Assessment of tissue reaction at suture knots; an adaptation of Sewell's scoring system

From a theoretical point of view and from reported animal work the knot side should be considered the most relevant part of the suture loop for studying inflammatory foreign body reaction. In the present study a semi-quantitative histological assessment of inflammatory tissue reaction around the knots of implanted sutures is presented. To test the reliability of this method an animal model was used in which two suture materials with well-known differences in tissue reactivity were studied. Differences in tissue response around the knots between these materials proved to be highly significant statistically (tissue reactivity score (TRS) 44.17 vs. 58.71: p less than 0.001). No differences in TRS could be demonstrated between different localizations in the anterior abdominal wall of male Wistar rats. Implications of these findings with respect to future studies are discussed.