title: Bacterial adhesion to suture material in a contaminated wound model: Comparison of monofilament, braided, and barbed sutures.
abstract: Contaminated suture material plays an important role in the physiopathology of surgical site infections. Recently, suture material has been developed characterized by barbs projecting from a monofilament base. Claimed advantages for barbed sutures are a shortened wound closure time and reduced maximum wound tension. It has also been suggested that these sutures would be advantageous microbiologically. The aim of this study was to test the microbiological characteristics of the barbed Quill in comparison to the monofilament Ethilon II and the braided sutures Vicryl and triclosan-coated Vicryl Plus. In our study, sutures were cultivated on color-change agar with Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecium, Escherichia coli, and Pseudomonas aeruginosa and the halo size was measured. In a second study arm with longer cultivation bacterial growth was followed by antibiotic treatment. Ethilon II and Quill showed good comparable results, whereas large halos were found around Vicryl. Vicryl Plus results depended on triclosan sensitivity. After longer bacterial cultivation and antibiotic treatment, halos were up to 3.6 times smaller on Quill than on Vicryl (p < 0.001), but 1.4 times larger than on Ethilon II (p < 0.001) regarding S. aureus. Confocal microscopy analysis showed bacterial colonization between the braided filaments on Vicryl and beneath the barbs on Quill. From a microbiological perspective, barbed sutures can be recommended in aseptic surgery, but should only be used carefully in septic surgery. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:925-933, 2017.
authors.affiliation: Medical Faculty of the University of Tübingen, D-72076 Tübingen, Germany.
authors.forename: Jonas
authors.initials: J
authors.lastname: Dhom
authors.affiliation: Cellular and Molecular Microbiology Division, Interfaculty Institute of Microbiology and Infection Medicine, University of Tübingen, D-72076 Tübingen, Germany.|German Center for Infection Research, Partner site Tübingen, D-72076 Tübingen, Germany.
authors.forename: Dominik A
authors.initials: DA
authors.lastname: Bloes
authors.affiliation: Cellular and Molecular Microbiology Division, Interfaculty Institute of Microbiology and Infection Medicine, University of Tübingen, D-72076 Tübingen, Germany.|German Center for Infection Research, Partner site Tübingen, D-72076 Tübingen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Peschel
authors.affiliation: Department of Orthopaedic Surgery, University Hospital of Tübingen, D-72076 Tübingen, Germany.
authors.forename: Ulf K
authors.initials: UK
authors.lastname: Hofmann
mesh_terms: D000362:Agar / Q000737:chemistry; D001422:Bacterial Adhesion; D018441:Biofilms; D016984:Enterococcus faecium; D004926:Escherichia coli; D018613:Microscopy, Confocal; D011098:Polyglactin 910 / Q000737:chemistry; D011550:Pseudomonas aeruginosa; D013203:Staphylococcal Infections / Q000382:microbiology*; D013211:Staphylococcus aureus; D013212:Staphylococcus epidermidis; D013530:Surgical Wound Infection / Q000382:microbiology*; D013536:Suture Techniques; D013537:Sutures; D014260:Triclosan / Q000737:chemistry; D014945:Wound Healing
chemical_list: D011098:Polyglactin 910; D014260:Triclosan; D000362:Agar
keywords: barbed suture; biofilm; surgical site infection; suture; wound closure