From the Research
For lip laceration repair, 6-0 non-absorbable monofilament suture material such as nylon is generally considered the best choice for the vermilion border and external skin, as it results in better cosmetic outcomes and fewer complications compared to absorbable sutures, as shown in a study published in 2022 1. When repairing lip lacerations, it is essential to prioritize the alignment of the vermilion border, as this is the most cosmetically important landmark. Some key points to consider when repairing lip lacerations include:
- Using 5-0 or 6-0 absorbable suture material like fast-absorbing gut or chromic gut for the mucosal surface inside the mouth
- Removing external sutures in 5-7 days to minimize scarring
- Using local anesthesia with 1-2% lidocaine with epinephrine (1:100,000) for hemostasis and pain control, though epinephrine should be used cautiously in end-arteriolar areas
- Thorough irrigation and debridement of the wound prior to closure to prevent infection
- Preferring monofilament sutures for external repairs because they cause less tissue drag and inflammatory reaction compared to braided materials, as noted in a study comparing 6-0 nylon and 6-0 Vicryl Rapide in cheiloplasty 2. Additionally, a study published in 2018 found that tissue reactivity was more common with the use of absorbable sutures compared to non-absorbable sutures, although the difference was only statistically significant on the 7th postoperative day 3. Another study from 2009 discussed the use of medical adhesives as an alternative to sutures for skin closure in cleft lip repair, highlighting the potential benefits of reduced distress and complications for patients 4. However, the most recent and highest quality study, published in 2022, found that nonabsorbable sutures resulted in more favorable wound healing cosmesis, but also had a higher prevalence of postoperative complications 1. Overall, the choice of suture material for lip laceration repair should be based on the individual patient's needs and the surgeon's professional judgment, taking into account the potential benefits and drawbacks of each option.