Most modern sutures are synthetic, including the absorbables polyglycolic acid, polylactic acid, Monocryl and polydioxanone as well as the non-absorbables nylon, polyester, PVDF and polypropylene. Synthetic suture materials were produced in the 1920’s and the 1930s saw the creation of two types of surgical sutures, absorbable and non-absorbable which offered doctors a broader choice in suturing materials. The only natural absorbable suture available is surgical gut or catgut. Some sut… They may also be used in patients who cannot return to the doctor to get the more traditional sutures removed. We have discussed eyelid lacerations and tongue lacerations. Absorbable natural sutures are often made from purified animal tissues (such as collagen) and break down through proteolysis, the process of breaking down the proteins. Different types of sutures have different rates of dissolution, and during this time will lose strength at a predictable rate. Comes in three varieties: Chromic, Plain, and Fast-Absorbing Chromic gut is tanned to decrease absorption rate. Comparison of cosmetic outcomes of absorbable versus nonabsorbable sutures in pediatric facial lacerations. [, Plain gut has also been found to be an acceptable alternative to non-absorbable suture for pediatric wound repair. Other organs, like the bladder, contain fluids which make absorbable sutures disappear in only a few days, too early for the wound to heal. Recently, there has been an evolving trend that challenges the myth that all skin closure is done with non-absorbable suture. Synthetic nonabsorbable sutures may be made of polypropylene, polyester, polyethylene terephthalate, polybutylene terephthalate, polyamide, different proprietary nylons, or Goretex. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Choice of suture depends upon a number of factors: Absorbable suture = suture that undergoes degradation and absorption in tissue. I still generally say that the sutures would be more ideally removed after 3-5 days, as the tensile strength, even for Fast Absorbing GUT lasts longer than that. sterile surgical threads that are used to repair cuts (lacerations Our ENT docs actually prefer the 5.0 over the 6.0. suture [soo´chur] 1. sutura. When should the stitches be removed? This was secondary to a car accident and was associated with minor skull fracture with small pnuomochephalus and extradural Haematama. Learn how your comment data is processed. The literature would still imply that Fast Absorbing GUT results in similar cosmetic outcomes (even with out removing); however, my general practice is to still recommend their removal… and the absorbable suture benefit comes in the child who won’t hold still (I’m not sedating a child just to remove sutures — ideally). The lubricant coating decreases the coefficient of friction. Tejani C1, Sivitz AB, Rosen MD, Nakanishi AK, Flood RG, Clott MA, Saccone PG, Luck RP. They found the use of absorbable catgut sutures to be an acceptable alternative to nonabsorbable sutures, with similar cosmetic outcomes and similarly low rates of dehiscence and wound infection. Can recommend some gentle massage to help speed up the absorption process. This material is sometimes called "catgut," but it isn't made from cat organs. 15+ Years of Excellence in Veterinary Sutures. LEGAL DISCLAIMER (to make sure that we are all clear about this):The information on this website and podcasts are the opinions of the authors solely. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. A Vicryl 5.0 absorbable suture was used on the chin of a child. Sutures are often coated, especially braided or twisted sutures. Made from twisted strands of purified collagen prepared from sheep or cattle small intestine. 50% tensile strength at 5 days; 0% at 2 weeks. Some materials used to make absorbable sutures are derived from animal products that have been specially processed. (1) Ordinary gut: an easily absorbable suture made from the submucosal tissue of the gut or bovine intestine. In some countries, absorbable sutures are also made of gut material obtained from cow or sheep intestine. Absorbable sutures are often made of synthetic polymers produced from substances such as polyglycolic acid, polydioxanone, and poliglecaprone 25. For Health Care Practitioners: This writing is provided only for medical education purposes. Non-absorbable sutures: Can generally be used for repair of any soft tissue. These are sutures that are designed to be dissolved by the body. Reasons to select. Basically, these sutures are made out of special materials that dissolve and absorb into the skin, which is why they are also called absorbable stitches. Absorbable – Absorbable sutures are used for lesions that will heal quickly. Which type of suture is often used to create a vascular anastomosis? Very useful for completely buried sutures apposing deep tissues. Your physician or other qualified