Wound Closure Materials

Wound is closed using various methods to achieve or restore tissue integrity, and wound edges that have lost integrity are brought together. Wound closure is facilitated and healing during the most critical phase of the wound is supported.

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The selection of materials used in wound healing depends on numerous factors including the nature of the wound tissue, its thickness, elasticity, rate of healing, tendency to scar, the patient’s health status, age, weight, comfort, and presence or absence of infection like. However, the general characteristics sought in wound closure materials are as follows:

• They should cause minimal tissue reaction
• They must provide the necessary tensile strength for the tissue
• They should be easily sterilizable
• They must not create a favorable environment for bacterial growth
• They should not be allergenic
• They must not be carcinogenic
• They should not be electrolytic
• They must not be capillary

Wound Closure Materials

Current wound closure materials include surgical staples, tissue adhesives, tapes, and sutures.

Surgical Staples

Staples are applied to the skin using an applicator and removed after healing using a specialized applicator. Their greatest advantage is a significant reduction in surgical procedure time. Staple use reduces the risk compared to sutures infection. However, removal of staples from the skin can be more difficult and painful than removal of sutures However.

There are two types:

1. Non-absorbable Staples

• Manufactured from stainless steel
• They have high tensile strength
• They exhibit low tissue reactivity
• These staples may irritate the skin, causing a sensation of embedded foreign bodies and pain

2. Absorbable Staples

• Composed of polyglactin and polyglycolic acid
• Absorbable staples are superior to metal staples in terms of inflammation, pain, and cosmetic outcomes

Tissue Adhesives

Tissue adhesives are a wound closure method that promotes more precise approximation of wound edges compared to other techniques. They are preferred for wound gaps ranging from 0.5 to 50 cm. They offer advantages in terms of low cost and ease of application, but their low tensile strength limits their use. Tissue adhesives are generally preferred for superficial wounds. In deep wounds, they are used as an adjunct to other closure techniques. The properties of tissue adhesives vary depending on their chemical composition and density. 2-octyl cyanoacrylate is the most preferred tissue adhesive due to its rapid bonding, strong tissue adhesion, and favorable cosmetic results common.

Surgical Wound Strips

Wound closure using porous tape creates higher resistance to infection compared to other closure methods. Tapes are unsuitable for areas of the wound that are tense or moist. Therefore, before applying wound closure, the wound area must be dried, sterilized, and hemostasis must be achieved. They are typically preferred in incision sites where wound edges have been approximated small, but they can also be used alongside staples or sutures to assist in wound closure.

Sutures

Sutures are the most commonly used wound closure material to accelerate and facilitate healing without visible scar formation. They offer advantages in terms of stability and flexibility at the wound site compared to other closure methods. Historically, materials such as dried animal intestine, at hair, tree shell, silk, gold, and steel wires have been used as suture materials. In the past, biodegradable materials such as PLLA and PLGA synthetic have also been used as suture materials. Although a wide variety of sutures are currently in use, no single suture is ideal for all types of wounds. Therefore, research on sutures continues. Most current sutures meet primary requirements such as tensile strength, anti-inflammatory properties, and flexibility for the wound site. However, current suture research focuses on developing sutures that actively support the wound healing process by incorporating drugs or therapeutic agents alongside existing suture properties row.