Is vicryl (polyglactin 910) an appropriate suture material for repairing a lip laceration?

Vicryl for Lip Laceration Repair

Yes, Vicryl (polyglactin 910) is appropriate for repairing lip lacerations, specifically for the intraoral mucosal layer and deeper muscular tissues, but non-absorbable sutures should be used for the external skin surface. 1

Suture Selection by Anatomic Layer

Intraoral Mucosal Surface

• Use absorbable monofilament sutures (including Vicryl) in 5-0 or 6-0 size for the mucosal layer because they eliminate the need for uncomfortable intraoral suture removal 1
• Vicryl rapide (rapidly absorbing polyglactin 910) is particularly well-suited for oral wounds, demonstrating faster healing with fewer wound dehiscence incidents and milder local reactions compared to catgut or standard Dexon 2
• Standard Vicryl has been successfully used in oral surgery procedures with no suture-related complications and superior handling characteristics 3

Muscular Layer (Orbicularis Oris)

• Close the deeper muscular layer with 4-0 or 5-0 absorbable sutures using a layered approach before addressing the mucosal and skin surfaces 1
• Vicryl provides adequate tensile strength for muscular approximation while avoiding the need for deep suture removal 1

External Skin Surface

• Use 5-0 or 6-0 monofilament non-absorbable sutures (nylon or polypropylene) for the cutaneous portion of through-and-through lip lacerations 1
• Remove these external sutures after 5-7 days to optimize cosmetic outcomes 1
• While one study found no difference in long-term cosmetic results between absorbable (Vicryl Rapide) and non-absorbable sutures for facial skin closure 4, another study documented increased tissue reactivity with Vicryl on skin surfaces at postoperative day 7 5

Critical Technical Considerations

Vermillion Border Alignment

• The vermillion border requires precise alignment as the most critical landmark to avoid permanent cosmetic deformity 1
• Place the first suture at the vermillion border to ensure perfect alignment before proceeding with the remainder of the closure 1

Suturing Technique

• Use continuous non-locking technique to distribute tension evenly across the suture line, reducing tissue edema and necrosis risk 1, 6
• Avoid locking sutures as they create excessive tension leading to tissue damage 6
• Account for the increased mobility and rich vascular supply of lip tissue when planning your repair 1

Postoperative Management

• Prescribe chlorhexidine 0.12% rinses twice daily for at least one week to reduce bacterial load 1
• Recommend a soft diet to minimize tension on the suture line during healing 1
• Keep the wound clean and dry for the first 24-48 hours 1
• Monitor for infection signs including increasing pain, redness, swelling, or purulent discharge 1

Common Pitfalls to Avoid

• Do not use Vicryl for the external skin surface if optimal cosmesis is the priority, as tissue reactivity may be more pronounced compared to non-absorbable sutures 5
• Avoid catgut entirely as it causes more pain and higher resuturing rates 1, 6
• Never place overly tight sutures that strangulate tissue and impair healing 6
• Do not skip the layered closure approach, as proper muscular approximation is essential for functional and cosmetic outcomes 1