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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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Yaman D, Paksoy T, Ustaoğlu G, Demirci M. Evaluation of Bacterial Colonization and Clinical Properties of Different Suture Materials in Dentoalveoler Surgery. J Oral Maxillofac Surg 2021; 80:313-326. [PMID: 34673005 DOI: 10.1016/j.joms.2021.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 08/20/2021] [Accepted: 09/08/2021] [Indexed: 01/25/2023]
Abstract
PURPOSE This study aimed to compare the effects of 10 different suture materials commonly used in dentoalveolar surgery on wound healing, their postoperative microbial colonization, and related clinical parameters. METHODS A total of 172 suture samples from patients who had undergone extraction of impacted third molars were included in the study. The suture materials studied were poly-glycolide-colactide, fast absorbable poly-glycolide-colactide, poly-glycolic acid-cocaprolactone, polydioxanone, silk, polypropylene, polyvinylidene difluoride, polyamide, polyester, and polytetrafluoroethylene (PTFE). The microbial colonization in all sutures and clinical parameters were evaluated after 1 week. RESULTS Multifilament sutures had higher bacterial colonization compared with monofilament sutures (P < .001). No dental plaque accumulation was observed in any samples of polypropylene sutures. Polydioxanone, PTFE, and poly-glycolic acid-cocaprolactone sutures exhibited less postoperative slack compared with all other sutures after 1 week. Patients with silk, polyvinylidene difluoride, and PTFE sutures had less suture-related discomfort. According to the Landry index score, monofilament sutures demonstrated superior wound healing to multifilament sutures (P = .019). In addition, nonabsorbable sutures showed significantly better wound epithelization than absorbable sutures (P ˂ .001). CONCLUSIONS Bacterial colonization and tissue reactions due to the surface properties of the suture affected the wound healing after dentoalveolar surgery. Multifilament sutures should not be applied for prolonged periods because of their tendency for microbial colonization. The tissue reaction to the absorbable suture materials may adversely affect wound healing.
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Affiliation(s)
- Deniz Yaman
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Bolu Abant Izzet Baysal University, Faculty of Dentistry, Bolu, Turkey.
| | - Tuğçe Paksoy
- Assistant Professor, Department of Periodontology, Beykent University, Faculty of Dentistry, Istanbul, Turkey
| | - Gülbahar Ustaoğlu
- Associate Professor, Department of Periodontology, Bolu Abant Izzet Baysal University, Faculty of Dentistry, Bolu, Turkey
| | - Mehmet Demirci
- Associate Professor, Department of Medical Microbiology, Kırklareli University, Faculty of Medicine, Kırklareli, Turkey
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Varma SR, Jaber M, Fanas SA, Desai V, Al Razouk AM, Nasser S. Effect of Hyaluronic Acid in Modifying Tensile Strength of Nonabsorbable Suture Materials: An In Vitro Study. J Int Soc Prev Community Dent 2020; 10:16-20. [PMID: 32181217 PMCID: PMC7055341 DOI: 10.4103/jispcd.jispcd_343_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 11/01/2019] [Indexed: 11/28/2022] Open
Abstract
Background and Aims: In periodontics and other surgical disciplines, sutures play a detrimental role in healing of wound. The use of chemical adjuncts to boost healing has been experimented in recent years. The aim of this study was to evaluate the role of hyaluronic acid rinse in influencing the tensile strengths of commonly used sutures. Materials and Methods: Two commonly used nonabsorbable suture materials, silk and polyamide, were used for this in vitro study. Tensile strengths of the suture materials were determined by pre- and post-immersion in hyaluronic acid (test) and chlorhexidine (control). A Tinius Olsen Universal Testing Machine was used to assess the tensile strength of the samples. The variables were assessed for normality using the Kolmogorov–Smirnov test. The Wilcoxon signed rank test and Mann–Whitney U test (for quantitative data within two groups) were used for quantitative data comparison of all the clinical indicators. The level of significance was set at P ≤ 0.05. Results: Polyamide showed better stability in terms of tensile strength when compared to silk. Hyaluronic acid as a chemical adjunct did not alter the tensile strengths of both suture materials pre- and post-immersion. Conclusion: This in vitro study has shown a promising property of hyaluronic acid with relation to stabilization of tensile strength of suture materials, which needs to be evaluated in clinical settings.
