Suture material choice can increase risk of hypersensitivity in hand trauma patients

Abstract

Introduction Hypersensitivity is an unfortunate potential outcome in patients undergoing surgery following traumatic injuries to their hands. In our practice, we noted that certain suture types may increase the risk of the patient developing hypersensitivity. Methodology We conducted a retrospective observational study to investigate if certain suture materials increase the risk of hypersensitivity when used to repair surgical wounds in hand trauma. Patients undergoing hand trauma surgery over a period of five consecutive months were included in the study. Ethics committee approval was obtained from Peninsula Health’s research office. Results 184 patients were included in the study. Hypersensitivity was observed in 30 (16.3%) patients post-operatively. Chromic gut suture was used in 53.3% of the patients who experienced hypersensitivity. Patients who had chromic catgut used in their surgery were 2.82 times more likely to develop hypersensitivity than patients who did not have chromic gut used (p = 0.0015). If a patient had a nerve repaired and chromic gut sutured used, they were 6.50 times more likely to develop hypersensitivity (p < 0.0001). Conclusion Surgeons should be aware that this data indicates that suture choice in hand trauma patients can greatly impact the risk of the patient developing hypersensitivity. Level of evidence: Level IV, risk/prognostic study.

Suture Selection to Minimize Postoperative Postinflammatory Hyperpigmentation in Patients With Skin of Color During Mohs Micrographic Surgery

“…We used a simple running suture with 4-0 nylon to close the surgical wound. We avoided fast-absorbing gut sutures because they have high tissue reactivity 1,4 ; use of sutures with low tissue reactivity, such as nylon and polypropylene, decreases the risk for inflammation without compromising alignment of wound edges and overall cosmesis of the repair. Prolene also is cost-effective and presents a decreased risk for wound dehiscence.…”

“…Despite these benefits, research suggests that natural absorbable gut sutures induce cutaneous inflammation and should be avoided in patients with skin of color. 1,3,4 Nonabsorbable sutures are less reactive, reducing PIH after MMS in patients with skin of color.…”