Histologic Comparison of Inflammatory Responses to Absorbable and Nonabsorbable Sutures in a Porcine Periorbital Model

Authors

• Rachel S. Lee, Michigan State University College of Human Medicine Medical Student
• Samuel Girian, Corewell Health West Resident
• Allison Gerras
• Akanksha Kapur, Michigan State University College of Human Medicine Medical Student
• Cameron Coates, Michigan State University College of Human Medicine Medical Student
• Zeinab Mhanna, Michigan State University College of Human Medicine Medical Student
• Harish Neelam
• Hanna Pfershy, Michigan State University College of Human Medicine Medical Student
• Ronald Ford, Corewell Health West
• Heather Laird-Fick
• Adam S. Hassan, Corewell Health West

Document Type

Conference Proceeding

Publication Date

9-2026

Publication Title

Plastic and Reconstructive Surgery. Global Open

Abstract

Background: The periorbital region is a specialized cutaneous area with distinct structural and biomechanical properties, rendering it susceptible to inflammatory injury. Suture selection in oculoplastic surgery remains debated, yet existing histologic evidence is limited and largely derived from prolonged in-situ durations that do not reflect standard periorbital surgical practice. The porcine periorbital model has been validated as a reliable representation for the human eyelid. This study evaluated histologic inflammatory and tissue responses to absorbable and nonabsorbable sutures in a porcine model.

Methods: Four Yorkshire swine (10 weeks, 20.5 kg) underwent bilateral upper and lower eyelid elliptical excisions, closed without tension using a simple running suture with randomly allocated 6-0 plain gut, 6-0 polypropylene, or 6-0 nylon. Animals were monitored daily for postoperative complications and distress. Tissues were harvested on postoperative day seven following euthanasia. Specimens were graded using a standardized 0-4 histologic scale across multiple inflammatory parameters: neutrophilic, macrophagic, and lymphoplasmacytic inflammation, as well as granulation tissue, fibrosis, hemorrhage/edema, epithelialization, and necrosis.

Results: All animals tolerated the procedures without major complications. Sixteen eyelid specimens were analyzed. No significant differences in acute inflammatory response were observed between individual suture materials or between absorbable and nonabsorbable suture classes. Lower eyelid specimens demonstrated significantly higher neutrophilic inflammation compared with upper eyelids (mean ±SD: 2.5 ±1.2 vs 1.0 ±0.0; p< 0.05). No interaction effects were identified between suture material or class and eyelid location for any histologic outcome.

Conclusion: Absorbable and nonabsorbable sutures elicit comparable acute inflammatory responses in the eyelid. Eyelid location appears to be a more influential determinant of acute inflammatory response than suture composition alone. Specifically, the lower eyelid demonstrated higher neutrophilic inflammation. These findings suggest that suture selection does not have to be guided by concern for differential tissue inflammation in the early postoperative period.

Volume

14

Issue

Suppl 4

First Page

23

Last Page

24

Recommended Citation

Lee RS, Girian S, Gerras A, Kapur A, Coates C, Mhanna Z, et al. [Pfershy H, Ford R, Hassan AS]. Histologic comparison of inflammatory responses to absorbable and nonabsorbable sutures in a porcine periorbital model. Plast Reconstr Surg Glob Open. 2026;14(Suppl 4):23-4. doi: 10.1097/01.GOX.0001276804.81125.cf.

Comments

Michigan Academy of Plastic Surgeons 34th Biennial Scientific Meeting, July 12-15, 2026, Mackinac Island, MI

DOI

10.1097/01.GOX.0001276804.81125.cf

ISSN

2169-7574