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Affiliation(s)
- Sudhir R Varma
- Department of Periodontics, University of Science and Technology, Fujairah, UAE
| | - Mohammed Jaber
- Department of Oral & Maxillofacial Surgery, Ajman University of Science and Technology, Ajman, UAE
| | - Salim A Fanas
- Department of Periodontics, Ajman University of Science and Technology, Ajman, UAE
| | - Vijay Desai
- Department of Periodontics, Ajman University of Science and Technology, Ajman, UAE
| | - Arij M Al Razouk
- Department of General Dentistry, Ajman University of science and Technology, Ajman, UAE
| | - Sara Nasser
- Department of General Dentistry, Ajman University of science and Technology, Ajman, UAE
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Dessena L, Dast S, Perez S, Mercut R, Herlin C, Sinna R. Inverted Nipple Treatment and Poliglecaprone Spacer. Aesthetic Plast Surg 2018; 42:958-963. [PMID: 29717339 DOI: 10.1007/s00266-018-1139-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 04/10/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Nipple inversion is defined as a non-projectile nipple. It is a frequent pathologic condition, in which the whole nipple, or a portion of its, is buried inward towards the lactiferous duct and lies below the plane of the areola. Numerous strategies have been described to correct nipple inversion. All the procedures have the purpose to give a good shape to the nipple, preserving its function and sensitivity, when it is possible. To avoid recurrences and to obtain good aesthetic results, we present a modified percutaneous technique. METHOD We performed a retrospective study between 2011 and 2016 and included all the cases of inverted nipples treated in our department. Our modified percutaneous technique consists of a minimal incision supported by a percutaneous suture as a temporary spacer to fill the defect caused by releasing the fibro-ductal bands. RESULTS A total of 41 cases of inverted nipples were corrected in 32 patients. After 1 year of follow-up, no recurrence was observed and all nipples maintained complete eversion. There was only one case of partial unilateral necrosis in a patient who underwent tumorectomy and radiotherapy. All patients were satisfied with the aesthetic outcomes. CONCLUSION This is a simple, safe and cheap technique that should be considered as a reliable method for long-term correction of nipple inversion. LEVEL OF EVIDENCE IV 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)
- Lidia Dessena
- Department of Plastic and Craniofacial Surgery, University Hospital of Montpellier, Montpellier, France
| | - Sandy Dast
- Department of Plastic Reconstructive and Aesthetic Surgery, University Hospital of Picardie, Amiens, France.
- Department of Plastic, Reconstructive and Aesthetic Surgery, Amiens University Hospital, Hopital Sud, 80054, Amiens Cedex 01, France.
