21 days	90 days	Chromium treated to decrease tissue reactivity
Vicryl (Polyglactin)	21 days	90 days	Synthetic
Vicryl Rapid	10 days	42 days	Synthetic with radiation treatment for increased absorption

Suture Type	Tensile Stength	Body Reactivity	Filliment
Nylon	High	Low	Monofilament
Silk	Low	High	multifilament
Prolene (Polypropylene)	Moderate	Low	Monofilament stiff

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"