Van Winkle W, Hastings J C, Barker E, Hines D, Nichols W
Surg Gynecol Obstet. 1975 Jan;140(1):7-12.
A systematic comparison has been made of six suture materials used as subcuticular closure of abdominal incisions in dogs. The effect on wound healing was measured by mechanical, biochemical, and histologic methods. No difference was demonstrated in wound breading strength among wounds closed with different suture materials up to 28 days postoperatively. At 70 days, wounds sutured with nonabsorbable sutures were weaker than those closed with absorbable sutures, but this difference probably was due to a much higher incidence of infection in wounds closed with nonabsorbable sutures. It was our observation that monofilament sutures were superior to multifilament sutures with regard to the incidence of wound infection. By five days, the rate of collagen synthesis in wounds was increased over that of normal skin and remained elevated throughout the 120 day observation period. Suture material had no effect on collagen synthesis. The rate of noncollagenous protein synthesis in the wound was not altered throughout the entire observation period and did not differ from that measured in normal skin. Catgut, both plain and chromic, produced only a mild cellular reaction in dogs after 21 days as contrasted with the intense inflammatory reaction reported by others in rats and rabbits. We observed neither plain nor chromic catgut was absorbed rapidly in dogs; intact sutures were frequently observed at 120 days. Polyglactin, a synthetic absorbable suture, produced a moderate tissue reaction and uniformly disappeared between the twenty-eighth and seventieth days. Silk and Mersilene showed the highest rate of wound infection and the most intense and prolonged tissue reaction. Prolene, a monofilament suture, produced only a mild to moderate tissue reaction. These results taken in conjunction with those of other investigators suggest a marked species difference in the reaction to suture materials, particularly catgut, and suggest caution in transferring these observations to human beings.
对用于犬腹部切口皮下缝合的六种缝合材料进行了系统比较。通过机械、生化和组织学方法测量对伤口愈合的影响。术后28天内，用不同缝合材料缝合的伤口在伤口抗张强度方面未显示出差异。在70天时，用不可吸收缝线缝合的伤口比用可吸收缝线缝合的伤口更脆弱，但这种差异可能是由于用不可吸收缝线缝合的伤口感染发生率高得多。我们观察到，在伤口感染发生率方面，单丝缝线优于多丝缝线。到第5天，伤口中胶原蛋白的合成速率比正常皮肤有所增加，并在整个120天的观察期内保持升高。缝合材料对胶原蛋白合成没有影响。在整个观察期内，伤口中非胶原蛋白的合成速率没有改变，与正常皮肤中测量的速率没有差异。普通肠线和铬制肠线在犬体内21天后仅产生轻微的细胞反应，这与其他研究人员在大鼠和兔子中报道的强烈炎症反应形成对比。我们观察到普通肠线和铬制肠线在犬体内都没有迅速吸收；在120天时经常观察到完整的缝线。聚乙醇酸，一种合成可吸收缝线，产生中度组织反应，并在第28天至第70天之间均匀消失。丝线和聚酯纤维显示出最高的伤口感染率以及最强烈和持久的组织反应。普理灵，一种单丝缝线，仅产生轻微至中度的组织反应。这些结果与其他研究人员的结果相结合，表明在对缝合材料的反应上存在明显的物种差异，特别是肠线，并表明在将这些观察结果应用于人类时应谨慎。
