Adhesion induction by suture of varying tissue reactivity and caliber

The importance of suture size and chronic reactivity in adhesion induction was evaluated in two experiments. In experiment I interrupted sutures (4/0 chromic, 4/0 polyglactin, and 6/0 polyglactin) were placed in the dorsal surfaces of rabbit uterine horns. Adhesions were infrequently induced by all suture materials. In experiment II 4-cm-long incisions were made in the distal antimesenteric uterine horns. These were then reapproximated with running sutures (4/0 chromic, 4/0 polyglactin, 6/0 polyglactin, and 8/0 nylon). Adhesion formation occurred to 16 of 18 incisions closed with 4/0 or 6/0 suture, whereas none of five incisions closed with 8/0 suture formed adhesions. These observations suggest that suture size rather than tissue reactivity is paramount in adhesion induction.