Comparative Evaluation Of Microbial Colony Counts On Sutures With Use Of Collagen Dressing (Fix Cote) And Non-Eugenol Periodontal Dressing (Coe-Pak): A Split-Mouth Randomized Controlled Study

Abstract

Background: Periodontal flap surgery is an established therapeutic approach for managing periodontitis by providing access for effective debridement and promoting periodontal healing. The success of the procedure depends not only on surgical technique but also on maintaining a stable wound environment and limiting postoperative microbial contamination. Silk sutures, although widely preferred because of their ease of handling and knot security, are susceptible to bacterial colonization due to their braided structure. Periodontal dressings are commonly applied to protect the surgical site during the initial healing phase. Collagen-based dressings possess biological properties that may enhance tissue repair while reducing microbial adherence when compared with conventional non-eugenol periodontal dressings. Therefore, this study evaluated and compared the microbial colony counts recovered from silk sutures placed beneath collagen dressing (Fix Cote) and Coe-Pak following periodontal flap surgery.

Methods: A randomized split-mouth clinical trial was conducted in ten systemically healthy patients diagnosed with Stage II or Stage III periodontitis requiring periodontal flap surgery in bilaterally comparable posterior sextants. After completion of flap surgery and placement of 3-0 black braided silk sutures, one surgical site received collagen dressing (Fix Cote) and the contralateral site received Coe-Pak according to a random allocation sequence. Sutures were removed on the seventh postoperative day, transferred into sterile tubes containing 1 mL of sterile peptone water, incubated, and processed microbiologically to determine colony counts of Enterococcus faecalis, Escherichia coli, Streptococcus mutans, and Staphylococcus aureus. Plaque Index and Debris Index were also recorded. Data were analyzed using the paired Student's t-test and Wilcoxon signed-rank test with the level of significance set at P< 0.05.

Results: Microbial colony counts for all four bacterial species were significantly lower in sites treated with collagen dressing than in those treated with Coe-Pak (P< 0.05). In contrast, no statistically significant differences were observed between the two groups with respect to Plaque Index and Debris Index scores.

Conclusion: Collagen dressing (Fix Cote) was associated with a significant reduction in postoperative microbial colonization of silk sutures compared with Coe-Pak. Although plaque and debris accumulation remained comparable between the treatment groups, the microbiological findings suggest that collagen dressing may offer advantages in maintaining a favorable environment for early periodontal wound healing