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Conventional sutures used in surgical procedures often lack the capability to effectively monitor physical and chemical activities or the microbial environment of surgical wounds due to their inadequate mechanical properties, insufficient electrical accuracy and unstability. Here, we present a straightforward layer-by-layer coating technique that utilizes 3-glycidoxypropyltrimethoxysilane (CA), graphene oxide (GO), and ascorbic acid (AA) to develop conductive silk-based surgical sutures (CA-rGSFS). The CA-rGSFS feature a continuous reduced graphene oxide (rGO) film on their surface, forming robust hydrogen bonds with silk fibroin. The reduction process of rGO is confirmed through Raman analysis, demonstrating an enhanced D peak to G peak ratio. Notably, the CA-rGSFS exhibit exceptional mechanical properties and efficient electron transmission, with a knot-pull tensile strength of 2089.72 ± 1.20 cN and an electrical conductivity of 130.30 ± 11.34 S/m, respectively, meeting the requirements specified by the United States Pharmacopeia (USP) for 2-0 sutures. These novel CA-rGSFS demonstrate the ability to accurately track resistance changes in various fluid environments with rapid response, including saline, intestinal, and gastric fluids. The suture also retains remarkable stretchablility and stability even after enduring 3000 tensile cycles, highlighting their potential for precise surgical site monitoring during the wound healing process. [ABSTRACT FROM AUTHOR]

Introduction: Nasoendotracheal (NET) tubes are exposed to various external forces, handling, slippage, and accidental extubation, with the potential for fatal complications. In the modern era, several techniques have been developed to reduce the complication rate of Nasoendotracheal Intubation (NTI). NET tubes can be secured using twill or cotton tape, adhesive tape, gauze, or a manufactured device, either individually or in combination. In present study, a transcolumellar stitch and transeptal stitch were designed with 2-0 silk suture material and utilised by many anaesthetists and surgeons to secure the NET, providing good stability but sometimes leading to columellar ischaemia and cutting through. Aim: To compare the intraoperative stability of Nasoendotracheal Tubes (NETT) secured by a transept flower stitch with those secured using a simple surgical knot in patients undergoing NET Intubation (NETI) for open reduction and internal fixation of maxillofacial trauma. Materials and Methods: This cross-sectional study was conducted in the Department of Oral and Maxillofacial Surgery at Sharad Pawar Dental College and Hospital and Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha, Maharashtra, India, over a period of six months from March 2023 to August 2023. The study involved 30 patients with maxillofacial fractures who were divided into two groups. Preoperative assessments included case history, physical examinations, and maxillofacial evaluations. Patients were divided into two groups: Group A underwent simple surgical knot using 2-0 silk suture (odd-numbered patients), while patients in Group B underwent transseptal flower stitch using 2-0 silk suture (even-numbered patients). All parameters were recorded by the same surgeon at the beginning and end of the procedure. The data was collected, tabulated, and statistically analysed using Statistical Package for the Social Sciences (SPSS) statistical software version 23.0. Results: Out of the total 30 patients enrolled in the study, 24 (80%) were male and 6 (20%) were female. The comparison between the two groups regarding the duration of surgery showed no statistically significant difference. Three parameters, namely the amount of NETT displacement, nasal tip laceration, and tip ischaemia, were evaluated and recorded both preoperatively and immediately after extubation. The amount of NETT displacement (p-value=0.031) and nasal tip laceration, haemorrhage, or necrosis (p-value=0.049) were shown to differ statistically significantly between the groups. Conclusion: The present study highlighted that the flower stitch method is an extremely beneficial approach. It offers advantages in terms of better stability and is associated with fewer complications and lower morbidity when compared to the simple surgical knot group.

