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Suture Selection

Brian Wai Lin, MD and Mike Weinstock, MD
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No me gusta!

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Brian Lin gives advice on the best ways to stock your wound cart in your UC setting.

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Jennifer M., DO -

I have not used plain gut. Since it is similar to chromic gut - with the addition that chromic is processed to provide better resistance to absorption - are the indication for plain gut the same as chromic gut? Thanks :)

Mizuho M., DO -

This is a great question Jennifer! Let me inquire with Dr.Brian Lin who will likely have better information on this! Thanks! ~Mizuho

Brian L., MD -

Hi Jennifer! Thanks for the question. You allude to the answer in your knowledge of the suture material: since chromic gut is treated with chromium (to decrease tissue reactivity and slow absorption) it absorbs more slowly than plain gut. Manufacturers indicate it will provide effective wound support for 10-21 days but it typically doesn't truly dissolve for 90 days on average .

I thus think of chromic gut as a good choice for areas where you can't retrieve the suture material easily, but want greater support (like a nail bed under a replaced nail, if you choose to repair it) or in areas where excess moisture will tend to hasten absorption (like a tongue laceration).

On the other hand, plain gut has an effective wound support of only 8-9 days, and a mean absorption time of about 30 days. Based on these characteristics I think of this suture as a good choice for superficial closure of extremity wounds in patients who won't be coming back for planned suture removal (I instruct them to pick out remaining suture threads at about 10 days time).

Hope this helps!

Brian Lin, MD

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Your Going to Irrigate That Wound With What?? Full episode audio for MD edition 183:08 min - 86 MB - M4AHippo Urgent Care RAP November 2015 Summary 660 KB - PDF