Tissue Reaction to Suture Materials Revisited: Is There Argument to Change Our Views?

Abstract

Tissue reactivity to ten different suture materials (silk, plain catgut, chrome catgut, tevdek, ticron, ethibond, vicryl, dexon, maxon and prolene) was evaluated on the basis of conventional microscopic assessment of eight histologic parameters at 7 days following surgery in the rat. Each suture material was placed at different localizations in the abdominal facial layer of 6 rats, thus a total of 60 rats were operated on. A completely standardized and reproducible system of microscopic assessment was used. Weighed discriminant sum values of these parameters showed no systematic differences between tissue reaction to these sutures. The computed addition of all possible magnitudes of weighing factors to the tissue reactivity parameters did not change this negative result. Discriminant analysis showed that it is unlikely that conventional histologic parameters of tissue reaction constitute a single concept like ‘tissue reactivity’. It is concluded that at 7 days after surgery the effect of surgical trauma still nullifies the possible differences between suture materials with respect to tissue reaction. Minimizing surgical trauma should, therefore, be reappraised as more important for physiologic wound healing than the use of biocompatible sutures.

Midcervical scar satisfaction in thyroidectomy patients

“…All of these variables have been found to promote optimal scar healing and improve the overall final appearance of the scar in terms of contour, shininess, color, and texture. Studies comparing suture techniques and types of suture have not been conclusive, but the trend favors the use of monofilament absorbable and nonabsorbable sutures …”

Influence of different types of surgical suture materials on mehanical damage of oral mucosa

“…Pobrojani klinički parametri su u međusobnoj povezanosti tako da eksponiranje jednog direktno utiče na druge, a svi zajedno utiču na proces zarastanja rane u usnoj šupljini [6][7][8][9].…”

“…Akumulirane naslage mehanički, svojim prisustvom, kao i hemijskim delovanjem (enzimi, toksini) oštećuju susedno tkivo i na taj način direktno kompromituju proces zarastanja rane [6][7][8][9].…”

“…Hirurški čvor i odsečeni krajevi konca svojom mehaničkom iritacijom mogu da dovedu do pojave dekubitusnih rana okolnih mekih tkiva i delova rane uz inciziju što može da dovede do dehiscencije operativne rane [6][7][8][9].…”

Scar outcomes in dermatological surgery

“…Certain suture materials that act as foreign bodies, along with the mechanical trauma of surgical procedures are thought to trigger this inflammatory process. 9 Proposed measures to improve postoperative outcomes in the short term include careful handling of tissue, choice of suture material and suturing technique, 6,7 as well as minimising skin tension. 4 However, existing studies on improving scar outcomes are limited to animal models 10 or comprise small numbers of patients.…”