OBJECTIVE: To compare the tensile strength of fast absorbable Polyglactin 910 suture material when impregnated with various agents for local anesthesia and to investigate whether the presence of ethanol in Xylocaine spray could explain a potential reduction in tensile strength after use of Xylocaine spray.
METHODS: In all, 120 suture samples of Polyglactin 910 were divided into four groups of 30. These four groups were randomly impregnated with isotonic sodium chloride, isotonic sodium chloride plus Xylocaine spray, isotonic sodium chloride plus Xylocaine gel, or isotonic sodium chloride plus ethanol. After impregnation, the sutures were stored in sealed glass tubes in a heating cabinet at 37°C for 72 h. Thereafter, the tensile strength of these 120 samples was assessed by a universal tensile testing machine. The maximal force needed to break the suture material was recorded in newtons (N).
RESULTS: Fast absorbable Polyglactin 910 suture material impregnated with Xylocaine spray or ethanol showed weakened tensile strength (mean values 11.40 and 11.86 N, respectively), whereas the specimens impregnated with Xylocaine gel or sodium chloride retained their tensile strength better (mean values 13.81 and 13.28 N, respectively; mean difference between Xylocaine gel and Xylocaine spray -2.41 N, P < 0.001).
CONCLUSIONS: In this in vitro experiment, ethanol and Xylocaine spray weakened the tensile strength of fast absorbable Polyglactin 910 sutures. Use of Xylocaine spray, which contains ethanol, for local anesthesia might lead to early breakdown of the suture material and wound rupture. The authors suggest caution when using Xylocaine spray in combination with fast absorbable Polyglactin 910 suture.

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.

UNASSIGNED: Connective tissue subacromial bursa-derived progenitor cells (SBDCs) have been suggested as a potent biologic augment to promote healing of the repaired rotator cuff tendon. Maximizing the amount of retained progenitor cells at the tendon repair site is essential for ensuring an optimal healing environment, warranting a search for proadhesive and proliferative adjuvants. The purpose was to evaluate the effect of magnesium (Mg), platelet-rich plasma (PRP), and a combination of both adjuvants on the in vitro cellular adhesion and proliferation potential of SBDCs on suture material commonly used in rotator cuff surgery.
UNASSIGNED: SBDCs were isolated from subacromial bursa samples harvested during rotator cuff repair and cultured in growth media. Commercially available collagen-coated nonabsorbable flat-braided suture was cut into 1-inch pieces, placed into 48-well culture dishes, and sterilized under ultraviolet light. Either a one-time dose of 5 mM sterile Mg, 0.2 mL of PRP, or a combination of both adjuvants was added, while a group without treatment served as a negative control. Cellular proliferation and adhesion assays on suture material were performed for each treatment condition.
UNASSIGNED: Augmenting the suture with Mg resulted in a significantly increased cellular adhesion (total number of attached cells) of SBDCs compared to PRP alone (31,527 ± 19,884 vs. 13,619 ± 8808; P < .001), no treatment (31,527 ± 19,884 vs. 21,643 ± 8194; P = .016), and combination of both adjuvants (31,527 ± 19,884 vs. 17,121 ± 11,935; P < .001). Further, augmentation with Mg achieved a significant increase in cellular proliferation (absorbance) of SBDCs on suture material when compared to the PRP (0.516 ± 0.207 vs. 0.424 ± 0.131; P = .001) and no treatment (0.516 ± 0.207 vs. 0.383 ± 0.094; P < .001) group. The combination of Mg and PRP showed a significantly higher proliferation potential compared to PRP alone (0.512 ± 0.194 vs. 0.424 ± 0.131; P = .001) and no treatment (0.512 ± 0.194 vs. 0.383 ± 0.094; P < .001). There were no significant differences in the remaining intergroup comparisons (P > .05, respectively).
UNASSIGNED: Augmenting suture material with Mg resulted in a significantly increased cellular adhesion of SBDCs compared to untreated suture material, as well as augmentation with PRP alone or a combination of both adjuvants. Further, Mg with or without PRP augmentation achieved a significant increase in the cellular proliferation of SBDCs on suture material compared to untreated sutures and augmentation with PRP alone. Application of Mg may be a clinically feasible approach to optimizing the use of SBDCs as a biological augment in rotator cuff repair, while combined augmentation with PRP may harness the full potential for optimized tissue recovery due to the high concentration of PRP-derived growth factors.

UNASSIGNED: Transverse-aortic constriction (TAC) operation is a widely used animal model to induce hypertrophy and heart failure through left-ventricular pressure overload. In mice, the cardiac response to TAC exhibits considerable variability influenced by factors such as strain, sub-strain, age, sex and vendor.
UNASSIGNED: To investigate the impact of suture material (silk versus prolene) and size (6-0 versus 7-0) on the TAC-induced phenotype, we performed surgeries on male C57BL6/N mice at 9 weeks of age defining the aortic constriction by a 27G needle, thereby employing most frequently used methodological settings. The mice were randomly assigned into four separate groups, 6-0 silk, 7-0 silk, 6-0 prolene and 7-0 prolene (10 mice per group). Echocardiography was conducted before TAC and every 4 weeks thereafter to monitor the development of heart failure. Repeated measures correlation analysis was employed to compare disease progression among the different groups.
UNASSIGNED: Our findings reveal a significant influence of the chosen suture material on TAC outcomes. Mice operated with prolene showed increased mortality, slower body weight gain, faster left-ventricular mass increase, and a faster decline in left-ventricular ejection fraction, fractional shortening and aortic pressure gradient compared to silk-operated mice. Moreover, despite non significant, using thinner suture threads (7-0) tended to result in a more severe phenotype compared to thicker threads (6-0) across all tested parameters.
UNASSIGNED: Collectively, our results highlight the importance of suture material selection in determining the cardiac phenotype induced by TAC and emphasize the need to consider this factor when comparing data across different research laboratories.

