Subcuticular sutures and the rate of inflammation in noncontaminated wounds

To determine whether buried, absorbable, subcuticular sutures increase the degree of inflammation in noncontaminated wounds.

Randomized, blinded, prospective trial.

Laboratory.

Eleven Sprague-Dawley rats weighing 300 to 325 g.

Four wounds were made on each rat. Two wounds on each were closed with three interrupted buried, absorbable, subcuticular sutures 6-0 polyglactin 910 and running 5-0 nylon skin sutures. The other two wounds were closed with running 5-0 nylon skin sutures alone.

Fourteen days after the sutures were placed, the animals were killed, and histologic preparations were made from each wound. Each sample was scored on a scale of 0 to 3 for the presence of inflammatory infiltrates, fibroplasia and capillary proliferation, necrosis, exudates, giant cells, and edema. We determined a total wound score by adding the scores from each category. The mean total wound score was 4.46 +/- 2.92 for those closed with buried, absorbable, subcuticular sutures and 4.91 +/- 2.56 for those closed without buried, absorbable, subcuticular sutures. Using the Wilcoxon rank-sum test, we found no statistically significant difference in mean total wound score of wounds closed with and without buried, absorbable, subcuticular sutures (alpha = .01). The probability of detecting a twofold difference in total wound scores was 60% (beta = .40).

Buried, absorbable, subcuticular sutures do not significantly increase the degree of inflammation in noncontaminated wounds.