Chart
Suture Usage
| Area
|
Size
|
Type
|
Days to Removal
|
| Scalp |
Staples or 4-0 or 5-0 |
non absorbable |
7
|
| Ear |
6-0 |
non absorbable (absorbable for cartilage repair) |
5-7
|
| Eyelid |
6-0 or 7-0 |
absorbable or nonabsorbable |
5-7
|
| Eyebrow |
5-0 or 6-0 |
absorbable or nonabsorbable |
5-7
|
| Nose |
6-0 |
absorbable or nonabsorbable |
5-7
|
| Lip |
6-0 |
absorbable |
NA
|
| Oral mucosa |
5-0 |
absorbable |
NA
|
| Other face / forehead |
6-0 |
absorbable or nonabsorbable |
5
|
| Chest/abdomen |
4-0 or 5-0 |
non absorbable |
12-14
|
| Back |
4-0 or 5-0 |
non absorbable |
7-10
|
| Extremities |
4-0 or 5-0 |
non absobrable |
7-10
|
| Hand |
5-0 |
non absorbable |
7-10
|
| Foot / Sole |
4-0 |
non absorable |
12-14
|
| Joint (Extensor) |
4-0 |
non absorable |
10-14
|
| Joint (Flexor) |
4-0 |
non absorbable |
7-10
|
| Vagina |
4-0 |
absorbable |
NA
|
| Penis |
5-0 |
non absorbable |
7-10
|
| Scrotum |
5-0 |
non absorbable |
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 absorbable sutures for facial repair especially in children
Types
Absorbable Sutures
| Suture Type
|
Days of Tensile Strength
|
Complete Absorption
|
Descriptions
|
| Chromic Gut |
7-21 days |
90 days |
Chromium treated to decrease tissue reactivity
|
| PDS (Polydioxone) |
14 days |
180-240 days |
Monofilament synthetic absorbable suture
|
| 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 Strength
|
Body Reactivity
|
Filament
|
| Nylon |
High |
Low |
Monofilament
|
| Silk |
Low |
High |
Multifilament
|
| Prolene (Polypropylene) |
Moderate |
Low |
Monofilament stiff
|
Technique
Wound before and after suture closure. The closure incorporates five simple interrupted sutures and one vertical mattress suture (center) at the apex of the wound.
- Simple Interrupted
- Less potential for causing wound edema or impaired circulation
- Allows for alignment adjustments
- Simple Running
- Useful for long, linear wounds
- Risk of dehiscence if suture ruptures
- Horizontal Mattress
- Spreads tension over wound
- Useful for high tension wounds
- Vertical Mattress
- Great for wound eversion, closure of both superior and deep layers
- Useful when there is a contraindication to deep sutures
See Also
References
- Tajirian Ani et al. A review of sutures and other skin closure materials. Journal of Cosmetic and Laser Therapy. 2010 Dec;12(6):296-302.
