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Nonabsorbable Barbed Sutures for Diastasis Recti. A Useful Device with Unexpected Risk: Two Case Reports.

Lorenzo Giorgi1,2, Veronica Ponti3, Filippo Boriani4

  • 1Division of General Surgery, Department of Surgery, Humanitas S. Pio X Hospital, Milan, IT, Italy.

Archives of Plastic Surgery
|September 30, 2024
PubMed
Summary

Nonabsorbable barbed sutures used for diastasis recti repair can lead to serious infections. These sutures may become colonized by bacteria, causing granulomas and requiring reoperation. Avoidance is recommended to prevent complications.

Keywords:
abdominal walldiastasis rectigranulomasnonabsorbable barbed suturepolypropylene suture

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Area of Science:

  • Plastic Surgery
  • Infectious Diseases
  • Surgical Materials Science

Background:

  • Nonabsorbable barbed sutures offer efficacy in plastic surgery.
  • However, lack of antibacterial coating may lead to bacterial colonization.
  • This can result in recurrent infective-inflammatory processes.

Purpose of the Study:

  • To report infectious complications associated with nonabsorbable barbed sutures in diastasis recti repair.
  • To highlight the risk of bacterial colonization and granuloma formation.
  • To provide recommendations for surgical practice.

Main Methods:

  • Case series of two patients undergoing diastasis recti repair with nonabsorbable barbed sutures.
  • Postoperative monitoring for surgical site infections.
  • Microbiological analysis of explanted sutures.

Main Results:

  • Both patients developed subacute surgical site infections localized to the suture line.
  • Infection was attributed to Staphylococcus aureus colonization of the barbed sutures.
  • Granuloma formation occurred, necessitating reoperation despite antibiotic therapy.

Conclusions:

  • Nonabsorbable barbed sutures may pose a risk for infectious complications in diastasis recti repair.
  • Bacterial colonization of untreated polypropylene sutures can lead to granulomas.
  • Avoidance of these sutures in diastasis recti repair is advised to minimize infection risk.