Systematic review and meta-analysis of surgical suture strength according to the type, structure and geometry of suture materials

Abstract

Purpose: As a rule, wound healing is a natural and spontaneous process. However, in acute or surgical wounds, the wound edges need to be approximated and held together by artificial means. Surgery within the abdominal cavity or elsewhere almost always involves cutting through the skin, after which a medical procedure is conducted, followed by wound closure. The suture provides temporary mechanical support during the natural healing process of the affected tissues. Not only does it stimulate the primary wound healing, but also provides mechanical protection against wound dehiscence. Methods: This analysis is intended to juxtapose the basic factors that contribute to a change in suture strength and the possible failure of surgical sutures, which may affect the wound healing process and increase the risk of postoperative complications. Results: The preliminary search criteria used in the databases included keywords such as: “strength of suture materials”, “strength of surgical sutures”, “surgical knot strength”. Five key articles were ultimately selected from a pool of 336 articles first identified based on these search criteria. Next, a meta-analysis of the literature data was performed, taking into account factors such as the type of suture materials used, biological conditions and model conditions used in research, having a significant impact on the mechanical properties of surgical sutures. Conclusions: This comparison revealed considerable variations in the suture strength between different sutures of the same size, it also demonstrated that the decrease in suture strength strongly depends on the finished suture and the thread type.