Influence of different types of surgical suture material on the intensity of tissue reaction in oral cavity

Abstract

Throughout the history the most diverse suture material have been used for closing and suturing surgical wounds. The four basic features of suture material are described: knot safety, stretch capacity, tissue reactivity and wound safety. Tissue reaction, even the minimum one, which develops during the first to seven days after applying the suture in the tissue. The aim of this study was to investigate influence of a monofilament suture material (nylon) on the intensity of local tissue reaction in experimental conditions, and to compare it with the multifilament suture used in the routine practice of oral surgery (silk). This investigation is a prospective experimental study carried out on Wistar rats. The experiment included 30 animals, in which Black Silk (thickness 4-1) and Nylon (thickness 4-0) were applied in the upper and lower jaw, respectively. To monitor tissue reaction on different suture materials the following parameters were used: coagulum formation, presence of polymorphonuclear leukocytes, presence of macrophages and granuloma, formation of epithelial bridge and connective tissue, collagen synthesis, granulomatous tissue formation and presence of fibrous tissue. After comparing parameters for the intensity of tissue reaction to the investigate suture materials by suturing the oral mucosa, certain advantage could be given to the monofilament suture materials.Istorijski gledano, za zatvaranje i zasivanje hirurskih rana korisceni su najrazlicitiji savni materijali. U strucnoj medicinskoj literaturi opisane su cetiri osnovne karakteristike savnog materijala: sigurnost cvorova, zatezna snaga, tkivna reakcija i sigurnost rane. Tkivna reakcija prikazana je inflamatornom reakcijom koja se, makar i minimalna, javlja tokom prvih dva do sedam dana nakon aplikacije savova u tkivo. Cilj istrazivanja je bio da se ispita uticaj monofilamentnog materijala za sivenje (Nylon) na intenzitet lokalne tkivne reakcije u eksperimentalnim uslovima i uporedi s istovetnim uticajem upredjenog materijala koji se rutinski koristi u oralnoj hirurgiji (svila). Ispitivanje predstavlja prospektivnu eksperimentalnu studiju sprovedenu na eksperimentalnim pacovima soja Wistar. Obuhvaceno je 30 zivotinja kod kojih se u gornjoj vilici kao savni materijal koristio Black Sylk debljine 4-0, a u donjoj vilici Nylon debljine 4-0. Za pracenje reakcije tkiva na savni materijal korisceni su sledeci parametri: formiranje koaguluma, polimorfonuklearni leukociti, makrofagi, granulom, formiranje epitelnog mosta, formiranje vezivnog tkiva, sinteza kolagena, granulaciono tkivo, fibrozno tkivo. Komparirajuci parametre intenziteta tkivne reakcije ispitivanih materijala, nakon suturiranja sluzokoze usne supljine, mogla bi se dati izvesna prednost sintetskim monofilamentnim savnim materijalima.