Experimental evaluation of horse hair as a nonabsorbable monofilament suture

History of Horsehair Hair Sutures: Perspectives in Green Surgery

Throughout history, animal hair and human hair have been used as suture materials in surgery and retain sporadic interest today. This systematic literature review examines 42 primary sources to uncover insights into the use of hair sutures. Several notable figures documented their experiences across specialties, highlighting horsehair's longevity and patient comfort. Despite waning popularity owing to synthetic alternatives, recent interest in autologous hair filaments for facial wounds signals a resurgence. The time-tested hair sutures offer a cost-effective, eco-friendly option, particularly in resource-limited settings.

Microbiological Evaluation of Four Different Suture Materials Used for the Surgical Removal of Impacted Lower Third Molars: A Single-Center Prospective Comparative Study

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.

Ophthalmological instruments of Al-Halabi fill in a gap in the biomedical engineering history

Al-Halabi is an intriguing ophthalmologist who invented numerous surgical instruments for treating various eye diseases. The illustrations of such instruments in his invaluable book "Kitab Al-Kafi fi Al-Kuhl" reflect his willingness to teach. Moreover, he included in his book a magnificent illustration of the anatomical structure of the eye. The book reflects Al-Halabi's medical practice and teaching and shows several advanced medical techniques and tools. His invaluable comments reflect his deep experimental observations in the field of ophthalmology. The current article provides proof that Al-Halabi is one of our early biomedical engineers from more than 800 years ago. Al-Halabi represents a ring in the chain of biomedical engineering history. His surgical instruments represent the biomechanics field. Al-Halabi should be acknowledged among the biomedical engineering students for his various contributions in the field of surgical instruments.

In-vivo study of tissue reaction to Crotalaria pallida and Sansevieria roxburghiana fibers

BACKGROUND

A suture material producing least tissue reaction is considered as ideal. Other characteristics like tensile strength, capacity to sustain sterilization process enhance its acceptability. In the present situation there is a need to reascertain the relevance and utility of these materials. Among the suture materials mentioned by Sushrutacharya, Moorva (Sansevieria roxburghiana) and Shana (Crotalaria pallida) have been showed insignificant tissue reaction in operated cases of inguinal hernia. An experimental study to confirm the extent of tissue reaction in deeper planes is needed before extending the use of materials in the deep tissues.

OBJECTIVE

The objective of the study was to analyze deep tissue reaction and tensile strengths of plant fibres extracted from Crotalaria pallida and Sansevieria roxburghiana.

MATERIALS AND METHODS

The study was conducted on 18 albino rats, 3 groups of 6 rats each for a period of 21 days inserting the suture materials in deeper tissue, studying histopathology changes of the deeper connective tissues, hydroxyproline content and blood parameters on 7th, 14th, 21st days of the study. The tensile strength of the two materials was also assessed on 7th day in three different conditions. Statistical analysis was carried out using paired and unpaired t tests.

RESULTS

S. roxburghiana had least tissue reaction. C. pallida showed greater tensile strength in comparison to Moorva.

CONCLUSION

C. pallida can be used for deep tissue approximation because of its moderate tissue reaction and tensile strength, successive increase in hydroxyproline content and its capacity to sustain sterilization.

Could Al-Zahrawi Be Considered a Biomedical Engineer? [Retrospectroscope]

In one?s career, it is good to look back at the predecessors in the field. Biomedical engineering history is full of hidden treasures, one of whom is Al-Zahrawi, a Muslim surgeon who had a wide reputation in Europe during the Middle Ages. Herein, besides recalling that he was a surgeon, the intent is to spotlight his talent in biomedical engineering. Important contributions in surgical instruments come up readily in a review of his work, contradicting the view some have maintained of him as a mere compiler. He was a true inventor, creating many surgical instruments that were not known in the Greco-Roman era. Quite early, he produced contributions influencing surgical procedures in Europe from the 14th to the 18th centuries. As a problem solver, he was aware of anatomical and physiological problems, and he moved through design, methods of manufacturing, and practical applications. The illustrations of such instruments in his encyclopedic work, Al-Tasrif, reflect his willingness to teach.

Effects of different suture materials on tissue healing

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.