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Optimal sutures for use in the abdomen: an evaluation based on the formation of adhesions and abscesses
Kenji Ishikawa1, Sotaro Sadahiro, Yoichi Tanaka
1Department of Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Purpose:
This study explored the optimal suture materials for use in the peritoneal cavity based on the formation of adhesions and abscesses under clean and contaminated conditions.
Methods:
The parietal peritoneum and muscle layer of rats were incised. The incision was followed by interrupted suturing in the clean group. A suspension of E. coli (1.0 × 10(6)) plus Bacteroides fragilis (1.0 × 10(5)) was sprayed onto the incision in the contaminated group, followed by interrupted suturing. Four types of sutures were used: nonabsorbable multifilament silk, absorbable multifilament Polyglactin 910 (Vicryl(®)), absorbable monofilament Polydioxanone (PDS(®)), and Poliglecaprone 25 (Monocryl(®)). The rats were killed at 2, 4 or 8 weeks after the surgery.
Results:
The incidence of adhesions in the clean group was low with Polyglactin 910. The incidence of adhesions was 96 % or higher regardless of the suture type in the contaminated group. The incidence of severe adhesions was low with Polyglactin 910 and Poliglecaprone 25 and significantly higher with Polydioxanone in the contaminated group. The incidence of abscess formation around the silk was significantly higher than the other three types of sutures in the contaminated group.
Conclusion:
Polyglactin 910 was less likely to form adhesions than the other three types of sutures under both conditions, suggesting that Polyglactin 910 may be the optimal type of suture to use in the peritoneal cavity.
Insights
Polyglactin 910 sutures showed fewer adhesions and abscesses in rat peritoneal surgery. This suggests Polyglactin 910 may be optimal for peritoneal cavity use.
Area of Science:
- Surgical innovation
- Biomaterials science
- Veterinary surgery
Background:
- Peritoneal adhesions and abscesses are common complications following abdominal surgery.
- Suture material selection significantly impacts surgical outcomes and complication rates.
Purpose of the Study:
- To determine the optimal suture material for use in the peritoneal cavity.
- To evaluate the formation of adhesions and abscesses with different suture types under clean and contaminated surgical conditions.
Main Methods:
- Rat models underwent peritoneal incision and suturing under sterile or contaminated (E. coli and B. fragilis) conditions.
- Four suture types were tested: silk, Polyglactin 910 (Vicryl), Polydioxanone (PDS), and Poliglecaprone 25 (Monocryl).
- Adhesion and abscess formation were assessed at 2, 4, and 8 weeks post-surgery.
Main Results:
- Polyglactin 910 demonstrated a low incidence of adhesions in the clean group.
- In contaminated conditions, Polyglactin 910 and Poliglecaprone 25 showed low severe adhesion rates, while Polydioxanone showed significantly higher rates.
- Abscess formation was significantly higher with silk sutures compared to the other three types in the contaminated group.
Conclusions:
- Polyglactin 910 exhibited a lower propensity for adhesion formation compared to silk, Polydioxanone, and Poliglecaprone 25.
- Polyglactin 910 is suggested as a potentially optimal suture material for minimizing complications in the peritoneal cavity.
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