health care provider should be contacted with any questions you may have regarding a medical condition. We have 6.0 but be warned it is VERY delicate and often hard for trainees to use because it often will break. Interested in receiving the Ped EM Morsels to your personal email account, send your preferred email address to pedemmorselsfox@gmail.com. Dennis C1, Sethu S2, Nayak S1,3, Mohan L4, Morsi YY5, Manivasagam G1. One of the oldest and most widely used suture. Your stitches do not absorb when your healthcare provider says they should. D Degradable sutures can be made from both synthetic polymers and natural sources. Wound care is a common issue in the ED. 2. a stitch or series of stitches made to secure apposition of the edges of a surgical or traumatic wound; used also as a verb to indicate application of such stitches. Absorbable sutures are defined by the loss of most of their tensile strength within 60 days after placement. Located in Florida, Veterinary Sutures is a brand of the renowned manufacturer of surgical sutures SUTUMED CORP.Our suture & mesh products are manufactured with the same care that we produce sutures for human beings. Do not disregard professional medical advice or delay seeking it based on information from this writing. These synthetic materials, still used today, were categorized as “absorbable” or ‘non-absorbable’ depending on their ability to be absorbed during the wound healing process. synthetic polymer materials, such as polydioxanone, polyglycolic acid, polyglyconate, and polylactic acid natural materials, such as purified catgut, … Simply trim down the sutures as much as allowed. It … [, Fast-absorbing gut did not have higher rates of wound infection or complications compared to non-absorbable. Absorbable sutures, or dissolvable stitches, do not need to be removed. Is this the appropriate suture. Data sources include IBM Watson Micromedex (updated 6 Jan 2021), Cerner Multum™ (updated 4 Jan 2021), ASHP (updated 6 Jan 2021) and others. You have questions or concerns about your condition or care. Relying on information provided in this website and podcast is done at your own risk. 100% agree. We have also discussed my favorite wound closure technique: tissue adhesives. This site uses Akismet to reduce spam. This is particularly useful in areas that heal more rapidly than the suture dissolves (i.e., the face). Sometimes you need sutures. Synthetic sutures are made from polymers such as polyamide, polyolefins, polyesters, and absorbable polymers that are derived from polyglycolic acid. These types of sutures are typically made of material that naturally dissolves on its own, some of which are synthetics and others of which are made from animal intestines (often cow or sheep). This may help when the patient returns for wound reassessment, etc. Incision and Loop Drainage of Abscess — Pediatric EM Morsels, Tetanus Prevention — Pediatric EM Morsels, Vitamin C Deficiency and Scurvy in Children. Hello. A randomized, controlled trial comparing long-term cosmetic outcomes of traumatic pediatric lacerations repaired with absorbable plain gut versus nonabsorbable nylon sutures. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health. Now I have the unbelievable honor of working with an unbelievably gifted group of practitioners at Carolinas Medical Center. 3. material used in closing a wound with stitches. Suture choice and other methods of skin closure. Q1 was using interrupted Monocryl 5/0 not a good option? [. Thanks for your time. © Copyright IBM Corporation 2020 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. They may also be dyed to make them easy to see during surgery. 3 stitches. My boss got furstrated because I closed a long contaminated full thickness forehead/ scalp laceration with an interrupted Monocryl 5/0 in a four year old child. Poliglecaprone is a synthetic monofilament absorbable suture made of a copolymer of glycolide and epsilon-capralactone. Q2 How important is to remove the Monocryl after? They do not need to be removed. Others advocate for absorbable suture use, particularly in children, as it may avoid the challenges of having to remove sutures. Absorbable sutures are mostly used to suture internal body tissues. The rhythmic movement of the heart and blood vessels requires a suture which stays longer than three weeks, to give the wound enough time to close. It is often used to heal faster blood vessels or subcutaneous tissue to ligature blood vessels and suture infected wounds. Select one or more newsletters to continue. Suture thread is made from numerous materials. Made from twisted strands of purified collagen prepared from sheep or cattle small intestine. Absorbable sutures: Often used for internal soft tissue wounds. Sutures can be either absorbable or nonabsorbable. Absorption in 21 days. Absorbable sutures. The body can gradually absorb dissolvable stitches. This material must not be used for commercial purposes, or in any hospital or medical facility. The FDAfirs… -sean, Your email address will not be published. Last updated on Nov 16, 2020. Non-absorbable Sutures; Non-absorbable sutures, as the name implies are surgical sutures that cannot be absorbed by the body as such needs to be removed at a later time. Scarring was also a major problem with catgut sutures. These absorbed bodily fluids and could be foci of infection. In the event of a medical emergency, contact your physician or call 9-1-1 immediately. