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Gu T, Gan Y, Huang X, Peng S, Wu J, Chen X, Guo Z, Lin J. Application of Submucosal Trans-Septal Suturing Technique in a Septal Extension Graft With Porous High-Density Polyethylene and Concurrent Nasal Lateral Osteotomy. J Craniofac Surg 2024:00001665-990000000-01816. [PMID: 39145750 DOI: 10.1097/scs.0000000000010501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 06/25/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Recently, a submucosal trans-septal suturing (STSS) technique was introduced to obviate the dead space of septum after septal extension graft (SEG) with porous high-density polyethylene (pHDPE). OBJECTIVE To investigate STSS technique after SEG with pHDPE and concurrent nasal lateral osteotomy (LO). METHODS A retrospective study was conducted in 53 patients who underwent a STSS technique after SEG with pHDPE and concurrent LO. The postoperative discomfort (nasal pain and obstruction), the width of the nasal bony base, Nasal Obstruction Symptom Evaluation (NOSE), Rhinoplasty Outcomes Evaluation (ROE), and complications were recorded and assessed. RESULTS The mean surgical duration of STSS was 862.53±227.73 seconds. The maximal mean score of postoperative nasal pain and nasal obstruction was 2.132±0.921 and 1.868±0.8995, respectively. The values on the width of the nasal bony base and ROE were significantly improved after surgery. There was no significant difference in NOSE values preoperatively versus 6 months postoperatively. An infection was found in 1 patient, a recurrent minor bleeding of septum in another patient, and a symptomatic nasal obstruction in other 2 patients. There was no major bleeding, hematoma, foreign body sensation, septal perforation, and other infection. CONCLUSION STSS can eliminate the postoperative dead space of nasal septum with low discomfort and complications, and help to avoid a lateral displacement of osteotomized nasal bony segment (ONBS) in patients undergoing SEG with pHDPE and concurrent LO.
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Affiliation(s)
- Tianya Gu
- Department of Plastic Surgery, the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University
| | - Yufeng Gan
- Department of Plastic Surgery, the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University
| | - Xin Huang
- Department of Plastic Surgery, the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University
| | - Su Peng
- Department of Plastic Surgery, the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University
| | - Jie Wu
- Department of Plastic Surgery, the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University
| | - Xiang Chen
- Department of Plastic Surgery, the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University
| | - Zongke Guo
- Department of Plastic Surgery, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China
| | - Jinde Lin
- Department of Plastic Surgery, the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University
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Aktı A, Cengiz ZO, Gürses G, Serin H. Investigation of Absorbable and Non-Absorbable Multifilament Suture Materials in Terms of Strength Changes Using Chlorhexidine Mouthwash and Thermal Cycling: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2024; 17:3862. [PMID: 39124526 PMCID: PMC11314026 DOI: 10.3390/ma17153862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 07/25/2024] [Accepted: 07/30/2024] [Indexed: 08/12/2024]
Abstract
Sutures are natural or synthetic biomaterials utilized to hold tissues together. Following oral surgery, the surgical site and sutures are physically affected by many different factors. This study was conducted to evaluate the effect of artificial saliva (AS) and chlorhexidine mouthwash on the tensile strength of absorbable multifilament PGLA (polyglycolide-co-l-lactide) and non-absorbable multifilament silk sutures. PGLA and silk sutures, which are commonly used in oral surgery, were used to evaluate the change in strength of the sutures. A total of 352 suture samples were divided into eight equal groups (n = 44) and used for the experiments. Tensile strength was tested on days 0, 3, 7, and 14. For the silk sutures, there was a significant decrease in tensile strength in all groups at time T3 compared to T0, T1, and T2, and at times T1 and T2 compared to T0. For PGLA sutures, there was a significant decrease in all groups at time T3 compared to T0, T1, and T2. This study shows that chlorhexidine mouthwash significantly reduces suture resistance for 14 days after surgery.
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Affiliation(s)
- Ahmet Aktı
- Oral and Maxillofacial Department, Faculty of Dentistry, Selcuk University, Konya 42250, Turkey; (A.A.); (G.G.)
| | - Ziya Ozan Cengiz
- Oral and Maxillofacial Department, Faculty of Dentistry, Selcuk University, Konya 42250, Turkey; (A.A.); (G.G.)
| | - Gökhan Gürses
- Oral and Maxillofacial Department, Faculty of Dentistry, Selcuk University, Konya 42250, Turkey; (A.A.); (G.G.)
| | - Hakan Serin
- Department of Biostatistics, Selcuk University of Veterinary Medicine, Konya 42250, Turkey;
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La Rosa GRM, Scapellato S, Cicciù M, Pedullà E. Antimicrobial Activity of Antibacterial Sutures in Oral Surgery: A Scoping Review. Int Dent J 2024; 74:688-695. [PMID: 38429145 PMCID: PMC11287137 DOI: 10.1016/j.identj.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/24/2024] [Accepted: 01/28/2024] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVE The aim of this scoping review was to explore and synthesise the current evidence on the antimicrobial activity of antibacterial suture materials used in oral surgery. METHODS The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. A bibliographic search was carried out in the PubMed and Scopus databases to retrieve all human clinical studies that investigated the antimicrobial efficacy of antibacterial-coated sutures used in oral surgery. Included studies were screened and extracted independently by 2 examiners. Data were tabulated and qualitatively described. RESULTS The search initially returned 150 articles and resulted in 5 included studies after the duplicates' removal and the full-text screening. Selected studies were published from 2014 to 2019. Three studies (60%) were randomised clinical trials, whilst the remaining studies did not report information on randomisation. The antimicrobial agents for coated sutures included triclosan and chlorhexidine. In almost all the studies, antibacterial-coated sutures exhibited lower bacterial retention compared to those without coating. CONCLUSIONS Within limitations, the antimicrobial-coated sutures employed in oral surgery exhibited good results in terms of their microbicidal activity when compared with sutures that were not coated. Considering the high variability and confounding factors identified in the included studies, more high-quality research is needed to confirm these results. Antimicrobial-coated sutures could represent a promising and clinically valid strategy to reduce microbial colonisation in oral surgery. The reduced bacterial adherence is likely to improve the clinical success of the surgical procedures. Yet, the cost-benefit ratio of antimicrobial-coated sutures should be assessed in larger clinical trials to confirm their efficacy over conventional noncoated sutures.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
| | - Simone Scapellato
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Marco Cicciù
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
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Aktı A, Kaya DI. Evaluation of Tensile Strength of Surgically Absorbable Suture Materials Used in Oral Surgery after Immersion in Different Beverages: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2024; 17:3586. [PMID: 39063878 PMCID: PMC11278735 DOI: 10.3390/ma17143586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 07/14/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024]
Abstract
Suture materials are natural or synthetic biomaterials used to close tissues together. After surgical procedures in the mouth, the surgical site and the sutures are physically affected by many different factors. This study was conducted to evaluate the effects of frequently consumed beverages on the tensile strength of monofilament PGLA (polyglycolide-co-l-lactide) and multi-filament PGCL (polyglycolide-co-caprolactone) absorbable sutures. In particular, PGLA and PGCL absorbable sutures, which are frequently used in oral surgery, were used to evaluate the change in the strength of suture materials. The suture materials were soaked in tea, coffee, and cola drinks five times a day for 5 min each and the rest of the time in artificial saliva. All suture materials were aged via thermal cycling. Tensile strengths were tested at 0, 3, 7, and 14 days. Mixed ANOVA (four replicates: within-group comparison and two factors: between-group comparison) was performed to evaluate the effects of groups and time on the tension levels of the Tekmon and Vicryl suture materials. Analysis of Variance was used for the within- and between-group comparisons, with the Bonferroni corrected t-test for multiple comparisons. For the PGCL suture material, there were significant decreases in tension levels in artificial saliva, tea, coffee, and cola at time T3 compared to T0, T1, and T2, and at T1 and T2 compared to T0. For the PGLA suture material, there were significant decreases in tension levels in artificial saliva, tea, coffee, and cola at time T3 compared to T0, T1, and T2. There was also a significant decrease in tension level at time T2 in cola compared to T0. The present study demonstrates that beverages significantly decrease the strength of suture materials for 14 days after surgery. In particular, cola decreased the resistance of the PGCL suture material more significantly in the first week when compared to other beverages.
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Affiliation(s)
- Ahmet Aktı
- Department of Oral and Maxillofacial Surgery, Dentistry Faculty, Selçuk University, Konya 42250, Turkey
| | - Doğan Ilgaz Kaya
- Department of Oral and Maxillofacial Surgery, Dentistry Faculty, Karamanoğlu Mehmetbey University, Karaman 70100, Turkey;
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Abou-Agwa TK, Al-Jundi A, Alhalaby YK, Alakari HM, Hajeer MY. The Effect of a Horizontal Apical Mattress Suturing Technique on the Width and Thickness of the Keratinized Mucosa After Dental Implant Surgery: A Cohort Study. Cureus 2024; 16:e65513. [PMID: 39071079 PMCID: PMC11283254 DOI: 10.7759/cureus.65513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2024] [Indexed: 07/30/2024] Open
Abstract
Introduction There is general agreement that a thick zone of the keratinized tissues around implants promotes accurate prosthetic procedures, permits oral hygiene maintenance, resists recession, and enables esthetic blending with surrounding tissues. A new procedure called Choukroun's technique has been suggested, and it consists of a combination of horizontal apical mattress suture with regular suture to increase the keratinized tissue in the mandibular arch during the first stage after implantation. The proposed procedure has not been evaluated yet in a cohort of patients. Therefore, this prospective study aimed to evaluate the impact of Choukroun's technique on the width and thickness of the keratinized gingiva after oral surgery. Materials and methods A one-group prospective cohort study was conducted on patients referred to the Department of Oral and Maxillofacial Surgery at the Dental College of Al-Wataniya Private University who had been referred to undergo dental implant surgery. The inclusion criteria for the study group were as follows: patients with mandibular missing teeth, good oral health, good general health, 18-70 years old, at least 1 mm thickness of keratinized gingiva, and at least 1 mm width of the attached gingiva. A total of 14 patients aged 27-67 years were included in the study. After inserting the dental implants, the suturing was accomplished according to Choukroun's method. The width and thickness of the keratinized gingiva were assessed before surgery and at one and two months post-surgery. Repeated measures analysis of variance (ANOVA) was applied to detect significant differences between assessment times. Results The study sample comprised 14 patients, of which four were females (28.6%) and 10 were males (71.4%). Patients' ages ranged from 27 to 67 years, with a mean age of 54.86 ± 11.73 years. The surgical procedure was performed in three different regions: the upper posterior teeth with four patients (28.6%), the upper anterior teeth with three patients (21.4%), and the lower posterior teeth with seven patients (50%). The mean gingival width before surgery was 5.78 mm, whereas the mean gingival thickness was 2.82 mm. There was no significant difference between the three evaluation times in the mean gingival width (P=0.222), and there was a significant difference between the three evaluation times in the mean gingival thickness (P<0.001). The mean mean gingival thickness one month after surgery was significantly greater than its mean value before surgery (mean difference: 0.749 mm). Additionally, the mean gingival thickness two months after surgery was significantly greater than its mean value before (mean differences: 0.636 mm). Conclusions Using horizontal apical mattress sutures (Choukroun's technique) does not provide any advantage in increasing the width of the keratinized gingiva. However, it does lead to an increase in the thickness of keratinized gingiva in the surgical area. Therefore, the use of horizontal apical mattress sutures is recommended.
