Sutures

Chart

Laceration Areas and Their Common Suture Type and Duration

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

Horizontal mattress

Vertical mattress

Vertical mattress

• 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

• Laceration Repair

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.