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Absorbable sutures are safe and convenient for use in traumatic skin wounds.

Three Part Question

In [patients with traumatic skin wounds] is [using an absorbable suture material] associated with a [adverse outcome]

Clinical Scenario

A 34 year old gentleman presents to the department with a cut to his right arm caused by a knife which slipped during a D.I.Y accident. The wound needs closure with sutures and you wonder if using an absorbable material would provide a more convenient and equally as safe option.

Search Strategy

Medline 1966-2008 using National Library for Health interface.
Cochrane Library Database of systematic reviews.
[(Exp *LACERATIONS/ OR Laceration*.ti.ab OR Wound*.ti.ab OR Cut*.ti.ab) AND (Exp *SUTURES/ OR ("Polyglycolic Acid" OR Polyglactin OR Polydioxone OR Polyglyconate).ti.ab)) AND (Exp *TREATMENT OUTCOME/ OR "Treatment Outcome*".ti.ab OR Exp WOUND INFECTION/ OR "Wound Infection*".ti.ab OR "Cosmetic Outcome*".ti.ab)]. LIMIT to human AND English AND All Ages.
[Suture OR Stitch OR Closure]

Search Outcome

122 Papers found of which 118 were irrelevant or of poor quality. A number of of these papers included outcome data for absorbable sutures vs non absorbable but not in the context of traumatic injury and so were discarded.

82 results. None relevant.

Relevant Paper(s)

Author, date and country Patient group Study type (level of evidence) Outcomes Key results Study Weaknesses
Karounis H et al
Paediatric patients (<18yrs) with traumatic facial woundsProspective, randomised controlled trial10 day review looking at infection, dehiscence, characteristics of wound and overall cosmetic appearanceNo difference in optimal wound evaluation scores (WES) 63% vs 49% non-absorbable, (RR 0.73; 95%CI 0.45-1.17)35% of patients lost to long term follow-up.
4 month review by a blinded plastic surgeon.No difference between WES scores. 36% vs 28%, (RR 0.88; 95%CI 73-85)
Dehiscence rateNo difference between the groups. (2% vs 11%; p=0.07)
Wound infectionNo difference between the groups. (0 vs 2; p=0.3)
Shetty P.C, Dicksheet S et al.
Patients of all ages with traumatic skin woundsProspective, randomised controlled trialComplications or infectionsNo reported complications in either group
Quality of scar formationNo difference in scar formation
Holger JS
Patients of all ages with traumatic facial lacerationsProspective randomised controlled trialVisual analog score (VAS) of wound measured by two blinded physicians and patient at 9 and 12 monthsNo significant difference between the VAS scores in each group. Maximum difference 3.6mm, below minimum clinical important difference of 10-15mm.42% of patients lost to follow-up.
Mouzas GL et al
Patients of all ages with traumatic skin woundsProspective randomised controlled trialRates of postoperative tissue reaction and wound infectionNo difference between rates of complications between polyglycolic acid and nylon. Slightly higher rates of infection with silk.Short term follow-up


Using an absorbable suture material is not associated with increased infection or dehiscence rates and the cosmetic outcome is comparable to using nonabsorbable sutures. As absorbable sutures do not require removal this has important benefits to both the patient and health service in cutting costs and avoiding the inconvenience of suture removal. In children this would have an even greater impact on avoiding emotional trauma.

Editor Comment


Clinical Bottom Line

Absorbable sutures are effective and safe to use in the closure of traumatic skin wounds.


  1. Karounis H; Gouin S; Eisman H; Chalut D; Pelletier H; Williams B. A randomised, controlled trial comparing long-term cosmetic outcomes of traumatic pediatric lacerations repaired with absorbable plain gut versus non absorbable nylon sutures Academic Emergency Medicine 2004 July vol 11/7 (730-5)
  2. Shetty PC,Dicksheet S,Scalea TM Emergency department repair of hand lacerations using absorbable vicryl sutures Journal of Emergency Medicine Sep 1997, vol./is.(673-4)
  3. Holger JS, Wandersee SC, Hale DB Cosmetic outcomes of facial lacerations repaired with tissue-adhesive, absorbable and non absorbable sutures. American Journal of Emergency Medicine July 2004, 22/4(254-7)
  4. Mouzas GL, Yeadon A. Does the choice of suture material affect the incidence of wound infection? British Journal of Surgery Dec 1975, vol62 (952-5)