Sutures need to retain adequate tensile strength during key phases of anastomotic healing, and have a minimal local inflammatory response.
- This study found that that some absorbable sutures lost strength too rapidly. However polydioxanone (PDS) had comparable strength to non-absorbable sutures.
- Multifilament (braided) materials (silk in this study, which did not include Polyglactin 910/Vicryl) were found to produce a prolonged tissue response and harbour bacterial colonisation (image above).
- Monofilament materials were least reactive and appeared least likely to delay healing (image below).
This study concluded that polydioxanone (PDS) sutures possessed the most desirable properties for anastomotic healing:
- monofilament
- little histologic reaction
- slowly absorbable with long preservation of strength
- low adherence of bacteria to the material
Related paper: Assessment of sutures for use in colonic surgery: an experimental study
Related paper: Polydioxanone in digestive surgery an experimental study
