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García-González S, Aboul-Hosn Centenero S, Baumann P, Fita-Esteban I, Hernández-Alfaro F, Weyer N. Prospective, multi-centric, international, single-arm, cohort study to assess a synthetic polyamide suture material in oral surgery to close the mucosa - MUCODA study. J Dent 2024; 145:104922. [PMID: 38490322 DOI: 10.1016/j.jdent.2024.104922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 02/27/2024] [Accepted: 03/01/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVES The aim was to collect different clinical parameters systematically and proactively regarding safety, effectiveness, and performance of a nylon monofilament suture under routine clinical practice for oral surgery. METHODS The study design was prospective, bicentric, international, single-armed, and observational. A non-absorbable suture was applied to close the mucosa after different dental surgical interventions. Main objective was the incidence of combined postoperative complications until suture removal. The 95 % Confidence Interval (Agresti-Coull method) was used to prove the non-inferiority with a pre-specified upper margin of 21.9 %. Secondary variables were intraoperative suture handling, patient pain and satisfaction, wound healing, aesthetic appearance, and bacterial contamination. RESULTS 105 patients were enrolled. Complication rate was low (1.9 %), 2 swellings occurred. Pain was present for 1.61 days ± 1.42 after various dental interventions with an average pain level of 20.98 ± 22.60 (VAS). Patients with impacted third molar extraction showed the longest pain duration (6 days) combined with the highest mean pain level of 35.33 ± 30.45 (VAS). Intraoperative suture handling was very good to excellent. Suture removal was done after an average duration of 7.56 ± 2.09 days. Patient's satisfaction was high, and an excellent wound healing was reported by the dentists. Aesthetic appearance only performed in implant patients was rated by oral surgeons with an average of 96.19 ± 3.79 points [min. 80 - max. 100] at 5 months postoperatively. Thread bacterial analysis showed that F. nucleatum was the most present species. CONCLUSIONS Our findings indicate that the non-absorbable, nylon-based monofilament suture used is safe and quite suitable for oral mucosal closure after various dental surgical interventions such as tooth extraction, implant placement and impacted third molar extraction. CLINICAL SIGNIFICANCE This study showed the safe use of a non-absorbable, nylon-based monofilament suture for different oral surgical interventions under daily routine clinical practice.
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Affiliation(s)
- S García-González
- Department of Oral Surgery, International University of Catalonia, Carrer de Josep Trueta, 08195 Sant Cugat del Vallès, Barcelona, Spain.
| | - S Aboul-Hosn Centenero
- Department of Oral Surgery, International University of Catalonia, Carrer de Josep Trueta, 08195 Sant Cugat del Vallès, Barcelona, Spain
| | - P Baumann
- Department of Medical Scientific Affairs, Aesculap AG, Am Aesculap Platz 78532 Tuttlingen, Germany
| | - I Fita-Esteban
- Department of Medical Scientific Affairs, B. Braun Surgical, S.A.U., Carretera de Terrassa 121 08191 Rubí, Barcelona, Spain
| | - F Hernández-Alfaro
- Department of Oral Surgery, International University of Catalonia, Carrer de Josep Trueta, 08195 Sant Cugat del Vallès, Barcelona, Spain
| | - N Weyer
- Praxisklinik für MKG, Ästhetische und Plastische Chirurgie, Schwerpunkt Implantologie, Fabrikstraße 10/1, 73728 Esslingen am Neckar, Germany
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Tatalović V, Marinković M, Perić R, Belopavlović R. Absorbable vs. non-absorbable suture: which one gives better results? Ir J Med Sci 2024:10.1007/s11845-024-03710-9. [PMID: 38771464 DOI: 10.1007/s11845-024-03710-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 05/08/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND There is no ideal suture material or ideal sewing technique. The type of suture material affects the quality of the scars. Patient and surgeon satisfaction with the quality and comfort of the scar is one of the main goals of modern surgery. AIMS This study aims to compare the quality of scars and patient satisfaction after using two different types of sutures. METHODS This research was conducted as a prospective study that included 64 patients whose surgical wounds were closed with intradermal suture using different suturing materials according to which the patients were divided into two groups: absorbable - Monocryle (32) and non-absorbable - DemeLENE suture (32). POSAS scale and an ultrasound machine were used to assess the scars. The doctor and the patient evaluated seven parameters on two occasions, after 2 and 6 weeks after the surgery. RESULTS The statistically significant advantage was found after 2 weeks in scars sewn with non-resorptive suture in terms of elasticity, doctor's general impression, pain, itching, color, stiffness, thickness, irregularity, and patient's general impression. After 6 weeks, statistically significantly better results were shown on scars sewn with non-resorptive thread for the parameters doctor's general impression, itching, irregularity, and patient's general impression. CONCLUSIONS Non-resorptive sutures show statistically significantly better results, especially after 2 weeks from the patient's point of view so we consider them more comfortable and convenient to use.
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Affiliation(s)
- Vanja Tatalović
- Clinic for Plastic and Reconstructive Surgery, University Clinical Center of Vojvodina, Novi Sad, Serbia.
- Medical Faculty Novi Sad, University of Novi Sad, Novi Sad, Serbia.