Introduction: Nasoendotracheal (NET) tubes are exposed to various external forces, handling, slippage, and accidental extubation, with the potential for fatal complications. In the modern era, several techniques have been developed to reduce the complication rate of Nasoendotracheal Intubation (NTI). NET tubes can be secured using twill or cotton tape, adhesive tape, gauze, or a manufactured device, either individually or in combination. In present study, a transcolumellar stitch and transeptal stitch were designed with 2-0 silk suture material and utilised by many anaesthetists and surgeons to secure the NET, providing good stability but sometimes leading to columellar ischaemia and cutting through. Aim: To compare the intraoperative stability of Nasoendotracheal Tubes (NETT) secured by a transept flower stitch with those secured using a simple surgical knot in patients undergoing NET Intubation (NETI) for open reduction and internal fixation of maxillofacial trauma. Materials and Methods: This cross-sectional study was conducted in the Department of Oral and Maxillofacial Surgery at Sharad Pawar Dental College and Hospital and Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha, Maharashtra, India, over a period of six months from March 2023 to August 2023. The study involved 30 patients with maxillofacial fractures who were divided into two groups. Preoperative assessments included case history, physical examinations, and maxillofacial evaluations. Patients were divided into two groups: Group A underwent simple surgical knot using 2-0 silk suture (odd-numbered patients), while patients in Group B underwent transseptal flower stitch using 2-0 silk suture (even-numbered patients). All parameters were recorded by the same surgeon at the beginning and end of the procedure. The data was collected, tabulated, and statistically analysed using Statistical Package for the Social Sciences (SPSS) statistical software version 23.0. Results: Out of the total 30 patients enrolled in the study, 24 (80%) were male and 6 (20%) were female. The comparison between the two groups regarding the duration of surgery showed no statistically significant difference. Three parameters, namely the amount of NETT displacement, nasal tip laceration, and tip ischaemia, were evaluated and recorded both preoperatively and immediately after extubation. The amount of NETT displacement (p-value=0.031) and nasal tip laceration, haemorrhage, or necrosis (p-value=0.049) were shown to differ statistically significantly between the groups. Conclusion: The present study highlighted that the flower stitch method is an extremely beneficial approach. It offers advantages in terms of better stability and is associated with fewer complications and lower morbidity when compared to the simple surgical knot group. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Surgical sutures are sterile filaments to support the healing process. Also Suture as a major part of surgical site management can challenge surgical wound healing. The objective of the current study was to prevent surgical site infection by creating a new antibacterial silk-nano cefixime suture.Methods: The silk suture became silk-nano cefixime suture by immersing in the 1, 2, and 3 wt % cefixime solutions. The antibacterial activity of silk-nano cefixime suture was tested on E. coli (ATCC25922). The healing effect of silk-nano cefixime suture was evaluated by H&E staining sections and compared between the control and treated groups on days 3, 8 and 14. The obtained quantitative data were presented as mean ± standard deviation. In order to compare the mean of quantitative variables between the studied groups, general linear model of statistical analysis test and 3-D SPSS charts were used (P ≤ 0.05).Results: The inhibition zone diameter of E. coli (ATCC25922) was 25 mm and no statistically significant difference was found between the healing properties (P≥.05). There was a significant difference in the mean of Polymorphonuclear leukocytes (PMN) and macrophage infiltration between the control and treated groups on day 8 (p≤ 0.05).Conclusion: Our data indicate that silk-nano cefixime suture has the potential to reduce the risk of surgical site infections. Finally, it is strongly recommended to introduce silk-nano cefixime suture as a reliable substitute for current surgical sutures.

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.

Introduction: Stitch abscess or suture granuloma is a rare complication defined as a benign granulomatous inflammatory lesion with an incidence rate of about 2 percent seen after various kinds of surgical procedures. Case presentation: Here we present a 49 years old woman that presented with bilateral neck swelling and pain one year and a half after total thyroidectomy surgery misdiagnosed as tumor recurrence. Discussion: Post-thyroidectomy suture reaction causing granulomatous lesions or abscess formation as seen in our case is even rarer with an incidence rate of 0.08% to 1.5%. Silk suture is the most common non-absorbable suture material that has been used in vascular ligation. Young adults, liver dysfunction and allergy history are predisposing factors for stitch abscess. Conclusion: Development of suture granuloma should be considered when vascular ligation by silk suture is preferred especially in patients with predisposing factors.

Introduction: As a new emerging nanotechnology approach, copper nanoparticles (CuNPs) coated on traditional silk suture were used. Its antimicrobial and anti-inflammatory properties, led to its increasing medical applications. Commercially available as wound dressings, surgical instruments and bone prostheses. Objectives: To compare physical parameters of nano-copper and silk suture. Methodology: Copper nanoparticles and deionized water were adopted for the preparation of the copper solution. The copper solution was obtained by dissolving 0.5 wt/v % of copper nanoparticles in a mixture of 5 v/v % of deionized water. The silk suture were dipped in the copper solution for 24 hr and then exposed to UV lamp in order to induce the synthesis of copper clusters on the surface of the suture. Inverted electron microscopy was performed in order to analyse the braided structure of the multifilament silk sutures and to verify the presence of copper on the surface. A quantitative spectrophotometry analysis was performed to quantify the percentage of copper deposited. Tensile strength was measured by Universal Testing Machine. Results: Nano-copper suture showed enhanced physical parameters as compared to silk suture. Conclusion: Copper nanoparticles due to their beneficial effects as antibacterial and wound healing accelerator in the periodontal surgeries could reduce inflammation and promote healing process.

