Is it suture material fault?

Re: Is it suture material fault?

Anthony Todd — Fri, 17 Aug 2012 16:17:52 GMT

[quote user="Fiona Dale"]he rapid loss of strength would not account for the knots unravelling, it is more likely that the suture material would snap.[/quote]

Yes, I'd agree, you'd find degenerated bits not an entire length without apparent knots or breaks in the material.

Why don't you get a length, knot it and soak it in Hartmans and see what happens? Could tie it round old bunched upgiving set or rubber glove to put it under tension?

Only times gut has given way IMHO the gut is partially digested and in bits.

Re: Is it suture material fault?

Ruta — Fri, 17 Aug 2012 07:13:01 GMT

Yes, Hannah, it's true, but as far as I have learned, you need to renew you knowledge time to time. And sometimes you can forget what you had learned before 4 or 5 years ago.

Ruta

Re: Is it suture material fault?

HMC — Thu, 16 Aug 2012 16:27:33 GMT

[quote user="Ruta"]This case made me open the books to read more about suture materials. Which I thought it's not so important at surgery, but it is indeed.[/quote]

Your profile says you have completed a residency in soft tissue surgery....

Re: Is it suture material fault?

Ruta — Thu, 16 Aug 2012 08:28:26 GMT

Hello,

Thank you very much for your opinion. I think I have my answer now. This case made me open the books to read more about suture materials. Which I thought it's not so important at surgery, but it is indeed.

Thank you a lot.

Ruta

Re: Is it suture material fault?

James Allsop — Wed, 15 Aug 2012 15:27:34 GMT

I agree with Fiona, I would not use caprosyn for midline. I really like caprosyn and use it a lot, its especially suited to intradermal sutures IMHO as it has such rapid absorption - 50% tensile strength at 10days. I suspect that if out of date the tensile strength may well be further compromised also.

Re: Is it suture material fault?

Fiona French — Wed, 15 Aug 2012 14:38:08 GMT

Personally I would not use caprosyn for midline closure, as it loses strength too quickly. I would use either PDS or maxon. However, the rapid loss of strength would not account for the knots unravelling, it is more likely that the suture material would snap.

Re: Is it suture material fault?

Gillian Mostyn — Wed, 15 Aug 2012 13:55:49 GMT

Had the knots untied themselves (like happens with vicryl) or were the knots intact but the suture had snapped? That should give you your answer....

Re: Is it suture material fault?

Bob Russell — Wed, 15 Aug 2012 10:01:35 GMT

I would tend to agree that the expired suture material is the probable issue. As far as I know this is a fast absorbing suture anyway and the combination of suture material and age of suture may have been a bad mix!

Re: Is it suture material fault?

Mark Hedberg — Wed, 15 Aug 2012 09:26:42 GMT

Without being a suture expert, I would expect that the expired suture material is your problem. I'd suggest finding out where you got that lone packet and make sure there's not a box of it around; don't want that happening again! :)