A NOTE ON THE USE OF HORSE HAIR SUTURES FOR THE CONJUNCTIVA

History of Horsehair Hair Sutures: Perspectives in Green Surgery

Throughout history, animal hair and human hair have been used as suture materials in surgery and retain sporadic interest today. This systematic literature review examines 42 primary sources to uncover insights into the use of hair sutures. Several notable figures documented their experiences across specialties, highlighting horsehair's longevity and patient comfort. Despite waning popularity owing to synthetic alternatives, recent interest in autologous hair filaments for facial wounds signals a resurgence. The time-tested hair sutures offer a cost-effective, eco-friendly option, particularly in resource-limited settings.

Experimental evaluation of horse hair as a nonabsorbable monofilament suture

Background:

Success of surgery depends on wound closure and healing. Ancients had coated many suture materials from plant and animal origin. As the quest for natural nonabsorbable, monofilament surgical suture continues, horsehair has been taken for study, which is mentioned in ancient literature.

Objectives:

Aim of the study was to evaluate detail mechanical and biophysical properties of horsehair.

Materials and Methods:

Physical properties, that are diameter, straight pull and knot pull tensile strength, bioburden, sterility tests were performed. Visual and histological wound healing parameters were studied in experimental Wistar rat incision wound model. Two experimental wounds about 5 cm long were created on each side of dorsal midline. Each animal received two sutures-Horsehair 4-0 and Ethilon 4-0. The sutured areas were grossly examined on 3^rd and 7^th days for visual observations like congestion, edema, infection, wound disruption, and impression of suture material on healed wound and then subjected for histological study.

Results:

Revealed that horsehair has got diameter of 0.19 mm which complies with the 4-0 size USP standard. Straight pull tensile strength was found 0.5851 ± 0.122 kg and knot pull tensile strength was 0.3998 ± 0.078 kg, which complies with the standards of United State Pharmacopia for class II nonabsorbable suture materials. In vivo study revealed that there was no evidence of edema, congestion, and discharge in both the groups. Wounds healed with minimum impressions of suture material with minimum scar mark. Mean histological scoring shows very mild tissue reaction.

Conclusion:

Horsehair has got properties of standard suture material except low tensile strength and hence can be used in reconstructive, plastic surgeries, and ophthalmic surgeries.