Clinical Oral Investigations

, Volume 23, Issue 2, pp 559–565 | Cite as

Microbial accumulation on different suture materials following oral surgery: a randomized controlled study

  • Ran Asher
  • Tali Chacartchi
  • Moshik Tandlich
  • Lior Shapira
  • David PolakEmail author
Original Article



The aim of the study was to compare bacterial accumulation on different suture materials following oral surgery.


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.


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.


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.


Nylon suture Coated polyglactin suture Silk suture Polyester suture 



The study was self-funded. Shvadent Ltd., Israel, contributed the sutures to the study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Burkhardt R, Lang NP (2015) Influence of suturing on wound healing. Periodontology 2000 68 (1):270–281. doi:
  2. 2.
    Banche G, Roana J, Mandras N, Amasio M, Gallesio C, Allizond V, Angeretti A, Tullio V, Cuffini AM (2007) Microbial adherence on various intraoral suture materials in patients undergoing dental surgery. J Oral Maxillofacial Surgery : Official J Am Assoc Oral Maxillofacial Surgeons 65(8):1503–1507. CrossRefGoogle Scholar
  3. 3.
    Leknes KN, Roynstrand IT, Selvig KA (2005) Human gingival tissue reactions to silk and expanded polytetrafluoroethylene sutures. J Periodontol 76(1):34–42. CrossRefGoogle Scholar
  4. 4.
    Selvig KA, Biagiotti GR, Leknes KN, Wikesjo UM (1998) Oral tissue reactions to suture materials. Int J periodontics Restorative Dentistry 18(5):474–487Google Scholar
  5. 5.
    Grigg TR, Liewehr FR, Patton WR, Buxton TB, McPherson JC (2004) Effect of the wicking behavior of multifilament sutures. J Endod 30(9):649–652CrossRefGoogle Scholar
  6. 6.
    Katz S, Izhar M, Mirelman D (1981) Bacterial adherence to surgical sutures. A possible factor in suture induced infection. Ann Surg 194(1):35–41CrossRefGoogle Scholar
  7. 7.
    Armitage GC (1999) Development of a classification system for periodontal diseases and conditions. Annals Periodontology 4(1):1–6. CrossRefGoogle Scholar
  8. 8.
    Masini BD, Stinner DJ, Waterman SM, Wenke JC (2011) Bacterial adherence to suture materials. J Surgical Education 68(2):101–104. CrossRefGoogle Scholar
  9. 9.
    Edlich RF, Panek PH, Rodeheaver GT, Turnbull VG, Kurtz LD, Edgerton MT (1973) Physical and chemical configuration of sutures in the development of surgical infection. Ann Surg 177(6):679–688CrossRefGoogle Scholar
  10. 10.
    Justinger C, Moussavian MR, Schlueter C, Kopp B, Kollmar O, Schilling MK (2009) Antibacterial [corrected] coating of abdominal closure sutures and wound infection. Surgery 145(3):330–334. CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PeriodontologyHebrew University-Hadassah Faculty of Dental MedicineJerusalemIsrael

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