Department of Oral Surgery, School of Dental Medicine, University of Belgrade, Dr Subotica 8, Belgrade, 11000, Serbia.
Department of Pathology, School of Dental Medicine, University of Belgrade, Dr Subotica 8, Belgrade, 11000, Serbia.
Clin Oral Investig. 2020 Apr;24(4):1527-1541. doi: 10.1007/s00784-019-03034-4. Epub 2019 Jul 24.
Sutures are the most frequently used medical device for wound closure. They support tissue during the early phase of healing until it regains enough tensile strength. The aim of this study was to compare four different suture materials in terms of the influence on wound healing, microbial adherence, tissue reaction, and relevant clinical parameters which determine their clinical value.
Total number of 32 patients undergoing surgical extraction of four impacted third molars were involved in the study. Clinical parameters were estimated intraoperatively and during the control check-ups. Soft tissue healing around sutures were evaluated on the 3rd and 7th day postoperatively. Microbial colonization was assessed by means of qPCR. Also, histological analysis was done to assess inflammatory reaction.
Significantly better soft tissue healing was found around monofilament and synthetic sutures compared to multifilament and natural ones respectively. Soft tissue healing was significantly better around all sutures on the 7th day than on the 3rd day postoperatively.
Non-resorbable polypropylene suture showed superior clinical characteristics among all sutures. Moreover, the best healing of soft tissue and the least inflammatory reaction was found around this thread. The poorest soft tissue healing was found around non-resorbable silk suture. This suture elicited strongest inflammatory reaction and showed the greatest microbial adherence affinity compared to alternative sutures.
Monofilament synthetic suture should be used in order to obtain the best soft tissue healing, reduce the risk of postoperative infection, and alleviate the suturing after oral surgery procedures.
缝线是最常用于伤口闭合的医疗器械。它们在组织愈合的早期阶段支持组织,直到组织恢复足够的拉伸强度。本研究旨在比较四种不同缝线材料对伤口愈合、微生物黏附、组织反应和相关临床参数的影响,这些参数决定了它们的临床价值。
共有 32 名接受四颗埋伏第三磨牙外科拔除的患者参与了这项研究。临床参数在手术中和控制检查期间进行评估。缝线周围的软组织愈合情况在术后第 3 天和第 7 天进行评估。通过 qPCR 评估微生物定植情况。此外,还进行了组织学分析以评估炎症反应。
与多股线和天然缝线相比,单股线和合成缝线周围的软组织愈合明显更好。与术后第 3 天相比,所有缝线在第 7 天周围的软组织愈合明显更好。
不可吸收聚丙烯缝线在所有缝线中表现出更好的临床特性。此外,这种缝线周围的软组织愈合最好,炎症反应最小。不可吸收丝线周围的软组织愈合最差。与其他缝线相比,这种缝线引起的软组织炎症反应最强,微生物黏附亲和力最大。
为了获得最佳的软组织愈合、降低术后感染风险并减轻口腔手术后的缝合,应使用单股合成缝线。