| | - Marija Marinković
- Clinic for Plastic and Reconstructive Surgery, University Clinical Center of Vojvodina, Novi Sad, Serbia
- Medical Faculty Novi Sad, University of Novi Sad, Novi Sad, Serbia
| | - Radmila Perić
- Medical Faculty Novi Sad, University of Novi Sad, Novi Sad, Serbia
- Clinic for Radiology, University Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Radomir Belopavlović
- Department of Psychology, Faculty of Philosophy, University of Novi Sad, Novi Sad, Serbia
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Rashid ME, Alam MK, Akhter K, Abdelghani A, Babkair HA, Sghaireen MG. Comparison of Different Suturing Techniques in Post-Extraction Socket Healing. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S675-S677. [PMID: 38595490 PMCID: PMC11000890 DOI: 10.4103/jpbs.jpbs_937_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 09/27/2023] [Accepted: 10/02/2023] [Indexed: 04/11/2024] Open
Abstract
Background The process of post-extraction socket healing is critical for ensuring proper tissue repair and minimizing complications in dental practice. Suturing techniques play a pivotal role in this process, influencing wound closure, hemostasis, and overall healing. Materials and Methods This prospective clinical trial involved 80 participants who required single-tooth extractions. Patients were randomly assigned to four groups, each receiving a distinct suturing technique: simple interrupted sutures, horizontal mattress sutures, vertical mattress sutures, and continuous sutures. Standardized assessments, including clinical examination and cone-beam computed tomography (CBCT) scans, were performed at baseline, 1 week, and 4 weeks post-extraction. Wound dehiscence, soft tissue healing, and bone preservation were evaluated. Results At 1-week post-extraction, the continuous suture group exhibited the lowest rate of wound dehiscence (5%) compared to other groups (simple interrupted, 15%; horizontal mattress, 10%; vertical mattress, 12%). Soft tissue healing scores at 4 weeks were significantly higher in the continuous suture group (8.7 ± 0.5) than in the other groups (simple interrupted, 7.2 ± 0.8; horizontal mattress, 7.8 ± 0.7; vertical mattress, 7.5 ± 0.6). CBCT analysis revealed superior bone preservation in the continuous suture group (98% remaining bone volume) compared to the other groups (simple interrupted, 92%; horizontal mattress, 95%; vertical mattress, 94%). Conclusion This study demonstrates that the continuous suturing technique offers advantages in post-extraction socket healing, including reduced wound dehiscence, improved soft tissue healing, and better bone preservation.
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Affiliation(s)
- Mohammed Enamur Rashid
- Department of Oral and Maxillofacial Diagnostic Sciences, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia
| | - Mohammad Khursheed Alam
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
- Department of Dental Research Cell, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Chennai, India
- Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, Bangladesh
| | - Khaleda Akhter
- Department of Periodontology and Oral Pathology, Pioneer Dental College and Hospital, University of Dhaka, Bangladesh
| | - Abedalla Abdelghani
- Department of Oral and Maxillofacial Diagnostic Sciences, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia
| | - Hamzah Ali Babkair
- Department of Oral and Maxillofacial Diagnostic Sciences, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia
| | - Mohammed Ghazi Sghaireen
- Department of Prosthetic Dentistry, College of Dentistry, Jouf University, Sakaka, Kingdom of Saudi Arabia
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Krishna S, Bhaskaran R, Kumar SP, Krishnan M, Lakshmanan S. Microbiological Evaluation of Four Different Suture Materials Used for the Surgical Removal of Impacted Lower Third Molars: A Single-Center Prospective Comparative Study. Cureus 2023; 15:e49370. [PMID: 38146549 PMCID: PMC10749685 DOI: 10.7759/cureus.49370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/24/2023] [Indexed: 12/27/2023] Open
Abstract
Introduction Sutures play a crucial role in the postoperative healing process, as they help approximate wound edges, promote hemostasis, and support tissue healing. The oral cavity harbors a diverse microbial population, and oral surgical procedures can introduce potential pathogens into the surgical site. Understanding the impact of suture material on wound infection rates and the colonization of potentially harmful microorganisms is vital for improving patient outcomes. This study was aimed to evaluate and compare the microbiological properties of prolene, vicryl plus, monocryl, and silk sutures used after the surgical removal of impacted lower third molars. Materials and methods A total of 40 patients requiring surgical extraction of impacted lower third molars were assigned to four groups: prolene, vicryl plus, monocryl, and silk sutures. Surgical extraction of impacted tooth was done, and wound was sutured with the abovementioned four different materials in four groups, respectively. After seven days, the sutures were removed and sent to the microbiology lab for colony count assessment. Total microbial colony count, streptococcus count, and lactobacillus count were assessed. Data was analyzed using IBM SPSS Statistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, New York, United States) with p-values less than 0.05 considered as statistically significant. The one-way analysis of variance (ANOVA) and post-hoc Tukey test were done to compare intergroup relations. Results The microbiological evaluation of the sutures revealed significant differences in bacterial colonization among the four groups. More bacterial quantities were found in the silk group followed by the monocryl, vicryl plus, and prolene groups in the descending order. Prolene demonstrated the lowest incidence of bacterial growth (p<0.001) compared to vicryl plus, monocryl, and silk sutures. Bacterial colony count was highest in the silk group. The predominant bacterial species found in all groups were Streptococcus viridans, Staphylococcus aureus, and Lactobacillus. Conclusion It was found that prolene and vicryl plus sutures exhibited superior microbiological properties compared to monocryl and silk sutures when used for the surgical removal of impacted lower third molars. The lower incidence and less quantity of bacterial colonization on prolene sutures suggest their potential for reducing the risk of postoperative infection; hence, these sutures can be preferred for oral surgical procedures.
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Affiliation(s)
- Sai Krishna
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Rajprakash Bhaskaran
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Santhosh P Kumar
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Murugesan Krishnan
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Saravanan Lakshmanan
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Scribante A, Ghizzoni M, Pellegrini M, Poli PP, Maiorana C, Spadari F. Microbiological and Clinical Assessments of Suture Materials and Cyanoacrylate Application in Impacted Third Molar Surgeries: A Scoping Review. J Funct Biomater 2023; 14:529. [PMID: 37888194 PMCID: PMC10607494 DOI: 10.3390/jfb14100529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/10/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
The extraction of impacted third molars is a common but potentially complication-prone oral surgical procedure. Wound healing plays a vital role in preventing complications. This scoping review aimed to assess the clinical and microbiological aspects of various suture materials and cyanoacrylates. Unlike existing studies, we included more articles and comprehensively compared suture materials. Articles published in languages other than English; duplicate studies; studies deemed irrelevant for the specific research questions, including those analyzing different supplementary treatments or not corresponding to the abstract's content; ex vivo or experimental animal studies; studies lacking approval from an ethics committee; and narrative reviews, systematic reviews, or systematic and meta-analysis reviews were excluded. Thus, only 17 studies, published between 2000 and 2023, were included in the search. Suture techniques varied among surgeons, with debates on primary and secondary closure methods. A comparison of different suture materials and their effects on wound healing, infection rates, and other factors was described. Cyanoacrylate has also been used as an alternative to traditional sutures. Microbiological analysis showed varying bacterial adhesion based on the suture material, with silk sutures retaining more microbes than PTFE sutures. Clinical assessments have revealed differing inflammatory responses that affect wound healing and complications. Cyanoacrylate has emerged as a promising alternative to traditional sutures, owing to its rapid polymerization and early healing. However, the choice of suture material in impacted third molar surgery remains controversial, considering microbiological factors and clinical outcomes. More extensive randomized clinical trials are required to better understand the effect of suture materials on surgical outcomes and potential improvements. This study could enhance the safety and effectiveness of this common oral surgical procedure.
