Vicryl Rapid vs. Normal Vicryl: Key Differences
Vicryl Rapide (irradiated polyglactin 910) is a fast-absorbing version of standard Vicryl that loses tensile strength in 7-10 days and completely absorbs in 42 days, eliminating the need for suture removal, while normal Vicryl maintains tensile strength for 21 days and absorbs in 56-70 days.
Absorption Timeline
- Vicryl Rapide: Tensile strength maintained for 7-10 days, with complete absorption occurring around 42 days 1
- Normal Vicryl: Tensile strength maintained for approximately 21 days, with complete absorption in 56-70 days 1
The key manufacturing difference is that Vicryl Rapide undergoes gamma irradiation, which accelerates the degradation process 1, 2.
Clinical Applications
Vicryl Rapide is optimal for:
- Pediatric surgery: Eliminates traumatic suture removal in children, though visible suture marks occur in 25% of cases if used on facial wounds or under tension 3
- Skin closure: Full-thickness skin grafts, scalp wounds, and oral mucosa where suture removal is undesirable 1, 2
- Episiotomy repair: Intracutaneous skin closure, though self-reported dehiscence rates may be higher (25%) compared to Monocryl (10%) 4
- Oral surgery: Wisdom tooth extraction sites show significantly reduced swelling duration (3.1 vs 5.5 days), less difficulty chewing, and reduced dysgeusia compared to standard Vicryl 5
Normal Vicryl is preferred for:
- Fascial closure: Cesarean delivery uterine incisions and abdominal wall closure where longer tensile strength is required 6
- Deep tissue repair: Situations requiring sustained wound support beyond 10 days 6
- High-tension areas: Where premature loss of tensile strength could compromise healing 4
Clinical Performance Comparison
Postoperative outcomes favor Vicryl Rapide in superficial closures:
- Significantly reduced swelling duration (3.1 vs 5.5 days, p<0.05) 5
- Lower pain scores (VAS 2.8 vs 3.7) in oral surgery, though not statistically significant 5
- No difference in infection rates or suppuration between materials 2, 5
- Eliminates need for suture removal, improving patient comfort 1, 3, 2
Critical Caveats
Avoid Vicryl Rapide in these situations:
- Facial wounds where suture marks are cosmetically unacceptable (visible in 25% of cases) 3
- Areas under significant tension, as premature absorption may cause dehiscence 3, 4
- Deep fascial closures requiring prolonged tensile strength 6
- Situations where wound support beyond 10 days is necessary 1
Antimicrobial Coating Considerations
Both standard Vicryl and Vicryl Rapide are available with triclosan coating. Triclosan-coated Vicryl significantly reduces surgical site infections (OR 0.67,95% CI 0.46-0.98) in abdominal fascial closure, though this benefit has not been demonstrated with PDS sutures 6. The coating provides additional infection prevention without compromising the fundamental absorption characteristics of either suture type 6.