Suturing Up Lacerations Right
The laceration is an irregular wound caused by tearing of the skin. In the case of most lacerations, tissue injury is minimal and infections are not common. However, severe lacerations can stretch out to the full thickness of the skin, extending into the subcutaneous tissues, which could include the internal organs, underlying muscles or bone. Such full-thickness lacerations require closure with sutures. Sutures also help in effective cosmetic recovery.
Sutures are used to close cuts and wounds; doctors sew the skin together with individual sutures and tie a knot, allowing the skin to heal naturally thereafter. These sutures can be absorbable, which are digested naturally by the body’s enzymes, or non-absorbable, which either need to be removed by the doctor at a later date or (in some cases) left in permanently. Furthermore, these sutures can be classified as monofilament sutures, which consist of a single thread that passes through the tissues, and braided sutures, which comprise of numerous small threads braided together that make the stitch more secure.
Lacerations are of different kinds and different suturing styles are implemented to address the wound appropriately with help from different types of sutures.
Let’s read on to understand Laceration little better:
Case 1: The Uncomplicated Laceration
A wound on the anterior surface of the leg with no tendon, nerve or vascular involvement in the clean, 6 cm wide laceration.
The best choice to repair such an uncomplicated laceration is a monofilament non-absorbable suture, as these surgical sutures have the lowest rate of infection. In this case, a size 3-0, 4-0 or 5-0 may be appropriate for the wound; the smallest diameter that can efficiently support the tension on the wound makes for the right choice. Knotless, barbed sutures from Covidien are also good alternatives for these kinds of wounds due to faster closure times.
Case 2: The Paediatric Laceration
A 3 cm wound that appears clean, on the left cheek after a fall.
When sutures are required for a clean laceration, especially for wounds on kids, fast-absorbing catgut sutures are recommended. These sutures allow similar cosmesis to non-absorbable sutures. Moreover, absorbable sutures eliminate the significant anxiety the child may have with suture removal.
Case 3: The Deep Laceration
A clean-appearing 6 cm laceration which actually extends deep into the adipose tissue.
In this case of a deep laceration, the generous use of interrupted, absorbable sutures reduces skin tension, thereby easing closure and in turn improving the cosmetic outcome.
The right suture and technique will stitch up the lacerations neatly to the point where the wound site may not recognizable. Go through the exhaustive list of the best surgical sutures in India.
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