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Affiliation(s)
- Andrea Scribante
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Martina Ghizzoni
- Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Matteo Pellegrini
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.P.P.); (C.M.); (F.S.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Pier Paolo Poli
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.P.P.); (C.M.); (F.S.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Carlo Maiorana
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.P.P.); (C.M.); (F.S.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
| | - Francesco Spadari
- Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.P.P.); (C.M.); (F.S.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122 Milan, Italy
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Li Y, Meng Q, Chen S, Ling P, Kuss MA, Duan B, Wu S. Advances, challenges, and prospects for surgical suture materials. Acta Biomater 2023; 168:78-112. [PMID: 37516417 DOI: 10.1016/j.actbio.2023.07.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/07/2023] [Accepted: 07/24/2023] [Indexed: 07/31/2023]
Abstract
As one of the long-established and necessary medical devices, surgical sutures play an essentially important role in the closing and healing of damaged tissues and organs postoperatively. The recent advances in multiple disciplines, like materials science, engineering technology, and biomedicine, have facilitated the generation of various innovative surgical sutures with humanization and multi-functionalization. For instance, the application of numerous absorbable materials is assuredly a marvelous progression in terms of surgical sutures. Moreover, some fantastic results from recent laboratory research cannot be ignored either, ranging from the fiber generation to the suture structure, as well as the suture modification, functionalization, and even intellectualization. In this review, the suture materials, including natural or synthetic polymers, absorbable or non-absorbable polymers, and metal materials, were first introduced, and then their advantages and disadvantages were summarized. Then we introduced and discussed various fiber fabrication strategies for the production of surgical sutures. Noticeably, advanced nanofiber generation strategies were highlighted. This review further summarized a wide and diverse variety of suture structures and further discussed their different features. After that, we covered the advanced design and development of surgical sutures with multiple functionalizations, which mainly included surface coating technologies and direct drug-loading technologies. Meanwhile, the review highlighted some smart and intelligent sutures that can monitor the wound status in a real-time manner and provide on-demand therapies accordingly. Furthermore, some representative commercial sutures were also introduced and summarized. At the end of this review, we discussed the challenges and future prospects in the field of surgical sutures in depth. This review aims to provide a meaningful reference and guidance for the future design and fabrication of innovative surgical sutures. STATEMENT OF SIGNIFICANCE: This review article introduces the recent advances of surgical sutures, including material selection, fiber morphology, suture structure and construction, as well as suture modification, functionalization, and even intellectualization. Importantly, some innovative strategies for the construction of multifunctional sutures with predetermined biological properties are highlighted. Moreover, some important commercial suture products are systematically summarized and compared. This review also discusses the challenges and future prospects of advanced sutures in a deep manner. In all, this review is expected to arouse great interest from a broad group of readers in the fields of multifunctional biomaterials and regenerative medicine.
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Affiliation(s)
- Yiran Li
- College of Textiles & Clothing, Qingdao University, Qingdao, 266071, China
| | - Qi Meng
- College of Textiles & Clothing, Qingdao University, Qingdao, 266071, China
| | - Shaojuan Chen
- College of Textiles & Clothing, Qingdao University, Qingdao, 266071, China
| | - Peixue Ling
- Shandong Academy of Pharmaceutical Science, Jinan, 250101, China
| | - Mitchell A Kuss
- Mary & Dick Holland Regenerative Medicine Program and Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Bin Duan
- Mary & Dick Holland Regenerative Medicine Program and Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Shaohua Wu
- College of Textiles & Clothing, Qingdao University, Qingdao, 266071, China; Shandong Academy of Pharmaceutical Science, Jinan, 250101, China.
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Chen C, Zhang X, Cheng ZQ, Zhang BB, Li X, Wang KX, Dai Y, Wang YL. Comparison of modified gunsight suture technique and traditional interrupted suture in enterostomy closure. World J Gastroenterol 2023; 29:4571-4579. [PMID: 37621751 PMCID: PMC10445006 DOI: 10.3748/wjg.v29.i29.4571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Prophylactic enterostomy surgery is a common surgical approach used to reduce the risk of anastomotic leakage in patients who have undergone partial intestinal resection due to trauma or tumors. However, the traditional interrupted suturing technique used in enterostomy closure surgery has several issues, including longer surgical incisions and higher incision tension, which can increase the risk of postoperative complications. To address these issues, scholars have proposed the use of a "gunsight suture" technique. This technique involves using a gunsight incision instead of a traditional linear incision, leaving a gap in the center for the drainage of blood and fluid to reduce the risk of infection. Building on this technique, we propose an improved gunsight suture technique. A drainage tube is placed at the lowest point of the incision and close the gap in the center of the gunsight suture, which theoretically facilitates early postoperative mobility and reduces the burden of dressing changes, thereby reducing the risk of postoperative complications. AIM To compare the effectiveness of improved gunsight suture technique with traditional interrupted suture in closing intestinal stomas. METHODS In this study, a retrospective, single-center case analysis was conducted on 270 patients who underwent prophylactic ileostomy closure surgery at the Department of Colorectal Surgery of Qilu Hospital from April 2017 to December 2021. The patients were divided into two groups: 135 patients received sutures using the improved gunsight method, while the remaining 135 patients were sutured with the traditional interrupted suture method. We collected data on a variety of parameters, such as operation time, postoperative pain score, body temperature, length of hospital stays, laboratory indicators, incidence of incisional complications, number of wound dressing changes, and hospitalization costs. Non-parametric tests and chi-square tests were utilized for data analysis. RESULTS There were no statistically significant differences in general patient information between the two groups, including the interval between the first surgery and the stoma closure [132 (105, 184) d vs 134 (109, 181) d, P = 0.63], gender ratio (0.64 vs 0.69, P = 0.44), age [62 (52, 68) years vs 60 (52, 68) years, P = 0.33], preoperative body mass index (BMI) [23.83 (21.60, 25.95) kg/m² vs 23.12 (20.94, 25.06) kg/m², P = 0.17]. The incidence of incision infection in the improved gunsight suture group tended to be lower than that in the traditional interrupted suture group [ (n = 2/135, 1.4%) vs (n = 10/135, 7.4%), P < 0.05], and the postoperative hospital stay in the improved gunsight suture group was significantly shorter than that in the traditional interrupted suture group [5 (4, 7) d vs 7 (6, 8) d, P < 0.05]. Additionally, the surgical cost in the modified gunsight suture group was slightly lower than that in the traditional suture group [4840 (4330, 5138) yuan vs 4980 (4726, 5221) yuan, P > 0.05], but there was no significant difference in the total hospitalization cost between the two groups. CONCLUSION In stoma closure surgery, the improved gunsight technique can reduce the incision infection rate, shorten the postoperative hospital stay, reduce wound tension, and provide better wound cosmetic effects compared to traditional interrupted suture.
