Sutures

Chart

Suture Usage

Area	Size	Type	Days to Removal
Scalp	Staples or 4-0 or 5-0	non absorable	7
Ear	6-0	non absorable	5-7
Eyelid	6-0 or 7-0	absorable or nonabsorbable	5-7
Eyebrow	5-0 or 6-0	absorable or nonabsorbable	5-7
Nose	6-0	absorable or nonabsorbable	5-7
Lip	6-0	absorable	NA
Oral mucosa	5-0	absorable	NA
Other face / forehead	6-0	absorable or nonabsorbable	5
Chest/abdomen	4-0 or 5-0	non absorable	12-14
Back	4-0 or 5-0	non absorable	7-10
Extremities	4-0 or 5-0	non absorable	7-10
Hand	5-0	non absorable	7-10
Foot / Sole	4-0	non absorable	12-14
Joint (Extensor)	4-0	non absorable	10-14
Joint (Flexor)	4-0	non absorable	7-10
Vagina	4-0	absorable	NA
Penis	5-0	non absorable	7-10
Scrotum	5-0	non absorable	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 absorable sutures for facial repair especially in children

Absorbable Sutures

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

Non Absorbable Sutures

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"