Morris Michael R, Bergum Christopher, Jackson Nancy, Markel David C
Detroit Medical Center/Providence Hospital Orthopaedic Surgery Residency Program, Detroit, Michigan.
Department of Orthopaedic Surgery, Providence Hospital, Southfield, Michigan.
J Arthroplasty. 2017 Apr;32(4):1272-1279. doi: 10.1016/j.arth.2016.11.010. Epub 2016 Nov 24.
Monofilament and barbed monofilament sutures have been shown in in vitro models to have less bacterial adherence than braided suture. This study evaluates bacterial adherence to suture materials and tissue reactivity with an in vivo contaminated wound mouse model.
Staphylococcus aureus was used to create an in vivo contaminated wound model at 2 amounts (10 colony-forming units [CFU] and 10 CFU) using a mouse air pouch. Three types of commonly used absorbable suture were evaluated: braided, monofilament, and barbed monofilament. Bacterial suture adherence was evaluated with suture culture, a photon-capturing camera system, and scanning electron microscopy. Tissue reactivity was assessed through histology and protein expression.
The braided suture group with the high amount of S aureus exhibited frank purulence and air pouch hypertrophy in all 8 mice. A significant difference was found between suture groups inoculated with 10 CFU (P < .05) as measured by bacterial culture concentration using the optical density method. The braided suture hosted more bacteria than either monofilament (P < .005) or barbed monofilament suture (P < .005). No difference was appreciated between the monofilament and barbed monofilament groups. Kruskal-Wallis test demonstrated a significant difference between groups in regard to levels of tumor necrosis factor-α (P < .05) and interleukin-1 (P < .05).
Our in vivo contaminated wound model demonstrated that barbed monofilament suture performed similarly to monofilament suture and better than braided suture in terms of bacterial adherence, biofilm formation, and tissue reactivity.
在体外模型中已表明，单丝缝线和倒刺单丝缝线比编织缝线具有更少的细菌黏附。本研究使用体内污染伤口小鼠模型评估细菌对缝线材料的黏附以及组织反应性。
使用金黄色葡萄球菌，通过小鼠气袋以两种数量（10个菌落形成单位[CFU]和10⁶ CFU）建立体内污染伤口模型。评估了三种常用的可吸收缝线：编织缝线、单丝缝线和倒刺单丝缝线。通过缝线培养、光子捕获相机系统和扫描电子显微镜评估细菌对缝线的黏附。通过组织学和蛋白质表达评估组织反应性。
在所有8只小鼠中，接种大量金黄色葡萄球菌的编织缝线组出现明显的化脓和气袋肥大。使用光密度法通过细菌培养浓度测量，接种10⁵ CFU的缝线组之间存在显著差异（P <.05）。编织缝线比单丝缝线（P <.005）或倒刺单丝缝线（P <.005）携带更多细菌。单丝缝线组和倒刺单丝缝线组之间无差异。Kruskal-Wallis检验表明，各组之间在肿瘤坏死因子-α水平（P <.05）和白细胞介素-1水平（P <.05）方面存在显著差异。
我们的体内污染伤口模型表明，在细菌黏附、生物膜形成和组织反应性方面，倒刺单丝缝线的表现与单丝缝线相似，且优于编织缝线。
