Surgical sutures and infection: A biomaterial evaluation

Abstract

Abstract A standardized readily reproducible experimental model has been developed to assess the relative importance of the chemical and physical configuration of sutures as determinants of early infection in contaminated wounds. The chemical structure of the suture appeared to be the most important factor in the development of surgical infection. The incidence of infection in contaminated tissues containing either polypropylene sutures or nylon sutures was lower than the infection rate of tissues subjected to any other nonabsorbable suture. Among the absorbable sutures, polyglycolic acid (PGA) sutures evoked the least inflammatory response. The infection rate of contaminated tissues containing the PGA sutures was not significantly different from the incidence of infection of tissues subjected to the least reactive nonabsorbable sutures. The physical configuration of the suture played a relatively unimportant role in the development of early infection. The infection rate of contaminated tissues containing monofilament nonabsorbable sutures did not differ significantly from the incidence of infection of tissues subjected to multifilament sutures made from the same material. Coating the multifilament suture with either silicone, wax, or Teflon did not alter the incidence of early infection in the contaminated tissue. Finally, the presence of even the least reactive suture in contaminated subdermal tissue potentiated the development of infection.