In a randomized trial, absorbable sutures achieved cosmetic results and complication rates similar to those of nonabsorbable sutures in both children and adults.
Absorbable sutures have been demonstrated to be safe and effective for repair of facial lacerations (NEJM JW Emerg Med Apr 25 2008). However, they are typically not used for repair of trunk or extremity lacerations because of the greater tension and lower blood supply in these areas — even though they are recommended to reduce children’s pain and anxiety in the emergency department (ED; NEJM JW Emerg Med Dec 7 2012). Researchers randomized a convenience sample of adult and pediatric patients to repair of acute trunk and extremity lacerations in the ED with either absorbable sutures (Vicryl Rapide) or nonabsorbable sutures (Prolene). Cosmetic outcome (the primary outcome) was assessed at 3 months on a visual analog scale by plastic surgeons blinded to suture type, and complications (infection or dehiscence) were assessed in the ED at 10-day follow-up.
Of 155 patients, 73 (mean age 22 years, 53% male) completed the study. The two suture groups had similar demographic characteristics, mean laceration length (2.8 cm), and mean number of sutures placed. Cosmetic outcomes and rates of complications were statistically similar in the two groups (no dehiscence in either group; infection rates of 11% and 3% in the absorbable and nonabsorbable groups, respectively).
Many of us use absorbable sutures to repair facial lacerations, and these data support their use for trunk and extremity wounds as well. However, this study was not powered to detect significant differences in complication rates. Whether their wounds are repaired with absorbable or nonabsorbable sutures, patients require careful instructions regarding wound care and the need for follow-up, particularly if infection or dehiscence occurs.
Tejani C et al. A comparison of cosmetic outcomes of lacerations on the extremities and trunk using absorbable versus nonabsorbable sutures. Acad Emerg Med 2014 Jul 5; [e-pub ahead of print]. (http://dx.doi.org/10.1111/acem.12387)