Editorial Type:
Surgery

Evaluation of the histologic reactions to commonly used suture materials in the skin and musculature of ball pythons (Python regius)

Michael S. McFadden Veterinary Teaching Hospital, Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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 MS, DVM
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R. Avery Bennett Veterinary Teaching Hospital, Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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 DVM, MS
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Michael J. Kinsel Zoological Pathology Program, Department of Pathobiology, College of Veterinary Medicine, University of Illinois, Maywood, IL 60153.

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Mark A. Mitchell Veterinary Teaching Hospital, Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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 DVM, PhD
DOI:
https://doi.org/10.2460/ajvr.72.10.1397
Volume/Issue:
Volume 72: Issue 10
Online Publication Date:
01 Oct 2011
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Abstract

Objective—To evaluate histologic reactions to 8 suture materials and cyanoacrylate tissue adhesive (CTA) in the musculature and skin of ball pythons.

Animals—30 hatchling ball pythons.

Procedures—In each snake, ten 1-cm skin incisions were made (day 0). At 8 sites, a suture of 1 of 8 materials was placed in the epaxial musculature, and the incision was closed with the same material. One incision was closed by use of CTA. No suture material was placed in the tenth incision, which was allowed to heal by second intention (negative control). Snakes (n = 5/group) were euthanized for harvest of treatment-site tissues at days 3, 7, 14, 30, 60, and 90. Skin and muscle sections were examined microscopically and assigned a subjective score (0 to 4) for each of the following: overall severity of inflammation, fibrosis, number of macrophages, number of granulocytes, number of perivascular lymphocytes, and degree of suture fragmentation.

Results—Subjective score analysis revealed that CTA did not cause a significant inflammatory response, compared with the negative control. All suture materials caused significantly more inflammation over all time points; for all suture materials, inflammatory response scores were significantly higher than values for the negative control 90 days after implantation. No sutures were completely absorbed by the end of the study period, and several sutures appeared to be in the process of extrusion.

Conclusions and Clinical Relevance—In snakes, CTA can be used to close small superficial incisions or lacerations with minimal inflammatory response, and sutures may undergo extrusion from tissues prior to complete absorption.

Abstract

Objective—To evaluate histologic reactions to 8 suture materials and cyanoacrylate tissue adhesive (CTA) in the musculature and skin of ball pythons.

Animals—30 hatchling ball pythons.

Procedures—In each snake, ten 1-cm skin incisions were made (day 0). At 8 sites, a suture of 1 of 8 materials was placed in the epaxial musculature, and the incision was closed with the same material. One incision was closed by use of CTA. No suture material was placed in the tenth incision, which was allowed to heal by second intention (negative control). Snakes (n = 5/group) were euthanized for harvest of treatment-site tissues at days 3, 7, 14, 30, 60, and 90. Skin and muscle sections were examined microscopically and assigned a subjective score (0 to 4) for each of the following: overall severity of inflammation, fibrosis, number of macrophages, number of granulocytes, number of perivascular lymphocytes, and degree of suture fragmentation.

Results—Subjective score analysis revealed that CTA did not cause a significant inflammatory response, compared with the negative control. All suture materials caused significantly more inflammation over all time points; for all suture materials, inflammatory response scores were significantly higher than values for the negative control 90 days after implantation. No sutures were completely absorbed by the end of the study period, and several sutures appeared to be in the process of extrusion.

Conclusions and Clinical Relevance—In snakes, CTA can be used to close small superficial incisions or lacerations with minimal inflammatory response, and sutures may undergo extrusion from tissues prior to complete absorption.

Contributor Notes

Dr. Bennett's present address is The Animal Medical Center, 510 East 62nd St, New York, NY 10065.

Dr. Kinsel's present address is Department of Pathobiology, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

Address correspondence to Dr. McFadden (mikemdvm@illinois.edu).
Cover American Journal of Veterinary Research
American Journal of Veterinary Research
Publication Date:
01 Oct 2011
  • 1.

    Mitchell MA. History of exotic pets. In: Mitchell MA, Tully TN, eds. Manual of exotic pet practice. St Louis: Saunders, 2009;1–3.

  • 2.

    Bennett RA, Lock BA. Nonreproductive surgery in reptiles. Vet Clin North Am Exot Anim Pract 2000; 3: 715–731.

  • 3.

    Bennett RA. Reptilian surgery part I: basic principles. Compend Contin Educ Pract Vet 1989; 11: 10–20.

  • 4.

    Bennett RA. Reptilian surgery part II: management of surgical diseases. Compend Contin Educ Pract Vet 1989; 11: 122–133.

  • 5.