| | - Simon Perez
- Department of Plastic Reconstructive and Aesthetic Surgery, University Hospital of Picardie, Amiens, France
| | - Razvan Mercut
- Department of Plastic and Reconstructive Surgery, UMF Craiova, Craiova, Romania
| | - Christian Herlin
- Department of Plastic and Craniofacial Surgery, University Hospital of Montpellier, Montpellier, France
| | - Raphael Sinna
- Department of Plastic Reconstructive and Aesthetic Surgery, University Hospital of Picardie, Amiens, France
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Mariano AD, Penninck DG, Sutherland-Smith J, Kudej RK. Ultrasonographic evaluation of the canine urinary bladder following cystotomy for treatment of urolithiasis. J Am Vet Med Assoc 2018; 252:1090-1096. [DOI: 10.2460/javma.252.9.1090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Lock AM, Gao R, Naot D, Coleman B, Cornish J, Musson DS. Induction of immune gene expression and inflammatory mediator release by commonly used surgical suture materials: an experimental in vitro study. Patient Saf Surg 2017; 11:16. [PMID: 28580016 PMCID: PMC5452533 DOI: 10.1186/s13037-017-0132-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 05/22/2017] [Indexed: 12/23/2022] Open
Abstract
Background Surgeons have a range of materials to choose from to complete wound closure, yet surprisingly very little is still known about the body’s immune response to the suture materials in current use. The growing literature of adverse suture material reactions provided the objective of this study, to use in vitro assays to quantify levels of inflammation produced by seven commonly used suture materials in surgical procedures. Methods Human monocyte/macrophage THP-1 cells were exposed to suture materials for 1, 3 and 5 days. Gene expression and protein secretion of six inflammatory cytokines and two cell surface markers were assessed using qPCR and ELISA respectively, with LPS exposure providing a positive control. Furthermore, a IL-1β/IL-1RA marker ratio was assessed to determine the balance between pro-/anti-inflammatory expression. Results The findings from our in vitro study suggest that four commonly used suture materials cause upregulation of pro-inflammatory markers indicative of an early foreign body reaction, with no balance from anti-inflammatory markers. Conclusions As prolonged early pro-inflammation is known to produce delayed wound healing responses, the knowledge produced from this study has potential to improve informed surgical decision making and patient safety. This work has the capability to reduce suture-related adverse immune reactions, and therefore positively affect patient outcomes.
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Affiliation(s)
- Alistair M Lock
- Department of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Ryan Gao
- Department of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Dorit Naot
- Department of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Brendan Coleman
- Department of Orthopaedics, Middlemore Hospital, Private Bag 93311, Auckland, New Zealand
| | - Jillian Cornish
- Department of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - David S Musson
- Department of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
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Nakayasu Y, Matsuda S, Moriyama K, Okafuji N, Mizohata A, Shoumura M, Kawakami T, Osuga N. Reactions to Bioabsorbable Suture Thread Embedded in Rat Subcutaneous Tissue. J HARD TISSUE BIOL 2017. [DOI: 10.2485/jhtb.26.281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Yoshikazu Nakayasu
- Department of Pediatric Dentistry, Matsumoto Dental University School of Dentistry
- Department of Hard Tissue Research, Matsumoto Dental University Graduate School of Oral Medicine
| | - Saeka Matsuda
- Department of Pediatric Dentistry, Matsumoto Dental University School of Dentistry
| | - Keita Moriyama
- Department of Pediatric Dentistry, Matsumoto Dental University School of Dentistry
| | - Norimasa Okafuji
- Department of Hard Tissue Research, Matsumoto Dental University Graduate School of Oral Medicine
| | - Akiko Mizohata
- Department of Pediatric Dentistry, Matsumoto Dental University School of Dentistry
| | - Masahito Shoumura
- Department of Pediatric Dentistry, Matsumoto Dental University School of Dentistry
| | - Toshiyuki Kawakami
- Department of Hard Tissue Research, Matsumoto Dental University Graduate School of Oral Medicine
| | - Naoto Osuga
- Department of Pediatric Dentistry, Matsumoto Dental University School of Dentistry
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Tuken M, Altinay S, Temiz MZ, Cakir OO, Aykan S, Semercioz A, Serefoglu EC. The effects of four different suture materials on penile tissue of rats. Int J Impot Res 2016; 28:50-3. [PMID: 26631923 DOI: 10.1038/ijir.2015.32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 08/25/2015] [Accepted: 10/12/2015] [Indexed: 02/07/2023]
Abstract
Several types of suture materials are being used for the correction of penile curvature and this study was designed to compare histopathological changes on penile tissue among different suture materials. A total of 30 male Sprague-Dawley rats were divided into five groups and right cavernosal body was sutured with 5/0 sutures (ETB: polyethylene terephthalate; PRL: polypropylene; VCR: polyglactine; and PDS: polydioxanone). An identical needle (3/8-13 mm cutting) was passed through the cavernosal bodies in the sham group (SHAM). After 3 weeks, all rats were killed and penile tissues were examined to assess the level (0-3) of inflammation, granuloma formation and fibrosis. There was a statistically significant difference among five groups regarding inflammation, granuloma formation and fibrosis levels (P<0.01 for all). The histological changes in the PRL group were not different from the SHAM group. Although the levels of granulation and fibrosis in the PDS group were also similar to the SHAM group, inflammation level was significantly higher. The inflammation, granulation and fibrosis levels were the highest in the ETB group. VCR caused similar levels of granulation and fibrosis to ETB. In conclusion, PRL suture is associated with the least histopathological change in the penile tissue. PDS can theoretically be a reasonable alternative to PRL as it causes similar levels of granulation and fibrosis.
