Briddell JW, et al. - Researchers aimed at quantifying the association of increased loss of strength of sutures over time after exposure to artificial saliva (hereinafter referred to as “saliva”). Findings demonstrate that all types of sutures—natural or synthetic and monofilament or braided—undergo more rapid degradation in the presence of saliva. Data revealed a greater association of saliva with the degradation of chromic sutures compared with polyglactin 910 sutures. They recommend considering this information while selecting sutures for oropharyngeal procedures in order to ensure that the suture will retain its strength and degrade at an appropriate rate to allow the effective healing of the wound.

Methods

• Researchers conducted an experimental in vitro study at Bucknell University (Lewisburg, Pennsylvania) from June 19, 2015, to July 4, 2015.
• This study involved no participants.
• They compared the loss of strength over time of sutures submerged in physiological saline and artificial saliva solutions.
• They tested 3 types of absorbable sutures commonly used in oral surgery: chromic, poliglecaprone 25, and polyglactin 910.
• From July 15, 2016, to August 16, 2016, they performed data analysis.
• For this study, 50% strength reduction was assessed as the primary outcome measure.
• They measured breaking strength via pulling 6 knotted sutures of each type to failure at regular time intervals after immersion in either saline or synthetic saliva at 37°C.
• Using regression analysis, they interpreted strength degradation profiles and estimated the time to reach 50% of the original breaking strength.

Results

• All the 3 suture types degraded to 50% strength faster (by 2 to 13 days) in saliva than in saline.
• Variation in the differences in the degradation profiles by suture type was noted.
• In both solutions, poliglecaprone 25 sutures displayed a sudden decrease in failure strength between day 5 and day 8; however, the decrease was greater in saliva (–10.2 N; 95% CI, –15.5 to –4.9 N) than in saline (–6.1 N; 95% CI, –11.2 to –0.9 N).
• A similar degradation profile was evident for the polyglactin 910 and chromic sutures when implanted in tissue; however, saliva was associated with more degradation of chromic sutures.
• Polyglactin 910 sutures showed differences in degradation rate after day 6 (saline: –0.9 N/d; 95% CI, –1.0 to –0.7 vs saliva: –1.2 N/d; 95% CI, –1.4 to –1.1).
• For chromic sutures, a degradation rate of –0.3 N/d was recorded (95% CI, –0.5 to –0.2) in saline and –0.5 N/d (95% CI, –0.6 to –0.3) in saliva after day 2.