SPOOL cotton is regarded as a satisfactory suture material by many surgeons. Its use was reported by Ginkovskiy1 in 1936, and extensive investigations of its properties were made by Meade and Ochsner,2 Meade and Long,3 Localio and Hinton4 and others.5 Even workers reporting occasional difficulties with sutures of this material seem to prefer their continued employment.
Adverse reactions to cotton have been recorded, but in the main these seem to be less prevalent and less severe than those encountered with other materials.6 Early experiences with cotton, as indeed with other nonabsorbable sutures, have inculpated the use of unnecessarily coarse threads as the factor responsible for many of the reactions.5b Lack of experience with "cotton technic" and unfamiliarity with its exacting requirements accounted for others.7 The use of cotton in cases complicated by bacterial infection or contamination has also, in the opinion of
ROSENBERG N, MOOLTEN SE, VROMAN L. TISSUE REACTIONS TO WAXES DERIVED FROM SPOOL COTTON: Possible Etiologic Relation to Suture Granulomas and Suture Extrusion. Arch Surg. 1950;60(2):363–371. doi:10.1001/archsurg.1950.01250010381014
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