Wound Closure ============= Wounds in General "Super Glue" for Wound Closure: Staples vs. Sutures Suture Materials Type Falls Off Completely Absorbed ------------------------------------------------------------------ Vicryl Rapide Fast absorbing gut 7-10 days 42 days Braided Vicryl 56-90 days Plain Gut after 70 days Chromic Gut after 90 days Needles PC-1: small conventional cutting 3/8 circle PC-3: larger conventional cutting 3/8 circle P-1, P-3, PS-2, PS-1: increasingly larger 3/8 circle reverse cutting RB-1, SH, CT-1: increasingly larger, taper point CT-1, CP-1: half circle, reverse cutting V-34: half circle, taper cut Deep closures: if more tension, bigger scar. Holander Singe Ann Amerg MEd 1995;25:695. But deep sutures increase infection rate. Plastics tend to do multiple-layer. Winn et al Amer J Surg 1977:;133:257: small study on back, no difference in scar size. Singer Plast Reconstr Surg 2002;110:429: no effect of deep sutures. Singer Plast Reconst Surg 2005: RCT of simple, linear, non-gaping, non bite face lacs, 60 patients. Time of closure: faster with single layer VAS of rating cosmetic scar 3 layer: no difference; WES of percentage of good outcomes: no difference; width: no difference. Quinn, BMJ 2002:324: finger laceration - sutures vs. bandaid. Bandaid less painful, quicker; no difference in cosmesis, return to school/work activity same.