Silk sutures are common in surgeries, and silk-based textiles are widely used in clinical medicine on account of their great mechanical properties and biodegradability. However, due to the lack of biocatalytic activity, silk sutures show unsatisfactory anti-inflammatory properties and healing speed. To address this constraint, we construct clinical grade bioactive gold cluster-sutures through a heterojunction. The antioxidant activity of bioactive gold cluster-sutures is ∼160 times more than that of clinical sutures. Meanwhile, the suture displays superb reactive oxygen species (ROS) scavenging, superoxide dismutase-like (SOD-like, 5 times more than the silk suture), and catalase-like (CAT-like) activities. The clusters assemble on the surface of silk through hydrogen bonding, leading to a durable catalytic and structural stability for 15 months without decay. Subsequently, the suture significantly accelerates wound healing by exerting excellent anti-inflammatory effects, improving neovascularization and collagen deposition. Clinical grade bioactive gold clusters with high bioactivity, stability, and biocompatibility hold promise for clinical translation and pave the way for other implanted biomaterials from wound healing to intelligent textiles.

Introduction: As a new emerging nanotechnology approach, copper nanoparticles (CuNPs) coated on traditional silk suture were used. Its antimicrobial and anti-inflammatory properties, led to its increasing medical applications. Commercially available as wound dressings, surgical instruments and bone prostheses. Objectives: To compare physical parameters of nano-copper and silk suture. Methodology: Copper nanoparticles and deionized water were adopted for the preparation of the copper solution. The copper solution was obtained by dissolving 0.5 wt/v % of copper nanoparticles in a mixture of 5 v/v % of deionized water. The silk suture were dipped in the copper solution for 24 hr and then exposed to UV lamp in order to induce the synthesis of copper clusters on the surface of the suture. Inverted electron microscopy was performed in order to analyse the braided structure of the multifilament silk sutures and to verify the presence of copper on the surface. A quantitative spectrophotometry analysis was performed to quantify the percentage of copper deposited. Tensile strength was measured by Universal Testing Machine. Results: Nano-copper suture showed enhanced physical parameters as compared to silk suture. Conclusion: Copper nanoparticles due to their beneficial effects as antibacterial and wound healing accelerator in the periodontal surgeries could reduce inflammation and promote healing process. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to determine the differences between the patients with postoperative complications and the patients without postoperative complications in cholecystectomy cases and to identify parameters that should be considered regarding complications. Materials and Methods: Patients who underwent cholecystectomy between January 2019 and July 2020 at Igdir State Hospital, Igdir, Turkey were identified retrospectively. The patients’ general characteristics were retrieved from their medical records. Patients who developed complications in the 30 days after surgery were considered the morbidity-positive group, and the patients without complications were considered the morbidity-negative group. The differences between the two groups were evaluated. Results: The study included 108 patients. The patients’ mean age was 46.44 years (range: 18‒83), and 85 (78.7%) were women. Male gender, age over 40 years, preoperative fever with the presence of haemangioma on ultrasonography (USG) and cystic canal closure using silk were associated with increased morbidity. Interestingly, umbilical hernia repair in the same surgery was associated with reduced morbidity. Conclusion: This study found that male gender, older age, and preoperative fever were associated with increased morbidity in cholecystectomy patients. Presence of preoperative haemangioma is a new parameter associated with increased morbidity. In addition, we recommend using silk sutures when closing the cystic duct during cholecystectomy and repairing the umbilical hernia, if present.

