[Doczilla]

Absorbable suture:
- To close deep layers of a wound when doing a multi-layer repair (ex: laceration to the forehead all the way to the skull). I usually use Vicryl for strength.
-Running subcuticular stitches to minimize stitch scar. Usually done with complex plastic repairs or closing surgical wounds. With the complex plastic repair, I'll revise the wound edges, close deep, do a running subcutic, and then a running 7-0 or 8-0 skin layer of absorbable sutures really close together to minimize tension on the individual sutures. Less tension = less stitch scar. Current dogma discourages subcuticular stitches in "dirty" wounds, since they may prevent draining of the wound.
- I'll use chromic gut on lips and face because there is less granulation around the suture material, leading to less stitch scar.
- If follow-up is a problem, and you don't think the patient can make it in to have their stitches removed, or if it's a child and you think they'll pitch a fit about suture removal because of where the stitches are or how they reacted to having them put in, I'll use absorbable.

Virtually everything else that is accessible: regular nonabsorbable suture, staples, "hair sutures", or superglue.


'zilla