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Affiliation(s)
- Tarek Khaled Abou-Agwa
- Department of Oral Surgery, College of Dentistry, Al-Wataniya Private University, Hama, SYR
| | - Azzam Al-Jundi
- Department of Orthodontics, Faculty of Dentistry, University of Hama, Hama, SYR
| | | | - Hamzah Majed Alakari
- Department of Oral Surgery, College of Dentistry, Al-Wataniya Private University, Hama, SYR
| | - Mohammad Y Hajeer
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, SYR
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Huang X, Gan Y, Xia X, Gu T, Peng S, Wu J, Chen X, Liang Y, Guo Z, Lin J. Submucosal Trans-Septal Suturing Technique After a Septal Extension Graft with Porous High-Density Polyethylene: A Technical Report. Aesthetic Plast Surg 2024:10.1007/s00266-024-04052-8. [PMID: 38831066 DOI: 10.1007/s00266-024-04052-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/09/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Porous high-density polyethylene (pHDPE) is an alternative material for a septal extension graft (SEG) in oriental rhinoplasty when autologous cartilage is limited. Although nasal packing (NP) and trans-septal suturing (TSS) techniques are routine procedures to obviate the dead space after septoplasty, they are associated with certain discomforts and complications. OBJECTIVE To investigate the application of a submucosal trans-septal suturing (STSS) technique after SEG with pHDPE. METHODS A prospective study was conducted on 60 female participants who underwent SEG with pHDPE. The participants were randomly divided into the NP group and STSS group. The extra surgical duration of NP and STSS, pain, nasal obstruction, and sleeping disturbance as well as postoperative complications were recorded and compared between groups. RESULTS No significant difference was found between group NP and group STSS in terms of mean age. The mean extra surgical duration of group STSS was significantly longer than group NP. There were significant higher pains of group NP at 24 hours and 48 hours postoperatively, compared with group STSS. The NP group also experienced significantly more nasal obstruction and sleep disturbance within 48h postoperatively compared to the STSS group. There was one infection in each group, minor bleeding in two NP patients, and one STSS patient. There was no major bleeding, hematoma, graft exposure, or septal perforation in both groups. CONCLUSION Although STSS needs a longer extra surgical duration than NP, it significantly improves the patient's postoperative comfort with a faster return to normal respiration compared to NP. LEVEL OF EVIDENCE I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Xin Huang
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Yufeng Gan
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Xiaofeng Xia
- Department of Plastic Surgery, Hangzhou Fuyang Hospital of Traditional Chinese Medicine, No.4 Guihua Road, Hangzhou, 311400, Zhejiang, China
| | - Tianya Gu
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Su Peng
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Jie Wu
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Xiang Chen
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Yan Liang
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Zongke Guo
- Department of Plastic Surgery, Zhongda Hospital, Southeast University, No.87 Dingjiaqiao, Nanjing, Jiangsu, China.
| | - Jinde Lin
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China.
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Sakr HM, AbdulSalam MR, Fayad MI, Moussa R, Alzahrani AAH. Microbial Adhesion to Different Thermoplastic Denture Base Materials in Kennedy Class I Partially Edentulous Patients. Cureus 2024; 16:e60421. [PMID: 38756717 PMCID: PMC11097705 DOI: 10.7759/cureus.60421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction Since the polished and fitting surface of the denture base may promote the colonization of microorganisms, it is essential to know how the different types of denture bases prevent or encourage the adhesion of microorganisms. This study aimed to compare the microbial adhesion to the polished and fitting surfaces of thermoplastic nylon, thermoplastic acetal, and thermoplastic acrylic denture bases in Kennedy Class Ⅰ, partially edentulous patients. Materials and methods Thirteen patients were included in the study. The group consisted of eight males (61.54%) and five females (38.46%), with an age range of 41-50 years (mean age 46.1 years). Three types (groups) of removable partial dentures will be made for each patient using different thermoplastic denture base materials: thermoplastic nylon; thermoplastic acetal; and thermoplastic acrylic. The polished and fitting surfaces of the denture bases were swabbed after a one-month follow-up period. Microbial adhesion was evaluated by counting the microorganisms' colony-forming units (CFU) in the collected specimens. The data were collected and statistically analyzed. Results The study revealed no statistically significant difference in microbial adhesion to both polished and fitting surfaces between all types of studied thermoplastic denture base materials. However, the results showed that for the polished surface, the microbial adhesion median of thermoplastic acrylic denture base (40.5 CC x 102/ml) was higher than that of thermoplastic acetal (29.0 CC x 102/ml) and thermoplastic nylon (16.0 CC x 102/ml). Regarding the fitting surface, the microbial adhesion median of thermoplastic acrylic (51.0 CC x 102/ml) is higher than that of thermoplastic acetal (41.0 CC x 102/ml) and thermoplastic nylon (23.0 CC x 102/ml). Conclusion The thermoplastic nylon denture base materials showed less microbial adhesion among the studied thermoplastic materials, so it may be recommended to be used as a denture base material for individuals at high risk of denture stomatitis.
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Affiliation(s)
- Hassan M Sakr
- Department of Prosthodontic Dental Science, College of Dentistry, Al-Baha University, Al-Baha, SAU
- Department of Removable Prosthodontics, Faculty of Dentistry, Al-Azhar University, Cairo, EGY
| | - Mahmoud R AbdulSalam
- Department of Prosthodontics, Faculty of Dentistry, Horus University, New Damietta, EGY
| | - Mostafa I Fayad
- Department of Substitutive Dental Science, College of Dentistry, Taibah University, Madinah, SAU
- Department of Removable Prosthodontics, Faculty of Dentistry, Al-Azhar University, Cairo, EGY
| | - Rania Moussa
- Department of Substitutive Dental Science, College of Dentistry, Taibah University, Madinah, SAU
| | - Abdullah Ali H Alzahrani
- Department of Dental Health, School of Applied Medical Sciences, Al-Baha University, Al-Baha, SAU
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Mathew S, Vijaya Kumar K, Prabhu A, Shastry RP, Rajesh KS. Braided silk sutures coated with photoreduced silver nanoparticles for eradicating Staphylococcus aureus and Streptococcus mutans infections. J Microbiol Methods 2024; 220:106923. [PMID: 38521504 DOI: 10.1016/j.mimet.2024.106923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/20/2024] [Accepted: 03/20/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Infections resulting from surgical procedures and wound closures continue to pose significant challenges in healthcare settings. To address this issue, the investigators have developed antibacterial non-resorbable braided silk sutures using in situ deposited silver nanoparticles (AgNPs) and investigated their efficacy in eradicating Staphylococcus aureus and Streptococcus mutans infections. METHODS The braided silk sutures were modified through a simple and efficient in situ photoreduction method, resulting in the uniform distribution of AgNPs along the suture surface. The synthesized AgNPs were characterized using scanning electron microscopy (SEM), dynamic light scattering analysis (DLS) and Fourier Transform Infrared Spectroscopy analysis (FTIR) confirming their successful integration onto the silk sutures. The antibacterial activity of the nanoparticle coated sutures were compared and evaluated with non-coated braided silk sutures through in vitro assays against both S. aureus and S. mutans. RESULTS The surface and cross-sectional analysis of the treated sutures revealed a uniform and homogeneous distribution of silver particles achieved through the photoreduction of silver solution. This observation confirms the successful coating of silver nanoparticles (AgNPs) on the sutures. The antimicrobial studies conducted, demonstrated significant reductions in bacterial colonies when exposed to the silver nanoparticle-coated sutures. Notably, the width of the inhibition zone surrounding the coated sutures remained consistently wide and stable for duration up to 7 days. This sustained and robust inhibitory effect against gram-positive bacteria, specifically S. aureus and S. mutans, serves as strong evidence of the antibacterial efficacy of the coated sutures. CONCLUSION The coating of silk sutures with AgNPs provided a significant and effective antibacterial capacity to the surgical sutures, with this activity being sustained for a period of 7 days. This suggests that AgNPs-in situ photoreduction deposited sutures have the potential to effectively manage S. aureus and S. mutans infections.
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Affiliation(s)
- Shilpa Mathew
- Department of Periodontology, Yenepoya Dental College, Yenepoya (Deemed to be University), University Road, Deralakatte, Mangaluru 575018, India
| | - K Vijaya Kumar
- Department of Periodontology, Yenepoya Dental College, Yenepoya (Deemed to be University), University Road, Deralakatte, Mangaluru 575018, India.
| | - Ashwini Prabhu
- Division of Cancer Research and Therapeutics, Yenepoya Research Centre, Yenepoya (Deemed to be University), University Road, Deralakatte, Mangaluru 575018, India
| | - Rajesh P Shastry
- Division of Microbiology and Biotechnology, Yenepoya Research Centre, Yenepoya (Deemed to be University), University Road, Deralakatte, Mangaluru 575018, India
| | - K S Rajesh
- Department of Periodontology, Yenepoya Dental College, Yenepoya (Deemed to be University), University Road, Deralakatte, Mangaluru 575018, India
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Ching EEB, Chaiyasamut T, Vorakulpipat C. In Vitro Study of Tensile Strength Comparison of Selected Nonabsorbable and Absorbable Suture Materials after Immersion in 0.12% Chlorhexidine Gluconate. J Int Soc Prev Community Dent 2024; 14:201-210. [PMID: 39055294 PMCID: PMC11268532 DOI: 10.4103/jispcd.jispcd_162_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 02/17/2024] [Accepted: 02/21/2024] [Indexed: 07/27/2024] Open
Abstract
Aim To compare the tensile strength (TS) of absorbable and nonabsorbable suture materials after immersion in 0.12% chlorhexidine gluconate. Materials and Methods Six 4-0-gauge suture materials were used, namely silk (S), polypropylene (PP), polyamide 6 (PA6), polyglactin 910 (PG910), poliglecaprone 25 (PL25), and polydioxanone (PDX). A total of 540 suture materials were divided equally (90) into six groups and tested. These materials were divided into a nonimmersed condition (10) and two thermostatically controlled immersion media (40 each), using artificial saliva for the control group (CG) and 0.12% chlorhexidine gluconate for the test group (TG). The specimens were tied to prefabricated rubber rods before immersion and removed at the testing timepoint. By using a universal testing machine (Instron 5566) with hooks attached, a hook-mounted specimen TS testing was performed on days 0, 1, 3, 7, and 14 at a 10 mm/min crosshead speed until the material was stretched to failure, and the maximum TS was recorded in Newtons (N). The continuous variables were taken as the mean and standard deviation across the six study groups to assess the significance at α = 0.05. A two-factor analysis of variance (ANOVA) was performed to assess the TSs over time in different media. A Bonferroni correction was performed when the data were statistically significant according to a two-factor ANOVA. Intragroup statistical comparisons were performed by repeated ANOVA for each study group. All data were analyzed using SPSS 26. Results The suture material TS analysis showed that nonabsorbable suture materials maintained their TS throughout the study; silk exhibited different behaviors, decreasing in TS from baseline to day 1 and maintaining its TS until day 14. All absorbable suture materials decreased in TSs by day 14. The silk and PG910 samples in the TG performed significantly better than those in the CG. Conclusions Prescribing 0.12% chlorhexidine gluconate as a postsurgical mouth rinse is safest when silk and PG910 are the optimal suture materials.
