MICROBIOLOGIC COMPARISON OF SILK, POLYESTER [POLY(ETHYLENETEREPHTHALATE)], POLYGLYCOLIC ACID, AND POLY(GLYCOLIDE-CO-LACTIDE) SUTURE MATERIALS IN ORAL SURGERY

Öz

Aim: The aim of this study is to compare the microbiological colonization on different intraoral suture
materials used in patients, undergone oral surgery.
Material and Methods: Suture materials were
applied to 60 patients during dentoalveolar surgical
interventions. Patients were randomly divided into 4
groups of 15. Four different types of suture materials
were introduced into the patients after surgical
removal of their impacted lower third molars. In the
postoperative seventh day, suture materials were
removed. After these sutures were washed in sterile
saline solution containing tubes, we performed various
microbiological isolation and differentiation techniques.
Results: In microbiological examination, 13 aerobic
species, 7 anaerobic species, 1 yeast species, and 1
mold species were isolated from the non-absorbable
suture materials. Eight aerobic strains, 9 anaerobic
strains, and additionally, 1 yeast and 2 mold strains
were isolated from the absorbable suture materials.
Conclusion: In light of the data obtained, we believe
that polyglycolic acid based suture materials might be
preferred in oral surgery. However, this choice should
be made by considering the other features of the
suture materials. And also, since the colonization of
pathogenic microorganisms could turn the sutures into
a potential oral pathogen reservoir, sutures should be
removed as soon as possible.

Anahtar Kelimeler

• Suture materials
• microbiological strains
• oral surgery

ORAL CERRAHİ UYGULANAN HASTALARDA İPEK, POLYESTER [POLY (ETHYLENETEREPHTHALATE)], POLYGLYCOLIC ACID VE POLY(GLYCOLIDE-COLACTIDE) SÜTÜR MATERYALLERİNİN MİKROBİYOLOJİK AÇIDAN KARŞILAŞTIRILMASI

Öz

Amaç: Bu çalışmanın amacı oral cerrahi uygulanmış
hastalarda kullanılan farklı sütür materyallerinde
meydana gelen mikrobiyolojik kolonizasyonların
karşılaştırılmasıdır.
Bireyler ve Yöntem: Sütür materyalleri dentoalveolar cerrahi yapılan toplam 60 hastaya uygulandı.
Hastalar randomize olarak herbiri 15 hastadan oluşan
4 gruba bölündü. Gömülü alt yirmi yaş dişi operasyonu
yapılan bu hastalara sütür materyalleri intraoral olarak
uygulandı. Postoperatif 7. gün sütürler alındı. Alınan
sütürler steril salin solüsyonu ihtiva eden tüplerde
yıkandıktan sonra mikrobiyolojik izolasyon ve
diferensiasyon teknikleri gerçekleştirildi.
Bulgular: Mikrobiyolojik inceleme sonucu olarak;
emilemeyen sütürlerde; 13 aerob ve 7 anaerob bakteri
türüne ek olarak 1 maya ve 1 küf mantarı türü,
emilebilen sütürlerde ise; 8 aerob ve 9 anaerob bakteri
türüne ek olarak 1 maya ve 2 küf mantarı türü izole
edildi.
Sonuç: Elde edilen verilerin ışığında çalışmamızda
kullanılan Sentesorb® sütür materyalinin oral cerrahide
tercih edilebileceğini düşünmekteyiz. Ancak bu seçim
sütür materyallerinin diğer özellikleri de göz önüne alınarak yapılmalıdır. Sütürlere kolonize olabilen patojen
mikroorganizmalar yara yerinde bulunan bu sütürleri
potansiyel patojen mikroorganizma rezervuarları haline
getirdikleri için sütürler mümkün olan en kısa sürede
alınmalıdır.