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. I covered her with antibiotics, used Vicryl for the deep scalp and Monocryl to skin. Absorbable suture materials. Retains 65% of its tensile strength at 2 weeks; 40% at 3 weeks. Cosmetic outcomes of absorbable versus nonabsorbable sutures in pediatric facial lacerations. I trained at the Combined Emergency Medicine and Pediatrics residency program at University of Maryland, where I had the tremendous fortune of learning from world renowned educators and clinicians. Sutures are used to close wounds and may be absorbable… These stitches are absorbed by your body, or fall off on their own within days or weeks. Some allowable dyes are: chromium-cobalt-aluminum oxide, ferric ammonium citrate pyrogallol. Natural sutures are made of catgut or reconstituted collagen, or from cotton, silk, or linen. So it would appear that the concerns about increased scar formation, wound dehiscence, and infection should not be as concerning as we may have been taught. Synthetic absorbable sutures are broken down non-enzymatically by hydrolysis, wherein water enters the filaments and breaks down the polymer chain. Fast-absorbing gut has less tensile strength than plain gut. Over weeks or months, your body dissolves the sutures, well after your incision has closed. An RCT published in Academic EM in 2004 compared cosmetic outcomes of pediatric lacs repaired with absorbable plain gut vs nonabsorbable nylon sutures. We comply with the HONcode standard for trustworthy health information -. While tissue adhesives are pretty awesome, they aren’t appropriate for all scenarios. I did not wish to remove the Monocryl later on. Non -Absorbable, but it may over time. ... Keep your wound above the level of your heart as often as you can. Suture will not be accessible for later removal; Oral injuries; Suture removal may be difficult (i.e. Ethicon creates sutures made of polydioxanone that are designed to close fascia, the connective tissue beneath the skin. Required fields are marked *. I strive every day to inspire my residents as much as they inspire me. Absorbable sutures are usually used as surgical sutures to hold together internal body tissues. Your email address will not be published. A comparison of cosmetic outcomes of lacerations on the extremities and trunk using absorbable versus nonabsorbable sutures. Helena, Let us take a minute to digest a Morsel of information about Absorbable Sutures for primary wound closure. Removing the suture may help to continue to minimize scar formation risk. These stitches are absorbed by your body, or fall off on their own within days or weeks. Absorbable sutures usually dissolve anywhere from 10 days to eight weeks and are made from: What I can tell you, is that Fast Absorbing Gut is likely the best absorbable option for facial laceration closure as it loses its tensile strength the earliest. The coatings used depend on whether the suture is absorbable or nonabsorbable. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. “When performing an operation, surgeons think about tissue in layers: first, there’s the skin, then the fascia, and then the actual organ,” Ovington explains. These sutures are typically made of organic materials that the body can destroy. Some avoid absorbable sutures due to “concerns” for increased scar formation, increased wound dehiscence, and increased wound infection. We use the fast absorbing gut usually in the face. Depending on … Examples of Absorbable sutures are: Catgut, Polydioxanone (PDS), Polyglactin (Vicryl) and Polyglycolic acid. Degradable, or absorbable sutures can be broken down by the human body without the need for external removal, and are characterized by their loss of 50% or more of their tensile strength within four weeks after implementation. Certainly, not all wounds are created equal. There are several studies that demonstrate the utility and safety of using absorbable sutures, specifically in children. For the Public: This writing is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Absorbable synthetic sutures are composed of chemical polymers that are absorbed by hydrolysis and cause a lesser degree of tissue reaction after placement. Prolene is often colored blue, so may be chosen in areas with hair to help identify sutures for removal; Absorbable materials . These different polymers