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Bacterial contamination of nylon corneal sutures
C J Heaven1, C R Davison, P M Cockcroft
1Manchester Royal Eye Hospital, UK.
Abstract:
We report the findings of a prospective study into the bacterial contamination of monofilament nylon sutures removed from corneal wounds following cataract surgery. Sutures were classified as tight, loose or broken at the time of removal. Loose and broken sutures showed significantly more bacterial contamination than tight sutures (p < 0.001, chi squared). Positive cultures were obtained from 2 (6.2%) of 32 tight sutures, 14 (38.9%) of 36 loose sutures and 11 (37.9%) of 29 broken sutures. Staphylococcus epidermidis was the most commonly isolated organism (isolated in pure growth from 22 (81.5%) of 27 positive cultures). These findings may explain the occasional association of biodegraded corneal monofilament nylon sutures and suppurative keratitis and highlight the potential risk of seeding a suture track infection at the time of suture removal. They also emphasise the need for prophylactic topical antibiotic when removing biodegraded sutures.
Insights
Loose and broken sutures from cataract surgery wounds had higher bacterial contamination than tight sutures. Staphylococcus epidermidis was the most common bacteria, highlighting infection risks during suture removal.
Area of Science:
- Ophthalmology
- Microbiology
- Surgical Infections
Background:
- Cataract surgery involves corneal incisions closed with sutures.
- Suture integrity may influence bacterial contamination.
- Understanding suture contamination is crucial for preventing post-operative infections.
Purpose of the Study:
- To prospectively investigate bacterial contamination levels on removed corneal sutures.
- To correlate suture condition (tight, loose, broken) with bacterial presence.
- To identify common bacterial species contaminating corneal sutures.
Main Methods:
- Prospective study of monofilament nylon sutures from corneal wounds post-cataract surgery.
- Sutures classified as tight, loose, or broken upon removal.
- Bacterial cultures performed on removed sutures to assess contamination.
Main Results:
- Significantly higher bacterial contamination in loose and broken sutures compared to tight sutures (p < 0.001).
- Positive cultures: 6.2% tight, 38.9% loose, 37.9% broken sutures.
- Staphylococcus epidermidis was the predominant organism, found in 81.5% of positive cultures.
Conclusions:
- Loose or broken corneal sutures are associated with increased bacterial contamination.
- Findings support the link between contaminated sutures and suppurative keratitis.
- Prophylactic topical antibiotics are recommended during removal of compromised sutures.