Introduction Sutures play a crucial role in the postoperative healing process, as they help approximate wound edges, promote hemostasis, and support tissue healing. The oral cavity harbors a diverse microbial population, and oral surgical procedures can introduce potential pathogens into the surgical site. Understanding the impact of suture material on wound infection rates and the colonization of potentially harmful microorganisms is vital for improving patient outcomes. This study was aimed to evaluate and compare the microbiological properties of prolene, vicryl plus, monocryl, and silk sutures used after the surgical removal of impacted lower third molars. Materials and methods A total of 40 patients requiring surgical extraction of impacted lower third molars were assigned to four groups: prolene, vicryl plus, monocryl, and silk sutures. Surgical extraction of impacted tooth was done, and wound was sutured with the abovementioned four different materials in four groups, respectively. After seven days, the sutures were removed and sent to the microbiology lab for colony count assessment. Total microbial colony count, streptococcus count, and lactobacillus count were assessed. Data was analyzed using IBM SPSS Statistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, New York, United States) with p-values less than 0.05 considered as statistically significant. The one-way analysis of variance (ANOVA) and post-hoc Tukey test were done to compare intergroup relations. Results The microbiological evaluation of the sutures revealed significant differences in bacterial colonization among the four groups. More bacterial quantities were found in the silk group followed by the monocryl, vicryl plus, and prolene groups in the descending order. Prolene demonstrated the lowest incidence of bacterial growth (p<0.001) compared to vicryl plus, monocryl, and silk sutures. Bacterial colony count was highest in the silk group. The predominant bacterial species found in all groups were Streptococcus viridans, Staphylococcus aureus, and Lactobacillus.  Conclusion It was found that prolene and vicryl plus sutures exhibited superior microbiological properties compared to monocryl and silk sutures when used for the surgical removal of impacted lower third molars. The lower incidence and less quantity of bacterial colonization on prolene sutures suggest their potential for reducing the risk of postoperative infection; hence, these sutures can be preferred for oral surgical procedures.

We report granuloma formation after using FiberWire® for flexor tendon repairs. Four subcutaneous granulomas were identified in 115 patients with FiberWire® core sutures, none in 426 with braided polyester. Foreign body reactions were found in the granuloma cases. We suggest early suture removal if this specific complication is encountered.

BACKGROUND: Laparoscopic inguinal hernia repair is a commonly performed procedure in children. Currently, monofilament polypropylene and braided silk are the two most frequently used materials. Studies have suggested more tissue inflammatory reactions with the use of multifilament non-absorbable sutures. However, little is known about the effects of suture materials on adjacent vas deferens. The aim of this experiment was to compare the effect of non-absorbable monofilament and multifilament sutures on vas deferens in laparoscopic hernia repair.
METHODS: All animal operations were performed by a single surgeon under aseptic conditions and anaesthesia. Ten male Sprague Dawley rats were divided into two groups. In Group I, \"hernia repair\" was performed using 5.0 Silk. In Group II, polypropylene sutures (Prolene®; Ethicon, Somerville, N.J., USA) were used. All animals also received sham operations in the left groin as a control. After 14 days, the animals were euthanised and a segment of vas deferens just adjacent to the suture was excised for histological review by an experienced pathologist who was blind to the treatment groups of the respective specimens.
RESULTS: The body sizes of the rats in each group were comparable. Group I had significantly smaller vas deferens than Group II (diameter: 0.2 vs. 0.6 ± 0.2, p = 0.005). Silk sutures appeared to cause more tissue adhesion than Prolene® sutures, as graded by blind assessors (adhesion grade: 2.8 ± 1.3 vs. 1.8 ± 0.8, p = 0.1), although this did not reach statistical significance. There was no significant difference in the histological fibrosis score and inflammation score.
CONCLUSIONS: The only effect of non-absorbable sutures on vas deferens in this rat model was the reduced cross-sectional area of vas deferens and increased tissue adhesion when using silk sutures. However, there was no significant histological difference in inflammation or fibrosis caused by either material.

