Revisiting the properties of suture materials: an overview

Narasimhan, Ashwin Kumar; Rahul, Thella Shalem; Krishnan, Saravanan

doi:10.1016/b978-0-12-819750-9.00011-5

Cited by 3 publications

(4 citation statements)

References 92 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One crucial antibacterial coating used on surgical sutures is triclosan, which has been in use since 2003. As supported by previous research, triclosan coating promotes an optimal environment for invasive procedures and supports the healing process 43 . The ongoing efforts to refine biomaterial design and coating techniques will likely lead to a significant reduction in SSIs and improve patient outcomes.…”

Section: Discussionsupporting

confidence: 55%

Impact of antibiotic-coated sutures on surgical site infections: a second-order meta-analysis

Suleiman,

Abbass,

Hossain

et al. 2023

International Journal of Surgery

View full text Add to dashboard Cite

Background: Surgical site infections (SSIs) pose a global challenge, impacting patients and healthcare expenditures. This second-order meta-analysis endeavors to assess the efficacy of antibiotic sutures in averting SSIs by amalgamating data from various meta-studies. Materials and Methods This research adhered to the PRISMA 2020 guidelines. The quality and comprehensiveness of the encompassed meta-analyses were assessed through the QUOROM checklist and AMSTAR techniques. The primary study overlap was evaluated via measures such as pairwise intersection heat maps, Corrected Covered Area (CCA), and the citation matrix of evidence. The statistical power at the study level was determined utilizing the meta-meta package. Data synthesis employed random and fixed effects models at a 95% confidence interval. A meta-regression analysis was conducted to explore potential correlations between the CDC classification of surgical site infections, trial types, and the observed effect sizes in the studies. Results This investigation revealed a significant reduction in SSI rates due to antimicrobial-coated sutures, evidenced by a relative risk (RR) of 0.68 (95% CI: 0.59 to 0.76), with a prediction interval of 0.38 to 1.19. The analysis encompassed 18 studies with 22 meta-analyses, demonstrating a median QUOROM score of 13.6 out of 18 and an AMSTAR score of 9.1 out of 11. The presence of moderate heterogeneity was noted (Q=106.611, I square=54.038%), with non-randomized controlled trials (RCTs) exhibiting an RR of 0.56 (95% CI: 0.39 to 0.80), and RCTs displaying an RR of 0.71 (95% CI: 0.63 to 0.81). Subgroup analysis unveiled variable RR reductions for specific surgical procedures. Conclusion Antimicrobial-coated sutures offer a promising approach to mitigating surgical site infection risk (SSIs). However, their efficacy is optimally realized when employed in conjunction with other robust practices.

show abstract

Section: Discussionsupporting

confidence: 55%

Impact of antibiotic-coated sutures on surgical site infections: a second-order meta-analysis

Suleiman,

Abbass,

Hossain

et al. 2023

International Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Regardless of the origin of the material, the primary role of suture threads is to support the tissue until mucosal continuity and tensile strength are re-established. Primarily, the factors taken into consideration by surgeons at the time of selection are related to the surgical site, the number of layers of tissue involved, duration until removal of the suture thread, resistance to tension, capillarity, 3D configuration, ease of handling, characteristics of security of the knot, and presence of edema expected post-operatively, with it being extremely important that the suture is free of irritating, carcinogenic, or infectious substances [22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the use of antimicrobial solutions in sutures, Indhumathi and Kumar [24] reported that the use of the bacteriostatic triclosan (2,4,4 -trichloro-2 -hydroxydiphenyl ether) did not affect the tissue or healing response; however, the documented benefits referred to the reduction or prevention of bacterial plaque formation owing to inhibition of the growth of microorganisms by interfering with cell membranes. Moreover, regarding the use of CHX, Asher et al [22] found that this chemical substance did not prevent bacterial accumulation or completely prevent infectious processes.…”

Section: Bacterial Retentionmentioning

confidence: 99%

Evaluating and Comparing the Tensile Strength and Clinical Behavior of Monofilament Polyamide and Multifilament Silk Sutures: A Systematic Review

