What type of sutures are recommended for use inside the lips?

Suture Selection for Intraoral Lip Lacerations

For lacerations inside the lips (mucosal surface), use 5-0 or 6-0 absorbable monofilament sutures such as poliglecaprone (Monocryl) or polyglactin 910 (Vicryl), as these eliminate the need for suture removal in a difficult-to-access location while providing adequate wound closure. 1, 2

Optimal Suture Material for Intraoral Surfaces

• Absorbable monofilament sutures are the standard for mucosal closure because they eliminate the need for suture removal inside the mouth, which would be uncomfortable and impractical for patients 3, 2

• Poliglecaprone 25 (Monocryl) is preferred as it demonstrates low tissue reactivity, maintains 20-30% breaking strength retention at 2 weeks (the critical healing period), and causes significantly fewer suture extrusions (3.1%) compared to polyglactin 910 (11.4%) 4, 5

• Size 5-0 or 6-0 is appropriate for intraoral lip tissue, providing adequate tensile strength while minimizing tissue trauma 1, 2

Layered Closure Technique

• Use a layered approach starting with the deeper muscular layer, then closing the mucosal layer separately from the skin layer if the laceration is through-and-through 1, 2

• Employ continuous non-locking suturing techniques to distribute tension evenly across the suture line, reducing tissue edema and necrosis risk 1, 2

Critical Anatomic Considerations

• The vermillion border requires precise alignment to avoid permanent cosmetic deformity—this is the most critical landmark in lip repair 1, 2

• Expect significant bleeding despite seemingly minor wounds due to the rich vascular supply of lip tissue 2

• Account for increased mobility in the lip area, which creates additional tension on the wound and influences suture selection 2

Post-Repair Management

• Prescribe chlorhexidine 0.12% rinses twice daily for 1 minute for at least the first week to reduce bacterial load in the oral cavity 1, 2

• Recommend a soft diet to minimize movement and tension on the suture line during the critical healing period 1, 2

• Keep the wound clean and dry for the first 24-48 hours 1, 2

Alternative Considerations

• Rapidly absorbing synthetic sutures (Vicryl Rapide) can be used for mucosal surfaces and provide faster absorption, though standard absorbable monofilaments remain first-line 3, 6

• Avoid catgut sutures as they are associated with increased pain and higher resuturing rates 1, 2

• For the cutaneous (skin) portion of through-and-through lip lacerations, use 5-0 or 6-0 monofilament non-absorbable sutures (nylon or polypropylene) that should be removed after 5-7 days 1, 2

Monitoring for Complications

• Watch for infection signs including increasing pain, redness, swelling, or purulent discharge 1, 2

• Pain disproportionate to injury severity may indicate deeper complications requiring further evaluation 1