Suture Material for Bleeding Lip Lacerations
For bleeding lip lacerations, monofilament non-absorbable sutures are recommended as they cause less bacterial seeding and are less likely to cause infection. 1, 2
Optimal Suture Material Selection
- Monofilament non-absorbable sutures (such as nylon or polypropylene) are the first choice for lip lacerations due to their reduced bacterial seeding properties and lower infection risk 1, 2
- 5-0 or 6-0 monofilament non-absorbable sutures are appropriate sizes for lip lacerations to achieve optimal wound closure while minimizing tissue trauma 1, 2
- Monofilament sutures have demonstrated superior performance in facial lacerations with significantly less inflammatory response compared to other materials 3
Suturing Technique
- Continuous non-locking suturing techniques are preferred as they distribute tension more evenly across the suture line, reducing the risk of tissue edema and necrosis 1, 2
- For lip lacerations, a layered closure approach should be used, starting with the deeper muscular layer and then closing the mucosal and skin layers 1
- When suturing the vermillion border, precise alignment is critical for both functional and cosmetic outcomes 2
Alternative Options
- If considering absorbable options, monofilament absorbable sutures like poliglecaprone (MONOCRYL) or polyglyconate (Maxon) can be used, though they're generally not first-line for lip lacerations 1, 2
- Rapidly absorbing synthetic sutures (polyglactin 910/VICRYL RAPIDE) may be considered for the mucosal side of the lip but are not ideal for the cutaneous portion 1
- Avoid catgut sutures as they are associated with more pain and higher risk of requiring resuturing 1
Post-Repair Care
- Keep the wound clean and dry for the first 24-48 hours 2
- Recommend soft diet to minimize movement and tension on the suture line 1
- Consider chlorhexidine rinses (0.12%) twice daily for 1 minute for at least the first week to reduce bacterial load 1
- Sutures should be removed after 5-7 days to minimize scarring 2
Complications to Monitor
- Watch for signs of infection including increasing pain, redness, swelling, or purulent discharge 2
- Lip lacerations may appear minor but can be associated with significant bleeding due to the rich vascular supply of the area 2
- Misalignment of the vermillion border can result in permanent cosmetic deformity, requiring meticulous attention during repair 2
Special Considerations
- The mobility of the lip area creates additional tension on the wound, making proper suture selection particularly important 4
- In pediatric patients, consider the potential trauma of suture removal when selecting materials; however, cosmetic outcome should remain the priority for lip lacerations 5
- For contaminated lip wounds, monofilament sutures are particularly advantageous due to their resistance to harboring bacteria 6