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Published on: June 16, 2023
Bacteria adhere less to barbed monofilament than braided sutures in a contaminated wound model
John R Fowler1, Tiffany A Perkins, Bettina A Buttaro
1Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Kaufmann Medical Building, Suite 1010, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA. johnfowler10@gmail.com
Background:
Previous studies have found fewer clinical infections in wounds closed with monofilament suture compared with braided suture. Recently, barbed monofilament sutures have shown improved strength and increased timesavings over interrupted braided sutures. However, the adherence of bacteria to barbed monofilament sutures and other commonly used suture materials is unclear.
Questions/Purposes:
We therefore determined: (1) the adherence of bacteria to five suture types including a barbed monofilament suture; (2) the ability to culture bacteria after gentle washing of each suture type; and (3) the pattern of bacterial adherence.
Methods:
We created an experimental contaminated wound model using planktonic methicillin-resistant Staphylococcus aureus (MRSA). Five types of commonly used suture material were used: Vicryl™, Vicryl™ Plus, PDS™, PDS™ Plus, and Quill™. To determine adherence, we determined the number of bacteria removed from the suture by sequential washes. Sutures were plated to determine bacterial growth. Sutures were examined under confocal microscopy to determine adherence patterns.
Results:
The barbed monofilament suture showed the least bacterial adherence of any suture material tested. Inoculated monofilament and barbed monofilament sutures placed on agar plates had less bacterial growth than braided suture, whereas antibacterial monofilament and braided sutures showed no growth. Confocal microscopy showed more adherence to braided suture than to the barbed monofilament or monofilament sutures.
Conclusions:
Barbed monofilament suture showed similar bacterial adherence properties to standard monofilament suture.
Clinical Relevance:
Our findings suggest barbed monofilament suture can be substituted for monofilament suture, at the surgeon's discretion, without fear of increased risk of infection.
Insights
Barbed monofilament sutures show low bacterial adherence, similar to standard monofilament sutures. This suggests they can be safely used as an alternative to monofilament sutures without increasing infection risk.
Area of Science:
- Surgical Materials Science
- Infectious Disease Research
- Microbiology
Background:
- Clinical infections are less common with monofilament sutures than braided ones.
- Barbed monofilament sutures offer strength and time-saving benefits over braided sutures.
- Bacterial adherence to barbed monofilament sutures remains unclear.
Purpose of the Study:
- To assess bacterial adherence to five suture types, including barbed monofilament.
- To evaluate bacterial culturability after washing sutures.
- To determine patterns of bacterial adherence on different suture materials.
Main Methods:
- An experimental wound model was created using methicillin-resistant Staphylococcus aureus (MRSA).
- Five suture types were tested: Vicryl™, Vicryl™ Plus, PDS™, PDS™ Plus, and Quill™ (barbed monofilament).
- Bacterial adherence was quantified by sequential washes, plating for growth, and confocal microscopy.
Main Results:
- Barbed monofilament sutures exhibited the least bacterial adherence among all tested materials.
- Monofilament and barbed monofilament sutures showed less bacterial growth than braided sutures.
- Antibacterial sutures (monofilament and braided) demonstrated no bacterial growth; braided sutures had higher adherence.
Conclusions:
- Barbed monofilament sutures possess bacterial adherence properties comparable to standard monofilament sutures.
- These findings support the substitution of barbed monofilament for monofilament sutures, at surgeon's discretion, without increased infection risk.
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