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Related Experiment Video

Updated: Jun 6, 2026

An In Vitro Skin Irritation Test (SIT) using the EpiDerm Reconstructed Human Epidermal (RHE) Model
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An In Vitro Skin Irritation Test (SIT) using the EpiDerm Reconstructed Human Epidermal (RHE) Model

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Significant differences in skin irritation by common suture materials assessed by a comparative computerized

Sofia M Parara1, Andreas Manios, Eelco de Bree

  • 1Athens and Herakleion, Greece From the Department of Plastic Surgery and Burns, KAT Hospital, Athens; and the Departments of Surgical Oncology and Dermatology, Herakleion University Hospital.

Plastic and Reconstructive Surgery
|November 20, 2010
PubMed
Summary

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Polydioxanone sutures caused the least skin irritation in surgical wound closure, outperforming other materials. Digital image analysis offers an objective method to quantify suture material reactivity and erythema.

Area of Science:

  • Dermatology
  • Surgical Innovation
  • Biomaterials Science

Background:

  • Erythema assessment is typically subjective, but digital image analysis provides objective quantification.
  • Suture materials can cause varying degrees of local skin irritation after surgical wound closure.
  • Comparing suture material reactivity is crucial for optimizing wound healing and patient outcomes.

Purpose of the Study:

  • To objectively compare the erythema produced by five different suture materials after clean surgical wound closure.
  • To evaluate the local skin irritation caused by polydioxanone, polypropylene blue, polyamide 6, metallic clips, and polyglactin.
  • To establish an objective method for measuring suture material unreactivity.

Main Methods:

  • Digital photographs of 100 patients were analyzed using software to quantify red color superiority (erythema) around surgical wounds.

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  • Five suture materials were compared: polydioxanone, polypropylene blue, polyamide 6, metallic clips, and polyglactin.
  • Statistical analysis included the Kolmogorov-Smirnov criterion and Wilcoxon signed rank test for paired data.

    • Main Results:

    • Polydioxanone demonstrated the best performance with the least skin irritation.
    • The order of increasing irritation was: polydioxanone, polyglactin, polyamide, polypropylene, and metallic clips.
    • Statistically significant differences in suture material effects were observed on postoperative day 10.

    Conclusions:

    • Absorbable sutures, like polydioxanone, can result in less erythema compared to nonabsorbable sutures in clean surgical wound closure.
    • Digital image analysis is a reliable and quantitative method for assessing skin erythema post-surgery.
    • This objective approach aids in selecting less reactive suture materials for improved surgical outcomes.