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Affiliation(s)
- Ezra Emmanuel B Ching
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Teeranut Chaiyasamut
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Chakorn Vorakulpipat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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10
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Agarwal A, Joseph J, Naik MN. Delayed infections following polybutylate-coated polyester (Ethibond) suture frontalis suspension surgery for severe blepharoptosis. Orbit 2024:1-7. [PMID: 38687955 DOI: 10.1080/01676830.2024.2338789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 03/27/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE To describe the incidence and management of delayed infections following frontalis sling suspension with polybutylate-coated polyester suture (Ethibond). METHODS Retrospective, interventional case series of 177 eyes of 150 patients, who underwent frontalis suspension surgery with Ethibond (Johnson and Johnson, USA), at L V Prasad Eye Institute, Hyderabad, India, between January 2016 and February 2022. Patients were assessed for chronic secondary sling infection, defined as infection/suture granuloma occurring beyond 6 weeks post-surgery. All patients received postoperative oral antibiotics. The clinical profile, microbiological evaluation, antibiotic sensitivity patterns, and management outcomes were analyzed. RESULTS Delayed infection following Ethibond sling suspension was noted in 14 eyes of 13 patients (7.9%). Of these, eight cases (61.5%) were females. The average time interval from surgery to presentation was 7.5 months (range: 2.5 months to 2.5 years). Eleven eyes underwent sling removal. Of the three who received initial antibiotic course, two eventually needed sling removal. Microbiological evaluation was available in seven eyes (50%), with Staphylococcus aureus as the most common organism. Of the six positive cultures, five (83.3%) were resistant to fluoroquinolones (FQs). CONCLUSION Frontalis suspension with Ethibond has an 8% incidence of delayed infections, with Staphylococcus aureus as the most common organism. The authors recommend early sling removal in all patients with infection and recommend consideration of an alternative material in the event of future revision surgery.
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Affiliation(s)
- Ayushi Agarwal
- Hariram Motumal Nasta & Renu Hariram Nasta Ophthalmic Plastic Surgery Service, L.V. Prasad Eye Institute, Hyderabad, India
| | - Joveeta Joseph
- Jhaveri Microbiology Centre, L.V. Prasad Eye Institute, Hyderabad, India
| | - Milind N Naik
- Hariram Motumal Nasta & Renu Hariram Nasta Ophthalmic Plastic Surgery Service, L.V. Prasad Eye Institute, Hyderabad, India
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11
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De Giorgio G, Matera B, Vurro D, Manfredi E, Galstyan V, Tarabella G, Ghezzi B, D'Angelo P. Silk Fibroin Materials: Biomedical Applications and Perspectives. Bioengineering (Basel) 2024; 11:167. [PMID: 38391652 PMCID: PMC10886036 DOI: 10.3390/bioengineering11020167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/13/2024] [Accepted: 02/05/2024] [Indexed: 02/24/2024] Open
Abstract
The golden rule in tissue engineering is the creation of a synthetic device that simulates the native tissue, thus leading to the proper restoration of its anatomical and functional integrity, avoiding the limitations related to approaches based on autografts and allografts. The emergence of synthetic biocompatible materials has led to the production of innovative scaffolds that, if combined with cells and/or bioactive molecules, can improve tissue regeneration. In the last decade, silk fibroin (SF) has gained attention as a promising biomaterial in regenerative medicine due to its enhanced bio/cytocompatibility, chemical stability, and mechanical properties. Moreover, the possibility to produce advanced medical tools such as films, fibers, hydrogels, 3D porous scaffolds, non-woven scaffolds, particles or composite materials from a raw aqueous solution emphasizes the versatility of SF. Such devices are capable of meeting the most diverse tissue needs; hence, they represent an innovative clinical solution for the treatment of bone/cartilage, the cardiovascular system, neural, skin, and pancreatic tissue regeneration, as well as for many other biomedical applications. The present narrative review encompasses topics such as (i) the most interesting features of SF-based biomaterials, bare SF's biological nature and structural features, and comprehending the related chemo-physical properties and techniques used to produce the desired formulations of SF; (ii) the different applications of SF-based biomaterials and their related composite structures, discussing their biocompatibility and effectiveness in the medical field. Particularly, applications in regenerative medicine are also analyzed herein to highlight the different therapeutic strategies applied to various body sectors.
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Affiliation(s)
- Giuseppe De Giorgio
- IMEM-CNR, Institute of Materials for Electronics and Magnetism-National Research Council, Parco Area delle Scienze 37/A, 43124 Parma, Italy
| | - Biagio Matera
- Center of Dental Medicine, Department of Medicine and Surgery, University of Parma, Via Gramsci 14/A, 43126 Parma, Italy
| | - Davide Vurro
- IMEM-CNR, Institute of Materials for Electronics and Magnetism-National Research Council, Parco Area delle Scienze 37/A, 43124 Parma, Italy
| | - Edoardo Manfredi
- Center of Dental Medicine, Department of Medicine and Surgery, University of Parma, Via Gramsci 14/A, 43126 Parma, Italy
| | - Vardan Galstyan
- IMEM-CNR, Institute of Materials for Electronics and Magnetism-National Research Council, Parco Area delle Scienze 37/A, 43124 Parma, Italy
- Department of Engineering "Enzo Ferrari", University of Modena and Reggio Emilia, Via Vivarelli 10, 41125 Modena, Italy
| | - Giuseppe Tarabella
- IMEM-CNR, Institute of Materials for Electronics and Magnetism-National Research Council, Parco Area delle Scienze 37/A, 43124 Parma, Italy
| | - Benedetta Ghezzi
- IMEM-CNR, Institute of Materials for Electronics and Magnetism-National Research Council, Parco Area delle Scienze 37/A, 43124 Parma, Italy
- Center of Dental Medicine, Department of Medicine and Surgery, University of Parma, Via Gramsci 14/A, 43126 Parma, Italy
| | - Pasquale D'Angelo
- IMEM-CNR, Institute of Materials for Electronics and Magnetism-National Research Council, Parco Area delle Scienze 37/A, 43124 Parma, Italy
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12
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Khalid GM, Billa N. Drug-Eluting Sutures by Hot-Melt Extrusion: Current Trends and Future Potentials. MATERIALS (BASEL, SWITZERLAND) 2023; 16:7245. [PMID: 38005174 PMCID: PMC10672932 DOI: 10.3390/ma16227245] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/06/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023]
Abstract
Surgical site infections (SSIs) may result from surgical procedures requiring a secondary administration of drugs at site or systemically in treating the infection. Drug-eluting sutures containing antimicrobial agents symbolise a latent strategy that precludes a secondary drug administration. It also offers the possibility of delivering a myriad of therapeutic agents to a localised wound site to effect analgesia, anti-inflammation, or the deployment of proteins useful for wound healing. Further, the use of biodegradable drug-eluting sutures eliminates the need for implanting foreign material into the wound, which needs to be removed after healing. In this review, we expound on recent trends in the manufacture of drug-eluting sutures with a focus on the hot-melt extrusion (HME) technique. HME provides a solvent-free, continuous one-step manufacturing conduit for drug-eluting sutures, hence, there is no drying step, which can be detrimental to the drug or suture threads and, thus, environmentally friendly. There is the possibility of combining the technology with additive manufacturing platforms to generate personalised drug-loaded implantable devices through prototyping and scalability. The review also highlights key material requirements for fabricating drug-eluting sutures by HME, as well as quality attributes. Finally, a preview of emerging drug-eluting sutures and advocacy for harmonisation of quality assurance by regulatory authorities that permits quality evaluation of novelty sutures is presented.
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Affiliation(s)
- Garba M. Khalid
- Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK;
- FabRx Ltd., Henwood House, Henwood, Asford TN24 8DH, UK
| | - Nashiru Billa
- Pharmaceutical Sciences Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
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13
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Hammad MI, Conrads G, Abdelbary MMH. Isolation, identification, and significance of salivary Veillonella spp., Prevotella spp., and Prevotella salivae in patients with inflammatory bowel disease. Front Cell Infect Microbiol 2023; 13:1278582. [PMID: 38053528 PMCID: PMC10694262 DOI: 10.3389/fcimb.2023.1278582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/30/2023] [Indexed: 12/07/2023] Open
Abstract
The global prevalence of inflammatory bowel disease (IBD) is on the rise, prompting significant attention from researchers worldwide. IBD entails chronic inflammatory disorders of the intestinal tract, characterized by alternating flares and remissions. Through high-throughput sequencing, numerous studies have unveiled a potential microbial signature for IBD patients showing intestinal enrichment of oral-associated bacteria. Simultaneously, the oral microbiome can be perturbed by intestinal inflammation. Our prior investigation, based on 16S rRNA amplicon sequencing, underscored elevated abundance of Veillonella spp. and Prevotella spp. in the salivary microbiomes of IBD patients. Noteworthy, Prevotella salivae emerged as a distinct species significantly associated with IBD. P. salivae is an under-recognized pathogen that was found to play a role in both oral and systemic diseases. In this study, we delve deeper into the salivary microbiomes of both IBD patients and healthy controls. Employing diverse cultivation techniques and real-time quantitative polymerase chain reactions (RT-qPCR), we gauged the prevalence and abundance of Veillonella spp., Prevotella spp., and P. salivae. Our isolation efforts yielded 407 and 168 strains of Veillonella spp., as well as 173 and 90 strains of Prevotella spp., from the saliva samples of IBD patients and healthy controls, respectively. Veillonella-vancomycin agar emerged as the discerning choice for optimal Veillonella spp. cultivation, while Schaedler kanamycin-vancomycin agar proved to be the most suitable medium for cultivating Prevotella spp. strains. Comparing our RT-qPCR findings to the previous 16S rRNA amplicon sequencing data, the results corroborated the higher abundance of Veillonella spp., Prevotella spp., and P. salivae in the saliva of IBD patients compared to healthy controls. However, it's worth noting that in contrast to RT-qPCR, the 16S rRNA amplicon sequencing data revealed greater absolute abundance of all three bacterial groups in both IBD patients and controls.
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Affiliation(s)
- Moshira I. Hammad
- Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule University Hospital, Aachen, Germany
| | - Georg Conrads
- Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule University Hospital, Aachen, Germany
| | - Mohamed M. H. Abdelbary
- Division of Oral Microbiology and Immunology, Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule University Hospital, Aachen, Germany
- Division of Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, Robert Koch Institute, Wernigerode, Germany
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14
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Krishna S, Bhaskaran R, Kumar SP, Krishnan M, Lakshmanan S. Microbiological Evaluation of Four Different Suture Materials Used for the Surgical Removal of Impacted Lower Third Molars: A Single-Center Prospective Comparative Study. Cureus 2023; 15:e49370. [PMID: 38146549 PMCID: PMC10749685 DOI: 10.7759/cureus.49370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/24/2023] [Indexed: 12/27/2023] Open
Abstract
Introduction Sutures play a crucial role in the postoperative healing process, as they help approximate wound edges, promote hemostasis, and support tissue healing. The oral cavity harbors a diverse microbial population, and oral surgical procedures can introduce potential pathogens into the surgical site. Understanding the impact of suture material on wound infection rates and the colonization of potentially harmful microorganisms is vital for improving patient outcomes. This study was aimed to evaluate and compare the microbiological properties of prolene, vicryl plus, monocryl, and silk sutures used after the surgical removal of impacted lower third molars. Materials and methods A total of 40 patients requiring surgical extraction of impacted lower third molars were assigned to four groups: prolene, vicryl plus, monocryl, and silk sutures. Surgical extraction of impacted tooth was done, and wound was sutured with the abovementioned four different materials in four groups, respectively. After seven days, the sutures were removed and sent to the microbiology lab for colony count assessment. Total microbial colony count, streptococcus count, and lactobacillus count were assessed. Data was analyzed using IBM SPSS Statistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, New York, United States) with p-values less than 0.05 considered as statistically significant. The one-way analysis of variance (ANOVA) and post-hoc Tukey test were done to compare intergroup relations. Results The microbiological evaluation of the sutures revealed significant differences in bacterial colonization among the four groups. More bacterial quantities were found in the silk group followed by the monocryl, vicryl plus, and prolene groups in the descending order. Prolene demonstrated the lowest incidence of bacterial growth (p<0.001) compared to vicryl plus, monocryl, and silk sutures. Bacterial colony count was highest in the silk group. The predominant bacterial species found in all groups were Streptococcus viridans, Staphylococcus aureus, and Lactobacillus. Conclusion It was found that prolene and vicryl plus sutures exhibited superior microbiological properties compared to monocryl and silk sutures when used for the surgical removal of impacted lower third molars. The lower incidence and less quantity of bacterial colonization on prolene sutures suggest their potential for reducing the risk of postoperative infection; hence, these sutures can be preferred for oral surgical procedures.