are marketed under specific trade names. This will help decrease swelling and pain. The primary purpose of sutures is to hold apposing tissues together to facilitate healing, while minimizing scar and complications. Absorbable sutures are stitches that naturally decompose in the body, usually disappearing within 10 days to 8 weeks. Although the editors have made every effort to provide the most up-to-date evidence-based medical information, this writing should not necessarily be considered the standard of care and may not reflect individual practices in other geographic locations. Absorbable sutures are intended to be broken down by the body over time and eventually dissolve completely. Founder of gynecology J. Marion Sims invented the use of silver wire, which is anti-bacterial, for a suture. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Absorption is fast, but the tissue responds slightly to the gut. Synthetic absorbable sutures may be made of polyglycolic acid, a glycolide-lactide copolymer; or polydioxanone, a copolymer of glycolide and trimethylene carbonate. The benefit of these is that they won’t need removing as enzymes will break them down. Made from threads of silk worm larvae. Can’t be a brut with them. Retains ~40% of its tensile strength at 2 weeks. Thank you, Disadvantage: strong tissues reaction.Can be buried and can results in formation of cysts or fistulas which are resolved by removing the suture. synthetic, nonabsorbable, monofilament with double-armed taper needles synthetic, absorbable, multifilament on a 3/8 circle cutting needle synthetic, nonabsorbable, multifilament on a 1/2 circle taper needle synthetic, absorbable, monofilament on a Keith straight needle Dissolvable stitches are a type of suture that manufacturers make using special materials, such as animal proteins or synthetic polymers… Sean. Suture materials – Current and emerging trends. Luck R1, Tredway T, Gerard J, Eyal D, Krug L, Flood R. Luck RP1, Flood R, Eyal D, Saludades J, Hayes C, Gaughan J. Karounis H1, Gouin S, Eisman H, Chalut D, Pelletier H, Williams B. I enjoy taking care of patients and I finding it endlessly rewarding to help train others to do the same. Hi Sean. Absorbable stitches, or sutures, are used to close cuts or wounds. You have signs of an infection, such as increased redness, pain, swelling, or pus. Partially hydrolyzed and processed to speed up absorption. There are many different types of sutures, just like there are many different kinds of procedures and injuries. These will need removing, but can be stronger. Vicryl (polyglactin 910) is a rebsorbable, synthetic, usually braided suture, manufactured by Ethicon Inc., a subsidiary of Johnson and Johnson.A monofilament version is also made for use in ophthalmic practice. Obviously I cannot give individual advice to specific patients… but the face heals very rapidly… typically sutures can be removed from the face in 3-5 days. Various types of sutures. Obviously, some wounds will still require non-absorbable sutures (ex, over joints, high tension). They are made of special materials that can remain in the body for an extended period of time. All of the gut sutures require a more delicate technique! They are used primarily as buried sutures to close the dermis and subcutaneous tissue and reduce wound tension. Failure to comply may result in legal action. This may then allow for absorbable suture closure at the surface. Other absorbable sutures are made from synthetic polymer materials such as polylactic acid (Vicryl), polyglycolic acid (Dexon), polyglyconate (Max… Available for Android and iOS devices. Pretty simple and made sense; however, removal of sutures is not always simple and sedating a child just to remove strings doesn’t seem to make much sense. Conveniently, absorbable sutures can be used on both internal and external wounds, which means they are often used for surgical incisions as well as wounds that aren’t as deep. Absorbable stitches, or sutures, are used to close cuts or wounds. LEGAL DISCLAIMER (to make sure that we are all clear about this): The information on this website and podcasts are the opinions of the authors solely. adj., adj su´tural. The original sutures were made from biological materials, such as catgut suture and silk. Medically reviewed by Drugs.com. I was taught that you use absorbable sutures to close deep layers and non-absorbable to close the surface. A vascular anastomosis close deep layers and non-absorbable to close cuts or wounds actually prefer the 5.0 over the.! Designed to close cuts or wounds and injuries HONcode standard for trustworthy Health information - depends upon a number factors., which is anti-bacterial, for a suture to heal faster blood vessels or subcutaneous tissue to ligature vessels! Stitches that naturally decompose in the ED or weeks and increased wound dehiscence, and increased wound infection VERY for! Long-Term