Читать книгу Complications in Equine Surgery - Группа авторов - Страница 139

Both the physical (monofilament vs. multifilament) and the chemical composition influence the reaction that takes place within the tissues [23]. Monofilament suture material withstands contamination better than multifilament suture material, while also having less tissue reactivity properties [23, 24]. Multifilament material results in more tissue trauma and has more capillary action, which may increase the potential for bacterial contamination [5]. Although bacteria can adhere to any suture material, multifilament suture surfaces tend to adhere to higher numbers of bacteria when compared to monofilament suture [4, 23]. Antibacterial‐coated suture may be responsible for increased risk of development of incisional edema [16]. Chronic granulomatous or abscess formation is a reaction that can occur secondary to suture material placement, which may result in a discharging sinus [9]. Surgical gut is a capillary multifilament suture that elicits a marked foreign body reaction when implanted in tissues because it is composed of collagen [23, 24]. In contrast, synthetic monofilament absorbable sutures such as polydioxanone, polyglyconate, and polyglecaprone 25 as well as synthetic multifilament absorbable sutures such as polyglycolic acid and polyglactin 910, cause a mild inflammatory response characterized by the presence of macrophages and fibroblasts at the wound site [23, 24]. Alternatively, synthetic nonabsorbable sutures such as nylon and polypropylene are biologically inert and cause minimal tissue reaction [23, 24]. Steel is biologically inert and incites no inflammatory reaction, except for that caused by inflexible suture ends [23, 24].