From the Guidelines
For facial sutures, the best option is typically a fine, non-absorbable monofilament suture such as 5-0 or 6-0 nylon (Ethilon) or polypropylene (Prolene). These sutures provide excellent wound edge approximation with minimal tissue reactivity, which helps reduce scarring on the face where cosmetic outcomes are particularly important. Although the provided evidence 1 discusses suture types for perineal repair, the principles of minimizing tissue reactivity and promoting optimal wound healing can be applied to facial sutures as well. For delicate areas like eyelids or lips, even finer sutures like 6-0 or 7-0 may be preferred.
- Key considerations for facial sutures include:
- Using fine, non-absorbable monofilament sutures for the epidermal layer
- Placing sutures with meticulous technique and minimal tension
- Achieving precise edge alignment for optimal cosmetic results
- Considering running subcuticular closure for the best outcomes
- The face's excellent blood supply promotes rapid healing, allowing for earlier suture removal than other body areas, typically within 3-5 days, to prevent track marks.
- For deeper layers, absorbable sutures like 4-0 or 5-0 Vicryl (polyglactin 910) or Monocryl (poliglecaprone 25) can be used to reduce tension on the wound edges, as mentioned in the study 1 for perineal repair, which may also apply to facial sutures in terms of reducing the need for removal of unabsorbed suture material.
- After suture removal, wound tapes can provide continued support during the healing process, enhancing the cosmetic outcome.
From the Research
Suture Materials for Facial Wounds
- The choice of suture material for facial wounds is crucial for optimal healing and minimal scarring.
- Two common suture materials used for facial wounds are rapidly absorbable polyglactin 910 and nylon.
Comparison of Suture Materials
- A randomized clinical trial 2 compared the effect of rapidly absorbable polyglactin 910 and nylon on facial scar appearance.
- The study found no significant difference in the appearance of facial scars at 6 months after surgery between the two suture materials.
- Another study 3 compared the performance of nylon and absorbable polyglactin 910 in the closure of punch biopsy sites.
- The study found no statistically significant difference between the two suture materials in terms of redness, infection, dehiscence, scar hypertrophy, and patient satisfaction.
Key Findings
- Both rapidly absorbable polyglactin 910 and nylon sutures can be used for epidermal closure of facial wounds with equivalent photographic appearance of facial scars at 6 months after surgery 2.
- Absorbable sutures are a good alternative in the primary closure of skin biopsy sites, with no significant difference in outcomes compared to nonabsorbable sutures 3.