Suture selection

Important Cautions:

• Do not use dyed sutures on the skin

• Use monofilament on the skin as

multifilament harbor bacteria

• Nonabsorbable cause less scarring but

must be removed

• Plus sutures (staph species, and monocryl

for E.Coli and Klebsiella; see website)

• Location and layer, patient factors,

strength, healing, site, and availability

Suture selection (Chapt 2)

• Absorbable for GI, urinary, or biliary

• Nonabsorbable or extended up to 6 months for

skin, fascia, tendons

• Cosmetics= monofilament or subcuticular

• Ligatures usually absorbable

• Drains depends on layer

• Site; type of tissue and layer for surgery

• Microsurgery and implantable devices

• Tensile strength, knot & days security, reactivity

Skin area and suture size:

• Scalp 4-0 or 5-0

• Face, ear, nose, lip,

forehead 6-0

• Eyelid 6-0 or 7-0

• Eyebrow 5-0 or 6-0

• Trunk or extremity

3-0, 4-0, or 5-0

• Plantar foot 3-0 or 4-0

• Hand 5-0

• Steristrips, etc.

Needle Tips

• Taper for soft tissue such as GI, muscle,

peritoneum usually rounded/small holes

• Tapercut reverse cutting edge/taper point

• Cutting for skin or tough tissue

conventional, reverse, and side

• Blunt not for friable; liver, kidney, OB, GYN

Suture removal

Facial and neck skin in 2-5 days

Other skin sutures in 5-8 days

Various surgery 7-14 days(Orthopedic 10-14 days)

Retention sutures in 2-6 weeks

Infection nonabsorbable monofilament

Assess wound healing; follow-up

Proper suture handling

Steristrips and appropriate dressings

Proper removal techniques sutures and staples

Suturing demo and practice