What suture size is recommended for leg lacerations?

Suture Size for Leg Lacerations

For leg lacerations, use 3-0 or 4-0 monofilament absorbable sutures, as this size provides adequate tensile strength for the high-mobility lower extremity while minimizing tissue trauma. 1

Recommended Suture Size

• 3-0 or 4-0 suture is the optimal size for leg lacerations, balancing adequate wound closure strength with minimal tissue trauma in this high-tension, high-mobility area 1, 2
• The smallest suture size that accomplishes secure wound closure should be selected to minimize tissue trauma and reduce foreign material within tissues 2
• Larger suture sizes (3-0) may be preferred for deeper leg lacerations or areas under greater tension, while 4-0 is appropriate for more superficial wounds 1

Optimal Suture Material

• Monofilament absorbable sutures are strongly recommended as they cause less bacterial seeding and reduce infection risk compared to multifilament sutures 1, 3
• Poliglecaprone (Monocryl) or polyglyconate (Maxon) are the preferred materials for leg lacerations, providing excellent tensile strength while maintaining absorbability 1, 4
• Polyglyconate specifically provides good tensile strength while maintaining absorbability, making it particularly suitable for high-mobility areas like the leg 1
• Absorbable options eliminate the need for suture removal, which is especially advantageous in the leg where removal can be uncomfortable and requires a return visit 1

Suturing Technique

• Use the continuous non-locking subcuticular technique as it distributes tension more evenly across the suture line, reducing tissue edema and necrosis risk 1
• This technique results in significantly lower rates of superficial wound dehiscence (RR 0.08; 95% CI 0.02 to 0.35) compared to interrupted sutures 1
• The continuous technique also provides a better seal against bacterial invasion and minimizes visible scarring 1
• Avoid placing sutures too tightly, which strangulates tissue and impairs healing, particularly problematic in high-mobility areas like the leg 1

Critical Pitfalls to Avoid

• Never use braided (multifilament) sutures in contaminated leg wounds as they significantly increase infection risk through bacterial seeding in the interstices 1, 2
• Do not select suture size based solely on wound length—consider the depth, tension, and mobility of the leg when choosing between 3-0 and 4-0 1, 2
• Avoid catgut sutures entirely, as they are associated with more pain and higher risk of requiring resuturing 3

Post-Repair Monitoring

• Keep the wound clean and dry for the first 24-48 hours 1
• Avoid excessive tension on the leg during initial healing, particularly in areas crossing joints 1
• Monitor for signs of infection including increasing pain, redness, swelling, or discharge 1
• Wound dehiscence is more common in high-mobility areas like the leg and requires close monitoring 1
• Follow-up within 24 hours by phone or office visit is recommended to ensure proper healing 1