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October 1964

Bacterial Infections In the HeartAn Experimental Study on the Influence of Silk and Synthetic Sutures

Arch Surg. 1964;89(4):669-676. doi:10.1001/archsurg.1964.01320040085014

Introduction  Although the exact incidence of bacterial endocarditis following cardiac surgery is unknown, the increasing frequency of individual cases reported in the literature indicates that this problem is common to all.1,3,6-9,11-13,15 In other types of surgery a certain minimal incidence of infection might possibly be tolerated. Nevertheless, in cardiovascular surgery, because of the often severe and debilitating results and the possible fatal outcome of such a complication, the infection rate should be reduced to a minimum.Numerous reports have implicated the use of silk sutures in cardiac surgery as well as arterial surgery as a contributing cause for the increased incidence and persistence of infection.1,5,9 Experimental evidence has shown the superiority of synthetic materials in comparison to silk in terms of local tissue reaction.2,4,5 Most synthetic materials are monofilamentous whereas silk is the braided multifilamentous type. It is debatable whether sterilization of the monofilamentous material is better

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