II. Category

III. Indications

  1. Deep, dermal closure
    1. Rarely used now
    2. Use Vicryl or Dexon instead for Absorbable Suture
  2. Superficial skin closure (esp. pediatric patients, allowing for no Suture removal)
    1. Controversial, but typically results in similar cosmetic results as Nonabsorbable Suture
    2. Fast Catgut for facial Lacerations and plain Catgut for trunk or extremity Lacerations

IV. Background: Catgut

  1. Derived from sheep intestinal intima
  2. Poor tensile strength
  3. Poor knot security
  4. Plain catgut Suture is quickly absorbed within 8-9 days (5 days for fast gut, 18 days for chromic gut)
  5. High tissue reactivity (absorbed by proteolysis)

V. Preparations: Catgut Absorbable Sutures

  1. See Catgut Suture
  2. Rarely used for deep, dermal Suture and replaced by synthetic Absorbable Sutures (see below)
  3. May be preferred of the Absorbable Sutures for superficial skin closure (least inflammation)
  4. Regular, plain catgut Suture (Plain Catgut)
    1. Effective wound support for 8-9 days
    2. Used for superficial skin closure of trunk or extremity Lacerations
  5. Fast-absorbing plain catgut Suture (Fast Gut)
    1. Heat-treated Suture for faster absorption
    2. Effective wound support for 5 days
    3. Used for superficial skin closure of facial Lacerations
  6. Chromic catgut Suture (Mild Chromic Gut)
    1. Chromic treated catgut Suture doubles the wound support duration
    2. Effective wound support for >18 days
    3. Increased inflammatory response

VI. References

  1. Epperson in Pfenninger and Fowler (1994) Procedures for Primary Care Physicians, Mosby, Chicago, p. 3-11
  2. Lin and Lin in Herbert (2014) EM:Rap 14(11): 8-10
  3. Mortiere (1996) Principles of Primary Wound Management
  4. Townsend (2001) Sabiston Textbook Surgery, p. 1552-3
  5. Howell (1997) Emerg Med Clin North Am 15(2):417-25 [PubMed]
  6. Moy (1991) Am Fam Physician 44(6):2123-8 [PubMed]

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