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Affiliation(s)
- Sai Krishna
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Rajprakash Bhaskaran
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Santhosh P Kumar
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Murugesan Krishnan
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Saravanan Lakshmanan
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Scribante A, Ghizzoni M, Pellegrini M, Poli PP, Maiorana C, Spadari F. Microbiological and Clinical Assessments of Suture Materials and Cyanoacrylate Application in Impacted Third Molar Surgeries: A Scoping Review. J Funct Biomater 2023; 14:529. [PMID: 37888194 PMCID: PMC10607494 DOI: 10.3390/jfb14100529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/10/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
The extraction of impacted third molars is a common but potentially complication-prone oral surgical procedure. Wound healing plays a vital role in preventing complications. This scoping review aimed to assess the clinical and microbiological aspects of various suture materials and cyanoacrylates. Unlike existing studies, we included more articles and comprehensively compared suture materials. Articles published in languages other than English; duplicate studies; studies deemed irrelevant for the specific research questions, including those analyzing different supplementary treatments or not corresponding to the abstract's content; ex vivo or experimental animal studies; studies lacking approval from an ethics committee; and narrative reviews, systematic reviews, or systematic and meta-analysis reviews were excluded. Thus, only 17 studies, published between 2000 and 2023, were included in the search. Suture techniques varied among surgeons, with debates on primary and secondary closure methods. A comparison of different suture materials and their effects on wound healing, infection rates, and other factors was described. Cyanoacrylate has also been used as an alternative to traditional sutures. Microbiological analysis showed varying bacterial adhesion based on the suture material, with silk sutures retaining more microbes than PTFE sutures. Clinical assessments have revealed differing inflammatory responses that affect wound healing and complications. Cyanoacrylate has emerged as a promising alternative to traditional sutures, owing to its rapid polymerization and early healing. However, the choice of suture material in impacted third molar surgery remains controversial, considering microbiological factors and clinical outcomes. More extensive randomized clinical trials are required to better understand the effect of suture materials on surgical outcomes and potential improvements. This study could enhance the safety and effectiveness of this common oral surgical procedure.
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Affiliation(s)
- Andrea Scribante
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Martina Ghizzoni
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Matteo Pellegrini
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.P.P.); (C.M.); (F.S.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Pier Paolo Poli
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.P.P.); (C.M.); (F.S.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Carlo Maiorana
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.P.P.); (C.M.); (F.S.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Francesco Spadari
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.P.P.); (C.M.); (F.S.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
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16
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Kandathil AM, Aslam SA, Abidha R, Cherian MP, Soman S, Sudarsanan M. Evaluation of Microbial Adherence on Antibacterial Suture Materials during Intraoral Wound Healing: A Prospective Comparative Study. J Contemp Dent Pract 2023; 24:515-520. [PMID: 38193173 DOI: 10.5005/jp-journals-10024-3553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
AIM To assess the efficacy of antiseptic-coated silk sutures with triclosan-coated polyglactin 910 suture in reducing bacterial colonization after oral surgical procedures. MATERIALS AND METHODS The patients who required multiple sutures after surgical procedures in the mandible were the study subjects. The sites of suturing were divided into three groups. Group A - surgical site receiving black-braided silk suture (control group). Group B - surgical site receiving triclosan-coated Polyglactin 910 suture (experimental group). Group C - surgical site receiving antiseptic-coated silk suture (experimental group). Evaluation was done on the 3rd postoperative and 7th postoperative day. Microbial adherence was evaluated by microbiological study. RESULTS The mean comparison of microbial count between 3rd and 7th post-op day in the three groups shows an increased microbial colonization in the control group when compared with the experimental groups. The combined mean microbial adherence in the three groups showed microbial count in the uncoated silk suture (group A) as 10.35 ± 3.74, triclosan-coated suture (group B) as 6.28 ± 2.17 and iodoform + calendula oil-coated suture (group C) as 7.1 ± 2.02 which is statistically significant (p < 0.05). CONCLUSION The present research concluded that the pomade-coated silk suture is as efficient as triclosan-coated VICRYL PLUS Polyglactin 910 sutures in reducing the bacterial colonization in intraoral wound healing. CLINICAL SIGNIFICANCE The pomade (iodoform + calendula oil) may be advocated in the field of oral and maxillofacial surgery for impregnating the suture materials which act as an antiseptic agent and a promoter of wound healing which is easily accessible and also cost-effective.
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Affiliation(s)
- Ayisha Moonnam Kandathil
- Department of Oral and Maxillofacial Surgery, MES Dental College and Hospital, Perinthalmanna, Kerala, India, Phone: +91 8589899343, e-mail:
| | - Sachin Aslam Aslam
- Department of Oral and Maxillofacial Surgery, MES Dental College and Hospital, Perinthalmanna, Kerala, India
| | - Roshni Abidha
- Department of Oral and Maxillofacial Surgery, MES Dental College and Hospital, Perinthalmanna, Kerala, India
| | - Mathew Pynummoottil Cherian
- Department of Oral and Maxillofacial Surgery, MES Dental College and Hospital, Perinthalmanna, Kerala, India
| | - Sooraj Soman
- Department of Oral and Maxillofacial Surgery, MES Dental College and Hospital, Perinthalmanna, Kerala, India
| | - Manju Sudarsanan
- Department of Oral and Maxillofacial Surgery, MES Dental College and Hospital, Perinthalmanna, Kerala, India
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17
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Microbiological Retention on PTFE versus Silk Suture: A Quantitative Pilot Study in Third Molar Surgery. Antibiotics (Basel) 2023; 12:antibiotics12030562. [PMID: 36978429 PMCID: PMC10044079 DOI: 10.3390/antibiotics12030562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/04/2023] [Accepted: 03/09/2023] [Indexed: 03/15/2023] Open
Abstract
Background: Mandibular third molar (M3M) removal and management of postoperative complications represent a common matter of interest in oral and maxillofacial surgery. This potential quantitative study assessed the ability of two types of surgical sutures, Silk and polytetrafluoroethylene polymer (PTFE), to carry aerobic and anaerobic bacteria on wounds after mandibular third molar surgery, with a collection of the stitches at the suture removal and study in the laboratory on the basis of colony-forming units. Methods: This prospective quantitative study sampled a total of 10 consecutive healthy patients for mandibular third molar surgery at the Oral Surgery School, Dentistry and Dental Prosthodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy. The mean age of the patients was 31 years (range 25–40 years), seven patients were male and three patients were female. Inclusion criteria were: presence of a partially impacted mandibular third molar. Exclusion criteria were: smoking and diabetes mellitus. Extraction of the mandibular third molar was performed under local anesthesia: after the third molar surgery, two sutures were applied on the surgical site distally to the second mandibular molar: one single 3/0 silk stitch; one single 3/0 PTFE stitch. No sutures were applied on the release incision. Sutures were removed after 7 days and were immediately conserved and sent to the laboratory to be rated on the basis of colony-forming units (CFUs). CFUs were evaluated and reported on GraphPad Prism and transformed into its base 10 logarithm. Data were analyzed with a non-parametric Wilcoxon test, and p-values < 0.05 were evaluated as statistically significant. Results: All the patients attended the suture removal date, and all the sutures were present in the site. None of the surgical sites presented dehiscence. No stitch loss was reported, and no patient reported mouth washing or tooth brushing in the surgery site. All interventions were uneventful and no major complications were reported after M3M surgery. Bacterial retention resulted as statistically greater in silk sutures rather than PTFE sutures, both in Brain Heart Infusion samples (p = 0.003) and Wilkins-Chalgren anaerobe samples (p = 0.002). Conclusions: We found the PTFE suture to be superior to the silk suture in a reduction in the bacterial biofilm in both aerobic and anaerobic evaluations after M3M surgery.
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18
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Meng Z, Li Z, Guo S, Wu D, Wei R, Liu J, Hu L, Sui L. MED1 Ablation Promotes Oral Mucosal Wound Healing via JNK Signaling Pathway. Int J Mol Sci 2022; 23:13414. [PMID: 36362197 PMCID: PMC9655393 DOI: 10.3390/ijms232113414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/31/2022] [Accepted: 10/31/2022] [Indexed: 08/12/2023] Open
Abstract
Mediator complex subunit 1 (MED1) is a coactivator of multiple transcription factors and plays a key role in regulating epidermal homeostasis as well as skin wound healing. It is unknown, however, whether it plays a role in healing oral mucosal wounds. In this study, we investigate MED1's functional effects on oral mucosal wound healing and its underlying mechanism. The epithelial-specific MED1 null (Med1epi-/-) mice were established using the Cre-loxP system with C57/BL6 background. A 3 mm diameter wound was made in the cheek mucosa of the 8-week-old mice. In vivo experiments were conducted using HE staining and immunostaining with Ki67 and uPAR antibodies. The in vitro study used lentiviral transduction, scratch assays, qRT-PCR, and Western blotting to reveal the underlying mechanisms. The results showed that ablation of MED1 accelerated oral mucosal wound healing in 8-week-old mice. As a result of ablation of MED1, Activin A/Follistatin expression was altered, resulting in an activation of the JNK/c-Jun pathway. Similarly, knockdown of MED1 enhanced the proliferation and migration of keratinocytes in vitro, promoting re-epithelialization, which accelerates the healing of oral mucosal wounds. Our study reveals a novel role for MED1 in oral keratinocytes, providing a new molecular therapeutic target for accelerated wound healing.
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Affiliation(s)
- Zhaosong Meng
- School of Stomatology, Tianjin Medical University, Tianjin 300014, China
| | - Zhe Li
- School of Stomatology, Tianjin Medical University, Tianjin 300014, China
| | - Shuling Guo
- School of Stomatology, Tianjin Medical University, Tianjin 300014, China
| | - Danfeng Wu
- School of Stomatology, Tianjin Medical University, Tianjin 300014, China
| | - Ran Wei
- School of Stomatology, Tianjin Medical University, Tianjin 300014, China
| | - Jiacheng Liu
- School of Stomatology, Tianjin Medical University, Tianjin 300014, China
| | - Lizhi Hu
- Immunology Department, Key Laboratory of Immune Microenvironment and Disease, Ministry of Education, Tianjin Medical University, Tianjin 300014, China
| | - Lei Sui
- School of Stomatology, Tianjin Medical University, Tianjin 300014, China
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19
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Abullais SS, AlOsman SS, AlQahtani SM, Khan AA, Nahid R, Basheer SA, Jameel AS. Effect of Common Mouthwashes on Mechanical Properties of Suture Materials Used in Dental Surgeries: A Laboratory Experiment. Polymers (Basel) 2022; 14:polym14122439. [PMID: 35746015 PMCID: PMC9227470 DOI: 10.3390/polym14122439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/25/2022] [Accepted: 06/02/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Sutures play a pivotal role in promoting healing in any surgical procedure. However, the versatile nature of the oral environment entails additional properties in the suture materials to assure uneventful healing. A surgeon needs to understand these delicate intricacies in the immediate postoperative phase and needs some kind of algorithm in the selection of sutures that suits the different surgical scenarios. Therefore, a study was designed to observe the effect of four different types of mouthwash, viz. Avohex, Aloedent, Parodontax and Betadine, on the mechanical properties of Vicryl (polyglactin 910), PTFE (polytetrafluoroethylene), Prolene (polypropylene) and Mersilk. Methods: A total of 288 suture samples were divided in four equal groups (72 = each group) and used for the experiments. Tensile load, tensile strength as well as percentage elongation of the suture materials were evaluated in the various stated media at 3rd, 7th, 10th and 14th days, which were compared with the controls. The results were analyzed statistically and inferences were drawn. Results: Mersilk in (Avohex, Parodontax and Betadine) solutions showed a statistically significant decrease in tensile load over time. All the sutures had the highest tensile strength in Parodontax and had the lowest in Betadine solution. Vicryl and PTFE presented significant percentage elongation over time as compared to Prolene and Mersilk. Conclusion: The author has given certain recommendations but also states that there is no standard rule for the use of a particular suture material in all clinical situations. However, the selection of the suture material should be based on the type of surgery and preferences of the surgeon.
