Sutures: Difference between revisions
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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: consider use of Fast Absorbing Gut (5-0/6-0) on Ear, Eyelid, Eyebrow, Nose, Lip and Face if anticipated difficulty with suture removal | ||
{| class="wikitable sortable" | |||
|+ Absorbable Sutures | |||
{| | |- | ||
! scope="col" | '''Suture Type''' | |||
! scope="col" | '''Days of Tensile Strength''' | |||
! scope="col" | '''Complete Absorption''' | |||
! scope="col" | '''Descriptions''' | |||
|- | |- | ||
| Chromic Gut||7-21 days||90 days||Chromium treated to decrease tissue reactivity | | Chromic Gut||7-21 days||90 days||Chromium treated to decrease tissue reactivity | ||
| Line 696: | Line 696: | ||
|} | |} | ||
{| class="wikitable sortable" | |||
{| | |+ Non Absorbable Sutures | ||
|- | |||
! scope="col"|'''Suture Type''' | |||
! scope="col"|'''Tensile Stength''' | |||
! scope="col"|'''Body Reactivity''' | |||
! scope="col"|'''Filliment''' | |||
|- | |- | ||
| Nylon||High||Low||Monofilament | | Nylon||High||Low||Monofilament | ||
| Line 709: | Line 710: | ||
| Prolene (Polypropylene)||Moderate||Low||Monofilament stiff | | Prolene (Polypropylene)||Moderate||Low||Monofilament stiff | ||
|} | |} | ||
== Technique == | == Technique == | ||
Revision as of 22:07, 5 February 2014
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
- Vicryl
- Braided
- Stronger but higher infection risk
See Also
Source
Lampe
Cincinnati Children's Hospital "The Pocket"