In-vitro antimicrobial evaluation of 4 different sutures, using DCT assays

Background: Suturing maintains the flap in the desired position until healing. However, the suture can allow bacteria from the oral cavity to penetrate to the deeper areas, interrupting wound healing.

Objective: To evaluate in vitro the antimicrobial effect of resorbable and non resorbable braided and monofilament sutures.

Materials and Methods: The direct contact test (DCT) was used to evaluate the antibacterial properties of 2 absorbable sutures: braided Vicryl plus (coated polyglactin 910 with triclosan) and monofilament Plain gut, and 2 non-absorbable braided sutures: Polyviolene, and Silk. The sutures were tested in contact with three bacteria: Staphylococcus Epidermidis, Staphylococcus Aureus and Pseudomonas Aeruginosa, in three different time spans: immediately after placing, 2 and 7 days after aging in Phosphate Buffered Saline (PBS).

Two ways ANOVA, One way ANOVA and Tukey multiple comparison procedures were applied on the results.

Results: Vicryl plus suture exhibited in vitro immediate antibacterial effect in contact with Staphylococcus Epidermidis and Staphylococcus Aureus which lasted for 2 and 7 days following soaking in PBS. However, when incubated with Pseudomonas Aeruginosa there was some antimicrobial activity causing delayed bacterial growth only immediately after placing. Polyviolene and Silk in contact with all tested bacteria had no apparent antibacterial effect and bacterial growth was similar to the control. Plain gut suture showed bacterial growth enhancement during the first 2 days after placement.

Conclusions: The in vitro antimicrobial characteristics of the Vicryl plus suture, as measured by the DCT, may be beneficial in preventing in vivo bacterial colonization on the suture and reducing the probability of wound area infection.