From the Research
Sutures can typically be placed on a 24-hour-old cut, though this is approaching the outer limit of the ideal timeframe. The standard recommendation is to seek medical attention within 6-12 hours of injury for optimal wound closure, but many wounds can still be sutured up to 24 hours after injury, depending on several factors.
Key Considerations
- The healthcare provider will first clean the wound thoroughly with saline or antiseptic solution and assess for signs of infection, as wound infection is associated with delayed healing, wound chronicity, and increased healthcare costs 1.
- If the wound appears clean without significant contamination or infection, primary closure with sutures is often still possible.
- The type of suture material used will depend on the wound location and depth, with absorbable sutures like Vicryl commonly used for deeper layers and non-absorbable sutures like nylon or polypropylene for skin closure.
- The provider may prescribe prophylactic antibiotics such as cephalexin 500mg four times daily for 5-7 days if the wound is at high risk for infection, considering the wound penetration of antibiotics during negative pressure wound therapy 2.
Post-Suturing Care
- After suturing, the wound should be kept clean and dry, with dressing changes as directed.
- Sutures typically remain in place for 5-14 days depending on the location (face: 5-7 days; trunk: 7-10 days; extremities: 10-14 days).
- Delayed closure carries a slightly higher risk of infection compared to immediate closure, which is why thorough cleaning and possibly antibiotics are important considerations at the 24-hour mark.
Evidence-Based Decision Making
- There is currently no systematic evidence to guide clinical decision-making regarding the timing for closure of traumatic wounds, highlighting the need for robust research in this area 3.
- However, based on the available evidence, primary closure of non-bite traumatic wounds within 24 hours post-injury may be considered, taking into account the individual patient's risk factors and wound characteristics.