Abstract
The success of surgical procedures is strictly related to the biomechanical properties of the suture. Mechanical comparisons are scarcely reported in the literature, so the purpose of the present study was to evaluate and compare the mechanical behavior of different sutures commonly used in oral surgery in terms of traction resistance. Sutures made of eight different materials were analyzed: silk (S), polyglycolide-co-caprolactone (PGCL), polypropylene (PP), rapid polyglycolide (rPGA), standard polyglycolide (PGA), polyamide (PA), polyester (PE), and polyvinylidene fluoride (PVDF). For each material, three different sizes were tested: 3-0, 4-0, and 5-0. The breaking force of each suture was assessed with a uniaxial testing machine after being immersed in artificial saliva at 37 °C. The outcomes analyzed were the breaking force, the needle–thread detachment breaking-point and the node response after forward–reverse–forward (FRF) tying when subjected to a tensile force. The 3-0 rPGA provided the maximum resistance, while the lowest value was recorded for the 5-0 PGCL. In general, 3-0 and 4-0 gauges showed non-statistically significant differences in terms of needle–thread detachment. The highest needle–thread detachment was found for the 3-0 PGA, whereas the lowest value was observed for the 5-0 PGCL. After tying the knot with an FRF configuration, the thread that showed the highest resistance to tension was the 3/0 silk, while the thread with the lowest resistance was the 5/0 silk. These data should be considered so that the operator is aware of as many aspects as possible on the behavior of various materials to ensure successful healing.
Highlights
Proper closure and stabilization of wound margins in their desired position are mandatory to obtain successful surgical procedures
The study consisted of eight different types of suture materials (LORCA MARÍN S.A., Murcia, Spain): silk (S), multifilament polyethylene (PE), monofilament polyvinylidene fluoride (PVDF), pseudo-monofilament polyamide (PA), monofilament polypropylene (PP), rapid synthetic multifilament polyglycolic acid, synthetic multifilament polyglycolic acid (PGA), and pseudo-monofilament polyglycolic acid (PGCL)
The highest breaking force (BF) was found for the 3-0 rapid synthetic multifilament polyglycolic acid (rPGA), with a v of 16.81 2.18 N (Figure 2)
Summary
Proper closure and stabilization of wound margins in their desired position are mandatory to obtain successful surgical procedures. Since the dehiscence of the surgical wound is frequently related to suture tension, it is evident that biomechanical properties of the sutures may play a critical role to counteract the physiological tensile forces arising on wound margins. The TS of a suture material is even more important in oral surgery, where, differently from other parts of the body, the constant presence of saliva, and functions related to tongue mobility, speech, mastication, and swallowing, may negatively affect the flap tension. In this matter, a relationship between wound-closing tension and TS was demonstrated. To the best of our knowledge, only a few studies have compared the TS of different suture materials under simulated oral conditions for clinical applications in dentistry
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