Evaluation of the efficacy of plain silk sutures versus chlorhexidine coated silk sutures on bacterial adherence post periodontal flap surgery

Nagaraj B. Kalburgi; Arati C. Koregol; Anjaly Roy; Uzma Parveen Sulthana

doi:10.18203/2394-6040.ijcmph20253279

Authors

Nagaraj B. Kalburgi Department of Periodontics, P. M. N. M Dental College and Hospital, Bagalkot, Karnataka, India
Arati C. Koregol Department of Periodontics, P. M. N. M Dental College and Hospital, Bagalkot, Karnataka, India
Anjaly Roy Department of Periodontics, P. M. N. M Dental College and Hospital, Bagalkot, Karnataka, India
Uzma Parveen Sulthana Department of Periodontics, P. M. N. M Dental College and Hospital, Bagalkot, Karnataka, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20253279

Keywords:

Chlorhexidine, Flap surgery, Suture

Abstract

Periodontal disease management is based on non-surgical measures like scaling and root planning and surgical treatment like periodontal flap surgery. Sutures are used for wound approximation following periodontal flap surgery. Sutures impregnated with antibacterial agents have been developed in an attempt to reduce bacterial adherence and colonization. Chlorhexidine, a synthetic antimicrobial drug can be used in such situations. This study aimed to evaluate the wound healing and colony count of P. gingivalis in plain silk suture and chlorhexidine gel coated silk suture 7 days post periodontal flap surgery. Twelve periodontitis subjects were selected and divided into group A with 6 subjects who undergone periodontal flap surgery followed by placement of plain silk sutures, group B with 6 subjects who undergone periodontal flap surgery followed by placement of chlorhexidine gel coated silk sutures. On 7^th day, wound healing was analysed and the sutures were sent for bacterial culture of P. gingivalis bacteria. On intergroup comparison, significant reduction in the CFU count of P. gingivalis was observed in group B. But there was no significant difference in wound healing between both groups. The chlorhexidine coated silk sutures resulted in a satisfactory clinical behavior for routine use without the risk of bacterial contamination of the surgical wound. Hence it can be used in the routine wound closure post periodontal flap surgery without the hindrance of bacterial adhesion.

Metrics

Metrics Loading ...

References

Rosen PS, Reynolds MA, Bowers GM. The treatment of intrabony defects with bone grafts. Periodontology 2000. 2000 Feb 1;22(1). DOI: https://doi.org/10.1034/j.1600-0757.2000.2220107.x

Varghese SS, Thomas H, Jayakumar ND, Sankari M, Lakshmanan R. Estimation of salivary tumor necrosis factor-alpha in chronic and aggressive periodontitis patients. Contemporary clinical dentistry. 2015 Sep 1;6(Suppl 1):S152-6. DOI: https://doi.org/10.4103/0976-237X.166816

Panda S, Jayakumar ND, Sankari M, Varghese SS, Kumar DS. Platelet rich fibrin and xenograft in treatment of intrabony defect. Contemporary clinical dentistry. 2014 Oct 1;5(4):550-4. DOI: https://doi.org/10.4103/0976-237X.142830

Thamaraiselvan M, Elavarasu S, Thangakumaran S, Gadagi JS, Arthie T. Comparative clinical evaluation of coronally advanced flap with or without platelet rich fibrin membrane in the treatment of isolated gingival recession. Journal of Indian Society of Periodontology. 2015 Jan 1;19(1):66-71. DOI: https://doi.org/10.4103/0972-124X.145790

Ramesh A, Varghese SS, Jayakumar ND, Malaiappan S. Chronic obstructive pulmonary disease and periodontitis–unwinding their linking mechanisms. Journal of Oral Biosciences. 2016 Feb 1;58(1):23-6. DOI: https://doi.org/10.1016/j.job.2015.09.001

Polimeni G, Xiropaidis AV, Wikesjö UM. Biology and principles of periodontal wound healing/regeneration. Periodontology 2000. 2006 Jun 1;41(1). DOI: https://doi.org/10.1111/j.1600-0757.2006.00157.x

Szpaderska AM, Walsh CG, Steinberg MJ, DiPietro LA. Distinct patterns of angiogenesis in oral and skin wounds. Journal of dental research. 2005 Apr;84(4):309-14. DOI: https://doi.org/10.1177/154405910508400403

Cohen ES. Atlas of cosmetic and reconstructive periodontal surgery. PMPH-USA; 2007.

Srinivasulu K, Kumar ND. A review on properties of surgical sutures and applications in medical field. Int. J. Res. Eng. Technol. 2014;2(2):85-96.

