Oral Surgery · patient case question
Approximately how long does PLAIN GUT suture retain useful tensile strength in the mouth?
Patient case: After a maxillary molar comes out
Patient: Male, 46 years old
Chief Complaint: Presented for extraction of a non-restorable maxillary first molar.
Background: Healthy, non-smoker, no medications. The molar had a large periapical lesion with roots closely related to the antral floor on the preoperative radiograph.
Vital Signs: BP 124/78 mmHg · HR 72 bpm
Findings: The extraction was difficult and soft tissue was retrieved from the depths of the socket and submitted for histopathology. A buccal advancement flap was raised and closed with resorbable sutures.
Show answer and explanation
Correct answer: C. About three to five days
- A. Months describes slowly resorbing synthetics such as polydioxanone (PDS), or non-resorbable materials that persist indefinitely.
- B. Roughly three to four weeks is the figure for POLYGLACTIN 910 (Vicryl), a braided synthetic absorbable suture that is hydrolysed rather than digested and is the usual choice when a flap needs prolonged support.
- C. CORRECT. PLAIN GUT loses useful tensile strength within roughly three to five days and is fully resorbed in about a week. It is broken down by enzymatic digestion, and the oral environment accelerates this considerably — salivary enzymes and bacterial action mean intra-oral resorption is FASTER than the manufacturers' systemic figures suggest. That short window suits a flap needing only brief support, but it is too short for a large advancement flap under tension.
- D. Twenty-four hours would provide no meaningful wound support and describes no material in use.
Note: The comparison set worth holding: PLAIN GUT 3–5 days; CHROMIC GUT, treated with chromium salts to slow digestion, 7–10 days; POLYGLACTIN 910 around 3–4 weeks. Non-resorbable sutures — silk, nylon, PTFE — are removed at 5 to 7 days intra-orally. SILK handles and ties best but is braided and WICKS bacteria along its length, which makes it the least favourable choice for a contaminated site despite being the most pleasant to use.