In our hospital guideline (http://www.urgencehsj.ca/protocoles/laceration/), we also have both options: vicryl rapide and fast absorbing plain gut for the face. When I wrote that guideline with the chief of plastics about 1 year ago, his preference was plain gut fast absorbing because it's faster to absorb than vicryl rapide. A couple of months ago, he told me his preference is now vicryl rapide because it leads to less inflammatory reaction. But I think he tends to see his patients 1 week after the repair, so he can remove stitches that are still in place despite washing and cleaning by parents. I personnally don't see my patients 1 week later.
I am not aware of any published evidence comparing vicryl rapide and fast absorbing plain gut in the face.
Regarding the question of plain gut vs plain gut fast absorbing, we have both in our ED. We use plain gut for trunk and extremities and fast absorbing for the face. The lacerationrepair website (https://lacerationrepair.com/wound-blog/absorbable-sutures/) states that the effective wound support for the fast absorbing is 5-7 days, and 8-9 days for plain gut (vicryl rapide is 10 days). They specifically recommend fast absorbing for the face and plain gut for chest and extremities. Again, I am not aware of any published evidence that compares both (regular plain gut and fast absorbing). I am interested to know if anyone has more on this topic.
Emergency medicine and Pediatric emergency medicine specialist
Emergency departement, Charles Lemoyne hospital, Quebec, Canada
Emergency departement, CHU St-Justine, Quebec, Canada
Matthieu Vincent MD, FRCPc (EM, PEM)
Direct Reply: https://www.docmatter.com/matthieuvincent
Pediatric Emergency Medicine and Emergency medicine physician
Montreal, QC, Canada
This is a reply to the discussion started by Michael Falk MD, FAAP, FRCP (C):
I always use "fast gut" when closing facial lacerations, but if it's not available, what would you use?...
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