Background: Mesioangular impacted mandibular third molar is a common dental anomaly, for which surgical extraction is required. Post-surgery closure of mucosa reduces the prevalence of pain and other surgery-associated complications. We compared tissue reaction/inflammation after 3 and 7 days of mucosal closure with Trusilk ® and Mersilk ® silk sutures, following impacted mandibular third molar removal. Methods: This multicenter, prospective, two-arm, parallel-group, randomized (1:1), single-blind study (July 2020-November 2021) included subjects (Trusilk ®, n=65 and Mersilk ®, n=64), requiring mucosal suturing following impacted mandibular third molar removal. The primary endpoint, incidence of pain, swelling and trismus at the extraction area on post-surgery day 3 and 7 was evaluated. The secondary endpoints, incidence of tissue reaction, wound infection, suture loosening, other complications, operative time, amount of anesthesia, intraoperative suture handling, time needed for complete wound healing and suture removal, and adverse events were also recorded. Results: Socio-demographic and intra-oral characteristics were comparable between the groups. In Trusilk ® and Mersilk ® groups, a gradually decreasing pain score, starting from day 0 post-surgery (42.17±22.38 vs. 45.97±22.20) to day 7 (8.40±11.93 vs. 8.28±12.13) to day 30 (1.98±0.89 vs. 1.75±0.76) was witnessed. After the surgery, 21.54% and 17.19% subjects in Trusilk ® and Mersilk ® groups, respectively, had no post-operative swelling, while at the last two visits none of the subjects had swelling. Non-significant difference in wound infection, suture loosening, wound healing, bleeding, taste changes, operative time, amount of anesthesia, intraoperative suture handling, and time needed for complete wound healing and suture removal was noted among the groups. No suture-related adverse events were recorded. Conclusions: The results indicated that the Trusilk ® and Mersilk ® silk sutures are clinically equivalent and can be used for mucosal closure after removal of an impacted mandibular third molar with a minimal rate of pain, swelling and trismus. Clinical Trial Registry of India Registration: CTRI/2020/03/024100 (20/03/2020)

Background: Surgical sutures are sterile filaments to support the healing process. Also Suture as a major part of surgical site management can challenge surgical wound healing. The objective of the current study was to prevent surgical site infection by creating a new antibacterial silk-nano cefixime suture. Methods: The silk suture became silk-nano cefixime suture by immersing in the 1, 2, and 3 wt % cefixime solutions. The antibacterial activity of silk-nano cefixime suture was tested on E. coli (ATCC25922). The healing effect of silk-nano cefixime suture was evaluated by H&E staining sections and compared between the control and treated groups on days 3, 8 and 14. The obtained quantitative data were presented as mean ± standard deviation. In order to compare the mean of quantitative variables between the studied groups, general linear model of statistical analysis test and 3-D SPSS charts were used (P ≤ 0.05). Results: The inhibition zone diameter of E. coli (ATCC25922) was 25 mm and no statistically significant difference was found between the healing properties (P≥.05). There was a significant difference in the mean of Polymorphonuclear leukocytes (PMN) and macrophage infiltration between the control and treated groups on day 8 (p≤ 0.05). Conclusion: Our data indicate that silk-nano cefixime suture has the potential to reduce the risk of surgical site infections. Finally, it is strongly recommended to introduce silk-nano cefixime suture as a reliable substitute for current surgical sutures. [ABSTRACT FROM AUTHOR]

Background: The most common technique for gingival augmentation is free gingival graft (FGG). The aim of this study is to clinically compare the efficacy of FGG harvested with erbium: yttrium-aluminum-garnet (Er: YAG) laser stabilized with 5-0 silk suture in comparison to N-butyl-2-cyanoacrylate tissue adhesive in increasing the width of keratinized gingiva (WK) for the management of Miller's Class I and II gingival recession. Methodology: Forty-eight gingival recession defects were divided into two Groups I and II. Group I sites were treated with FGG harvested using Er: YAG laser stabilized with 5-0 silk suture and Group II sites were treated with FGG harvested using Er: YAG laser stabilized with N-butyl-2-cyanoacrylate tissue adhesive. Clinical parameters such as gingival recession depth, clinical attachment level (CAL), gain in gingival tissue thickness, and WK were recorded at baseline and 3 and 6 months postoperatively. Results: A significant reduction in gingival recession defects, gain in CAL, increase in WK, and gain in gingival tissue thickness were observed in both the groups. Intergroup comparison of gingival recession defects, CAL, WK, and gingival tissue thickness yielded nonsignificant differences. Conclusion: Within the limits of this study, it can be concluded that both 5-0 silk suture and n-butyl-2-cyanoacrylate were equally efficacious in the stabilization of FGG. N-butyl-2-cyanoacrylate was easy to apply, consumed less operating time, and had no adverse effect. Hence, cyanoacrylate can be used as an alternative to suture in stabilization of FGG.