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Affiliation(s)
- Chang Chen
- Department of Colorectal Surgery, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China
| | - Xiang Zhang
- Department of Colorectal Surgery, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China
| | - Zhi-Qiang Cheng
- Department of Colorectal Surgery, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China
| | - Bin-Bin Zhang
- Department of Nursing, Qilu Hospital of Shandong University De Zhou Hospital, Dezhou 254300, Shandong Province, China
| | - Xin Li
- Department of General Surgery, Huantai Branch of Qilu Hospital of Shandong University, Zibo 255000, Shandong Province, China
| | - Ke-Xin Wang
- Department of Colorectal Surgery, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China
| | - Yong Dai
- Department of Colorectal Surgery, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China
| | - Yan-Lei Wang
- Department of Colorectal Surgery, Qilu Hospital, Shandong University, Jinan 250012, Shandong Province, China
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Zhao J, Zhang Y, Cheng Y, Xie S, Li DD, Zhang PF, Ren XY, Wang X. Effects of modified triangular flap for third molar extraction on distal periodontal health of second molar: A randomized controlled study. Heliyon 2023; 9:e16161. [PMID: 37234672 PMCID: PMC10208835 DOI: 10.1016/j.heliyon.2023.e16161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/26/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Objective The aim of this study was to assess the effect of flap design for impacted mandibular third molar extraction on the distal periodontal tissue of their neighbors clinically, immunologically, and microbiologically. Study design This randomized controlled study comprised 100 patients who were allocated randomly to receive either a triangular flap or a modified triangular flap. The distal periodontal pocket depth, plaque index, bleeding on probing, the presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia, and the level of interleukin-1β, interleukin-8 and matrix metalloproteinase-8 of adjacent second molars were measured at baseline, and 1, 4 and 8 weeks after surgery. Results After 1 and 4 weeks, distal periodontal conditions of adjacent second molars deteriorated, along with an increase in subgingival microbiota and inflammatory factors in both groups. And compared to the modified triangular flap group, the triangular flap group significantly increased (p < 0.05). Prevotella intermedia, interleukin-1β and probing depth were positively correlated in both groups. After 8 weeks, they returned to the preoperative level. Conclusions In this study, both flap designs for impacted mandibular third molar extractions was associated with worse clinical periodontal indices, increased inflammatory biomarkers of gingival crevicular fluid, and more subgingival pathogenic microbiota within 4 weeks. But compared with the triangular flap, the modified triangular flap was better for distal periodontal health of adjacent second molars, which provides certain directions for clinical treatment.
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Affiliation(s)
- Jing Zhao
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Yuan Zhang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Yongfeng Cheng
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Si Xie
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | | | - Peng-Fei Zhang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Xiu-Yun Ren
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Xing Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
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Microbiological Retention on PTFE versus Silk Suture: A Quantitative Pilot Study in Third Molar Surgery. Antibiotics (Basel) 2023; 12:antibiotics12030562. [PMID: 36978429 PMCID: PMC10044079 DOI: 10.3390/antibiotics12030562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/04/2023] [Accepted: 03/09/2023] [Indexed: 03/15/2023] Open
Abstract
Background: Mandibular third molar (M3M) removal and management of postoperative complications represent a common matter of interest in oral and maxillofacial surgery. This potential quantitative study assessed the ability of two types of surgical sutures, Silk and polytetrafluoroethylene polymer (PTFE), to carry aerobic and anaerobic bacteria on wounds after mandibular third molar surgery, with a collection of the stitches at the suture removal and study in the laboratory on the basis of colony-forming units. Methods: This prospective quantitative study sampled a total of 10 consecutive healthy patients for mandibular third molar surgery at the Oral Surgery School, Dentistry and Dental Prosthodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy. The mean age of the patients was 31 years (range 25–40 years), seven patients were male and three patients were female. Inclusion criteria were: presence of a partially impacted mandibular third molar. Exclusion criteria were: smoking and diabetes mellitus. Extraction of the mandibular third molar was performed under local anesthesia: after the third molar surgery, two sutures were applied on the surgical site distally to the second mandibular molar: one single 3/0 silk stitch; one single 3/0 PTFE stitch. No sutures were applied on the release incision. Sutures were removed after 7 days and were immediately conserved and sent to the laboratory to be rated on the basis of colony-forming units (CFUs). CFUs were evaluated and reported on GraphPad Prism and transformed into its base 10 logarithm. Data were analyzed with a non-parametric Wilcoxon test, and p-values < 0.05 were evaluated as statistically significant. Results: All the patients attended the suture removal date, and all the sutures were present in the site. None of the surgical sites presented dehiscence. No stitch loss was reported, and no patient reported mouth washing or tooth brushing in the surgery site. All interventions were uneventful and no major complications were reported after M3M surgery. Bacterial retention resulted as statistically greater in silk sutures rather than PTFE sutures, both in Brain Heart Infusion samples (p = 0.003) and Wilkins-Chalgren anaerobe samples (p = 0.002). Conclusions: We found the PTFE suture to be superior to the silk suture in a reduction in the bacterial biofilm in both aerobic and anaerobic evaluations after M3M surgery.
