Suture Types for Scalp Lacerations
For scalp lacerations, monofilament sutures are preferred due to less bacterial seeding and reduced infection risk, though staples are also an excellent option due to faster application time and less pain during the procedure. 1
Optimal Suture Materials
- Monofilament sutures are recommended for scalp lacerations as they cause less bacterial seeding and may be less likely to cause infection 1
- Absorbable suture options include monofilament poliglecaprone (MONOCRYL) and polyglyconate (Maxon) 2
- Rapidly absorbing synthetic sutures (e.g., polyglactin 910 - VICRYL RAPIDE) can be considered to eliminate the need for suture removal 2
- Standard synthetic sutures (polyglycolic acid or polyglactin 910) are effective but may require removal if non-absorbable 2
- Avoid catgut sutures as they are associated with more pain and higher risk of requiring resuturing 2
Staples vs. Sutures for Scalp
- Staples are a fast and cosmetically acceptable alternative to suturing for simple scalp lacerations 3
- Stapling is significantly faster than suturing (p=0.001) with similar cosmetic outcomes 3
- Stapling carries no risk of accidental needle-stick injury, making it safer for the provider 4
- Studies show no significant difference in infection rates or morbidity between staples and sutures for scalp wounds 4
- Stapling is less painful during the procedure compared to suturing 4
Absorbable vs. Non-absorbable Sutures
- Absorbable sutures can provide the same cosmetic and functional results as non-absorbable sutures for scalp lacerations 5
- Using absorbable sutures reduces the need for patient returns for suture removal 5
- Absorbable sutures may be more cost-effective due to elimination of follow-up visits 5
Suturing Techniques
- Continuous non-locking suturing techniques are preferred as they distribute tension more evenly across the entire length of the suture 2
- Non-locking technique is preferred because locking sutures can cause excessive tension leading to tissue edema and necrosis 2
- For optimal wound closure in scalp lacerations, 4-0 or 5-0 suture size is typically appropriate 1
Alternative Closure Methods
- Tissue adhesives are an option for minor scalp lacerations with low skin tension 6
- The tissue adhesive hair apposition technique is effective in repairing scalp lacerations 6
- Skin-closure tapes may be used for very superficial lacerations 6
Post-Repair Care
- Keep the wound clean and dry for the first 24-48 hours 1
- White petrolatum ointment is as effective as antibiotic ointment in postprocedure care 6
- Wetting the wound as early as 12 hours after repair does not increase infection risk 6
- Follow up within 24 hours either by phone or during an office visit to ensure proper healing 1