Individualized Wound Closure—Mechanical Properties of Suture Materials

Abstract

Wound closure is a key element of any procedure, especially aesthetic and reconstructive plastic surgery. Therefore, over the last decades, several devices have been developed in order to assist surgeons in achieving better results while saving valuable time. In this work, we give a concise review of the literature and present a biomechanical study of different suturing materials under mechanical load mimicking handling in the operating theatre. Nine different suture products, all of the same USP size (4-0), were subjected to a standardized crushing load by means of a needle holder. All materials were subjected to 0, 1, 3 and 5 crushing load cycles, respectively. The linear tensile strength was measured by means of a universal testing device. Attenuation of tensile strength was evaluated between materials and between crush cycles. In the pooled analysis, the linear tensile strength of the suture materials deteriorated significantly with every cycle (p < 0.0001). The suture materials displayed different initial tensile strengths (in descending order: polyglecaprone, polyglactin, polydioxanone, polyamid, polypropylene). In comparison, materials performed variably in terms of resistance to crush loading. The findings were statistically significant. The reconstructive surgeon has to be flexible and tailor wound closure techniques and materials to the individual patient, procedure and tissue demands; therefore, profound knowledge of the physical properties of the suture strands used is of paramount importance. The crushing load on suture materials during surgery can be detrimental for initial and long-term wound repair strength. As well as the standard wound closure methods (sutures, staples and adhesive strips), there are promising novel devices.

Evaluation of the effects of silk and polyethylene terephthalate sutures on postoperative complications in impacted lower third molar surgery

“…Thus, sutures hold the wound edges together until the edges are strong enough to resist tensile forces [ 7 ]. There are numerous varieties of suture materials with different properties [ 8 ]. Sutures are mainly classified as natural/synthetic, absorbable/non-absorbable, and monofilament/multifilament.…”

Special Issue “Plastic and Reconstructive Surgery in Personalized Medicine”

“…They highlight that the safety of lipotransfer has still not been clarified yet due to contradictory data, and they present an innovative approach to provide more scientific data to clarify the issue [ 11 ]. Polykandriotis et al present their research on the mechanical properties of suture materials and studies of how sutures break down under cycling loading [ 12 ]. Luze and coworkers assess the viability of skin flaps with thermal imaging as a potential personalized approach [ 13 ].…”