Surgical sutures are the most well-known surgical biomaterial device for ligating blood vessels. The primary goal of wound closure is to align wound margins to provide a closed and stable environment. Sutures with lesser tensile strength are susceptible to break throughout the healing process due to edema. To evaluate the tensile strength of absorbable and nonabsorbable suture materials after immersion in fruit juices. In this in vitro study, eight samples of commercially available sutures such as black silk and vicryl were divided into two groups: sample -1 were immersed in grape juice and sample -2 were immersed in lemon juice for 1 week. Universal testing machine INSTRON E300 UTM was used to test the tensile strength of various suture materials. The data are statistically analyzed using an independent t-test. The P < 0.05 was considered to be statistically significant. The mean of vicryl suture after immersion in grape and lemon juice was found to be 34.445 and 43.39; the mean value of black silk after immersion in grape and lemon juice was found to be 36.95 and 33.1. The tensile strength of black silk was slightly lower than the vicryl. Independent sample t-test showed that P = 0.561 (>0.05) which is statistically insignificant. Vicryl suture tested to have the highest tensile strength along with excellent knot holding capacity than black silk suture after immersion in fruit juices.

The aim of this study was to compare the surgical results and the complications of absorbable suture (AS) versus permanent suture (PS) in sacrocolpopexy (SCP).
We systematically searched PubMed, Embase, ClinicalTrials.gov, and the Cochrane Library Central Register of Controlled Trials for articles in which researchers compared AS with PS in SCP. The primary outcomes were the surgical success rate and suture-related complications (suture exposure/erosion, mesh erosion, and suture removal). All analyses were performed with Review Manager 5.3.
Four articles involving 689 patients were ultimately included. Our findings demonstrated that AS had similar surgical success rates to those of PS (OR=1.34; 95% CI, 0.60-2.96) and no significant differences in failure rates were noted between the two groups (OR=0.75; 95% CI, 0.34-1.66). Subgroup analyses in patients with anatomical failure revealed no significant differences in recurrent posterior prolapse (OR=0.33; 95% CI, 0.05-2.10) or in recurrent apical (OR=0.64; 95% CI, 0.03-13.66) or anterior prolapse (OR=0.45; 95% CI, 0.13-1.57). However, the AS group were at a lower risk of suture exposure/erosion (OR=0.18; 95% CI, 0.06-0.58) and a lower suture removal rate (OR=0.14; 95% CI, 0.03-0.61) and retreatment (OR=0.36; 95% CI, 0.16-0.82), but the mesh erosion was not significantly different (OR=1.00; 95% CI, 0.49-2.08).
The data showed that AS had a similar success rate, less exposure/erosion, and were less likely to be removed and require retreatment than PS, which supported the notion that AS is as effective as PS but safer.

UNASSIGNED: Clinical trials are a prerequisite for any investigational suture materials before a market approval application. The appropriate study designs and primary outcome measures are key to the validity and reliability of clinical trial results. This study aimed to characterize the study designs and primary outcome measures being applied in clinical trials of investigational suture materials.
UNASSIGNED: The systematic searches on PubMed, EMBASE, Web of Sciences, Scopus, and Cochrane databases were conducted to gather relevant studies published between January-2019 and May-2021. Data on general characteristics, suture intervention, study design, and primary outcome measures were extracted and analyzed.
UNASSIGNED: Of 46 included studies, the majority of them were conducted with a randomized-controlled (93.5%), single-blind (50.0%), two-arm (84.8%), and parallel (76.1%) design with a 1:1 allocation ratio (95.7%). Through correlation network and heatmap analysis, the moderate-to-very strong correlations between some types of investigational suture materials and primary outcome measures were found including barbed vs non-barbed suture and suturing time, antibacterial-coated vs non-coated suture and wound infection, mono- vs multi-filament suture and wound healing index/markers, and different sizes of suture materials and scar assessment.
UNASSIGNED: Our analysis provides guidance, with several key considerations, for designing a clinical trial evaluating investigational suture materials.

