[Intraperitoneal adhesion formation and tissue reaction following the use of microsurgical suture material]

In 60 female rats we investigated intraperitoneal adhesion and tissue reaction of Vicryl, PDS, Ethilon und Prolene depending on the thickness of the thread (6-0 versus 9-0) and the length of the ends of the threads cut off in the region of the knot. The results did not show any significant difference in respect of degree of adhesion and tissue reaction, for the four suturing materials tested in this study. It was also not possible to detect any definite influence of the thread strength (6-0 versus 9-0) on the adhesion and tissue reaction. Only in the case of Ethilon the intraperitoneal adhesion was significantly lower if the thread strength was 9-0, compared against 6-0 (p less than 0.02). With all the other types of thread, adhesion was found to be independent of the strength of the thread. However, the length of the ends of the thread in the region of the knot exercises a great influence on the degree of adhesion. If the ends of the threads have a length of 0.3 cm, adhesion is statistically significantly greater than if the ends have been cut short (p less than 0.001). Results from these animal experiments indicate that the choice of microsurgical suturing material does not depend on the type of thread, as far as intraperitoneal adhesion and inflammatory tissue reaction are concerned, whereas the thread strength (6-0 or 9-0) has a slight influence only. For preventing adhesion, it is important to cut off the ends of the threads as short as possible after knotting, i.e. as short as safety of the knot would permit.