Wednesday, July 16, 2014

You Can Use Absorbable Sutures Anywhere

Although, can and should are entirely different interpretations of these data.

There have been many studies showing facial lacerations can be repaired with absorbable sutures with similar cosmetic and adverse outcomes compared with non-absorable sutures.  The same principles, presumably, hold for the trunk and extremities – although, there are significant differences in blood supply and healing time.

This study aimed to demonstrate the non-inferiority of absorbable sutures – specifically, Vicryl Rapide – compared with non-absorbable monofilament.  All lacerations were simple, superficial, and repaired using identical interrupted technique.  At plastic surgery 3-month follow-up, although the absorbable sutures were judged to have generated increased “train tracking” of wounds, cosmesis on the visual analog scale was identical.

However, of the 113 patients they enrolled, they lost 40 to follow-up at 3 months – 20 in each group.  There was no wound dehiscence in either group, but 4/35 developed wound infectious in the Vicryl cohort versus 1/38 in the Prolene cohort.  Given the small sample sizes, this did not reach statistical significance, but increased infection cannot be ruled out.

So – yes, you can use absorbable sutures anywhere.  However, given the attrition in this study and the confidence intervals around infection rates, this study does not represent strong evidence in support.

“A Comparison of Cosmetic Outcomes of Lacerations on the Extremities and Trunk Using Absorbable Versus Nonabsorbable Sutures”
http://onlinelibrary.wiley.com/doi/10.1111/acem.12387/abstract

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