A mysterious pacemaker suture: an uncommon foreign body reaction

Area of Science:

• Surgical pathology
• Implantable device complications
• Foreign body reactions

Background:

• Surgical sutures are typically inert, aiming for minimal tissue inflammation.
• However, suture materials can elicit foreign body reactions, including granuloma, abscess, or sinus formation.
• These reactions are a known, albeit infrequent, complication of surgical interventions.

Purpose of the Study:

• To report a rare case of chronic granulomatous reaction to non-absorbable suture material.
• To highlight this entity in the context of pacemaker implantation surgery.
• To review existing literature on suture-related foreign body reactions.

Main Methods:

• Histopathological examination of excised tissue from an incision site mass.
• Clinical correlation with patient history, including pacemaker implantation.
• Literature review of foreign body granulomatous reactions to surgical sutures.

Main Results:

• Histopathology confirmed a chronic granulomatous reaction to non-absorbable suture material.
• The mass presented as a protrusion from the pacemaker incision site in an elderly female.
• This specific presentation in the context of pacemaker implantation appears to be previously undescribed.

Conclusions:

• Foreign body granulomatous reactions to non-absorbable sutures can occur even after pacemaker implantation.
• This underrecognized complication warrants consideration in patients presenting with late-onset wound issues.
• Further awareness and reporting are needed for this specific clinical scenario.