What is the best suture material for oral mucosa repair?

Best Suture Material for Oral Mucosa Repair

For oral mucosa repair, monofilament non-absorbable sutures (5-0 or 6-0) are the optimal choice due to less bacterial seeding, reduced infection risk, and minimal tissue reaction. 1

Suture Material Options

Recommended Options

• Monofilament sutures (primary recommendation):

  • 5-0 or 6-0 monofilament non-absorbable sutures 2, 1
  • Examples: Polypropylene (Prolene) or nylon (Ethilon)
  • Benefits: Less bacterial seeding, reduced infection risk, minimal tissue reaction 1, 3

• Rapidly absorbing synthetic sutures (alternative option):

  • Polyglactin 910 (Vicryl Rapide)
  • Benefits: Eliminates need for suture removal, reduces patient discomfort 1
  • Consideration: Higher cost than standard options 1

Materials to Avoid

• Silk sutures - Associated with:

  • More intense inflammatory response 4
  • Delayed wound healing 4
  • Greater bacterial adherence 3

• Multifilament sutures - Cause more inflammatory tissue reactions than monofilament materials, particularly in oral mucosa 3

Suture Selection Algorithm Based on Location

1. For keratinized gingiva:

   • If good oral hygiene can be maintained: Silk, nylon, or polyglycolic acid are all acceptable 3
   • Optimal choice: Monofilament non-absorbable (5-0 or 6-0) 1

2. For non-keratinized oral mucosa:

   • Monofilament sutures strongly preferred 3
   • Avoid multifilament materials due to increased inflammatory reaction 3

3. For coronally advanced flap procedures:

   • Non-absorbable monofilament sutures recommended 2

Suture Technique Considerations

• Continuous non-locking technique is preferred over interrupted sutures for:

  • More even distribution of tension
  • Less pain
  • Improved cosmetic outcome 1

• When using fast-absorbing materials:

  • Add interrupted "security sutures" if using a continuous suture technique 5
  • This prevents wound dehiscence, which occurs more frequently with absorbable sutures 5

Clinical Pearls

• Oral mucosa elicits stronger inflammatory reactions to suture materials than keratinized gingiva 3
• Proper tension is critical - excessive tension leads to tissue necrosis and poor healing 1
• Suture removal timing is important - typically 5-7 days for facial sutures 1
• Consider triclosan-coated sutures in high-infection-risk scenarios, as they significantly reduce surgical site infection prevalence 2

By selecting monofilament non-absorbable sutures and employing proper suturing techniques, you can minimize tissue reaction, reduce infection risk, and optimize healing outcomes in oral mucosa repair procedures.