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Affiliation(s)
- Shahabe Saquib Abullais
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | - Shaker Saleh AlOsman
- Inters, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia; (S.S.A.); (S.M.A.)
| | - Sultan Mansoor AlQahtani
- Inters, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia; (S.S.A.); (S.M.A.)
| | - Abdul Ahad Khan
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
- Correspondence: ; Tel.: +96-658-3576764
| | - Rakhshinda Nahid
- Department of Periodontology, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India;
| | - Sulphi Abdul Basheer
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | - Ahmad Saib Jameel
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
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20
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Robo I, Heta S, Papakozma D, Ostreni V. Modification of implant surfaces to stimulate mesenchymal cell activation. BULLETIN OF THE NATIONAL RESEARCH CENTRE 2022; 46:52. [PMID: 35261541 PMCID: PMC8894561 DOI: 10.1186/s42269-022-00743-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The process of osteointegration, as key point has the activation of mesenchymal cells at implant-bone interspace, their differentiation into osteoblasts and connection between the implant surface and the surrounding bone. MAIN TEXT Implant surfaces composed by biocompatible, organism-friendly materials require changes in content and surface morphology; changes that may further stimulate mesenchymal cell activation. The way the implant surfaces are affected with advantages and disadvantages, that typically bring each methodology, is also the purpose of this study. The study is of review type, based on finding articles about implant surface modification, with the aim of promoting the mesenchymal cell activation, utilizing keyword combination. CONCLUSIONS Implant success beyond the human element of the practicioner and the protocol element of implant treatment, also relies on the application of the right type of implant, at the right implant site, in accordance with oral and individual health status of the patient. Implant success does not depend on type of "coating" material of the implants. Based at this physiological process, the success or implant failure is not a process depending on the type of selected implant, because types of synthetic or natural materials that promote osteointegration are relatively in large number.
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Affiliation(s)
- Ilma Robo
- Faculty of Dental Medicine, University of Medicine, Tiranë, Albania
| | - Saimir Heta
- Pediatric Surgery, Pediatric Surgeon, University Hospital, QSUT, Tiranë, Albania
| | | | - Vera Ostreni
- Pediatric Surgery, Pediatric Surgeon, University Hospital, QSUT, Tiranë, Albania
- Department of Morphology, University of Medicine, Tiranë, Albania
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Evaluation of mechanical properties of three commonly used suture materials for clinical oral applications: An in vitro study. VOJNOSANIT PREGL 2022. [DOI: 10.2298/vsp200114079a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aim. Appropriate selection of suture materials is a crucial step in oral, maxillofacial and periodontal surgery for uneventful healing. We have scarcity of comprehensive studies comparing mechanical properties of commonly used suture material in oral surgery. The present in vitro study sought to evaluate the effect of saliva on the strength, elongation and stiffness of the commonly used suture material over a period of two weeks. Methods. Three suture materials, silk (SL), polyglactin 910 (PG) and polypropylene (PP), were used in 4?0 gauge. A total of 120 suture samples (40 from each material) were used for the investigation. Artificial saliva was mixed with human serum in 1:1 ratio and maintained at pH of 7.4 to 8.1 to simulate oral environment. All samples were tested at pre-immersion (baseline), as well as on the 3rd, 7th and 14th day in the post-immersion period. A universal testing machine was used to test the selected mechanical properties. The collected data were subjected to statistical analysis. Results. The distribution of mean baseline strength and percentage elongation was significantly higher in the PP group (p < 0.001), whereas stiffness score was the highest in the SL group (p < 0.001). Inter-group comparison revealed that the PP group had maximum tensile strength compared to the PG and SL groups at all time points. When percentage elongation was compared, the PP and PG groups showed the highest values on the 7th and 14th day, respectively. The PP group exhibited the highest stiffness values compared to the SL and PG groups on the 7th and 14th day in the post-immersion period (p < 0.001). Intra-group comparison showed that all suture materials had significant difference in mechanical properties when pre-immersion values were compared to the 14th day post-immersion values (p < 0.001). Conclusion. PP sutures are the strongest and have the highest tensile strength and elongation property. PP seems to sustain its tensile strength better than SL and PG at the end of the 14th day. Controlled clinical studies are necessary to verify this finding in an in vivo set-ting.
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Chen HF, Papadakis M, Jeng SF. Recurrent cervical stitch sinus arising from the deep neck space after thyroidectomy: case study and review. J Wound Care 2021; 30:612-616. [PMID: 34382851 DOI: 10.12968/jowc.2021.30.8.612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE We describe a one-stage surgical technique for the management of recurrent cervical stitch sinus after thyroidectomy. METHOD A retrospective, single-centre study of all patients who were operated on because of cervical neck sinus after thyroidectomy. We provide a detailed description of our surgical approach, based on guided sinus removal after prior tract staining with methylene blue and subsequent obliteration using local strap muscle flap. RESULTS A total of seven patients with a mean age of 46 years were included in the study. All patients had a past history of thyroidectomy because of goitre (n=5) or thyroid cancer (n=2) which had previously been unsuccessfully debrided two or three times. Surgical sinus removal was successful in all cases and no recurrence was observed during the follow-up time. CONCLUSIONS We conclude that a comprehensive en bloc resection down to the suture granuloma is essential in order to provide surgical cure and prevent recurrence.
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Affiliation(s)
- Hsing-Fu Chen
- Department of Plastic and Reconstructive Surgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Marios Papadakis
- Department of Plastic and Reconstructive Surgery, E-Da Hospital, Kaohsiung, Taiwan
| | - Seng-Feng Jeng
- Department of Plastic and Reconstructive Surgery, E-Da Hospital, Kaohsiung, Taiwan
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Ertem SY. Partially resorbed unremoved silk sutures after tooth extraction: A unique Case report. Clin Case Rep 2021; 9:1621-1623. [PMID: 33768902 PMCID: PMC7981646 DOI: 10.1002/ccr3.3853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 01/06/2021] [Accepted: 01/09/2021] [Indexed: 11/21/2022] Open
Abstract
Suturation may remain in the mouth for a long time due to incomplete information to patients due to inadvertency. Forgotten silk sutures might be sunk and cause irritation into the alveolar mucosa.
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Affiliation(s)
- Sinan Yasin Ertem
- Department of Oral and Maxillofacial SurgerySchool of DentistryAnkara Yildirim Beyazit UniversityAnkaraTurkey
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Abullais SS, Alqahtani NA, Alkhulban RM, Alamer SH, Khan AA, Pimple S. In-vitro evaluation of commonly used beverages on tensile strength of different suture materials used in dental surgeries. Medicine (Baltimore) 2020; 99:e19831. [PMID: 33235053 PMCID: PMC7710252 DOI: 10.1097/md.0000000000019831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Sutures are used for the approximation of incised flaps, assistance in primary healing, and hemorrhage control. In oral and periodontal surgery, the appropriate selection of suture material is vital for favorable healing.The aim of the present in-vitro experiment was to evaluate the tensile strengths of 4 different types of suture materials (silk, polygalactine 910, polypropylene, chromic catgut) by simulating potential short-term intraoral exposure to various beverages (saliva, Arabic coffee, tea, cola).A total of 280 suture specimens were prepared, out of which 10 specimens from each group were selected for pre-immersion testing. Remaining suture specimens were immersed in 4 different thermostatically controlled media (1 control [artificial saliva], 3 tests [Cola drink, Arabic coffee, Tea]). Tensile strength was measured at pre-immersion, 3, 7, and 14 days using a universal tensile testing machine. The maximum load required to break the suture material was recorded in Newton.At day 3, tea caused significant reduction in tensile strength of silk and cola caused significant reduction in tensile strengths of polygalactine 910 and chromic catgut. Whereas, at day 7, silk and polypropylene retained their tensile strengths better than others.The authors recommend precaution in the use of these beverages in the first postoperative week, to avoid adverse effect on the mechanical strength of sutures. When exposure to these beverages are anticipated, it is better to use polypropylene sutures that resists rapid fall in tensile strengths in the early postoperative period.
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Affiliation(s)
| | | | | | | | - Abdul Ahad Khan
- Department of Oral and Maxillofacial surgery, College of Dentistry, King Khalid University, Abha, KSA
| | - Sandeep Pimple
- Department of Periodontics, Nair Dental College and Hospital, Mumbai Central, Maharashtra, India
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25
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Akici M, Ersen O. The effect of suture selection in complex anal fistulas on the success of cutting seton placement and patient comfort. Pak J Med Sci 2020; 36:816-820. [PMID: 32494280 PMCID: PMC7260917 DOI: 10.12669/pjms.36.4.1920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: The aim of our study was to compare the success rates of suture selection, recovery times and pain associated with local wound infection and seton placement in patients undergoing cutting seton placement for complex anal fistula. Methods: The study included a total of 90 patients who were admitted with the diagnosis of complex anal fistula between January 2015 and July 2018. Results: The first session and other revision appointments demonstrated that the number of patients who required fistulotomy was significantly higher in group-1 as the seton failed to complete the transection (p = 0.001). When the patients were asked to rate pain for 3 different conditions according to numeric rating scale (NRS), the patients in group-2 had significantly higher pain in all 3 cases compared to the patients in group-1 (p 0.001). The impact of the suture material on local infection was examined and it was determined that the results of cultures for seton material were significantly more positive in group-1 (p = 0.001). Conclusions: We conclude that a multi-stage tight seton placement with silk material can lead to satisfactory results by aiming to shorten the cutting time of silk seton.
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Affiliation(s)
- Murat Akici
- Dr. Murat Akici. Department of General Surgery, Afyonkarahisar Health Sciences University, Afyon, Turkey
| | - Ogun Ersen
- Dr. Ogun Ersen, Department of General Surgery, Afyonkarahisar Health Sciences University, Afyon, Turkey
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Effect of antiseptic gels in the microbiologic colonization of the suture threads after oral surgery. Sci Rep 2020; 10:8360. [PMID: 32433572 PMCID: PMC7239853 DOI: 10.1038/s41598-020-65007-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 04/22/2020] [Indexed: 11/30/2022] Open
Abstract
Three different bioadhesive gels were evaluated in a double-blind randomized clinical trial in which microbial growth in the suture thread was assessed following post-surgical application of the aforementioned gels. Also assessed in this trial were, the intensity of post-surgical pain as well as the degree of healing of the patients’ surgical wounds. A total of 21 patients (with 42 wisdom teeth) participated in this trial. Chlorhexidine gel, chlorhexidine-chitosan gel, and hyaluronic acid gel were evaluated, with a neutral water-based gel serving as the control agent. The aerobic and facultative anaerobic bacterial recovery on blood agar was lower in the placebo group than in the experimental groups. The most significant difference (p = 0.04) was observed in the chlorhexidine-chitosan group. in which the growth of Blood Agar and Mitis Salivarius Agar was significantly higher than in the placebo group. The intensity of post-surgical pain was very similar among all the groups. Significantly better healing rates were observed in the patients treated with chlorhexidine-chitosan gel when compared with those who used the placebo gel (p = 0.03), and in particular when compared with those patients who used hyaluronic acid gel (p = 0.01). Through our microbiological analyses, we were able to conclude that none of the bioadhesive gels tested resulted in beneficial reductions in the bacterial/fungal populations. However, the healing rates of patients who were treated with chlorhexidine-chitosan were better than those of the patients who used either the placebo gel or the hyaluronic acid gel.
