Suture with resorbable cones: Histology and physico-mechanical features

BACKGROUND: Silhouette Sutures (Kolster Methods, Inc., Corona, CA) exhibit different biological characteristics at various time points after their placement. OBJECTIVES: The goals of this study were to understand the biological reactions of Silhouette Sutures in human tissues at different time intervals and to determine the index of resistance of the sutures in subcutaneous tissue. METHODS: Histologic examination was performed on section soft tissue containing the sutures at 1 month, 3 months, 6 months, and 1 year after suture placement. The study comprised 8 patients, each of whom received 4 sutures in the lower abdomen under local anesthesia. The sutures were placed exactly 1 month, 3 months, 6 months, and 1 year before planned post-bariatric abdominal surgery. Dynamometric evaluation was performed on a never-used suture and on sutures removed from 1 year after placement. The scar process around the threads was also examined. RESULTS: A progressive increase in scar tissue around the sutures was observed. One year after placement, there was a reduction of 16.7% in yield and tensile strength and a reduction of 14.29% in elongation at break, relative to the never-used suture. By 1 year, the cones in polylactic and glycolic acids had been replaced by scar tissue. CONCLUSIONS: Fibrous tissue around the sutures increased progressively over time, and was most prominent at the level of the nodes. Cones were completely resorbed within 6 months. A reduction in the index of resistance of the suspension sutures occurred over 1 year.