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Adverse reaction to surgical sutures in thyroid surgery
Eitan Hocwald1, Jean-Yves Sichel, Ithak Dano
1Department of Otolaryngology/Head & Neck Surgery, Hadassch University Hospital, Jerusalem, Israel.
Head & Neck
|December 13, 2002
Summary
Severe reactions to silk sutures after thyroid surgery, though rare, can occur. Surgical removal of sutures and affected tissue is the recommended treatment, with skin tests predicting suture allergy.
Area of Science:
- Surgical Pathology
- Allergy and Immunology
Background:
- Mild reactions to surgical sutures post-thyroidectomy, including edema and inflammation, are common.
- Severe reactions, manifesting as microabscesses and granulomatous masses, are infrequent.
Observation:
- Two cases of severe reactions to silk sutures following thyroid surgery were documented.
- Patients presented with microabscesses and granulomatous masses requiring intervention.
Findings:
- Meticulous surgical excision of sutures, granulomatous masses, and granulation tissue led to patient recovery.
- Pathological examination revealed characteristic inflammatory infiltrates, including giant cells and lymphocytes.
- Intradermal skin tests confirmed a specific allergy to silk sutures in both cases.
Implications:
- Severe allergic reactions to silk sutures, while rare, necessitate prompt surgical intervention.
- Surgical suture removal is the primary treatment for severe suture reactions.
- Intradermal skin testing serves as a valuable diagnostic tool for identifying suture allergies.