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Chepyshko SI, Maksymiv OO, Gomon ML, Rozhko VI, Tkachyk SV, Tsymbaliuk HY, Fedoniuk LY. RESULTS OF INFLAMMATORY AND IMMUNOLOGICAL PARAMETERS OF THE ORAL CAVITY AFTER CYSTECTOMY WITH DIFFERENT METHODS OF CONNECTING THE EDGES OF THE OPERATED AREA. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:964-971. [PMID: 37326077 DOI: 10.36740/wlek202305112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The aim: To analyze the results of inflammatory and immunological parameters of the oral cavity after cystectomy with different methods of connecting the edges of the operated area. PATIENTS AND METHODS Materials and methods: The research was conducted in 87 patients who sought surgical treatment of odontogenic cysts of the jaws. Patients were divided into groups depending on the method of wound closure after surgery. We analyzed the results of laboratory tests (leukocytes, ESR, IL-1β, IL-6, TNF-α, IL-8, NO synthase, MMP-9). RESULTS Results: The analysis of the effectiveness of using different methods of approximation of the oral mucosa wound on inflammatory and immunological pa¬rameters showed that when using welding of the edges of the operated area using the EKVZ-300 "Patonmed" apparatus, we get positive results of laboratory indicators of inflammatory markers faster (leukocyte counts are normal on day 30, ESR, IL-1β - on the 14th day, TNF-α - on the 7th day, IL-6, IL-8, NO synthase, MMP-9 - on the 30th day), that is, healing in such patients is faster than in patients with wound closure with classic suture material or laser. CONCLUSION Conclusions: When comparing the methods of approximation of postoperative oral mucosa wounds by different methods, based on the results of these inflammatory and immunological parameters, the best results were obtained when using electric welding of tissues. Further research and use of the proposed method will facilitate and shorten the rehabilitation period of patients after surgery.
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Affiliation(s)
| | | | - Mykola L Gomon
- NATIONAL PIROGOV MEMORIAL MEDICAL UNIVERSITY, VINNYTSIA, UKRAINE
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11
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Narsingyani RG, Patel SM, Sood RA, Bhimani KK, Makwana SV, Savani RR. Attached Oral Mucosal Wound Closure using Blue Glue - A Prospective Clinical Study. Ann Maxillofac Surg 2023; 13:31-36. [PMID: 37711540 PMCID: PMC10499272 DOI: 10.4103/ams.ams_2_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/28/2023] [Accepted: 06/02/2023] [Indexed: 09/16/2023] Open
Abstract
Introduction Traditionally, sutures have been widely used to close intraoral wounds. Various alternatives have been developed amongst which newer tissue adhesives such as N-butyl-2-cyanoacrylate having accepted clinical properties are gaining popularity. The primary purpose of the present study is to evaluate the efficacy of N-butyl-2-cyanoacrylate for intraoral attached mucosal wound closure following alveoloplasty. Materials and Methods In this prospective split-mouth study, 25 patients requiring alveoloplasty in either maxillary or mandibular arch bilaterally with a total of 50 sites were divided into two equal groups, namely silk suture (Group 1) and cyanoacrylate (Group 2). Each patient was evaluated on the first, third, seventh, 14th and 21st post-operative days. Parameters evaluated were time taken to close incision and to achieve haemostasis, pain, oedema, post-operative wound healing, patient discomfort and possible complications. Results Time taken to close incision, time taken to achieve haemostasis, post-operative pain and oedema were found to be less in Group 2. Wound healing too was found to be better in Group 2. There was one case of adhesive peel off on the first post-operative day which was managed by reapplying the tissue adhesive. The incidence of wound dehiscence and wound infection was observed more in Group 1 on the third post-operative day. Suture breakage (16%) and adhesive dislodgement (8%) were reported on the seventh post-operative day. Discussion The use of cyanoacrylates' inherent benefits, such as improved wound seal off in attached mucosa, quick polymerisation and bacteriostatic characteristics can be beneficial when performing minor oral surgical procedures on elderly, young and mentally challenged patients.
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Affiliation(s)
- Roma Gopaldas Narsingyani
- Department of Oral and Maxillofacial Surgery, AMC Dental College and Hospital, Gujarat University, Ahmedabad, Gujarat, India
| | - Shital Mayank Patel
- Department of Oral and Maxillofacial Surgery, AMC Dental College and Hospital, Gujarat University, Ahmedabad, Gujarat, India
| | - Ramita Atul Sood
- Department of Oral and Maxillofacial Surgery, AMC Dental College and Hospital, Gujarat University, Ahmedabad, Gujarat, India
| | - Kruna K. Bhimani
- Department of Oral and Maxillofacial Surgery, AMC Dental College and Hospital, Gujarat University, Ahmedabad, Gujarat, India
| | - Sanjaykumar V. Makwana
- Department of Oral and Maxillofacial Surgery, AMC Dental College and Hospital, Gujarat University, Ahmedabad, Gujarat, India
| | - Rajan R. Savani
- Department of Oral and Maxillofacial Surgery, AMC Dental College and Hospital, Gujarat University, Ahmedabad, Gujarat, India
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12
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Meng Z, Li Z, Guo S, Wu D, Wei R, Liu J, Hu L, Sui L. MED1 Ablation Promotes Oral Mucosal Wound Healing via JNK Signaling Pathway. Int J Mol Sci 2022; 23:13414. [PMID: 36362197 PMCID: PMC9655393 DOI: 10.3390/ijms232113414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/31/2022] [Accepted: 10/31/2022] [Indexed: 08/12/2023] Open
Abstract
Mediator complex subunit 1 (MED1) is a coactivator of multiple transcription factors and plays a key role in regulating epidermal homeostasis as well as skin wound healing. It is unknown, however, whether it plays a role in healing oral mucosal wounds. In this study, we investigate MED1's functional effects on oral mucosal wound healing and its underlying mechanism. The epithelial-specific MED1 null (Med1epi-/-) mice were established using the Cre-loxP system with C57/BL6 background. A 3 mm diameter wound was made in the cheek mucosa of the 8-week-old mice. In vivo experiments were conducted using HE staining and immunostaining with Ki67 and uPAR antibodies. The in vitro study used lentiviral transduction, scratch assays, qRT-PCR, and Western blotting to reveal the underlying mechanisms. The results showed that ablation of MED1 accelerated oral mucosal wound healing in 8-week-old mice. As a result of ablation of MED1, Activin A/Follistatin expression was altered, resulting in an activation of the JNK/c-Jun pathway. Similarly, knockdown of MED1 enhanced the proliferation and migration of keratinocytes in vitro, promoting re-epithelialization, which accelerates the healing of oral mucosal wounds. Our study reveals a novel role for MED1 in oral keratinocytes, providing a new molecular therapeutic target for accelerated wound healing.