    Smith DA, Barker IK. Healing of cutaneous wounds in the common garter snake (Thamnophis sirtalis). Can J Vet Res 1988; 52: 111–119.

  • 6.

    Smith DA, Barker IK, Allen B. The effect of ambient temperature and type of wound on healing of cutaneous wounds in the common garter snake (Thamnophis sirtalis). Can J Vet Res 1988; 52: 120–128.

    • Search Google Scholar
    • Export Citation
  • 7.

    Smith DA, Barker IK, Allen B. The effect of certain topical medications on healing of cutaneous wounds in the common garter snake (Thamnophis sirtalis). Can J Vet Res 1999; 52: 129–133.

    • Search Google Scholar
    • Export Citation
  • 8.

    Roush JK. Biomaterials and surgical implants. In: Slatter D, ed. Textbook of small animal surgery. 3rd ed. Philadelphia: Saunders, 2003;141–148.

    • Search Google Scholar
    • Export Citation
  • 9.

    Bellenger CR. Sutures part I: the purpose of sutures and available suture materials. Compend Contin Educ Pract Vet 1982; 4: 507–515.

  • 10.

    van Rijssel EJC, Brand R, Admiraal C, et al. Tissue reaction and surgical knots: the effect of suture size, knot configuration, and knot volume. Obstet Gynecol 1989; 74: 64–68.

    • Search Google Scholar
    • Export Citation
  • 11.

    Bennett RA, Yaeger MJ, Trapp A, et al. Histologic evaluation of the tissue reaction to five suture materials in the body wall of rock doves (Columba livia). J Avian Med Surg 1997; 11: 175–182.

    • Search Google Scholar
    • Export Citation
  • 12.

    DeNardo GA, Brown NO, Trenka-Benthin S, et al. Comparison of seven different suture materials in the feline oral cavity. J Am Anim Hosp Assoc 1996; 32: 164–172.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Govett PD, Harms CA, Linder KE, et al. Effects of four different suture materials on the surgical wound healing of loggerhead sea turtles, Caretta caretta. J Herpetol Med Surg 2004; 14: 6–10.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Hurty CA, Brazik DC, Law JM, et al. Evaluation of the tissue reactions in the skin and body wall of koi (Cyprinus carpio) to five suture materials. Vet Rec 2002; 151: 324–328.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Tuttle AD, Law JM, Harms CA, et al. Evaluation of the gross and histologic reactions to five commonly used suture materials in the skin of the African clawed frog (Xenopus laevis). J Am Assoc Lab Anim Sci 2006; 45: 22–26.

    • Search Google Scholar
    • Export Citation
  • 16.

    Woods DS, Collins JE, Walshaw R. Tissue reaction to nonabsorbable suture materials in the canine linea alba: a histologic evaluation. J Am Anim Hosp Assoc 1984; 20: 39–94.

    • Search Google Scholar
    • Export Citation
  • 17.

    Sanz LE, Patterson JA, Kamath R, et al. Comparison of Maxon suture with Vicryl, chromic catgut, and PDS sutures in fascial closure in rats. Obstet Gynecol 1988; 71: 418–422.

    • Search Google Scholar
    • Export Citation
  • 18.

    Yaltririk M, Dedeoglu K, Koray M, et al. Comparison of four different suture materials in soft tissues of rats. Oral Dis 2003; 9: 284–286.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Bennett RA. Preparation and equipment useful for surgery in small exotic pets. Vet Clin North Am Exot Anim Pract 2000; 3: 563–585.

  • 20.

    Homsy CA, McDonald KE, Akers WW. Surgical suture—canine tissue interactions for six common suture types. J Biomed Mater Res 1968; 2: 215–230.

  • 21.

    Jacobson ER, Millichamp NJ, Gaskin JM. Use of a polyvalent autogenous bacterin for treatment of mixed gram-negative bacterial osteomyelitis in a rhinoceros viper. J Am Vet Med Assoc 1985; 187: 1224–1225.

    • Search Google Scholar
    • Export Citation
  • 22.

    Fossum TW. Biomaterials, suturing, and hemostasis. In: Fossum TW, ed. Small animal surgery. St Louis: Mosby, 2002;43–59.

  • 23.

    Drake DB, Rodeheaver PF, Edlich RF, et al. Experimental studies in swine for measurement of suture extrusion. J Long Term Eff Med Implants 2004; 14: 251–259.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Conn KS, Dunning JJ, Pillai R. Extrusion of Teflon aortic pledgets from a sternal wound six years after cardiac surgery. Eur J Cardiothorac Surg 1997; 12: 150–151.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Morecraft RJ, Blair WF, Maynard JA. Suture extrusion in small arteries and veins. Scand J Plast Reconstr Surg 1988; 22: 121–126.

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