This study evaluated histologic reactions to 8 suture materials and cyanoacrylate tissue adhesive (CTA) in the skin and musculature of hatchling ball pythons (n = 30). Ten incisions were made along the dorsal midline of each snake (≥1-cm intervals). A single interrupted suture was placed in the musculature, and a single horizontal mattress suture of the same material was placed in the skin over implanted sutures. A total of 8 different suture materials were used for each of 8 incisions. Incision 9 was closed with CTA, while incision 10 was left to heal by second intention.

Samples of skin and muscle were scored by severity of inflammation, fibrosis, inflammatory cell infiltrates, granuloma formation, bacterial contamination, presence of foreign material, and degree of suture fragmentation. All suture types were still present by day 90, with significantly higher inflammatory response scores than the negative control. CTA was the least reactive over all time points, with no significant difference in inflammation versus the negative control. CTA was found to be a good choice for closure of small skin incisions or lacerations in reptiles; when suture is used, more rapidly absorbed materials may be most appropriate.

Surgeons have used various suture materials in reptiles with little knowledge of tissue reactions. In this study, the authors demonstrated that reptiles can absorb suture material by hydrolysis, phagocytosis, or body extrusion.

Surgeons should therefore choose absorbable suture that is broken down as rapidly as possible. Newer suture materials that are even more rapidly absorbed are available but were not part of this study. —Stephen Barten, DVM

Evaluation of the histologic reactions to commonly used suture materials in the skin and musculature of ball pythons (Python regius). McFadden MS, Bennett RA, Kinsel MJ, Mitchell MA. AM J VET RES 72:1397-1406, 2011.