Clinical and biomechanical analyses to select a suture material for uvulopalatopharyngeal surgery.
OBJECTIVE
The selection of the degradation pattern of suture materials is critical in uvulopalatopharyngeal surgery because of the complex oral environment such as the constant presence of saliva; the microbial accumulation; and the functions related to speech, mastication, and swallowing. The aim of the study was to identify appropriate suture materials for uvulopalatopharyngeal surgery by analyzing the clinical and biomechanical results obtained using four different absorbable suture materials.


METHODS
A randomized open-label trial.


METHODS
Tertiary referral center.


METHODS
Eighty patients with obstructive sleep apnea syndrome who had undergone microdebrider-assisted extended uvulopalatoplasty were randomized into the four suture groups: sutures of polyglycolide (Dexon) and copolymers of polyglycolide and other degradable polymers (Polysorb, Monocryl, Maxon). Handling characteristics, surgical outcomes, Young's modulus reduction, morphologic changes by scanning electron microscope, and saliva absorption test were analyzed.


RESULTS
Monocryl (poly(glycolide-co-ε-caprolactone)) had the optimal handling characteristics and exhibited two-stage degradation: sufficient tensile strength was maintained initially to allow wound healing, and then the suture degraded rapidly to avoid irritation. In contrast, the hydrolytic degradation of Dexon, Polysorb, and Maxon seemed to involve only an approximately single-stage process in the oral environment. Moreover, a large amount of debris was observed among filaments in Dexon and Polysorb, whereas only some scattered debris accumulated on Monocryl and Maxon under scanning electron microscope.


CONCLUSIONS
Poly(glycolide-co-ε-caprolactone) has good handling characteristics and degrades in two stages. It is a suitable suture material for uvulopalatopharyngeal surgery.
Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.
Tsung-Wei
TW
Huang
Po-Wen
PW
Cheng
Yen-Hui
YH
Chan
Chi-Te
CT
Wang
Kai-Min
KM
Fang
Tai-Horng
TH
Young
D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D008297:Male; D008422:Materials Testing / Q000379:methods*; D008855:Microscopy, Electron, Scanning; D019647:Oral Surgical Procedures / Q000379:methods; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D011100:Polyglycolic Acid / Q000032:analysis*; D011108:Polymers / Q000032:analysis*; D011446:Prospective Studies; D015203:Reproducibility of Results; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures
D011108:Polymers; D011100:Polyglycolic Acid; C046409:polyglyconate