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Affiliation(s)
- M Tuken
- Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - S Altinay
- Department of Pathology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - M Z Temiz
- Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - O O Cakir
- Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - S Aykan
- Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - A Semercioz
- Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - E C Serefoglu
- Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey
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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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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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Khiste SV, Ranganath V, Nichani AS. Evaluation of tensile strength of surgical synthetic absorbable suture materials: an in vitro study. J Periodontal Implant Sci 2013; 43:130-5. [PMID: 23837127 PMCID: PMC3701834 DOI: 10.5051/jpis.2013.43.3.130] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 03/29/2013] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate the tensile strength of surgical synthetic absorbable sutures over a period of 14 days under simulated oral conditions. METHODS Three suture materials (polyglycolic acid [PGA], polyglactin [PG] 910, and poly (glycolide-co-є-caprolactone) [PGC]) were used in 4-0 and 5-0 gauges. 210 suture samples (35 of each material and gauge) were used. All of the samples were tested preimmersion and 1 hour and 1, 3, 7, 10, and 14 days postimmersion. The tensile strength of each suture material and gauge was assessed. The point of breakage and the resorption pattern of the sutures were also assessed. RESULTS During the first 24 hours of immersion, all 4-0 and 5-0 samples of PGA, PG 910, and PGC maintained their initial tensile strength. At baseline (preimmersion), there was a statistically significant (P<0.001) difference in the tensile strengths between the 4-0 and 5-0 gauge of PGA, PG 910, and PGC. PGA 4-0 showed the highest tensile strength until day 10. At 7 days, all the 4-0 sutures of the three materials had maintained their tensile strength with PGA 4-0 having significantly greater (P=0.003) tensile strength compared to PG. CONCLUSIONS 4-0 sutures are stronger and have greater tensile strength than 5-0 sutures. The PGA 4-0 suture showed the highest tensile strength at the end of day 10.
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Affiliation(s)
- Sujeet Vinayak Khiste
- Department of Periodontology, AECS Maaruti College of Dental Sciences and Research Centre, Bangalore, India
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Bernis-Filho WO, Wouters F, Wouters AAB, Bernis VMO, Lopes LR, Andreollo NA. Estudo comparativo entre os fios de algodão, poliglactina e poliglecaprone nas anastomoses intestinais de cães. ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2013; 26:18-26. [DOI: 10.1590/s0102-67202013000100005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2012] [Accepted: 11/27/2012] [Indexed: 11/22/2022]
Abstract
RACIONAL: Nos últimos anos muitos fios de sutura foram desenvolvidos e depois abandonados. Até hoje não foi encontrado um fio cirúrgico ideal aos intestinos ou a outros tecidos de um modo geral, tornando sua escolha tarefa difícil. OBJETIVO: Avaliar macro e microscopicamente a cicatrização de anastomoses do intestino delgado de cães, utilizando suturas com fios de poliglecaprone 25; poliglactina 910 e algodão. MÉTODOS: Vinte cães machos adultos foram operados e submetidos a três anastomoses no intestino delgado empregando a técnica extramucosa com pontos separados. Foram utilizados os três tipos fios e as anastomoses foram analisadas em diferentes períodos no pós-operatório: grupo I -três