Abstracts
Forty Wistar-Tecpar rats were used to determine the performance of polyglecaprone 25 sutures in the abdominal wall, contaminated or not. The animals were anesthetized and polyglecaprone 25 was implanted into the ventral abdominal wall on the left side and compared to the use of plain catgut implanted on the right. The subcutaneous tissue of 20 animals was contaminated with a standardized Staphylococcus aureus solution and the remaining 20 animals were not contaminated. The animals were checked on the third and seventh day after implant and the tissue reaction caused by polyglecaprone 25 in the presence or absence of contamination was found to be significantly less intense.
Catgut; Polyglecaprone 25; Sutures; Abdomen; Contamination; Rats
Comparou-se as suturas realizadas com poliglecaprone e categute na parede abdominal, contaminada ou não, de ratos. Foram utilizados 40 ratos Wistar Tecpar divididos em dois grupos de 20 designados A e B. Implantavam-se os fios na parede abdominal ventral, com o poliglecaprone à esquerda e o categute à direita. No grupo B inoculava-se na tela subcutânea 1,0ml de solução padronizada de Staphylococcus aureus no trajeto de cada um dos fios. Praticava-se a eutanásia, em 10 animais de cada grupo, no terceiro e no sétimo dia. A parede abdominal ventral, repartida em duas metades, direita e esquerda, era fixada em formalina e encaminhada para estudo histopatológico. O fio de poliglecaprone 25, na presença ou ausência de contaminação da parede abdominal de ratos, apresentou reação tecidual significantemente menos intensa do que o fio de categute, em ratos.
Categute; Poliglecaprone 25; Suturas; Abdome; Contaminação; Ratos
5 - ORIGINAL ARTICLE
A COMPARATIVE STUDY OF THE PERFORMANCE OF CATGUT AND POLYGLECAPRONE 25 SUTURES IN RAT ABDOMINAL WALLS, CONTAMINATED OR NOT. 1 1. Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). . Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). 2. Professor of the Disciplin. 3. Residents. 4. Medical students. 5. Professor of Pathology.
Maria de Lourdes Pessole Biondo-Simões21. Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). . Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). 2. Professor of the Disciplin. 3. Residents. 4. Medical students. 5. Professor of Pathology.
Marcelo Sech31. Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). . Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). 2. Professor of the Disciplin. 3. Residents. 4. Medical students. 5. Professor of Pathology.
Regina Célia Adur31. Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). . Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). 2. Professor of the Disciplin. 3. Residents. 4. Medical students. 5. Professor of Pathology.
Luciana de Oliveira Marques31. Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). . Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). 2. Professor of the Disciplin. 3. Residents. 4. Medical students. 5. Professor of Pathology.
Melisa Corbellini41. Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). . Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). 2. Professor of the Disciplin. 3. Residents. 4. Medical students. 5. Professor of Pathology.
Lucilea Santos Canalli41. Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). . Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). 2. Professor of the Disciplin. 3. Residents. 4. Medical students. 5. Professor of Pathology.
Milene Veronese41. Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). . Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). 2. Professor of the Disciplin. 3. Residents. 4. Medical students. 5. Professor of Pathology.
Pablo Cabrera41. Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). . Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). 2. Professor of the Disciplin. 3. Residents. 4. Medical students. 5. Professor of Pathology.
Lidia Isabel Vaz51. Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). . Work performed in the Discipline of Scientific Methodology , Clinical and Surgical Experimentation, Faculdade Evangélica de Medicina do Paraná (FEMPAR). 2. Professor of the Disciplin. 3. Residents. 4. Medical students. 5. Professor of Pathology.
BIONDO-SIMÕES, M.L.P.; SECH, M.; ADUR, R.C.; MARQUES, L.O.; CORBELLINI, M.; CANALLI, L.S.; VERONESE, M.; CABRERA, P.; VAZ, L.I. - A comparative study of the performance of catgut and polyglecaprone 25 sutures in rat abdominal walls, contaminated or not. Acta Cir. Bras., 12(3):163-8, 1997.
SUMMARY: Forty Wistar-Tecpar rats were used to determine the performance of polyglecaprone 25 sutures in the abdominal wall, contaminated or not. The animals were anesthetized and polyglecaprone 25 was implanted into the ventral abdominal wall on the left side and compared to the use of plain catgut implanted on the right. The subcutaneous tissue of 20 animals was contaminated with a standardized Staphylococcus aureus solution and the remaining 20 animals were not contaminated. The animals were checked on the third and seventh day after implant and the tissue reaction caused by polyglecaprone 25 in the presence or absence of contamination was found to be significantly less intense.
