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Microscopic Lint Accumulation on Barbed Poliglecaprone 25 Sutures
Summary
Barbed sutures (a special stitch design surgeons use to speed up procedures) collect way more lint fibers from surgical cloths and towels than regular smooth sutures do, especially the more times they're dragged across fabric during surgery. Since this trapped lint can trigger the body's immune system to react to it like a foreign invader, surgeons may want to limit how much they drag these sutures over cloth to reduce complications and inflammation at the surgery site.
BACKGROUND: Lint is a fuzzy accumulation of tiny fibers that can deposit on surgical materials and elicit foreign body reactions. Barbed sutures in plastic surgery distribute tension and reduce operative times, but whether their engineered barbs capture lint is unknown. This pilot study quantifies lint accumulation on regular versus barbed poliglecaprone 25 sutures dragged across operative fabrics. METHODS: 24 regular and 48 barbed (Stratafix) sutures were drawn 21.5 cm across textiles in reproducible linear motion, using an inclined plane. Sutures underwent 1- or 5-pass testing across SMS polypropylene gowns and drapes and 100% cotton OR towels. Lint particles were quantified by light microscopy, with group comparisons performed using Wilcoxon rank-sum and Kruskal–Wallis tests (p < 0.05) in SAS 9.4 (SAS Institute, Cary, NC). RESULTS: Significantly greater lint accumulated in barbed versus regular sutures (23.5 [IQR 27.0] vs 0.0 [0.0]; p < 0.001). Lint clustered around the barbs, and sutures exposed to 5-passes demonstrated twice the lint compared to those with 1-pass (35.5 [25.0] vs 14.5 [12.5]; p=0.0002). There was a statistically significant difference across all textiles (p=0.0022), with the greatest lint accumulation using Rx Only Towels (27.5 [22.5]). CONCLUSIONS: A striking number of lint fibers accumulated on barbed sutures. Our results suggest that lint progressively accumulates at the barbs over repeated passes, with cotton textiles transferring the most lint. Surgeons should minimize the times a barbed suture is dragged over sterile fabrics to minimize foreign body reactions.