Banche Giuliana, Roana Janira, Mandras Narcisa, Amasio Mario, Gallesio Cesare, Allizond Valeria, Angeretti Alessandra, Tullio Vivian, Cuffini Anna Maria
Department of Public Health and Microbiology, University of Turin, Turin, Italy.
J Oral Maxillofac Surg. 2007 Aug;65(8):1503-7. doi: 10.1016/j.joms.2006.10.066.
Sutures used in oral surgery should avoid or limit bacterial adhesion and proliferation to those parts exposed to oral fluids. Hence, microbial colonization on various intraoral suture materials from patients undergoing dental surgery was compared.
During dentoalveolar surgery, various suture materials were used in 60 patients, who were randomly divided into 5 groups of 12. In each group, silk was placed intraorally in association with a different type of suture (ie, Supramid, Synthofil, Ethibond Excel, Ti-cron, Monocryl) at the same site to compare microbial colonization intraindividually. Eight days postoperatively, the sutures were removed, and adhered micro-organisms were isolated, counted, and identified through enzymatic activities and fermentation of sugars.
In all 60 patients, silk sutures exhibited the smallest affinity toward the adhesion of bacteria compared with considerable proliferation with nonresorbable multifilament sutures (Supramid, Synthofil, Ethibond Excel, Ti-cron). On the contrary, the microbial load was significantly lower when absorbable monofilament Monocryl was used. A greater quantity of bacteria was found on nonresorbable sutures than on absorbable ones, and nearly 2 times more facultative anaerobic bacteria were isolated in total.
Our results show that bacteria adhere with different affinity to various types of suture materials. Absorbable silk and Monocryl exhibited the smallest number of adherent bacteria. Colonization by pathogens on sutures leads to the recommendation that sutures should be removed as early as possible after surgery is performed, to eliminate or to limit the reservoir for oral pathogens. This recommendation is dependent on whether the suture is absorbable.
口腔外科手术中使用的缝线应避免或限制细菌在暴露于口腔液体的部位黏附和增殖。因此，对牙科手术患者使用的各种口腔内缝线材料上的微生物定植情况进行了比较。
在牙槽外科手术中，60例患者使用了各种缝线材料，这些患者被随机分为5组，每组12例。在每组中，将丝线与不同类型的缝线（即Supramid、Synthofil、Ethibond Excel、Ti-cron、Monocryl）在口腔内同一部位放置，以比较个体内的微生物定植情况。术后8天，取出缝线，分离、计数并通过酶活性和糖发酵鉴定黏附的微生物。
在所有60例患者中，与不可吸收多丝缝线（Supramid、Synthofil、Ethibond Excel、Ti-cron）大量增殖相比，丝线缝线对细菌黏附的亲和力最小。相反，使用可吸收单丝Monocryl时微生物负荷显著降低。在不可吸收缝线上发现的细菌数量比可吸收缝线上的多，总共分离出的兼性厌氧菌数量几乎多两倍。
我们的结果表明，细菌对各种类型的缝线材料的黏附亲和力不同。可吸收丝线和Monocryl上黏附的细菌数量最少。缝线上病原体的定植导致建议在手术后尽早取出缝线，以消除或限制口腔病原体的储存库。这一建议取决于缝线是否可吸收。
