Effect of different suture materials on cartilage reshaping.
BACKGROUND
Suturing techniques are one of the most commonly used means to reshape the nasal cartilage; however, no data exist regarding the optimal suture material and its long-term effect.


OBJECTIVE
The aim of the present study was to determine whether any absorbable materials will provide the same long-lasting effect on cartilage reshaping as permanent materials.


METHODS
Thirty-six New Zealand white rabbits were divided into three groups of 12. A 3 mm x 4 mm cartilaginous fold was created on a 5 mm x 10 mm in situ strip of cartilage on the posteromedial surface of each ear with different suture materials to simulate transdomal sutures. Nylon was used as a control suture material on the right ear of every rabbit, while plain catgut, monocryl, or polydioxanone (PDS) was used on the left ear, depending on the study group. At the end of 3 months, the folds were harvested and their dimensions and histology were compared.


RESULTS
The cartilaginous folds were graded on a scale of 1 to 4 based on the final fold height measurement. The mean grades were 3.51 for nylon, 3.50 for PDS, 2.08 for monocryl, and 1.83 for plain catgut. Nylon provided a significantly better fold grade compared to monocryl and plain catgut (P < .05 for both groups), whereas there was no difference between the fold created with nylon and PDS (P > .05). Among the pathologic factors examined, only the amount of adipose tissue between the fold correlates with a higher fold grade (P < .05).


CONCLUSIONS
Cartilaginous folds created using PDS are comparable to those created using nylon and are significantly better than monocryl and plain catgut materials. On this animal model, it appears that permanent suture material is not required to maintain a long lasting cartilaginous fold as long as the suture material holds the fold in shape for a certain period of time.
Iamphongsai
Seree
S
Department of Plastic Surgery, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA. iamphongsai@yahoo.com
Eshraghi
Yashar
Y
Totonchi
Ali
A
Midler
John
J
Abdul-Karim
Fadi W
FW
Guyuron
Bahman
B
D000818:Animals; D002398:Catgut; D004146:Dioxanes; D004425:Ear Cartilage / Q000601:surgery*; D016014:Linear Models; D009757:Nylons; D016687:Polydioxanone; D011091:Polyesters; D011817:Rabbits; D012107:Research Design; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome
D004146:Dioxanes; D009757:Nylons; D011091:Polyesters; D016687:Polydioxanone; C095495:glycolide E-caprolactone copolymer