dias; grupo II - sete dias; grupo III - 14 dias; grupo IV - 21dias. A análise macroscópica consistiu em avaliar a presença ou não de peritonite, aspecto das anastomoses e aderências. Os estudos histológicos das anastomoses, empregando a hematoxilina e eosina e o tricrômico de Masson analisaram a inflamação exsudativa, inflamação granulomatosa, o revestimento epitelial da mucosa e as fibras colágenas. RESULTADOS: Na avaliação macroscópica os fios apresentaram boa coaptação das bordas com moderado grau de aderência entre alças e omento do 3º ao 21º dia do pós-operatório. A avaliação microscópica mostrou inflamação exsudativa com neutrófilos e fibrina que variou de discreta a moderada até o 14º dia; inflamação granulomatosa com presença de macrófagos, células gigantes multinucleadas e células epitelioides mais evidentes ao 14º dia para o fio algodão; presença de tecido de granulação (fibroblastos) e fibras colágenas, de forma moderada, a partir do 7º dia para os três fios. CONCLUSÃO: Os três tipos de fios de sutura apresentaram comportamento semelhante, com boa cicatrização e podem ser recomendados em anastomoses do intestino delgado.
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Deeken CR, Faucher KM, Matthews BD. A review of the composition, characteristics, and effectiveness of barrier mesh prostheses utilized for laparoscopic ventral hernia repair. Surg Endosc 2011; 26:566-75. [PMID: 21898010 DOI: 10.1007/s00464-011-1899-3] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Accepted: 08/07/2011] [Indexed: 02/06/2023]
Abstract
BACKGROUND The objective of this review was to provide an overview of the components that comprise each of the eight barrier mesh prostheses commonly utilized for LVHR and to review the current literature related to the characteristics and effectiveness of these materials to guide the general surgeon in selecting the most appropriate material for LVHR. METHODS Composite prostheses with permanent barriers (Bard™ Composix™ E/X, Bard™ Composix™ L/P, and DUALMESH(®) Biomaterial) were compared to composite prostheses with absorbable barriers (C-QUR™ Mesh, PROCEED™ Surgical Mesh, Bard™ Sepramesh™ IP Composite, Parietex™ Composite, and PHYSIOMESH™) using scanning electron microscopy and a review of the current preclinical and clinical literature. RESULTS Clinical studies and preclinical animal models have attempted to determine the adhesion characteristics and effectiveness of barrier mesh prostheses available for ventral hernia repair applications. However, it is difficult to make any definitive statements about the adhesion characteristics and effectiveness of these materials because all meshes were not included in all studies and likewise not compared under identical conditions. Overall, Parietex™ Composite and DUALMESH(®) Biomaterial were cited most frequently for improvement of adhesion characteristics, followed closely by Bard™ Sepramesh™ IP Composite and C-QUR™ Mesh. Bard™ Composix™, PROCEED™ Surgical Mesh, and uncoated polypropylene were cited most frequently as having the most tenacious and extensive adhesions. CONCLUSIONS Differences observed between the various barrier prostheses are likely attributable to the chemical composition of the barrier or the conditions required for resorption and metabolism of the barrier components. It is likely that the components of these barriers incite a wide range of inflammatory responses resulting in the range of adhesion coverage and tenacity observed in the preclinical and clinical studies reviewed. Clinical trials are needed to more appropriately define the clinical effectiveness of these barriers.
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Affiliation(s)
- Corey R Deeken
- Department of Surgery, Section of Minimally Invasive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8109, St. Louis, MO, 63110, USA.
