Suture Sizes

Sutures come in various sizes. The bigger the suture material, usually
the bigger the needle. The sizing of sutures is similar to the sizing of
needles for injection: the bigger the number, the smaller the size of the
suture. Suture sizes range from 00 (very large, used to close the abdominal
wall—about the size of large fishing line) to 10-0 (very tiny, used
for microvascular anastomoses—as fine as a human hair). You generally
will use sizes in the middle range: 3-0 to 5-0.
It is best to use small sutures on the face, such as 5-0 or 6-0. Smaller sutures
are associated with decreased scarring, which is a concern with
facial wounds. (See chapter 16, “Facial Lacerations,” for more specific
details.) On areas where cosmetic concerns are less important, 3-0 or 4-
0 sutures are best, because the larger size makes the technique easier
and the thicker sutures are stronger. The tendency is to use smaller sutures
on children because of their more delicate skin. Rarely do you
need anything larger than a 4-0 suture.