Subcuticular Sutures and the Rate of Inflammation in Noncontaminated Wounds, ,

Study objective: To determine whether buried, absorbable, subcuticular sutures increase the degree of inflammation in noncontaminated wounds. Design: Randomized, blinded, prospective trial. Setting: Laboratory. Participants: Eleven Sprague-Dawley rats weighing 300 to 325 g. Interventions: Four wounds were made on each rat. Two wounds on each were closed with three interrupted buried, absorbable, subcuticular sutures 6-0 polyglactin 910 and running 5-0 nylon skin sutures. The other two wounds were closed with running 5-0 nylon skin sutures alone. Results: Fourteen days after the sutures were placed, the animals were killed, and histologic preparations were made from each wound. Each sample was scored on a scale of 0 to 3 for the presence of inflammatory infiltrates, fibroplasia and capillary proliferation, necrosis, exudates, giant cells, and edema. We determined a total wound score by adding the scores from each category. The mean total wound score was 4.46±2.92 for those closed with buried, absorbable, subcuticular sutures and 4.91±2.56 for those closed without buried, absorbable, subcuticular sutures. Using the Wilcoxon rank-sum test, we found no statistically significant difference in mean total wound score of wounds closed with and without buried, absorbable, subcuticular sutures (α=.01). The probability of detecting a twofold difference in total wound scores was 60% (β=.40). Conclusion: Buried, absorbable, subcuticular sutures do not significantly increase the degree of inflammation in noncontaminated wounds. [Austin PE, Dunn KA, Eily-Cofield K, Brown CK, Wooden WA, Bradfield JF: Subcuticular sutures and the rate of inflammation in noncontaminated wounds. Ann Emerg Med March 1995;25:328-330.]