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.

The choice of the most appropriate suture threads for pancreatic anastomoses may play an important role in reducing the incidence of post-operative pancreatic fistula (POPF). The literature on this topic is still not conclusive. The aim of this study was to analyze the mechanical characteristics of suture materials to find the best suture threads for pancreatic anastomoses. A single-axial electromagnetic actuation machine was used to obtain the stress-deformation relationship curves and to measure both the ultimate tensile strength (UTS) and the Young\'s modulus at the 0-3% deformation range (E0-3) of four different suture materials (Poliglecaprone 25, Polydioxanone, Polyglactin 910, and Polypropylene) at baseline and after incubation in saline solution, bile, and pancreatic juice for 1, 3, and 7 days. Polydioxanone and Polypropylene showed stable values of UTS and E0-3 in all conditions. Polyglactin 910 presented significant UTS and E0-3 variations between different time intervals in all types of liquids analyzed. Poliglecaprone 25 lost half of its strength in all biological liquids analyzed but maintained low E0-3 values, which could reduce the risk of lacerations of soft tissues. These results suggest that Polydioxanone and Poliglecaprone 25 could be the best suture materials to use for pancreatic anastomoses. In vivo experiments will be organized to obtain further confirmations of this in vitro evidence.

In surgical dentistry, suture material is the only foreign body that remains in the tissues after surgery, and it can lead to several negative reactions, for example, infection of the wound. The purpose of this study was to compare the mechanical properties and microbiological resistance of mono- and polyfilament suture materials used in tooth extraction operations. The study of elongation and knot force was carried out on an Instron 5969 Dual Column Testing System device. The capillarity of the materials was studied on a setup assembled by the authors manually by immersing the ends of the filaments in a colored manganese solution. A microbiological study was carried out on the threads taken for the experiment immediately after wound suturing, and on day 7, at which time they were removed. The comparison was made according to Rothia mucilaginosa, Streptococcus sanguinis, Staphylococcus epidermidis. Results: monofilament suture materials (Prolene and Glycolon), after calculating the Kruskal-Wallis and Mann-Whitney indices, showed better performance in all experiments compared to polyfilament sutures (Vicryl and PGA). In capillarity comparison, there was a significant difference between groups (p = 0.00018). According to the sum of the results of three microbiological studies on day 7, monofilament suture materials absorbed less of the studied bacteria on their surface compared to the polyfilament ones (p < 0.05). Conclusions: Of the studied suture materials, Prolene had the best microbiological resistance and good mechanical properties.

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.

OBJECTIVE: To evaluate success and safety of sacrospinous ligament fixation (SSLF) using permanent versus absorbable suture materials 12 months following surgery.
METHODS: Following IRB approval, the electronic medical records of women who underwent SSLF in the gynecology department of a university-affiliated medical center from November 2012 to September 2021 were retrospectively reviewed. SSLF was carried out using Capio®and Digitex™, with either absorbable (polyglactin-910 or polydioxanone) sutures (group 1), or permanent (polypropylene) sutures (group 2), Pre-operative and post-operative assessment included prolapse staging using the pelvic organ prolapse quantification system and validated quality of life questionnaires (Pelvic Floor Distress Inventory and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12). Patients with postoperative information on objective and subjective outcome at 12 months were included in final analysis. Anatomical success was defined as POP stage < 2 at 12-months following surgery. For statistical analysis, the Mann-Whitney test was used for continuous variables, Fisher\'s exact test for dichotomous variables, and Chi-squared test of independence for variables with>2 categories.
RESULTS: During the study period, 234 women underwent SSLF. One-hundred and forty-two patients (60.7 %) returned at the 12-month follow-up and were included in final analysis. Seventy-two (50.7 %) patients had absorbable suture and 70 patients (49.3 %) had permanent suture. Estimated blood loss was significantly higher in group 1 [100 (50-150) cc vs 50 (50-100) cc respectively, p =.016]. Moderate to severe pain on POD-1 was significantly higher in group 2 [VAS: 2.00 (0.00-4.00) vs 4.00 (3.00-5.75) respectively, p =.001]. Anatomical success, defined as POP ≤ stage 2 at 12 months, was similar between groups: 69 % in group 1 vs 67 % in group 2 (p =.77). Subjective cure was similar between groups, 97.2 % in group 1 vs 94.3 % in group 2 (p =.44). At the 12-month follow-up, none of the patients had gluteal pain. The rate of de-novo dyspareunia was similar between groups: 4 women (5.9 %) in the absorbable suture group versus 2 women (3.3 %) in the permanent suture group (p =.49).
CONCLUSIONS: Our findings suggest that absorbable or permanent suture material does not affect outcome of SSLF. Permanent sutures may be related to increased immediate postoperative pain.

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.