The effect of saliva and oral intake on the tensile properties of sutures - An experimental study

Division of Plastic Surgery, University of Kentucky College of Medicine, Lexington, KY 40536-0284, USA.
Annals of Plastic Surgery (Impact Factor: 1.49). 04/2007; 58(3):268-72. DOI: 10.1097/
Source: PubMed


The plastic surgeon often operates in the oral cavity. Little or no information exists regarding the effect of saliva and oral intake upon the tensile properties of suture. Polyglactin 910 (Vicryl) and chromic gut were studied. Five sutures of each type were subjected to saline, saliva, milk, or soy milk over different durations of exposure. Suture breaking strength was tested. A 4-way interaction between suture type, size, liquid, and time was significant (P = 0.0046). Sutures soaked in saliva were significantly weaker. No significant difference was observed between sutures soaked in milk or soy. Saliva appears to enhance degradation rates in both sutures. Suture selection in the oral cavity should be predicated upon the demands of the repair and surgeon's preference. Postoperative feeding instructions should limit tension across mucosal repairs, but the selection of formula should be based upon nutritional requirements and preferences of the child rather than concern over suture degradation.

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    • "The present study is in agreement with study carried out in vitro [8] and shows a reduction in the tensile strength of PG sutures under simulated oral conditions; however, that study evaluated the tensile strength for a period of 35 days. In another study [20], PGC demonstrated a decrease in tensile strength from baseline until two weeks, which was in agreement with the present study. "
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    ABSTRACT: The purpose of this study was to evaluate the tensile strength of surgical synthetic absorbable sutures over a period of 14 days under simulated oral conditions. Three suture materials (polyglycolic acid [PGA], polyglactin [PG] 910, and poly (glycolide-co-є-caprolactone) [PGC]) were used in 4-0 and 5-0 gauges. 210 suture samples (35 of each material and gauge) were used. All of the samples were tested preimmersion and 1 hour and 1, 3, 7, 10, and 14 days postimmersion. The tensile strength of each suture material and gauge was assessed. The point of breakage and the resorption pattern of the sutures were also assessed. During the first 24 hours of immersion, all 4-0 and 5-0 samples of PGA, PG 910, and PGC maintained their initial tensile strength. At baseline (preimmersion), there was a statistically significant (P<0.001) difference in the tensile strengths between the 4-0 and 5-0 gauge of PGA, PG 910, and PGC. PGA 4-0 showed the highest tensile strength until day 10. At 7 days, all the 4-0 sutures of the three materials had maintained their tensile strength with PGA 4-0 having significantly greater (P=0.003) tensile strength compared to PG. 4-0 sutures are stronger and have greater tensile strength than 5-0 sutures. The PGA 4-0 suture showed the highest tensile strength at the end of day 10.
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    ABSTRACT: Among biomaterials used as implants in human body, sutures constitute the largest groups of materials having a huge market exceeding $1.3 billion annually. Sutures are the most widely used materials in wound closure and have been in use for many centuries. With the development of the synthetic absorbable polymer, poly(glycolic acid) (PGA) in the early 1970s, a new chapter has opened on absorbable polymeric sutures that got unprecedented commercial successes. Although several comparative evaluations of suture materials have been published, there were no serious attempts of late on a comprehensive review of production, properties, biodegradability, and performance of suture materials. This review proposes to bring to focus scattered data on chemistry, properties, biodegradability, and performance of absorbable polymeric sutures.
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