Evaluation of tensile strength and knot security of commonly used sutures in commonly consumed beverages, an in-vitro study

Suture selection significantly impacts surgical outcomes, with tensile strength and knot security being critical factors. This study investigated the influence of suture material and environmental factors on these parameters. We compared four suture types: polyglactin 910 (PG), polypropylene (PP), silk (SK) and polytetrafluoroethylene (PTFE). Tensile strength was assessed initially and during two weeks of immersion in various media (saliva, tea, coffee and cola). Knot security, specifically knot slippage and breakage, was evaluated across the different suture materials and media. Prolene displayed highest TS of all sutures. However this difference was statistically significant when compared with SK and PTFE sutures (p < 0.05). The mean tensile strength is significantly higher at day 3, day 7 and day 10 compared to baseline in Tea, Cola and Coffee with PG suture material (p-value < 0.05 for all). The incidence of knot slippage at baseline is significantly higher for PTFE as compared to all other types of suture materials (p < 0.05). The incidence of knot slippage at day 7 and day 14 is significantly higher compared to baseline in Cola by SK, PG and PP (p-value < 0.05 for all) The incidence of knot breakage at baseline is higher for silk as compared to all other sutures but it is statistically significant when compared to PTFE (p < 0.05). Environmental factors, such as acidic media, can negatively affect knot security. These findings underscore the importance of careful suture selection based on specific clinical requirements. However, further research needs to be undertaken to confirm these findings in-vivo.