What type of suture is recommended for a minor laceration wound?

Suture Selection for Minor Lacerations

For minor lacerations, use monofilament absorbable sutures (such as poliglecaprone/MONOCRYL or polyglyconate/Maxon) in 4-0 or 5-0 size, as they reduce infection risk, eliminate the need for removal, and provide excellent cosmetic outcomes. 1, 2

Optimal Suture Material

Monofilament absorbable sutures are the preferred choice for the following reasons:

• Monofilament sutures cause less bacterial seeding and reduce infection risk compared to multifilament (braided) sutures, making them superior for routine wound closure 1, 2
• Absorbable options eliminate the need for suture removal, saving time and reducing patient anxiety and discomfort 1, 3
• Poliglecaprone (MONOCRYL) demonstrates minimal tissue reactivity and is excellent for routine lacerations 2
• Polyglyconate (Maxon) provides good tensile strength while maintaining absorbability 1, 2
• Rapidly absorbing synthetic sutures like polyglactin 910 (VICRYL RAPIDE) can be considered when faster absorption is desired, though they cost more than standard synthetic sutures 4, 1

Materials to Avoid

• Catgut sutures should be avoided as they are associated with more pain and higher risk of requiring resuturing 4, 1
• Standard synthetic multifilament sutures may require removal if non-absorbable material persists 4

Suture Size Selection

• 4-0 or 5-0 is appropriate for most routine lacerations including facial, scalp, and hand wounds 1, 2, 5
• This size provides optimal wound closure without excessive tissue trauma 1, 2

Suturing Technique

Use continuous non-locking subcuticular technique rather than interrupted sutures:

• Distributes tension more evenly across the suture line, reducing tissue edema and necrosis risk 1, 2
• Results in lower rates of superficial wound dehiscence (RR 0.08; 95% CI 0.02 to 0.35) 2
• Provides better seal against bacterial invasion 2
• Minimizes visible scarring through subcuticular closure 2, 5

Technical Considerations

• Use the "small bite" technique (approximately 5mm from wound edge and between stitches) to ensure adequate tension distribution and minimize tissue damage 5
• Avoid overly tight sutures that can strangulate wound edges and impair healing 2, 5

Location-Specific Modifications

Hand Lacerations

• Use 4-0 or 5-0 monofilament absorbable sutures due to high mobility in this area 2, 5
• Absorbable sutures are particularly advantageous as removal can be painful in the hand 5
• Consider polyglyconate for good tensile strength in this high-mobility area 5

Facial/Scalp Lacerations

• 4-0 or 5-0 monofilament absorbable sutures are appropriate 1, 2
• No difference in long-term cosmetic results between absorbable and permanent sutures in clean facial wounds 3

Post-Repair Care

• Keep wound clean and dry for first 24-48 hours 1, 2, 5
• Avoid excessive tension on the wound during initial healing 2, 5
• Follow up within 24 hours by phone or office visit to ensure proper healing 1, 2, 5
• Use acetaminophen or ibuprofen for pain management 2

Complications to Monitor

• Signs of infection: increasing pain, redness, swelling, or discharge 1, 2, 5
• Pain disproportionate to injury severity may suggest deeper complications such as periosteal penetration 1, 2, 5
• Monitor for wound dehiscence, especially in high-mobility areas 2

Common Pitfalls to Avoid

• Do not use braided sutures in contaminated wounds as they increase infection risk 2
• Do not place sutures too tightly, which strangulates tissue and impairs healing 2, 5
• Do not use inappropriate suture size for the anatomical location 2
• Do not fail to consider area mobility when selecting suture material 2, 5