ORAL-TISSUE REACTIONS TO SUTURE MATERIALS

Tissue reactions to natural and synthetic braided and monofilament sut ure materials in gingiva and oral mucosa were studied. A total of 138 sutures made of four commonly used materials were placed in the edentu lous ridges and vestibular mucosa of eight beagle dogs. Biopsy specime ns including the suture loop and surrounding tissues were obtained aft er 3 7,and 74 days and processed for histologic analysis. The inflamma tory reaction was more rapid and intense than the reaction that has be en reported after suture placement in skin. Bacterial invasion of the suture track was a common sequela regardless of the material used but it was particularly prominent for silk. The formation of a perisutural epithelial sleeve was well under way at 3 days and in some instances included the entire suture track within 7 days. Connective tissue reac tions consisted of several well-defined, concentric perisutural zones. At 14 days, these zones were partly replaced by granulation tissue su rrounded by a fibrous capsule. The synthetic monofilament suture elici ted a mild inflammatory tissue response. The results showed that sutur es placed in gingiva and oral mucosa produce a prolonged tissue respon se that is most likely a result of the continual influx of microbial c ontamination along the suture channel, which may be a lesser problem w hen sutures are placed in other surgical compartments. The results ind icate that chromic gut sutures are rapidly and unpredictably absorbed when used in an environment characterized by moisture and infectious p otential.