title: Bacterial adherence to suture materials.
abstract: BACKGROUND
  Wound infections may be problematic for physicians. Whether a practitioner is managing complex penetrating trauma or a skin biopsy, there may be a need for suture closure. Suture material is an operator dependent variable and while little objective data exist to guide the choice of suture, it may play a role in wound infection. This study evaluates bacterial adherence to commonly used suture materials with a bioluminescent in vitro model.
  
  
  METHODS
  In all, 11 strands of size 2-0 poliglecaprone suture (Monocryl; Ethicon, Inc, Somerville, New Jersey), polypropylene suture (Prolene; Ethicon, Inc), silk suture (Ethicon, Inc), polyglycolic acid suture (Vicryl; Ethicon, Inc), and antimicrobial polyglycolic acid suture treated with triclosan (VicrylPlus; Ethicon, Inc) were immersed in a broth of Staphylococcus aureus engineered to emit photons. After biofilm formation, the suture strands were irrigated and imaged with a photon-capturing camera system yielding a total photon count that correlates with residual bacteria.
  
  
  RESULTS
  The Vicryl suture had the highest counts and was statistically significant in bacterial adherence versus all other sutures. No other suture material was significantly different from any other.
  
  
  CONCLUSIONS
  This study gives data to guide the selection of suture materials. Absorbable braided suture should not be used in closure of contaminated wounds or wounds at risk for developing infection. The antibiotic impregnated absorbable braided suture was similar to the other suture types; however, it is at risk for reverting to the properties of its untreated counterpart over time. The bacterial adherence of suture materials should be taken into account by all practitioners when closing wounds or debriding infected wounds.
authors.affiliation: Department of Orthopaedics and Rehabilitation, Brooke Army Medical Center, Ft Sam Houston, Texas 78234, USA. Brendan.Masini@amedd.army.mil
authors.forename: Brendan D
authors.initials: BD
authors.lastname: Masini
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Stinner
authors.forename: Scott M
authors.initials: SM
authors.lastname: Waterman
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Wenke
mesh_terms: D000704:Analysis of Variance; D001422:Bacterial Adhesion; D018441:Biofilms; D003470:Culture Media; D004146:Dioxanes / Q000494:pharmacology*; D004866:Equipment Contamination; D006801:Humans; D008422:Materials Testing; D011091:Polyesters / Q000494:pharmacology*; D011126:Polypropylenes / Q000494:pharmacology; D011322:Primary Prevention / Q000379:methods; D018570:Risk Assessment; D013211:Staphylococcus aureus / Q000502:physiology*; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control; D013537:Sutures / Q000009:adverse effects / Q000382:microbiology*
chemical_list: D003470:Culture Media; D004146:Dioxanes; D011091:Polyesters; D011126:Polypropylenes; C095495:glycolide E-caprolactone copolymer