From the Research
To best suture an ear, use 6-0 non-absorbable sutures like nylon or polypropylene with a small cutting needle, and consider utilizing a modified "slip knot" technique for securing the sutures, as described in a study on knot integrity 1. When suturing an ear, it is crucial to prioritize techniques that minimize trauma and promote optimal healing.
- Begin by thoroughly cleaning the wound with sterile saline and administering local anesthesia (1-2% lidocaine with epinephrine 1:100,000) to ensure patient comfort and reduce the risk of infection.
- Ensure hemostasis is achieved before suturing to provide a clear and stable field for the procedure.
- For simple lacerations, place interrupted sutures approximately 2-3mm apart, taking care to align the cartilage precisely without placing sutures through the cartilage itself, as this can lead to complications such as infection or necrosis due to the cartilage's poor blood supply.
- Instead, suture through the perichondrium on both sides of the wound, which helps in maintaining the structural integrity of the ear and supports the healing process.
- For complex tears, use a layered closure technique, first approximating the perichondrium with 5-0 or 6-0 absorbable sutures like Vicryl, then closing the skin with the non-absorbable sutures, to ensure a strong and durable repair.
- Apply antibiotic ointment (such as bacitracin) and a non-adherent dressing afterward to protect the wound and promote a healthy environment for healing.
- Remove sutures in 5-7 days, depending on the location and extent of the laceration, as well as the patient's overall healing progress, to minimize scarring and prevent suture marks. This approach, combined with careful attention to suture technique, such as the use of a slip knot for securing monofilament nylon sutures 1, can help achieve the best outcomes in terms of morbidity, mortality, and quality of life for patients with ear lacerations.