From the Guidelines
For a laceration repair on the thigh, monofilament sutures such as poliglecaprone (MONOCRYL, Ethicon) or polyglyconate (Maxon, Medtronic) are recommended due to their lower risk of infection and bacterial seeding 1. When considering the type of suture for a laceration repair on the thigh, it's essential to prioritize morbidity, mortality, and quality of life. The thigh experiences significant tension and movement, requiring strong sutures that can maintain wound closure during healing.
- Monofilament sutures are preferred over braided options because they have less tissue drag and lower risk of harboring bacteria, which reduces infection risk.
- The suture size should be selected based on the laceration's depth and location, with 3-0 being appropriate for deeper or more tension-prone areas and 4-0 for more superficial repairs.
- Sutures should typically remain in place for 10-14 days on the thigh due to the area's slower healing rate compared to the face or scalp.
- When performing the repair, ensure adequate local anesthesia (such as 1-2% lidocaine with epinephrine), thorough wound irrigation, and proper wound edge approximation.
- Consider using deep dermal absorbable sutures (like 4-0 Vicryl) before placing the monofilament skin sutures if the wound is deep, as this reduces tension on the skin closure and improves cosmetic outcome. The use of monofilament sutures, as recommended in the study by 1, is associated with less pain and a lower risk of requiring resuturing, making it a preferable choice for laceration repair on the thigh.
From the Research
Suture Materials for Lac Repair on the Thigh
- The choice of suture material for lac repair on the thigh depends on various factors, including the type of injury, location, and patient's overall health.
- According to the studies, monofilament sutures such as Monocryl (poliglecaprone 25) 2 and nylon 3, 4 are commonly used for skin closure and have shown excellent handling properties and minimal tissue reaction.
- Monocryl sutures have been shown to provide an in vivo breaking strength retention of approximately 20-30% after 2 weeks, which is considered the critical wound healing period 2.
- A study comparing Monocryl and Vicryl (a braided multifilament synthetic suture) for subcuticular skin closure at cesarean delivery found that both sutures had comparable rates of surgical site infection and other wound complications 5.
- Another study compared the gliding resistance of two monofilament sutures, Prolene and Nylon, for repair of partially lacerated tendons and found that Nylon had a lower gliding resistance than Prolene 3.
- A study on the tissue reactivity of monofilament suture materials, nylon and poliglecaprone 25, in rats found that external sutures done with nylon produced less tissue reactivity, while internal sutures done with nylon contributed to the maintenance of tissue reaction 4.
Recommendations for Suture Material
- Based on the studies, Monocryl (poliglecaprone 25) or nylon monofilament sutures may be suitable for lac repair on the thigh due to their excellent handling properties and minimal tissue reaction.
- The choice of suture material ultimately depends on the surgeon's preference and the specific needs of the patient.