Alves de Oliveira,

Arcanjo,

Castro

et al. 2024

Surgeries

View full text Add to dashboard Cite

Objective: This systematic review was carried out with the primary objective of verifying which suture (polyamide or silk) of two non-resorbable suture materials with different structures had better/greater tensile strength/resistance to tension, thereby presenting better mechanical behavior. The secondary objective was to verify which one had better performance. The null hypothesis was that both types of sutures had the same behavior. Methods: This systematic study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. The focused clinical question was: “In patients that underwent oral surgery treatment (P), is there significantly higher tensile strength/resistance for silk sutures (I) or for polyamide sutures (C) when comparing the outcomes (O)?” The bibliographic search was conducted on ScienceDirect, B-On, and PubMed/MedLine between March and May 2023. The following MeSH terms were defined: sutures, breaking strength, tensile strength, oral surgery, and dentistry, which were articulated and combined using Boolean operators. There were restrictions, such as articles published in Portuguese, Spanish, or English between 1 January 2018 and 3 April 2023. The quality assessment involved the use of the Joanna Briggs Institute (JBI) checklist for RCTs and the QUIN tool (Quality Assessment Tool For In Vitro Studies) for in vitro assays. Results: Ten articles were included in this review (eight in vitro studies and two RCTs). For the RCTs, there were moderate and high levels of bias, whereas in the in vitro studies, three were classified as having a high risk of bias and five as moderate risk. The results proved that suture thread with a monofilament polyamide physical structure causes a less inflammatory reaction owing to less bacterial retention and capillarity, while multifilament sutures, such as silk, have superior mechanical characteristics. Regarding hydration, the evidence demonstrated that the preservation and stability of mechanical properties lacked uniformity. Otherwise, hyaluronic acid (HA) presents a promising solution with the same characteristics and antibacterial capabilities. Conclusion: It was possible to reject the null hypothesis that both types of sutures had the same behavior and result. It was proven by the results above that sutures with a monofilament polyamide physical structure cause a less inflammatory reaction owing to less bacterial retention and capillarity. In contrast, multifilament sutures (silk) have superior mechanical characteristics. Regarding hydration using chlorohexidine in surgical sites, the evidence demonstrated in the preservation and stability of mechanical properties lacks uniformity and congruence. However, HA seems to present a promising option with the same characteristics and antibacterial capabilities.

show abstract

“…Absorbable sutures readily degrade into small molecules that can be efficiently eliminated by the body due to the presence of water. Sutures made from common absorbable materials include catgut, polyglycolic acid, polydioxanone, and regenerated cellulose [13,14]. Absorbable sutures provide several advantages, including the avoidance of suture removal, reduction in infection risk due to the absence of foreign material, and suitability for use in anatomical regions where suture removal is difficult or impossible [15,16].…”

Section: Introductionmentioning

confidence: 99%

Fabrication and Characterization of Poly(lactic acid)-Based Biopolymer for Surgical Sutures

Alhulaybi

2023

ChemEngineering

View full text Add to dashboard Cite

Medical sutures are important surgical aids for promoting wound closure and establishing the ideal environment for wound healing. Several key factors must be considered in medical sutures, including the material of choice for the wound closure, the type of injury (internal or external), the mechanical support required to sustain the closure, the causes of infection, and the suture’s thickness and absorbability. Therefore, this study focuses on producing absorbable surgical sutures from a bio-compatible polymer material called polylactic acid (PLA) along with a PLA–chitosan composite suture initially using the extrusion method followed by the stretching method. The experimental results showed that the PLA suture can be successfully produced and coated with chitosan. The resulting suture elongated up to 148% with an achieved crystallinity of 27%, along with a superior surgical tying and knotting quality. The average thickness of the PLA sutures and PLA sutures coated with chitosan were found to be 0.33 mm and 0.58 mm, respectively. The efficient biocompatibility and wound healing/closure of the sutures were practically deep-rooted using a human skin simulator and rat animal tissue. Based on the degradation study, the manufactured suture in this study proved its degradability in physiological saline water. After a period of 15 days, the sutures lost 50% of their weight and the pH decreased from 6.49 to 4.42.

show abstract

Revisiting the properties of suture materials: an overview

Cited by 3 publications

References 92 publications

Impact of antibiotic-coated sutures on surgical site infections: a second-order meta-analysis

Impact of antibiotic-coated sutures on surgical site infections: a second-order meta-analysis

Evaluating and Comparing the Tensile Strength and Clinical Behavior of Monofilament Polyamide and Multifilament Silk Sutures: A Systematic Review

Fabrication and Characterization of Poly(lactic acid)-Based Biopolymer for Surgical Sutures

Contact Info

Product

Resources

About