From the Research
For a deep forearm laceration, 3-0 or 4-0 absorbable sutures are recommended for the deep tissue layers, as they have been shown to have comparable outcomes to non-absorbable sutures in terms of wound dehiscence, infections, and complications 1. When choosing the suture size for a deep forearm laceration, it is essential to consider the depth and location of the wound.
- The deep layers should be closed with absorbable materials like polyglactin (Vicryl) or polydioxanone (PDS) to eliminate dead space and reduce tension on the skin closure.
- For the skin, non-absorbable materials such as nylon or polypropylene can be used, but absorbable sutures like monocryl have also been shown to be effective 1. Proper wound preparation is crucial before suturing, including thorough irrigation with normal saline and debridement of devitalized tissue, as outlined in general principles of laceration repair 2.
- Local anesthesia with 1% lidocaine (maximum 5mg/kg) with or without epinephrine should be administered before cleaning and suturing. Deep forearm lacerations require careful assessment for potential damage to underlying structures, including tendons, nerves, and blood vessels, which may necessitate surgical consultation.
- Sutures should typically be removed after 10-14 days, and patients should be advised to keep the wound clean and dry, watch for signs of infection, and follow up if complications develop.