Suture Material for Finger Lacerations
For finger lacerations, use 4-0 or 5-0 monofilament absorbable sutures (such as poliglecaprone or polyglyconate) with a continuous non-locking subcuticular technique. 1, 2
Optimal Suture Material Selection
Monofilament absorbable synthetic sutures are the first-line choice because they cause significantly less bacterial seeding and reduce infection risk compared to multifilament alternatives 1, 2
Poliglecaprone (Monocryl) or polyglyconate are specifically recommended for hand and finger lacerations due to their excellent handling properties, good tensile strength, and optimal absorption profile 1, 2
Absorbable sutures eliminate the need for removal, which is particularly advantageous in finger lacerations where removal can be painful and requires a return visit 1, 2
4-0 or 5-0 gauge is appropriate for finger lacerations, providing adequate wound closure without excessive tissue trauma 1, 2
Suturing Technique
Use continuous non-locking subcuticular technique rather than interrupted sutures, as this distributes tension more evenly across the suture line and reduces tissue edema 1, 2
Avoid locking sutures entirely because they create excessive tension leading to tissue edema and necrosis 1, 3
Avoid placing sutures too tightly, as this strangulates wound edges and impairs healing in high-mobility areas like fingers 1, 2
The "small bite" technique (approximately 5mm from wound edge and between stitches) ensures adequate tension distribution and minimizes tissue damage 1
Special Considerations for Finger Lacerations
Fingers require longer healing times (10-14 days) compared to other body areas due to high mobility and tension 1
Monofilament sutures are particularly important in fingers because of the high-mobility environment and increased infection risk 1
Polyglyconate provides superior tensile strength for high-mobility areas like fingers while maintaining absorbability 1, 2
Materials to Avoid
Never use catgut sutures as they are associated with more pain, higher resuturing rates, and inferior outcomes 1, 3
Avoid braided/multifilament sutures in finger lacerations as they increase bacterial seeding and infection risk 1, 2
Non-absorbable sutures (like nylon or polypropylene) are not preferred for routine finger lacerations, despite being acceptable alternatives, because they require painful removal and offer no advantage over modern absorbable monofilaments 4
Post-Repair Care
Keep the wound clean and dry for 24-48 hours after repair 1, 2
Elevate the injured hand if swollen to accelerate healing 1
Avoid excessive tension on the finger during the initial healing phase 1, 2
Follow up within 24 hours by phone or office visit to ensure proper healing 1, 2
Critical Pitfalls to Monitor
Watch for pain disproportionate to injury severity near bones or joints, which may suggest periosteal penetration or deeper complications 1
Monitor for infectious complications including septic arthritis, osteomyelitis, subcutaneous abscess, and tendonitis 1
Hand wounds are often more serious than wounds to fleshy body parts and require closer monitoring 1