title: Bacteria adhere less to barbed monofilament than braided sutures in a contaminated wound model.
abstract: BACKGROUND
  Previous studies have found fewer clinical infections in wounds closed with monofilament suture compared with braided suture. Recently, barbed monofilament sutures have shown improved strength and increased timesavings over interrupted braided sutures. However, the adherence of bacteria to barbed monofilament sutures and other commonly used suture materials is unclear.
  
  
  OBJECTIVE
  We therefore determined: (1) the adherence of bacteria to five suture types including a barbed monofilament suture; (2) the ability to culture bacteria after gentle washing of each suture type; and (3) the pattern of bacterial adherence.
  
  
  METHODS
  We created an experimental contaminated wound model using planktonic methicillin-resistant Staphylococcus aureus (MRSA). Five types of commonly used suture material were used: Vicryl™, Vicryl™ Plus, PDS™, PDS™ Plus, and Quill™. To determine adherence, we determined the number of bacteria removed from the suture by sequential washes. Sutures were plated to determine bacterial growth. Sutures were examined under confocal microscopy to determine adherence patterns.
  
  
  RESULTS
  The barbed monofilament suture showed the least bacterial adherence of any suture material tested. Inoculated monofilament and barbed monofilament sutures placed on agar plates had less bacterial growth than braided suture, whereas antibacterial monofilament and braided sutures showed no growth. Confocal microscopy showed more adherence to braided suture than to the barbed monofilament or monofilament sutures.
  
  
  CONCLUSIONS
  Barbed monofilament suture showed similar bacterial adherence properties to standard monofilament suture.
  
  
  CONCLUSIONS
  Our findings suggest barbed monofilament suture can be substituted for monofilament suture, at the surgeon's discretion, without fear of increased risk of infection.
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Kaufmann Medical Building, Suite 1010, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA. johnfowler10@gmail.com
authors.forename: John R
authors.initials: JR
authors.lastname: Fowler
authors.forename: Tiffany A
authors.initials: TA
authors.lastname: Perkins
authors.forename: Bettina A
authors.initials: BA
authors.lastname: Buttaro
authors.forename: Allan L
authors.initials: AL
authors.lastname: Truant
mesh_terms: D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus; D013203:Staphylococcal Infections / Q000382:microbiology*; D013530:Surgical Wound Infection / Q000382:microbiology*; D013537:Sutures / Q000382:microbiology*