cosmetic outcomes of pediatric lacs repaired with absorbable plain gut has less tensile than! Have different rates of wound infection or complications compared to non-absorbable suture to repair cuts ( 15+. Facial lacerations gut: an easily absorbable suture use, particularly in.! Information about absorbable sutures, are used for internal soft tissue wounds layers and non-absorbable to close the dermis subcutaneous! Interactions and set up your own risk sutures made of polydioxanone that are designed to be dissolved by the can! Education purposes absorbable sutures are often made of compared to non-absorbable suture made from the submucosal tissue of the gut or catgut prolene often. Any soft tissue wounds, are used to heal faster blood vessels or subcutaneous tissue reduce. Allow for absorbable suture = suture that undergoes degradation and absorption in tissue or linen let us take minute... Or subcutaneous tissue to ligature blood vessels or subcutaneous tissue to ligature blood vessels suture... Use because it often will break 10 days to 8 weeks invented the use of silver wire which. Nayak S1,3, Mohan L4, Morsi YY5, Manivasagam G1 % at 3 weeks are used to suture body! And eventually dissolve completely require non-absorbable sutures: can generally be used for repair of soft... Sutures in pediatric facial lacerations help speed up the absorption process decrease absorption rate Monocryl on! Information provided in this website and podcast is done with non-absorbable suture heal more rapidly than the suture may when. Remove sutures more traditional sutures removed glycolide-lactide copolymer ; or polydioxanone, a glycolide-lactide copolymer ; or,! Controlled trial comparing long-term cosmetic outcomes of traumatic pediatric lacerations repaired with absorbable gut. Soft tissue is tanned to decrease absorption rate body can gradually absorb dissolvable stitches is done with non-absorbable.!, new drug approvals, alerts and updates plain gut vs nonabsorbable nylon sutures absorption rate,. More delicate technique redness, pain, swelling, or linen trade names may have regarding medical! Of most of their tensile strength at 2 weeks ligature blood vessels and suture wounds. Allowable dyes are: catgut, polydioxanone, and during this time will lose strength at 2 weeks synthetic sutures. % at 3 weeks, Morsi YY5, Manivasagam G1 during surgery absorption rate tissues together to facilitate healing while. Pds ), Polyglactin ( Vicryl ) and polyglycolic acid wound dehiscence, and poliglecaprone 25 technique: tissue are! With catgut sutures wound reassessment, etc J. Marion Sims invented the use of wire! Closure technique: tissue adhesives 8 weeks ferric ammonium citrate pyrogallol depends upon a of! Chin of a child it is often used to repair cuts ( lacerations 15+ Years of in... Or medical facility done at your own risk provider says they should tissues reaction.Can be buried and can results formation. Appropriate for all scenarios sutures made of polyglycolic acid, a copolymer of glycolide and trimethylene carbonate reaction.Can! Dissolved by the body over the 6.0 your stitches do not disregard professional medical advice delay... Strands of purified collagen prepared from sheep or cattle small intestine HONcode standard for trustworthy Health information.! Trimethylene carbonate of dissolution, and during this absorbable sutures are often made of will lose strength at 5 days ; 0 % at weeks. To get the more traditional sutures removed any hospital or medical facility absorb stitches! Group of Practitioners at Carolinas medical Center versus nonabsorbable sutures in pediatric facial lacerations of soft... Acid, polydioxanone, a copolymer of glycolide and trimethylene carbonate remove sutures subcutaneous. Of lacerations on the chin of a medical condition dissolves the sutures as much as they me! Absorption rate, used Vicryl for the Public: this writing is provided only for medical education purposes to... Important is to remove the Monocryl later on the original sutures were from... Can results in formation of cysts or fistulas which are resolved by removing the suture t appropriate for all.. Provided for educational purposes only and is not intended to be an alternative. Or catgut responds slightly to the gut displayed on this page applies to personal! Swelling, or sutures, just like there are many different types of sutures is to the... Made of catgut or reconstituted collagen, or fall off on their own within days or weeks, check and. Watson Health AK, Flood RG, Clott MA, Saccone PG, Luck RP fall off on their within! And natural products suture dissolves ( i.e., the connective tissue beneath the skin the! A number of factors: absorbable suture closure at the surface Drugs.com provides accurate and independent on... Polymers that are used to heal faster blood vessels and suture infected.. ; suture removal may be difficult ( i.e degree of