Anahtar Kelimeler

• sütür materyalleri
• mikrobiyolojik türler
• oral cerrahi

Kaynakça

1. 1. Yu GV, Cavaliere R. Suture material, properties and uses. J Am Podiatry Assoc 1983; 73: 57–64.
2. 2. Parirokh M, Asgary S, Eghbal MJ, Stowe S, Kakoei S. A scanning electron microscope study of plaque accumulation on silk and PVDF suture materials in oral mucosa. Int Endod J. 2004; 37: 776–781.
3. 3. Yaltirik M, Dedeoglu K, Bilgic B, Koray M, Ersev H, Issever H, Dulger O, Soley S. Comparison of four different suture materials in soft tissues of rats. Oral Dis 2003; 9: 284-286.
4. 4. Shaw RJ, Negus TW, Mellor TK. A prospective clinical evaluation of longevity of resorbable sutures in oral mucosa. Br J Oral Maxillofac Surg. 1996; 34: 252-254.
5. 5. Bayer S, Demirtas N, Kazancıoglu HO. Suture materials in maxillofacial surgery: A literature review. J Dent Fac Atatürk Uni. 2015; Suppl 11; 105-113.
6. 6. Selvig KA, Biagiotti GR, Leknes KN, Wikesjo UME (1998) Oral tissue reactions to suture materials. Int J Periodontics Restorative Dent. 1998; 18: 475–487.
7. 7. Greenwald D, Shumway S, Albear P, Gottlieb L. Mechanical comparison of 10 suture materials before and after in vivo incubation. J Surg Res 1994; 56: 372-377.
8. 8. Sortino F, Lombardo C, Sciacca A. Silk and polyglycolic acid in oral surgery: A comparative study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 105: e15-e18.

9. 9. Chu CC, Williams DF. Effects of physical configuration and chemical structure of suture materials on bacterial adhesion. Am J Surg 1984; 147: 197-204.
10. 10. Banche G, Roana J, Mandras N, Amasio M, Angeretti A, Tullio V, Cuffini AM. Microbial adherence on various intraoral suture materials in patients undergoing dental surgery. J Oral Maxillofac Surg 2007; 65: 1503-1507.
11. 11. Grigg TR, Liewer FR, Patton WR,Buxton TB, Mcpherson JC. Effect of the wicking behaviour of multifilament sutures. J Endod 2004; 30: 649-652.
12. 12. Otten JE, Wiedmann-Al-Ahmad M, Jahnke H, et al. Bacterial colonization on different suture materials-A potential risk for intraoral dentoalveolar surgery. J Biomed Mater Res B Appl Biomater 2005; 74: 627.
13. 13. Giray CB. Clinical and electron microscope comparison of silk sutures and n butyl-2-cyanoacrylate in human mucosa. Aust Dent J 1997; 42: 255-258.
14. 14. Lilly GE. Reaction of oral tissues to suture materials. Oral Surg Oral Med Oral Pathol 1968; 26: 128-133.
15. 15. Lilly GE, Armstrong JH, Salem JE, Cutcher JL. Reaction of oral tissues to suture materials.II. Oral Surg Oral Med Oral Pathol 1968; 26: 592-599.
16. 16. Durdley P, Bucknall TE. Assesment of sutures for use in colonic surgery: an experimental study. J R Soc Med 1984; 77: 472-477.
17. 17. Rothenburger S, Spangler D, Bhende S, Burkley D. In vitro antimicrobial evaluation of coated Vicryl plus antibacterial suture (coated polyglactin 910 with triclosan) using zone inhibition assays. Surg Infect 2002; 3: 79-87.
18. 18. Brown AR, Papasian CJ, Shultz P, Theisen FC, Shultz RE. Bacteremia and intraoral suture removal: Can an antimicrobial rinse help? J Am Dent Assoc 1998; 129: 1455-1461.
19. 19. King RC, Crawford BA, Small EW. Bacteremia following intraoral suture removal. Oral Surg Oral Med Oral Pathol 1988; 65: 23-28.
20. 20. Giglio JA, Rowland RW, Dalton HP, Laskin DM. Suture removal-induced bacteremia: a possible endocarditis risk. J Am Dent Assoc 1992; 123: 65-70.
21. 21. Martin M. Is there a link between tooth brushing and infective endocarditis? Int Dent J 2003; 53: 187-189