What is the best suture to use for a chin laceration?

Best Suture for Chin Laceration

Use 5-0 monofilament absorbable suture (poliglecaprone or polyglyconate) with a continuous non-locking subcuticular technique for chin lacerations, as this provides optimal cosmetic outcomes while eliminating the need for painful suture removal.

Optimal Suture Material

• Monofilament absorbable sutures are the preferred choice because they cause less bacterial seeding and reduce infection risk compared to multifilament sutures 1
• Poliglecaprone (Monocryl) is specifically recommended as it eliminates the need for suture removal, saving time and reducing patient anxiety and discomfort 1
• Polyglyconate (Maxon) provides excellent tensile strength while maintaining absorbability, making it suitable for the chin which is a high-mobility area 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 options 1
• Avoid catgut sutures entirely as they are associated with more pain and higher risk of requiring resuturing 3, 2

Suture Size

• 5-0 is the appropriate suture size for facial lacerations including the chin, as it provides optimal wound closure without excessive tissue trauma 1, 4
• 4-0 can be used for deeper dermal layers if layered closure is needed 1

Suturing Technique

• The continuous non-locking subcuticular technique is strongly recommended because it distributes tension more evenly across the suture line, reducing tissue edema and necrosis risk 1, 2
• This technique provides a better seal against bacterial invasion and minimizes visible scarring through subcuticular closure 1
• Never use locking sutures as they cause excessive tension leading to tissue edema and necrosis 3, 5
• Place sutures approximately 5mm from the wound edge and between stitches to ensure adequate tension distribution and minimize tissue damage 5
• For layered closure, ensure the entire depth of the dermis is accurately approximated, as the dermis provides the skin's greatest strength 6

Important Chin-Specific Considerations

• The chin is a high-mobility area that experiences significant tension during talking, eating, and facial expressions 1
• While tissue adhesive can be used for chin lacerations, research shows the probability of dehiscence is higher for chin lacerations compared to other facial locations (1.6% difference), though tissue adhesive versus sutures showed no statistical difference in dehiscence rates 7
• Given the higher baseline dehiscence risk in the chin area, sutures remain the preferred method over tissue adhesive for optimal wound security 7

Post-Repair Care

• Keep the wound clean and dry for the first 24-48 hours 1, 2
• Avoid excessive tension on the wound during initial healing, which means limiting extreme facial expressions and eating soft foods 1
• Follow-up within 24 hours by phone or office visit to ensure proper healing 1, 2
• Use acetaminophen or ibuprofen for pain management 1

Complications to Monitor

• Watch for signs of infection including increasing pain, redness, swelling, or discharge 1, 2
• Pain disproportionate to injury severity may suggest deeper complications 1, 2
• Monitor for wound dehiscence, especially given the chin's high-mobility status 1

Common Pitfalls to Avoid

• Do not use braided (multifilament) sutures as they increase infection risk through bacterial seeding 1
• Do not place sutures too tightly as this strangulates tissue and impairs healing 1
• Do not use non-absorbable sutures unless absolutely necessary, as removal in facial areas causes patient discomfort and requires an additional visit 4
• Do not ignore the need for proper wound irrigation and debridement before closure 8, 6