Suture Removal Timing for Hand Lacerations
For hand lacerations, sutures should typically be removed after 10-14 days to ensure proper wound healing while minimizing scarring and complications. 1
Factors Affecting Suture Removal Timing
- Hand lacerations require longer suture retention times (10-14 days) compared to other body areas due to high mobility and tension in this region 1, 2
- The thumb webbing area specifically benefits from extended suture duration (12-14 days) to ensure complete healing before exposure to mechanical stress 1
- Monofilament sutures are preferred for hand lacerations as they cause less bacterial seeding and may reduce infection risk in this high-mobility area 1
- Absorbable sutures (like poliglecaprone/MONOCRYL or rapidly-absorbing polyglactin 910/VICRYL RAPIDE) eliminate the need for suture removal, which is particularly advantageous in the hand where removal can be painful 1, 3
Suture Material Considerations for Hand Lacerations
- Monofilament absorbable sutures are recommended for hand lacerations due to reduced bacterial seeding while maintaining good cosmetic outcomes 1
- Polyglyconate (Maxon) provides good tensile strength for high-mobility areas like the hand 1
- Absorbable plain gut sutures have shown comparable or slightly better cosmetic outcomes compared to nonabsorbable sutures in traumatic lacerations 4
- A 5-year retrospective study found no difference in scar quality between absorbable (Vicryl) and nonabsorbable (nylon) sutures for hand lacerations at 6-month follow-up 3
Suturing Technique Recommendations
- Continuous non-locking suturing technique is preferred over interrupted sutures as it distributes tension more evenly across the suture line 1
- For optimal wound closure in hand lacerations, 4-0 or 5-0 suture size is appropriate 1
- Consider subcuticular closure for the final layer to minimize scarring in functionally important areas 1
- Avoid tight sutures that could strangulate wound edges in high-mobility areas like the hand 1
Post-Repair Care
- Keep the wound clean and dry for the first 24-48 hours 1
- Avoid excessive tension on the hand during the initial healing phase 1
- Use acetaminophen or ibuprofen for pain management 1, 5
- Watch for signs of infection (increasing pain, redness, warmth, swelling, purulent drainage) 1, 5
- Elevation of the injured hand, especially if swollen, accelerates healing 6
- Follow up within 24 hours either by phone or during an office visit to ensure proper healing 6
Complications to Monitor
- Infectious complications include septic arthritis, osteomyelitis, subcutaneous abscess formation, and tendonitis 6
- Pain disproportionate to the severity of injury but located near a bone or joint should suggest periosteal penetration 6
- Hand wounds are often more serious than wounds to fleshy parts of the body and may require closer monitoring 6
- Noninfectious complications include nerve or tendon injury, compartment syndromes, post-traumatic arthritis, and bleeding 6