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16
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McFadden MS. Suture Materials and Suture Selection for Use in Exotic Pet Surgical Procedures. J Exot Pet Med 2011. [DOI: 10.1053/j.jepm.2011.04.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Nakajima D, Kamakura S, Nakamura M, Suzuki O, Echigo S, Sasano Y. Analysis of appositional bone formation using a novel rat experimental model. Oral Dis 2008; 14:308-13. [PMID: 18410575 DOI: 10.1111/j.1601-0825.2007.01377.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To analyze the process of appositional bone formation using our original rat experimental model. MATERIALS AND METHODS Rats were anesthetized and a ring made of polytetrafluorethylene was placed on the parietal bone surface in the surgical procedure. The time course of appositional bone formation was analyzed with histomorphometry and in situ hybridization for type I collagen and bone sialoprotein. RESULTS The rat experimental model allowed new bone to be formed on the pre-existing bone surface and persist for 12 weeks. We demonstrated that bone is apposed actively for the first 4 weeks and less actively thereafter. CONCLUSIONS The experimental model may contribute to biological analysis for appositional bone formation expected to occur in clinical procedures such as alveolar bone augmentation and sinus lifting.
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Affiliation(s)
- D Nakajima
- Divisions of Oral Surgery, and Craniofacial Development and Regeneration, Tohoku University Graduate School of Dentistry, Sendai, Japan
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A lightweight, partially absorbable mesh (Ultrapro) for endoscopic hernia repair: experimental biocompatibility results obtained with a porcine model. Surg Endosc 2007; 22:1100-6. [DOI: 10.1007/s00464-007-9585-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2006] [Revised: 05/16/2007] [Accepted: 06/13/2007] [Indexed: 10/22/2022]
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Banche G, Roana J, Mandras N, Amasio M, Gallesio C, Allizond V, Angeretti A, Tullio V, Cuffini AM. Microbial Adherence on Various Intraoral Suture Materials in Patients Undergoing Dental Surgery. J Oral Maxillofac Surg 2007; 65:1503-7. [PMID: 17656275 DOI: 10.1016/j.joms.2006.10.066] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2006] [Revised: 07/12/2006] [Accepted: 10/23/2006] [Indexed: 10/23/2022]
Abstract
PURPOSE Sutures used in oral surgery should avoid or limit bacterial adhesion and proliferation to those parts exposed to oral fluids. Hence, microbial colonization on various intraoral suture materials from patients undergoing dental surgery was compared. PATIENTS AND METHODS During dentoalveolar surgery, various suture materials were used in 60 patients, who were randomly divided into 5 groups of 12. In each group, silk was placed intraorally in association with a different type of suture (ie, Supramid, Synthofil, Ethibond Excel, Ti-cron, Monocryl) at the same site to compare microbial colonization intraindividually. Eight days postoperatively, the sutures were removed, and adhered micro-organisms were isolated, counted, and identified through enzymatic activities and fermentation of sugars. RESULTS In all 60 patients, silk sutures exhibited the smallest affinity toward the adhesion of bacteria compared with considerable proliferation with nonresorbable multifilament sutures (Supramid, Synthofil, Ethibond Excel, Ti-cron). On the contrary, the microbial load was significantly lower when absorbable monofilament Monocryl was used. A greater quantity of bacteria was found on nonresorbable sutures than on absorbable ones, and nearly 2 times more facultative anaerobic bacteria were isolated in total. CONCLUSIONS Our results show that bacteria adhere with different affinity to various types of suture materials. Absorbable silk and Monocryl exhibited the smallest number of adherent bacteria. Colonization by pathogens on sutures leads to the recommendation that sutures should be removed as early as possible after surgery is performed, to eliminate or to limit the reservoir for oral pathogens. This recommendation is dependent on whether the suture is absorbable.
