The Effect of Suture Size on Skin Wound Healing Strength in Rats

It is known that sutures enhance wound closure and promote healing. Sutures initially provide the mechanical strength to seal the wound and protect it from pathogens. Previous studies of suture mechanics focused on the material strength or knotting methods in vitro. Only a few studies have investigated the correlation between the healing strength of wounds and suturing. The purpose of this study was to investigate how the size of 4-0 and 6-0 nylon sutures affect the healing skin strength in rats. The temporal tensile breaking strength and normalized recovery index were measured by tensile testing. The histology observations were also obtained for structural correlation. Our results find that the mechanical strengths of both 4-0 and 6-0 groups do not have a statistical difference in the first two weeks. After four weeks, however, the breaking strengths of healing skin from the thicker 4-0 suture group are higher than the thinner 6-0 suture group. Histological observation showed more inflammatory cells in the 6-0 group than in the 4-0 group in the first week. These results reveal that small sutures can prolong healing time. The histological results are consistent with this finding, which demonstrated more inflammatory cells and extension of the inflammation phase.

[1]  T. Gibson,et al.  Physical properties of skin. , 1969, Journal of anatomy.

[2]  M. Mokry,et al.  Early changes in the tensile strength and morphology of primary sutured skin wounds in rats. , 2006, Folia biologica.

[3]  A. Singh,et al.  Simplified method of skin closure with a knot-free absorbable subcuticular suture. , 2005, Annals of the Royal College of Surgeons of England.

[4]  B. Sumpio,et al.  Enhanced production of endothelium-derived contracting factor by endothelial cells subjected to pulsatile stretch. , 1990, Surgery.

[5]  Francesca Lombardi,et al.  In vitro mechanical compression induces apoptosis and regulates cytokines release in hypertrophic scars , 2003, Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society.

[6]  R. Guidoin,et al.  Development of In Vitro Performance Tests and Evaluation of Nonabsorbable Monofilament Sutures for Cardiovascular Surgery , 1998, ASAIO journal.

[7]  S. Levenson,et al.  The Healing of Rat Skin Wounds , 1965, Annals of surgery.

[8]  小熊 潤也,et al.  Knot-tying force during suturing and wound healing in the gastrointestinal tract , 2007 .

[9]  G. Piérard,et al.  Skin tensile strength modulation by compressive garments in burn patients. A pilot study. , 2000, Journal of medical engineering & technology.

[10]  C. Powell.  Wound healing: Relationship of wound closing tension to tensile strength in rats , 1990 .

[11]  F. Su,et al.  Mechanical Evaluation of the Influence of Different Suture Methods on Temporal Skin Healing , 2009, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[12]  P. Gál,et al.  Simple Interrupted Percutaneous Suture versus Intradermal Running Suture for Wound Tensile Strength Measurement in Rats: A Technical Note , 2009, European Surgical Research.