SUBJECT HEADINGS: Catgut. Polyglecaprone 25. Sutures. Abdomen. Contamination. Rats.
INTRODUCTION
The placement of sutures in subcutaneous tissue often induces chronic inflammatory processes. Plain catgut has been more extensively used at this location.
Polyglecaprone 25 is a recently developed synthetic, absorbable monofilament suture prepared from a copolymer of the glycolide epsilon caprolactone.
There are no reports in the literature about the inflammatory response of tissue to the implant of this suture into the abdominal wall. Since it is a monofilament, polyglecaprone 25 may harbor fewer bacteria. On this basis, the objective of the present study was to investigate the performance of this suture in the abdominal wall of rats, contaminated or not, and compare it to that of plain catgut.
METHOD
The study was conducted on 40 female rats (Rattus norvegicus albinus, Rodentia, mammalia) of the Wistar-Tecpar strain aged 100 to 120 days and weighing on average 243 g (range: 211.4-295.2 g), provided by the Technological Institute of Paraná.
The animals were anesthetized by ether inhalation and the ventral abdominal wall was shaved and disinfected with polyvinylpyrrolidone-iodine. Two 2.0 cm long lines separated by a distance of 2.0 cm were then marked on the abdomen with ink, parallel to the midline. Plain 5-0 catgut was then introduced under one line into the deep subcutaneous tissue on the right using a 1.5cm traumatic needle, while polyglecaprone 25 was similarly introduced on the left side using a PS-2 needle. The suture was cut at the points of entry and exit and the skin was stretched in the craniocaudal direction so that the entire length of the suture would be contained in the wall.
Twenty animals were selected at random to form group A and the remaining 20 were used to form group B. The latter group was inoculated with 1.0 ml of a solution containing Staphylococcus aureus at the concentration of 106 CFU/ml along the path of each suture.
After recovering from anesthesia, the animals were identified and returned to their cages where they had free access to water and commercial ration until the time for evaluation. Ten animals from each group were picked at random and sacrificed by excess ether inhalation on the third and seventh day. The ventral abdominal wall was resected in all its thickness and the piece was divided into a left half and a right half which were fixed in 10% formalin and submitted to histopathologic examination after staining with hematoxylin-eosin and Mallory trichrome.
The histological sections were examined for the presence of suture and of its integrity, for the presence of a leucocyte infiltrate and the predominance of mono- or polynuclear cells, and for the presence of fibroblasts, collagen fibers, blood vessels, hemorrhage and edema. The presence and arrangement of these elements were recorded.
When granulomas were present they were measured with an Olympus® OSM-4 ocular micrometer. The widest diameter was measured and another measurement was made in its center, perpendicular to the first. The mean diameter and the area occupied by the granuloma were then calculated.
Data were analyzed statistically by the Mann-Whitney test, with the level of significance set at 0.05 or 5.00%.
RESULTS
No animal died during the experiment and no abscesses were observed macroscopically. The inflammation caused by the sutures is presented comparatively between the two groups and the two sides for each time of sacrifice.
THIRD DAY
Group A - right side
At microscopy, the catgut suture appeared to be intact or partially fragmented, surrounded by an inflammatory reaction distributed into 2 layers. In the inner layer there was an intense leucocyte infiltrate with a predominance of polymorphonuclear cells. In the outer layer there were few collagen fibers, fibroblasts, vascular congestion, and few mono-and polymorphonuclear cells (Figure 1.a).
Group A - left side
Polyglecaprone 25 was found to be intact or partially fragmented. The inflammatory reaction was similar to that observed on the right side, but the layers were thinner (Figure 1.b).
Group B - right side
Catgut was found to be intact or partially fragmented at equal proportions and was surrounded by two layers. An intense leucocyte infiltrate with a predominance of polymorphonuclear cells was observed in the inner layer. In the outer layer there were few collagen fibers, slight edema and neoformed blood vessels, few fibroblasts and poly- and monomorphonuclear cells (Figure 1.c).
Group B - left side
The polyglecaprone 25 suture was found to be intact or partially fragmented at equal proportions and was surrounded by two layers similar in appearance to those described for the right side. However, these layers, although similar to those on the right side, were thinner and the cell infiltrate was less dense (Figure 1.d).
SEVENTH DAY
Group A - right side
The catgut suture was found to be intact or partially fragmented. The inflammatory reactions showed a polymorphonuclear and monomorphonuclear infiltrate in the inner layer. In the outer layer there were fibroblasts, collagen fibers, and poly- and monomorphonuclear cells (Figure 2.a).
Group A - left side
Polyglecaprone 25 was intact or partially fragmented and surrounded by an inflammatory reaction similar to that described for the right side, but less intense (Figure 2.b).