We aimed to compare magnetic resonance imaging (MRI) findings and corresponding clinical outcomes of repaired Achilles tendons using absorbable and nonabsorbable sutures. Patients who underwent Achilles tendon repair were divided into 2 groups, with 11 in the absorbable group (group A) and 11 in the nonabsorbable group (group B). For all patients, MRI findings taken 6 months postoperatively were evaluated for morphological changes in the tendon. Concurrently, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot score and incidence of postoperative complications were evaluated. Regarding MRI findings, the extent to which the cross-sectional area of the repaired tendon was thicker than that of the preoperative tendon was significantly greater in group B than in group A (p = 0.0012). Notably, more stitches remained within the tendon in group B than in group A (p = 0.0063). No other MRI findings showed a significant difference between the two groups. No significant difference was observed in the AOFAS score, and there was one re-rupture each in both groups. Because nonabsorbable suture material in the treatment of Achilles tendon rupture yielded a thicker postoperative MRI cross-sectional area, enhanced rehabilitation is recommended in order to prevent scar formation.

OBJECTIVE: Cesarean scar defects (CSD) are a problem that may lead to complications and excessive cost. The optimal way to suture the uterus is a matter of debate. The aim of this study was to evaluate the effect of two suture materials on cesarean scar niches.
METHODS: This was a cohort study that allocated women into two groups: uterotomy closure with vicryl or catgut sutures. Transvaginal ultrasound (TVUS) was performed six months after the cesarean section (CS) to assess the scar.
RESULTS: Totally, 250 patients enrolled in this study. After six months, 20 (18.2 %) patients in the catgut suture group and 13 (9.3 %) patients in the vicryl group had isthmocele according to their sonography reports. The prevalence of isthmocele was higher in the catgut group (p = 0.03). The residual myometrial thickness was greater in the vicryl group (4.98 cm ± 2.18) compared to the catgut suture group (3.70 cm ± 1.50; p = 0.001). The prevalence of postoperative gynecological sequelae such as postmenstrual spotting and pain were similar between the two groups.
CONCLUSIONS: Vicryl sutures were associated with a lower risk of CSD formation in comparison with catgut sutures.

Mixed opinions exist regarding cosmetic outcomes of 5-0 fast absorbing plain (FG) gut relative to nonabsorbable suture material, such as 5-0 polypropylene (PP). High quality randomized trials comparing these two suture materials are lacking. To determine whether the use of PP during layered repair of linear cutaneous surgery wounds improves scar cosmesis compared to wound closure with FG. A randomized, split wound, comparative effectiveness trial was undertaken. Patients were evaluated 3 months after the intervention by two blinded physicians using the validated patient observer scar assessment scale (POSAS). Patient assessments were also captured using the same instrument as well as scar width and complications. The mean sum of the six components of the POSAS was 10.26 vs 12.74 for PP and FG, respectively, significantly (p < 0.001) in favor of PP. Mean observer overall opinion similarly showed better outcomes for PP than for FG [1.88 vs 2.52, respectively (p < 0.006)]. The mean sum of the patient assessed components of the POSAS for PP and FG was 12.3 vs 14.34, respectively (p = 0.11). Patient overall opinion significantly favored PP (2.41 vs 3.14, p = 0.043). PP resulted in small but statistically significant better cosmetic outcomes than FG. Pain experienced during suture removal was minimal for most patients.

Background: Impaired healing of the uterine scar after cesarean has been associated with adverse gynecological and obstetric outcomes. Although a large number of studies have been conducted on the events leading to this, information obtained from prospective randomized studies examining the role of suture material in the formation of cesarean scar defect (CSD) is lacking. Objective: To evaluate the effects of synthetic suture materials on CSD formation. Study design: We performed a two-arm 1:1 randomized study in women with singleton pregnancies undergoing elective primary cesarean delivery after the 38th week of gestation. Uterine scar closure was performed using synthetic absorbable monofilament and multifilament sutures. The primary outcome was residual myometrial thickness (RMT) in the area of the scar, measured by transvaginal ultrasound 6-9 months after birth. Secondary outcomes included differences in mean operative time, mean estimated blood loss at the time of surgery, and the rates of postoperative gynecological sequelae. Results: Complete follow-up was obtained from 94 (88%) of 107 participants. RMT was thicker in the monofilament compared to the multifilament suture group (5.5 ± 2.24 vs. 4.18 ± 1.76, p = 0.01). Hemoglobin delta was higher in the monofilament suture group (1.59 ± 0.96 vs. 1.25 ± 0.60, p = 0.04). There was no statistically significant difference between the monofilament suture and multifilament suture groups in terms of gynecological sequelae. Conclusion: Closure of the uterine scar with monofilament suture has a positive effect on scar healing and increases RMT thickness.