29 November 2021

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The suture in oral surgery: four different suture materials compared

Lara Figini

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Sutures are the most commonly used medical device for wound closure. The main purpose of the suture is to control bleeding in the immediate post-surgery, and to support the tissue until the soft tissue closes and heals, reducing contamination from foreign bodies.
In contemporary oral surgery, good primary healing, achieved through the use of adequate sutures as well as adequate intraoperative soft tissue manipulation, is now considered an absolute imperative to achieve optimal long-term functional and aesthetic results. But what is the best suture?

Materials and Methods
In a clinical study, published in the Clincal Oral Investigation of April 2020, the authors compared four different suture materials, investigating their influence on wound healing, microbial adhesion, tissue reaction and other relevant clinical parameters.

A total of 32 patients undergoing surgical extraction of four third molars were considered in this study. Clinical parameters were evaluated during the intervention and during the follow-up visits. The quality of soft tissue healing around the sutures was assessed on day 3 and day 7 after surgery. Microbial colonization was examined by qPCR. A histological analysis was also conducted to evaluate the inflammatory reaction of the tissues around the sutures.

Results
Significantly better soft tissue healing was found around monofilament sutures and synthetic sutures compared to multifilament and natural sutures. Soft tissue healing was significantly better in all sutures on day 7 compared to day 3 after surgery.

Conclusions
From the data emerging from this study, which must be confirmed in other similar studies, it can be concluded that the non-resorbable polypropylene suture has superior clinical characteristics among all sutures. Around this type of suture there is improved soft tissue healing and minimal inflammatory reaction. The worst soft tissue healing occurs around non-absorbable silk sutures. This suture elicits the most intense inflammatory reaction, showing the greatest bacterial adhesion compared to alternative sutures.

For additional information: Comparison of four different suture materials in respect to oral wound healing, microbial colonization, tissue reaction and clinical features-randomized clinical study.