Comparing the Tolerability of a Novel Wound Closure Device Using a Porcine Wound Model

Abstract

Objective: To compare the tolerability and mechanical tensile strength of acute skin wounds closed with nylon suture plus a novel suture bridge device (SBD) with acute skin wounds closed with nylon suture in a porcine model. Approach: Four Yucatan pigs each received 12 4.5 cm full-thickness incisions that were closed with 1 of 4 options: Suture bridge with nylon, suture bridge with nylon and subdermal polyglactin, nylon simple interrupted, and nylon simple interrupted with subdermal polyglactin. Epithelial reaction, inflammation, and scarring were examined histologically at days 10 and 42. Wound strength was examined mechanically at days 10 and 42 on ex vivo wounds from euthanized pigs. Results: Histopathology in the suture entry/exit planes showed greater dermal inflammation with a simple interrupted nylon suture retained for 42 days compared with the SBD retained for 42 days (p < 0.03). While tensile wound strength in the device and suture groups were similar at day 10, wounds closed with the devices were nearly 8 times stronger at day 42 compared with day 10 (p < 0.001). Innovation: A novel SBD optimized for cutaneous wound closure that protects the skin surface from suture strands, forms a protective bridge over the healing wound edges, and knotlessly clamps sutures. Conclusion: This study suggests that the use of a SBD increases the tolerability of nylon sutures in porcine acute skin wound closures allowing for prolonged mechanical support of the wound. For slow healing wounds, this may prevent skin wound disruption, such as edge necrosis and dehiscence.

Keywords: acute wound; device; surgical wound; suture bridge; wound closure.

Conflict of interest statement

This study was funded by JULVIA Technologies Inc. of which W.L. and J.A. are the cofounders. No competing financial interests exist for D.S.R., B.L.R., J.J.K., and K.L.T. The content of this article was expressly written by the authors listed. No ghostwriters were used to write this article.

Figures

Katy L. Townsend, BVSc, MS, DACVS

Figure 1.

SBD in an open configuration (A) and in a closed configuration clamping on suture (B). SBD, suture bridge device.

Figure 2.

SBD applied to a porcine skin incision model showing wound eversion into the recess without compression of wound edge skin. To see this illustration in color, the reader is referred to the web version of this article at www.liebertpub.com/wound

Figure 3.

Routine histopathology of skin at 42 days, with simple interrupted suture alone (A) showing marked inflammatory response versus SBD (B) showing mild inflammatory response (p < 0.03). The asterisk (*) marks the dermal scar, defined by fibroblast hypercellularity. Arrows mark the suture exit point. To see this illustration in color, the reader is referred to the web version of this article at www.liebertpub.com/wound