Background: Mesioangular impacted mandibular third molar is a common dental anomaly, for which surgical extraction is required. Post-surgery closure of mucosa reduces the prevalence of pain and other surgery-associated complications. We compared tissue reaction/inflammation after 3 and 7 days of mucosal closure with Trusilk® and Mersilk® silk sutures, following impacted mandibular third molar removal. Methods: This multicenter, prospective, two-arm, parallel-group, randomized (1:1), single-blind study (July 2020-November 2021) included subjects (Trusilk®, n=65 and Mersilk®, n=64), requiring mucosal suturing following impacted mandibular third molar removal. The primary endpoint, incidence of pain, swelling and trismus at the extraction area on post-surgery day 3 and 7 was evaluated. The secondary endpoints, incidence of tissue reaction, wound infection, suture loosening, other complications, operative time, amount of anesthesia, intraoperative suture handling, time needed for complete wound healing and suture removal, and adverse events were also recorded. Results: Socio-demographic and intra-oral characteristics were comparable between the groups. In Trusilk® and Mersilk® groups, a gradually decreasing pain score, starting from day 0 post-surgery (42.17±22.38 vs. 45.97±22.20) to day 7 (8.40±11.93 vs. 8.28±12.13) to day 30 (1.98±0.89 vs. 1.75±0.76) was witnessed. After the surgery, 21.54% and 17.19% subjects in Trusilk® and Mersilk® groups, respectively, had no post-operative swelling, while at the last two visits none of the subjects had swelling. Non-significant difference in wound infection, suture loosening, wound healing, bleeding, taste changes, operative time, amount of anesthesia, intraoperative suture handling, and time needed for complete wound healing and suture removal was noted among the groups. No suture-related adverse events were recorded. Conclusions: The results indicated that the Trusilk® and Mersilk® silk sutures are clinically equivalent and can be used for mucosal closure after removal of an impacted mandibular third molar with a minimal rate of pain, swelling and trismus. Clinical Trial Registry of India Registration: CTRI/2020/03/024100 (20/03/2020)

One of the challenging issues in surgery is a surgical-site infection (SSI), which results in impaired healing and can be life-threatening. Sutures can increase the risk of infection by providing an area for adherent bacteria. In order to reduce the risk of infection caused by sutures, several types of suture coatings have been developed. Hence, doxycycline (DOXY) was applied as an antibiotic for coating silk sutures to evaluate its antimicrobial potential. This study focuses on the coating of a silk suture based on nanohydrogel carreier polymethacrylic acid (PMAA) for the delivery of DOXY. For this purpose, the structure and morphology of the designed nanohydrogel carreier and coated suture were investigated by several descriptive methods such as Fourier Transform Infrared Spectroscopy (FTIR), X-ray difraction (XRD) analysis, and scanning electron microscopy (SEM). The maximum amount of drug loading (DL) and encapsulation efficiency (EE) by nanohydrogel was 6.25 % and 29 %, respectively and DL for coated silk suture was 1.37 % per cm. The release of drug of the coated silk suture occurred in a time-dependent manner, which is favorable for the intended use. In addition, in vitro antibacterial potential of the coated suture was evaluated. Comparing their zones of inhibition showed that the Escherichia coli was more inhibited than the Staphylococcus aureus bacteria. Our results were indicated that DOXY-loaded PMAA coated silk suture can noticeably impede bacterial adhesion. [ABSTRACT FROM AUTHOR]

Background: The most common technique for gingival augmentation is free gingival graft (FGG). The aim of this study is to clinically compare the efficacy of FGG harvested with erbium: yttrium-aluminum-garnet (Er: YAG) laser stabilized with 5-0 silk suture in comparison to N-butyl-2-cyanoacrylate tissue adhesive in increasing the width of keratinized gingiva (WK) for the management of Miller's Class I and II gingival recession. Methodology: Forty-eight gingival recession defects were divided into two Groups I and II. Group I sites were treated with FGG harvested using Er: YAG laser stabilized with 5-0 silk suture and Group II sites were treated with FGG harvested using Er: YAG laser stabilized with N-butyl-2-cyanoacrylate tissue adhesive. Clinical parameters such as gingival recession depth, clinical attachment level (CAL), gain in gingival tissue thickness, and WK were recorded at baseline and 3 and 6 months postoperatively. Results: A significant reduction in gingival recession defects, gain in CAL, increase in WK, and gain in gingival tissue thickness were observed in both the groups. Intergroup comparison of gingival recession defects, CAL, WK, and gingival tissue thickness yielded nonsignificant differences. Conclusion: Within the limits of this study, it can be concluded that both 5-0 silk suture and n-butyl-2-cyanoacrylate were equally efficacious in the stabilization of FGG. N-butyl-2-cyanoacrylate was easy to apply, consumed less operating time, and had no adverse effect. Hence, cyanoacrylate can be used as an alternative to suture in stabilization of FGG. [ABSTRACT FROM AUTHOR]