Group B - right side
The catgut suture was intact or partially fragmented and was surrounded by two layers. In the inner layer there were poly- and monomorphonuclear cells, with no predominance of one type over the other. In the outer layer there was a moderate amount of collagen fibers, fibroblasts and few leucocytes (Figure 2.c).
Group B - left side
Polyglecaprone 25 was intact or partially fragmented and surrounded by two layers of inflammatory tissue. In the inner layer there was a predominance of monomorphonuclear cells, and the outer layer was similar in appearance to that on the right side, but thinner (Figure 2.d).
The areas occupied by granulomas are described in Table I for the 3rd day and in Table II for the 7th day.
DISCUSSION
The objective of the present experiment was to determine the behavior of polyglecaprone 25 suture implanted into the abdominal wall and compare it to that of plain catgut in the absence and in the presence of contamination with Staphylococcus aureus. The suture was placed in the deep subcutaneous tissue in contact with connective tissue and with the abdominal muscles.
Plain catgut was chosen as a control because of its wide use in surgery in this location.
The option for suture thickness was aleatory since, according to LAWRIE, ANGUS and REESE (1959), the inflammatory reaction is influenced more by the chemical nature than by the thickness of the suture.
We observed that the two sutures triggered an inflammatory reaction of the same appearance, although the ones surrounding polyglecaprone 25 were significantly less intense, as demonstrated by the size of the granulomas. The two sutures also behaved similarly in the presence of contamination, although the reaction was significantly less intense for catgut.
The present findings are similar to those reported by POSTLETHWAITH, SCHAUSLE, DILLON and MORGAN (1959) and FONSÊCA, ORTIZ, SIMÕES, NOVO, JULIANO and GOLDENBERG (1990) for catgut without the use of an antibiotic. No reports of the use of polyglecaprone 25 are available for comparison with the present results.
CONCLUSION
The polyglecaprone 25 suture produces a significantly less intense tissue reaction than catgut both in the presence and in the absence of contamination of the abdominal wall of rats.
BIONDO-SIMÕES, M.L.P.; SECH, M.; ADUR, R.C.; MARQUES, L.O.; CORBELLINI, M.; CANALLI, L.S.; VERONESE, M.; CABRERA, P.; VAZ, L.I. - Estudo comparativo entre o fio de categute e o poliglecaprone 25cm em paredes abdominais, contaminadas ou não, de ratos. Acta Cir. Bras., 12(3):163-8, 1997.
RESUMO: Comparou-se as suturas realizadas com poliglecaprone e categute na parede abdominal, contaminada ou não, de ratos. Foram utilizados 40 ratos Wistar Tecpar divididos em dois grupos de 20 designados A e B. Implantavam-se os fios na parede abdominal ventral, com o poliglecaprone à esquerda e o categute à direita. No grupo B inoculava-se na tela subcutânea 1,0ml de solução padronizada de Staphylococcus aureus no trajeto de cada um dos fios. Praticava-se a eutanásia, em 10 animais de cada grupo, no terceiro e no sétimo dia. A parede abdominal ventral, repartida em duas metades, direita e esquerda, era fixada em formalina e encaminhada para estudo histopatológico. O fio de poliglecaprone 25, na presença ou ausência de contaminação da parede abdominal de ratos, apresentou reação tecidual significantemente menos intensa do que o fio de categute, em ratos.
DESCRITORES: Categute. Poliglecaprone 25. Suturas. Abdome. Contaminação. Ratos.
Address reprint request:
Maria de Lourdes P. Biondo Simões
Rua Ari José Vale, 1987 - Santa Felicidade
CEP: 82030-000 CURITIBA - PR
Accepted for publication on april, 1997
- 1. FONSĘCA, A.S.; ORTIZ, V.; SIMŐES, M.J.; NOVO, N.F.; JULIANO, I.;GOLDENBERG, S. - Aspectos morfológicos e morfométricos do processo inflamatório provocado por fio de categute simples na tela subcutânea de ratos com ampicilina. Acta Cir. Bras.,5:66-70, 1990.
- 2. LAWRIE, P.; ANGUS, G.E.; REESE, A.J.M. - The absorption of surgical catgut. Br. J. Surg., 46:638-42, 1959.
- 3. POSTLETHWAIT, R.W.; SCHAUBLE, J.F.; DILLON, M.L.; MORGAN, J. - Wound healing. II: An evolution of surgical suture material. Surg. Gynecol. Obstet., 108:555-66, 1959.
Publication Dates
-
Publication in this collection
08 June 2001 -
Date of issue
Sept 1997
History
-
Accepted
Apr 1997
