Owing to the equivalent scar profile of absorbable suture and permanent suture, and the ability of the surgeon to conserve time and minimize patient anxiety by using absorbable suture, most surgical patients have the superficial layer of their surgical wounds closed with 5-0 fast-absorbing gut suture. The main criterion for this decision is surgeon preference. At 1-week follow-up, a subset of these patients show dehiscence of the most superficial layer of skin closure. The superficial epidermis pulls apart, and no evidence of the fast-absorbing gut sutures can be found. The separated wound closes by secondary intention over the ensuing 3 to 4 weeks without significant complications. Extensive questioning of these patients reveals that most of them used hydrogen peroxide to clean their wounds postoperatively. The question of whether hydrogen peroxide affects the tensile strength of fast-absorbing gut sutures by increasing its degradation rate became the focus of this study.
On preliminary visual examination, nylon and polypropylene sutures did not appear to be affected by either water or hydrogen peroxide. Both groups of suture samples retained their shape, color, and general feel when handled. The fast-absorbing gut suture, however, was different. The fast-absorbing gut suture subjected to water did not appear to be affected compared with control suture. The fast-absorbing gut suture subjected to hydrogen peroxide rinses completely disintegrated during handling. It could not hold any tension at all, and in 1 case, the hydrogen peroxide–treated suture had completely degraded; the only thing left behind was the needle.
FUNDAMENTAL CHANGE IN THOUGHT NEEDED
Athre RS, Park J, Leach JL. The effect of a hydrogen peroxide wound care regimen on tensile strength of suture. Arch Facial Plast Surg. 2007;9:281-284.
Dr RS Athre interviewed by Cosmetic Surgery Times on his study; April 2008 Issue