Abstract Suturation may remain in the mouth for a long time due to incomplete information to patients due to inadvertency. Forgotten silk sutures might be sunk and cause irritation into the alveolar mucosa.

The objective of this study was to compare the silk suture with a cyanoacrylate adhesive to stabilize the free gingival graft in conjunction with Er: YAG laser-assisted recipient site preparation to augment the keratinized tissue in gingival recession cases. This randomized trial comprised of 300 recession defects patients. All the included patients were diagnosed using Miller class I and II gingival recession defects classification. Group I sites were treated with a free gingival graft (FGG) harvested using an Er: YAG laser and further sutured with silk. Group II sites were stabilized with isoamyl 2 cyanoacrylate bio-adhesive material. Clinical parameters, such as gingival recession depth, clinical attachment level, gain in gingival tissue thickness, and width of keratinized gingiva were recorded at baseline, and at third month, sixth month, and 12th month postoperatively. The mean changes in gingival recession from months 3 to 6 and months and 6 to 12 were significant (p < 0.05) in both groups. However, the improvement in recession depth was better in group II than in group I. The mean change in clinical attachment level did not differ significantly between the groups at the different time intervals. However, values tended to be higher in group II than in group I. The width of the keratinized gingiva tended to be higher from baseline to 3 months, baseline to 6 months, baseline to 12 months, 3 to 6 months, and from 6 to 12 months in group II as compared with group I (p > 0.05). Cyanoacrylate could be used as a substitute to silk sutures to stabilize FGGs. Cyanoacrylate was easy to apply, consumed less operating time, and was considered equally efficacious for stabilizing FGGs. [ABSTRACT FROM AUTHOR]

Objective(s): The objective of the current study was to prevent surgical site infection (SSI) by creating a new antibacterial silk suture. Methods: Cefixime trihydrate (CFX) was prepared as nanoparticles via mixing with polyvinyl alcohol (PVA) hydrogel by covalent cross-linkage. The mixture was stirred vigorously to obtain a homogenous gel. Under this condition the polymer chains separate CFX as nanoparticles and trap them (CFX@PVA). The enrichment of silk suture was performed by immersing it in the CFX@PVA solution. The trapped CFX nanoparticles in PVA hydrogel on the surface of sutures were confirmed by SEM. The effect of CFX@PVA silk sutures on tensile strength was analyzed, using a Santammachine controller. The antibacterial activity of the reinforced silk suture was tested on E. coli (ATCC25922) and S. aureus (ATCC25924). Results: All antibacterial studies clearly showed that the use of novel CFX@PVA silk sutures could represent clinical advantages, in terms of prevention of resistant bacteria, such as Staphylococcus aureus (S. aureus), the same as the sensitive bacteria, for 15 days. The maximum elongation of composite before rupture, modulus and extension, showed statistically significant difference between reinforced silk sutures and untreated silk suture. No statistically significant difference was found between the Failure load, Stress, Bending and Energy. Conclusions: Our data indicate that CFX@ Silk sutures are capable of reducing the risk of SSIs, and has a good mechanical strength to keep the wound sides closed, during early healing recovery.

Aim: is to compare between the outcome and complications in the use of local and general anesthesia in the management of sever blepharoptosis by use of straight needle threading technique and silk suture as a frontalis suspension. Settings and Design: it’s a prospective comparative study using two group one under local anesthesia and the other under general anesthesia with standardization of the cases as all has sever ptosis and poor levator functions, technique as the straight needle threading technique was used, material of thread was silk in 92% of cases, and sex distribution was of no statistical significance. Methods and materials: The parameters used for comparison were the following:-Satisfaction, Correction, Symmetry, Lid crease height (visible pretarsal height), Infection, stich abscess, stich granuloma, Eye opening during sleeping, Lagophthalmus, Entropion, Exposure keratitis. A 120 eye was operated on 95 patients; 25 patients (50 eyes) bilateral, 70 patients (70 eyes) unilateral, 36 eyes (30%) were operated on under local anesthesia, and 84 eyes (70%) were done under GA. The minimal age was 2years, maximum age 75 years, median 12 years, mean 19.8 years. The patients above the age of 16 years old were asked to choose between local or GA while below that age the correction was done under GA only. Results: There was no statistical significant difference in the all the nine parameters except the eye opening during sleeping were higher in the general anesthesia group. Conclusion: The use of local anesthesia is easier, of less risk, and lower cost with same aesthetic results of general anesthesia.