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Affiliation(s)
- Zhaosong Meng
- School of Stomatology, Tianjin Medical University, Tianjin 300014, China
| | - Zhe Li
- School of Stomatology, Tianjin Medical University, Tianjin 300014, China
| | - Shuling Guo
- School of Stomatology, Tianjin Medical University, Tianjin 300014, China
| | - Danfeng Wu
- School of Stomatology, Tianjin Medical University, Tianjin 300014, China
| | - Ran Wei
- School of Stomatology, Tianjin Medical University, Tianjin 300014, China
| | - Jiacheng Liu
- School of Stomatology, Tianjin Medical University, Tianjin 300014, China
| | - Lizhi Hu
- Immunology Department, Key Laboratory of Immune Microenvironment and Disease, Ministry of Education, Tianjin Medical University, Tianjin 300014, China
| | - Lei Sui
- School of Stomatology, Tianjin Medical University, Tianjin 300014, China
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Parikh UM, Mentz J, Collier I, Davis MJ, Abu-Ghname A, Colchado D, Short WD, King A, Buchanan EP, Balaji S. Strategies to Minimize Surgical Scarring: Translation of Lessons Learned from Bedside to Bench and Back. Adv Wound Care (New Rochelle) 2022; 11:311-329. [PMID: 34416825 DOI: 10.1089/wound.2021.0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Significance: An understanding of the physiology of wound healing and scarring is necessary to minimize surgical scar formation. By reducing tension across the healing wound, eliminating excess inflammation and infection, and encouraging perfusion to healing areas, surgeons can support healing and minimize scarring. Recent Advances: Preoperatively, newer techniques focused on incision placement to minimize tension, skin sterilization to minimize infection and inflammation, and control of comorbid factors to promote a healing process with minimal scarring are constantly evolving. Intraoperatively, measures like layered closure, undermining, and tissue expansion can be taken to relieve tension across the healing wound. Appropriate suture technique and selection should be considered, and finally, there are new surgical technologies available to reduce tension across the closure. Postoperatively, the healing process can be supported as proliferation and remodeling take place within the wound. A balance of moisture control, tension reduction, and infection prevention can be achieved with dressings, ointments, and silicone. Vitamins and corticosteroids can also affect the scarring process by modulating the cellular factors involved in healing. Critical Issues: Healing with no or minimal scarring is the ultimate goal of wound healing research. Understanding how mechanical tension, inflammation and infection, and perfusion and hypoxia impact profibrotic pathways allows for the development of therapies that can modulate cytokine response and the wound extracellular microenvironment to reduce fibrosis and scarring. Future Directions: New tension-off loading topical treatments, laser, and dermabrasion devices are under development, and small molecule therapeutics have demonstrated scarless wound healing in animal models, providing a promising new direction for future research aimed to minimize surgical scarring.
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Affiliation(s)
- Umang M. Parikh
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - James Mentz
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Ian Collier
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Matthew J. Davis
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Amjed Abu-Ghname
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Daniel Colchado
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Walker D. Short
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Alice King
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Edward P. Buchanan
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
| | - Swathi Balaji
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA
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Becker P, Kasaj A, Schumann S, Kämmerer PW, Thiem DGE, Heimes D, Pabst A. Biomechanical evaluation of cyanoacrylate-based tissue adhesive for intraoral wound closure. Clin Oral Investig 2022; 26:4499-4507. [PMID: 35217903 DOI: 10.1007/s00784-022-04414-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/15/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The aim of this study was to analyze the biomechanical characteristics of a novel cyanoacrylate-based tissue adhesive (CTA) for soft-tissue closure of the (non-) tooth-bearing alveolar process and around dental implants. MATERIALS AND METHODS Halves of porcine mandibles (n = 21) were randomly divided into three experimental intraoral wound closure groups (A-C) with three different mucoperiosteal flap types (F1-3, n = 7 each): F1, crestal incision between the last incisor and the canine with a mesial and distal vestibular relief; F2, crestal double-T-shaped incision and dental implant placement between the canine and the first premolar; and F3, trapezoidal incision on the second premolar. F1-3 were respectively closed using (A) monofil non-resorbable sutures, (B) CTA, and (C) a combination of both. Tensile strength (TS) and elasticity (E) measurements were performed for biomechanical analysis. RESULTS In F1, CTA showed a significantly reduced TS compared to A (p < 0.001) and C (p < 0.01). In F2, an increased TS of C compared to A (p < 0.01) and B (p < 0.001) was found. Here, E was significantly increased in C compared to B (p < 0.02). In F3, TS was significantly decreased in B compared to A (p < 0.01) and C (p < 0.001). The E in group C was significantly increased compared to B (p < 0.01). CONCLUSIONS Different biomechanical characteristics between CTA and sutures were found. CTA could be a possible alternative to sutures for intraoral wound closure in special conditions. CLINICAL RELEVANCE A combination of both, suturing and CTA, could be a promising option in critical soft-tissue wounds requiring high functional stability and elasticity.
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Affiliation(s)
- Philipp Becker
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstr. 170, 56072, Koblenz, Germany
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Adrian Kasaj
- Department of Periodontology and Restorative Dentistry, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Sven Schumann
- Institute for Microscopic Anatomy and Neurobiology, University Medical Center Mainz, Johann-Joachim-Becherweg 13, 55128, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Daniel G E Thiem
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Diana Heimes
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Andreas Pabst
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstr. 170, 56072, Koblenz, Germany.
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
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15
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Dukaew N, Sakuludomkan W, Na Takuathung M, Pruksakorn D, Punyodom W, Koonrungsesomboon N. Analysis of Study Designs and Primary Outcome Measures in Clinical Trials of Investigational Suture Materials. Expert Rev Med Devices 2022; 19:247-258. [PMID: 35289244 DOI: 10.1080/17434440.2022.2054333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Clinical trials are a prerequisite for any investigational suture materials before a market approval application. The appropriate study designs and primary outcome measures are key to the validity and reliability of clinical trial results. This study aimed to characterize the study designs and primary outcome measures being applied in clinical trials of investigational suture materials. METHODS The systematic searches on PubMed, EMBASE, Web of Sciences, Scopus, and Cochrane databases were conducted to gather relevant studies published between January-2019 and May-2021. Data on general characteristics, suture intervention, study design, and primary outcome measures were extracted and analyzed. RESULTS Of 46 included studies, the majority of them were conducted with a randomized-controlled (93.5%), single-blind (50.0%), two-arm (84.8%), and parallel (76.1%) design with a 1:1 allocation ratio (95.7%). Through correlation network and heatmap analysis, the moderate-to-very strong correlations between some types of investigational suture materials and primary outcome measures were found including barbed vs non-barbed suture and suturing time, antibacterial-coated vs non-coated suture and wound infection, mono- vs multi-filament suture and wound healing index/markers, and different sizes of suture materials and scar assessment. CONCLUSIONS Our analysis provides guidance, with several key considerations, for designing a clinical trial evaluating investigational suture materials.