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27
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Mahesh L, Kumar VR, Jain A, Shukla S, Aragoneses JM, Martínez González JM, Fernández-Domínguez M, Calvo-Guirado JL. Bacterial Adherence Around Sutures of Different Material at Grafted Site: A Microbiological Analysis. MATERIALS 2019; 12:ma12182848. [PMID: 31487852 PMCID: PMC6765980 DOI: 10.3390/ma12182848] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 08/21/2019] [Accepted: 08/31/2019] [Indexed: 01/08/2023]
Abstract
Closure of the surgical incision has been the primary function of sutures since their introduction. However, whatever the type, they are known to carry bacteria, which can be a source of infection. Five types of surgical sutures, Gut, Silk, Vicryl, PTFE, and Polyamide, were selected and tested on their ability to carry aerobic and anaerobic bacteria and were rated on the basis of forming colony-forming units (CFUs). Aerobic bacteria grown around gut sutures showed minimum CFUs (≈30 × 104/suture). Though very less anaerobic bacteria growth was seen among all tested suture materials, it was maximum around Vicryl and polyamide sutures. Every suture material is capable, albeit not equally, of holding bacterial biofilm formation, which can be a source of surgical site infection.
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Affiliation(s)
| | | | - Anshi Jain
- Department of Oral Pathology, ITS Dental College, Ghaziabad 201009, Uttar Pradesh, India
| | - Sagrika Shukla
- Private Practice in Periodontology, New Delhi 110001, India
| | - Juan Manuel Aragoneses
- Department of Dental Research in Universidad Federico Henríquez y Carvajal (UFHEC), Santo Domingo 10107, Dominican Republic
| | | | - Manuel Fernández-Domínguez
- Department of Oral Surgery and Implantology and Director of Research in Dentistry in the Doctoral Program of Translational Medicine, CEU San Pablo University, 28223 Madrid, Spain
| | - José Luis Calvo-Guirado
- Department of Oral Surgery and Implant Dentistry, Faculty of Health Sciences, Universidad Católica de Murcia, UCAM, 30107 Murcia, Spain.
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Etemadi A, Bitaraf T, Amini A, Goudarzi M, Nadafpour N. Bacterial Accumulation on Triclosan-Coated and Silk Sutures After Dental Implant Surgery. JOURNAL OF RESEARCH IN DENTAL AND MAXILLOFACIAL SCIENCES 2019. [DOI: 10.29252/jrdms.4.3.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Dragovic M, Pejovic M, Stepic J, Colic S, Dozic B, Dragovic S, Lazarevic M, Nikolic N, Milasin J, Milicic B. Comparison of four different suture materials in respect to oral wound healing, microbial colonization, tissue reaction and clinical features—randomized clinical study. Clin Oral Investig 2019; 24:1527-1541. [DOI: 10.1007/s00784-019-03034-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 07/16/2019] [Indexed: 11/27/2022]
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30
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Legaria MC, Barberis C, Camporro J, Traglia GM, Famiglietti A, Stecher D, Vay CA. Intra-peritoneal abscess after an abdominal hysterectomy involving Cutibacterium avidum (former Propionibacterium avidum) highly resistant to clindamycin. Anaerobe 2019; 59:176-183. [PMID: 31254654 DOI: 10.1016/j.anaerobe.2019.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 06/20/2019] [Accepted: 06/24/2019] [Indexed: 10/26/2022]
Abstract
Cutibacterium avidum is a gram-positive anaerobic rod belonging to the cutaneous group of human bacteria with preferential colonization of sweat glands in moist areas. The microorganism rarely cause disease, generally delayed prosthetic joint infections (PJIs). We describe the second case of intraperitoneal abscess by C. avidum after an abdominal surgery in an obese female patient and the first case after a non-prosthetic abdominal surgery due to a highly clindamycin resistant strain in a patient with underling conditions. The patient was successfully treated with surgical drainage and beta-lactam antibiotics. Although rare and apparently non-pathogenic, C. avidum may be involved in infections, especially in some high-risk patients with obesity who have undergone surgical incision involving deep folder of the skin. The microorganism was identified by phenotypic methods, MALDI-TOF MS and 16S rRNA gene sequencing. Susceptibility test should be performed in C. avidum because high level resistance to clindamycin could be present. We present a literature review of C. avidum infections.
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Affiliation(s)
- M C Legaria
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Buenos Aires, Argentina.
| | - C Barberis
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Buenos Aires, Argentina
| | - J Camporro
- Universidad de Buenos Aires. Facultad de Medicina, Hospital de Clínicas José de San Martín, Servicio de Infectología, Buenos Aires, Argentina
| | - G M Traglia
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Buenos Aires, Argentina
| | - A Famiglietti
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Buenos Aires, Argentina
| | - D Stecher
- Universidad de Buenos Aires. Facultad de Medicina, Hospital de Clínicas José de San Martín, Servicio de Infectología, Buenos Aires, Argentina
| | - C A Vay
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Buenos Aires, Argentina
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Li H, Cheng F, Chávez-Madero C, Choi J, Wei X, Yi X, Zheng T, He J. Manufacturing and physical characterization of absorbable oxidized regenerated cellulose braided surgical sutures. Int J Biol Macromol 2019; 134:56-62. [PMID: 31071394 DOI: 10.1016/j.ijbiomac.2019.05.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/30/2019] [Accepted: 05/05/2019] [Indexed: 01/28/2023]
Abstract
Suture is an important part of surgical operation, and closure of the wound associated with this procedure continuous to be a challenge in postoperative care. Currently, oxidized regenerated cellulose (ORC) is widely used in the absorption of hemostatic materials. However, there is no ORC medical suture product in the market. The objective of this article was to prepare novel braided sutures by TEMPO-mediated oxidation regenerated cellulose (TORC) to achieve a suturable material with biodegradability and ideal mechanical properties. Regenerated cellulose (RC) strands were made into sutures on a circular braiding machine, and TEMPO-mediated oxidation treatment was introduced alternatively after braiding. The RC sutures under different oxidation time were characterized by ATR-FTIR, electrical conductivity, XRD analysis, physical properties and in vitro degradation property. We further demonstrate that the RC sutures were oxidized and formed the carboxylic (-COOH) functional group. With the extension of oxidation duration, the carboxyl content in TORC sutures increased gradually from 5.1 to 10.4% and the strength, weight, and diameter of TORC sutures decreased gradually. Moreover, we proved that the knot-pull strength of TORC-45 declined by 77.8% after 28 days, thus this sutures fulfilled U.S. Pharmacopeia requirement of knot-pull strength. We have shown that TEMPO oxidation reaction significantly promoted the degradation of TORC sutures. Overall, TORC sutures were successfully produced with favorable biodegradability, revealing potential prospects of clinical applications.
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Affiliation(s)
- Hongbin Li
- MIIT Key Laboratory of Critical Materials Technology for New Energy Conversion and Storage, School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin, Heilongjiang 150001, China; College of Light Industry and Textile, Qiqihar University, Qiqihar, Heilongjiang 161000, China
| | - Feng Cheng
- MIIT Key Laboratory of Critical Materials Technology for New Energy Conversion and Storage, School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin, Heilongjiang 150001, China
| | - Carolina Chávez-Madero
- Departamento de Ingeniería Mecatrónica y Eléctrica, Escuela de Ingeniería y Ciencias, Tecnológico de Monterrey, CP 64849 Monterrey, Nuevo León, Mexico
| | - Jiwon Choi
- Saint Mark's School, Southborough, MA 01772, United States
| | - Xinjing Wei
- MIIT Key Laboratory of Critical Materials Technology for New Energy Conversion and Storage, School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin, Heilongjiang 150001, China
| | - Xiaotong Yi
- MIIT Key Laboratory of Critical Materials Technology for New Energy Conversion and Storage, School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin, Heilongjiang 150001, China
| | - Ting Zheng
- School of Materials Science and Engineering, Harbin Institute of Technology, Harbin, Heilongjiang 150010, China
| | - Jinmei He
- MIIT Key Laboratory of Critical Materials Technology for New Energy Conversion and Storage, School of Chemistry and Chemical Engineering, Harbin Institute of Technology, Harbin, Heilongjiang 150001, China.
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Stavropoulou C, Atout RN, Brownlee M, Schroth RJ, Kelekis‐Cholakis A. A randomized clinical trial of cyanoacrylate tissue adhesives in donor site of connective tissue grafts. J Periodontol 2018; 90:608-615. [DOI: 10.1002/jper.18-0475] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 11/19/2018] [Accepted: 11/25/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Chrysi Stavropoulou
- Department of Dental Diagnostic and Surgical SciencesRady Faculty of Health SciencesUniversity of Manitoba Winnipeg Manitoba Canada
| | - Reem N. Atout
- Department of Dental Diagnostic and Surgical SciencesRady Faculty of Health SciencesUniversity of Manitoba Winnipeg Manitoba Canada
| | - Meredith Brownlee
- Department of Dental Diagnostic and Surgical SciencesRady Faculty of Health SciencesUniversity of Manitoba Winnipeg Manitoba Canada
| | - Robert J. Schroth
- Department of Preventive Dental Sciencesand Department of Pediatric and Child HealthRady Faculty of Health SciencesUniversity of Manitoba
| | - Anastasia Kelekis‐Cholakis
- Department of Dental Diagnostic and Surgical SciencesRady Faculty of Health SciencesUniversity of Manitoba Winnipeg Manitoba Canada
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The Effect of Chlorhexidine and Listerine® Mouthwashes on the Tensile Strength of Selected Absorbable Sutures: An In Vitro Study. BIOMED RESEARCH INTERNATIONAL 2018; 2018:8531706. [PMID: 30539024 PMCID: PMC6257908 DOI: 10.1155/2018/8531706] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 10/17/2018] [Indexed: 11/18/2022]
Abstract
Background Suturing plays a critical role in the healing of surgical wounds. The tensile strength of suture materials indicates the ability of the material to withstand stress during knotting and protect the wound during an extended period of healing. Objective An in vitro study was conducted to determine the effect of two commercially available mouthwashes on the tensile strength and breakage mode of two absorbable intraoral sutures. Materials and Methods Two common absorbable sutures, Vicryl® and Monocryl®, both with 4-0 and 5-0 gauges were used. A total of 400 specimens were sutured around rubber rods and immersed in three thermostatically controlled experimental conditions: artificial saliva, 0.2% chlorhexidine gluconate (Parodontax® extra), and essential oils-based rinse (Listerine® Zero™), and these were compared to a nonimmersed dry condition. All specimens were stored in an incubator at 37°C. Tensile strengths were assessed after days 1, 3, 7, 10, and 14 of immersion using a universal Instron® testing machine. The maximum load for suture breakage and the location of the point of breakage were assessed. Results Unlike Monocryl® 4-0, the tensile strength of both gauges of Vicryl® sutures significantly increased in chlorhexidine and Listerine®. There was a significant decrease in the strength for all suture types after day 10, regardless of the immersion solution. Listerine® significantly reduced the tensile strength of Monocryl® 5-0. Conclusion Oral surgeons and periodontists should be cautious when prescribing commercial mouthwashes for patients relative to their selection of suture materials. However, further studies are needed to understand the molecular changes in sutures when exposed to chemical solutions found in mouthwashes.
