Comparison of the Effects of Three Different Wound Closure Techniques on Tissue Healing: Experimental Studies in Rats
World Small Animal Veterinary Association World Congress Proceedings, 2004
Mustafa Aktap, S.Seçkin Arun, Ýbrahim Firat, Oktay Duzun, Emrah Yatkin and H. Hakan Bozkurt
Istanbul University, Faculty of Veterinary Medicine, Department of Surgery

The methods practically used in wound closure were classical sutures techniques, adhesive strips or tapes, laser, tissue glues (Magee et al., 2003, Bowen et al., 2002), stapler (Clayer and Southwood, 1991), stapler, zipper etc. Silk is one of the most employed nonabsorbable material; easy to use, low cost and oldest one but with a big disadvantage; this braided multifilament material have the inconvenient of sustain sometimes bacterial inocula (Wetter et al., 1991). The aim of this study, was the comparison of this three techniques and to determinate the appropriate one for the veterinary patricians. Three groups of 30 Sprague Dawley rats each, aged between 3-6 months were used. All the groups were divided in 3 other groups of 10 rats. Rats were anesthetized under controlled ventilation with halothan (Halothan®, Hoechst, Istanbul, Turkey). All the animals were incised: the standardised incision was realised on the laparotomy line of the animals. In the first group, the skin closure was realised with a classical suture technique (interrupted simple) with an atraumatic silk suture USP: 4/0 (Boz®, Sincan-Ankara, Turkey). In the second group, the incision area was closed by the application of stapler (Weck Visistat®, Mechanical stapler model SSC-35R, Creation Medical Appliances Co., LTD.USA.). In the last group, the closure was realised by the application of a layer of tissue glue (Epiglu®, (Ethyl-2-Cyanoacrylate), Meyer-Haake Medizin und Dentalhandels Gmbh, Germany). All the animals received postoperatively the same doses of 0.5 mg/100 gr BW IM sid of antibiotics during the first 5 days of the experimentation (gentamicin-Gentasol®, Eczacıbaşı-Istanbul-Turkey). The sacrifications were realised post-operatively at days 7, 14 and 28, respectively. Microscopic evaluation was made considering the pathologic and histologic criterias (Longaker and Adzick, 1991). The criteria of exudation and vascularisation were scored as none (0), mild (1), moderate (2) and severe (3). The ratio of re-epithelisation* were scored as good (0), mild (1), bad/worst (2) and none/absent (3). This 3 criterias were scored with the analysis of the group values/means and the inflammatory reaction/process. Statistical analysis were performed with student-test (Table 1, 2).

The histopathological results showed a statistical difference in the amount of connective tissue cells release at the 7th day in the site between tissue glue-stapler (p<0.001) and tissue glue-suture (p<0.001), respectively. The comparison of the inflammatory processes between stapler and epiglue groups was significant as p<0,05 in the 7th day, although it was increased to p<0.001 in the 28th day.In conclusion, we observe a fast tissue reorganisation and healing process in tissue-glue group compared to the other two groups with the advantages of the tissue glue like application facilities, realisation time gain, antibacterial effects, etc. We suggest to the veterinary practicians the use of the tissue-glue in the wound closure compared to the two other methods.

Table 1: Means values of the histological scoring of the groups


7. Days

14. Days

21. Days


0.662 b,c

0.78 a,c

0.753 a,c






0.725 e

0.763 d

0.787 d

ap<0.05 stapler vs epiglue, bp<0.001 stapler vs epiglue, cp<0.05 stapler vs suture, dp<0.05 suture vs epiglue, e p<0.001, suture vs epiglue

Table 2: Means values of the inflammatory process of the groups.


7. Days

14. Days

21. Days


2.6083 a,c

2.33 b,c

1.6066 b,c








1.2166 d

a p<0.05 stapler vs epiglue, b p<0.001 stapler vs epiglue, c p<0.05 stapler vs suture, d p<0.05 suture vs epiglue


1.  Magee WP JR, Ajkay N, Gythae B, Rosenblum RS. (2003). Use of octyl-2-cyanoacrylate in cleft lip repair. Ann Plast Surg.; 50(1):1-5.

2.  Bowen ML, Selynger M., (2002). Episiotomy closure comparing enbucrilate tissue adhesive with conventional sutures. Int J Gynaecol Obstet.; 78(3):201-5.

3.  Clayer M, Southwood RT. (1991). Comparative study of skin closure in hip surgery. Aust N Z J Surg.;61(5):363-5.

4.  Wetter LA, Dinneen MD, Levitt MD, Motson RW.(1991). Controlled trial of polyglycolic acid versus catgut and nylon for appendicectomy wound closure. Br. J. Surg., 78(8): p. 985-987.

5.  Longaker M.T. and Adzyck N.S. (1991). The biology of the fetal wound healing: a review. Plast. Recons. Surg. 87: 788-798.

Speaker Information
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Mustafa Aktap
Istanbul University
Faculty of Veterinary Medicine, Department of Surgery

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