Effect of a buried knot in the healing process of dental extraction sites: a prospective study in cats
Effect of a buried knot in the healing process of dental extraction sites: a prospective study in cats
Open access
In our edition of: Jun 2025
In our categories of: small animals
our summary:
Klim E.B., Mestrinho L.A. and Gawor J.P. (2025) Effect of a buried knot in the healing process of dental extraction sites: a prospective study in cats. Journal of Feline Medicine and Surgery. 27 (3).
The aim of this prospective study was to evaluate the effect of the buried-knot suture technique on gingival wound healing in cats undergoing dental extractions. The author’s hypothesized that simple interrupted sutures with buried knots would be associated with reduced inflammation and fewer wound complications compared to traditional sutures.
Cats attending two veterinary clinics that underwent anaesthesia and subsequent dental extractions for orodental disease were eligible for the study. For inclusion cats needed to be classified as ASA risk groups I and II that required bilateral extractions; either full mouth extraction (FMX) or partial mouth extraction [PMX]. Cats with retroviral infections or chronic gingivostomatitis with long-term treatment involving antibiotics or corticosteroids were excluded from the study.
Using a split-mouth model the gingiva of one side of the oral cavity was sutured using the buried-knot technique (group B) and the other side with a standard simple interrupted technique (group S), randomisation was achieved by the toss of a coin. All cats were followed up at two, four and six weeks postoperatively with a visual examination. At weeks two and four assessment indicators for wound healing including swelling, bleeding, redness, wound dehiscence, ulceration, exudate, pain on palpation, presence of necrotic tissue, flap instability, suture loosening and food debris on suture material were recorded.
A total of 40 cats were included in the study, 22 males and 18 females. Thirty-three cats underwent PMX and seven underwent FMX. Each cat had dental extractions performed in all four quadrants therefore both groups included 40 wounds. No significant differences were recorded between the groups for dehiscence, necrotic tissue, flap instability or suture loosening. In group B there was significantly less swelling, bleeding, redness, ulceration, pain on palpation and food debris at both weeks two and four. Knot exposure was observed in six cats in group B at four weeks, and in group S there was a significantly higher presence of exudates at week two though no difference was recorded at week four. No complications were observed at the six-week postoperative assessment in either group.
Limitations of the study include the lack of blinding with evaluators able to identify the suture type used and the subjective evaluation of a wide range of healing variables.
This study provides some evidence that the use of a buried-knot suture technique offers healing advantages when compared to traditional sutures. Further research is needed on a larger sample including cats with retroviral infections or long-term treatment with antibiotics or corticosteroids for chronic gingivostomatitis is needed to confirm the generalisability of the findings.
The following may also be of interest:
Guidelines: Dental [WSAVA] [online] Available from: https://wsava.org/global-guidelines/dental-guidelines/ [Accessed 20 June 2025]
inFOCUS: World Small Animal Veterinary Association Global Dental Guidelines [RCVS Knowledge] [online] Available from: https://infocus.rcvsknowledge.org/world-small-animal-veterinary-association-global-dental-guidelines/ [Accessed 20 June 2025]
Durand, C.L. (2017) Comparison of knotless barbed suture versus monofilament suture in the oral cavity of cats. Journal of Veterinary Dentistry, 34 (3), pp. 148-154. https://doi.org/10.1177/0898756417715869
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