Comparison between tensile characteristics of various suture materials with two suture techniques: an in vitro study
Clinical Oral Investigations. 2021;25(11):6393-6401.
ABSTRACT
Objective: The first objective of the present study was to evaluate the tensile strength and elongation to failure of commonly used suture materials in oral surgery. As a secondary objective, it was aimed to make a comparison between two different suture techniques within the same suture materials.
Materials and methods: Eight different suture materials with 3-0 gauge (silk, polytetrafluoroethylene, polypropylene, polyester, polyglactin 910, polyglycolic acid, poliglecaprone 25, polydioxanone) underwent tensile testing for maximum load of failure and elongation rate. All strands were tied by one investigator on the experimental platform using the surgeon's knot plus additional square knots in both simple suture and horizontal mattress suture techniques. Prepared specimens were examined using a microtensile testing device before (baseline) and after 3, 7, and 14 days' immersion in artificial saliva.
Results: Statistical analysis of the current study revealed that the tensile strength for polyglycolic acid, polyglactin 910, polypropylene, and silk sutures was significantly lower at day 3 than at the baseline. By day 14, polyglycolic acid and polyglactin 910 showed a significant reduction in tensile strength for both techniques. While polydioxanone obtained the highest tensile strength and elongation values in both techniques, polytetrafluoroethylene showed the most stable tensile strength even with the lowest value. Tensile strength in simple suture techniques was almost twice than that of horizontal mattress suture technique for each specimen.
Conclusions: Polyglycolic acid and polyglactin 910 were considerably sensitive to immersion time. Polydioxanone demonstrated optimum performance during each immersion period among the tested materials, whereas polytetrafluoroethylene was the most stable.
Clinical relevance: The selection of the most proper suture material remains challenging for clinicians. The present study provides relevant information for clinicians to guide them in their choice of the suitable material. In this context, clinicians can benefit from the use of polydioxanone for its high tensile strength regardless of the suture technique used, whereas polytetrafluoroethylene shows a long-term stability. The strength and stability differences among suture materials and techniques need to be considered before making an informed decision.
KEYWORDS
Sutures · Suture techniques · Wound healings · Materials testing · Artificial saliva
STUDY SUMMARY
This in vitro study measured the tensile strength and elongation to failure of eight suture materials tied with two suturing techniques, testing specimens at baseline and after three, seven and fourteen days in artificial saliva. Polyglycolic acid and polyglactin 910 lost tensile strength markedly with immersion time, polydioxanone gave the highest strength and elongation with both techniques, and polytetrafluoroethylene was the most stable despite its lower values. Tensile strength with the simple suture technique was approximately twice that of the horizontal mattress technique for each material.