Absorbable Sutures for Repair of Pediatric Facial Lacerations

Absorbable sutures offer several advantages over nonabsorbable sutures — including ease of use, less skin reactivity, and lower cost — but their use in children has not been well studied. In a prospective, randomized trial, researchers compared the two types of sutures for repair of acute pediatric facial lacerations of 1 to 5 cm. Patients were excluded if the lacerations had irregular borders, resulted from mammalian bites, were contaminated, occurred more than 8 hours before presentation, or could be repaired with a topical adhesive.

Children (age range, 1–18 years) were randomized to wound closure with either 5–0 or 6–0 fast-absorbing surgical gut or nonabsorbable nylon. At 3-month follow-up, wounds were photographed, and three pediatric emergency physicians who were blinded to group assignment assessed cosmetic appearance (the primary outcome) using a 100-mm continuous cosmesis visual analog scale (VAS; with a score of 100 representing the best scar). A between-group difference of ≥15 mm was defined as being clinically important. Wounds were assessed at 5 to 7 days for infection (defined as requirement for systemic antibiotics) and dehiscence (defined as requirement for additional sutures).

Overall, 23 of 49 patients in the absorbable-suture group and 24 of 39 in the nonabsorbable-suture group completed the study. Baseline demographic and wound characteristics were similar between the two groups and between patients who did and did not complete follow-up. At 3 months, mean VAS scores between the absorbable-suture and nonabsorbable-suture groups differed by only 1.4 mm (92.3 mm and 93.7 mm). Correlation among the blinded observers was good (r=0.42). Two patients, both in the absorbable-suture group, had wound dehiscence. No wound infections occurred.