Influence of suturing material on wound healing – An experimental study on dogs
Abstract
Background/Aim. The most common materials implanted in the human organism are suture materials that are classified on the basis of several criteria, usually the origin, structure, and properties. The properties of suture materials are related to its absorbability and non-absorbability. When using resorbable materials it is of great importance to determine whether its absorbability and tensile strength help wound healing in function of time. Sutures themselves can become a source of inflammation, that may reduce or compromise the potential of reparation and regeneration. The aim of this experimental study on dogs was to ascertain whether the absorption rate and the degree of local tissue reactions differ from information provided by the manufacturers, whether there are differences between the applied suture materials and which of the used suture materials have better effect on wound healing. Methods. Experimental testing of the selected suture materials basic characteristics was performed on 6 German Shepherd dogs, which, after induction of general anesthesia, were made 3 identical incisions each in all 4 quadrants (left and right side of the upper and lower jaws), so that 12 horizontal incisions were formed, 10 mm long, 20–25 mm distant from one another, on each animal. Randomly, incisions were stitched up in the following order, starting from back to front: catgut, Dexon®, Vicryl-Rapid®. The experiment was terminated by histopathological examination of tissue samples, taken on postoperative day 3, 7, 14 and 21 in order to identify the effect of healing and the degree of local reaction. Results. The obtained results suggest that catgut has the highest absorption rate, while Dexon® the lowest. Vicryl-Rapid® causes the lowest level of local reactions, while Dexon® the highest. Conclusion. There is no ideal suture material because various patient factors also influence the wound healing process.
References
Capperauld I. Suture materials: a review. Clin Mater 1989; 4: 3−12.
Margota R. The story of medicine. New York: Golden Press; 1968.
Sabiston DC. Textbook of surgery. 14th ed. Philadelphia: WB Saunders Co; 1991.
Snyder CC. On the history of suture. Plast Reconstr Surg 1976; 58(4): 401−6.
LaBagnara J Jr. A review of absorbable suture materials in head & neck surgery and introduction of monocryl: a new absorba-ble suture. Ear Nose Throat J 1995; 74(6): 409−15.
Kostić I. The influence of suture material and the type of stitching up upon tracheal anastomonis healing [dissertation]. Niš: Faculty of Medicine, University of Niš; 1989. (Serbian)
Capanglou D. (1999-2000) Spring term sutures. Available from: http//www.biometu.edu.tr/biomed/sutures.htm
O'Neal RB, Alleyn CD. Suture materials and techniques. Curr Opin Periodontol 1997; 4: 89−95.
Stone IK, von Fraunhofer JA, Masterson BJ. A comparative study of suture materials: chromic gut and chromic gut treated with glycerin. Am J Obstet Gynecol 1985; 151(8): 1087−939.
Stone IK. Suture materials. Clin Obstet Gynecol 1988; 31(3): 712−7.
Racey GL, Wallace WR, Cavalaris CJ, Marquard JV. Comparison of a polyglycolic-polylactic acid suture toblack silk and plain catgut in human oral tissues. J Oral Surg 1978; 36: 776−70.
Guyuron B, Vaughan C. A comparison of absorbable and non-absorbable suture materials for skin repair. Plast Reconstr Surg 1992; 89(2): 234−6.
Peterson L, Ellis E, Hupp JR, Tucker MR. Contemporary Oral and Maxillofacial Surgery. 3rd ed. St Louis, Mo: Mosby Year-Book; 1998.
Aderriotis D, Sàndor GK. Outcomes of irradiated polyglactin 910 Vicryl Rapide fast-absorbing suture in oral and scalp wounds. J Can Dent Assoc 1999; 65(6): 345−7.
Quayle AA, El Bawdrawy H. Clinical and Experimental Studies with a Resorbable Transosseous Ligature. Br J Oral Maxillofac Surg 1984; 22(1): 24−9.
Pini Prato GP, Cortellini P, Agudio G, Clauser C. Human fibrin glue versus sutures in periodontal surgery. J Periodontol 1987; 58(6): 426−31.
Mirković S. Influence of suturing material on wound healing af-ter mucoperiostal incision [thesis]. Novi Sad: Faculty of Denti-stry, University of Novi Sad; 2000. (Serbian)
Greene JC, Vermillion JR. Simplified oral hygiene index. J Am Dent Assoc 1964; 68: 7−13.
Loë H. The Gingival Index, the Plaque Index and the Reten-tion Index Systems. J Periodontol 1957; 38: 610−6.
Lalević P. Anestesiology IV. Beograd: Zavod za udžbenike i nastavna sredstva; 1999. (Serbia)
Nary Filho H, Matsumoto MA, Batista AC, Lopes LC, de Góes FC, Consolaro A. Comparative Study of Tissue Response to Polyg-lecaprone 25, Polyglactin 910 and Polytetrafluorethylene Suture Materials in Rats. Braz Dent J 2002; 13(2): 86−91.
Certosimo FJ, Nicoll BK, Nelson RR, Wolfgang M. Wound healing and repair: a review of the art and science. Gen Dent 1998; 46(4): 362−9.
Beswada RS, Jamiolkowski DD, Lee IY, Agarwal V, Persivale J, Trenka-Benthin S, et al. Monocryl suture, a new ultra-pliable absorbable monofilament suture. Biomaterials 1995; 16(15): 1141−8.
Shaw RJ, Negus TW, Mellor TK. A prospective clinical evaluation of the longevity of resorbable sutures in oral mucosa. Br J Oral Maxillofac Surg 1996; 34(3): 252−4.
Nary Filho H, Okamoto T, Padovan LEM. Estudo comparativo da resposta tecidual frente a fios de sutura de catgut e polig-lecaprone 25 em subcutaneo de ratos. Salusvita 1996; 15: 127−42.
McCaul LK, Bagg J, Jenkins WM. Rate of loss of irradiated po-lyglactin 910 (Vicryl Rapide) from the mouth: a prospective study. Br J Oral Maxillofac Surg 2000; 38(4): 328−30.
Duprez K, Bilweis J, Merle M. Experimental and clinical study of fast absorption cutaneous suture material. Ann Chir Main 1988; 7(1): 91−6.
Winstanley RP. The use of sutures in the mouth. Br J Maxillofac Surg 1985; 23(5): 381−5.
Craig PH, Wiliams JA, Davis KW, Magoun AD, Levy AJ, Bogdansky S, et al. Somerville, New Jersey. A biologic comparison of Polyglactin 910 and Polyglycolic acid synthetic absorbable su-tures. Surg Gynecol Obstet 1975; 141(1): 1−9.
Mirković S, Đurđević-Mirković T. Influence of different types of surgical suture materials on mehanical damage of oral mucosa. Med Pregled 2011; 64(3−4): 157−60. (Serbian)
Mirković S, Đurđević-Mirković T, Bajkin B, Šarčev I. Choice of surgical suture material used in oral cavity-clinacal study. Med Pregled 2010; 63(7−8): 497−501. (Serbian)
Wallace WR, Maxwel GR, Cavalaris CJ. Comparison of polygli-colic acid to black silk, chromic, and plain catgut in human oral tissues. J Oral Surgery 1970; 28(10): 739−16.
