Kajsa Gustafsson

Background Medical grade honey (MGH) has been introduced as a protective measure against surgical site infections in equine surgery, but the effect on suture material has not been investigated. Objective To evaluate the effect of MGH on the tensile properties of three synthetic absorbable suture materials. Study Design In vitro experiments. Methods Ten strands of Polydioxanone USP 2 (PD2), Polyglactin 910 USP 2 (PG2) and Polyglecaprone USP 2‐0 (PC2‐0) were incubated 1, 7, 14, 21 and 28 days in MGH, phosphate‐buffered saline (PBS), equine plasma (EP) and MGH mixed with equine plasma (HP). Mechanical testing was performed recording maximum load at failure (N), strain at failure and Young's modulus (N/mm 2 ). The results were reported from a Welch or regular ANOVA. Results PD2 in MGH had a significantly higher tensile strength compared to PD2 in EP ( p < 0.05, mean difference (md) = 16.95 N, CI95% (9.19–24.70 N)) and PBS ( p < 0.05, md = 14.48 N CI95% (6.73–22.23 N)) on day 7 and the remaining time points. PG2 incubated in MGH had a significantly higher tensile strength compared to EP ( p < 0.05, md = 69.28 N CI95% (64.16–74.40 N)) and PBS ( p < 0.05, md = 56.90 N CI95% (51.78–62.02 N)) until day 28. PC2‐0 incubated in MGH had a significantly higher tensile strength compared to EP ( p < 0.05 md = 12.40 N CI95% (4.59 N–20.20 N)) and PBS ( p < 0.05 md = 11.23 CI95% (3.42–19.03 N)) on day 7 and the remaining time points. Main Limitations The sutures were unloaded during incubation and a single cycle to failure test was only performed, which does not reflect the in vivo environment where shear forces are present. Conclusions MGH did not negatively affect the tensile strength of the suture material and can safely be applied in contact with suture materials commonly used in equine surgery.