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Hi Folks


Interesting question and the studies to date (Tejani et al.; Karounis et al.) seem to suggest either Plain gut (which I suspect is synonymous with Fast gut) or Vicryl Rapide are both appropriate for suturing wounds on the face.  At our hospital, both are on our laceration guideline albeit personally I have used Plain gut with great results (suspect I was simply trained with plain gut more than vicryl rapide)


However, I note in some of the replies some statements related to one being better than the other and am curious as to whether anyone kows of any studies that have compared these two absorbable materials?


Sasha Dubrovsky


ps. if plain gut is NOT synonymous with fast gut, would be curious on why one is better than the other as well.

________________________________
From: Pediatric Emergency Medicine Discussion List <[log in to unmask]> on behalf of Myers, Sage R <[log in to unmask]>
Sent: Tuesday, August 22, 2017 11:56:24 AM
To: [log in to unmask]
Subject: Re: Facial sutures?

If you just have them follow-up as a scheduled visit for re-evaluation and removal of sutures the vicryl rapide can be removed if they haven't already fallen out on their own.  With fast gut, I have patients follow-up as needed for signs of infection or for removal if the sutures don't fall out on their own (after parents do a little wash of the area with a washcloth to make sure that the sutures aren't just stuck in a surface scab).  For vicryl rapide I have them scheduled a follow-up visit since they are more likely not to absorb on their own in the time period I would like.  But if they do, all the better for the kid and the PMD can just do a wound check.  At the very least some of them may have absorbed so there are less sutures to try to get out of a wiggly kid than if I used non-absorbable.


Sage Myers, MD MSCE

Children's Hospital of Philadelphia

________________________________
From: Pediatric Emergency Medicine Discussion List <[log in to unmask]> on behalf of Cena Tejani <[log in to unmask]>
Sent: Tuesday, August 22, 2017 10:48:53 AM
To: [log in to unmask]
Subject: Re: Facial sutures?

The reason not to use vicryl rapide on the face is that it takes much
longer to fully absorb.  It works very well on the trunk and extremities,
but potential for worse scars on the face exists.  See article for details.
Cena Tejani

On Tue, Aug 22, 2017 at 9:39 AM, Mike Falk <[log in to unmask]> wrote:

> I always use "fast gut" when closing facial lacerations, but if it's not
> available, what would you use?  Anyone know of any reason to not use vicryl
> rapide?
> Thanks,
> Mike Falk
> NY, NY
>
> Sent from my iPhone
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