Early local stoma complications in relation to the applied suture material: comparison between monofilament and...

The frequency and character of early complications following creation of enterostomies, and their relation to the applied suture material, were studied in 50 consecutive patients. The stomas were matured by mucocutaneous eversion and were fixated with Maxon (Davis & Geck, Pearl River, NY) 4-0 and Vicryl (Ethicon, Inc., Somerville, NJ) 3-0 sutures. Half of the stoma circumference was sutured with one suture type, and vice versa. Three patients died within 10 days. Of the remaining 47 patients, 34 (72 percent) had one or more complications diagnosed. Four (9 percent) suffered major complications (one total stoma loosening and three partial stoma necroses), and 30 (64 percent) had mucocutaneous affections only. There was no statistically significant correlation between enterostomy type or surgical procedure and complications, whereas the incidence of mucocutaneous complications was significantly higher following fixation with Vicryl as compared with Maxon sutures. The cause of this difference is uncertain; however, the physical configuration of the sutures, Maxon being monofile vs. Vicryl being braided, seems important. Whether the chemical structure is significant as well remains undetermined at present.