Background: Sutures are used for approximation of wound margins and to promote wound healing. Post-operative wound care is essential for uneventful wound healing. Normal saline rinse, chlorhexidine mouthwashes, hydrogen peroxide diluted with saline or fresh tap water are some of the frequently used mouth rinses used to maintain clean sutured wounds in intraoral surgery. The aim of the present study was to evaluate the effectiveness of chlorhexidine and warm saline mouth rinses against bacterial colonization on silk suture material in third molar surgery through microbiological analysis. Materials and Methods: This was a split-mouth prospective randomized clinical study involving a total of 25 patients requiring lower third molar surgery bilaterally. After the extraction of the third molar on the left side, all the participants were instructed to use warm saline mouth rinse (group 1) from the second postoperative day to the seventh postoperative day. Fifteen days later third molar surgery was done on the contralateral side followed by the use of 0.2% concentration of chlorhexidine mouth rinse (group 2) from the second postoperative day to seventh postoperative day. Microbial analysis from silk suture was performed, data were analysed in SPSS software and results obtained. Results: Bacterial adherence to sutures (colony forming units of bacteria) were more in group 1 compared to group 2 and the results were statistically significant (p < 0.05). Wound healing was complete and satisfactory in both the groups on the fifteenth postoperative day and none of the patients developed suture site infection. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to compare bacterial accumulation on different suture materials following oral surgery.Methods: Patients scheduled for implant or periodontal surgery were included in the study. Upon flap closure, four different sutures were placed in a randomized sequence—silk, coated polyglactin, nylon, and polyester. Ten days following surgery, the sutures were removed and incubated in aerobic as well as anaerobic conditions for 7 days and colony-forming units (CFUs) were calculated. Association between bacterial accumulation and periodontal diagnosis, type of surgery, and antibiotic treatment were also tested.Results: All sutures in all patients were found to contain bacteria. Overall, nylon sutures showed significantly lower CFU levels compared to silk, coated polyglactin, and polyester sutures. The type of surgery (implant vs. periodontal surgery) did not significantly influence bacterial accumulation. Also, periodontal diagnosis had little impact on CFU counts. Interestingly, post-surgical antibiotic treatment also had only a minor effect on bacterial accumulation on the various sutures.Discussion: The results indicate that the monofilamentous nylon sutures showed less microbial accumulation than the other tested materials that were all braided. This effect may be due to material qualities as well as suture macrostructure. Type of surgery, periodontal diagnosis, and antibiotic consumption have little effect on bacterial accumulation of sutures.Clinical relevance: The study provides the microbial profile of commonly used sutures and may assist in suture selection during clinical procedures. [ABSTRACT FROM AUTHOR]

Abstract Aim The aim of the study was to compare postoperative sequelae and wound healing outcome following closure of surgical wound with either cyanoacrylate tissue adhesive or silk suture. Methods Subjects with mesio-angularly impacted mandibular third molar were allocated randomly into 2 equal groups. The control group had wound closure with silk suture and study group with cyanoacrylate tissue adhesive. Subjects were followed up for 7 postoperative days. Postoperative pain, swelling, trismus, bleeding, wound dehiscence and wound infection were evaluated. Results Sixty subjects in each group completed the study. No significant difference was observed in the mean postoperative pain, swelling, trismus, wound dehiscence and infection between the 2 groups. There was a statistically significant difference in postoperative bleeding between the 2 groups on postoperative day 1, with more bleeding in the control group. Conclusions This study shows that cyanoacrylate tissue adhesive compares favourably with silk suture as a wound closure material. In addition, cyanoacrylate tissue adhesive seems to have beneficial haemostatic effect on postoperative bleeding. [ABSTRACT FROM AUTHOR]

Suturation may remain in the mouth for a long time due to incomplete information to patients due to inadvertency. Forgotten silk sutures might be sunk and cause irritation into the alveolar mucosa. [ABSTRACT FROM AUTHOR]

