A Retrospective Review of Vaginal Cuff Dehiscence: Comparing Absorbable and Nonabsorbable Sutures

Area of Science:

• Gynecologic Surgery
• Surgical Innovation
• Patient Safety

Background:

• Vaginal cuff dehiscence (VCD) is a rare but serious complication following hysterectomy.
• Suture material choice for vaginal cuff closure may influence VCD rates.
• Optimizing closure techniques is crucial for minimizing postoperative complications.

Purpose of the Study:

• To compare the incidence of spontaneous vaginal cuff dehiscence (VCD) between absorbable and nonabsorbable sutures used for vaginal cuff closure after hysterectomy.
• To evaluate the rate of complete VCD in relation to suture material.
• To identify potential risk factors associated with VCD in different suture groups.

Main Methods:

• Retrospective comparative cohort study design.
• Analysis of women undergoing hysterectomy for benign conditions between October 2013 and April 2018.
• Comparison of VCD rates in patients closed with absorbable Vicryl sutures versus nonabsorbable Ethibond sutures, with the latter requiring surgical removal at 90 days.

Main Results:

• No significant demographic or clinical differences were observed between the nonabsorbable and absorbable suture groups.
• Spontaneous VCD occurred in 0.52% of patients in the nonabsorbable group versus 1.4% in the absorbable group (p=0.183).
• In the absorbable group, 11 of 12 VCD cases were associated with intercourse within 90 days of surgery.

Conclusions:

• Nonabsorbable sutures may offer a potential advantage in preventing spontaneous vaginal cuff dehiscence (VCD).
• The decision to use nonabsorbable sutures should balance the potential VCD reduction against the risks and necessity of a secondary suture removal procedure.
• Further research may be warranted to optimize VCD prevention strategies in gynecologic surgery.