Comparison of effects of suture materials and suture patterns on healing in skeletal muscle laceration repair

Healing in muscle injury occurs by slow and irregular muscle regeneration. Suturing the lacerated muscle improves muscle healing but can not prevent dense fibrous scar tissue formation. There are various kinds of absorbable suture materials used in muscle repair. Multifilament sutures are known to cause more inflammation in tissue than monofilament sutures. Tears and separations due to its fibrous structures make muscles difficult to repair.In our study, we aimed to search the effects of suture techniques namely modified Kessler and modified Mason-Allen combined with epimisial sutures, indicated in the literature having the highest maximum loads, and monofilament and multifilament suture material use on muscle healing especially in fibrosis stage.Totally 48 Sprague-Dawley female rats in 8 groups, 6 rats in each group, were included in the study. A full thickness laceration in the gastrocnemius muscle of the right hind limb was repaired by modified Mason Allen technique together with epimyseal suture and Vicryl in Groups I and II, by modified Kessler technique and Vicryl in Groups III and IV, by modified Mason Allen technique together with epimyseal suture and PDS II in Groups V and VI and modified Kessler technique and PDS II in Groups VII and VIII. Rats in groups I, III, V and VII were sacrificed at the postoperative sixth week and the remainder rats were sacrificed in the postoperative eighth week. Histologic studies were done by using Hematoxylen-eosin, Masson tricrome stains and Pax3, Pax7 and MyoD antibodies.As a result, in the samples obtained from 8 week groups indicated preservation of tissue integrity and more organized appearance of muscle fibers when compared with the samples of 6 week groups. Connective tissue increase and inflammation were less in PDS II groups than Vicryl groups. Pax3, Pax7 and MyoD immunstains used in evaluating satellite cell activation indicated an increased uptake in 6 week groups and decreased immunreactivity in 8 week groups. It was concluded that the process of regeneration in the groups when modified Kessler suture technique and PDS II suture material is thought to be efficient.