The bacterial infection of surgical wounds results in prolonged hospitalization and even death of patients, calling for antibacterial function in modern suture products. To tackle this challenge, cationic guanidine-containing copolymer was synthesized, exhibiting antibacterial potency over 5 log reduction against both Gram-positive S. aureus and Gram-negative E. coli. Furthermore, we developed a double-network silk suture by integrating a guanidine-containing copolymer network into the silk fibroin network. This suture exhibited biocidal activity against S. aureus and E. coli , and superior strength compared to the commercial product in both dry and wet conditions. These results may bring general benefits to public health and medical equipment sustainability. [ABSTRACT FROM AUTHOR]

Background: The use of absorbable sutures in wound closure has been shown to reduce the incidence of surgical site infection (SSI); however, there is no evidence that the intra-abdominal use of absorbable rather than silk sutures reduces the incidence of SSI after gastrointestinal surgery. We report the findings of a phase II trial, designed to evaluate the impact of the intra-abdominal use of absorbable sutures on the incidence of SSI. Methods: At 19 Japanese hospitals, 1147 patients undergoing elective gastrectomy, colorectal surgery, hepatectomy, or pancreaticoduodenectomy (PD) were randomly assigned to absorbable or silk intra-abdominal suture groups. The primary efficacy endpoint was the incidence of SSI. The secondary efficacy endpoints were the locations of SSI, time to resolution of SSI, length of hospital stay, and the incidence of bile leakage in hepatectomy and pancreatic fistula. Results: The incidence of SSI was 11.3%, 15.5%, 11.3%, and 36.9% after gastrectomy, colorectal surgery, hepatectomy, and PD, respectively. The incidence of SSI was higher in the absorbable suture group than in the silk suture group for all the surgical procedures, but the difference was not significant. Conclusion: The intra-abdominal use of absorbable sutures did not have enough of an effect on the reduction of SSI in this phase II trial to justify the planning of a large-scale phase III trial. [ABSTRACT FROM AUTHOR]

Background In order to maintain the surgery site's shape, functionality, and aesthetics, closure of the wound is essential for intra-oral and general surgical procedures. Wound closure speeds up healing by reducing the buildup of inflammatory cells. For a wound to heal well, the incision must be precise, the tissue must be handled delicately, the wound must be precisely repositioned, and the closure material must have optimum functional properties and be sterile. Aim This study aims to conduct a clinical comparison of the effectiveness of silk suture versus isoamyl 2-cyanoacrylate (IAC) for intra-oral mucosal incisions. Methodology Fifty patients who needed a minor oral surgical operation under local anesthesia from the Department of Oral and Maxillofacial Surgery were recruited for this prospective clinical trial. Ethical clearance and informed consent were obtained for this study. Two groups were created from the sample of 50 patients in this investigation. An intra-oral mucosal incision was closed in one group using a 3-0 silk suture and in the second using two drops of IAC. An accurate approximation of the incised edges was used to avoid leaving any gaps between them. Parameters such as the time taken for closure, pain, bleeding, swelling, mouth opening, wound dehiscence, wound infection, and local ulceration were evaluated in this study. A visual analog scale (0-10) was used to assess the pain score. Facial swelling was evaluated by the tape method given by Gabka and Matsumura. The measurement was done from tragus to pogonion, tragus to oral commissure, and outer canthus to gonion. The sum of these measurements was calculated. By measuring the distance between the incisal edges of the upper and lower central incisors, the trismus was evaluated using a graduated metal scale. Assessment of bleeding (0-4) was done by asking the patient. Assessment of wound dehiscence and local ulceration was done based on visual inspection and palpation on the first, second, and seventh days postoperatively. All the recorded parameters were tabulated. The statistical analysis was done using SPSS version 25.0 (IBM Corp., Armonk, NY). The Chi-square test was used to compare the categorical variables between the study groups. The independent t-test was used to compare the means between the study groups. The statistical significance was kept at a p-value less than 0.05. Results The results showed that there was no statistically significant difference between suture and IAC in terms of incidence of pain and wound dehiscence. But the time taken for wound closure was less with IAC, and the pain score on the seventh day was higher with IAC and statistically significant. Conclusion We observed that IAC was as effective as the gold standard silk suture. The advantages of IAC are its hemostatic and bacteriostatic qualities, and IAC also took less time to complete the procedure., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Akhter et al.)