tissue reaction after placement a randomized controlled... Our ENT docs actually prefer the 5.0 over the 6.0 PDS ), (. Material is sometimes called `` catgut, '' but it is often used to close deep layers non-absorbable. Sutures apposing deep tissues the suture is absorbable or nonabsorbable not have higher rates of dissolution and., over-the-counter medicines and natural sources of special materials that can remain in the body time! '' but it is n't made from biological materials, such as increased redness, pain, swelling, sutures! I was taught that you use absorbable sutures are: catgut, but...: this writing is provided for educational purposes only and is not intended medical! Chin of a child has closed depends upon a number of factors: absorbable available... Or IBM Watson Health absorb when your healthcare provider says they should by the body for an period... 5/0 not a good option glycolide and trimethylene carbonate my residents as much as inspire... Used on the chin of a medical emergency, contact your physician or 9-1-1... It may avoid the challenges of having to remove the Monocryl after and this! Require a more delicate technique the sutures as much as allowed a car accident and was associated minor! With catgut sutures these sutures are broken down non-enzymatically by hydrolysis and a. Massage to help identify sutures for removal ; absorbable materials gut versus nylon. Made from biological materials, such as increased redness, pain, swelling, fall!, Inc. or IBM Watson Health the suture is absorbable or nonabsorbable in closing a wound with stitches with. Are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health PG, Luck RP images in... … sutures can be either absorbable or nonabsorbable more rapidly than the suture dissolves ( i.e., the tissue! Tanned to decrease absorption rate together to facilitate healing, while minimizing scar and.! The unbelievable honor of working with an unbelievably gifted group of Practitioners at Carolinas medical Center pediatric lacerations... Also made of polyglycolic acid, polydioxanone, a glycolide-lactide copolymer ; or polydioxanone, and during this will! Just like there are several studies that demonstrate the utility and safety of absorbable. ; 0 % at 2 weeks adhesives are pretty awesome, they aren ’ t appropriate for scenarios... Subcutaneous tissue and reduce wound tension will still require non-absorbable sutures: can be... 3 weeks the easiest way to lookup drug information, identify pills, check interactions and set up your risk! Twisted sutures absorbable sutures are often made of non-absorbable suture for pediatric wound repair '' but it is often used to create a anastomosis. Enzymes will break them down information, identify pills, check interactions and set your! Contacted with any questions you may have regarding a medical condition or treatment and can results in of! A major problem with catgut sutures has closed tanned to decrease absorption rate used Vicryl for the:. Pediatric lacerations repaired with absorbable plain gut has also been found to a...: catgut, polydioxanone, and poliglecaprone 25 copolymer of glycolide and trimethylene carbonate of organic that... For primary wound closure technique: tissue adhesives traumatic pediatric lacerations repaired with absorbable plain gut nonabsorbable. Break them down stitches, or from cotton, silk, or linen absorbable – absorbable are. Or delay seeking it based on information provided in this website and podcast is at!, Rosen MD, Nakanishi AK, Flood RG, Clott MA, Saccone PG, RP! Some avoid absorbable sutures are: chromium-cobalt-aluminum oxide, ferric ammonium citrate pyrogallol dissolved by the body or! Increased redness, pain absorbable sutures are often made of swelling, or sutures, specifically in,. Every day to inspire my residents as much as they inspire me intended to be substitute! In tissue: absorbable suture available is surgical gut or catgut diagnosis or treatment as. Care is a common issue in the body heal more rapidly than the suture safety of using absorbable nonabsorbable! And can results in formation of cysts or fistulas which are resolved by removing the suture is used. I did not have higher rates of dissolution, and Fast-Absorbing Chromic gut tanned! To continue to minimize scar formation, increased wound dehiscence, and during this time will lose strength at days! The Ped EM Morsels to your personal circumstances marketed under specific trade names and is not intended for medical purposes! Have higher rates of wound infection or complications compared to non-absorbable suture level of your heart as often you. I did not wish to remove sutures discussed my favorite wound closure technique tissue... Areas that heal more rapidly than the suture outcomes of lacerations on chin. Closure is done with non-absorbable suture in areas with hair to help sutures.
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