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Affiliation(s)
- Nahathai Dukaew
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Wannachai Sakuludomkan
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Mingkwan Na Takuathung
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Dumnoensun Pruksakorn
- Musculoskeletal Science and Translational Research Center (MSTR), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Department of Orthopedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Center of Multidisciplinary Technology for Advanced Medicine (CMUTEAM), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Biomedical Engineering Institute, Chiang Mai University, Chiang Mai, Thailand
| | - Winita Punyodom
- Polymer Research Laboratory, Department of Chemistry, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand.,Center of Excellence in Materials Science and Technology, Chiang Mai University, Chiang Mai, Thailand
| | - Nut Koonrungsesomboon
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Musculoskeletal Science and Translational Research Center (MSTR), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Mikhaylusov R, Negoduyko V, Pavlov S, Litvinova O, Babenko N, Kumetchko M. The influence of foreign textile bodies from military clothes on the healing process of experimental injuries of soft tissues. Porto Biomed J 2022; 7:e145. [PMID: 38304160 PMCID: PMC10830079 DOI: 10.1097/j.pbj.0000000000000145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/14/2021] [Indexed: 11/26/2022] Open
Abstract
Background The healing of combat wounds can be complicated by the presence of foreign bodies, including fragments of military clothing. The present work aims to study the morphological features of soft tissue injuries with textile fibers implanted into wounds, personnel military forms during wound healing, in the experiment. Methods By randomization, 54 rats were divided into 3 groups. Control group animals performed a layer-by-layer incision of soft tissues without implantation of foreign bodies. Animals of the experimental group 1 were made implantation of fibers of a fabric consisting of 100% cotton, and of the experimental group 2-of fibers of a fabric consisting of 65% cotton and 35% polyester. Removal of laboratory animals from the experiment was carried out on the 15th, 30th, and 60th day. Soft tissue samples were histologically examined. Results The least pronounced inflammation was observed in rats of the control group. Wound healing in the experimental groups was slowed down due to the presence of inflammatory foci. A more pronounced inflammatory reaction was characterized by a group of animals with implanted tissue fibers consisting of 100% cotton. In the group with implanted tissue fibers consisting of 65% cotton and 35% polyester, the inflammatory reactions were less pronounced. Conclusions The presence of textile foreign bodies hampers the healing process of wounds of soft tissues due to the developing processes of inflammation around foreign bodies. The uniform of servicemen (35% synthetic and 65% natural fiber) is less reactive, leaving a wound as a textile foreign body, and has a less pronounced inflammatory effect, apparently due to the presence of synthetic threads that are more inert compared to fabric containing 100% natural fiber. This confirms the need for thorough debridement of combat wounds during the primary surgical treatment.
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Affiliation(s)
| | - Vladimir Negoduyko
- Military Medical Clinical Center of the Northern Region of the Ministry of Defense of Ukraine, Ukraine
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17
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Bertran J, Thomson AC. Current Concepts in Head and Neck Surgery. Vet Clin North Am Small Anim Pract 2022; 52:489-512. [DOI: 10.1016/j.cvsm.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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18
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Insuasti‐Cruz E, Suárez‐Jaramillo V, Mena Urresta KA, Pila‐Varela KO, Fiallos‐Ayala X, Dahoumane SA, Alexis F. Natural Biomaterials from Biodiversity for Healthcare Applications. Adv Healthc Mater 2022; 11:e2101389. [PMID: 34643331 DOI: 10.1002/adhm.202101389] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 09/20/2021] [Indexed: 12/22/2022]
Abstract
Natural biomaterials originating during the growth cycles of all living organisms have been used for many applications. They span from bioinert to bioactive materials including bioinspired ones. As they exhibit an increasing degree of sophistication, natural biomaterials have proven suitable to address the needs of the healthcare sector. Here the different natural healthcare biomaterials, their biodiversity sources, properties, and promising healthcare applications are reviewed. The variability of their properties as a result of considered species and their habitat is also discussed. Finally, some limitations of natural biomaterials are discussed and possible future developments are provided as more natural biomaterials are yet to be discovered and studied.
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Affiliation(s)
- Erick Insuasti‐Cruz
- School of Biological Sciences & Engineering Yachay Tech University Urcuquí 100119 Ecuador
| | | | | | - Kevin O. Pila‐Varela
- School of Biological Sciences & Engineering Yachay Tech University Urcuquí 100119 Ecuador
| | - Xiomira Fiallos‐Ayala
- School of Biological Sciences & Engineering Yachay Tech University Urcuquí 100119 Ecuador
| | - Si Amar Dahoumane
- Department of Chemical Engineering Polytech Montreal Montreal Quebec H3C 3A7 Canada
- Center for Advances in Water and Air Quality (CAWAQ) Lamar University Beaumont TX 77710 USA
| | - Frank Alexis
- School of Biological Sciences & Engineering Yachay Tech University Urcuquí 100119 Ecuador
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Katorza A, Horwitz J. Esthetic Mucogingival Treatment After Biopsy of Inflammatory Fibroepithelial Hyperplasia. Clin Adv Periodontics 2021; 12:175-179. [PMID: 34590443 DOI: 10.1002/cap.10187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/23/2021] [Indexed: 11/08/2022]
Abstract
INTRODUCTION This case reports a biopsy of a large soft tissue defect with gingival grafting. The therapeutic approach presented here combines a partly de-epithelialized free gingival graft (PDFGG) with an envelope technique, which may be useful for cases needing a large reactive lesion biopsy. CASE PRESENTATION A patient with an aesthetic and functional complaint due to a fibroepithelial hyperplastic lesion was treated by excisional biopsy leaving a 10 mm cervical defect on tooth 23. A palatal PDFGG was harvested and sutured into the defect, using an "envelope technique" to improve the blood supply to the graft. The procedure is aimed at both recession coverage and reduction in root hypersensitivity. Stability of the outcome is demonstrated 9 months post-operative. CONCLUSIONS Gingival margin biopsies pose a significant challenge due to the need to combine significant tissue removal while providing a predictable aesthetic and functional outcome. The case is the first description of a successful grafting of a large residual gingival biopsy defect, resulting from using combined mucogingival surgical approach. This technique may be helpful for similar cases.