Özçaka Ö, Arikan F, Sönmez Ş, Veral A, Kendirci S. Evaluation of the tissue reaction of five different suture materials in rabbit palatal mucosa. EÜ Dişhek Fak Derg. 2010;31:29-37. DOI: https://doi.org/10.5505/eudfd.2010.69875

Moy RL, Waldman B, Hein DW. A review of sutures and suturing techniques. Dermatologic Surgery. 1992 Sep 1;18(9):785-95. DOI: https://doi.org/10.1111/j.1524-4725.1992.tb03036.x

Baqain ZH, Moqbel WY, Sawair FA. Early dental implant failure: risk factors. British Journal of Oral and Maxillofacial Surgery. 2012 Apr 1;50(3):239-43. DOI: https://doi.org/10.1016/j.bjoms.2011.04.074

Yaltirik M, Dedeoglu K, Bilgic B, Koray M, Ersev H, Issever H, Dulger O, Soley S. Comparison of four different suture materials in soft tissues of rats. Oral diseases. 2003 Nov;9(6):284-6. DOI: https://doi.org/10.1034/j.1601-0825.2003.00954.x

Storch ML, Rothenburger SJ, Jacinto G. Experimental efficacy study of coated VICRYL plus antibacterial suture in guinea pigs challenged with Staphylococcus aureus. Surgical infections. 2004 Sep 1;5(3):281-8. DOI: https://doi.org/10.1089/sur.2004.5.281

Sanz M, Newman MG, Anderson L, Matoska W, Otomo—Corgel J, Saltini C. Clinical enhancement of post‐periodontal surgical therapy by a 0.12% chlorhexidine gluconate mouthrinse. Journal of periodontology. 1989 Oct;60(10):570-6. DOI: https://doi.org/10.1902/jop.1989.60.10.570

Newman MG, Sanz M, Nachnani S, Saltini C, Anderson L. Effect of 0.12% chlorhexidine on bacterial recolonization following periodontal surgery. Journal of periodontology. 1989 Oct;60(10):577-81. DOI: https://doi.org/10.1902/jop.1989.60.10.577

Landry RG, Turnbull RS, Howley T. Effectiveness of benzydamine HCl in the treatment of periodontal post-surgical patients. Research and Clinical Forums 1988;10:105-18.

Gomez-Alonso A, Garcia-Criado FJ, Parreno-Manchado FC, Garcia-Sanchez JE, Garcia-Sanchez E, Parreno-Manchado A, Zambrano-Cuadrado Y. Study of the efficacy of Coated VICRYL Plus® Antibacterial suture (coated Polyglactin 910 suture with Triclosan) in two animal models of general surgery. Journal of Infection. 2007 Jan 1;54(1):82-8. DOI: https://doi.org/10.1016/j.jinf.2006.01.008

Grigg TR, Liewehr FR, Patton WR, Buxton TB, McPherson JC. Effect of the wicking behavior of multifilament sutures. Journal of Endodontics. 2004 Sep 1;30(9):649-52. DOI: https://doi.org/10.1097/01.DON.0000121617.67923.05

Edmiston CE, Seabrook GR, Goheen MP, Krepel CJ, Johnson CP, Lewis BD, Brown KR, Towne JB. Bacterial adherence to surgical sutures: can antibacterial-coated sutures reduce the risk of microbial contamination?. Journal of the American College of Surgeons. 2006 Oct 1;203(4):481-9. DOI: https://doi.org/10.1016/j.jamcollsurg.2006.06.026

Lambert PM, Morris HF, Ochi S. The influence of 0.12% chlorhexidine digluconate rinses on the incidence of infectious complications and implant success. Journal of oral and maxillofacial surgery. 1997 Dec 1;55(12):25-30. DOI: https://doi.org/10.1016/S0278-2391(16)31194-6

Gupta SJ, Tevatia S, Khatri V, Dodwad V. Comparative evaluation of antiseptic pomade to prevent bacterial colonization after periodontal flap surgery-A clinical & microbiological study. J Dent Spec. 2017 Sep 1;5:102-7.

Karde PA, Sethi KS, Mahale SA, Mamajiwala AS, Kale AM, Joshi CP. Comparative evaluation of two antibacterial-coated resorbable sutures versus noncoated resorbable sutures in periodontal flap surgery: A clinico-microbiological study. Journal of Indian Society of Periodontology. 2019 May 1;23(3):220-5. DOI: https://doi.org/10.4103/jisp.jisp_524_18

Sharma C, Rajiv NP, Galgali SR. Microbial adherence on 2 different suture materials in patients undergoing periodontal flap surgery–A pilot study. J Med Sci Clin Res. 2017;5:23390-7. DOI: https://doi.org/10.18535/jmscr/v5i6.99