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Asher R, Chacartchi T, Tandlich M, Shapira L, Polak D. Microbial accumulation on different suture materials following oral surgery: a randomized controlled study. Clin Oral Investig 2018; 23:559-565. [DOI: 10.1007/s00784-018-2476-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 04/25/2018] [Indexed: 01/09/2023]
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Yamamoto N, Takahashi Y, Kono T, Abe A, Kawamura K, Joujima T, Wakasugi-Sato N, Nishimura S, Oda M, Tanaka T, Kito S, Kawano K, Morimoto Y. Importance of absorbable surgical sutures for the prevention of stitch abscess after surgery in patients with oral squamous cell carcinoma. Med Oral Patol Oral Cir Bucal 2017; 22:e349-e353. [PMID: 28390120 PMCID: PMC5432083 DOI: 10.4317/medoral.21445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 01/01/2017] [Indexed: 01/25/2023] Open
Abstract
Background To elucidate the significance of absorbable surgical sutures in the occurrence of stitch abscess after surgery in patients with oral squamous cell carcinoma (SCC). Material and Methods The subjects were 251 patients who underwent excision and/or reconstruction and/or neck dissection for oral SCC using absorbable surgical sutures. Detection rates and characteristics of patients with stitch abscess were retrospectively evaluated by comparing between our present and previous data. Results There was only one stitch abscess among the 251 patients. A significant difference in the incidence of stitch abscess was found between the present data and our previous data. Of course, no significant correlations were found between the occurrence of stitch abscess using absorbable surgical sutures and the various factors seen in our previous analysis. Conclusions A complete switch of surgical sutures from silk to absorbable surgical sutures is needed for surgery in patients with oral SCC. Key words:Stitch abscess, oral cancer, occurrence, absorbable surgical sutures, silk suture.
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Affiliation(s)
- N Yamamoto
- Division of Oral and Maxillofacial Radiology, Kyushu Dental University, 2-6-1 Manazuru, Kokurakita-ku, Kitakyushu 803-8580, Japan,
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Accelerated biodegradation of silk sutures through matrix metalloproteinase activation by incorporating 4-hexylresorcinol. Sci Rep 2017; 7:42441. [PMID: 28205580 PMCID: PMC5304327 DOI: 10.1038/srep42441] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 01/09/2017] [Indexed: 12/31/2022] Open
Abstract
Silk suture material is primarily composed of silk fibroin and regarded as a non-resorbable material. It is slowly degraded by proteolysis when it is implanted into the body. 4-Hexylresorcinol (4HR) is a well-known antiseptic. In this study, the biodegradability of 4HR-incorporated silk sutures were compared to that of untreated silk sutures and polyglactin 910 sutures, a commercially available resorbable suture. 4HR-incorporated silk sutures exhibited anti-microbial properties. Matrix metalloproteinase (MMP) can digest a wide spectrum of proteins. 4HR increased MMP-2, -3, and -9 expression in RAW264.7 cells. MMP-2, -3, and -9 were able to digest not only silk fibroin but also silk sutures. Consequently, 59.5% of the 4HR-incorporated silk suture material remained at 11 weeks after grafting, which was similar to that of polyglactin 910 degradation (56.4% remained). The residual amount of bare silk suture material at 11 weeks after grafting was 91.5%. The expression levels of MMP-2, -3 and -9 were high in the 4HR-incorporated silk suture-implanted site 12 weeks after implantation. In conclusion, 4HR-treated silk sutures exhibited anti-microbial properties and a similar level of bio-degradation to polyglactin 910 sutures and induced higher expression of MMP-2, -3, and -9 in macrophages.
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Rodanant P, Wattanajitseree K, Shrestha B, Wongsirichat N. Pain and quality of life related to suture removal after 3 or 7 days at the extraction sites of impacted lower third molars. J Dent Anesth Pain Med 2016; 16:131-136. [PMID: 28879306 PMCID: PMC5564082 DOI: 10.17245/jdapm.2016.16.2.131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 06/25/2016] [Accepted: 06/27/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the patient's pain and quality of life after suture removal at either 3 or 7 days following the bilateral surgical extraction of impacted lower third molars. METHODS This study was a prospective, randomized controlled clinical trial carried out in 30 patients, who acted as their own control. Each patient required the bilaterally impacted mandibular third molars to be extracted. The impacted teeth were removed and the wound margins were approximated and sutured with black braided silk. The suture material was removed on day 3 on one side and on day 7 on the other. Each participant was asked to complete a questionnaire after the removal of the suture material on each designated day. RESULTS Regarding overall clinical symptoms, the mean VAS scores of male and female participants on day 3 were not significantly different from those on day 7. A significant difference was found in female participants, in that overall daily activity was better on day 7. There were significant differences in the ability to smile and laugh in both sexes and the ability to chew in the male participants was better on day 7. CONCLUSIONS There were no significant differences in the patient's pain and quality of life between suture removal on day 3 or on day 7 following surgery to remove impacted lower third molars.
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Affiliation(s)
- Pirasut Rodanant
- Department of Advanced General Dentistry, Faculty of Dentistry Mahidol University, Bangkok, Thailand
| | - Kannika Wattanajitseree
- Department of Advanced General Dentistry, Faculty of Dentistry Mahidol University, Bangkok, Thailand
| | - Binit Shrestha
- Maxillofacial Prosthetic Unit, Department of Oral and Maxillofacial Prosthodontic, Faculty of Dentistry Mahidol University, Bangkok, Thailand
| | - Natthamet Wongsirichat
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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The effects of different suture materials in the nasal cavity. The Journal of Laryngology & Otology 2016; 130:352-6. [PMID: 26857847 DOI: 10.1017/s002221511600027x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate the effects of different suture materials in the nasal cavity on encrustation and micro-organism colonisation. METHODS Four different suture materials were used to suture the nasal septum. The effects of suture materials on intranasal encrustation were evaluated with anterior rhinoscopy. The sutures were removed and evaluated in terms of micro-organism colonisation on the 7th and 21st post-operative days. RESULTS Monofilament sutures were found to cause less encrustation and micro-organism colonisation. There was increased late-stage encrustation if an absorbable monofilament suture remained in place for a long time. The removal of a non-absorbable monofilament suture in the early or late post-operative period made no difference in terms of micro-organism growth on the suture. CONCLUSION The material and physical characteristics of sutures placed inside the nose may indirectly affect the healing process. It may be more appropriate to use different materials depending on the length of time the suture is to remain in place.
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Selvi F, Cakarer S, Can T, Kirli Topcu Sİ, Palancioglu A, Keskin B, Bilgic B, Yaltirik M, Keskin C. Effects of different suture materials on tissue healing. J Istanb Univ Fac Dent 2016; 50:35-42. [PMID: 28955553 PMCID: PMC5573451 DOI: 10.17096/jiufd.79438] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 01/08/2016] [Indexed: 11/21/2022] Open
Abstract
Purpose: The purpose of this study was to investigate the
healing differences in between four different widely used suture
materials in the oral surgery practice, including silk (Perma-
Hand; Ethicon, INC., Somerville, NJ, USA), polypropylene
(Prolene; Ethicon, INC., Somerville, NJ, USA), coated
polyglactin 910 (Ethicon, INC., Somerville, NJ, USA). and
polyglecaprone 25 (Ethicon, INC., Somerville, NJ, USA ). Materials and Methods: 20 male rats were randomly allocated into
two groups depending on their sacrification days (post-operative
1st and the 7th days). Four longitudinal incision wounds, each
1cm in size, were created on the dorsum of each animal which
were then primarily closed with four different types of sutures. Results: The effects of these suture materials on soft tissue healing
were compared histopathologically, by means of density of the cells,
necrosis, fibrosis, foreign body reaction, the presence of cells of
acute and chronic infection. No statistically significant difference
was observed between the groups regarding the density of the
cells, necrosis, fibrosis, foreign body reaction, and the presence
of the cells of acute and chronic infections. Of note, propylene
showed slightly less tissue reaction among the other materials. Conclusion: The results of our study showed that there is no
only one ideal suture material for surgical practice. The factors
related to the patient, the type of the surgery and the quality of
the tissue are important to decide an appropriate suture material.
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Affiliation(s)
- Firat Selvi
- Department of Oral and Maxillofacial Surgey Faculty of Dentistry Istanbul University Turkey
| | - Sırmahan Cakarer
- Department of Oral and Maxillofacial Surgey Faculty of Dentistry Istanbul University Turkey
| | - Taylan Can
- Department of Oral and Maxillofacial Surgey Faculty of Dentistry Istanbul University Turkey
| | | | - Alen Palancioglu
- Department of Oral and Maxillofacial Surgey Faculty of Dentistry Istanbul University Turkey
| | - Basak Keskin
- Department of Oral and Maxillofacial Surgey Faculty of Dentistry Istanbul University Turkey
| | - Bilge Bilgic
- Department of Pathology Faculty of Medicine Istanbul University Turkey
| | - Mehmet Yaltirik
- Department of Oral and Maxillofacial Surgey Faculty of Dentistry Istanbul University Turkey
| | - Cengizhan Keskin
- Department of Oral and Maxillofacial Surgey Faculty of Dentistry Istanbul University Turkey
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Tummalapalli M, Anjum S, Kumari S, Gupta B. Antimicrobial Surgical Sutures: Recent Developments and Strategies. POLYM REV 2016. [DOI: 10.1080/15583724.2015.1119163] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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de Castro Costa Neto O, Lobo LA, Iorio NLP, de Fátima Carvalho Vasconcelos M, Maia LC, Tannure PN, Antonio AG. Oral bacteria adherence to suture threads: an in vitro study. Oral Maxillofac Surg 2015; 19:275-280. [PMID: 25711725 DOI: 10.1007/s10006-015-0487-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 02/15/2015] [Indexed: 06/04/2023]
Abstract
PURPOSE This study investigated the adherence of oral microorganisms to different types of suture threads. METHODS Pieces of thread were distributed on 24-well plates, according to the following groups: (G1) nylon, (G2) silk, (G3) polyglactin 910, (G4) polyglactin 910 with triclosan. Blank control (G5) consisted of one thread from each group. Adherence to thread tests was performed to observe adhesion of total microorganisms from saliva or two isolates of Prevotella intermedia (ATCC49046) and Fusobacterium nucleatum (ATCC51190). Brain-heart infusion (BHI) medium with or without bacterial inoculum (1.8 × 10(7) CFU/mL) was added to each well of microplates. The microplates were incubated in an anaerobic chamber at 37 °C, for 5 days for biofilm formation. RESULTS There was no difference between the groups as regard to adhesion of F. nucleatum (p > 0.05). For P. intermedia, the threads in G1 and G4 showed a lower level of adhesion (p < 0.05), with no difference between them. Against total microorganisms, G1 presented a lower level of adherence (p < 0.05), followed by G4; and no difference was observed between G2 and G3. CONCLUSIONS Total microorganisms and P. intermedia have different affinities to the tested suture threads, whereas F. nucleatum presented a similar adherence level. Among the threads, nylon (G1), followed by polyglactin 910 with triclosan (G4) presented the lowest microbial adherence level.