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Affiliation(s)
- Giuliana Banche
- Department of Public Health and Microbiology, University of Turin, Turin, Italy
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Junge K, Rosch R, Krones CJ, Klinge U, Mertens PR, Lynen P, Schumpelick V, Klosterhalfen B. Influence of polyglecaprone 25 (Monocryl) supplementation on the biocompatibility of a polypropylene mesh for hernia repair. Hernia 2005; 9:212-7. [PMID: 15703859 DOI: 10.1007/s10029-004-0315-5] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2004] [Accepted: 11/16/2004] [Indexed: 12/20/2022]
Abstract
BACKGROUND Supplementary polyglecaprone 25 (Monocryl) monofilaments were added to a lightweight pure monofilament polypropylene mesh (PP mesh) to improve intraoperative handling (PP+M mesh). This study was designed to evaluate the influence of this additional supplementation on the biocompatibility in a rodent animal model. METHODS Two mesh materials, a composite mesh (PP+M) and the pure polypropylene variant (PP), were compared after subcutaneous implantation in a standardized rat model. Histological analysis of the inflammatory response was performed after 28, 56 and 84 days of implantation. Material absorption, inflammatory tissue reaction, fibrosis and granuloma formation were investigated, as well as the percentage of proliferating and apoptotic cells at the interface. RESULTS Both mesh materials showed a slight foreign body reaction involving mainly macrophages and foreign body giant cells. Total absorption of the Monocryl filaments of the PP+M mesh occurred between 56 and 84 days of implantation. Both the inflammatory and the fibrotic reaction were decreased (n.s.) in the PP+M mesh group compared to the pure PP mesh. Whereas the percentage of proliferating cells showed no significant difference, the rate of apoptotic cells was significantly decreased in the PP+M mesh group over the whole implantation period. CONCLUSION Compared to the pure polypropylene mesh, our data confirm that the use of a polypropylene mesh supplemented with absorbable Monocryl filaments is feasible without additional short-term mesh-related complications in the experimental model or negative side effects on biocompatibility.
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Affiliation(s)
- K Junge
- Department of Surgery, Technical University of Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
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Ribeiro CMB, Silva Júnior VAD, Silva Neto JCD, Vasconcelos BCDE. Estudo clínico e histopatológico da reação tecidual às suturas interna e externa dos fios monofilamentares de nylon e poliglecaprone 25 em ratos. Acta Cir Bras 2005; 20:284-91. [PMID: 16186947 DOI: 10.1590/s0102-86502005000400005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJETIVOS: Neste estudo realizamos a análise clínica e histopatológica da reação tecidual dos fios de nylon e poliglecaprone 25 monofilamentares nas suturas interna e externa em ratos. MÉTODOS: Foram utilizados 40 Rattus norvegicus (Wistar) machos. O ato operatório consistiu de incisão e divulsão dos planos muscular e cutâneo realizadas na região posterior das coxas dos animais. As suturas internas e externas da coxa direita foram realizadas com o fio de nylon n°5-0, e na coxa esquerda aplicamos o poliglecaprone 25 n°5-0. Os animais foram divididos em 4 grupos (n=10) de acordo com o tempo pós-operatório G1 (7 dias), G2 (14 dias), G3 (21 dias) e G4 (28 dias). Para a avaliação cínica foi considerada a ocorrência de deiscência, de exsudato e edema. Na análise histopatológica objetivou-se avaliar reação inflamatória, células gigantes de corpo estranho, proliferação fibroblástica e fibrose. RESULTADOS: Clinicamente, não foram observadas alterações nos grupos estudados. Histopatologicamente a reação inflamatória, presença de células gigantes de corpo estranho, proliferação fibroblástica e fibrose foram maiores nas suturas internas realizadas com Nylon. Nas suturas realizadas com poliglecaprone 25 essa reação declinou com o passar do tempo pós-operatório. CONCLUSÃO: De acordo com a metodologia empregada podemos concluir que as suturas externas realizadas com nylon induziram menor reação tecidual, enquanto que nas suturas internas este fio contribuiu para perpetuar a reação tecidual. As suturas externas realizadas com poliglecaprone 25 apresentaram maior reação tecidual, e suturas internas realizadas com o mesmo fio a reação tecidual declinou na medida em que o fio estava sendo absorvido.
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