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Affiliation(s)
- Anat Katorza
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
| | - Jacob Horwitz
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
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Histotopographic and morphometric characteristics of the oral mucosa postoperative wounds healing, depending on the method of connecting the wound edges. EUREKA: HEALTH SCIENCES 2021. [DOI: 10.21303/2504-5679.2021.001845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Implementation of high-quality tissue connections and hemostasis in oral surgery is an urgent problem of modern dentistry, due to the lack of available universal methods that would help to facilitate the work of oral surgeon and reduce wound healing time.
The aim of the research. To investigate and study the regeneration processes in the oral mucosa after high-frequency electric welding, suturing and medical adhesive composition.
Materials and methods. This study compared the effect of three connection methods and hemostasis: high-frequency electric welding (EKVZ-300M1 “PATONMED®”, Ukraine), suture method (nylon 5/0 “PIRUS®”, China), adhesive composition (“Histoacryl®”, Germany). 72 rabbits were involved in experiment. An incision of the soft tissues of the vestibulum of the oral cavity of the maxilla with a length of 1.3–1.5 cm was made. On days 3, 7, 14 and 21, tissue samples were excised, histological and morphometric examination of the material were performed.
Results. By statistical data processing of 72 rabbits was found that the reliability of differences in the levels of morphometric parameters between groups on each day is very high, as evidenced by the calculated values of the U-test. In 38 cases (90.5 %), the significance level was p≤0.01, in the other 4 cases – p≤0.05. The lowest value level of neutrophilic granulocytes was in rabbits of group No.1 (electric welding). In rabbits of group No. 1 GFBC were not observed in the 8 fields of view throughout the experiment.
Conclusions. High-frequency electric welding of soft tissues can be used for effective intraoperative hemostasis and connection of the intraoral wound edges.
Due to the absence of a foreign body (adhesive masses, filaments) and moderate alterative effect, histological examination indicates accelerated activation of regenerative processes in the early stages of observation in rabbits of group No. 1.
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Liu Y, Huang W, Meng M, Chen M, Cao C. Progress in the application of spider silk protein in medicine. J Biomater Appl 2021; 36:859-871. [PMID: 33853426 DOI: 10.1177/08853282211003850] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Spider silk protein has attracted much attention on account of its excellent mechanical properties, biodegradability, and biocompatibility. As the main protein component of spider silk, spidroin plays important role in spider spinning under natural circumstances and biomaterial application in medicine as well. Compare to the native spidroin which has a large molecular weight (>300 kDa) with highly repeat glycine and polyalanine regions, the recombinant spidroin was maintained the core amino motifs and much easier to collect. Here, we reviewed the application of recombinant spider silk protein eADF4(C16), major ampullate spidroin (MaSp), minor ampullate spidroin (MiSp), and the derivatives of recombinant spider silk protein in drug delivery system. Moreover, we also reviewed the application of spider silk protein in the field of alternative materials, repairing materials, wound dressing, surgical sutures along with advances in recombinant spider silk protein.
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Affiliation(s)
- Yi Liu
- 1Key Laboratories of Fine Chemicals and Surfactants in Sichuan Provincial Universities, School of Chemical Engineering, Sichuan University of Science & Engineering, Zigong, China
| | - Wei Huang
- 1Key Laboratories of Fine Chemicals and Surfactants in Sichuan Provincial Universities, School of Chemical Engineering, Sichuan University of Science & Engineering, Zigong, China
| | - Minsi Meng
- 1Key Laboratories of Fine Chemicals and Surfactants in Sichuan Provincial Universities, School of Chemical Engineering, Sichuan University of Science & Engineering, Zigong, China
| | - Minhui Chen
- 2Department of Neurosurgery, Zigong Fourth People's Hospital, Zigong, China
| | - Chengjian Cao
- 3Department of Clinical Laboratory, Zigong First People's Hospital, Zigong, China
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Wu M, Huang S, Ye X, Ruan J, Zhao S, Ye J, Zhong B. Human epidermal growth factor-functionalized cocoon silk with improved cell proliferation activity for the fabrication of wound dressings. J Biomater Appl 2021; 36:722-730. [PMID: 33663262 DOI: 10.1177/0885328221997981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Human epidermal growth factor (hEGF) is a key factor involved in wound healing owing to its powerful ability to stimulate cell proliferation. In this study, we used piggyBac transposon technology to produce transgenic silkworms expressing the hEGF protein fused to truncated heavy chain (FibH-hEGF). The FibH-hEGF fusion protein was successfully expressed and secreted into silkworm cocoons. Compared to wild-type silk, the transgenic silkworm silk had the similar morphology about silks fiber surface and cocoon nets, while the secondary structure between the transgenic silk and wild-type silk was different. Most importantly, transgenic silkworm cocoon silk powder extract significantly increased human fibroblast FIB cell proliferation for a long duration with no apparent cytotoxicity. Our study provides a promising method for obtaining cost-effective and functional biomaterials for the fabrication of wound dressings.
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Affiliation(s)
- Meiyu Wu
- College of Animal Science, 12377Zhejiang University, Hangzhou, Zhejiang, China
| | - Shenyu Huang
- College of Animal Science, 12377Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaogang Ye
- College of Animal Science, 12377Zhejiang University, Hangzhou, Zhejiang, China
| | - Jinghua Ruan
- College of Animal Science, 12377Zhejiang University, Hangzhou, Zhejiang, China
| | - Shuo Zhao
- College of Animal Science, 12377Zhejiang University, Hangzhou, Zhejiang, China
| | - Juan Ye
- College of Animal Science, 12377Zhejiang University, Hangzhou, Zhejiang, China
| | - Boxiong Zhong
- College of Animal Science, 12377Zhejiang University, Hangzhou, Zhejiang, China
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