A basic principle of surgery is selection of an optimal suture material.1 The size, type (absorbable or not absorbable), and nature (natural or synthetic) of suture material selected will differ depending on the nature of the tissue repaired and surgeon preference. In vitro studies2–13 conducted in several species have provided information on properties of suture materials after incubation in various tissues and body fluids. Choice of suture material for use in cattle is typically extrapolated from results obtained in other species.
Injury to the mammary glands is common in cattle.14 Obstruction of milk flow and teat lacerations require surgical intervention, which results in exposure of the suture line to milk. With proper surgical technique, noncomplicated thelotomy incisions heal rapidly with reported complication rates of 25% for cows with mastitis and an incidence of 6% for incisional dehiscence.15,16 There is a guarded prognosis for successful repair of teat lacerations, with a high incidence of dehiscence and fistula formation. Many factors predispose to dehiscence, including inadequate suture materials and inappropriate suture patterns. The unusual forces applied to teats during milking can also be a contributing factor. Because the suture line is exposed to milk in animals undergoing teat surgery, it is important to evaluate the effect of this fluid on suture materials and determine suture materials that should be used to avoid postsurgical complications.
In the face of infection (ie, mastitis), pH and the somatic cell count of milk increase as polymorphonuclear cells migrate into the mammary glands. Inflammation during mastitis compromises healing of incisions. In cattle, infection of the mammary glands is typically caused by gram-negative or -positive bacteria.17 Teat surgery may be performed in cattle with mastitis; however, in an effort to decrease the chance of complications, the effects of mastitis must be taken into consideration when choosing suture materials. In human and veterinary medicine, there is a significant loss of tensile strength and elasticity of suture materials that have been incubated in infected urine.7-9,12,13 Therefore, it is important to examine the effect of bacteria found in mastitic milk on suture properties and determine the best suture for use in cattle with mastitis to avoid post-surgical complications.
For the study reported here, we hypothesized that tensile properties (ie, breaking strength and elasticity) of suture materials would decrease more rapidly after incubation in milk and BCM, compared with results after incubation in PBSS. Our objectives were to determine the in vitro effects of incubation in PBSS, milk, and BCM on suture properties of 3 types of synthetic absorbable suture materials.
Monocryl, Ethicon, Johnson & Johnson, Somerville, NJ.
Dexon II, Syneture, Norwalk, Conn.
PDS II, Ethicon, Johnson & Johnson, Somerville, NJ.
Instron 1322, Instron Industrial Products, Grove City, Pa.
Universal test program (UTP-III) 1993, Interlaken Technology, Chaska, Minn.
PRISM, version 4, GraphPad Software Inc, San Diego, Calif.
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