Localized Nanoindentation Paradigm for Revealing Sutured Tissue Interface Mechanics and Integrity

This study investigates the nanoindentation technique to elucidate the quasi-static and dynamic stress response at the wounded and sutured tissue interface. In vitro modeling and wound healing analysis enable an understanding of sutured tissue interface integrity, modulus, and stability using an artificial abdominal wall model. Sutured tissues with simple interrupted suturing (SIS) demonstrated a 35-40% higher modulus than simple continuous suturing (SCS). High-density suturing with a suture space of 2.5 mm exhibited a 2-fold higher modulus than low-density suturing with a suture space of 5 mm. The elastic modulus of the sutured pad immersed in deionized water was ∼70-95% of the dry condition. The dynamic stress data indicate that long-term body motions-triggered stress instability at the wound interface was affected by suturing style and density. The pivotal factors determining wound healing are quasi-static and dynamic modulus at the sutured interface, which is intimately associated with patient pain, wound complications, healing speed, and blood flow. The proposed method and data are an original approach to addressing wound healing, contributing to patient well-being and identifying, interpreting, and breaking the drawn-out debates in the suturing field.