Scar quality examination comparing titanium-coated suture material and non-coated suture material on flap donor sites in reconstructive surgery

Abstract

Background Wound healing and scar quality after trauma are subject to impairment through excessive wound healing, chronic wound or even surgical site infections. Optimizing the process of scar formation and skin healing is crucial in virtually all fields of medicine. In this regard, we tested the possible usage and advantages of titanium coated suture material. Methods We performed a prospective observational cohort study including 30 patients who underwent soft tissue reconstruction. One half of the donor flap site was sutured with titanium coated suture material, while the other half was closed with non-coated sutures. Scar quality of the donor flap site was assessed by photographs and POSAS scores on days 2–5, 14, 42, 72 and 180 postoperatively. Results No difference between the titanium coated sutures and non-coated sutures was seen in the POSAS assessment, neither for the patient scale at 14, 42, 72 and 180 days, nor for the observer scale on the same dates. Comorbidities like diabetes, chronic renal failure and smoking as well as the BMI of each patient affected the wound healing process to an equal degree on both sides of the suture. Conclusions No difference between the titanium coated and non-titanium-coated suture material was seen in the POSAS assessment in regard to scar quality and wound healing. The titanium-coated suture material can be considered to be equally as effective and safe in all qualities as the non-titanium-coated suture material, even in patients with comorbidities. Clinical trial register This study is registered at the German Clinical Trials Register (DRKS) under the registration number DRKS00021767. (https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021767)

The Pathogenesis of Mesh-induced Inflammatory Response and Pain: Rationale for Development of New Mesh

“…Silk and Titanium have angiogenic effects in wound healing, in contrast to many other biomaterial sutures which were ultimately associated with adverse events [54,55]. No difference between the Titanium-coated and non-titanium-coated suture material was seen concerning scar quality and wound healing [56]. Chronic pain rate is reduced by Titaniumcovered PP mesh [57].…”

Using visible light to activate antiviral and antimicrobial properties of TiO2 nanoparticles in paints and coatings: focus on new developments for frequent-touch surfaces in hospitals

“…There are many examples in the literature, ranging from applications where TiO 2 was coated onto suture material for wound healing, on titanium implants, combined with nanofibers loaded with antibiotics as a controlled drug delivery system, used for self-sterilizing catheter coatings, on stainless steel as coatings and as paint additives or surface coatings. 53 – 61 …”

“…There are many examples in the literature, ranging from applications where TiO 2 was coated onto suture material for wound healing, on titanium implants, combined with nanofibers loaded with antibiotics as a controlled drug delivery system, used for self-sterilizing catheter coatings, on stainless steel as coatings and as paint additives or surface coatings. [53][54][55][56][57][58][59][60][61] The physicochemical characteristics of NPs play a significant role in their efficacy against pathogenic microorganisms. Small-sized NPs boost antimicrobial and antibacterial properties due to the increase in the surface area-to-volume ratio; on the contrary, smaller particles are more toxic to mammalian cells, so increased leaching needs to be considered.…”