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Affiliation(s)
- Oswaldo de Castro Costa Neto
- Department of Post-graduation, Professional Master's Degree in Dentistry, School of Dentistry, "Universidade Veiga de Almeida", Rio de Janeiro, Brazil
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Bekele T, Bhokre AP, Tesfaye A. Tissue reactivity and suture handling characteristics of "jimat" against silk and chromic gut in cat thigh muscle: A comparative study. Vet World 2015; 8:958-69. [PMID: 27047183 PMCID: PMC4774762 DOI: 10.14202/vetworld.2015.958-969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 07/03/2015] [Accepted: 07/12/2015] [Indexed: 11/16/2022] Open
Abstract
AIM This study was conducted to evaluate and compare the tissue reactivity and suture handling characteristics of chromic gut, silk, and 'jimat' suture materials in cat thigh muscle. MATERIALS AND METHODS This experimental study was conducted from November, 2013 to April, 2014 in Kombolcha Animal Diseases Survey, Research and Diagnostic Laboratory, Kombolcha, Ethiopia. A total of 36 local breed male cats were randomly assigned into chromic gut, silk, and "jimat" groups of 12 cats each as A, B, and C, respectively. The hind leg muscle biceps femoris was incised and sutured with suture materials according to their groups. The muscle samples with its suture were collected at six different days interval i.e. 1, 3, 7, 14, 21, and 28 and processed histopathologically to assess the degree of leukocytic infiltration and fibrous and granulation tissue formation (GTF). In addition, all suture materials were evaluated intraoperatively about their handling characteristics, by rating the precision of knot tying, square knot positioning, and resistance to knot slippage. The statistical analysis was done with two-way ANOVA, Kruskal-Wallis, and Chi-square tests. RESULTS The histopathology showed that "jimat" thread (2.4±1.2) had produced least leukocytic infiltration than chromic gut (4.5±1.9) and silk (4.3±1.5) sutures during the study period. Higher GTF was seen at day 3 (6 [100%]), 7 (6 [100%]) and day 14 (4 [66.7%]) in all sutures, whereas "jimat" showed significantly (p<0.05) higher fibrous tissue formation (10 [83.3%]) than others. Moreover, "jimat" suture had equal suture handling characteristics (p>0.05) with both chromic gut and silk. CONCLUSION The result indicated that a single strand "jimat" thread appears to be the most satisfactory suture material as regards to both tissue reaction and suture handling characteristics for skeletal muscle approximation in cats and provided that studies on its carcinogenic effects should be done.
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Affiliation(s)
- Tilahun Bekele
- School of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Jimma University, P. O. Box 307, Jimma, Ethiopia
| | - A. P. Bhokre
- Department of Veterinary Medicine, College of Veterinary Medicine, Mekelle University, P. O. Box 231, Mekelle, Ethiopia
| | - Abreha Tesfaye
- Department of Veterinary Medicine, College of Veterinary Medicine, Mekelle University, P. O. Box 231, Mekelle, Ethiopia
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Meghil MM, Rueggeberg F, El-Awady A, Miles B, Tay F, Pashley D, Cutler CW. Novel Coating of Surgical Suture Confers Antimicrobial Activity Against Porphyromonas gingivalis and Enterococcus faecalis. J Periodontol 2015; 86:788-94. [PMID: 25703732 DOI: 10.1902/jop.2015.140528] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The oral cavity is colonized by >10(9) bacteria, many of which can increase heart disease risk when seeded into the bloodstream. Most dentoalveolar surgeries require the use of surgical sutures. Suture placement and removal can increase the risk of postoperative infection and bacteremia. The aim of this study is to evaluate the antimicrobial activity of a novel quaternary ammonium compound, K21, when coated on different suture materials. METHODS The periodontal pathogen Porphyromonas gingivalis and the endodontic species Enterococcus faecalis were grown to early log phase and inoculated on enriched Brucella blood agar, on which were placed identical lengths of surgical suture (chromic gut, polyester suture, silk, and nylon suture) and control unwaxed dental floss impregnated with K21 at 5%, 10%, 20%, and 25% volume/volume in ethanol vehicle. Controls included the following: 1) sutures treated with vehicle; 2) untreated sutures; and 3) unwaxed floss. Zones of inhibition in millimeters were measured at five randomized sites per suture/floss for each concentration and material used. Mean ± SD of zones of inhibition were calculated, and analysis of variance (P <0.05) was used to determine whether differences were statistically significant. RESULTS The results indicate that K21-coated suture at concentrations ranging from 5% to 25%, depending on the type of suture, have antimicrobial activity for P. gingivalis and E. faecalis. Nylon suture coated with K21 at 5%, 10%, 20%, and 25% resulted in zones ranging from 3 to 11 mm. Polyester suture was more effective at lower K21 concentrations with 5% (P = 0.0031), 10% (P = 0.0011), and 20% (P = 0.0002), yielding 7.5, 8.3, and 10.5 mm zones of inhibition. K21-coated silk suture yielded significant zones of inhibition at 25% (P <0.0001), whereas chromic gut was effective at K21 concentrations of 5% (P = 0.0081) and 25% (P <0.0001). CONCLUSION It is concluded that K21-coated surgical sutures have antimicrobial activity for bacterial species of direct relevance to postoperative infection and bacteremia.
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Affiliation(s)
- Mohamed M Meghil
- *Department of Oral Biology, Georgia Regents University, Augusta, GA
| | - Frederick Rueggeberg
- †Division of Infectious Diseases, Anschutz Medical Campus, University of Colorado Denver, Aurora, CO
| | - Ahmed El-Awady
- ‡Department of Oral Rehabilitation, Georgia Regents University
| | - Brodie Miles
- §Department of Periodontics, Georgia Regents University
| | - Franklin Tay
- ‖Department of Endodontics, Georgia Regents University
| | - David Pashley
- *Department of Oral Biology, Georgia Regents University, Augusta, GA
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di Summa PG, Yvon A, Larcher L, Raffoul W, Koch N. Propionibacterium avidum infection following breast reduction: high morbidity from a low-virulence pathogen. J Surg Case Rep 2015; 2015:rjv002. [PMID: 25672974 PMCID: PMC4323737 DOI: 10.1093/jscr/rjv002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Propionibacterium avidum is a common inhabitant of sebaceous glands, traditionally considered to be of low virulence and generally found on implanted foreign material. We report a rare case of P. avidum breast abscess, causing severe morbidity following breast reduction surgery. A 36-year-old woman presented with a non-painful wound discharge 3 weeks postoperatively, and was treated conservatively. She was readmitted 7 weeks postoperatively with a red and tender breast. A purulent discharging abscess was drained under ultrasound guidance. A 2-week intravenous course of amoxicillin–clavulanic acid, followed by oral replacement for a month resulted effective. Serial ultrasound imaging was useful in treatment decision-making. The infective potential of P. avidum may be underappreciated. Proximity of sutures to the axilla, tobacco smoking and the potential for resorbable sutures to host bacteria may predispose to infection, and should raise the clinician's awareness.
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Affiliation(s)
- Pietro G di Summa
- Department of Plastic, Reconstructive and Aesthetic Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Adrien Yvon
- University Hospital of South Manchester, Manchester, UK
| | - Lorenz Larcher
- Department of Plastic, Reconstructive and Aesthetic Surgery, BHB - PMU, Salzburg, Austria
| | - Wassim Raffoul
- Department of Plastic, Reconstructive and Aesthetic Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Nathalie Koch
- Department of Plastic, Reconstructive and Aesthetic Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
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ALSHEHRI MA, BASKARADOSS JK, GEEVARGHESE A, RAMAKRISHNAIAH R, TATAKIS DN. Effects of myrrh on the strength of suture materials: an in vitro study. Dent Mater J 2015; 34:148-53. [DOI: 10.4012/dmj.2013-317] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Jagan Kumar BASKARADOSS
- Department of Dental Public Health, School of Dental Medicine, Case Western Reserve University
| | - Amrita GEEVARGHESE
- Department of Dental Public Health, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences
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Scalas D, Roana J, Boffano P, Mandras N, Gallesio C, Amasio M, Banche G, Allizond V, Cuffini AM. Bacteriological findings in radicular cyst and keratocystic odontogenic tumour fluids from asymptomatic patients. Arch Oral Biol 2013; 58:1578-83. [DOI: 10.1016/j.archoralbio.2013.07.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 06/19/2013] [Accepted: 07/21/2013] [Indexed: 11/26/2022]
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Karthik K, Sivakumar, Sivaraj, Thangaswamy V. Evaluation of implant success: A review of past and present concepts. J Pharm Bioallied Sci 2013; 5:S117-9. [PMID: 23946563 PMCID: PMC3722692 DOI: 10.4103/0975-7406.113310] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 05/04/2013] [Accepted: 05/04/2013] [Indexed: 12/04/2022] Open
Abstract
Dental Implants have become the standard care of rehabilitation of missing teeth. This article intends to review the success criteria for implants from 1979 till date. Earlier days implant success was evaluated by immobility and peri-implant radiolucency. But currently, the width of the attached gingiva, co-existing medical conditions, smoking, and width of the implant also play a role in evaluating implant success. Genetic and immunological markers have also been identified.
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Affiliation(s)
- Kaneesh Karthik
- Department of Oral and Maxillofacial Surgery, JKK Nataraja Dental College, Komarapalayam, Namakkal, Tamil Nadu, India
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Sanders D, Lambie J, Bond P, Moate R, Steer JA. An in vitro study assessing the effect of mesh morphology and suture fixation on bacterial adherence. Hernia 2013; 17:779-89. [PMID: 23780573 DOI: 10.1007/s10029-013-1124-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Accepted: 06/08/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE Prosthetic infections, although relatively uncommon in hernia surgery, are a source of considerable morbidity and cost. The aims of this experimental study were to assess the influence of the morphological properties of the mesh on bacterial adherence in vitro. The morphological properties assessed were the polymer type, filament type, filament diameter, mesh weight, mean pore size, and the addition of silver chlorhexidine and titanium coatings. In addition, the study assessed the effect on bacterial adherence of adding a commonly used suture to the mesh and compared adherence rates to self-gripping mesh that does not require suture fixation. METHODS Eight commercially sourced flat hernia meshes with different material characteristics were included in the study. These were Prolene(®) (Ethicon(®)), DualMesh(®) (Gore(®)), DualMesh(®) Plus (Gore(®)), Parietex™ ProGrip (Covidien™), TiMesh(®) Light (GfE Medical), Bard(®) Soft Mesh (Bard(®)), Vypro(®) (Ethicon(®)), and Omyra(®) (Braun(®)). Individual meshes were inoculated with Staphylococcus epidermidis and Staphylococcus aureus with a bacterial inoculum of 10(2) bacteria. To assess the effect of suture material on bacterial adhesion, a sterile piece of commonly used monofilament suture material (2.0 Prolene(®), ZB370 Ethicon(®)) was sutured to selected meshes (chosen to represent different commonly used polymers and/or the presence of an antibacterial coating). Inoculated meshes were incubated for 18 h in tryptone soy broth and then analysed using scanning electron microscopy. A previously validated method for enumeration of bacteria using automated stage movement electron microscopy was used for direct bacterial counting. The final fraction of the bacteria adherent to the mesh was compared between the meshes and for each morphological variable. One-way analysis of variance (ANOVA) was performed on the bacterial counts. Tukey's test was used to determine the difference between the different biomaterials in the event the ANOVA was significant. RESULTS Properties that significantly increased the mean bacterial adherence were the expanded polytetrafluoroethylene polymer (P < 0.001); multifilament meshes (P < 0.001); increased filament diameter (P < 0.001); increased mesh weight (P < 0.001); and smaller mean pore size (P < 0.001). In contrast, mesh coating with antibacterial silver chlorhexidine significantly reduced bacterial adhesion (S. epidermidis mean bacterial count 140.7 ± 19.1 SE with DualMesh(®) vs. 2.3 ± 1.2 SE with DualMesh(®) Plus, P < 0.001; S. aureus mean bacterial count 371.7 ± 22.7 SE with DualMesh(®) vs. 19.3 ± 4.7 SE with DualMesh(®) Plus, P = 0.002). The addition of 2.0 Prolene suture material significantly increased the mean number of adherent bacteria independent of the mesh polymer or mesh coating (P = 0.04 to <0.001). CONCLUSION The present study demonstrates the significant influence of the prosthetic load on bacterial adherence. In patients at increased risk of infection, low prosthetic load materials, i.e., lightweight meshes with large pores, may be beneficial. Furthermore self-fixing meshes, which avoid increasing the prosthetic load and antibacterial impregnated meshes, may have an advantage in this setting.
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Affiliation(s)
- D Sanders
- Peninsula College of Medicine and Dentistry, John Bull Building, Tamar Science Park, Plymouth, PL6 8BU, UK,
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