Abstract
BackgroundGlycomer 631 and lactomer 9–1 are absorbable suture materials indicated for soft tissue approximation in non-infected wounds. Pigs are often used as surgical models in translational research; however, reports of tissue reactions to both suture materials in pigs are limited. The aim of this study was to assess clinical and histologic responses of skin incisions closed with a subcuticular technique using glycomer 631 and lactomer 9–1 in pigs.ResultsSkin incisions on 17 pigs were closed with glycomer 631 and lactomer 9–1, and a clinical reactive score (CRS) including erythema, swelling, discharge and dehiscence was calculated on postoperative days 7 and 14. Subcuticular tissue reaction was assessed histologically on postoperative day 14 (the presence of extravascular neutrophils, macrophages, multinucleated giant cells, lymphocytes, fibroblasts, bacterial colonies and the overall severity of the inflammatory response to the suture material), and the cumulative score of the variables was calculated as an aggregate tissue irritation score (ATIS). Tissue samples were examined for suture extrusion and evaluated microbiologically. The clinical reactive score did not differ between the suture materials. Only one ATIS variable, namely the overall severity of the inflammatory response, was lower (p = 0.029) when glycomer 631 was used. Suture extrusion was found in 10/17 of the incisions closed by glycomer 631 and in 7/13 of the incisions closed by lactomer 9–1. Trueperella pyogenes was isolated from the skin and from the area of tissue reaction in six pigs.ConclusionsNo difference in CRS between the suture materials was observed, and thus both materials may be used for the subcuticular technique in pigs. Glycomer 631 induced less tissue reaction only in terms of the overall severity of the inflammatory response. Suture extrusion was observed in more than 50% of incisions regardless of the suture material, possibly due to a large amount of suture material in the wound. Trueperella pyogenes was the only pathogen isolated from the tissue surrounding the suture material.
Highlights
Glycomer 631 and lactomer 9–1 are absorbable suture materials indicated for soft tissue approximation in non-infected wounds
Scar formation is decreased, and better cosmetic appearance of the skin closure was noted in dogs 10 to 14 days after ovariohysterectomy when compared to a single interrupted suture pattern [5]
Histopathologic evaluation The dermal tissue reaction in all samples included a variably wide zone of granulation tissue rich with collagen and was infiltrated predominantly with macrophages and less numerous lymphocytes, which extended from the epidermis into the subcutis
Summary
Glycomer 631 and lactomer 9–1 are absorbable suture materials indicated for soft tissue approximation in non-infected wounds. Primary wound closure is accomplished through subcutaneous tissue apposition followed by either cutaneous or buried subcuticular suture placement [1]. Cutaneous sutures with non-absorbable suture materials are easy to perform and provide excellent apposition of wound edges. The buried continuous subcuticular suture pattern with absorbable suture material provides exceptional skin edge apposition, which promotes rapid epithelization in dogs [3] and does not increase the degree of inflammation in noncontaminated wounds in rats [4]. Scar formation is decreased, and better cosmetic appearance of the skin closure was noted in dogs 10 to 14 days after ovariohysterectomy when compared to a single interrupted suture pattern [5]. There is no need for suture removal [6], and the risk for selfinduced trauma is reduced due to the absence of protruding material for the animal to scratch or lick [3]
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