Chromic Gut Suture for Chin Laceration
Chromic gut suture is an acceptable option for closing a chin laceration, offering comparable cosmetic outcomes to nonabsorbable sutures while eliminating the need for suture removal. 1, 2
Suture Material Considerations
- Absorbable sutures like chromic gut provide similar long-term cosmetic outcomes compared to nonabsorbable sutures in facial lacerations, with no significant difference in infection or dehiscence rates 1, 2
- Chromic gut suture has a mean longevity of approximately 11-12 days in oral environments, which is adequate for facial wound healing 3
- Monofilament absorbable sutures (like poliglecaprone/Monocryl) may be preferred over chromic gut as they cause less bacterial seeding and potentially lower infection risk 4
- Rapidly absorbing synthetic sutures like polyglactin 910 (Vicryl Rapide) are also effective alternatives that eliminate the need for suture removal 4
Suturing Technique Recommendations
- Continuous subcuticular suturing technique may reduce superficial wound dehiscence compared to interrupted sutures 5
- A 4-0 or 5-0 suture size is typically appropriate for facial lacerations including chin areas 4
- Continuous non-locking suturing techniques distribute tension more evenly across the suture line, potentially improving cosmetic outcomes 4
Evidence-Based Outcomes
- Studies comparing absorbable sutures (including chromic gut) to nonabsorbable sutures in facial lacerations found no clinically important differences in cosmetic outcomes at 9-12 months 6, 2
- In pediatric facial lacerations, fast-absorbing catgut demonstrated comparable cosmetic results to nylon sutures at 3 months post-repair 2
- Patient satisfaction scores were similar between absorbable and nonabsorbable suture groups in facial laceration repairs 6, 2
Potential Complications and Considerations
- Monitor for signs of infection, including increasing pain, redness, swelling, or discharge at the suture site 4
- Be aware that rare hypersensitivity reactions to chromic catgut have been reported, which may present as excessive inflammation or delayed healing 7
- Consider that the chin area experiences significant movement during talking and eating, which may place additional stress on the wound closure 4
- Avoid overly tight sutures that can strangulate tissue and impair healing, particularly important in mobile facial areas 4
Additional Wound Care Recommendations
- The wound should be kept clean and dry for the first 24-48 hours 4
- Follow-up should occur within 24 hours to ensure proper healing 4
- The use of adhesive steri-strips as additional wound support does not significantly improve outcomes when used with buried sutures 5
In conclusion, while monofilament absorbable sutures may offer some theoretical advantages, chromic gut suture is a reasonable choice for chin lacerations with evidence supporting comparable cosmetic outcomes to nonabsorbable sutures while eliminating the need for a removal visit.